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Health Impact Assessment: Making the Difference

Health Impact Assessment: Making the Difference. Plenary 1 Chair: Professor Gareth Williams. 7th International Health Impact Assessment Conference. Health Impact Assessment: Making the Difference. Supported by:. Health Impact Assessment: Making the Difference. Chris Tudor-Smith

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Health Impact Assessment: Making the Difference

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  1. Health Impact Assessment: Making the Difference Plenary 1 Chair: Professor Gareth Williams

  2. 7th International Health Impact Assessment Conference Health Impact Assessment: Making the Difference Supported by:

  3. Health Impact Assessment: Making the Difference Chris Tudor-Smith Head of Public Health Improvement Division, Welsh Assembly Government

  4. Tackling inequalities in health in Wales Chris Tudor-Smith Public Health Improvement Division Office of the Chief Medical Officer

  5. The presentation will cover... • The situation in Wales • The policy context • From policy to action • Sustainable Health Action Research Programme • Concluding remarks ‘So what do I need to know about health inequalities then Humphrey?’ ‘Well Minister…’

  6. ‘Headline’ indicator: all deaths by quintile of deprivation, Wales, 1993-97 European age-standardised mortality rate per 100,000 population Source: NAfW (2001) Expert Group on Indicators of Health Inequality

  7. Coronary heart disease mortality (age under 65) by quintile of deprivation, Wales, 1996 European age-standardised mortality rate per 100,000 population Source: NAfW (2001) Expert Group on Indicators of Health Inequality

  8. Adult mental health status by quintile of deprivation, Wales, 1998 SF36 Mental Component Summary score Source: NAfW (2001) Expert Group on Indicators of Health Inequality

  9. Adults smoking by quintile of deprivation, Wales, 1996 Source: NAfW (2001) Expert Group on Indicators of Health Inequality

  10. Teenage conceptions by quintile of deprivation, Wales, 1992-1997 Conceptions to girls under 18 per 1,000 girls aged 15-17 Source: NAfW (2001) Expert Group on Indicators of Health Inequality

  11. The policy context in Wales • ‘Better Health Better Wales’ - late 1990’s policy document dealing with public health in Wales • health inequalities acknowledged and described • Townsend review ‘Targeting Poor Health’ • NHS resource allocation favouring those most in need • ‘Review of Health and Social Care in Wales’ (Wanless Report) • notes inequalities and action being taken in other policy areas • Topic specific strategies with a focus on health inequalities • e.g. Food and Well Being identifies priority groups (low income, ethnic minorities…) • Health targets and inequality indicators • e.g. to improve CHD mortality in all groups and at the same time aim for a more rapid improvement in the most deprived groups.

  12. Tackling health inequalities in Wales – working at different levels • Government socio-economic policy e.g. • responsibility with UK government e.g. fiscal policies • Wales: A Vibrant Economy • Collaboration and partnership between communities and agencies e.g. • SHARP • Health Impact Assessment • Communities First • Development of food cooperatives • Individual behaviour change e.g. • Inequalities in Health Fund (focus on risk factors for CHD) • Health Challenge Wales • Programmes tackling smoking, nutrition, physical activity…

  13. Sustainable Health Action Research Programme (SHARP) • Roots in Better Health Better Wales – attempt to develop learning and add to evidence base on partnership-driven and community-based action research approaches to tackling broad social determinants of health • Focused on communities with the highest incidence of ill-health and premature death, social exclusion and poor life chances • Project level and overarching evaluation (Cropper S., Carlisle S., Beech R., Little R – Centre for Health Planning & Management, Keele University) • Seven projects funded for six year period, ending spring 2006

  14. ‘Barefoot’ Triangle Pembs Holway BeWEHL HYPP R2R

  15. SHARP funded projects (1) • HYYP ProjectAn evaluation of community involvement in Powys to meet the health needs of young people in rural areas • ‘Right 2 Respect’ ProjectA project to identify and begin to address issues of particular concern to girls and young women (11 to 25 years) in Wrexham • BeWEHL ProjectAn initiative in Newport to examine the contribution of women’s learning to community health development • Triangle ProjectA programme to support local health alliances in Cardiff, Merthyr and Powys in tackling health inequalities

  16. SHARP funded projects (2) • Healthy Living Approach ProjectAn evaluation of the Healthy Living approach to improving the health and wellbeing of communities in Pembrokeshire • Holway Project HouseCommunity development and regeneration in the Holway community in Flintshire • ‘Barefoot’ Health Workers ProjectA project to support the health improvement of Somali, Yemeni and Bangladeshi communities in the Butetown/Grangetown area of Cardiff

  17. Assets & Legacies • ‘Barefoot’: Expertise in working with minority ethnic groups; community researchers skilled in working with agencies and local people. • Triangle: framework for establishing sustainable community health partnerships; model of participatory action research as tool for community health engagement – ‘local health champions’; locally sustainable projects. • Pembrokeshire SHARP: Community research training programme and handbook - transferable inquiry into local priorities; Community Action Plans. • Holway House: community transformation - residents working in partnership with external organisations. Source: Cropper (2005)

  18. Assets & Legacies • BeWEHL: improvements in women’s mental and ‘social’ health (increased confidence/self-esteem, wider networks); transferable approach to developing women’s capacity to engage in lifelong learning. • HYPP: civic participation by young people, better relationships between different generations; Youth Council and OASIS roll-out. • Right 2 Respect: impact on Wrexham CBC Youth Services; ONC in a/r for single gender youth work; outdoor worker; sustainable spin-off projects. Source: Cropper (2005)

  19. Policies tackling health inequalities – a synthesis • Successful policies will need to be broadly based including : • lifecourse approach • multisectoral interventions • health impact assessment • focus on the distribution of social determinants • tailoring where appropriate • Policies on health inequalities and social justice/inclusion should be inextricably linked • Local capacity building is required to deliver policies • Importance of (applied) research, particularly monitoring impact of policies and developing evidence base of effective interventions • Commitment

  20. 7th International Health Impact Assessment Conference Health Impact Assessment: Making the Difference Supported by:

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