Fostering Productive Relations A natural fit between Sociology, Public Health and Local Government Jim McManus, Director of Public Health, Hertfordshire County Council Vice-President, Association of Directors of Public Health Chair, Behavioural Science and Public Health Network 8 th April 2019 www.hertfordshire.gov.uk www.hertfordshire.gov.uk
Epidemiology • Early and avoidable disability and disease • Early avoidable death • Smoking prevalence uneven • Obesity rising in adults, flattening in children in most places, rising in some • Alcohol related disease on the increase • Preventable cost to public health • Multiple needs, worklessness www.hertfordshire.gov.uk
Then the NHS Plan arrived….and I felt… www.hertfordshire.gov.uk www.hertfordshire.gov.uk
Context • The discourse that clinical procedures and investments in more kit is the answer • The discourse of individual lifestyle as the salient issue in health policy • The increase in avoidable morbidity and mortality where clinical procedures are not the answer • A failure to understand complexity in policy making www.hertfordshire.gov.uk
Worlds Colliding :some pejorative stereotypes • Public Health • Sociologists – Status obsessed Boffins – No population perspective – Think they're scientists, – Evidence free zone – Passive recipients of others’ research – What earthly use is that? – Not very real world – No controls – Too linear – Fluffy and call it “organic” – Empiricism gone mad “we could do their job” “we could do their job” www.hertfordshire.gov.uk
A better way • Start from first principles – Mutual strategic aims – Complementary statutory and policy duties • England – top tier authority duties • A “mutual appreciative inquiry” approach • Start with quality and impact www.hertfordshire.gov.uk
A starting point. The national strategy • We have a national strategy to get Public Health to use social and behavioural sciences more wisely, purposively and systematically. • That’s a start www.hertfordshire.gov.uk
Elected members as naturally inclined to sociological approaches • Meaning and value • Lived experience of users • Understanding why and how not just numbers and what • What do residents want? What does this mean? • Tools for understanding communities • IPA • Ethnography www.hertfordshire.gov.uk
Two important reports www.hertfordshire.gov.uk
What could good look like? 1. Clear conceptualisation of how PH and Sociology work together 2. Clear agreement on big priorities and each discipline’s contributions 3. Sociology competencies in PH specialists 4. Placements 5. Joint research agendas 6. Systems science 7. Emphasis on Human Flourishing in social context www.hertfordshire.gov.uk
Some major need for sociological input to Public Health practice Long term, medium term, short term, matrix Prevention, Enablement, Health meaning, access, Improvement Commissioning priorities, Evidence, Methodologi making it work with cal and for people Imagination Health supporting Service Protection implementation Quality and Improvement How do we get it right with and for people www.hertfordshire.gov.uk
Some current work • Masterclasses for practitioners • Building Research imagination – scholarships, scholars in residence, honorary contracts, liaison groups • Advice on tap • Skills sessions • Discourse and content analysis on policy – “Predictive Prevention” • Doctoral work on why people refuse treatment www.hertfordshire.gov.uk
A word about Leadership...we’d like some different leadership on both sides Contextual Technical Relational Personal www.hertfordshire.gov.uk
thank you Jim.mcmanus@hertfordshire.gov.uk www.hertfordshire.gov.uk
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