The Mayor’s Health Inequalities Strategy Laura Austin Croft Greater London Authority laura.austincroft@london.gov.uk 21 October 2014
Presentation outline: 1. Health inequalities in London 2. The Mayor’s Health Inequalities Strategy and its delivery plan refresh 3. The London Health Commission recommendations to the Mayor 4. Questions
Health Inequalities • Differences in health between social groups or populations. Demographic Social Environmental Categories of factors that can Political result in health inequalities Economical Behavioural • Interaction of factors make health inequalities complex
What makes a difference to our health
Socio-economic determinants of health – London Compared to England, London: • Has a higher unemployment rate but more young people in employment, education and training • Performs slightly better across most economic security indicators • Performs worse across all housing indicators • Has lower rates of depression and hospital admissions for self-harm • More low birth weight babies and a significantly higher rate of tuberculosis
Child poverty in London • Child poverty levels in London are a third higher than in England overall: 27% of London’s children live in families who are below the poverty line, versus 20% nationally. • Levels of child poverty in the poorest boroughs are nearly five times those of the wealthiest. • Just 53% of London’s five-year-olds reach a good level of development at this age. • Highest rate of childhood obesity of any major global city
The Mayor’s Health Inequalities Strategy (2010) Five strategic objectives • Empowering individuals and communities • Equitable access to high quality health and social care services • Income inequality and health • Health and employment • Healthy places Taken forward by influence, working collaboratively with others and sharing expertise. http://www.london.gov.uk/priorities/health/tackling- inequality
HIS delivery plan 2015-2016 Recognise the work we have done to date (and its strengths) Describe the new health and social care landscape and opportunities for reducing health inequalities Developing a way of describing and tracking HI over time Respond to the London Health Commission recommendations – where the Mayor is best placed for strategic leadership
Delivery to date Achievements from the first few years of Strategy delivery Identifying a pattern of what the GLA can uniquely do (and the breadth of action) Part of the narrative that supports the delivery refresh (i.e. what we are going to build on going forwards…)
Six delivery strengths Strength Example 1. Coordinating collaborative Well London, Healthy Schools, Healthy Workplaces, Volunteering action 2. Instigating pan London The London Health Board; the London Health Commission leadership 3. Building the case for The economic case for investing in early years; The invisible cost of mental health action 4. Communication HIV national testing week; cancer awareness pop up shops; World Mental Health day campaigns Improving the health of Londoners transport 5. Integrating action across action plan; influencing the Strategic Planning plans and strategies Guidance of the London Plan Commissioning healthcare support for rough 6. Highlighting the health sleepers; children leaving care in the Mayor’s needs of vulnerable groups education plan
The new health and social care landscape Highlights new duties on reducing health inequalities Updates the role of the GLA and its scope for reducing health inequalities across London Supports conversation about how the new duties are being/can be used to support a reduction in health inequalities
Levers for reducing health inequalities Local authorities Clinical commissioning Health and well-being groups & NHS providers boards; Joint Strategic Access, outcomes, Needs Assessments; integration of services Health and well-being strategies GLA and the GLA Group TfL; London Enterprise Public Health Panel; London Housing England Board; London Plan; London Health Board; Public Health Health Mayor’s Office for Outcomes Policing and Crime. inequalities in Framework; PHE- London . London Other : Social Value Act 2013; Equality Duty Act 2010
Indicators need to be… 1. Meaningful to stakeholders in terms of relevant health issues and determinants 2. Easy to understand and to communicate to a range of health and non-health stakeholders, and to the general public 3. Relevant to the rapidly changing and future policy context 4. Span the life-course for London’s population 5. Able to be tracked over time 6. Useful as levers for action within regional & local authorities 7. Uses the most accurate and valid data sources, available for both London as a whole, and for London borough levels, collected on an annual basis 8. Manageable in number i.e. maximum of 12.
Indicators for health inequalities – Plan so far 1. ‘Late’ 4. 3. 6. Statutory 2. School antenatal London 5. Educational 7. Influenza Homelessness Readiness care Living Unemployment achievement vaccination Wage rates Department for NHS PHOF Department for Communities Public Health England Department for Office for Education and Local England National Work and Pensions Government Statistics Childhood and Conception Working age Older age Adolescence Birth 8. RTC rate based on exposure Transport for London 9. Self-reported well- 10. Healthy Life 11. Slope Index of Inequality for Life being Expectancy Expectancy AND AND Office for National Statistics PHOF PHOF
Indicators in more detail Indicator Explanation Reducing the % of women who access maternity ‘Late’ antenatal care services later in pregnancy will help to reduce the health inequalities these groups face. Readily available and key measure of early year’s School readiness development across a wide range of developmental areas. Educational qualifications are a determinant of an Educational individual's labour market position, which in turn achievement influences income, housing and other material resources. Tackling low pay has a positive impact on individuals and London Living Wage their families’ health. This measure counts some of the most vulnerable Statutory members of our communities. homelessness This highlights deaths and serious injuries in those Road traffic casualties people walking, cycling or riding motorbikes, which helps us to understand whether a place is safe and healthy.
London Health Commission recommendations R13. Health and care commissioners should jointly develop a new model to improve support for parents of vulnerable children under 3 yrs old. R14. Mayor use the ‘London Plan’ to protect children from junk food R15. Work with Ofsted to ensure more data is published on school health and well-being R16. Address the variation in quality of care for children www.londonhealthcommission.org.uk
Next steps 1) Mayor responds to the LHC commission recommendations (end of 2014) 2) Stakeholder engagement on the HIS delivery plan summarised and changes made 3) Delivery plan sent to the London Assembly 4) Delivery plan published (early 2015)
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