Agenda item

John Radford, Director of Public Health

Dr. John Radford, Director of Public Health, presented the first annual report since the 2012 Health and Social Care Act placed the responsibility for Public Health within local authorities. 

The report focussed on an analysis of the causes of death and disability in the Borough and the health inequalities that existed between Rotherham and the rest of England.

It was split into the following sections:-

-          Overview

-          Public Health Outcomes Framework

-          Children and Young People’s Health

-          Life Expectancy and Cause of Death

-          Heart Disease and Stroke

-          Cancer

-          Liver Disease and Other Digestive Disease

-          Mental Wellbeing

-          Respiratory Disease

-          Mortality from Infectious Disease

Discussion ensued on the document with the following highlighted:-

·           Rotherham was doing a lot better than other parts of North England in respect of health inequalities.

·           Approximately 70% of health inequalities was due to other determinants of health.

·           Maternal and infant health was an issue across the Borough.

·           Maternal mental health was a big issue with large numbers of mothers living in poverty, unemployed, using drugs and/or alcohol and depressed.  This had a knock on effect on the next generation.

·           As the Health Visiting Service transferred into the Local Authority there was a need to look at more innovative methods of working to support young mothers and engage them in society.

·           Work was taking place with Planning with regard to incorporating conditions in Planning Policy in connection with takeaways near to schools, as recommended by the Commission. 

·           Approximately 1/3 of the premature deaths in Rotherham were due to heart disease and stroke.  A number of those were preventable  in terms of lifestyle interventions e.g. increasing exercise, stop smoking.

·           The importance of exercise and healthy lifestyles and how Members can promote activities locally to encourage people to become more active, as well as influencing through policies.

·           Encouraging on-site policies in secondary schools.

·           Approximately 1/3 of Rotherham’s health inequalities was due to smoking related Cancer.

·           A number of the respiratory causes of death were linked to historical industries and Pneumonia.

·           As a whole, GPs in Rotherham were late in referring patients to hospital with symptoms of Cancer and work was required to improve the referral rate.  Some Cancers could be helped by surgery but early detection was imperative and it is important to get out to the public information about the early signs of cancer.

·           1 in 20 respiratory deaths were due to air pollution and was known as the silent killer.  There were issues around the M1 corridor but also traffic hotspots - Rotherham was no different from the rest of the country.

·           E-cigarettes and trying to ban them in schools and on non-Council sites.

·           Importance to increasing uptake of Healthchecks.

·           There had been an increase nationally in Liver disease and Liver cirrhosis.  There were 3 main causes – alcohol cirrhosis, fat due to obesity and Hepatitis B.  Rotherham had very good vaccination programmes against Hepatitis B in terms of “at risk” groups including occupational groups.

·           There was an epidemic of Hepatitis C which was largely found in intravenous drug users who were at high risk of cirrhosis.

·           Late referrals to the Stop Drinking Service.

·           The Hospital reported a rising trend of young women with significant issues with alcohol

·           Real challenge with regard to mental ill health and the upsurge in the last 12-18 months of suicide in Rotherham plus growing awareness of the issues of mental wellbeing in the elderly, especially those who  lived alone unsupported.

·           It was a major cause for people being off work, not only those who had severe mental illness, but those who felt anxious, low and had difficulties in coping with day-to-day life. 

·           Research had discovered social networks that discussed self harm and suicide and almost normalised it.  How agencies should respond and intervene to support young people change their attitudes was extremely difficult and complex.

·           Making Every Contact Count – about discussing mental health openly and being aware that it was extremely common.  Work had taken place with front line staff to try and identify those who may be at risk and get access to services to support them.  Gender differences with regard to suicide and seeking support were noted.

·           Work had taken place with the Youth Cabinet with regard to self-harm and support offered to address self-harm issues.  The Safeguarding Board had also worked with schools to respond to the issue.

·           Quite often self-harm was a way of staying alive and remaining in control, however, it did put people at risk and may result in permanent disability or death.

·           It was not a case of pushing people to do something they did not want to do but provide them with the environment that allowed them to do things that were more healthy.

·           At risk groups were 4-20 times more likely to die from influenza than non-risk groups.  Currently in Rotherham GPs managed to vaccinate 60% of those in the at risk group.  Rotherham was 1 of the national pilots to introduce a School Influenza Vaccination Programme for Y7/8 pupils in the attempt to stop transmission home.

·           The recommendations from this year’s annual report will be reported in next year’s report.

Resolved:-  (1)  That the report be noted.

(2)  That an update be submitted on progress in reducing health inequalities.