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The Health of Hertfordshire
Raymond JankowskiDeputy Director of Public Health
Challenges• Children and young people realising their full potential• Working age adults realising their full potential• Supporting older people to live independent lives
• Tobacco control• Obesity• Alcohol misuse• Health inequalities• Mental health and wellbeing• Quality Innovation Productivity Prevention (QiPP)• Lifelong learning• Climate change
The Life Course Approach
Pre-conception and pregnancyInfancy (0-6 months)Early Years (6 months – 4/5 years)Primary school years Secondary school yearsYoung adults (16-18 years)Working age adultsOlder adults P
reve
ntio
n &
Tre
atm
ent
Tobacco control: the challenge
• Increase referrals to Hertfordshire smoking cessation services• Reduce number of people starting smoking• Effective communication and social marketing• Reduce supply of cheap and illicit tobacco• Reduce health inequalities
Smoking prevalence in Hertfordshire by age
Pregnancy 9-11 years old
15 years old Adults
Girls Boys Girls Boys
10.5% 2% 6% 21% 15% 19.5%
National targets
11% - -
12%
12%
18.5%
Key IMD 3 to 8.9 9 to 14.9 15 to 20.9 21 to 26.9 27 and over
Hertfordshire IMD 2010 by MSOA with district averages
Key Range
0 to 10.9
11 to 12.9
13 to 14.9
15 to 16.9
17 to 18.9
19 and over
GP-recorded Smoking prevalence by MSOA 2010-11
Estimated NHS and wider economy costs of tobacco control in Hertfordshire
• NHS - £54M• Wider economy - £275M
– Cleaning up cigarette butts - £5.8M– Smoke related fires - £8.7M
Summary
Build on a strong Hertfordshire Tobacco Control Alliance, to reduce smoking prevalence by:
• Supporting smokers in priority groups to quit• Continuing to support actions to reduce supply of illicit
tobacco• Reducing the uptake of smoking among young people
Obesity in Hertfordshire: challenges
Prevalence %4-5
year olds10-11
year oldsAdults
8-9% 14-16% 21.4%
Estimated NHS and economic costs in Hertfordshire
NHS Wider economy
2007 £84M £320M
2050 £174M £1000M
Key IMD 3 to 8.9 9 to 14.9 15 to 20.9 21 to 26.9 27 and over
Hertfordshire IMD 2010 by MSOA with district averages
Prevalence of obesity in school age children (Year 6 aged 10-11 years) in MSOAs in Hertfordshire for 2009-10
Key Prevalence of obesity 0 to 8.9% 9% to 13.9% 14% to 18.9% 19% to 23.9% 24% and over
Reducing Obesogenic environment
Individuals,
Families,
Communities
Physical activity
Healthy eating and sensible drinking
Motivation
Self esteem
Cost and availability of leisure facilities
Availability of green space
Cycle lanes
Pedestrian friendly
Community safety
Healthy workplace
Motivation
Self esteem
Cost of healthy eating
Shopping skills
Cooking skills
Availability of fresh produce
Advertising
Healthy workplace
NHS Wider economy
% NHS/wider economy
Tobacco control
£54M £275M 20%
Obesity £84M £320M 26%
Alcohol £54M £400M 13.5%
NHS versus wider economy costs in Hertfordshire
Challenges in older age
• Falls• Dementia• Social isolation• Intermediate care• End of Life• Influenza• Fuel poverty
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