What Social Science can contribute to improving the nation’s health:

Perspectives of Public Health Practice

Mala Rao

Head of Public Health Workforce and Capacity

Department of Health

Declaration of Alma-Ata, 1978

Article IThe Conference strongly reaffirms that health, which is a

state of complete physical, mental, and social wellbeing, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the

highest possible level of health is a most important world-wide social goal whose realization requires the action of

many other social and economic sectors in addition to the health sector.

The link between Social Sciences and Public Health over a decade ago…

Rao M, Hoinville E. Review of postperinatal mortality in a health district with a garrison town. BMJ 1988; 297; 662.

-Review of postperinatal mortality in a health district with a garrison town

-Examination of mortality rate of babies 1 week to 1 year

Social Support and Health

Highly Influenced by….-Ann Oakley: Love or Money? Social support,

class inequality and the health of women and children Demonstrated the association between the social

support resources of mothers and improved health outcomes for mothers and babies•Rao M, Benton D, Bremberg M. A Comparative study of Army and civilian babies in a UK garrison town. Public

Health 1997;317-319.

•Oakley A, Hickey D, Rigby AS. Love or money? Social support, class inequality and health of women and children. Eur J Public Health 1994; 4: 265-273

“The public health implications of our findings are considerable and diverse. While improving people’s social support resources could be argued to lie beyond the bounds of a public health policy, the promotion of a healthy social environment in a general sense must clearly be regarded as an integral part of what promoting the public health means.”

-A comparative study of army and civilian babies in a garrison town

Social Determinants of Health

•Policies and strategies for promoting social equity in health. G. Dahlgren and M. Whitehead, 1991.

PSA Health Inequalities Targets

By 2010 to reduce inequalities in health outcomes by 10 per cent as measured by infant mortality and life expectancy at birth.

This target is underpinned by two more detailed objectives:

1. Starting with children under one year, by 2010 to reduce by at least 10% the gap in mortality between routine and manual groups and the population as a whole;

2. Starting with local authorities, by 2010 to reduce by at least 10% the gap between the fifth of areas with the lowest life expectancy at birth and the population as a whole.

Securing Good Health for the Whole Population: 2004 Wanless

Report “It is important to note that fully

engaged did not simply represent satisfactory achievement of objectives set in recent years, for example, for smoking prevalence. It was designed to represent the achievement of much more stretching and comprehensive aims.”

“The main savings under the fully engaged scenario on the demand side come from a reduction in ill health in old age, gains in public health and prevention and gains from more self-care.”

Linking Social Science to Public Health Practice

Health Trainers

NHS Health Trainers – the journey so far ….

Choosing Health White Paper Manifesto commitment Expressions of interest

57 partnerships (incl pcts, local authorities, academic institutions etc) expressed interest

Remaining 21 Spearhead areas also engaged

78 partnerships Early Adopter Phase

nearly half the NHS Other participants – Army,

Prison and Initial Hospital Services

Investing in Social Science Research

DH and the NHS are major investors is Social Sciences

research…..

DH RDD/ NHS Investment through:

DH Policy Research Programme NHS Health Technology

Assessment Programme NHS Service Delivery and

Organisation Programme …..and others

New Developments:

Choosing Health – R&D Commitments

Public Health Research Consortium

National Prevention Research Initiative

UKCRC Public Health Strategic Planning Group

Social Science Teaching

Teaching Public Health Networks

Objective – to equip the wider workforce with the competence to benefit their own health, their family’s health, and the public’s health through their work based roles.

One in each of the 9 regions in England. Puts Social Sciences at centre stage. Connects teaching, research, and practice. Includes Higher Education and Further Education.

“The science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals.”

Wanless Definition of Public Health

Happiness and Health

(Subramanian, Kim, and Kawachi, JECH

2005)

In Conclusion…It is time that the social sciences reclaimed Public Health (health improvement) by:

• enhancing knowledge about the effectiveness of public health interventions and how complexities and challenges may be addressed

• help translate public health knowledge into action

because health improvement is a social issue.