Agenda item

Mrs M Varshney, Consultant in Public Health, was in attendance for this item.

1.         Mrs Varshney introduced the report and reminded Members that the action plan for addressing health inequalities followed on from a report to the Committee on ‘Mind the Gap’ in March 2013.  Mrs Varshney, Mr Scott-Clark and Ms Peachey responded to comments and questions from Members and the following points were highlighted:-

a)         the action plan’s focus on outcomes was welcomed by Members;

b)         the percentage reduction in the number of smokers would need to be increased and the rate of cessation speeded up, as only 9,000 out of a total of more than 246,000 smokers gave up last year. Mr Scott-Clark explained that there were two ways of measuring smoking cessation: the number of smokers and the prevalence of smoking. The 9,000 total quoted in the report referred to those who had given up as part of the County Council’s smoking cessation campaign, but to this should be added the many people who stopped on their own. Measuring the prevalence of smoking would cover all those who had stopped smoking. The Public Health campaign was moving towards harm reduction and tobacco control through a long-term programme which encouraged smokers onto Nicotine Replacement Therapy as a step-down measure;

c)         in response to a question, Mr Scott-Clark explained that, as e.cigarettes were unregulated, there was no reliable information on their safety and effectiveness.  The e.cigarette market was growing rapidly, and the European Union and the Medicines Regulation Authority in the UK was currently seeking to licence them. The County Council could only support the use of licensed, recognised products as part of its smoking cessation campaign, so did not currently recognise e.cigarettes as a valid option;

d)         the ‘emerging themes’ for most Kent districts included reducing obesity, but many families, especially those on low incomes, would experience problems in finding and affording healthy foods. What would help was more lobbying of supermarkets to persuade them to promote foods lower in sugar and fat.  Ms Peachey explained that the National Institute of Clinical Excellence had produced good public guidance about identifying and choosing healthy foods and supplementing dietary changes with physical exercise. However, factors such as the loss of many school playing fields in recent years did not support increased physical exercise. Some London Boroughs had restricted takeaway outlets near school premises. Under the new national Public Health Responsibility Deal, Public Health authorities had scope to work with the food industry, as they had in the past with off-licences to address under-age sales of alcohol and cigarettes. Mrs Varshney added that the national Responsibility Deal was supplemented by local programmes with businesses wishing to encourage healthy weight among their staff. The Public Health directorate was also working with spatial planners to address aspects of town planning relating to the physical environment, such as the provision of open spaces, to encourage walking and physical activity;

e)         in response to a question about trends around young people starting to smoke, and the contribution of recent immigrants to the number of smokers in Kent, Mr Scott-Clark said that the number of young men starting to smoke was falling while the number of young women starting to smoke was rising.  The Public Health directorate was working with schools to dissuade young people from starting.  Ms Peachey added that a survey of 45,000 school children by the National Foundation for Education Research, undertaken 3 years ago, had measured young people’s attitudes to, and patterns of, smoking.  It would be useful to repeat the survey to see if either of these had since changed;

f)          resurrecting the teaching of domestic science in school would teach children about nutrition and how to budget for and prepare healthy meals.  Mr Scott-Clark agreed that this would be useful and said this would be included, with the school nursing review, as part of improving the overall school care environment.

2.         The Cabinet Member, Mr Gibbens, added that addressing health inequalities was the largest single area of activity for the Public Health directorate and something on which he, as Cabinet Member, would expect to be held to account by the Cabinet Committee.  He said that health inequalities were widening as many people lived longer, and varied across Kent.  Smoking cessation was particularly important as it affected other areas of health inequality.  He proposed adding childhood obesity to the list of indicators in paragraph 7.2 of the report and this found general support from the Committee.

3.         RESOLVED that:-

a)         the delivery of the health inequalities (Mind the Gap) action plan across Kent, particularly in the areas of high mortality rates, be supported;

b)         the principle of an increased pace when working with local schools to promote physical activity, promoting programmes to reduce harm from smoking and encouraging uptake of NHS Health Checks, be endorsed; and

c)         a progress report be presented to this Committee in 12 months’ time on the indicators mentioned under section 7.2 of the report, including the addition of a new indicator of childhood obesity, as agreed above.