Agenda item

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Director of Public Health on proposals to develop a new health inequalities plan for Kent, on which the committee is invited to comment.

1.            Dr Khan introduced the report, which sought the committee’s comments on the work being undertaken.  She and Mr Scott-Clark responded to comments and questions from Members, as follows:-

a)    targets against which health inequalities would be measured would change on 30 September 2015.  The new targets would look similar to the previous targets but would focus more on specific issues and areas of Kent in which inequalities were particularly hard to address;

b)    Mr Scott-Clark supported a view expressed that work on health inequalities should cover people’s whole lifespan, from birth to death. To help achieve this, all services – such as the health visiting and early years services, as well as housing, employment and education services – would need to be engaged and work together. To reflect this, the public health transformation programme had three sections – Starting Well, Living Well and Ageing Well. Work would focus on areas of Kent which had the poorest record of life expectancy;

c)     Dr Khan explained that work was ongoing to seek to understand why some areas of the population disregarded health messages. One speaker suggested that shock tactics might be needed to convey a message, eg that smoking during pregnancy could result in  low birth weight and increased risk of developing a range of illnesses, as many women continued to smoke during pregnancy;

d)    the lifestyle changes necessary to reduce health inequalities would require culture change and much financial and practical investment.  County Council Members could be involved in campaigns in their electoral divisions, be aware of the patterns of inequality in their areas and be advised of what they could do to help.  Although life expectancy could be increased by addressing health issues, it was important that quality of life should also be improved;

e)    a view was expressed that health improvement campaigns did have some effect in some areas of the county, which had shown improved life expectancy.  Dr Khan pointed out that life expectancy had increased generally across the whole of the UK. This was due to improvements in medical science, housing and sanitation;

f)     public messages about health had been very different in the past, eg cigarettes and alcohol had previously been seen as useful  aids to relaxation, and cigarettes had previous been thought to improve lung health. Soldiers in the trenches in the first world war were supplied with cigarettes to boost their morale. To achieve the culture change necessary to alter some people’s perceptions and ingrained habits could take generations. Past research into changing habits had shown that people had to be told something ten times before they would take sufficient notice to take action;

g)    there was a section of the population which would resist health improvement messages and choose to continue to drink, smoke, use drugs and eat fatty foods, even once they knew the negative effects of these behaviours.  The County Council could better direct its efforts to those who wanted to change;

h)   the work currently ongoing to address health inequalities would go a long way to reach the people that it needed to reach; and

i)     it was suggested that the Child Poverty Strategy be reviewed alongside the Mind the Gap plan as the two were closely linked.

2.            The Cabinet Member, Mr Gibbens, pointed out that the ‘Mind the Gap’ plan had been prepared, and work had been ongoing to raise Members’ awareness of health inequalities across Kent, long before the County Council had taken over the public health function in April 2013. However, the gap in Kent was currently widening; Kent’s highest and lowest life expectancy rates were both in his electoral division.  He suggested the best way forward would be for the County Council to identify and target areas of greatest deprivation.  He undertook to ensure that a further report on progress was brought to this committee, but to avoid duplication it would not be repeated at the Children’s Social Care and Health Cabinet Committee.  Members of that committee could perhaps be invited to attend the meeting of this committee. The Mind the Gap plan had previously been discussed by the full Council and he hoped that this could be repeated.

3.            RESOLVED that the proposed direction of travel and timescales for developing a new health inequalities plan for Kent be endorsed.