Agenda item

Public Health presentation and report

 Professor Kevin Fenton MD PhD FFPH, Strategic Director of Place and Wellbeing & Director of Public Health will provide a presentation, enclosed,  on the below:

 

·  Evidence base, data and programmes to promote health amongst disadvantaged people and those with poor health

·  Behaviour change

·  Social regeneration

·  Healthy communities

 

 

Cllr Evelyn Akoto, Cabinet Member for Community Safety and Public Health, will attend and input into this item.

Minutes:

The item started with a Public Health presentation by Kevin Fenton, strategic director, with input from lead cabinet member Cllr Evelyn Akoto, based on the paper circulated with the agenda.

 

The chair then invited questions from members and the following issues were raised:

 

Air Quality

 

Members asked about the links between pollution levels and inequality; have these been mapped this out? Officers said while there is not detailed data, there appear to be a correlation as many more deprived people live near busy roads. There is a concentration in the midst of the borough, the most deprived segment.

 

How much focus is there on air pollution? The strategic director responded this is identified as an important issue that the council need to address in his report. The council are monitoring and educating people; most of the solutions lie outside at regional and national level so elected members advocacy here is important. Cllr Akoto added the council is looking at tree planting to reduce pollution on the Old Kent Road.

 

Lambeth are considering an emission free zone across Brixton, is this something the council could consider? This is something that could be raised with Cllr Livingston as the cabinet lead.

 

What data is available? The council monitors flows, but does not gather  detailed data on pollutants ( particulates , Nitrogen Dioxide ).

 

What about radical solutions to tackle air pollution  like banning car driving? Are we prioritising our interventions in areas that experience most health inequalities? What if we increased the price of cars parking, as currently cars are only used 2% of the time?  Car parking is still free on estates. Do we have a public conversation about the levels of pollution and the harm, and the kinds of actions that are needed to tackle this?  Places like Amsterdam didn’t nudge; they took drastic issues. Should the council end parking and instead plant on our streets? The strategic director said that places like Stockholm have been working on this agenda for many decades as part of the post war plan . As well incentives we need to nudge with transport.

 

Cllr Akoto said the council are doing anti idling programmes and many of the new developments are now car free .She will talk to Cllr Livingston about what more is planned. Members welcomed this, given air pollution public health crisis .The strategic director agreed that air pollution is concerning ; the data on dementia is very worrying if showing significant  risks 50 metres from a major road.

 

Nurseries are being monitored by the Mayor, which is good, however not on the Old Kent Road where the need seem highest.

 

A member from St George’s ward mentioned the success of a temporary road closure which made a big difference. This is part of creating a ‘tranquil triangle’ and was achieved just by putting in a gate in a strategic place.

 

Regeneration

 

Old Kent Road provides an example of making regeneration work for public health; for example through the provision of parks the provision of gyms. The strategic director said he had a remit to work across the council on social regeneration; and that will be a healthy communities element to all regenerations schemes.

 

Precarious employment

 

Could the council look at precarious employment, as there is evidence that this is linked to more adverse mental health than unemployment? The strategic director responded precarious employment is a new issue and one that members are right to focus on. Council data is also limited as we do not track this specifically. There are ad hoc studies and which demonstrate problems . This is an area the council could focus on and it could be worthwhile.

 

Food growing

 

Poverty indicators are showing that increasing problems with food insecurity, this is concerning.

 

Members suggested establishing a food growing culture and asked how community gardening can be promoted to tackle nutritional poverty; because there is a big appetite for this. There is capacity on the Aylesbury.

 

Cllr Akoto said that one of the issues on the plots is lack of knowledge about how to garden; community gardens could tackle this. The strategic director said that there is a vital role for community and voluntary groups here and a plan to create a network across the borough .The chair endorsed this and mentioned another group, Bankside Trust, which has set up food growing. There is enthusiasm from community groups; however these do need to be well resourced.  The strategic director said that these initiatives ought to link to the school garden programmes.

 

A member commented that we need to connect children with nature; there is a community kitchen in Bermondsey.

 

The chair recommended sending appropriate resources to CGS (Cleaner, Greener, and Safer) to promote this work.

 

The London Mayor is proposing to create a garden city, so there may be an opportunity here. There are also national parks initiatives, which may come with new money; Southwark is blessed with parks.

 

Health Checks

 

It was noted that more deprived communities are taking health checks, which is reassuring.

 

Gender, men, women & girls health

 

Ought the council to be focusing on men’s health? The strategic director said it is not a choice though between men and women. He agreed that men’s health has been neglected; there are problems with mental health, bowl cancer screening checks. We need to target women and men. Members commented men are more reluctant to go to the doctors often and men’s poor health is related to stigma and less positive attitude to health. The strategic director added that women engage with the NHS service because they are asked too because of health checks and giving birth. Men really do not have this earlier in life; it tends to kick only at 40, unless they have an STI. We can look at other times and approaches; such as workplace time to talk programmes to improve mental health. We need to introduce a health engagement programme.

 

Male mortality rates are much higher. The strategic director said this is a national trend here with late diagnosis. There is less screening programme for men. There needs to be a focus on early intervention and raising awareness.

 

A member said that there is a need to look at heart attacks in women which present differently. She also rises concerned about girls and their poor health, and damaging concepts of gender.

 

The strategic director said that this conversation highlights  some limitations to Public Health’s freedom to initiate. 90% of money is committed to mandated programmes (smoking / sexual health). Most of the mental health programme is with CAMHS at the more acute end rather than upstream on prevention; the council are working with schools to tackle self harm.  He added that concerns around gender are being flagged up; particularly toxic masculinity and domestic abuse. The money to tackle gender and health is very tight; the Public Health budget is being cut by 2.5 % per year. Cllr Akoto added that the financial challenges are very big.

 

Public Health priorities

 

Members asked the strategic director for to name three priorities and he  mentioned getting kids to move more,  through initiatives that close streets down and improve access to parks. The council need to create safe spaces such as play streets. Improving mental heath and wellbeing is important ; the council is looking at peer reviews, support and interventions. Addressing social isolation is another top priority.

 

Social isolation

 

Members asked if we were doing enough to combat social isolation, and about the role of halls in council estates. The council are developing a strategy to  tackle this.

 

 

Supporting documents: