Public health framework drafted

A new 10-year strategy for improving health and well-being across Northern Ireland is taking shape.  agendaNi summarises its main priorities.

‘Fit and Well – Changing Lives’ will be the Department for Health, Social Services and Public Safety’s public health strategic framework for 2012-2022.  However, it will only start to take effect in 2013 as the consultation was held between 19 July and 16 November this year.  A final version is expected before the Assembly’s summer recess next July.

It follows on from ‘Investing for Health’ which aimed to “improve the health and well-being status of all our people, and to reduce inequalities in health.”  Its successor’s draft vision is of a society where “all people are enabled and supported in achieving their full health potential and well-being.”

Progress is acknowledged.  Men in Northern Ireland now tend to live eight years longer than in 1981, with women living an extra six years.  Advances in treatment and care allow chronic conditions to be better managed.

The focus on reducing health inequalities will continue.  Indeed, the draft document’s front page points out how male life expectancy falls from 80 years to 71 years in wards along the bus route between Finaghy and Belfast city centre.

Many deaths from coronary heart disease, cancer and respiratory disease can be prevented, partly through individual choices on smoking, diet and exercise.  Poverty, neighbourhood deprivation, housing conditions, employment and education are also “powerful drivers” that influence the choices that people can or cannot make.

As a person’s health needs change as they grow older, the draft framework has different priorities for each part of the “life course”.  Five stages are identified:

• pre-birth and early years (0-5 years);
• children and young people (5-16 years);
• early adulthood (17-24 years);
• working age adults (25-64 years); and
• later years (65 years and over).

These, in turn, influence the seven policy aims of the framework:

• give every child the best start;
• enable all children and young people to develop the skills and capacity to reach their full potential and have control over their lives;
• enable young adults to grow, manage change and maximise their potential;
• enable working age adults to have a full and satisfying life and social well-being;
• enable people in later years to have a satisfying and active life;
• promote healthy safe, sustainable places and thriving communities; and
• ensure that health is a consideration in the development of public policies.

Practical examples include ensuring that stable secure relationships are provided for children in care, making sure that young people gain careers advice and support to help them make good choices when leaving school, and reducing the number of accidents in the home and on the road.

This broad range of targets demonstrates that health is wider than treatment and care in itself but also covers the “social determinants” of what makes a person content and well, many of which are well beyond the Health Service’s remit.  The draft framework has therefore been signed off by the First Minister and deputy First Minister and its commitments are to be overseen by a range of government departments.

The state, though, cannot deliver this change on its own and personal responsibility is a clear running theme throughout the document, as is “working in partnership” with other sectors.  Society, as a whole, has a responsibility to improve its health and well-being.