Annual Report of the Director of Public Health

3. Why do we write Annual Reports of the DPH? The ‘So What?’ Question Assessment of Impact of recent Annual Reports Annual Report of the Director of Public Health

4. Immunisation Co-ordination Team • Breastfeeding inequalities • Substance and alcohol misuse • Obese and overweight children • Teenage pregnancy rates • Asset approach in all JSNA • Asset approach in CCG commissioning • Healthy weight vs. overweight / obesity • National recognition: Brighton University British Red Cross • International: World Congress of Epidemiology

5. New models of primary care • Primary Care / Public Health alliance • Avoidable cancer deaths • Preventable death audit • Inequalities across practices • Public information on practices • Mental wellbeing embedded in policies • University engagement – Alcohol / Wellbeing • Self-harm priority • Suicide reduction / suicide safer city • Mental wellbeing in the arts / public sector • City Strategy for mental wellbeing • National recognition: Assoc. of DPH 1st Prize PH England

6. Annual Report of the Director of Public Health Why a Report for 2024?

7. Drug fuelled dystopia • Debauchery and violence • Recreational sex • In-vitro fertilisation • Hallucinogenic use • Materialism • Institutionalised under-class • Longstanding economic crisis • On-going II world war – Germany / Poland • Religious suppression • Benevolent dictatorship • Utopian polymaths emerge Annual Report of the Director of Public Health 2024 – a Brave New Shape of Things to Come? • Dystopian “Ingsoc” • On-going war • Big Brother • Thought crimes • Newspeak (Spin) • Two minutes hate • 2024 • Utopia / Dystopia • Healthy / Debauched lives • Inequalities / Underclass?

8. Why a 2024 Report? A force to influence policy, practice and behaviour to ‘change the future’ Annual Report of the Director of Public Health

9. DEMOGRAPHY in 2024 • 6.2% population growth over last decade • University city: Students = 31,500 = 54% of 20-24 year olds • Frail elderly and dependent: Reduction in number of over 75 years 50% increase in over 90 years • More 50-59 year olds: From 28,200 to 37,200 • More ethnic diversity: 3 in 10 births ‘White other’ = 1 in 5 • Fewer teenagers: 3% decrease in 10-19 year olds • More young children: 7% increase in 0-9 year olds

10. Students: transport, waste, housing, street scene • Dependency ratios - older carer support - technology use • Aging “irresponsibly?” cohort with new responsibilities • Ethnic identity • Education standards Flexible school use DEMOGRAPHY in 2024 – Impact

11. More visitors than ever • Greater Brighton: Valley Gardens, Circus Street, i360, Brighton Centre, Rampion wind farm • More cycle trips (6,600 – 13,000 in last 10 years) • More bus journeys(10% increase in last 5 years) SUSTAINABLE ECONOMY SUSTAINABLE COMMUNITIES in 2024

12. SUSTAINABLE ECONOMY SUSTAINABLE COMMUNITIES – Impact? • Air quality compromised • Sustainable transport rewards • Severe weather events • Continuous Council Resilience • New Community Resilience • “Solutions from within communities, technologically improved social contact”

13. LIFESTYLES in 2024 • Unhealthy weight – the Biggest PH challenge • E-cigs and nicotine addiction • Fall in Opiates, but rise in Novel Psychoactive Substances • Sex less popular but a persistent core group of high risk takers

14. Obesogenic environments – the Biggest PH challenge • Food and drink retailer partnerships • Addiction services – working with BAT and Head Shops? • Abortion a contraceptive of choice for the under 18s • CASH / abortion contraceptive services or lifestyle ambition • Wellbeing –mental and physical in all Commissioning and Providing LIFESTYLES in 2024 – Impact

15. The BIG killers in 2024 • Cancer – Melanoma and Oral cancer increases • Type II Diabetes – still increasing

16. The BIG killers in 2024 – Impact • Combined Commissioning / Organisation / Budgets? • “Neurosurgery, Radiotherapy, Major Trauma” • “Decentralised Local Services” • “Technologically advanced primary care” • “Voluntary sector replacing the state sector” • Singing from the same hymn sheet?

17. HOUSING in 2024 • >5,000 increase in student numbers • Growing property price affordability gap • Intergenerational living

18. HOUSING in 2024 – Impact • Students = Houses of Multiple Occupation • Temporary Solutions become ‘permanent’ • Persistent ‘homelessness’ • “Commuter fatigue sees young entrepreneurs relocate” • “Housing becomes an economic fault-line” • A city designed by reaction to ‘apparent events’

19. 2024? The Shape of Things to Come? A Brave New World? • Demography – do we really understand the changes and are we planning explicitlyfor them? – Schools / Care Homes • Sustainability – are we properly prepared, and are we preparing communities for new social relationships using technology? • Commissioning – do we have the right partnerships? • Lifestyles – are we tackling the most difficult behaviours and do we need to make deals with different people? • Big Killers – are we planning for how we want services to be, rather than what we need them to deliver? • Housing – are we watching events happen to us?

20. Annual Report of the Director of Public Health Thank you Dr. Tom Scanlon Director of Public Health Brighton & Hove City Council tom.scanlon@brighton-hove.gcsx.gov.uk