Initiating a Well Being Strategy in Moray

1. Initiating a Well Being Strategy in Moray Strengthening the public health function and role of Moray Council as a health improvement organisation in tackling the wider determinants of health.

2. The health improvement role of local government/LA’s in tackling the wider determinants of health: the Scottish policy context… • The National Health Service (Scotland) Act 1978 placed a duty on NHS Boards and local authorities to "co-operate with one another in order to secure and advance the health of the people of Scotland". • The Local Government (Scotland )Act 2003created a new power which enables local authorities to do anything they consider is likely to promote or improve the well-being of their area and/or persons in it. The power to advance well-being has been provided to encourage innovation and closer partnership working between local authorities and other bodies in better responding to the needs of communities. • The Smoking, Health and Social Care (Scotland) Act 2005 • The Schools (Health Promotion and Nutrition) (Scotland) Act 2007 • The Public Health etc. (Scotland) Act 2008 updates the law on public health, enabling Scottish Ministers, health boards and local authorities to better protect public health in Scotland. • Preventing Overweight and Obesity in Scotland: A Route map Towards Healthy Weight (2010) a national programme which identifies local authorities as having a lead role with its partners in tackling obesity in Scotland.

3. A social perspective on health & wellbeing… The context in which the role of local government in tackling the wider determinants of health assumes an important role… 'Poverty, low wages and occupational stress, unemployment, poor housing, environmental pollution, poor education, limited access to transport and shops, crime and disorder, and a lack of recreational facilities all have had an impact on people's health' (Acheson Report- Independent Inquiry into Inequalities in Health 1998) ‘Some commentators estimate that in terms of what might be done to improve the health of the population less than ten percent of the relevant determinants are found within the sphere of health care’. (Effective Strategies for tackling the wider causes of ill-health Office of the Deputy Prime-Minister 2006) Dahlgren & Whitehead 1991 Therefore, the remaining ninety per cent are dependent upon decisions made elsewhere – such as the policy, services and activities undertaken by the local authority that are associated with the wider determinants of health & wellbeing(Carruthers et al. 1998).

4. “Improving health / overcoming health inequalities must be tackled in a way which recognises the social model of health, and that improvement can only be achieved by permeating a concern for this purpose throughout the services and other activities undertaken by the local authority.” (Effective strategies for tackling the wider causes of ill health 2006) • e.g. - Obesity • Culture, Leisure & Recreation Services • Affordability & Access Schemes i.e. passport to recreation, high life access scheme • Education & Community Learning Services • Cycle & walking to school schemes, cooking & budgeting skills courses, nutritional guidelines, health promotion events • Roads & Transportation • Workplace health promotion schemes i.e. active travel to work plans & staff schemes (HWL), • Planning & the Environment • Healthy Urban Planning Principles, Health Impact Assessments, Healthy Cities (WHO)

5. AIM:To strengthen the public health function of the local authority as a health improvement organisation in tackling the wider determinants of health; to maximise the opportunities for improving the health and wellbeing of Moray. The wellbeing strategy would therefore: • Provide an opportunity for the LA to articulate a clear vision (and values) for improving the health & wellbeing of Moray and its communities/populations; • Demonstrate Moray council’s commitment to health promotion and improvement in its widest sense, emphasising its role in the prevention of illness and the advancement of wellbeing • Support the development of Moray Council as a health promotion organisation by providing a greater focus and prioritisation of existing plans and activities on health improvement and wellbeing • Mainstream health by permeating its vision and priorities throughout the services and activities undertaken by the LA • Provide a platform for the local authority to fully exercise its duties and powers via a broad strategic and co-ordinated approach which recognises the linkages and channels of influence between the various levels of determinants • Provide the big picture that shows how all the individual activities across council services are joined up and co-ordinated to achieve the desired result of promoting the health & wellbeing of its communities

6. Cont… • Unlock the potential for maximising the LA contribution to improving health - by guiding staff & services and promoting best practice • Secure co-ordinated action across council services and between NHS and community planning partners through the implementation of its action planning • Complement actions by other partner agencies, which together comprise the work of community planning and other local partnership planning mechanisms such as MCHSCP • Provide an opportunity to (meaningfully) engage with local communities and their concerns and views concerning local issues, to ensure that any local strategy and actions are responsive to local needs • Provide an opportunity to examine and articulate the external opportunities and threats as well as the internal strengths and weaknesses for promoting and improving health and community wellbeing; • Provide an opportunity to assess & identify the potential impact of its policy, plans and activities on the health and wellbeing of its communities

7. Proposed direction of travel for initiating a wellbeing strategy…