"Practical Public Health for the Geriatrician".

1. "Practical Public Health for the Geriatrician". Paul Johnstone PHE Regional Director North of England

2. What is Public Health? • Facts and figures • Older people focus • How is PH organised? • How to get involved and work on Dementia

3. What is public health? The Faculty defines public health as: The science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society.

4. Public health: • is population based not patient individual base • emphasises collective responsibility for health, its protection and disease prevention • recognises the key role of the state, linked to a concern for the underlying socio-economic and wider determinants of health, as well as disease • emphasises partnerships with all those who contribute to the health of the population.

5. Determinants of Health

6. Three domains of public health practice: Health Improvement • Inequalities, Education, Housing, Employment • Family/community • Lifestyles • Surveillance and monitoring of specific diseases and risk factors Improving services • Clinical effectiveness, Efficiency • Service planning • Audit and evaluation, Clinical governance • Equity Health Protection • Infectious diseases • Chemicals and poisons, Radiation • Emergency response • Environmental health hazards

7. Public health and healthcare success stories Data Source: Mortality in England and Wales Average Life Span, December 2012 A tale of two populations- 26th Sept 2013

8. Data Source HSE 2011 Volume 1 HSCI Presentation title - edit in Header and Footer

9. Greatest reduction in CVD Data source Avoidable Mortality in England and wales 2011 ONS may2013 Presentation title - edit in Header and Footer

10. Public health working with healthcare professionals- reducing stillbirths.

11. Unfinished business- inequalities Data source: ONS Inequalities in LE and DFLE , 2001-2004 to 2007-2010 Source: ONS Statistical bulletin Life expectancy at birth and at age 65 for local areas in England and Wales, 2009-11 Presentation title - edit in Header and Footer

12. Increasing retirement age will not increase tax revenue if people are too ill to work By the time retirement age reaches 68, only the richest 10% of people will reach retirement without disability

13. Years of disability and dependency

14. Unfinished business- obesity Morbidly obese 83,000 Morbidly obese 96,000 2009 2015 Obese 930,000 Obese 930,000 Healthyweight 870,000 Healthy weight 1.65 m Obese 1.45 m Over-weight 1.48 m Over-weight 1.45 m

15. Unfinished Business- primary care prevention Unfinished business- primary care

16. Immediate causes of disease burden Ed AM, Monika Strategic Review

17. Top causes of under 75 mortality – 2010 …leading to the major killers. Raised blood pressure accounts for 50% of all heart disease Around 86% of lung cancer deaths in the UK are caused by tobacco smoking

18. Causes of long term disability

19. http://www.wmpho.org.uk/olderpeopleatlas/Atlas/atlas.html

20. What is Public Health? • Facts and figures • Older people focus • How is PH organised? • How to get involved and work on Dementia

21. Public Health England “Public Health England exists to serve the system, a system led locally by elected members” 21 Presentation title - edit in Header and Footer

22. PHE’s National Priorities REDUCING PREVENTABLE DEATHS Helping people to live longer by reducing preventable deaths from conditions such as heart disease, stroke, cancer and liver disease REDUCING THE BURDEN OF DISEASE Increasing healthy life expectancy by tackling conditions which place a burden on many lives, such as anxiety, depression and back pain PROTECTING THE COUNTRY’S HEALTH Protecting the population from infectious diseases and environmental hazards, including emerging risks and the growing problem of antimicrobial resistance GIVING CHILDREN AND YOUNG PEOPLE THE BEST POSSIBLE START Supporting families to give children the best start in life, through working with health visitors, Family Nurse Partnerships and the Troubled Families Programme IMPROVING HEALTH IN THE WORKPLACE Helping employers to facilitate and encourage their staff to make healthy choices

23. PHE’s local presence • Four regions, fifteen centres • Centres in North: • Cumbria and Lancs • Cheshire and Mersey • Greater Manchester • Yorkshire and Humber • North East • Knowledge Intelligence Teams • North West • Northern and Yorkshire • Other local presence • microbiology laboratories • field epidemiology teams • Centre for Radiation, Chemicals and Environmental Hazards units

24. Place-based approach to public health Non-statutory providers* NHS providers People and communities Health and wellbeing boards NHSE area team PHE centre Local government CCGs • EPPR • Screening and immunisation • Offender public health programmes • Specialised commissioning • Primary care public health programmes and population healthcare Public health advice *Including voluntary and community sector 24

25. What is Public Health? • Facts and figures • Older people focus • How is PH organised? • How to get involved?

26. http://www.makingeverycontactcount.co.uk/ Cross-government narrative on health

27. Political Strategic Review

28. Local Govt Funding and Social Care Presentation title - edit in Header and Footer

29. Dementia National Executive Meeting 18 February 2014

30. Why is dementia an area of focus?

31. Dementia Friends Movement in Partnership with Alzheimer's Society in 2014/15 :