Mark Dooris Director, Healthy Settings Development Unit University of Central Lancashire mtdooris@uclan.ac.uk www.uclan.

1. Investing for Health in North West England: Using the Healthy Settings Approach Mark Dooris Director, Healthy Settings Development Unit University of Central Lancashire mtdooris@uclan.ac.uk www.uclan.ac.uk/hsdu

2. Healthy Settings: Overview, Origins & History  Healthy Settings: Theory & Practice  North West Healthy Settings Development Unit &  Regional Health Promotion Planning Challenges and Opportunities  - ‘fully developed’ approach within settings - - integrating different settings initiatives - - corporate citzenship agenda - Presentation Outline

3. Healthy Settings Development UnitAim & Functions To improve the health of the people of North West England & beyond by supporting & facilitating the development of the settings-based approach to health promotion & health development within the context of broad-based investment for health

4. Healthy Settings: Origins Health for All 1977- Ottawa Charter 1986 Healthy Settings Settings • New public health – socio-ecological model • Health not illness – ‘salutogenesis’

5. Ottawa Charter “Health is created & lived by people within the settings of their everyday life; where they learn, work, play & love.” WHO 1986

6. Background Policy Context Health for All 2000 Ottawa Charter Sundsvall Statement Agenda 21 Jakarta Declaration ‘Settings for Health’ in WHO Glossary Health 21 – Target 13 ‘settings for health’ WHO European Office: Investment for Health & Development Settings-related Initiatives Healthy Cities Project Health Promoting Hospitals Project Health Promoting Schools Network Regions for Health Network Health in Prisons Project Health Promoting Universities Book Healthy Settings: International/European Timeline

7. What?  Why?  Where?  How?  Who? Theory & Practice

8. Settings as a Dimension of the Health Education Matrix Setting Population Group Health Problem

9. Aim: to integrate a commitment to health within culture, structures, processes & routine life of organisational & other settings Healthy Settings: What? “The place or social context in which people engage in daily activities in which environmental, organizational & personal factors interact to affect health & wellbeing. A setting is also where people actively use & shape the environment & thus create or solve problems relating to health. Settings can normally be identified as having physical boundaries, a range of people with defined roles & an organizational structure.” Settings for Health - WHO Health Promotion Glossary, 1998

10. Healthy Settings: Why (1)? • Health largely ‘produced’ outside of  Illness [health] services • Health improvement requires investment in  social systems in which people live their lives • Settings approach represents tangible way  of ‘investing for health’ at local level – health as asset for & outcome of development & productivity of organisations

11. Healthy Settings: Why? Illness Leisure & Recreation ‘Health’& Social Care Criminal Justice Ottawa Charter - strategies - - processes - Community Work/ Economy Education Health Source: adapted from Grossman & Scala (1993)

12. Healthy Settings: Where? Workplaces Other – eg clubs, homes Health & Social Care Cities & Communities Prisons Schools Universities & Colleges

13. Healthy Settings: Who? Youth Service Community Groups Students Teachers Healthy School Co-ordinator Non- Teaching Staff Faith Organisations Parents/ Carers Police School Nurse Governors Health & Social Care Businesses

14. 3 focus areas or elements Creating supportive/healthy living  & working environments Integrating health development  into daily activities Developing links with other settings &  wider community – ‘straddling settings’ Healthy Settings: How (1)?

15. Healthy Settings: How (2)? multidisciplinary ‘whole systems’ socio-ecological approach organisational development & change management  high visibility innovative project top-down political/ managerial commitment  bottom-up engagement & empowerment public health development agenda  institutional agenda/core business Values participation, equity, partnership, sustainability

16. North West England: Investment for Health

17. North West England: Investment for Health

18. Healthy Settings Development UnitAim & Functions To improve the health of the people of North West England & beyond by supporting & facilitating the development of the settings-based approach to health promotion & health development within the context of broad-based investment for health

19. Healthy SettingsDevelopment Unit Home New!! Conference 2003 Context Evidence History Theory Settings Topics Services: Events, Training & Consultancy Links Publications Newsletters Reports Contact Us Healthy Settings Development Unit: Products Welcome to the website of the North West England Healthy Settings Development Unit Introduction The unit aims to support and facilitate the holistic and integrated development of healthy settings throughout England's North West. 'Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love.' This website aims to provide a gateway for settings-related information. As well as pages on individual settings, it provides in-depth background and contextual information. The site is dynamic and developing, and includes details of useful resources and contacts as well as a host of helpful links to other sites of interest. What are healthy settings? At their simplest, settings such as schools and workplaces are convenient places for health interventions. However, healthy settings are about more than this, because they use whole systems thinking. This aims to integrate a commitment to health into the fabric of settings - within their cultures, structures, processes and routine life. More information on healthy settings... Background information on health, health promotion, health development and public health..

20. Healthy Settings Development Unit: Products

21. Healthy Settings Development Unit: Products

22. Healthy Settings Development Unit: Staff & Work Programmes • Director • Regional Healthy Workplace Co-ordinator • Regional Healthy Prisons Co-ordinator • National Health Promoting Hospitals Co-ordinator • Health Promoting University Co-ordinator • Research and Development Officer • Administrative Assistant + links to Healthy Schools, Colleges, Care Homes, Nightlife • + commitment to integration with topic-based programmes (e.g. physical activity, transport, tobacco, mental health, violence and food)

23. Conclusions: Implications, Opportunities & Challenges Within settings– fully developed ‘whole system’ approach • connections between people, environments & behaviours  • links between different health issues  • personal and corporate citizenship – wider impacts  Between settings – ‘joined up’ approach • bridge the gaps  • co-ordinate & integrate  • maximise contribution to healthy city or community  • horizontal & vertical networking  Evaluation & evidence • developing appropriate tools & investing in building evidence base

24. Conclusions: Implications, Opportunities & Challenges Settings as springboards for corporate citizenship Potential for settings to use intra- and inter-organisational leverage to maximise their contribution to ethical practice and sustainable regeneration and development – linking local action to global agendas

25. Investing for Health in North West England: Using the Healthy Settings Approach Mark Dooris Director, Healthy Settings Development Unit University of Central Lancashire mtdooris@uclan.ac.uk www.uclan.ac.uk/hsdu