Agenda item

The 2017 Annual Report of the Director of Public Health for Lincolnshire

(To receive a report from Derek Ward (Director of Public Health), which presents the 2017 Annual Report of the Director of Public Health for Lincolnshire)

Minutes:

Consideration was given to a report which provided the Committee with the opportunity to consider the Annual Report of the Director of Public Health (DPH).

 

Members were advised that one of the statutory duties of each local authority was to produce an independent report on the state of the health of the people they serve on an annual basis.  It was noted that the 2017 DPH Annual Report covered two topics which were high on the agenda for organisations locally, which were:

·         A chapter on the case for investing in prevention in support of the Lincolnshire Health and Care System's need to shift investment into proven prevention interventions.

·         A chapter reviewing the focus on the biological and environmental threats to people's health and the systems in place to track those hazards and protect Lincolnshire people from harm.

 

The Committee received a short powerpoint presentation from the Director of Public Health on the Annual Report, and further information in relation to the following areas was provided:

·         Ageing Apocalypse

·         Years to Life! Life to Years?

·         Life to years works

·         All is not lost

·         Every gain helps

 

Members were advised that this was a retrospective report, and it was important to note that there was a statutory duty for the Director of Public Health to produce this report and a statutory responsibility for the Council to publish the report.

 

It was noted that there was there was a big growth expected in the 65-74 and 75+ age groups by the year 2039.

 

Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the presentation and report and some of the points raised during discussion included the following:

·         The presentation focused on the concept of 'healthy ageing' and how the benefits of exercising could help to prevent or delay the onset of some conditions associated with older age.

·         It was commented that evidence from recent studies on dementia, that exercise was not a panacea for 'curing' dementia.  However, it was acknowledged that it could be helpful in preventing vascular dementia.

·         It was noted that older people with dementia could decline very quickly, and there was evidence that those in the 70-75 age group, living a reclusive life could decline even quicker.  It was important to be able to give people with dementia the confidence to go out and participate in activities such as singing and dancing which had been shown to slow the progression of dementia.

·         It was reported that when babies were born their neural pathways developed, and there was emerging evidence that with some forms of dementia, certain types of stimulation helped to find new neural pathways and could help to relieve some of the symptoms.

·         Members were also advised that unhealthy behaviours tended to cluster, and people demonstrating these behaviours were likely to develop more than one health condition as they aged.  However, if a person currently only had one condition, it was important to help them to maintain that health to avoid development of further conditions.  This was known as secondary prevention.

·         It was commented that it was important to acknowledge the link between mental health and exercise.

·         It was noted that there had been an increase in people with addictions to prescription medication coming through the substance misuse programme.

·         It was highlighted that there had been a health referral scheme run by East Lindsey District Council which offered a whole range of activities such as walking etc. but had fallen victim to funding cuts.  However, it was commented that investing in these services was a way to save money further down the line.  It was also noted that there was a lot that communities could do themselves, but initial investment may be required.

·         It was suggested that it was those people who were now in their late 30's and 40's who needed to be targeted to improve their health/exercise level to try and reduce the number of health issues when they were older.  It was also suggested that the children of people in this age range needed to be involved as well as the clustering of bad behaviours could take place within families and if the parents' habits were tackled, this could also have an effect on the children.

·         In relation to dementia, it was commented that social contact was just as important as physical exercise for relieving some of the symptoms.

·         It was queried why there had not been a n improvement in people living healthier for longer, as work had been taking place on this issue for a long time.  It was queried whether there was any evidence that the work had had an impact or whether it could be converted to a monetary amount that the NHS had been saved, so that Public Health could argue for additional funding.  Members were advised that this was difficult question to answer, as Public Health was about avoiding something from happening, whereas the public sector generally was about dealing with something when it happened.  However, one area where it was easy to demonstrate benefits was with health protection programmes and vaccinations, as if these were not carried out there would be outbreaks of measles etc.

·         It was suggested that there was a need to better understand the food available such as the amount of ready-made meals in supermarkets and the increasing number of takeaways.  There was a need for people to make a decision about the type of food they fed their families.

·         It was suggested that there was a need for parents to take more responsibility and say no to their children when they asked for unhealthy food/snacks.  However, it was acknowledged that children could be very persuasive in supermarket situations when sweets were right in front of them.  there were small changes though which could have a cumulative impact.

·         It was noted that by 2040 the numbers of those people economically dependent and economically active would be almost 50/50 in Lincolnshire.

·         In the future, people may choose to be economically active for longer, and so a fit and healthy workforce would be vital.  Ill health was something which could be tackled.

·         It was commented that no matter how much work and engagement was carried out there would always be a minority of people who would not change their unhealthy behaviours.

·         It was noted that the smoking prevalence rate was 18% in Lincolnshire.  It had taken 40 years to get to the 'tipping point' and now a reduction in smoking was starting to be seen.  With the increase in popularity of e-cigarettes, it was expected that the numbers would continue to reduce.  However, it was still expected that there would be approximately 10% of the population who would continue to smoke.  However, in terms of obesity, this was a much higher proportion of the population.

·         It was noted that risks from high density, pre-packed processed food were not fully understood yet.

·         In relation to fast food outlets in close proximity to schools, there were local conditions which could restrict the opening times of these fast food outlets so they could not open between 3pm and 5pm, when children would be leaving school.

·         It was commented that a discussion was needed in relation to personal responsibility and personal freedom, and also that there were establishments which needed to earn a living.

·         In relation to the data relating to TB, it was confirmed that the disease had been almost been eradicated several years ago and it had got to the point where the BCG vaccine was no longer required.  It was noted that there continued to be individual cases of TB, due mainly to a person's country of origin.  It was noted that one of the main issues with TB, once it was identified, was the treatment regime as it could anywhere between 12 and 24 months, and it was important to ensure that the treatment regime was completed.

·         Members were informed that there was currently a debate within NHS Lincolnshire whether those people being listed for elective surgery (such as knee/hip replacements) that smoke, should be asked to stop smoking prior to the surgery.  Similar conversations were starting to take place regarding obesity as well.

·         It was commented that it was not known what the impact of some of the additives being put into food would be in the future. 

·         In relation to the three recommendations set out in the report, they were three areas of prevention.  When working towards the report for the following year, there was a need to engage with those three areas to see how they had been influenced.  It was important to demonstrate that money spent on preventative treatment and measures was worthwhile, as there was a need for more funding for preventative services.

 

RESOLVED

 

            That the Committee receive the Annual Report on the Health of the People of Lincolnshire.

 

Supporting documents:

 

 
 
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