Public health and wellbeing
Public health is defined as “the science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised efforts of society” (1). It is holistic and inclusive in its approach, assessing the causes of disease and ill health within the population and developing interventions across communities and neighbourhoods to tackle them. Whilst endeavouring to improve outcomes at a population level, public health remains engaged with the wellbeing, attitudes, behaviours and choices of individuals.
As a profession, public health is split into three broad domains: health protection, health improvement and health services. Within these domains, public health specialists and practitioners monitor population health data, identify health needs, help develop appropriate services and evaluate health programmes.
Public health involves advocacy and action to promote healthy lifestyles, reduce health inequalities, prevent disease, protect health and improve healthcare services. As a discipline, it recognises that health is not merely the absence of disease, but is “a state of complete physical, mental and social wellbeing” (2).
The concept of wellbeing is in some ways more difficult to define, but relates to quality of life, satisfaction, happiness, positive mental health welfare and wellness. It requires that basic needs are met, that individuals have a sense of purpose and are able to participate in society (3).
The public health and wellbeing division is the team within the Children, Adults and Health directorate that coordinates, facilitates and supports the work of the council and its partners in this area. Professor Mark Pietroni leads and manages the division in his role as the local director of public health and this is his annual report.
The publication of an annual report by the director of public health is both a longstanding professional tradition and an opportunity to highlight ongoing and emerging population health issues and how they will be addressed. Readers may be less aware that the publication of an independent annual report is also a legal requirement (a) for local authorities. The duty has two parts: firstly that the director of public health must prepare the report; and secondly that the local authority must publish it. This arrangement helps to ensure that information is disseminated, policy making is transparent, and the advice is seen to be objective and independent (4).
Previous annual reports have variously provided a comprehensive assessment of the health and wellbeing of the population or taken a more focused approach to specific themes and topics. A back catalogue of previous annual reports is available on the South Gloucestershire Council website.
Over the past twelve months, a great deal of good work has gone into the revision of the South Gloucestershire JSNA. This document provides a comprehensive picture of the current and future health and wellbeing of the local population. It is used by health and social care organisations as an evidence base for commissioning and developing services, to improve public health and reduce inequalities. Similar to the annual report of the director of public health, the production and maintenance of the JSNA is a statutory responsibility placed on the local health and wellbeing board (b).
The refreshed JSNA contains over forty chapters of detailed analysis which have been prepared in partnership with a range of stakeholders both within and without the council. An executive summary is available which identifies the key findings from the JSNA under five areas:
- Overview of health
- Wider determinants of health
- Children and young people’s health
- Adult’s health
- Communicable diseases and health protection
In addition to this resource, Public Health England continues to produce an annual local health profile for South Gloucestershire (7) which complements the data it publishes online under the Public Health Outcomes Framework.
Addressing many wider wellbeing issues, the South Gloucestershire annual report on quality of life indicators ‘Better or Worse’ was published in 2015 to include the results of the 2014 Viewpoint survey and other key sources of data (8). The report illustrates trends over time for the following areas:
- Quality of life
- Our place
- Our economy
- Our communities
- Our health
Rather than duplicate the information contained in these four important resources, this report instead focuses on addressing a specific question – that is how to allocate and prioritise public health resources in an apparently healthy population like South Gloucestershire.
- In Section 1 of the report, there is a review of the previous year, starting with a short review of the previous annual report. This section includes a discussion on the financial challenges for local authority public health teams and how they are being addressed in South Gloucestershire.
- Section 2 of the report considers South Gloucestershire as a healthy area in which to live and work. There is a review of how the area compares favourably in comparison to the rest of the country in terms of health and wellbeing and consideration of what this means for public health.
- In Section 3, there is a discussion about how the distribution of disease, disability and ill health within South Gloucestershire presents challenges which must be addressed collectively by the council, its partners and the public.
- Section 4 outlines possible approaches to prioritising needs and allocating resources, drawing on academic research and the experience of other health and wellbeing boards in England.
- Finally, Section 5 is a look forward to the coming year with consideration of how the findings of the JSNA can be used in agreeing priority objectives for the next Joint Health and Wellbeing Strategy which is due for publication in April 2017.
A local atlas of health determinants and outcomes has been prepared as a companion to this report and is available to download from the council website.
[a] Section 73B of Part 3 of the National Health Service Act 2006 as amended by Section 31 of the Health & Social Care Act 2012
[b] Sections 176 – 183 of the Health and Social Care Act 2012