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Thank you for reading this director of public health annual report for South Gloucestershire 2016. I hope that you find it interesting. I am very grateful to the many colleagues who have helped to put it together.

The last year has been one of significant challenge for the public health and wellbeing division. The comprehensive spending review announced cuts to funding for public health of 17% over four years with a flat cash settlement for another year after that. As a result we have been reviewing our activity and are in the process of deciding how to make best use of the resources we have – people, money, networks, professional capital, processes – to support our purpose ‘To promote and protect the health of the population of South Gloucestershire and to advocate for those whose voice is seldom heard’ and to deliver our vision ‘To improve healthy life expectancy and reduce health inequalities in South Gloucestershire’.

Two years ago we reviewed public health issues in South Gloucestershire in some detail. South Gloucestershire is one of the healthiest places to live in the country with excellent outcomes in many areas including some of the longest lifespans in England; and in last year’s report we set out our priorities. This year we are looking in more detail at the contributors to health and wellbeing and specifically inequalities in health. This is particularly important in South Gloucestershire as the population figures are generally good and it is easy to miss parts of the population who do significantly worse in terms of health outcomes.

Some of the recent work in the department has illustrated this issue, for example our recent Child Poverty Needs Assessment. Children in South Gloucestershire are less likely to live in poverty than in most parts of the country because many of the wider determinants of health are better here – employment, housing, environment etc. However if you are a child living in poverty you can do worse in South Gloucestershire than in areas with a higher prevalence of child poverty. We know that the single largest contributor to child poverty persisting across generations is educational attainment and that one of the best ways to break the cycle is for children from low income families to do well at school. However, the attainment gap at schools in South Gloucestershire for children who qualify for free school meals (a proxy indicator for low income) compared with those who do not grows more rapidly in South Gloucestershire as children get older than in areas where child poverty is more prevalent.

There are no easy or quick answers to the question ‘how should we prioritise?’

However, it is precisely this kind of detailed analysis that helps to ensure that we make the best use of our resources, especially at a time of reducing budgets. This report is part of that process and describes in some detail the tools available and what they say about individual wards in South Gloucestershire. We are very interested in your comments and I would be delighted if you would like to get in touch with me or members of the team to discuss this further.

Professor Mark Pietroni
Director of Public Health, South Gloucestershire Council