Dudley Strategy for Tackling Health Inequalities 2010-15

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numbers of alcohol related sexual offences remains low and the overall trend isdownwards even though there was a small increase in recorded offences in 2008/09.Local Patterns of alcohol consumptionThere are a number of accepted categories of alcohol consumption and the NorthWest Public Health Observatory has produced synthetic estimates of the number ofhazardous, harmful and binge drinkers for every local authority in England. Theestimates probably understate the extent of problematic drinking because they relyon self reporting through surveys e.g. the Health Survey for England and Dudley‟sAdult Lifestyle SurveyDefinitions of drinking levels- Sensible drinking: no more than 3-4 units a day for men, and no more than 2-3units a day for women.- Binge drinking: 8 or more units of alcohol for men, and 6 or more units ofalcohol for women on their heaviest drinking day in the past week.- Hazardous drinking: drinking above recognised „sensible‟ levels but not yetexperiencing harm. Defined as drinking between 22 and 50 units of alcohol perweek for males, and between 15 and 35 units of alcohol per week for females.- Harmful drinking: drinking above „sensible‟ levels and experiencing harm. Canbe defined as drinking more than 50 units of alcohol per week for males, andmore than 35 units of alcohol per week for females.- Alcohol dependence: drinking above „sensible‟ levels and experiencing harmand symptoms of dependence.Table 1:NWPHO synthetic estimates of hazardous, harmful and binge drinking in adults (aged 16+,HSE 2005)Binge drinking Hazardous drinking Harmful drinking% number % number % number17.7 (15.7,18.4 (16.9,5.2 (4.7,43,46545,25312,84020.0)19.9)5.8)DudleyPCTWest17.3 (16.3,Midlands19.6)RegionEngland 18.0 (17.4,18.6)763,43016.5 (16.8,19.8)7,278,674 20.1 (18.4,21.8)770,333 5.2 (4.4,5.4)8,027,474 5.0 (4.5,5.6)206,9622,010,856Key findings from the most recent Dudley Health Survey 2009 (Dudley PCT, 2009b)show:The proportion of respondents who are binge drinkers has fallen significantlysince 2004, from 22% to 17%. The proportion of respondents that are heavydrinkers has also fallen significantly, from 34 to 27%.115
There are significantly more male binge and heavy drinkers than female.In both sexes the proportion of respondents who are binge drinkers falls withincreasing age. The proportion of males who are binge drinkers is higher thanfemales in all age bands, although in 18-24 year olds this difference is notsignificant. The same pattern is seen in heavy drinkers.The proportion of respondents who are binge or heavy drinkers is muchhigher in white respondents than BME in both males and females.There is no gradient between least and worst deprived areas for either heavyor binge drinking.The prevalence of both heavy and binge drinking is lowest in those who havenever worked/long term unemployed. The prevalence of binge drinking ishighest in lower supervisory and technical occupations and heavy drinking ishighest in higher managerial and professional occupations.Evidenced based interventions for hazardous, harmful and moderatelydependent drinkersDudley‟s Alcohol Strategy (Dudley Community Safety Partnership, 2010) key aim is,„To reduce the harm caused by alcohol to individuals, families and the community.‟The national health inequalities team have identified four key actions that will impacton health inequalities and result in both short term and longer term health gainsthrough:1. Tackling underage/illegal alcohol consumption and encourage the industry topromote responsible drinking2. Combating crime related disorder3. Raising awareness of, and educating about, safe and sensible drinking4. Facilitate identification of at risk individuals and enabling access to alcoholtreatment services which are consistent with national standardsOptimal outcomes at a population level require a population focus to facilitate localcommunities‟ optimal use of the services as well as providing the most effectiveevidence based interventions. Central to the success of this approach is effectivemulti-agency partnership working as well as effective planning and commissioning ofthe services and activities that are necessary to achieve maximum health gain.RECOMMENDATIONSThe local alcohol strategy has identified actions that address all these points and hasbeen written in line with the key government documents as well as ensuringimplementation of the high impact changes that are known to make the greatestimpact on reducing alcohol related admissions to hospital. The keyrecommendations recommended by HINST are now incorporated into the deliveryplan.116
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2010FDudley Strategy forTackling He
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ENDORSEMENT OF THE 2010 - 2015HEALT
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CONTENTSFOREWORD………………
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Standardised Rate per 100,000 Popul
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There were three principles that un
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This work has been built on trustin
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ENSURE A HEALTHY STANDARD OF LIVING
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with, or at high risk of vascular d
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Tackling underage/illegal alcohol c
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2. VISION STATEMENTThe mission stat
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tackle health inequalities in the t
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These recommendations are addressed
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injustice and deprivation impact ne
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- Giving priority to pre and post-n
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Percentage of live and still births
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EYFS Median Scores by National Depr
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data which shows us locally what ac
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instability. Factors such as job se
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Proportion of population claiming J
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Data is available for those ALMPs f
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Labour market outcomes to date are
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achieved through transfer payments,
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% share of equivalised incomeA comp
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Figure 7 shows the income distribut
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Figure 9Proportion of the populatio
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Although temperature variations dur
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5. LEADERSHIP AND PARTNERSHIPDudley
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A Community Renewal team which coor
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6. COMMUNITY ENGAGEMENTCommunity En
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o DMBC sharing their community enga
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Transferring power to communitiesNI
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Standardised Rate per 100,000 Popul
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Page 67 and 68: Ratio of obsevred vs. expected prev
Page 69 and 70: Performance variation cannot be exp
Page 71 and 72: Table 4: Range of performance gapDi
Page 73 and 74: Conclusions:The general conclusions
Page 75 and 76: 7.2 ACUTE CARDIO-VASCULAR DISEASE (
Page 77 and 78: Standardised Rate per 100,000 Popul
Page 79: Timely ResponseApproximately 30% of
Page 82 and 83: IMD ScoreRevascularisation Ward Rat
Page 84 and 85: That an increase in access to diagn
Page 86 and 87: Establishing the level of health eq
Page 90 and 91: Timely ResponseTimely access to tre
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Page 96 and 97: Percentage who currently smokePerce
Page 98 and 99: 1. Stop Smoking Service ProvisionDu
Page 100 and 101: Proportion of clients that have qui
Page 102 and 103: 3. Communication and EducationDSSS
Page 104 and 105: The PCT, Acute Trust, Local Authori
Page 108 and 109: admissions. The following year Dudl
Page 110 and 111: Standardised Rate per 100,00 popula
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Page 114 and 115: women the Mosaic groups with signif
Page 118 and 119: These include:Securing additional i
Page 122 and 123: The deprivation gap in invasive can
Page 124 and 125: Age standardised incidence rate rat
Page 128 and 129: One of the priorities of the Cancer
Page 130 and 131: Colorectal cancerProstate cancerThe
Page 132 and 133: and less radical treatment than you
Page 134 and 135: As more people than ever are surviv
Page 136 and 137: • Benchmarking of surgery aspirin
Page 142 and 143: There is a weak correlation between
Page 144 and 145: 7.7 SEASONAL EXCESS DEATHSREDUCING
Page 146 and 147: Excess Winter Mortality Index (%)Me
Page 148 and 149: Brockmoor & PensnettSt JamesKingswi
Page 150 and 151: Percentage uptake of seasonal flu v
Page 152 and 153: Percentage uptake of seasonal flu v
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Page 158 and 159: Standardised Rate per 100,000 popul
Page 160 and 161: Standardised Rate per 100,000 popul
Page 162 and 163: PercentagePercentageFigure 7aMechan
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Key findings from analysis of morta
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Standardised rate per 100,000 popul
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Standardised Rate per 100,000 popul
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Standardised Rate per 100,000 popul
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PercentageFigure 17bMechanism of in
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Key findings from analysis of emerg
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Action plan updated in 2008 to rein
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the minimum standards set out by th
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Further analysis shows that for hyp
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8.2 SOCIAL CAREAdult Social CareSoc
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8.3 TRANSFORMING COMMUNITY SERVICES
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DCS has some key performance target
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8.4 DEVELOPING THE ROLE OF THE VOLU
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at the heart of action to address c
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CHC‟s are trained and supported t
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capacity and confidence of individu
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which it has never done before. The
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centres‟ outreach workers and Hea
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9.1 DUDLEY HEALTH INEQUALITIES HIGH
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RECOMMENDATION ACTIVITY OUTCOMES LE
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Dudley Community Partnership (2005)
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Great Britain. Department of Health
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NHS Dudley and Dudley Metropolitan
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APPENDIX 1 - PERFORMANCE INDICATORS
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Indicator Dudley England Least Most
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APPENDIX 2 - DELIVERY PLANS FOR PRI
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PRIORITY AREA: TOBACCO CONTROLRECOM
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All of these initiatives will requi
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Empower community members toraise a
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Develop an integrated alcoholtreatm
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Offender ManagementRECOMMENDATION A
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PRIORITY AREA: SEASONAL EXCESS DEAT
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APPENDIX 3 - HEALTH INEQUALITIES CH
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PRIORITY ACTIONENGAGEMENT- WORKFORC
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Dudley Strategy for Tackling Health Inequalities 2010-15

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