The Director of Public Health’s proposed
approach to the theme and content of the Annual Public Health report for 2015 being considered by one of Croydon's Scrutiny Committees on 27 January is very welcome in its emphasis on looking at geographic inequalities in the Borough. As such it is in line with what
I recommended last year in dialogue over the 2014 report. However, I am not convinced that the proposed work goes far enough.
It is vital as the inequalities in
Croydon grow that the Council, other agencies and the community and voluntary
organisations, have an in-depth understanding of them and their impact on
public health and other social problems. The aim for the proposed 2015 Annual
Report analysis to assist the work of the Opportunities and Fairness Commission
is vital to its work, especially as the delay in its start makes meeting its
original timetable difficult.
I submitted comments on the 2014 Annual
Report to the 14 July Cabinet meeting and followed it up with a paper to the
Director. He expressed his appreciation for my analysis
of the trends in deprivation in Croydon and my suggestions ‘of how we could
widen our conceptual thinking about tackling this.’ ‘Whilst the public health
team is committed to reduce inequalities through all its work, we do not have
the staff capacity to deal with your paper in full. … (W)e will take note
of your suggestions for our further work, and our planning for next year’s
report in particular.’
While I am pleased that this has turned
out to be the case, I have some
reservations about the proposed depth of the analysis to be undertaken.
Public Health Priorities
Para 3.4 of his paper to the Committee suggests a focus on the Council’s
public health priorities. This misses two elements of concern.
(1) The negative impact on well-being and
therefore health of the growing population density in some parts of the Borough
especially in the North resulting from the growth of the private rented sector
especially through multiple occupation and the conversion of family houses into
flats, with growing conflicts over neighbour noise, cars using residential
streets as rat runs and car parking conflicts.
(2) The linkage of alcohol and drug related
crime and health. This ignores the fact that these addictions are illnesses
that affect all social classes and groups, and include many famous people. Many
addicts are high functioning, maintain their jobs, and do not need to resort to
crime. Yet the health impact on themselves and their families can be enormous.
There is an urgent need for greater public understanding about the nature of
addiction and a more understanding response by agencies. I have attempted to do
this with a paper to members of the four Norbury Residents Association
Committees, who have been concerned about the level of street drinking.
Inequalities analysis
In para 3.5 of the report the
Director states:
‘There
are many forms of health inequalities including those associated with
geographic deprivation, gender and ethnicity, and other protected
characteristics. To keep focus and manage within existing capacity, the report
will focus on geographic deprivation alone.’
I think that this will still give too
limited an understanding of how geographically concentrated heath inequalities
associated with gender, ethnicity and other protected characteristics will be,
as discussed in my paper to the Director last year.
Having worked with IT statisticians on
the Censuses in 1991 and 2001 in several local authority areas I am aware of
the fact that the kind of analysis that I advocate should be capable of being
done within current resources. If extra officer man hours are needed perhaps
they could be made up by IT apprentices.
Spending on Public Health and
Inequalities
In its answer (7 October 2014) to the
Freedom of Information Inquiry by Jack Stanson, for the separate
annual spend on some public health areas for 2014/15: the Council provided the
following information:
Sexual Health: £7,310,238
Drug
and Alcohol misuse: £2,713,371
Alcohol
misuse: £2,713,371
Smoking: £1,285,059
Obesity: £557,117
Physical
activity: £278,558
Total: £14,857,71
It would underpin understanding of inequalities and tackling them if there is a geographic breakdown of the spending on all the public health priorities.
Conclusion
I have emailed members of the Committee in the hope that while endorsing the theme of
the proposed 2015 Annual Public Health report they will agree that the Public
Health Director should produce a more in depth analysis than he is currently
proposing.
The Committee report can be accessed via
https://secure.croydon.gov.uk/akscroydon/users/public/admin/kabmenu.pl?cmte=HAS
https://secure.croydon.gov.uk/akscroydon/users/public/admin/kabmenu.pl?cmte=HAS
For further details about my two papers mentioned above contact sean.creighton1947@btinternet.com