Better Health For All

• Helen Ross – Insight Specialist – Public Health
• Nottingham City Council

The second meeting of the Faculty of Public Health’s Strategic Interest Group for Sustainable Development on 4 December began with a reminder of the reasons why it is important for us to tackle climate change.

This was clearly illustrated by the photograph below of Cockermouth’s public illustration of the height of their floods in 2009.  Following the flooding, new and improved flood defences were installed.

Cockermouth’s public illustration of the height of their floods in 2009

However, they did not protect homes and businesses in the area from the severe weather event that occurred during the first week of December 2015 in the Lake District. Our thoughts go out to all those who have suffered as a result of the flooding, many of whom have experienced this for the second or third time in 10 years.

Evidence from the Lancet Commission and the Intergovernmental Panel on Climate Change (IPCC) confirms that an unsustainable approach to the future (including climate change) is almost certainly one of the biggest threats to public health this century.  Tackling this needs a transformation in the way our industries (including the health sector) and we as individuals carry out our business and day-to-day lives.  The evidence is clear and widely accepted that inaction is unacceptable; the multiple benefits for health are profound; and time is running out.

We were joined at this meeting by:

• Dr Stephen Morton, Programme Director, Sustainability for Public Health Benefits at Public Health England, who shared his thoughts about best value for public health return on investment
• Councillor Alex Norris, Nottingham City Health and Wellbeing Board chair and Executive Member for Adults, Commissioning & Health, and
• Councillor Rory Palmer, Deputy Mayor of Leicester City Council with the portfolio for Health Integration and Wellbeing and chair of the Leicester City Health and Wellbeing Board.

They offered their insights into Public Health and Sustainable Development in a Local Authority setting and Fernando Antezana-Aranibar: former Deputy Director General of the World Health Organisation gave his international perspective about Climate Change and health.

Key points emerging included:

• This is a very important issue for the Faculty of Public Health because:
  •    The health of the public, now and in the future, depends on us living within limits and developing all sustainable assets – environmentally, economically and socially.
  •    The natural and built environment, public spaces, transport, food supply, biodiversity, energy, education, employment, social capital, community resilience, diversity, social justice, and sustainable public services are fundamental to health, equity, and wellbeing.
  •    For environmental sustainability to be achieved, the health system – and society generally – must be capable of being maintained without depleting natural resources or causing ecological damage, so that environmental resources are available for future generations, both in the UK and around the world.
  •    Achieving our goals in sustainable and low carbon ways is critical to turning the biggest health threat we face into the greatest opportunity for collective action and health improvement.
  •    Ensuring environmental sustainability also ensures financial sustainability, and promotes social sustainability (making best use of all human and social assets including asset based community development approaches to public health).
  •    These approaches are fundamental to improving health and addressing health inequalities.  An unsustainable world harms the health of the poorest members of society disproportionately, both nationally and globally.
  •    Professional organisations such as FPH are crucial in helping professionals, public and the media in this transition. This is why FPH has established this Sustainability Development and Health SIG.
• The terms of reference were agreed: The aims of the SIG are to:
  •    drive forward strategic action that embeds the principles of sustainable development into all that the Faculty of Public Health stands for, in order to create a healthy, equitable and sustainable future.
  •    provide a focal point for FPH members who share a common interest in sustainable public health, and a forum for the exchange of ideas, knowledge information and the coordination of action.
  •    act as one of the expert resources on knowledge, practice and the development of policies and strategies in this field. The FPH needs to use all the competence and commitment within staff, Fellows, members and partners to develop, articulate and advocate sustainable development as a key part of the Faculty’s policies, training programmes and standards so that they closely align with FPH’s vision, mission and objectives.
  •    Assemble, co-ordinate and signpost to other resources the key evidence, science, policy, advocacy and actions in line with the FPH’s vision, mission and objectives.  There are well quantified co-benefits of tackling climate change for the health of the public in multiple areas, both immediate and long term.
  •    Closely align this work with the National Strategy for Sustainable Development in the Health and Care system and other key strategies around the wider determinants of health by:
  •    reducing risks (extreme events and disaster reduction, improved air quality; safer roads; reduced emissions; smarter ways of preventing the preventable);
  •    improving resilience and developing sustainable assets (education, good housing; life-enhancing public spaces, resilient people, vibrant culture);
  •    ensuring every opportunity, plan, policy, and contact contributes to healthy lives, healthy communities and healthy environments now and in the future.
  •    reducing the environmental impact of the health and care system and highlighting the potential health co-benefits of doing so.
  •    Work in partnership with other organisations and networks to exchange ideas and expertise
  •    Embed all of this into the professional development of its members (an example of a key sustainability competency for FPH Specialists is provided at Appendix 3).
  •    Build alliances with people with a broad range of perspectives; you do not have to be a member of the Faculty of Public Health to join the SIG.  However, Faculty of Public Health members will determine the direction of the SIG and the way that it operates to ensure that it is in line with our professional practices.

  Progress
  •    The FPH is one of the leading UK organisations to publish on health, sustainable development and climate change.
  •    There is already a significant reference to climate change and sustainable development manifesto in the most recent manifesto from the FPH.
  •    A well consulted national cross system strategy exists for the entire health and care system which is closely aligned with the values and remit of FPH members.
  •    There is a clear commitment from the FPH on Environmental Sustainability & Public Health Training in the UK with placements available in organisations such as the Sustainable Development Unit. •    The new Public Health Training Curriculum (2015) recognises that sustainability is fundamental and cuts across the entire curriculum; and includes a new learning outcome, “Demonstrate leadership in environmental sustainability with a focus on the links to health and climate change”.
  •    And finally, FPH has close links with the Climate and Health Council and is a founder member of the Alliance of the newly formed Health Professionals Alliance for Combating Climate Change (HACC) 2015.

The new FPH SIG is now developing a strategic work plan that takes a whole system approach which addresses human activity and health in its social, environmental, economic and cultural complexity coordinate action and provide leadership and strong voice – to support the organisation internally and its members, fellows and partners more widely.

The time is right to seize the day, build on FPH’s work on Sustainable Development and assure the future.

With thanks to David Pencheon, Lindsey Stewart, Femi Biyibi, James Smith, Jane Beenstock, Jilla Burgess, Sue Atkinson and Simon Capewell and all participants for their contributions and encouragement.