Better Health For All

Jim McManus is Executive Director of Public Health for Hertfordshire and President of the Association of Directors of Public Health.

Hertfordshire County Council recently approved its new Public Health Strategy (2022-2027), produced by multiple stakeholders including elected members. One of its main aims is to continue reducing the health inequalities existing in the county, which have been brought into sharp relief and worsened by the COVID-19 pandemic.

Our strategy recognises that Public Health has a major role to play in fulfilling the council’s corporate strategic priority – for our residents to lead healthy and fulfilling lives. We want to ensure we continue to develop and deliver a range of preventative services promoting health and wellbeing for all residents, particularly targeting people most in need. The strategy sets out the role of Public Health in getting there, and means citizens and partners know what they can expect of us.

This is important, because while the county’s health statistics are mostly favourable compared to national figures, there are persistent health inequalities, especially, but not only, in areas of deprivation. To take one example, we have historically significant and large Gypsy, Roma and Traveller populations across 55 sites. The work they are co-leading with us on suicide prevention, education and training and vaccination uptake will reduce inequalities.

The COVID-19 pandemic led to many more people experiencing inequalities through changed economic, employment or health circumstances.   Several new health challenges have also arisen in Hertfordshire, including long Covid, an increase in mental health needs, more widespread harm from drugs and alcohol and increased numbers of overweight and obese adults and children.

The new strategy outlines our vision and priorities and highlights how, informed by best practice and evidence, we will work with colleagues, partners and communities to reduce health inequalities and support healthy lives for all.

A great example of how we are already doing this, is our Shape Up Together programme. Originally launched as Shape Up in 2015 to address inequalities in mens’ access to healthy living support – it was funded by Public Health, the Premier League and Hertfordshire’s district and borough councils, and run by Watford Football Club’s Community Sports and Education Trust. Delivered free, the programme aimed to improve the lives of men with a BMI of above 30 through bespoke programmes. Since its launch, over 1,000 people have collectively lost seven and half tonnes of weight and that’s just one outcome.

Although Shape Up continues to run, last year we identified a need to develop a programme aimed at some of our Black, Asian and Eastern European populations, people with a physical and/or learning disability and people with severe mental health issues. As a result, Shape Up Together was born. Although still in its early days, Shape Up Together (which is open to both women and men) is set to be as successful as its predecessor.

In May, we invited community and voluntary organisations to apply for grants of up to £10,000 each, funded by Public Health, to develop innovative community projects which responded to local needs and focused on promoting mental health wellbeing through physical activity.

With a specific remit to tackle inequalities by building resilience for residents with low to moderate mental health problems, the programme has awarded just over £100,000 to 15 local organisations.  Successful projects included some very creative ideas, from dancing and Nordic walking to horticultural gardening and wild play. We are working on strong pathways between these projects and Money Advice services to reduce financial inequalities too.

Equitable digital inclusion is a corporate priority for us, but lack of availability of online access must not disproportionately exclude lower-income areas. We are using Togetherall, an evidence-based, clinically-moderated, online 24/7 peer-to-peer mental health community, for residents aged 16+ who are feeling low or depressed. It can help prevent mental health unwellness with support and courses, plus the additional benefit of professionals monitoring for signs of distress. This is just one tool in our kit of mental health support, ensuring those disadvantaged by limited access to other services have an option, but at the same time we’re working to make digital access itself more equal.

With the full support of our Executive Member, Morris Bright MBE, who was persuaded that part of our work was identifying what our role was in a world where COVID-19 has worsened health inequalities, we hope the strategy will set us on the road to tackling these inequalities and placing Public Health firmly at the centre of a forward-thinking council whose aim is to help our residents lead healthy, happy, and fulfilling lives. You can read the strategy here.

Jim McManus