People who are homeless, “looked after” children, and people in prison have been highlighted as among those most likely to suffer from avoidable ill health and die prematurely.
Dr. Eric Baijal stresses that tackling health inequalities in Highland’s rural and island communities will take a different approach from that adopted in the urban central belt.
He said: “We can’t address this issue simply by improving support and treatment services in particular neighbourhoods because many people who experience deprivation in Highland live in the same postcode area as the wealthiest. We have to identify those who are at risk through their circumstances and by the health problems that affect them. Alcohol-misuse, teenage pregnancy, smoking during pregnancy and self-harm affect disadvantaged people to a much greater extent than the well-off and they can trap people in poverty. Our challenge, and it must not be underestimated, is to improve the health of these less visible groups faster than the general population; to close the gap.”
Throughout his annual report Dr Baijal has underlined the need for partnership working to improve health.
“Health is determined by the complex interaction of many factors of which the provision of health care, particularly by general practitioners in primary care, is only one. We must work with our local authorities, government agencies, employers, voluntary groups and crucially with communities and individuals themselves to achieve change” he said.
A Highland Healthy Working Lives Partnership with employers is promoting workplace health. The NHS along with our partners particularly Jobcentre Plus is spearheading the “Unlock your potential” and Condition Management Programme to help people who are long-term unemployed back into work.
The annual report shows progress is being made in many areas. NHS Highland is on course or ahead of trajectory on targets for Coronary Heart Disease, smoking and suicide. However the Director of Public Health and Health Policy has identified new threats.
Almost every area of Highland has higher rates of alcohol-related admissions to hospital than the Scottish average. The Scottish Health Survey, last undertaken in 2003, indicated that 66.2% of the adult Highland population may be overweight or obese. This compares with 65.4% of the Scottish adult population.
Dr Baijal said: “Alcohol misuse and obesity may soon overshadow smoking as threats to public health. It has taken great changes in our culture and lifestyle over countless decades to get us to this point and it will take just as big changes to undo it. It sounds like a tall order but the change of attitude towards smoking proves that it can be done.”
Smoking remains the single biggest cause of preventable ill health and death and efforts will continue to reduce the death toll particularly among deprived groups who are more likely to be smokers. During 2006 NHS Highland set up a specialist smoking cessation service in all Community Health Partnerships and Raigmore Hospital (the Specialist Services Unit). Providers include 24 trained advisors (11 of them community pharmacists) in 36 clinic locations covering all areas of need. Nearly 700 participants have set a quit date in the first six months of 2007.
