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Growing healthy communities: The Health and Wellbeing Index

It has long been recognised that the health of a population is strongly linked to the circumstances in which people live. Our health and wellbeing index clearly supports
this assertion and highlights the extent to which economic, social and environmental determinants translate to good or bad health outcomes in their broadest sense. It also shows the scale and nature of inequality across the country and reiterates the need for a local, place-based approach to tackling health outcomes.

The wider economic determinants that affect health outcomes are often beyond the control of the NHS. It is becoming increasingly apparent that a number of outcomes can be influenced by other elements of the public sector, predominantly by local authorities, but also other bodies, including – as our Lancashire case study shows in a really positive fashion – the police. It is a factor that gives weight to the focus of providing a joined-up, multi-service approach to addressing public policy challenges at a local level.

The organisational and structural environment in which the public sector can effect these changes has arguably never been stronger. The renewed responsibility for public health given to local government in 2013 as part of the 2012 health and social care reforms, the creation of the Better Care Fund to encourage joint planning, the ambitious, leadingedge messages from the NHS chief executive in ‘The Five Year Forward View’, the creation of 29 vanguards and the developing devolution agenda, all point to the increased opportunity for public sector bodies to work together to answer the challenge of continued austerity and the NHS £30 billion funding gap by tackling prevention, rather than cure.

Given the financial and other pressures on local authorities, there needs to be a clear way to focus on determinants that will make the most difference. Health and well-being is an area where data is not in short supply. However, having a clear understanding of local dynamics can help CEOs and other stakeholders to navigate effectively through the mass of available data and to make decisions based on what it is that needs to be done here and now strategically to make a tangible difference. A correlation assessment of the health determinants measured and the outcomes shows that the determinants that most influence health outcomes are tackling child poverty, deprivation, unemployment, childhood education and social cohesion.

The reality of achieving successful collaboration is never as easy as it may sound. The purpose of this report is to help stakeholders – NHS providers and clinical commissioning groups (CCGs), local authorities, health and social care providers, housing associations, fire authorities and the police – to improve collaboration through a better understanding of the correlation between the economic, social and environmental health determinants and health outcomes within their locality. This includes enabling joint health and wellbeing strategies to be better targeted on actions that will make a difference. Alongside this, our presentation of the data is also designed to provide health organisations with an insight into some of the tools and information available to local authorities that more traditionally and readily have a
place-based approach to decision-making. We also provide a set of questions to help facilitate those discussions in the light of joint service needs assessments.