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Tackling Health Inequalities in North _ West Belfast


									Tackling Health Inequalities
  in North & West Belfast

Goretti Horgan
   Where this work came from…
• The need for this secondary analysis was
  identified as a result of work carried out within
  Investing for Health Improvement Planning
  workshops in N&W Belfast.
• Two Wellnet partners – NI Anti Poverty Network
  and National Energy Action NI – took the lead.

• A reference support group was formed to
  develop the brief and commission the work.
• NI Anti Poverty      • University of Ulster
  Network              • Health Promotion
• National Energy        Agency
  Action NI            • Save the Children
• DSD Housing          • North & West
• HEART Healthy          Investing for Health
  Living Centre        • North & West Health
• EH & SSB               Action Zone
• Queens University,
Inequalities the overarching theme:

    The secondary research has focused on a
    number of the key determinants of health and
    wellbeing namely:
•   Poverty incl. child poverty
•   Low income (employment & unemployment)
•   Fuel poverty ……with consideration given to the
    impact they have on Health and Social Exclusion
  The overarching purpose of the
          work was to ….
• Strategically address inequalities by directly influencing
  the focus and planning of health planners and policy

• To provide strong indicators and guidance for planners
  and decision makers, as well as community and
  programme providers on the type of effective work which
  will make a positive difference to the long term health of
  individuals, families and communities’

• To enable service providers to develop and deliver
The message many politicians may
      not want to hear…
Since socio-economic inequality is the main cause
of health inequalities, policy and practice towards
reducing inequalities in health must address the
broader inequality in society.
   What works to reduce health

Little evidence – from WHO, EU, UK or Ireland –
of effective interventions (not aimed at reducing
broader inequalities in society) that work to reduce
inequalities in health.
Poverty & ill-health in N&W Belfast
      High levels of deprivation and ill-health
       Interaction of layers of disadvantage…

                 Social distress seen in high levels
 of mental ill-health, especially depression and
Impact of stress on physical health

   Low income                     Stress

         +                          +

      Caring                     Smoking
  responsibilities                  +
                              Smoking more

 Impact of stress on diabetes and heart disease
 more than its impact on other health-related
Reducing impact of child poverty
  Much good practice e.g.
• SureStart
• Healthy Living Centres,
• Working in schools - to teach children relaxation
  techniques; self-esteem; how to talk about
  feelings; problem solving; healthy eating; anger
  management; physical activity
       Impact of the conflict

•   Over a third of all deaths in five postal
    districts – all in N&W Belfast
•   Same areas among poorest in NI

•   Psychological damage continues

•   Segregation + FEAR
Tackling the Impact of the Conflict
 • High levels of mental ill-health due to combination
   of financial strain, caring responsibilities and
 • HLCs, community groups, women’s groups
   providing complementary therapies to relieve
 • Signposting to counselling and statutory services
 • Short term funding only
    Why such low levels of economic
•   Stress + anxiety of making ends meet
•   Mental ill-health in wake of conflict
•   High levels of fear across N&W Belfast
•   Low educational qualifications
•   Low quality of available jobs
•   Lack of childcare/caring services
• Poor public transport
     Key messages from research
• Community provision of health and health-related
  services must be additional and complementary to
  statutory services, not substitutes for services
  which are being cut.

• Funding for community-based preventative work,
  whether carried out by statutory or community
  organisations, should be ring-fenced and
• Long-term funding strategies need to be
  developed urgently for community-based
  services. Particular where cumulative
  disadvantage facing communities in N&W
  Belfast need to be included in regional funding

• A targeted advertising initiative and pension
  credit take-up campaign is needed to address
  the misunderstanding of the basis of pension
  credits as compared to other tax credits
          The interactions between:
                  • Poverty
                  • Conflict
           • Disability and ill-health
   • A low wage economy and employability

Requires greater attention by policy makers and
             needs more research.

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