NARROWING THE GAP What are we advising the July LSP Board to do next on NTG Narrowing the gap Changing context Approach Positive impacts / outcomes Challenges / Next steps Changing Context Public sector resources ( money and staff) reducing Slow growth or recession continues and increases the Gap Does our focus on NTG need to change Approach to date Assess need Know population High impact changes Implement evidence base/ or ensure evaluation undertaken Focus on target groups Lead organisation identified APPROACH Determinants / Prevention (long term) Early detection ( Short / medium term) Services to Make it Better ( Short term) Narrowing the Gap Themes Life Expectancy Adults basic literacy, numeracy and IT skills % Pupils achieving 5 GCSE A-C Young people not in education, employment or training (NEET) Fuel poverty Residents satisfaction levels Super Output areas in 5% most deprived nationally Feelings of safety Crime rates Unemployment rates Causes of Death Accounting for Lower Life Expectancy in Deprived Areas Source: Association of Public Health Observatories and Department of Health Risk factors Smoking accounts for half of the difference in life expectancy between best /worst areas Other major contributers Physical activity Alcohol Diet 2 case studies breastfeeding and smoking Identify need Segment population Understand what approach works for segments Breast feeding infant inequalities Our vision is to improve the health of the people of Calderdale, one step on this journey is to encourage mothers to breastfeed We want to increase and sustain the uptake of breastfeeding for new mums in North Halifax, specifically in Ovenden, Illingworth & Mixenden Within six months, we hope to see: - 10% increase in new mums having attempted to breastfeed at the time of discharge from hospital - 5% increase in new mums breastfeeding at 10 days - 3% increase in new mums breastfeeding at 6-8 weeks Insight research highlighted two main barriers to breastfeeding attitude and lack of belief that breast milk is superior to artificial milk Developed a six month marketing campaign targeting year old females in North Halifax (January 09) The campaign and messages have been tested by the target audience at each step A need for information before birth and support during breastfeeding clearly exists Attitudes Towards Breastfeeding Attitudes towards breastfeeding varied, however most do feel that it is not the norm and is frowned on by some in public, possibly the older generation? For some there are two hurdles to get over; breastfeeding at all & breastfeeding wherever Mums need/want to. This supports the need for the campaign to support Mums who do want to try breastfeeding and to reinforce the benefits. Positive Some Mums are positive regarding breastfeeding The benefits are seen as:- Naturalness Closeness with baby Some health benefits Mixed Some acknowledged the benefits but also felt embarrassment at breastfeeding in public and had experienced physical difficulty with breastfeeding Negative Some feel that health professionals try to force breastfeeding on Mums Formula was seen as equal to or superior than breastfeeding by some Lifestyle Context A Typical Day Mums feel that they are constantly busy, with weekends being much like weekdays, as all were on maternity leave and not working. Most try to get outside daily so a lot of small trips to the shops/window shopping occurs. Doing Chores At Home Looking After Children Attending Baby Groups Going To The Shops Sometimes Seeing Friends Social Networking Sites A Typical Day Mums can still have a social life & breast feed Educating friends re: acceptability of breastfeeding There are health benefits due to breastfeeding Key Messages Communicated By Each Advert You can breastfeed when you are out & about There are health benefits due to breastfeeding Some query whether breastfeeding is the norm currently This is expected to be very noticeable First is the bus company used most in the area. It is also more pushchair friendly in comparison to TJ Walsh Posters On/In Buses & At Bus Stops Stickers In Local Businesses This idea was welcomed as most Mums are not sure where they will be encouraged to breastfeed while out of the house A suggestion was made to swap over the text so that the welcoming breastfeeding is more obvious than the campaign tag line Campaign Delivery - Detail This was a popular idea of the respondents currently use Facebook, none were using Bebo and only a minority were using MySpace A snowball effect expected as many Mums felt that they would pass invites on to friends Ideally the Facebook group would include blogs to share experiences, an area to ask questions - ideally from professionals as well as other Mums FacebookWebsite This idea was liked as it is there if Mums want it as a resource for further informationCampaign Delivery - Detail Leaflets A number of locations were suggested, including; supermarkets, waiting areas, train stations & bus stations The leaflets are expected to be more noticeable than current leaflets on the subject as the colours are more eye catching/interesting Impact of campaign Changing Context Public sector resources ( money and staff) reducing Slow growth or recession continues and increases the Gap Does our focus on NTG need to change Challenges 1 What works elsewhere What should our focus be the 10 themes topic Eg Smoking population groups Eg young children or families Geographical Eg ward Short term or long term interventions - here and now or the next generation Challenges 2 People constraints (are people ready to change) better population segmentation to maximise impact Scale Large scale mainstream from small scale projects Resource constraints money Workforce ( skills and capacity) Narrowing the Gap Themes Life Expectancy Adults basic literacy, numeracy and IT skills % Pupils achieving 5 GCSE A-C Young people not in education, employment or training (NEET) Fuel poverty Residents satisfaction levels Super Output areas in 5% most deprived nationally Feelings of safety Crime rates Unemployment rates DISCUSSION What do we focus on to have the most impact in the next 3- 5 years ? What about the long term ? What are we are we advising the July LSP Board to do next on NTG NEXT STEPS WE HAVE REWARD MONEY BECOMING AVAILABLE WE HAVE MAINSTREAM INVESTMENT (subject to savings) ARE THE 3 AREAS THE LSP SHOULD FOCUS ON FOR THE BIGGEST IMPACT SMOKING EMPLOYMENT YOUNG PEOPLE (0-5) CONTINUE WITH THE 10 NTG THEMES (EFFICIENCY AND IMPACT) TEST WITH DELIVERY GROUP/ THEME GROUPS/LSP / SCRUTINY