1 Living in interesting times: Thoughts for DsPH in the 21 st Century Association of Directors of...

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Living in interesting times: Thoughts for DsPH in the 21st Century

Association of Directors of Public HealthVictory Services Club, London

13th May 2011

Dr Tony JewellChief Medical Officer for Wales

Tobacco killsMortality from lung cancer, 1991 - 2008 Source: World Health Organization

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Living in interesting times


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Male deaths 1848-1871 (average) and 2009

1848 - 1871 2009

Source: Office for National Statistics


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Significant progressReports of infectious disease in England and WalesSource: Health Protection Agency


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Heart disease is next?Selected causes of death, Wales, 1969 - 2009Source: World Health Organization


Prevention worksMale mortality from lung cancer, 1970 - 2006 Source: World Health Organization

0

20

40

60

80

100

120

1970

1973

1976

1979

1982

1985

1988

1991

1994

1997

2000

2003

2006

Euro

pean

age

-sta

ndar

dis

ed r

ate p

er

100,0

00

France

Sweden

UK


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Encourage

Enable

Engage

Exemplify

Catalyse

High excise taxesBan marketing practices

Address smuggling

(nb. Personal incentives)

NHS 'stop smoking' treatmentSmoke-free policies

Quit-linesPharmaceutical deregulation

Social marketing campaignsMore graphic warnings

Major news media assaultConstant revisiting evidence

“Denormalisation”

Smoke-free policiesClear messages from NHS

Consistent packageClear goals

Commercial arguments

The 4 E’s


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Improving quality

• Great progress in improving health service delivery and quality

• Still much work to do – learning from the best


Changing times and the end of eras


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The impact of poverty, neglect and hopelessness


Non evidence-based behaviour


Responses to human and natural tragedy

Source: NHS SDU

At least 15,000 people died prematurely as a result of Europe’s heat wave in 2003 in France1

1. Unprecedented heat-related deaths during the 2003 heat wave in Paris: consequences on emergency departments

Jean-François Dhainaut, Yann - Erick Claessens, Christine Ginsburg, and Bruno Riou.

Crit Care. 2004; 8(1): 1–2.

Published online 2003 December 4. doi: 10.1186/cc2404.

and Bhattacharya, S. (October 2003), ‘European heat wave caused 35,000 deaths’, The New Scientist. http://www.newscientist.com/article/dn4259


The origins of our trade


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Fusing a new model

Biomedical model

AgeSexGenderGenetics

EducationEnvironmentCultureEmploymentLifestyle

Social Determinant model

A new approach to Public Health


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The centrality of the DPH


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Collegial support


Global movements for health


Evidence

• Evidence is vital as it can be convincing

• Doesn’t always win the argument

• Need to close the gap between policy makers and evidence through better communication


Advocacy


Brokerage


Excellence


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The future

• Demonstrate daily the importance of Directors of Public Health

• Find new and different forms of communication

• Remember to have a voice

Diolch yn fawrThank you very much

[email protected] http://wales.gov.uk/topics/health/ocmo/?lang=enhttp://wales.gov.uk/topics/health/ocmo/?lang=cy

mailto:[email protected]

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