Conference feedback

Almost 180 people attended a one day conference which launched East Lothian’s Equally Well test site – Support from the Start.

The day was started off with Dr Sue Ross Executive Director of Community Services for East Lothian Council welcoming participants and setting the scene for the day with a description what the test site hopes to achieve. 

The keynote speaker for the morning was Dr Harry Burns – Chief Medical Officer for Scotland – who spoke about the ‘Need for action’ to tackle inequality in health. He explained the latest research on the causes of health inequality and emphasised the importance of intervention in the early years of life if Scotland is to redress inequality in health outcomes. Dr Burns presentation made it very clear that the environment that children are brought up in has a clear and direct influence on physical and mental development in a way that can continue to influence responses to social and environmental stimuli in later life. His central thesis, from a variety of research sources, was that environmental, social and psychological influences that produce an inconsistent parenting environment creates a physically evident stress response in children. In turn this stress response prompts maladaptive responses in the way that children respond to the physical, social and psychological environment they inhabit and this produces health and social problems both in childhood and later life. 

Participants in the conference were invited to discuss what they had heard from Dr Ross & Dr Burns in the light of their own concerns for health and well being in their service areas. Having identified their concerns for trends in health they looked at the consequences of these concerns / trends if nothing was done to address them. Finally they were asked to think what could be done to address the consequences they had identified and in particular to complete the statement  – We will tackle inequality in health by……  A summary of the output from the discussion can be found here. These statements will contribute towards an action plan for Support from the Start

The morning session was closed by Don Ledingham Acting Executive Director for Education and Children’s Services for East Lothian Council with a presentation on the theme of – ‘A call to Action’. Don Ledingham’s presentation focused on the need for a sense of ‘belonging’ in children and communities as an essential part of what is required to create the circumstances for god health. He emphasised that services had a responsibility to generate that sense of belonging in all children, and that unconditional positive regard (or in old money – love)  was essential to achieve this. He also pointed to free school entitlement as a marker for many of poor social, educational and health outcomes that Support from the Start seeks to address and suggested that this would be one way of making sure that the right suppport is reaching the right people.

The them of the afternoon session was creating a ‘conversation’ about health and inequality that actively engages communities and families. The session was opended by East Lothian’s Depute Provost, Councillor Roger Knox who spoke about the importance of making connections, and reaching different parts of the community with support and information.

The keynote speaker for the afternoon session was Andrew Lyon of the Intrnational Futures Forum. Andrew’s presentation focused on how we think about the future, and critically that our individual and collective futures are created by what we do in the present. He talked about the role a ‘civic conversation’ can have in shaping our understanding of the present and future, by bringing together the many different perspectives that exist about the same issues to create a shared understanding of what is needed and what is possible.

Th table discsussions in the aftenoon focused on what communities could do to create a conversation about health and inequality. Folowing the same process as the morning the participants genrated – We will ….. ‘ statements and these will aslo be usedto form the action plan for Support from the Start.

The conference was closed by Alan Blackie, Chief Executive of East Lothian Council. His presentation was on the theme of ‘Keeping the conversaton going’. he emphasised that Support from the Start was not a short life project but a focus within mainstream services on tackling the kind of inequality in health that can be passed from generaton to generation if action wasnt taken to break the cycle. He made it clear that this could not be achieved without the active engageent of families and communites and that a consistent and creative dialogue had to be  developed with communities on this issue. This dialogue or conversation was not the purpose but a means to ensuring that services were doing all that could be done to redress inequality in health and improve life chances for children in East Lothian.

Copies of the presentation and a summary of the ‘We will statement will be posted here shortly.

Dr Harry Burns presentation slides dr-harry-burns-part-1 dr-harry-burns-part-2 

 Andrew Lyons International futures forum Andrew Lyons presntation equally-well-east-lothian-march-09

Regards

Steven Wray

Support from the Start

Scotland’s public health minister Shona Robinson chaired a ministerial taskforce to look at how Scotland can challenge the kind of inequality that leads to significantly different health outcomes for different parts of our community. The taskforce published a report called ‘Equally Well’ which amongst a number of recommendations called for the setting up of ‘test sites’ to lead on the learning that is needed to address the issue of health inequality. East Lothian has been selected as one of eight test sites in Scotland with a focus on early years and parenting. We have called the test site in East Lothian ‘Support from the Start’ to reflect the aim of ensuring that communities and services are doing all that is possible to address the health needs of the youngest members of our community in the areas where we know that health outcomes are poorest.

Support from the Start is not a short term project but rather a focus within all mainstream services on health inequality in the early years of life. Governance for the programme will be provided by a steering Board consisting of Councillor Roger Knox (Depute Provost & Health Spokesman); Councillor Ruth Currie (Cabinet Member for Joint Future & Community Care & Youth Champion); Sue Ross (Director of Community Services & Chair of Joint Health Improvement Project Board); Don Ledingham (Acting Director of Education & Children’s Services & Chair of Children’s Services Chief Officers Group); Gerry Power (General Manager East Lothian Community Health Partnership)  This group will provide strategic leadership and ensure that all relevant planning groups are involved in developing Support from the Start.

Four broad outcome areas for mainstream services in relation to health inequality have been identified:-

  • Community Engagement with key health issues in the early years,
  • Improving Support for Parents & Carers,
  • Improving Support for Families,
  • Creating Child Friendly Environments

We know that there is already lots of good practise in these areas but ‘Support from the Start’ will be asking service providers to review what they are are already doing with the following questions in mind : –

  • How do we get our communities, parents and children involved in key health improvement challenges for the early years of life? e.g. increasing the number of breastfeeding mothers, reducing passive smoking in the home environment, increasing physical activity levels of children in the early years, improving diet and dental hygiene
  • Do East Lothian services make it easy for parents to be ‘good enough’, and can parents access the right support, early enough when they are finding it hard to cope?
  • How do we target support for children and families that are at risk of poor health, and is it effective?
  • Does the physical space of our communities contribute to creating good health in the early years and support parents in raising healthy children safely

 Key to ensuring success in this endeavour will be engagement, leadership and learning. A process has started to identify individuals from across a range of services who can act as ‘champions’ for ‘Support from the Start’. These champions will be tasked with creating a learning environment in their service areas on the issues of health and social justice related to tackling health inequality in the early years. The champions will be contributors to this blog.

My hope for this web log is that it will be a space in which discussion and reflection on the complex task of reducing health inequalities in East Lothian can be supported and encouraged.

All views and opinions welcome.

Steven Wray

Health Improvement Development Officer