Reflections on one year as a Consultant in Public Health
Public healthy
by Andy T
1y ago
It’s that time of year when a new batch of freshly made Public Health Consultants roll off the public health specialty training scheme, and 80-odd new recruits begin their own journey. As my fellow consultant and former training pal here in the North West Steve Senior and I tick off our first anniversary of being a consultant, we thought it worth reflecting on our first year. We wanted to share our thoughts and tips in the hope that it will be useful for other consultants and for those on or thinking about joining the training scheme, our consultants of the future. We’ll miss you, training sch ..read more
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Poverty is poverty… isn’t it?
Public healthy
by Andy T
2y ago
I recently read an article about Bex Taylor, a primary school teacher and all-round-fantastic human being, who has been providing beds to children in Leeds who need them since founding her charity in 2018.  In that time, she’s given out more than 1,400 beds, mattresses, duvets and the like to children who otherwise would go without. Poor sleep and tiredness have a massive impact on children’s wellbeing, education and development and it’s staggering really to know how common the need for a proper bed is. So bravo, Bex. The article called the problem that Bex is doing her best to tackle “be ..read more
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Addressing the causes of the causes through a wellbeing economy
Public healthy
by Andy T
2y ago
*This article was written on behalf of the Wellbeing Economy Alliance on the launch of their Wellbeing Economy Policy Design Guide, and originally published here* — Those of us working in public health are interested in the causes of poor health and wellbeing, but also in ‘the causes of the causes’. Consider someone with coronary heart disease, for example, for which the cause is blocked arteries. But what caused the arteries to be blocked? Often, it’s an unhealthy diet. But what caused that? It’s a more difficult concept to grasp, but even what many think of as purely individual behaviours ..read more
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Picking our battles: public health in public
Public healthy
by Andy T
2y ago
I started thinking about this blog last year, when it was still basically socially acceptable to cough on strangers.  Simpler times.  It was to be about my worries that we were losing the battle for ‘hearts and minds’ on what public health is, and should be, and how we are occasionally our own worst enemies.     Then Covid-19 hit and I thought it wasn’t the right time to write about something I thought we don’t do so well as a profession, at a time when we were all working our arses off on what we do really well.  But, right from the outset of the pandemic I ..read more
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Proper prevention Part II: Shit Place Syndrome
Public healthy
by Andy T
2y ago
This is the second of two blogs on ‘proper’ prevention, with the first on the need for a general ‘shit life reduction strategy’ and this one on what I’ve come to think of as ‘Shit Place Syndrome’. Acknowledging ‘Shit Place Syndrome’ A quick thought experiment – two people, same income, one in a nice leafy area and one living in a run-down estate.  Who’s more likely to end up ill? What about you, would you rather have a 20% pay rise but live in a bad area, or stay as you are and live somewhere nice?  It’s not just about how much money you’ve got in your pocket is it? The places we liv ..read more
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For proper prevention we need a General Shit Life Reduction Strategy – Part I
Public healthy
by Andy T
2y ago
In health terms, ‘prevention’ basically means doing stuff that reduces risks to health.  Primary prevention focuses on the whole population to stop a problem occurring in the first place, for example through immunisation or discouraging smoking;  secondary prevention focuses on at-risk individuals and aims to nip an issue in the bud by detecting and treating it as soon as possible, like we do with screening programmes; and tertiary prevention aims to reduce the impact of an existing condition and maximise a person’s quality of life, for example through rehabilitation and ongoing supp ..read more
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Public health has a language problem
Public healthy
by Andy T
2y ago
How many of you were inspired to work in public health because you wanted to champion a sustainable place-based locality-level social movement to address the underlying upstream determinants of health agenda through a transformative bottom-up asset-based community co-production approach?  Not me, because I had no idea what any of that meant.  For those of you working in public health, I bet you won’t be particularly surprised if I told you that I’d come across phrases including “proactively maximize multidisciplinary ideas” and “intrinsically harness professional methodologies” in a ..read more
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Good intentions but the right approach? The case of ACEs
Public healthy
by Andy T
2y ago
Adverse Childhood Experiences (ACEs) are traumatic events that children can be exposed to while growing up.  These include the direct impact of suffering abuse or neglect, or the indirect effects of living in a household affected by domestic violence, substance misuse or mental illness.  The original ACEs study found that those with a higher number of ACEs were more likely to have physical and mental health difficulties and to engage in health-related risk-taking behaviours than those with less traumatic childhoods.  In the 20 years since the study was published the ‘ACEs moveme ..read more
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‘Wellbeing in every decision’: re-framing ‘health in all policies’
Public healthy
by Andy T
2y ago
We know that most of the things that influence population health — poverty, education, the environment, transport, work, relationships, safe and comfortable homes — are not really touched by what the money marked as ‘health’ gets spent on. If we’re going to make a big impact on health, what we really need therefore is an approach in which local and national decision makers explicitly consider health in all policies…. Luckily we do — and it’s called, nattily, Health in All Policies (HiAP). The WHO defines HiAP as “an approach to public policies across sectors that systematically takes into acc ..read more
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Investment in public health – we need better arguments, not better evidence
Public healthy
by Andy T
2y ago
Here in the UK, we’ll soon have a chance to make the case for investment in public health and prevention (again). The NHS 10 year plan and a spending review are on the way, and both the Prime Minister and Secretary of State have said that prevention is one of their main priorities. Should be an easy win. But it won’t be, will it? In public health we think arguments for investment are watertight, both economically (public health measures tend to give back more than they cost) and socially (keeping your citizens as healthy and content as possible should just be what Governments do, shouldn’t it ..read more
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