Citizen Health Experts doing it for themselves: increased personal autonomy and responsibility for health

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1 Citizen Health Experts doing it for themselves: increased personal autonomy and responsibility for health Professor Kevin Fenton National Director, Health and Wellbeing Public Health England September 2016

2 Contents Health and Wellbeing in England today - Why we need Citizen Health Experts The changing landscape of citizen engagement and the role of the Citizen Health Expert PHE s Public Engagement approach to citizen engagement and some examples in action Concluding thoughts 2 Opportunities for prevention and improving

3 Health and wellbeing in England today Morbidity in England We are living longer Between , life expectancy in England saw a 5.4 year increase from 75.9 to 81.3 years (one of the biggest increases in EU15+ countries). This is mainly due to falls in the death rate from CVD, stroke, COPD and some cancers. But we are spending more years in ill-health. For several conditions, although death rates have declined, the overall health burden is increasing. Deaths rates from diabetes fell by 56%, but illness and disability associated with diabetes went up 75%. Sickness and chronic disability are now causing a much greater proportion of the burden of disease Getting serious about

4 Health and wellbeing in England today Social and structural determinants While life expectancy has increased overall, there has been little, if any, improvement in inequalities While individuals behaviours do matter (for example, studies show around half of the health inequalities between rich and poor are the result of smoking), the reality is that our health is impacted by a range of wider determinants including: good employment higher educational attainment safe, supported, connected communities poor housing and homelessness living on a low income social isolation, exclusion and loneliness stigma and discrimination 4 Getting Getting serious serious about about prevention

5 Health and wellbeing in England today Why we need citizen engagement Opportunities for prevention and improving

6 A changing landscape of citizen health engagement Role of social media in connecting people and raising awareness of health issues that may have not been visible Rise in advocacy e.g. online petitions The immediacy of smart phones and social media to spread the word Volunteering as the bedrock of community action Peer support roles Social movements, e.g. Dementia Friends Crowdsourcing 6 Getting serious about

7 What is a citizen health expert? Citizen Health Experts? Citizen engagement people engaged in taking more responsibility for their own health and that of others. Community engagement people coming together with others to take action and improve population health or health services, including volunteers Public engagement exemplifying this behaviour in our own organisation through engaging citizens in our work. Health and care services also include citizen health experts in care and treatment such as expert patient programmes, patient activation, personalisation/ personal health budgets, coproduction 7 Getting serious about

8 The role of community centred approaches in citizen engagement Community centred approaches: Local government and NHS, with third sector have roles to play Mobilise assets within communities, promote equity and increase people s control over their lives Approaches include strengthening communities, volunteer and peer roles, collaborations and partnerships; access to community resources PHE/NHS England : A guide to community-centred approaches for health and wellbeing briefing. 8 Getting serious about

9 PHE/NHS England : A guide to community-centred approaches for health and wellbeing briefing. 9 Getting serious about

10 The impact of citizen and community control on outcomes Increasing individual and community control is associated with more positive outcomes PHE/NHS England : A guide to community-centred approaches for health and wellbeing briefing Getting serious about

11 Is this a role for everyone? Not all individuals find it easy to participate for a variety of reasons e.g. lack of life chances, disempowerment Need to develop capability opportunity motivation 11 Getting serious about

12 A model of behaviour change: COM-B Behaviour results from the interaction of Capability, Opportunity and Motivation. The COM-B behaviour change model (Michie et al. 2011d) can be applied to changing citizen behaviour to become more engaged as health experts. This model (used by PHE and recommended in NICE Guidance PH 49) states that for a behaviour change to occur, Capability, Opportunity and Motivation is needed: 12 Getting serious about

13 PHE s Public Engagement Strategy Public Involvement in PHE PHE Executive PHE Board PHE s organisational approach to engaging citizens in the work we do. PI Steering Group PI Advisory Group People s Panel Public Opinion Survey PHE Working Groups and Committees Discussion groups, workshops and consultation events 13 Getting serious about prevention

14 Examples of citizen engagement: Dementia Friends The aim of Dementia Friends is to raise awareness of dementia in the community The PHE Dementia Friends campaign launched nationwide in May 2014 and ran until February Following the success of recruiting over 1 million Dementia Friends, Alzheimer s Society pledged to recruit 4 million dementia friends by Dementia Friends has gone global with the programme rolling out in Japan and elsewhere 14 Getting serious about prevention

15 Examples of citizen engagement: e-cigarettes Tobacco dependence is one of the hardest addictions to break E-cigarettes have a particular appeal as an alternative to smoking and are the most popular quitting aid in England In Britain, 1.3 million vapers have managed to quit smoking; a further 720,000 have given up both smoking and vaping The rise of e-cigarettes is a consumer-led phenomenon, almost entirely unmediated by the healthcare profession Clear parallels with the citizen-led approach to harm reduction seen during the early HIV epidemic 15 Getting serious about

16 Examples of citizen engagement: local health champions Use their own experiences to transform health and well-being in their communities. Empower and motivate people to get involved in healthy social activities and signpost people to support services. Influence and shape local services, increase public participation, initiate community development opportunities and gain skills to move into further training, volunteering roles and employment. 16 Getting serious about prevention

17 Citizen engagement in action 17 Getting serious about

18 Conclusions Citizen engagement is a growing area, particularly with social media and smart phones. PHE has a public engagement strategy and actively promotes this work. Engaging and empowering communities is an effective way of reducing health inequalities. Citizens experts can go a long way by doing it for themselves but they can go even further when supported by health professionals. As public health professionals we are the servants of the public. Our mission is to help them achieve their own ambitions for a healthier, happier life. 18 Getting serious about

19 Citizen Health Experts doing it for themselves: increased personal autonomy and responsibility for health Professor Kevin Fenton National Director, Health and Wellbeing Public Health England September 2016