A JOINT HEALTH IMPROVEMENT PLAN FOR EAST LOTHIAN
Joint Health Improvement Plan 2002 / 2003
East Lothian Council
Section 1:
1.1
Introduction
About East Lothian
Section 2:
2.1
2.2
2.3
What is health?
What is Health?
What is Health Improvement?
What are Health Inequalities?
Section 3:
Health in East Lothian.
3.1.
Health & Lifestyle in East Lothian
3.2.
A statistical profile of East Lothian
3.3.
Health & Environment in East Lothian
3.4.
Health & Housing in East Lothian
3.5.
Health & Social Inclusion in East Lothian
3.6.
Health & Education in East Lothian
3.7.
Health & Community in East Lothian
3.8.
Health & the workplace in East Lothian
Section 4:
4.1
4.2
4.3
4.4
4.5
4.6
4.7
Planning for Health Improvement in East Lothian.
Who is involved in Health Improvement?
Planning for Health Improvement
Health Well being & Lifelong Learning Forum
Health Promotion Network
East Lothian Joint Public Health team
Health Impact Assessments
Linked strategies and plans
Section 5:
5.1
5.2
5.3
5.4
The Community Plan Objectives for Health Improvement
The aim
The objectives
How do we know if we are making a difference?
Case Studies
The Joint Health Improvement Action Plan 2002 – 2003
5.5
Appendix
1.
2.
Charts showing statistical profile of communities within East Lothian based on School Cluster Areas.
Organisational Chart for health improvement Planning in East Lothian
Introduction.
The Scottish Executive view health improvement as a central theme of the Community Planning Process,
and have given Community Planning Partnerships responsibility for developing Health Improvement
Plans. The strategic documents that highlight the role of community planning in health improvement are:
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Our national health – a plan for action, a plan for change.
Rebuilding our NHS – a change programme for implementing Our National health
Partnership for Care
Improving Health In Scotland. The Challenge.
The overarching Social Justice Policy described in the document ‘Social Justice: A Scotland where
Everyone Matters’. (Scottish Executive, Nov.1999) sets out a programme to tackle poverty and injustice,
and includes a commitment to reducing health inequalities as part of a drive to build strong and inclusive
communities. The Social Justice Milestones provides a number of challenges to improve the health of the
most disadvantaged in our communities.
The shared vision for East Lothian described in the Community Planning document “Working together
for a Better East Lothian” (East Lothian Council 2000) is for:
“an East Lothian where Communities are vibrant with opportunities for
participation and development for people of all ages and backgrounds, where
services are people centred and responsive to community needs and where the
quality of East Lothian’s environment is recognised, valued and protected for
future generations.”
The importance of health in working towards the vision outlined above is underlined by the creation of
the Health Well Being & Lifelong Learning Forum as central co-ordinating forum with responsibility for
Health Improvement.
Section 1
1.1 About East Lothian
East Lothian is one of Scotland’s most scenic areas; it covers some 270 square miles, and includes some
43 miles of coastline.
Its population is approximately 90,000 with traditional industries of farming and fishing. Musselburgh is
the largest town the other principal towns being Haddington, Tranent, North Berwick, Prestonpans and
Dunbar. East Lothian shares border with Edinburgh City, Midlothian and the Scottish Borders.
Although often seen as a relatively prosperous area, East Lothian does have significant pockets of
deprivation often complicated by the rural nature of much of the area.
The population of East Lothian is growing with significant pressures for development of new housing. It
is estimated that East Lothian needs 10,000 new houses over the next 10-15 years to provide for the
growing population. In addition to this a further 40 hectares of land requires to be identified for new
business development.
It is known that many of the residents of East Lothian commute to Edinburgh to work. The escalation of
house prices and the growth of the Edinburgh economy and labour market have significant effects on East
Lothian.
In terms of health service coverage East Lothian Boundaries are co-terminus with the East Lothian Local
Health Care Co-operative and falls entirely within the Lothian NHS catchment area.
EAST LOTHIAN
Gullane
NORTH
BERWICK
Aberlady
MUSSELBURGH
DUNBAR
East Linton
PRESTONPANS
HADDINGTON
TRANENT
Gifford
Section 2
1.1 What is health?
The World Health Organisation defines health as a:
‘state of complete physical, mental and social well being and not merely the absence of disease or
infirmity.’
The following is perhaps a more comprehensive description of health:
“To reach a state of complete physical, mental and social well-being an individual or group must be able
to identify and to realise aspirations to satisfy needs and to change or cope with the environment. Health
is seen as a resource for everyday life and not the object of living. Health is a positive concept,
emphasising social and personal resources as well as physical capacities”
World Health Organisation 1986.
A model of health.
Below is a model that shows the several influences on health e.g. economic factors, physical environment,
social environment, individual response etc.
1.2 What is Health Improvement?
Health Improvement is a term that covers a wide area of human activity. The following three broad
themes are frequently used to describes areas where intervention can be made which will have outcomes
in relation to the health of individuals and communities
1. Life Circumstances – for example, through tackling unemployment, poverty, poor housing and
improving the environment and educational standards
2. Lifestyles – eating a healthy diet, taking more physical activity, reducing smoking, drug and alcohol
misuse
3. Health Topics – child health, dental and oral health, sexual health including teenage pregnancies and
sexually transmitted diseases, coronary heart disease cancer etc.
(Toward A Healthier Scotland, SODH 1999)
1.3 What are Health Inequalities?
Although Scotland’s health is improving it has a poor record of health compared to the rest of the United
Kingdom and to the rest of Europe. In general people live shorter lives in Scotland and are more likely to
suffer from preventable illness. However, even considering the Scottish populations relative disadvantage
compared to our European neighbours one of the most intractable and pressing issues for healthcare in
Scotland is that of inequality. The level of morbidity and mortality is not evenly spread throughout the
population. Socio-economic status is a major determinant of health status in Scotland. (Towards a
Healthier Scotland. SODH 1999)
The exact reason why health inequalities persist against a background of generally improving health is not
completely understood. However, it is most likely that life circumstances and lifestyles have a very
significant role to play in determining the increased mortality and morbidity in people and communities
with lower incomes. (Tackling Health Inequalities in Lothian. Lothian Health. 1999)
Health Inequalities are a major issue for promoting Social Inclusion. The Scottish Executives Social
Justice Milestones provide a number of challenges to improve the health of the most disadvantaged in our
communities. This East Lothian Joint Health Improvement Plan has taken the lead from Community
Planning Partners in adopting the Social Justice policy as described in the document ‘Social Justice: A
Scotland Where Everyone Matters, Scottish Executive, Nov, 1999) as it’s overarching strategic direction.
Section Three
3.1.
Health & lifestyle in East Lothian
Results from interviews with a representative panel of 1500 East Lothian residents (Citizens Panel) have
shown that most of the people living in East Lothian describe their health as good or fairly good. Those
who were over 60 or on a low income tended to describe their health as ‘not good’. A similar response
was found in the Scottish Household Survey as shown in the following table:
East Lothian: State of respondents health over past 12 months
(Banded net annual income Cross tabulation)
State of respondent
health over past 12
months
Good
Fairly Good
Not Good
Total
£0 £10,000
£10,000 £15,000
£15,000 £20,000
£20,000+ Total
48.1%
27.9%
24%
100%
42%
38.4%
19.6%
100%
57.4%
36.8%
5.9%
100%
68.9%
27.5%
3.6%
100%
55.3%
31.5%
13.2%
100%
East Lothian: State of respondents health over past 12 months
(Banded age of random adult cross tabulation)
State of respondent
health over past 12
months
Good
Fairly Good
Not Good
Total
16 –34
35 to 44
45 to 59
60 plus
Total
66.1%
28.3%
5.5%
100%
69.5%
24.4%
6.1%
100%
55.6%
29.3%
15%
100%
37.3%
40.1%
22.5%
100%
55.4%
31.4%
13.2%
100%
Constituency Health Report.
The Public health Institute for Scotland have provided health reports for each of the Scottish Parliament
Constituencies. The report entitled ‘A Profile of the health of the people in East Lothian’ (PHIS 2001)
summarises East Lothian’s Health as follows:
“A rounded view of the constituency would suggest that it has an above
average household income. Both the level of educational attainment
among school leavers and the rate of unemployment are fairly close to
the Scottish average. Whilst most of the health indicators are either close
to or better than the Scottish average the rates for stroke and cancer
mortality are higher.”
Constituency Health Report (PHIS 2001)
3.1.1
Health & Lifestyle in East Lothian.
Although health and well being is the result of a complex range of circumstances, there are particular
behaviours that are known to have a major impact on health. Behaviours such as smoking, our dietary
choices, the amount of exercise we take and how much alcohol we consume can have important
influences on how healthy we feel and what illnesses we are vulnerable to.
At the present time there is very limited data about the lifestyle of East Lothian residents in relation to
health. However, Lothian Health Board is addressing this with the development of the Lothian Health &
Life Survey. This survey is a cross sectional population survey of adults aged over 16 years in the
Lothian Health Board area.
It will use a self-completion questionnaire that has been developed from questions validated and used in
similar surveys. The actual sample totals 18,770 which will be stratified according to age, sex and LHCC
of residence. Separate data will be available for the East Lothian area with a sample size of 2,255. It is
also planned to follow-up a small sample with interviews. It is planned to repeat this survey at regular
intervals.
This survey should address the lack of information about health and lifestyle within East Lothian, and
assist with future project planning.
Tobacco
The Scottish Household Survey 1999/2000 does give some information in relation to smoking
as follows:
East Lothian: Do you smoke cigarettes nowadays?
(Banded age of random adult cross tabulation)
Do you smoke cigarettes
nowadays?
Yes
No
Total
16 to 34
35 to 44
45 to 59
60 plus
Total
34.4%
65.6%
100%
25.6%
74.4%
100%
25.6%
74.4%
100%
21.8%
73.2%
100%
26.8%
73.2%
100%
Frequency of use of sports & leisure facilities in East Lothian
The Scottish Household survey collects data on the use of sports / leisure facility. The following table is
adapted from the Scottish Household Survey (figures rounded to nearest whole number).
Frequency of respondents use of sport / leisure
facilities
Within Last Week
Within Last Month
Within Last Year
Longer Than Year
Never / Not Known
16 to34
26%
17%
23%
19%
15%
35 to 44
26%
11%
20%
16%
28%
45 to 59
13%
8%
14%
33%
32%
60 plus
8%
8%
3%
38%
45%
Total
17%
9%
14%
28%
31%
Frequency of respondents use of swimming pools
Within Last Week
Within Last Month
Within Last Year
Longer Than Year
Never / Not Known
16 to34
17%
17%
10%
23%
8%
35 to 44
19%
17%
10%
22%
24%
45 to 59
8%
10%
11%
58%
27%
60 plus
7%
6%
1%
45%
38%
Total
12%
11%
8%
51%
26%
3.2
A Statistical Profile of East Lothian
The Social Inclusion section of the Social Work and Housing Department East Lothian Council has
collated the data presented in appendix 1. It is modelled on the Public Health Institute for Scotland Profile
of Paisley. However, rather than political areas of geography it uses school cluster areas as the
geographical boundaries for data collection within East Lothian. These areas closely match the areas
defined as natural communities in work being done by the Health Intelligence Unit of NHS Lothian. The
charts in appendix 1 compare, where possible, data from East Lothian school cluster areas with Scotland
wide data.
East Lothian School Cluster Areas
North Berwick
Edinburgh
Dunbar
Prestonlodge
Musselburgh
Knox
Ross
M id lo th ia n
Borders
3.3
Health and Environment in East Lothian.
The earliest public health development in the United Kingdom began in the 19th century with pioneers
such as Edwin Chadwick, secretary to the poor law commission. He compiled a report, ‘The Sanitary
Conditions of the Labouring Population of Great Britain’, which resulted in the Public Health Act of
1848. This act established what is now the profession of Environmental Health. Local Authorities have
many statutory responsibilities to protect public health through advising, monitoring and enforcing on a
range of issues that can affect the public’s health and help to address social exclusion.
In East Lothian many of these functions are dealt with by the Council’s Environmental & Consumer
Services Department. The department covers Environmental Health, Trading Standards and Waste
Services. The following summarises the range of service activity which the department undertakes to
protect an improve health in East Lothian.
Activity
Description
Animal Health & welfare
Enforcement of Animal Health act in liaison with State Veterinary Service. Inspection of
farms, regulation of animal feedingstuffs, licensing of animal movements.
Monitoring of air pollutants, assessment of local air quality. Investigation of complaints.
Investigation of infectious food and water borne disease
Identification and prioritisation of contaminated land
Provision of professional advice on environmental health, trading standards and waste
services matters to other council services in relation to planning applications, licensing board
reports etc
Clean Air
Communicable Disease
Contaminated land
Development control,
building control and liquor
licensing
Environmental radiation
Food Safety
Occupational Health &
Safety at work
Licensing
Noise pollution
Pest Control
Public Health Protection
Trading standards
Water quality
Waste management
Monitoring of environmental radiation
Inspection of food businesses, licensing of butcher shops, regulation of specific food
manufacturing premises, investigation of complaints, sampling of foodstuffs, inspection of
food, food hazard warnings / management, enforcing food standards
Programmed workplace inspections, ad hoc surveys, ad hoc surveys, investigation of
accidents, pursuit of complaints, health & safety promotion to over 1500 businesses in East
Lothian
Licensing for a range of sites and activities such as petrol storage, caravan sites, riding
establishments, sale of fireworks etc
Investigation & pursuit of complaints of noise nuisance,
Advice and information about rodents and insect pests, & enforcement
Investigation and enforcement of powers designed to prevent public health nuisance or
detriment, through dampness in houses, defective structures, premises and drainage systems
Investigating consumer complaints, information and advice to consumers & businesses.
Inspection & regulation of businesses in relation to weights and measures, product safety, qnd
other trading standards legislation. Enforcement of Underage sales legislation in relation to
tobacco, fireworks etc. Advice and regulation about consumer credit and fair trading.
Programmed sampling of public and private water supplies. Monitoring of leisure waters &
bathing water quality
Provision of refuse collection, recycling and waste disposal services. Developing future
waste strategy
Key Strategic Planning links to health Improvement.
Environment Strategy East Lothian Council – 2002 –2005
East Lothian Council – Air Quality Review & Assessment 2000-2003
East Lothian Council – Contaminated Land Strategy – 2001
East Lothian’s Local Bio-Diversity Action Plan
Lothian & Borders – Area Waste Plan - 2003
3.4
Health & Housing in East Lothian
A decent and affordable home in a good environment is a pre-requisite for health of the people who live
in it. A well insulated, warm, damp free and secure home is vital to people's physical, mental, social, and
general well being.
Homeless people are often unable or unwilling to access mainstream services such as primary care
services, psychiatric care, counselling, support and education. This can result in poorer health compared
to those living in a secure home.
East Lothian has a growing population and it is expected to grow by a further 11% by 2015. People
moving to East Lothian from outside the area fuel this growth. The buoyant Edinburgh economy has
caused a very rapid increase of house prices, which means that housing is becoming less and less
affordable too many people on low incomes. All this has led to increasing pressures on housing that is
reflected in a growing problem of homelessness in East Lothian. Around 950 households applied to the
council as homeless every year. This is above the national average for Scotland.
East Lothian Council Social Work& Housing Department have developed a strategy for dealing with the
housing problems in East Lothian – The Local Housing Strategy 2002- 2012, currently undergoing a
consultation process.
The strategy has five objectives as follows:
Objective 1 – to promote and enable sustainable communities
Objective 2 – to promote and enable sustainable housing
Objective 3 - to increase the supply of affordable housing
Objective 4 – to prevent and reduce homelessness
Objective 5 - to provide and enable appropriate housing provision for people with particular needs
Key Strategic Planning links to health Improvement.
Lothian Health & Homelessness Action Plan
Homelessness Strategy 2003 – 2008 (East Lothian Council)
Local Housing Strategy 2002- 2012
3.5
Health & Social Inclusion in East Lothian
Social Inclusion and Social Justice is a cross cutting agenda for all the agencies involved in the
Community Planning Process in East Lothian.
Social Inclusion policies recognises the need for a healthy community to enable all of its members to
participate to their fullest extent. People may feel excluded if they have no direct access to services, or are
unable to have a voice in the way that the community is run. Or they may feel excluded because they have
special needs as a result of age, disability or health. It can happen to anyone but people at particular at
risk include:

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Children experiencing difficulties at school
Disabled people
Older people
Offenders and ex offenders
Substance misusers
Carers
Ethnic Minorities
Looked after children
It is now well recognised that the ability to feel involved in ones community and to have some sense of
control over ones environment can have a significant influence over the health of individuals.
Key Strategic Planning links to health Improvement.
East Lothian Social Inclusion Strategy – Consultative Draft, October
2002.
3.6
Health & Education in East Lothian.
It is well established that Health status improves with level of education.
Effective education for children and lifelong learning for adults are key contributors to health and
prosperity for individuals. Education contributes to health and prosperity by equipping people with
knowledge and skills for problem solving, and helps provide a sense of control and mastery over life
circumstances. It increases opportunities for job and income security, and job satisfaction. And it
improves people's ability to access and understand information to help keep them healthy.
Schools are also important settings for the promotion of good health this is reflected in the Health
promoting schools philosophy. The health promoting school is one which actively promotes the health of
students, staff and the wider community associated with the school.1
The World Health Organisation has described Health promoting schools as follows:
“The formal curriculum fosters informed choices and skills relevant to physical and social health and
personal development. The school ethos fosters good relations both among and between staff and
students. The physical environment is safe, hygienic and provides an environment which promotes work
and play. School policies and practices promote healthy eating, the use of protective equipment and the
management of violence and distress in students. The school-home-community interaction encourages
parent participation in the health promotion activities of the school. There is an organisational structure,
e.g. committee or team, within the school which focuses on the health of the school community. Health
services provide support with health screening, advice to those with chronic diseases and counselling for
those who are distressed or troubled.”
New Community Schools are a strategy that ensures that services work together to ensure that all children
can take the maximum advantage from the educational process as is possible. New Community School
resources in East Lothian are focused on vulnerable children and their families.
Community learning plans are being developed within East Lothian which aim to:
 Develop the individual through informal learning activities
 Build community capacity
 Invest and secure investment in community learning
Key Strategic Planning links to health Improvement.
Learning and Teaching for All - Consultative draft 2002.
East Lothian Community Learning Strategy 2000 – 2003
Edinburgh & Lothian’s Health promoting School Scheme
1
1. WHO Expert Committee on comprehensive school health education and promotion. Geneva: World Health Organisation,
1995
3.7.
Health & the Workplace in East Lothian
"Occupational Health is a serious issue that affects us all. It is estimated that in Scotland alone over
170,000 people have a health problem which they believe is caused by their work.
"This is bad for the individuals concerned, bad for their families, bad for business, and bad for the
economy. It is estimated that the Scottish economy loses 2.2 million working days each year due to
occupational ill health.”
George Foulkes (March 2001)
Workplace health creates a work environment which promotes positive health and well-being. There are
five major components to a healthy workplace programme.

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


Human resources and management practice, which includes training; counselling; mentoring and
the development of support networks for new or redundant staff; policies that address the needs of
parents, carers and the bereaved; incentive schemes; and the involvement of staff in decisionmaking
Health and safety, which includes the assessment and control of noise; physical and chemical
hazards; ergonomic problems; and the prevention of accidents.
Occupational health, which includes ensuring that people at work are fit for their tasks; screening
for occupational risks and diseases.
Transport and environment, which includes policies that encourage physical activity and support
sustainable development; and facilities for the disabled and others with special needs. Provision of
effective heating, ventilation and noise insulation systems.
Lifestyle, which includes a healthy eating policy in the staff restaurant; the development of a nonsmoking policy; and ways of encouraging people to become more physically active.
Taking this type of organisational approach to workplace health means establishing an integrated,
sustainable programme that reflects the priorities of the staff and organisation across each of these areas.
The HSE and Government aim to achieve the following by 2010:

A 20% reduction in the incidence of work-related ill-health;

A 20% reduction in ill health to members of the public caused by work activity;

A 30% reduction in the number of work days lost due to work related ill health.
Key Strategic Planning links to health Improvement.
Occupational Health & Safety East Lothian Council
3.8
Health & Community in East Lothian
It was noted above that health inequalities are one of the biggest challenges for health improvement in
Scotland. ‘Community Health Projects’ and a ‘Community Development Approach’ have been
highlighted as an important vehicle for ensuring that interventions are delivered to those most in need.
The Community Health Exchange views ‘Community Development’ as a process of:




Promoting learning, knowledge, skills, confidence and the capacity to act collectively
Taking positive action to address inequalities in power, access and participation
Strengthening organisation, networking and leadership with and between communities
Working for change through increased local democracy, participation and involvement in
public affairs
Taken together, evidence shows that these four processes can lead to communities having
greater control and influence on positive health, social, economic and environmental outcomes
which result in a better quality of life for all people.
East Lothian has a diverse range of volunteers and voluntary organization supported by Volunteer
Development East Lothian and the East Lothian Voluntary Organisations Network.
There are a number of specific ‘Community Health Projects’ in East Lothian:
Organisation
Changes
Roots & Fruits
Carefree Kids
Positive Parenting
Forum
Contact Details
82, High Street, Musselburgh, EH217BX
0131 653 3878
changes@changeschp.fsnet.co.uk
82, High Street Tranent, EH33 1HH.
01865 615423
emailelvon@scvo.org.uk
82, High Street Tranent, EH33 1HH
Prestonpans Partnership
Gardiner Terrace, Prestonpans. EH32 9RT
01875 814897
Remit
Promoting positive mental health
Providing access to fruit and
vegetables and promoting healthy diet
Provision of safety equipment to
parents on low income to reduce
accident to toddlers and babies
Supporting vulnerable parents
Key Strategic Planning links to health Improvement.
Community Planning. Working Together for a better East Lothian
Section 4
4.1:
Who is involved in Health improvement?
Health Improvement is everyone’s business. In section 2 the diagram showing the influences on
individual health makes it clear that many things contribute to shaping our health.
Clearly the services provided by the NHS have a central role to play in maintaining and improving the
health of the communities they serve. However, the Health Improvement agenda is wider than treatment
and care of members of the community who become ill. It is this wider agenda of prevention and
improvement that is the concern of the Joint Health Improvement Plan. Local authorities have a key role
to play in health improvement because of their role within education, housing, planning, environmental
health, leisure and recreation, and social care. All of these services have direct impact on health status.
The main participants in the drive to improve health in East Lothian include:

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


4.2
All departments of East Lothian Council
NHS Lothian
East Lothian Health Care Co-operative
New Community Schools
Health Promotion Network
Tranent Social Inclusion Partnership
Voluntary Organisation & Community Groups
The wider Community Planning Partnership
Private Sector
Planning for Health Improvement
The Community Planning partnership
The partnership provides a structure and process by which we can bring together the contributions of the
Local Authority, the NHS, other public bodies and voluntary and community groups into an agreed vision
for East Lothian. There are three main themes of the community plan each of which has it’s own planning
forum. The themes of the Community Plan are:
 Health Well being & Life Long Learning
 Enterprise & Skills
 Sustainable Development
An organisational chart has been appended to this document as appendix 2
4.3
The Health Well Being & Lifelong Learning Forum
The Forum considers a range of areas that affect our everyday life and explores how we can work toward
improving the health, well-being and lifelong learning opportunities of the individuals and communities
that make up East Lothian. They have put together a framework based around three main themes:
 Healthy Communities and Healthy Citizens
 Strong and Inclusive Communities
 Working and Learning Communities.
This forum has overall responsibility within the community planning process for the development and
production of the Joint Health Improvement Plan
4.4
The Health Promotion Network
The East Lothian Health Promotion Network is an inter-agency group that aims to promote health
improvement by enabling agencies to plan and work together in accordance with the principles laid out in
the East Lothian Community Plan. It is linked to the Community Planning process through the Health,
Well-being and Lifelong Learning Forum. The Network currently has six groups co-ordinating work
around health topic areas. The sub-groups are as follows:
 food and health
 mental health
 parenting
 peer support
 physical activity
 sexual health
The network has published an ‘ActionPlan’ which describe in detail the work of each of the above subgroups.
4.5
The East Lothian Public Health Team
The group complements the Health Promotion Network by providing specialist public health / health
improvement / health promotion advice, support and information and ensuring good communication
between East Lothian Council, NHS Lothian, ELHCC and agencies involved in the Health Promotion
Network.
4.6
Health Impact Assessments
Health impact assessments are a tool that can be compared to the more familiar environmental impact
assessments. These assessments are based on the presumption that human activity in one field is likely to
have consequences in another field of life. Health Impact Assessments assist in the identification of
health impacts that may result from a particular development or policy.
The World health Organisation define Health Impact Assessment as follows:
“Health Impact Assessment is a combination of procedures, methods and tools by which a policy,
program or project may be judged as to distribution of those effects within the population”
World Health Organisation 1999
There are three levels of assessment that can be undertaken varying as to the intensity of the assessment
and enquiry.



Health Impact screening
Rapid Health Impact Assessment
Detailed Health Assessment
Health Impact Assessment is tool that can assist those responsible for planning and delivering services /
programs / policies to ensure that health impacts have been considered
4.7
Linked Strategies and Plans
Health and consequently health improvement is a very broad area which impacts on almost all services
and areas of human activity. Hence it is not intended that this Joint Health Improvement Plan will in
anyway encompass all activity related to Health Improvement within East Lothian. It focuses on the
objectives laid out in the Community Plan, but we remain aware that many other strategies and plans have
an important influence on Health Improvement within East Lothian. In particular the Joint Health
Improvement Plan recognises the contribution of the following plans to health improvement.

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

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
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Community Care Plan
Children's Services Plan
Housing Strategy
Community Safety Strategy
Domestic Abuse Strategy
Agenda 21 Action Plan & East Lothian Environmental Strategy
Health Promotion Network Action Plan
East Lothian Drug & Alcohol Strategy
East Lothian Local Transport Strategy
Local Structure Plan
ELHCC Service Plan
Social Inclusion Strategy
New Community Schools
East Lothian Homelessness Strategy
East Lothian Early Years Education & Childcare Plan
Strategy to increase Rates of Breastfeeding in Lothian
Education & Community Services Improvement Plan
Supporting People Strategic Plan
Section 5
The Community Plan and Health
5.1
In the Community Plan the Health Well Being & Lifelong Learning Forum states that its main aim
is:
” to improve the health of individuals and families and reduce health inequalities in
East Lothian”
[East Lothian Community Plan, 2001, Page 8.]
5.2
This aim will be realised by acting on the following objectives:






increasing the number of people participating in active leisure activities
producing healthy diet indicators
reducing the percentage of women smoking while pregnant
reducing mortality rate from cancer and coronary heart disease
reducing incidents of drug misuse
reducing unwanted pregnancies and sexually transmitted infections in
16 – 24 year olds . . .
[East Lothian Community Plan, 2001, Page 8.]
5.3
How do we know if we are making a difference?
A range of quantitative indicators are being tracked for each of the objectives stated above. Indicators are
chosen on the basis that they are able to show change over the period of the Community plan.
In addition to this the Health Promotion Network subgroups each have an Action Plan which details how
the partners within the network intend to measure their planned activity and outcomes.
The Joint Health Improvement Plan also draws on the corporate / service departmental plans of the
partner agencies which each have their own methods of measuring the effectiveness of their work.
Measuring quantitative change in public health, is well known to present numerous methodological
problems. The main difficulty being the length of time between an intervention occurring and any
expected health benefits becoming apparent. Another and more immediate method of evaluating health
improvement projects is through case studies. Case studies also have the advantage that they often
involve people as receivers of services in the process of evaluation It is important not to lose sight of the
people we are seeking to help, whose self esteem is a vital influence on their health in itself. The
processes used may therefore be as relevant as the outcomes and evaluation tools should reflect this. Case
studies provide one way of tracking process and how this impacts on people’s lives and their health.
5.4
Case Study 1.
Improving the access of school children to health information and support about mental / emotional
distress.
The following case study has bee been provided by Charmian Currie (Mental Development worker) –
Chairperson of the East Lothian Health Promotion network Mental health Sub –group.
Background to case study
Around 10% of 5 – 15 year olds in the United Kingdom have a mental disorder according to
a Office for National Statistics survey published in 2000 – ‘Mental Health of Children &
Adolescents’
Of this group 5% were diagnosed with conduct disorders
4% were diagnosed with emotional disorder (anxiety / depression)
1% were diagnosed as hyperkinetic
Risk Factors for Mental Ill Health in children included:

Higher incidence in boys

Lower income household

Separation of parents

Loss of parent

Parents have mental health problems

High levels of family discord

Parents in trouble with police

Recently split up with boyfriend / girlfriend.
The Identified Need
 To reduce stigma relating to health issues, particularly mental health
 To accustom young people to accessing mental health support/information. This aimed at increasing
their confidence in using health services in the future.
 To give advice/information.
 To address issues at an early stage or to prevent problems from developing
Approach To Meeting Identified Need
The development of Health Drop-in Clinics in upper primary and in secondary school. Last academic
year two were run in primary schools and one is about to commence in a secondary school. The
service provides:
 members of health staff available to answer questions/give advice
 leaflet pick-up
 library of health related books available to read during Drop-In
 letter writing service. The young people post letters during the Drop-In and get a reply the next
week. This can be anonymous if they choose.
There have not as yet been any funding implications other than the initial outlay for materials. The DropIns have been staffed by a Mental Health Development Worker (Health Improvement Fund) and a School
Nurse.
How The Project Is Meeting Needs
There was very good take up of the service in both primary schools. An
average of 30 young people attended each session. The letter writing service
proved to be particularly popular with an average of 25 letters being written
each session.
Each Drop-In was evaluated by use of a questionnaire on the last session. The
young people rated it very highly. The main part of their comments were about
them feeling that they benefited from having a safe place to go to discuss
problems and that they were able to address issues that worried them but which
they normally kept hidden.
Statistics were compiled on the main issues which young people presented with. These were found to be
stress and anxiety, feelings of depression, bereavement, parental separation and conflict and issues around
friendship. This information was later used in the writing of leaflets for schools as it informed us of what
young people need information about.
Strengths and Difficulties
This project proved to be very successful and the initial interest in the Drop-In which is about to
commence in a secondary school would indicate that it will receive a similar response. The Drop-Ins are
easy to organize and run, but the letter writing requires a large additional time commitment.
Unfortunately, the two primary school Drop-Ins have not been able to continue this term due to lack of
school nurse availability.
Future Planning
In order for this service to be developed, further resources are required in terms of staffing. One member
of staff with a remit to set up, organize the Drop-Ins and co-work them could allow for expansion and
make it a very successful project offered to a number of schools.
Case Study 2
Dunbar Grammar School Nutrition Action Group
Background to Case Study.
The Scottish Diet plan recommends that the following action need to be taken to develop a more healthy
diet



Reduce intake of the following:
Salt
Sugar
Saturated fats




Fruit
Vegetables
Oily Fish
Fibre
Increase intake of the following:
(Source: Eating For Health Targets 1995 – 2010)
The Identified Need
At the present time no data is collected on the eating habits of children in East Lothian. However, much
concern has been expressed on a national basis about the diet of children, and obesity is becoming an
increasing problem amongst children.
It is widely understood that eating patterns and choices tend to be established early in life, and hence it is
important that children understand the benefits of a healthy diet so that they can make their own choices
based on a knowledge of healthy eating.
The Dunbar Grammar School Improvement Plan is based on the National Priorities for Education set by
the Scottish Executive. Priority Five – Learning For Life - states that schools should “equip pupils with
the foundation skills, attitudes and expectations necessary to prosper in a changing society and to
encourage creativity and ambition.” Under the banner of this priority Dunbar Grammar has set itself the
following objective in relation to Health Improvement
“Develop a ‘Healthy Living’ strategy – explore and implement a range of initiatives
aimed at transforming Dunbar Grammar School into a healthy living school”.
Approach To Meeting Identified Need
Establishing a ‘School Nutrition Action Group’ (SNAG) has been an important step to achieving the
schools aim of becoming a healthy living school. The Health Education Trust defines a SNAG as follows:
School Nutrition Action Groups are school based alliances in which staff, pupils and
caterers, supported by health and education professionals work together to review and
expand the range of food and drink to increase the uptake of a healthier diet and ensure
consistent messages from the curriculum and food service.
The Dunbar Grammar SNAG is made up of people from a cross section of school life – parents and
school board member, teachers including the home economics teacher, representatives from school
catering, the school nurse, the new community schools co-ordinator and of course the headmaster. The
group has a direct involvement from the Pupil Council, who are regularly consulted on developments.
The school was assisted in developing the SNAG by the Health Promotion Networks Food and Health
group.
How The project is Meeting Needs
The Dunbar SNAG group has established a ‘Fruit Bar’, which is run by pupils and has just established a
‘Breakfast Club’. The ‘Breakfast Club’ is a new development for the school and is in the early stages of
establishment. The school has provided the resources to start the club but is hoping that it will quickly
become a self - sustaining resource. It currently has an average of twenty pupils attending it per day.
A small example of how a SNAG can work within the school environment is a request to the group made
by learning support teachers. The teachers found that the children in their class were beginning to flag by
mid-afternoon and asked the group if they had any ideas that could help boost energy and concentration in
the children. The group provided the class with a basket of fruit and suggested a 10 minute fruit break.
The idea was popular with the children in the class, and the teachers have noted an improvement as result
of the fruit break. The cost of this intervention for two learning support classes is £6.00 per week.
The Future
Dunbar Grammar sees the development of its SNAG group very much as part of the overall drive to
develop the school as a healthy living school. Head Teacher, Don Ledingham, also stresses the
importance of ensuring that nutrition and the wider health and community agendas are linked as part of
the schools involvement in the community of Dunbar.
The group’s immediate focus is on ensuring that the newly established breakfast club is sustainable.
However, the group is currently looking at the choices available in school vending machines, and the
availability of water in the school. A planned development includes a ‘Survival Cooking Course’ aimed at
first and second year boys, and participating in a cross-curricular audit of healthy living. This audit will
involve the whole school and aims to build a picture of both how health is managed within the curriculum
and of the school pupils’ knowledge of health as an issue.
The group will also be able to influence the developments taking place to the fabric of the school as part
of a Public Private Partnership (PPP).
Case Study Three
Warm & Well
Background to Case Study
The health impact of energy efficiency and the importance of tackling fuel poverty to address socioeconomic inequalities in health and promote social inclusion are now clearly on the national policy
agenda.
Energy inefficient, hard to heat housing impacts on health in three main ways:
cold and dampness have a negative health impact.

additional expense incurred by low income households trying to heat poor housing reduces
household resources available to protect or promote health in other ways and causes financial
hardship

energy inefficiency impacts on the economy and the environment as a whole, with long term health
impact on the population.
To tackle this problem the Warm and Well project was developed in partnership between Lothian Primary
Care NHS Trust, LEEP and East Lothian Council. Midlothian Council have recently joined the
partnership and West Lothian and Borders local authority areas have expressed interest in joining.
The Identified Need
Communities Scotland have undertaken research that estimate moderate fuel poverty2 affects 25 percent
of households in Lothian, Border and Fife, and extreme fuel poverty3 affects a further 7 percent. Poor
energy efficiency is thought to be a significant cause of fuel poverty. In the same area it is thought that
1.5% of dwelling have problems with moderate or severe dampness or condensation.
Older people and children are more likely to live in households with issues with energy efficiency and or
dampness.
Approach To Meeting Identified Need
Warm and Well was launched in May 2002. Its particular focus is on those whose health is suffering as a
result of fuel poverty. Local health and social care professionals identify clients whose health is impaired
by fuel poverty, poor housing and refer directly to Sitar Ramsay the Warm and Well energy efficiency
advisor. Warm and Well ensure clients access all energy efficiency benefits they are entitled to and hence
interventions are at no cost to clients.
How the Project is Meeting Needs
To date 24 referrals have been received in East Lothian, with the referral rate increasing steadily. Across
Lothian 79 referrals have been received and £98,000 of intervention funding has been allocated to these
2
3
Spend more than 10-20% of annual income on fuel without heating home to an acceptable standard.
Spend more than 20% of annual income on fuel without heating home to an acceptable standard.
clients, including the installation of 27 central heating systems. Current estimates are that Warm and
Well clients are saving on average £150 per year in fuel costs.
The Future
Warm & well has recently received an Energy Savers Award.
Based on existing data, the conservative estimate is that referrals will double in the next 6 months.
The project was consolidated by a grant award from the Energy Savings Trust of £180K. The eligibility
criteria for the award included a requirement to work in partnership with the health service, hence the
focus on a service based on referrals from health professionals4. The overall package of funding for
Warm and Well (including funding for interventions) is around £500K, with the majority of funding for
infrastructure (Warm and Well advisors) currently being from local authority partners.
The NHS funding to initiate this project was non-recurring for one year, with only £15K NHS funding via
the primary care development fund. More sustainable funding is being sought. The Warm and Well team
are seeking NHS funding to underpin a minimum of one of the Warm and Well advisor posts for 3 to 5
years.
Case Study 4
Supporting Parents – a Community Development Approach
As part of a multi-agency approach led by Tranent SIP through its established Health and Well Being
Group a range of professionals that include; Health visitors, Housing officers and voluntary sector staff
identified gaps in services to young parents. The service provides a range of relevant information and
advice that includes:



Further education opportunities
Welfare rights
Access to work
(parents can self-refer or may be referred by partner agencies)
A range of training opportunities have also been identified and been provided – again through a
collaborative approach courses have included Parenting Skills alongside a range of Issue Based inputs.
This work led to the setting up of a Women’s group (T.O.W.N.S.) originally based in Tranent Early Years
Centre. The group have grown in confidence and developed a wide range of skills.
They are now fully constituted and successfully applied for funding towards developing their own
programme of activities that includes crèche provision. Due to ongoing success of this group they have
outgrown their original premises and transferred to a larger venue.
Again through effective partnership working, further work with this client group has been identified and
the ‘Health and Well Being Group’ are currently identifying a mix of funding towards employing a fulltime parents support worker who will operate both in Tranent and surrounding villages.
4
The project has been extended with the agreement of the Energy Saving Trust to include social care professionals in line with
the Joint Futures Agenda. The focus of the work remains on people with health problems living in fuel poverty.
East Lothian Joint Health Improvement plan.
“Improving the health of
individuals and families and
reducing health inequalities
across East Lothian
”
The following Action plan describes the targets & indicators for each of the community planning objectives in the first table of each section. The
remaining tables describe the planned action by each department / agency for the year 2003–2004 which develop work towards achieving the
community planning objectives.
*Objective
1.1
Targets & Indicators
Community Plan Objective: - Increase Numbers of people participating in active leisure activities.
. No
1.1
Objective
Data Source
Increase
Numbers of
people
participating in
active leisure
activities.
Dept of Education New Computer System
& Community
will track use of leisure
Services
facilities.
Scottish Health
Survey (1998)
Scottish
Household
Survey (2000)
Lothian Health
Survey
*
Baseline Position
Proposed Target for June 2004
National
Children - one hour of moderate activity
most Days of the week
Adults should accumulate (build up) at least
Figures are for whole of 30 minutes of moderate activity on most days
Scotland % given are for of the week.
those who meet required All children should have two hours of
level of activity for
physical education in schools.
health
Adult Males 38%
Local
Adult Females 27%
(See Physical Activity Action Plan)
Boys
73%
1] To increase opportunities for people to
Girls
60%
participate in physical activities within their
local communities.
2] To provide training for staff and volunteers
Frequency of
to enable them to assist with the delivery of
respondents use of sport activity programs within community facilities
/ leisure facilities
and schools
3 To develop interest in exercise, recreation
and health related issues.
Source of Target(s)
Physical Activity Taskforce
(Scottish Exec)
Physical Activity Taskforce
(Scottish Exec)
Physical Activity
sub-group of Health
promotion
Network
Available in 2003/04
Social Justice milestone
Increasing the number of older people taking physical exercise and reducing the rates of mortality from coronary heart disease and the prevalence of respiratory disease. (No. 22)
*Objective
1.1
Planned Activity
Community Plan Objective - Increase Numbers of people participating in active leisure activities.
Agency
Planned Action
Health
Promotion
Network
Physical
Activity
Sub group.
Get Going – Physical Activity for young people (HIF); Dance/Drama project, TOPS programme (sport, dance, outdoor education) into the
community, increase participation among young people with special needs.
Ageing Well Project aims to improve and maintain the health of older people (50+ years) in East Lothian through increasing their physical activity
levels, increasing their access to leisure facilities and promoting the development of a locality wide multi-agency programme based on Ageing
Well principles, set out by the Active/Age Unit of Age Concern.
Paths to Health – project to promote walking amongst the inactive population and raise awareness of the health benefits relating to walking by
offering regular, led volunteer walks, and by producing leaflets to encourage independent walks. Primary Care Teams will refer patients to the
scheme where appropriate.
Promote Active Living Course which provides sports coaches with information on healthy lifestyles and how to pass on the message during
regular coaching sessions.
Agency
Paths
Steering
Group
Planned Action
Planning, development and promotion of pathways for cycling, walking and horse riding within East Lothian.
*Objective
1.1
Planned Activity
Community Plan Objective - Increase Numbers of people participating in active leisure activities.
Agency
Planned Action
East Lothian
Council
Social Work
& Housing
Domiciliary Care Team encourages people to get out and about with assistance thus maintaining independence.
Agency
East Lothian
Council
Environment
& Technical
Services
Planned Action
Residential Care Health Project
A programme of repairs include dropping kerbs at key points to facilitate wheelchair and pushchair access, & actively encouraging public transport
to be wheelchair accessible
Town centre improvements – prioritising pedestrians in Musselburgh & Haddington
Safer Routes to Schools – ensure new developments in school have designed into them a safe route ethos
Provision for Cyclists
Extension of cycle route to include a re-determined section of old A1 between Haddington & Dunbar.
Community Plan Objective 1.1 - Increase Numbers of people participating in active leisure activities.
Agency
East Lothian
Council
Education &
Community
Services
Planned Action
Provision of appropriate active play areas for toddlers, children and teenagers
Agency
East Lothian
Council
Education &
Community
Services
Planned Action
Encourage increased use of facilities provided for sport and physical activity.
Continue to provide swimming lessons to all primary school children, with additional support to children who do not reach standard
Physical education in schools
Provision of Outdoor education and adventure activities
Provision of Countryside Ranger led activities
Dance & Drama
Provision of sports and exercise facilities
Development of school facilities will release capacity in community leisure facilities in Musselburgh, North Berwick and Haddington and to a
lesser extent at the Meadowmill, Loch Centre & Dunbar facilities in the short to medium term.
On-going support for community groups and voluntary sector through free provision of staff and facilities to groups that meet the aspirations of
East Lothian Council.
Agency
NHS Lothian
Planned Action
Develop a strategic approach to physical activity with community planning partners & Implement the Lothian Physical Activity Strategy.
Target specific “at risk groups” to promote physical activity.
Work with the new national Physical Activity Taskforce
Objective 1.2
Community Plan Objective*:
No.
*
Objective
Targets & Indicators
Data Source
Produce healthy diet indicators.
Baseline Position
Proposed Target for June 2004
Social Justice milestone.
Improving the health of families by reducing smoking, alcohol misuse, poor diet and mortality rates from coronary heart disease. (No.18)
Source of Target(s)5
Planned Activity
Objective 1.2
1.2
Community Plan Objective*:
Produce Healthy
diet indicators.
Scottish Health
Survey
Lothian Health
(Annual Report
2002)
(Data for all
Lothian & Fife)
Agency
Health
promotion
Produce healthy diet indicators.
Diet indicators produced
in Scottish Health
Survey and ‘Towards a
Healthier Scotland’.
East Lothian Council is
working towards
producing a ‘healthy
food policy’.
Lifestyle Survey data for
2002 on percentage –
 Eating oily fish
(36%)
 Eating fresh fruit
daily. (27%)
 Eating potatoes (not
chips) pasta or rice
once a day or more.
(34.5%)
 Eating cooked
vegetables once per
day. (27.5%)
 Eating raw salad &
vegetables once per
day. (7%)
Eating for Health Targets for 1995 – 2010.
 400grams or five portions of fruit and
vegetables per day.
 Increase intake of oily fish
 Increase amount of fibre in diet
 Reduce sugar intake
 Reduce Salt intake
 Reduce intake of saturated fats.
Eating For Health: A
Diet Action Plan for
Scotland. (1996)
Support the establishment of School Nutrition
Action Groups (SNAGS)
Food & Health Subgroup of Health
Promotion Network
Planned Action
Gather information from across East Lothian on current practice and initiatives
Network
Food & Health
Sub Group
Promote the “Eating for Health” model in primary schools.
Audit school meals against national standards for school meals.
Produce materials for the promotion of healthy packed lunches
Support schools establish School Nutrition Action Groups (SNAGs)
Review nutrition education within the curriculum in accordance with the 5-14 National Guidelines for Health Ed.
Develop and implement a council wide policy on “Eating for Health”.
Contribute and commit to a Lothian wide Food and Health Strategy as an active partner in this group.
Review East Lothian’s position in relation to the recommendations of Scotland’s Health – a Challenge for us all – Eating for Health – a Diet
Action Plan for Scotland.
Agency
Education &
Community
services
Planned Action
Support schools to establish School Nutrition Action Groups (SNAGs)
Review nutrition education within the curriculum in accordance with the 5- 14 National Guidelines for Health Education
Review & develop provision of drinking water machines
Provide breakfast clubs at every primary school within Prestonpans & Preston Lodge High school
Objective 1.2
Agency
NHS Lothian
Community Plan Objective*:
Produce healthy diet indicators.
Planned Action
Promote a structured approach to food and health with our partners through the community planning structures.
Work with the national diet action co-ordinator, when appointed to ensure consistent implementation of the diet action plan for Scotland.
Tackle food poverty and reduce food related health inequalities.
Focus on children and their parents and deprived communities.
Take forward the objectives set out in Lothian NHS Board Breast - feeding Strategy. Ensure breastfeeding is supported by appropriate policy
and practice in the NHS and other workplace settings
Agency
Roots & Fruits
Planned Action
Agency
Planned Action
Social Work &
Housing
Residential Care health Project
Continue to provide:
A] mobile van service to communities poorly provided for by retailers, or where there are issues of deprivation
B] provision of a range of fruits for playtime snacks for children in nursery and primary schools.
C] support for food co-ops within East Lothian
Objective 1.3
Targets & Indicators
Community Plan Objective:
Reduce the percentage of women smoking during pregnancy.*
No.
1.3
Objective
Data Source
Baseline Position
Proposed Target for June 2004
Source of Target(s)6
Reduce
Percentage of
women smoking
during
pregnancy.
Public Health
Annual Report
(1999)
18.5% women who are
registered as pregnant
smoke.
In line with a reduction to 23% by 2005 and
20% by 2010
NHS Lothian
‘Towards a Healthier
Scotland’
ISD (SMR02 –
1998)
Lothian Health.
East Lothian.
N= 213 26.8% of
pregnant women.
(6.7% below Scottish
Average)
Public health
Annual Report,
(1999)
Lothian Health.
Low birth weigh babies
4.4%
(0.9% below Scottish
Average)
Objective 1.4
Agency Planned Action
Targeted smoking cessation support, pregnant women and their partners. Address Smoking at booking clinic and subsequently at antenatal clinics as
NHS
Lothian appropriate.
Training to be completed for midwives for ‘hard to reach’ pregnant smokers.
*
Social Justice Milestone
Improving the well-being of our young children through reductions in the proportion of women smoking during pregnancy, the percentage of low birth-weight babies, dental decay
among five year olds, and by increasing the proportion of women breastfeeding. (No. 5) Improving the health of families by reducing smoking, alcohol misuse, poor diet and
mortality rates from coronary heart disease. (No.18)
Objective 1.4
Targets & Indicators
Community Planning Objective*:
No.
1.4
Reduce mortality rate from cancer and coronary heart disease.
Objective
Data Source
Baseline Position
Proposed Target for June 2004
Source of Target(s)
Reduce mortality
rate from cancer
and coronary
heart disease.
P.H.I.S
Constituency
reports based on
General Register
Office for
Scotland figures
for 1998.
East Lothian Data.
National Targets.
Reduction in cancer rates consistent with a
20% reduction by 2010
NHS Lothian
All Cancer (N=237)
Rate per 100,000 = 3.4
(13.7% above Scottish
Average)
Reduction in CHD rates consistent with a
50% reduction by 2010
Lung Cancer (N=50)
Rate per 100,000 = 0.7
(11.2% below Scottish
Average)
CHD (N=196)
Rate per 10,000 = 2.8
(3.3% above Scottish
Average)
*
Social justice milestone
Improving the health of families by reducing smoking, alcohol misuse, poor diet and mortality rates from coronary heart disease. (No. 18)
‘Towards a Healthier
Scotland’
Objective 1.4 Community Planning Objective*:
Agency
Health
promotion
Network
Physical
Activity
SubGroup
Food &
Health subgroup
Reduce mortality rate from cancer and coronary heart disease.
Planned Action
Increase awareness about health and benefits of physical activity
Increase participation by young people with special needs.
Raise awareness of and link into local and national initiatives promoting active lifestyles
Increase physical activity levels in 5 - 18 year olds in Tranent, Dunbar & Prestonpans
Increase physical activity levels in 50+ age group – through Ageing Well Programme
Survey of current Food and Health initiatives in schools
Promote healthy snacks and meals within East Lothian Schools
Improve training for staff on ‘Eating For Health’.
Develop a council wide policy on ‘Eating for Health’.
Contribute and commit to a Lothian wide Food and Health Strategy as an active partner in this group.
Review East Lothian’s position in relation to the recommendations of Scotland’s Health – a Challenge for us all – Eating for Health – a Diet Action
Plan for Scotland.
*
Social justice milestone
Improving the health of families by reducing smoking, alcohol misuse, poor diet and mortality rates from coronary heart disease. (No. 18)
Agency
NHS
Lothian
Planned Action
Development of a Primary Care Coronary Heart Disease Strategy
Cardiac Rehabilitation Redesign
Train local people in emergency life support and healthy lifestyle information in areas where CHD discharge rates are high – Heartstart +
Development of Primary Care services indicators to be agreed with LHCCs / Localities
Offer one to one support for smokers wishing to quit across the county via General Practise
Support and training is available to any worker who is keen to develop their skills in smoking cessation support for the general population.
Multidisciplinary training in smoking cessation for young people provided for workers in Dunbar and Prestonlodge cluster areas
Agency
Prestonpans
Partnership
Planned Action
Develop and offer smoking cessation services for young people
Objective 1.5
Community Plan Objective
Reduce the incidence of drug misuse.
No.
Objective
Data Source
Baseline Position
Proposed Target for June 2004
Source of Target(s)
1.5
Reduce incidence
of drug misuse.
Local DAAT
154 individual patients
treated for drug misuse
per year.
Tackling Drugs in
Scotland.
Scottish Executive
2001.
Public Health
Institute for
Scotland –
constituency
report cards –
(Data recorded in
1998 Source:
Scottish office
Statistical
Bulletin, Criminal
Justice Series
March 1999)
Lothian &Borders.
Drugs related Crime
figures for 1998 for
Lothian & Borders.
Rate per 10,000 + 38
(N=3,357) Variation
from Scottish average –
37.7%
DAAT Report by
Hay and Gannon
Oct 2001
East Lothian
Opiates &
Benzodiazipines N=239
Problem drug Users
(N=779 or 1.6% of the
15 to 54 year old pop.
Scottish Average
=2.0%)
National Targets
Reduce the proportion of people under 25
reporting use of illegal drugs, and heroin use
by 25%, by 2005.
Reduce repeat offending by increasing the
number of drug misusing offenders entering
treatment from criminal justice diversion and
community disposals by 40% by 2004
Increase the number of drug mis-users in
contact with drug treatment and care services
in the community, by at least 10% every year
until 2005.
Reduce the proportion of injecting drug users
sharing needles and syringes by 20% by
2005, and reduce the percentage of injecting
drug users testing positive for hepatitis C by
20% by 2005. Reduce the proportion of
young people under 25 who are offered illegal
drugs significantly, and heroin by 25% by
2005.
Increase the number of Drug seizures by 25%
by 2004.
Increase the number of offences recorded by
Scottish Police forces for “supply or
possession with intent to supply drugs”, by
25% by 2004.
Reverse the upward trend in drug related
deaths and reduce the total number, by at least
25% by 2005.
Objective 1.5
Community Plan Objective
Agency
Al-Anon
Alcoholics Anonymous
AXIS
Brenda House
ELCA
Libra
MELD
SACRO Transitional
Care Service
Simpson House
Turning Point Scotland
- The Links Project
Agency
Social Work &
Housing
Reduce the incidence of drug misuse.
Planned Action
The voluntary sector provides a variety of support, advice, confidence building, decision making, planning ahead, daysupport programmes, relapse prevention, employment and training opportunities, detoxification and rehabilitation, guidance,
practical assistance with everyday tasks, information, counselling, self-help groups, family support, streetwork, education,
needle exchange, work with offenders, work with under-16s, harm reduction
Planned Action
Criminal justice Social Work interventions 
Carry out a feasibility study of a ‘court based’ arrest referral scheme for drug/alcohol users.

Develop a bail scheme for drug/alcohol users.

Ensure all assessments and programmes for all offenders on statutory orders address drug / alcohol related offenders.

Investigate feasibility of developing a police-led needle exchange scheme.
Funding provided for three new family aid workers who will be managed by children's services but linking in with other agencies.
Education &
Community
Services
Phase two of multi-agency training to support the Drug Ed. Programme (P1-S2).
Carry out audit of drug education resources in schools, including provision for ‘special needs’ pupils, and produce an updated list of curricular
materials.
Produce an S3–S6 School Drug Education Programme
A range of training courses to be provided via the staff development programme.
School guidance team training
Objective 1.5 Community Plan Objective
Agency
Lothian & Borders Police
Reduce the incidence of drug misuse.
Planned Action
Lothian & Borders Police continue enforcement work to disrupt trafficking and stifle availability of illegal drugs.
Develop closer links and relationships with drug enforcement agencies.
Drugs awareness officer to promote the availability of local confidential drugs line, and the benefit of ‘Crime Stoppers’.
Agency
The Alcohol Problem Service
Planned Action
Assessment and support, home and outpatient detoxification,
Community Drug Problem
Service
Assessment and treatment to drug users, oral methadone, specialist mental health interventions, community
detoxification, relapse prevention
East Lothian Locality Drug
Clinic
Fast-track assessment, advice & treatment services
Woodside Unit
Counselling, alcohol support group, anxiety group, stress management group, relaxation group
Garleton Ward
Day-patient detoxification, Antabuse supervision.
Soutra Day Hospital
Inpatient and day-patient detoxification, counselling, alcohol support group, anxiety group, stress management
group, relaxation group, weekly AA meetings, Antabuse supervision
Harm Reduction Team
Provision of harm reduction service including injecting equipment, safer drug/sex advice, low threshold
methadone programme, training in drug use interventions, joint co-ordination of pharmacy-based needle
exchange scheme
Objective 1.5
Agency
East
Lothian
Drugs and
Alcohol
Team
Targets & Indicators
Community Plan Objective
Reduce the incidence of drug misuse.
Planned Action
Drugs education in schools
Training programmes for community based staff on drug education, and examine education needs of specific groups such as foster parents and
looked after children
Develop support packages for drug misusing parent and their children
Examine models of user involvement that enable involvement in planning process.
Continue to support an monitor services provided by MELD, ELCA & Libra
Objective 1.6
Targets & Indicators
Community Planning Objective*:
Reduce unwanted pregnancies and sexually transmitted diseases in 16-24 year old group.
Source of Target(s)
No. Objective
Data Source
Baseline Position
Proposed Target for June 2004
1.6
ISD (2000)
Reduce
unwanted
pregnancies and ISD(2000)
sexually
transmitted
infection in 16-24
year olds.
35.9 per 1000 females
(N=127)
Figure for terminations
is for all Lothian (N= 71
for under 24 age group)
National Targets.
Reduction of 20% between 1995 & 2010 for
13 to 15 year olds.
NHS Lothian
‘Toward a Healthier
Scotland’
Reduce teenage terminations of pregnancy by
50% (1998 baseline)
Local Targets.
1] Improve access to and development of
local sexual health services.
Sexual Health SubGroup of Health
Promotion Network
2] Improve knowledge and skills of local
workers to undertake sexual health work
through training
3] Increase knowledge and awareness of
sexual health issues within East Lothian
4] Promote Joint planning and, strategic
development to influence and inform
community planning.
*
Social Justice Milestone
Improving the health of young people through reductions in smoking by 12-15 years old, teenage pregnancies among 13-15 year olds and the rate of suicides among young people.
(N0 11)
Objective 1.6
Reduce unwanted pregnancies and sexually transmitted diseases in 16-24 year old group.
Agency
Health promotion
Network
Peer Support Sub
Group
Planned Action
Development of peer support systems for young people across East Lothian in areas such as:
Conflict resolution / Anti-bullying / Curricular learning / Buddying / Mediation / Health improvement
Health promotion
Network
Mental Health Sub
Group
A range of initiatives to promote self esteem and problem solving skills for school aged children within the school
environment
Agency
Health promotion
Network
Sexual Health Sub
Group
Planned Action
Work within the communities of East Lothian to promote the sexual health and well being of those living in East Lothian
through planning service & training provision with individuals, communities, voluntary agencies, Health Services and the
local authority to address people’s needs.
Objective 1.6
Reduce unwanted pregnancies and sexually transmitted diseases in 16-24 year old group
Agency
Planned Action
Education &
Community
Services
Provide ‘virtual babies’ sessions, open to all pupils in S2 year at Dunbar New Community School
Social Work & Through children’s services support individuals identified as at risk, and support teenage parents.
Housing
Establish emergency accommodation for young people
Develop a project through the homeless families group that will address the recommendations from the homelessness report commissioned
by Tranent SIP and ELC housing
Appoint a development officer with the aim of developing an accommodation strategy.
Healthy
Agency
Respect
Demonstration
Project in
Musselburgh
area
Demonstrate
increased self-esteem and confidence among the target group resulting in a healthy respect for themselves and their
Planned Action
partners
Community
Nurse Service Health Visiting
Provide targeted and individually tailored support to all young mothers
Reduce pregnancy and termination of pregnancy rate amongst 13-15 year-olds in Musselburgh area.
Increase awareness of and reduce incidence of STIs especially Chlamydia
Objective 1.6 Reduce unwanted pregnancies and sexually transmitted diseases in 16-24 year old group
Agency
Planned Action
Tranent
Social
Inclusion
Partnership
Positive Parenting
Forum
Through Health & Well Being Group provide a network of continued health, housing and educational support to young people and
parents
T-BAG young
parents group
Provide community led peer support for young parents
Targets & Indicators
Community Planning Objective:
Promote positive mental health.
Objective 1.7
No. Objective
1.7
Data Source
Promote
positive mental Reported in Choose Life
National Framework for
health.
Mental Health
Office for National
Statistics survey
published in 2000 –
‘Mental Health of
Children &
Adolescents’.
Baseline Position
Proposed Target for June 2004
National
Amongst general population:
13% reported suicidal thoughts
4% attempt suicide
2% had deliberately self harmed
National
Reduce suicide rate by 20% by 2013.
Source of
Target(s)
Choose Life
National
Framework for
Mental Health
Around 10% of 5 – 15 year olds
in the United Kingdom have a
mental disorder.
Of this group 5% were
diagnosed with conduct
disorders 4% were diagnosed
with emotional disorder (anxiety
/ depression)
1% were diagnosed as hyper
kinetic
Reduce by a third the days lost every year
through exclusion from school and truancy.
Social Justice
Milestone
Reduce suicide rate amongst young people.
Social Justice
Milestone
Samaritans &
GRO (Scotland (1998)
Suicides in young Scottish men
33 / 100,000
Scottish Exec’
Exclusions from schools
2000/01.
Education & Community
Services, ELC..
Attendance & Absence
in Scottish Schools
1998/99 to 2000/01.
Scottish Exec’
Local.
Exclusion Rates
7.84%
(2.59% below Scottish Average)
Un-authorised absence
Primary
Secondary (excluding S6) 3%
(1% above Scottish Average)
ISD & HIU
Discharges due to self harm
Alcohol Related discharge from
psychiatric & non-psychiatric
hospitals
Local.
To improve delivery of and access to Tier 1
and 2 mental health services for young
people and their families.
Improve the co-ordination of services
delivered for Tier 1 & 2
Health
Promotion
Network
(Mental health
Sub-Group
Action Plan)
Objective 1.7
Community Planning Objective:
Agency
Health
Promotion
Network –
Mental health
sub group
Promote positive mental health.
Planned Action
Develop a co-ordinated, inter-agency approach
Develop effective referral systems
Establish local multi-agency mental health groups.
Increase awareness of mental health services available to young people and families in East Lothian.
Establish inter-agency training.
Agency
Education &
Community
Services
West Barnes
Primary School
Planned Action
Agency
NHS Lothian
Planned Action
Investment in child and adolescent mental health services
Roll out of new community schools – targeting vulnerable children and families.
Edinburgh & Lothian’s Health Promoting School Scheme promotes a whole school approach to promoting health. The
resources and scheme are currently being piloted across Lothian with West Barnes Primary school as the pilot site for East
Lothian.
Develop capacity of LHCCs and their primary care services to promote mental health and well being
Objective 1.7
Agency
Changes
Promote positive mental health.
Planned Action
Continue to provide a community access point for people to learn about positive mental health and positive coping strategies
Poster campaign aimed at young men
Continue to provide a range of courses promoting mental health .eg. relaxation, positive thinking.
Support the development of peer mentoring
Develop well being walks
Work in partnership with other agencies to provide courses to school aged children
Objective 1.8
Objective
Targets & Indicators
Data Source
National
targets for
Lothian Workplace
Securing Health Together
HSE Self Reported
Scotland’s
Health at Work
Promote
workplace
Health
Promotion
(Health
& Safety
(Scottish2003-2006.
Executive) Work Related Illness
Strategy
health
Executive)
Household Survey
2001/02
HSE Self Reported
Work Related Illness
Household Survey
2001/02
Scotland’s Health at
Work Database
Promoting Health in the Workplace.
Baseline Position
Proposed Target for June 04
National
2.3 million individuals in Great Britain
were suffering from an illness in the last
12 months, which they believed was
caused or made worse by their current or
past work.
National
20% reduction in the incidence of
work-related ill health.
33 million working days were lost in the
previous 12 months through illness caused
or made worse by work.
Scotland’s Health at Work
National
938 organisation are participating in
SHAW across Scotland.
30% reduction in the number of work
days lost due to work-related ill health
Scotland’s Health at Work
SHAW scheme to cover 40% of
Scottish workforce by 2006
300 additional SMEs across Scotland
to register with SHAW by 2003
To contribute to the targets for physical
activity, healthy eating, mental health,
drug misuse cancer and CHD for the
working age population.
Scotland’s Health at
Work Database
Local
Three organisations are participating in
SHAW in East Lothian
Source of Target (s)
Local
Increase the number of organisation
promoting health in the workplace with
particular emphasis on SME’s.
To encourage fifteen SME’s in East
Lothian to participate in SHAW.
Physical Activity Taskforce
(Scottish Exec)
Eating for Health: A diet Action
Plan for Scotland (1996)
Health Promotion Network
(Mental Health Sub-Group Action
Plan)
Tackling Drugs in Scotland
(Scottish Exec 2001)
Towards a Healthier Scotland
Objective 1.8
Promoting Health in the Workplace.
Agency
Planned Action
Lothian NHS Board
-
Take forward objectives set out in the Lothian Workplace Health Promotion Strategy 2003-2006
-
Raise awareness of workplace health promotion amongst employers and encourage them to promote health at work.
-
Increase the number of organisations participating in the Scotland’s Health at Work scheme.
-
Focus on small and medium enterprises (SME’s).
-
Provide ongoing advice and support to employers promoting health in the workplace.
-
Run training / seminars on workplace health issues in East Lothian.
-
Encourage partnership working with key partners such as Small Business Gateway and the Economic Development
Division at East Lothian Council.
East Lothian Council
-
To actively work towards the bronze award for Scotland’s Health at Work.
Prestonpans New Community School Cluster is implementing “Teacher Well Being” pilot to address health and
well being issues for all school staff
Lothian Primary Care
Trust

To actively work towards the bronze award for Scotland’s Health at Work.

Continue to offer staff opportunities to improve and protect their health.
Appendix
North Berwick School Cluster Area
Indicator
Value
Relevant
Time
period
Above/Below Scottish Average (%)
Source
Population aged 0-19
%
22.00%
-2.6%2000
a
Population aged 20 - 24
%
55.20%
-4.8%2000
b
Population aged 65 +
%
22.60%
7.2%2000
c
Lone Parent Household
%
2.00%
-3.0%1991
d
Lone Pensioner Household
%
20.40%
6.4%1991
e
Households with over 3 children
%
4.00%
-5.0%1991
f
Carstairs Deprivation: no car
%
15.5%
-18.3%1991
g
Carstairs Deprivation: male unemployment
%
6.94%
-6.0%1991
h
Carstairs Deprivation: overcrowding
%
3.30%
-4.1%1991
I
Carstairs deprivation: social class 4/5
%
16.48%
-3.3%1991
j
Wholly unemployed claimants
No.
51
June
k
Average House price - New Build
£
£131,30
94.8%1998-2002 l
Average House price - Second Hand
£
£117,66
91.4%1998-2002 m
Affordable Housing Need
Av
458
2001-2006 n
Free School Meals
%
5.10%
Clothing Grants
4.7
2000/01
School Attendance unauthorised absence- Secondary %
1%
-1.0%1998-2001 q
School Attendance unauthorised absence -Primary
%
0%
0.0%Sep-00
r
School Exclusions - Secondary
%
2.22%
-8.2%Sep-00
s
School Exclusions - Primary
%
0.20%
-0.8%2000/01
t
Educational attainment - Standard Grade
%
91%
14.0%2000/01
u
Educational Attainment - Higher
%
46%
24.0%2000/01
v
Destination of School Leavers: Further Education
%
12%
-8.0%
W
Destination of School Leavers: Higher Education
%
48%
16.0%
X
Cancer registrations
CR
586.21
13.7%2000/01
y
Hospital Discharge - Self harm
CR
86
Hospital Discharge -Mental health
CR
554.9
-13.5%2000/01
A1
Hospital Discharge - Alcohol related*
CR
226.7
-56.7%2000/01
b2
Hospital Discharge Accidents
CR
984.8
-3.6%1999/00
C2
Hospital Discharge R.T.A's
CR
93.8
-43.0%1999/00
D2
Hospital Discharge - Heart disease
CR
1571
-11.9%1999/00
E2
Premature years of life lost (to 75) - Male
No.
463
2000/01
F2
Premature years of life lost (to 75) - Female
No.
188
2001
G2
Premature death (under 65)
CR
172
-37.2%2001
H2
Crime - Possession of drugs with intent to supply
CR
0
-100.0%2001/02
I2
Crime - Possession
CR
47
-90.8%2001/02
J2
Crime - Vandalism
CR
380
-78.4%2001/02
K2
Crime - Fire raising
CR
47
-16.0%2001/02
L2
11.6%2000/011
1998
o
p
z
Preston lodge School Cluster
Area
Indicator
Value
Above/Below Scottish Average
Relevant
Time
(%) period
Source
Population aged 0-19
% 24.10%
-0.5% 2000
a
Population aged 20 - 24
% 59.90%
-0.1% 2000
b
Population aged 65 +
% 15.90%
0.5% 2000
c
Lone Parent Household
% 3.40%
-1.6% 1991
d
Lone Pensioner Household
% 15.90%
0.5% 1991
e
Households with over 3 children
% 4.20%
-4.8% 1991
f
Carstairs Deprivation: no car
% 31%
-2.8% 1991
g
Carstairs Deprivation: male unemployment
% 5.60%
-1.8% 1991
h
Carstairs Deprivation: overcrowding
% 10.83%
-2.1% 1991
I
Carstairs deprivation: social class 4/5
% 21.50%
0.7% 1991
j
Wholly unemployed claimants
No.
June
k
Average House price - New Build
£
£40,729
-39.5% 1998-2002 l
Average House price - Second Hand
£
£54,461
-11.3% 1998-2002 m
Affordable Housing Need
Av
Free School Meals
% 16.80%
Clothing Grants
School Attendance unauthorised absence Secondary
School Attendance unauthorised absence Primary
% 17.30%
2001-2006 n
0.1% 2000/011 o
2000/01
p
% 5%
3.0% 1998-2001 q
% 1%
1.0% Sep-00
r
School Exclusions - Secondary
% 15.99%
5.6% Sep-00
s
School Exclusions - Primary
% 0.20%
-0.8% 2000/01
t
Educational attainment - Standard Grade
% 63%
-14.0% 2000/01
u
Educational Attainment - Higher
% 14%
-8.0% 2000/01
v
Destination of School Leavers: Further Education % 14%
-6.0% 2000/01
w
Destination Of School leavers: Higher Education % 38%
6.0% 2000/01
x
4.4% 2000/01
y
Cancer registrations
CR 522.84
Hospital Discharge - Self harm
CR 138.2
Hospital Discharge -Mental health
CR 480.8
-25.0% 2000/01
a1
Hospital Discharge - Alcohol related*
CR 336.5
-50.1% 2000/01
b1
Hospital Discharge Accidents
CR 1093.8
Hospital Discharge R.T.A's
CR 126.2
Hospital Discharge - Heart disease
CR 1935.1
Premature years of life lost (to 75) - Male
No. 261
Premature years of life lost (to 75) - Female No. 370
1998
6.9% 1999/00
z
c
-23.5% 1999/00
d1
8.4% 1999/00
e1
2000/01
f1
2001
g1
Premature death (under 65)
Crime - Possession of drugs with intent to
supply
CR 144.2
-47.3% 2001
h1
CR 34
-82.7% 2001/02
i1
Crime - Possession
CR 270
-47.2% 2001/02
j1
Crime - Vandalism
CR 1380
-21.6% 2001/02
k1
Crime - Fire raising
CR 34
-39.2% 2001/02
l1
Musselburgh Grammar School
Cluster Area
Indicator
-100.0%
-50.0%
Value
0.0%
50.0%
100.0%
Above/Below Scottish Average (%)
Relevant
Time
Period
Source
150.0%
Population aged 0-19
%
24.60%
0.0% 2000
a
Population aged 20 - 24
%
59.20%
-0.8% 2000
b
Population aged 65 +
%
16.10%
0.7% 2000
c
Lone Parent Household
%
4.40%
-0.6% 1991
d
Lone Pensioner Household
%
13.30%
-0.7% 1991
e
Households with over 3 children
%
4.40%
-4.6% 1991
f
Carstairs Deprivation: no car
%
30%
-4.3% 1991
g
Carstairs Deprivation: male unemployment
%
10.25%
-2.7% 1991
h
Carstairs Deprivation: overcrowding
%
4.80%
-2.6% 1991
I
Carstairs deprivation: social class 4/5
%
19.00%
-1.0% 1991
j
Wholly unemployed claimants
No.
319
June
k
Average House price - New Build
£
£157,543
Average House price - Second Hand
£
£66,467
Affordable Housing Need
Av
395
Free School Meals
%
12.80%
Clothing Grants
133.7% 1998-2002 l
8.0% 1998-2002 m
2001-2006 n
-3.9% 2000/011 o
14.5
2000/01
p
School Attendance unauthorised absence - Secondary
%
3%
1.0% 1998-2001 q
School Attendance unauthorised absence -Primary
%
1%
1.0% Sep-00
r
School Exclusions - Secondary
%
6.57%
-3.8% Sep-00
s
School Exclusions - Primary
%
0.65%
Educational attainment - Standard Grade
%
Educational Attainment - Higher
0.4% 2000/01
t
64%
-13.0% 2000/01
u
%
14%
-8.0% 2000/01
v
Destination of School Leavers: Further Education
%
11%
-9.0%
w
Destination of School Leavers: Higher Education
%
10%
-22.0%
x
Cancer registrations
CR
569.1
Hospital Discharge - Self harm
CR
184.2
Hospital Discharge -Mental health
CR
737
14.8% 2000/01
a2
Hospital Discharge - Alcohol related*
CR
520
-60.3% 2000/01
b2
Hospital Discharge Accidents
CR
1068.6
4.5% 1999/00
c2
Hospital Discharge R.T.A's
CR
53.2
-67.7% 1999/00
d2
Hospital Discharge - Heart disease
CR
2268.3
27.1% 1999/00
e2
Premature years of life lost (to 75) - Male
No.
885
2000/01
f2
Premature years of life lost (to 75) - Female
No.
344
2001
g2
Premature death (under 65)
CR
155.6
-43.2% 2001
h2
Crime - Possession of drugs with intent to supply
CR
110
-44.1% 2001/02
i2
Crime - Possession
CR
257
-49.8% 2001/02
j2
Crime - Vandalism
CR
1383
-21.5% 2001/02
k2
Crime - Fire raising
CR
89
58.9% 2001/02
l2
12.0% 2000/01
1998
y
z
Knox Academy School Cluster Area
Above/Below Scottish Average (%)
Indicator
Relevant
Time
Period
Value
Source
Population aged 0-19
% 24.30%
Population aged 20 - 24
% 60.20%
0.2% 2000
a
b
Population aged 65 +
% 15.30%
-0.1% 2000
c
Lone Parent Household
% 3.00%
-2.0% 1991
d
Lone Pensioner Household
% 15.30%
1.3% 1991
e
Households with over 3 children
% 5.10%
-3.9% 1991
f
Carstairs Deprivation: no car
% 18.7%
-15.1% 1991
g
Carstairs Deprivation: male unemployment
% 7.90%
-5.1% 1991
h
Carstairs Deprivation: overcrowding
% 4.10%
-3.3% 1991
I
Carstairs deprivation: social class 4/5
% 18.59%
No
. 93
-2.2% 1991
j
June
k
Wholly unemployed claimants
Average House price - New Build
£
£133,84
5
Average House price - Second Hand
£
£83,719
Affordable Housing Need
Av 352
Free School Meals
% 6.60%
Clothing Grants
School Attendance unauthorised absence Secondary
0.3%
2000
98.6% 1998-2002
l
36.2% 1998-2002
m
2001-2006
n
-10.1% 2000/011
8.1
% 3%
School Attendance unauthorised absence -Primary % 0%
2000/01
o
p
1.0% 1998-2001
q
0.0% Sep-00
r
School Exclusions - Secondary
% 3.50%
-6.9% Sep-00
s
School Exclusions - Primary
% 0.50%
-0.5% 2000/01
t
Educational attainment – Standard Grade
% 79%
2.0% 2000/01
u
Educational Attainment - Higher
% 35%
13.0% 2000/01
v
Destination of School Leavers: Further Education
% 16%
-4.0%
w
Destination of School Leavers: Higher Education
% 39%
7.0%
x
Cancer registrations
CR 458.8
Hospital Discharge - Self harm
CR 144.4
Hospital Discharge -Mental health
CR 518.2
-19.2% 2000/01
a2
Hospital Discharge - Alcohol related*
CR 314.3
-6.0% 2000/01
b2
Hospital Discharge Accidents
CR 815.6
-20.2% 1999/00
c2
Hospital Discharge R.T.A's
CR 110.4
-33.1% 1999/00
d2
Hospital Discharge - Heart disease
CR 1580.2
No
. 310
No
. 278
-11.4% 1999/00
e2
2000/01
f2
2001
g2
Premature death (under 65)
Crime - Possession of drugs with intent to
supply
CR 152.9
-44.1% 2001
h2
CR 8
-95.9% 2001/02
i2
Crime - Possession
CR 119
-76.2% 2001/02
j2
Crime - Vandalism
CR 1445
-35.0% 2001/02
k2
Crime - Fire raising
CR 8
-85.7% 2001/02
l2
Premature years of life lost (to 75) - Male
Premature years of life lost (to 75) - Female
-8.0% 2000/01
1998
y
z
Dunbar Grammar School
Cluster Area
Above/Below Scottish Average
Value (%)
Indicator
Relevant
Time
period
Source
Population aged 0-19
%
24.50%
0.1% 2000
a
Population aged 20 - 24
%
58.80%
-1.2% 2000
b
Population aged 65 +
%
16.60%
1.2% 2000
c
Lone Parent Household
%
1.60%
-3.4% 1991
d
Lone Pensioner Household
%
14.50%
0.5% 1991
e
Households with over 3 children
%
4.20%
4.8% 1991
f
Carstairs Deprivation: no car
%
15%
-18.7% 1991
g
Carstairs Deprivation: male unemployment
%
2.80%
-3.1% 1991
h
Carstairs Deprivation: overcrowding
%
9.80%
-5.6% 1991
I
Carstairs deprivation: social class 4/5
%
20.60%
0.2% 1991
j
Wholly unemployed claimants
No.
188
June
k
Average House price - New Build
£
£95,557
41.8% 1998-2002 l
Average House price - Second Hand
£
£72,192
17.5% 1998-2002 m
Affordable Housing Need
Av
244
Free School Meals
%
9.60%
Clothing Grants
8.7
School Attendance unauthorised absence - Secondary %
1%
School Attendance unauthorised absence -Primary
%
1%
School Exclusions - Secondary
%
5.30%
School Exclusions - Primary
%
0.20%
Educational attainment - Standard Grade
%
Educational Attainment - Higher
2001-2006 n
-7.1% 2000/011 o
2000/01
p
-1.0% 1998-2001 q
1.0% Sep-00
r
-5.1% Sep-00
s
0.8% 2000/01
t
88%
11.0% 2000/01
u
%
25%
3.0% 2000/01
v
Destination of School Leavers: Further Education
%
14%
-6.0%
w
Destination of School Leavers: Higher Education
%
38%
6.0%
x
Cancer registrations
CR
553.8
Hospital Discharge - Self harm
CR
86.5
Hospital Discharge -Mental health
CR
398.1
-37.9% 2000/01
a2
Hospital Discharge - Alcohol related*
CR
294.2
-4.4% 2000/01
b2
Hospital Discharge Accidents
CR
1029.8
70.0% 1999/00
c2
Hospital Discharge R.T.A's
CR
121.1
-26.6% 1999/00
d2
Hospital Discharge - Heart disease
CR
1851.9
3.8% 1999/00
e2
Premature years of life lost (to 75) - Male
No.
211
2000/01
f2
Premature years of life lost (to 75) - Female
No.
166
2001
g2
Premature death (under 65)
CR
138.5
-49.4% 2001
h2
Crime - Possession of drugs with intent to supply CR
18
-90.8% 2001/02
i2
Crime - Possession
CR
138
-73.0% 2001/02
j2
Crime - Vandalism
CR
717
-59.3% 2001/02
k2
Crime - Fire raising
CR
18
-67.8% 2001/02
l2
10.6% 2000/01
1998
y
z
Ross High School Cluster Area
Indicator
Value Above/Below Scottish Average
Relevant
Time
(%) Period Source
Population aged 0-19
%
25.00%
0.4% 2000
a
Population aged 20 - 24
%
60.60%
0.6% 2000
b
Population aged 65 +
%
14.20%
-1.2% 2000
c
Lone Parent Household
%
2.70%
-2.3% 1991
d
Lone Pensioner Household
%
11.30%
-2.7% 1991
e
Households with over 3 children
%
4.60%
-4.4% 1991
f
Carstairs Deprivation: no car
%
20%
-14.2% 1991
g
Carstairs Deprivation: male unemployment
%
5.40%
-2.7% 1991
h
Carstairs Deprivation: overcrowding
%
10.33%
-1.7% 1991
I
Carstairs deprivation: social class 4/5
%
19.26%
-1.6% 1991
j
Wholly unemployed claimants
No. 176
June
k
Average House price - New Build
£
£71,831
6.5% 1998-2002 l
Average House price - Second Hand
£
£56,882
-7.4% 1998-2002 m
Affordable Housing Need
Av
199
Free School Meals
%
13.40%
2001-2006 n
-3.3% 2000/011 o
Clothing Grants
11.4
2000/01
School Attendance unauthorised absence - Secondary %
3%
1.0% 1998-2001 q
School Attendance unauthorised absence -Primary
%
1%
1.0% Sep-00
r
School Exclusions - Secondary
%
12.40%
2.0% Sep-00
s
School Exclusions - Primary
%
0.70%
-0.3% 2000/01
t
Educational attainment - Standard Grade
%
70%
-7.0% 2000/01
u
Educational Attainment - Higher
%
12%
-10.0% 2000/01
v
Destination of School Leavers: Further Education
%
15%
-5.0%
w
Destination of School Leavers: Higher Education
%
22%
-10.0%
x
Cancer registrations
CR
447.95
-10.4% 2000/01
y
Hospital Discharge - Self harm
CR
100.2
Hospital Discharge -Mental health
CR
589.4
-8.1% 2000/01
a2
Hospital Discharge - Alcohol related*
CR
306.5
-59.2% 2000/01
b2
Hospital Discharge Accidents
CR
1055.1
3.0% 1999/00
c2
Hospital Discharge R.T.A's
CR
112
-32.1% 1999/00
d2
Hospital Discharge - Heart disease
CR
1461.7
-18.0% 1999/00
e2
Premature years of life lost (to 75) - Male
No. 478
2000/01
f2
Premature years of life lost (to 75) - Female
No. 289
2001
g2
Premature death (under 65)
CR
188.6
-31.1% 2001
h2
Crime - Possession of drugs with intent to supply CR
36
-81.7% 2001/02
i2
Crime - Possession
CR
194
-62.0% 2001/02
j2
Crime - Vandalism
CR
936
-53.1% 2001/02
k2
Crime - Fire raising
CR
79
41.0% 2001/02
l2
1998
p
z
Data sources
Ref.
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
A2
B2
C2
D2
Source
Small Area Population Estimates
Small Area Population Estimates
Small Area Population Estimates
Scottish Household Survey
Scottish Household Survey
Scottish House Condition Survey
Carstairs Scores from Scottish Postcode Sectors Public Health Research Unit, University of Glasgow
Carstairs Scores from Scottish Postcode Sectors Public Health Research Unit, University of Glasgow
Carstairs Scores from Scottish Postcode Sectors Public Health Research Unit, University of Glasgow
Carstairs Scores from Scottish Postcode Sectors Public Health Research Unit, University of Glasgow
Average number of persons, Unemployment Counts and Rates, ONS
Three Year Average, Local Housing Strategy, East Lothian Council, HBOS House Price Index
Three Year Average, Local Housing Strategy, East Lothian Council, HBOS House Price Index
Three Year Average, Local Housing Strategy, East Lothian Council.*Average annual flow of units, The Role of the Planning
System in the Provision of Housing, Scottish Executive Central Research Unit
% of school roll. School Meals in Education Authority Schools, Scottish Executive, Education and Community Services
Department, East Lothian Council
% of school roll, Education and Community Services Department, East Lothian Council
% of school roll, *excluding S6. Attendance and Absences in Scottish Schools, Scottish Executive
% of school roll, *excluding S6. Attendance and Absences in Scottish Schools, Scottish Executive
% of school roll. Exclusions from Schools, Scottish Executive, Education and Community Services Department, East Lothian
Council
% of school roll. Exclusions from Schools, Scottish Executive, Education and Community Services Department, East Lothian
Council
% of S4 achieving 5 or more Standard Grades at level 4 or better% achieving 3or more Highers at A-C level by the end of S5.
Examination Results in Scottish Schools, Scottish Executive
% of S4 achieving 5 or more Standard Grades at level 4 or better% achieving 3or more Highers at A-C level by the end of S5.
Examination Results in Scottish Schools, Scottish Executive
% of school leavers. Destinations of Leavers from Scottish Schools, Scottish Executive
% of school leavers. Destinations of Leavers from Scottish Schools, Scottish Executive
Rate per 100,000 for all malignant neoplasm’s, excluding non-melanoma skin-cancer. HIU, Lothian NHS Board
Rate per 100,000 population, HIU, Lothian NHS Board *discharges from non-psychiatric hospitals
Rate per 100,000 population, HIU, Lothian NHS Board *discharges from non-psychiatric hospitals
Rate per 100,000 population.,HIU, Lothian NHS Board *discharges from non-psychiatric hospitals
Rate per 100,000 population. HIU, Lothian NHS Board
Rate per 100,000 population. HIU, Lothian NHS Board
Date
2000
2000
2000
1999/00
1999/00
1991/1996
1991
1991
1991
1991
June 2002 –July 2002
2002-2012
2002-2012
2002-2012
2001/02
2000/01
1998/99 to 2000/01
1998/99 to 2000/01
2000/01
2000/01
1999-2001
1999-2001
2000/01
2000/01
1998
2000 /2001
2000/2001
1999/2000
1999/2000
2000
Ref.
E2
F2
G2
H2
Source
Rate per 100,000 population. HIU, Lothian NHS Board
Total years of life lost. Scottish figures not available. East Lothian Average for males 435 years
Total years of life lost. Scottish figures not available. East Lothian Average for females 273 years
* Rate per 100,000 population. HIU, Lothian NHS Board.
I2
J2
K2
L2
Rate per 100,000 population. Recorded Crime in Scotland, Scottish Executive
Rate per 100,000 population. Recorded Crime in Scotland, Scottish Executive
Rate per 100,000 population. Recorded Crime in Scotland, Scottish Executive
Rate per 100,000 population. Recorded Crime in Scotland, Scottish Executive
Date
2000
2001
2001
Estimated figure based on
2000 data.
2001
2001
2001
2001
Appendix 2
Communication & Planning Networks for Health
Improvement In East Lothian
JOINT OFFICERS GROUP
HEALTH, WELL BEING & LIFELONG
LEARNING FORUM
Community
Care
Children &
families
ELC Departments
Health Promotion
Network
Service Providers
LHCC
NHS Lothian
Public Health
Team
Voluntary Sector