Skip to 0 minutes and 3 secondsPROFESSOR MARY RENFREW: Hello, and welcome to week three. Last week, we looked at a programme of work focusing on children's early years, exploring an approach that aims to reduce the inequalities children experience in their early lives and give them the best start in life. This week, we'll build on the idea that we can help to reduce lifelong inequalities by supporting interventions in pregnancy and at other vulnerable times.

Skip to 0 minutes and 29 secondsOne of the issues we'd like you to think about as we move into a new week is that of what people often call lifestyle factors, such as drug use, smoking, alcohol consumption, and poor diet, as they can all have a direct link to health inequalities and are at the heart of public health promotion. These factors will be explored in more detail as we look at this week's examples. In Scotland, for example, we have the second highest rate of obesity in the developed world. Smoking rates here are declining, but there is a big difference in smoking rates between the least and most deprived areas in our society.

Skip to 1 minute and 12 secondsIn the most affluent areas, around 11% of adults smoke compared to 40% in the most deprived areas. We also have high rates of alcohol and substance abuse compared with other parts of Europe, and very low rates of breastfeeding. It's important to remember, of course, that poverty is not always the main problem. Alcohol consumption has been growing steadily in more affluent areas, for example. You've probably seen many public health promotion campaigns that try to encourage people to drink less alcohol, stop smoking, make healthier food choices, or engage in safe sex. Individual behaviour does play an important part in health, but to say that these factors are all about self-control misses the mark. Lifestyle factors are often not a matter of choice.

Skip to 2 minutes and 6 secondsCircumstances outside of a person's control play a large part. For example, if the community you live in has high rates of smoking or drug use, there's likely to be ready access to these, and there may be peer pressure to try smoking or drugs. If there isn't easy or free access to support or counselling services, it can be difficult for young people to stop once they've started. If young people are not provided with sexual health education, they're more likely to engage in high risk activity. If you live in an area where buying fast food cost less than cooking at home with fresh produce, you're unlikely to have a healthy diet.

Skip to 2 minutes and 47 secondsIndeed, some people have almost no control over the environment in which they live. An obvious example being people in prison. One of the challenges we face in trying to change lifestyle factors is that they're easily passed on from one generation to the next. Children of parents who smoke are more likely to smoke themselves. Daughters of teen mothers are more likely to become pregnant at an early age. Young boys who grew up in violent environments are more likely to exhibit violent behaviour. So if we can modify behaviours in the family before a child is born, we may be able to help the baby and family towards a healthier and happier life.

Skip to 3 minutes and 33 secondsSo please tell us what it's like where you live and work. What activities do you know about that aim to help women during pregnancy? How can we actually have an impact on the lifestyle factors I've talked about? I hope you'll enjoy this week's learning and the examples we'll be showing you, and I'll see you again next week.

Welcome to Week 3

Welcome to Week 3.

Last week, we explored methods of improving the health of children and families, by examining a national initiative where practitioners from across health, social care and education are coming together to make early interventions and break the cycle of inequality.

This week, we’ll be looking at two projects in Scotland that are working towards reducing inequalities in vulnerable populations. First, at-risk pregnant women who have substance misuse issues, and, second, the prison population.

These are two disparate groups whose health outcomes are often connected. Substance misusers often have encounters with the criminal justice system. But, not all problem substances are illegal. In Scotland, there are also problems with prescription drug addiction, alcohol and cigarette smoking that are exacerbated by health inequalities. These, and other ‘lifestyle factors’ will come into play this week, as we think about ways to reduce health inequalities in particularly vulnerable groups.

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Tackling Inequalities Through Health and Social Care Design

University of Dundee

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