What we learned at the Tackling Inequalities conference 2023: Prevention

Continuing our series of articles, we share insights from NHS England’s report on key learnings from our joint Tackling Inequalities conference in January 2023. The report has been published ahead of the upcoming second conference on 16 January 2024, which will focus on tackling inequalities through innovation and entrepreneurship. This article delves into the first conference's insights on prevention, with a focus on smoking cessation.

Smoking is a major contributor to morbidity and mortality in England, particularly affecting marginalised groups and those in low socioeconomic areas. It significantly influences the Core20PLUS5 approach, with higher smoking rates in low-income groups and a direct correlation with neighbourhood deprivation. Ethnic minority groups generally have lower smoking rates, except for those with mixed ethnicities.

In maternal health, smoking during pregnancy poses severe risks, including low birth weight and stillbirth. Individuals with mental health conditions are twice as likely to smoke, contributing to respiratory diseases, cancer deaths, and cardiovascular risks, whereas older smokers face double the risk of cardiovascular mortality compared to non-smokers.

Addressing smoking is crucial for improving health outcomes and reducing health inequalities.

Conference participants broadly endorsed the national approach of Prevention and Core20PLUS5. The approach recognises the need for wider social cooperation and co-production to address healthcare inequalities. Cultural considerations were acknowledged as crucial, emphasising training on cultural awareness to engage diverse communities effectively. Effective communication, positive motivational approaches and engagement with trusted voices were underscored. The areas for improvement included a need for more detailed information on Core20PLUS5, a desire for local and personalised approaches, enhanced collaboration with third-sector partners, and addressing specific health issues like tobacco bans, oral care, and promoting healthy eating.

The conference identified potential missed opportunities, emphasising the need to strengthen community support, integrate social prescribing, and involve stakeholders and volunteers for comprehensive engagement. Addressing social determinants of health, especially poverty-related factors, is crucial, participants agreed, advocating for local recruitment and encouraging the real living wage. In education, there was a call for training in motivational interviewing and cultural competence, along with embedding prevention in professional training. A specific health focus on weight management, obesity prevention, oral health, access to dental care, and improving childhood nutrition and activity levels was suggested. Additionally, recognising the untapped potential in data sharing and analysis, including cross-referencing with GP records, was emphasised.

Conference participants emphasised key tools and interventions for addressing health inequalities in smoking cessation. They highlighted the need for enhanced screening programmes with increased funding, a patient-centred approach involving communities in co-creation, and prioritised health education, literacy, and cultural considerations. Additionally, they advocated for adopting a strengths-based approach, building upon existing services, and emphasising a comprehensive, whole-system approach involving multiple sectors.

They pledged to support service users struggling with alcohol and drug misuse, target poorer communities for health advice promotion, promote Making Every Contact Count (MECC) in their organisations, and actively explore patients' wider determinants of health for a more personalised approach to care.

Access the full report here.

Book your place at Tackling Inequalities: Through innovation and entrepreneurship on 16 January 2024.