Public Health Information Network for Scotland PHINS

In this blog post, Elspeth Gracey from the CHEX team reflects and shares her experience at the recent  PHINS conference. 

I attended this recent conference in Glasgow and as well as learning some new terminology e.g. what a ‘health geographer’ and ‘interlocking directorates’ are, I found the information that was presented useful and informative. Of particular interest was the presentation from Gerry McCartney of Health Scotland who included in his summary of the causes of health inequalities and the responses needed that “Health inequalities are due to politics and policies” and “The evidence suggests that the most effective actions on health behaviours involve legislation, regulation and taxation” Here at CHEX we would add that more sustainable investment in Community-led Health would also be a desirable thing.

This event was well chaired by Katherine Trebeck of OXFAM.

She began by posing questions to the delegates and I found the overwhelmingly positive response to “Who thinks Public Health is getting better?” question interesting. Given the predominately health professional audience it did give me pause for thought that there might have been a different response from a substantively Community and Voluntary Sector audience.

One question from another Voluntary Sector person in relation to how the sector can demonstrate our contribution to public health brought the response from an academic contributor that aggregating up and collating all the small bits of information from different initiatives remains an ongoing challenge. This is something in which CHEX has long had an interest and remains a challenge to be more fully addressed.

The first presentation by Diane Stockton from Health Scotland was called 'What is the Burden of Disease in Scotland, and what are the implications for policy and planning?' This provided very interesting data much of it new and still in analysis but clearly showed who dies first and who suffers most. Her take home message was “we should make the case for prevention” adding that this would have ‘workforce implications’. A whole range of abbreviations that might be new to some people are used in this work including:

  • Years of life lost – YLL – the years lost because of early death
  • Years lived with disability – YLD – the years lost because people live with less than ideal health, also called ‘non-fatal burden’
  • Disability-adjusted life year – DALY – the measure used to describe the overall burden of disease.

I previously made reference to Diane’s work in an earlier blog, see here.

Next was Sarah Curtis of Durham and Edinburgh Universities. Her presentation linked mental health and the recession. She is described as a Health Geographer which means she studies how place impacts on health. The most significant thing I took from her presentation was the not surprising conclusion that the recession affects the mental wellbeing of those in work as well as those who are unemployed.

John Reilly of Strathclyde University was a very engaging speaker on the theme of Obesity in Children and Adults and Physical Activity. Some information that interested me included:

  • Physical activity declines from the age of 7 not the teenage years.
  • Sitting displaces physical activityBMI is a misleading measure and you can have an apparently low 
  • BMI but still be obese in terms of percentage body fat. However a high BMI means you are definitely obese!
  • Being at home is not as ‘safe’ as it is perceived to be so keeping children indoors instead of encouraging play outdoors may not avoid accidents.

Gerry McCartney, Health Scotland, Insights from theory and practice. Gerry started with a quote from Dr Martin Luther King “Of all inequalities, injustice in health is the most shocking and inhumane.” — he then showed that inequalities are real and why merely behavioural approaches are not valid. “It’s the context in which people live that drive inequalities”. He then itemised initiatives that would have no impact on inequalities and those that would. – most of that is exactly what those of us in community-led health would look for structural changes, legislation, fiscal policies, income support, reducing barriers, improving access, prioritising disadvantaged groups etc.His summary slide highlighted his analysis of health inequalities:

  • Health inequalities are due to politics and policies 
  • Behaviours are only part of the story 
  • Addressing poverty, inequality and the social determinants of health is essential 
  • The evidence suggests that the most effective actions on health behaviours involve legislation, regulation and taxation.

Jeff Collin Uni of Edinburgh. One unhealthy commodities industry? Implications for health policy in Scotland.

Jeff introduced us to the term Interlocking Directorates and showed a slide of a single person who was linked at director level to 35+companies including alcohol and tobacco giants such as Diageo, Pernod Ricard and Imperial Tobacco and yet was also on the International Centre for Alcohol Policy and the Advertising Standards Authority. He maintains that this is how big business involved in unhealthy products such as tobacco, alcohol and ultra-processed foods influences regulatory bodies. He suggested that we should adopt a ‘polluter pays’ approach to producers of ‘unhealthy products’.

Kat Smith University of Edinburgh. Lay understanding of health inequalities and potential policy responses...

Kat presented information about those involved in health policy and public health and what they feel needs to happen in terms of policies to address health inequalities. She also presented data from citizen juries in Glasgow, Manchester and Liverpool; highlighting that people living in areas of deprivation have sophisticated understanding of what impacts on their health but that they also feel stigmatised and disempowered by the media profiling of deprived areas while also expressing a deep sense of the unfairness of inequalities. Having engaged citizens juries to provide the basis of this research, Kat also entreated the assembled public health audience to be more pro-active in engaging with communities.


The presentations are now available to view on the here.


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