Social Determinants of Health in Lewisham: A Report

This report provides a comprehensive analysis of the healthcare system in Lewisham, an inner London borough characterized by significant deprivation and a diverse population. The report begins with an overview of Lewisham's demographic profile, highlighting key statistics such as population size, ethnic composition, and socioeconomic factors. It then identifies cardiovascular diseases as a major health issue, exploring the prevalence of conditions like hypertension and their impact on life expectancy. The analysis delves into health inequalities within Lewisham, examining how ethnicity and other factors contribute to disparities in health outcomes. A central focus of the report is the examination of social determinants of health, including socioeconomic status, access to healthcare, and environmental factors, and their influence on cardiovascular disease. The report also explores relevant health policies implemented in Lewisham, such as those aimed at promoting healthy weights, improving immunization rates, and enhancing mental health services. Furthermore, it discusses public health provisions, including initiatives to integrate health and social care and the development of a health and wellbeing strategy. The report concludes by summarizing the key findings and emphasizing the importance of addressing social determinants and implementing effective policies to improve the health and wellbeing of Lewisham residents.

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HEALTHCARE IN LEWISHAM 1
Contents
Introduction......................................................................................................................................2
Demographic Profile of Lewisham..................................................................................................2
Health Issue in Lewisham................................................................................................................4
Health Inequalities in Lewisham.....................................................................................................4
Social Determinants of Health.........................................................................................................5
Policy issues relating to Lewisham..................................................................................................6
 Ensuring our children and young people are healthy weight...............................................7
 Improving our rate of immunizations...................................................................................7
 Improving emotional and mental health...............................................................................8
Public Health Provision in Lewisham.............................................................................................8
 Bringing Health and Social Care together............................................................................9
 Health and Wellbeing Strategy.............................................................................................9
 Care and Support................................................................................................................10
Conclusion.....................................................................................................................................11
Bibliography..................................................................................................................................12

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Introduction
Lewisham is an inner London division with maximum level of discrimination,
dispossession and idleness. Inhabitants in Lewisham are comparatively young and
pointedly underprivileged. Therefore, Government of Lewisham announced fitness and
community care services which is dedicated to having a fair and organized system.
Lewisham health and social care services try to make the finest use of resources so that
they can offer high-quality services to the citizens in a custom-made way. Lewisham
health and social care ensure to contemplate a variety of things that can impact the health
of wellbeing such as housing, health, and other support, along with social care. The major
goal is to maintain risk management together with service delivery which endorses
independent and authorized individuals to regulate their social and health care
requirements. From 2018, Lewisham and NHS started working together to transmute
health and social care in the constituency for all citizens.
Social care and support providers work together to safeguard the needs of the residents
which can maximize the independence percentage (Anon., 2019). This report includes the
health and social care policies of Lewisham, the social elements of health and fitness and
social care services in Lewisham for cardiovascular diseases.
Demographic Profile of Lewisham
With a population of 292,000 (per 2014 data), Lewisham stands as the 13th biggest
constituency in London. The area is 13.4 square miles and covers the greenest part of
south east London. Lewisham’s quarter inhabitants are under the age of 19. In 2004-
2014, increment of 27% was observed under the count of 0-4 age toddlers (Anon., 2019).

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As of 2017 data, male count of Lewisham is 148,583 and female count is 152,724
(Brinkhoff, 2018). In Lewisham, two out of 5 citizens belongs to black and smaller ethnic
upbringing. Largest BME groups of Lewisham are “Black Caribbean” and “Black
African”. 30% of the total inhabitants of Lewisham consist of Black folkloric people. For
males and females, increment is observed in life expectancy of Lewisham as a whole
compared with England. However, there are substantial disparities in life anticipation for
both males and females (Anon., 2019). Men and Women under the age of 75 die
impulsively from tumor, cardiovascular and respirational diseases. Furthermore,
Lewisham’s mortality rate fluctuates year to year. However, stable reduction has been
observed in the last years. The main reason of passing in Lewisham is cancer, respiratory
diseases and circulatory diseases.
Image Source: (Anon., 2019)

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Circulatory system diseases are the biggest reason of death. As per the 2017 data,
employment rate of Lewisham increased more than 6%. Most of the working residents of
Lewisham are still living in poverty (Witton, 2018). Furthermore, 26% of the citizens are
living in poverty and 42% of new adults do not qualify for Level 3 educations (Anon.,
2019).
Health Issue in Lewisham
In Lewisham, cardiovascular diseases are the chief contributor to the life expectancy.
Lewisham lacks in the identification and management of the cardiovascular diseases.
Cardiovascular disease is the term given to the group of heart and blood vessel related
disorders. Circulatory diseases comprise coronary heart disease, hypertension, atrial
fibrillation, cardiomyopathies, and heart failure and, stroke and transient ischaemic
attack. In 2008-09, deaths due to cardiovascular diseases in Lewisham reached 33%
surveyed by cancer (26%) and respiratory diseases (15%). According to the research, the
most mutual prolonged health condition is Hypertension. Hypertension is enormously
adjustable threat for stroke and heart failure. It is estimated that of the residents are living
with undiagnosed disorder.
Health Inequalities in Lewisham
As per WHO, health disparity is well-defined as “differences in health status or in the
distribution of health determinants between different population groups” (Anon., 2019).
Ethnicity is related with health inequality in cardiovascular disease. However, less ability
of the language is the major risk factor associated with health inequality (Mackey, 2017).
Premature mortality for Lewisham is the maximum for all causes. Although in recent

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years, Lewisham resulted progressive in relation with cardiac diseases. Reduction in the
count of heart attack was observed. There are noteworthy differences in morbidity level.
In 2004-08, Bellingham, Sydenham, Downham Evelyn, Rushey Green, Perry vale and
Lewisham central qualified high number of premature mortalities commencing all
circulatory diseases. Similarly for males, New Cross, Brockley, Evelyn and, Whitefoot
skilled significantly high count of premature mortalities from CVD. Similarly for
females, Downham, Perry vale and Evelyn experienced high premature mortalities from
CVD. In 2006, “The Directorate of Public Health” audited and identified difference in
practicing and managing the patients with cardiovascular diseases. Most of the practices
were below the average in terms of performance which was settled in the “Quality and
Outcomes Framework. In 2007, Lewisham originated “Healthy Communities
Collaborative programme” to increase the alertness of heart diseases and to reduce the
health disparities.
In Lewisham, the “Local Strategic Partnership (LSP)” completely focuses on the
reduction of premature mortality from cardiovascular diseases as a chief provider to
achieve health inequality.
Social Determinants of Health
Social Determinants of Health (SDOH) are termed as complex situations wherein people
are born and live which impact health. SDOH comprises of factors like socioeconomic,
political, cultural, healthcare and tutoring systems, safe environment and healthy food
accessibility (Anon., 2017).

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Lewisham’s Joint Health and Wellbeing plan role is to improve health, care and
efficiency of the residents.
Social determinants related with cardiovascular diseases are diabetes mellitus,
dyslipidemia, physical inactivity, hypertension, tobacco smoking and, unhealthy alcohol
consumption (Martínez-García, 2018). Environmental, social and economic factors plays
significant role for the evolution, development and consequences of cardiovascular
diseases midst populations. SDOH reflects the influence of the communal atmosphere on
health among individuals sharing a community. The enormousness of upsurge in the
occurrence of multiple cardiovascular disorder threats has shifted investigation exertions
to study risk factor which includes SDOH (Kreatsoulas C1, 2010). The “NHS Health
Check Programme” was originated in 2010 wherein free cardiovascular checks were
introduced for 40-74 year old to identify risks related to heart disease, dementia, diabetes,
stroke and, kidney disorders. Apparently, health checks helped in the reduction of
inequality in mans, however, no decrement was observed for women (Anon., 2015).
Policy issues relating to Lewisham
In Lewisham, issues and options is the first stage of the Local Development Framework
procedure. Council of Lewisham consulted the conclusions from evolving substantiation
base, responsiveness of local issues and, views of participants and the native municipal.
The options and problems were conferred in overall and detailed terms and a prospect
was delivered for raised options and other issues. Therefore, for the expansion of the
Core strategy, site allocations document and, the development policies sequence of
papers were equipped. Additionally, the consultation carried out in four segments from

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25th July to 30th November 2005. Health related policy issues are stated below (Anon.,
2019).
 Ensuring our children and young people are healthy weight
In Lewisham, overweight, obesity, physical inactivity and malnutrition is the major
challenge in the current and future fitness of children and young citizens. Maternal
corpulence has increased the threat of deprived pregnancy consequences which is the risk
factor of infant obesity. As per research conducted in 2013-14 by “Lewisham and
Greenwich NHS Trust” indicated 43.5% women are overweight and obese at the time of
booking appointment in hospitals. Therefore, it is essential to provide the healthy
balanced die to the children’s (Anon., 2019).
For Lewisham, anticipation and early interference is crucial. Therefore, below mentioned
fundamentals are significant in local plan to discourse this issue:
1. Parental corpulence programme
2. Humanizing uptake of School meals
3. Accomplishment and conservation of “UNICEF Baby Friendly Status”
4. Executing a methodical program of interference and strategies to help children
and decrease the impact of the “obesogenic environment”.
 Improving our rate of immunizations
Use of modern vaccines for activating immunization stands as the most cost effective
healthcare involvement. This programme is protracted for all children’s in Treatment and
in Years 1 & 2. In recent existences, increase in acceptance of immunization has been
observed in Lewisham. Immunization is at priority for the children’s (Anon., 2019).
Below mentioned are the steps taken for the implementation for this programme:

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1. Starter of vaccines in contradiction of “group B meningococcal disease and group
W diseases”.
2. Changes in system for “neonatal BCG programme”.
3. Increment in efforts to recover uptake of HPV Vaccine.
4. Implementation of “NHS England Action Plan for Immunization”.
 Improving emotional and mental health
Around 72% children’s have behavioral and emotional issues and around 95% young
children’s have mental issues. Risk factors are exposure to trauma, insecure housing and,
poverty. In every 1,000 citizen, 12.4% are chemical drug users compared to 9.55 in
London and 8.4 nationally. “Lewisham’s community Child and Adolescent Mental
Health Service” had a case grip of 1,375 citizens in March, 2015. Mental Health and
Emotional wellbeing approach focuses on:
1. Increment in the support for perinatal and mental health provision.
2. Development and implementation of transition curriculum.
3. Harness the opportunities for the delivery of mental health via youth service
support.
4. Development of online tools so that young citizens can seek mental health
support.
5. Improvement of ways among acute and community health support.
Public Health Provision in Lewisham
Enclosure, anticipation and Public Health Commissioning transports the strategy of
provisioning housing, alcohol and drug services and a wide range of further public health

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support including physical commotion sexual health services and “health check obesity”.
Below mentioned are the provisions for Public Health in Lewisham:
 Bringing Health and Social Care together
Lewisham government is working with “Lewisham Clinical Commissioning Group” to
transform the health and social care facilities delivered in Lewisham. They want to
provide accurate care in the right place to encounter the health and social care needs of
the residents (Anon., 2019). Their significances to achieve the goal are:
1. To support and encourage individuals to improve health and safety.
2. To deliver robust GP practices and principal care facilities so that individuals can
recover from the diseases quickly.
3. To offer coordinated provision for citizens with prolongs diseases so that they can
help themselves and stay self-regulating for long.
4. To deliver services for young and children’s so that they can use the services
when needed.
 Health and Wellbeing Strategy
Lewisham’s government connected with “Clinical Commissioning Group” to formulate
strategies for health and wellbeing. The strategies formulated outline the major health
challenges citizens face, possessions, assistances and services should be available to
support individuals. Below mentioned are the major priorities areas of Health and
Wellbeing Strategy:
1. Attain a healthy weight.
2. To increase the count of individuals who survived colorectal, lung and breast
cancer.

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3. Develop immunization uptake
4. Reduction of harmful alcohol
5. Improve the mental and sexual health of the residents
 Care and Support
In 2015, for better care and support changed. The care act helps the individuals to support
and care in a more consistent manner and makes individual’s options, rights and
responsibilities clear. The act provides a legal foundation for the new manner of working
to make communities strong and help individual to improve wellbeing. Care and support
generally refers to help adults who need to live with possible illness. It includes help like
washing, getting to work, eating, caring for families, dressing and, cooking meals (Anon.,
2019). In 2015, Care and Support Act introduced:
1. Update to information and guidance services to create care and support easy to
recognize and circumnavigate.
2. Service improvements which intervene early and help people to recover from
health crisis.
3. Wide support for care takers, who have great access to assessments and choices
for personal budgets.

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Conclusion
Over past years, Lewisham government is successful in providing the assurances. There
is a huge reduction in the count of individuals who were living on the support of social
care. Furthermore, there is an increment in the number of citizens being helped in
communities. Additionally, an increase was observed in the count of residents existing in
their own household. Moreover, people recovering from prolonged disorder count were
increased. People started regulating their own health and requirements. All the staff and
workers connected with “London Borough of Lewisham” understand vision and are
committed to increase the independence and life quality.