Health Improvement Programme for
Doncaster 2000 - 2003

Strategic Direction

The strategic direction, which is being adopted locally, is described in National Priorities Guidance 1999/00-2001/02:

To improve the heart and stroke health of the general population by continuing to develop effective targeted interventions which address risk factors and promote healthy lifestyles, to improve services and access to them and to develop long term strategies to tackle the wider determinants of health and reduce inequalities within the district. To develop appropriate, accessible services based on a process of assessment, treatment and rehabilitation in line with the emerging findings of the National Service Framework.

Target

Coronary Heart Disease (CHD) is a major cause of illness. It is an area where there is considerable scope for improvement and 'Saving Lives: Our Healthier Nation' has identified this as a priority and set a target which has been adopted as a local target.

To reduce the death rate from circulatory diseases amongst people under 75 years by at least 40% by 2010 from a base line at 1997

General Commentary

The Director of Public Health's Annual Report shows that the number of deaths from CHD is higher in Doncaster than the average for England and Wales. The report also demonstrates that this higher mortality is associated with greater levels of deprivation. There may be as many as 12,000 people in Doncaster with CHD, 53,000 with heart failure and over 50,000 smokers.

There is no single cause of CHD but some of the risk factors include: smoking, raised blood pressure, raised plasma cholestrol and inadequate physical activity. Other contributing factors include: poverty, unemployment, social exclusion, environmental factors, variations in health care services, excessive alcohol consumption, obesity, high salt intake and diabetes. Risk factors interact, and the effect of two or more is greater than the addition of their individual risks. Smoking and obesity are increasing in the community.

Effective action to reduce CHD needs to tackle all these factors. It is important to prevent the development of CHD as well as treating the symptoms. A comprehensive strategy has therefore been devised that allows us to attack CHD on a broad front by creating partnerships with health promotion, primary care, secondary care, Local Government, the ambulance service and across the Health Action Zone. In addition, systems are being developed to increase communication between health care professionals and local communities to encourage imaginative actions to tackle many of these risk factors. The Government is about to publish a National Service Framework (NSF) for coronary heart disease which will indicate the sort of actions required in all areas relating to CHD, set national standards for clinical practice and thereby inform our local CHD strategy.

Further information can be obtained by downloading the full text version of the Health Improvement Programme for Doncaster 2000 - 2003

Any comments on this section should be submitted to the theme lead, Dr. John Cornell, Consultant in Public Health Medicine at: Doncaster Health Authority, White Rose House, Ten Pound Walk, Doncaster DN4 5DJ. Email: john.cornell@doncaster-ha.trent.nhs.uk