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January 12, 2023
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Presidential postulations and predictions for 2023

I would like 2023 to be the year that we really get to grips with the recruitment and retention issues facing public health, and indeed the wider health system.

Prof Jim McManus
ADPH President

As I write, we are already into the second week of 2023 and, at this time of year it can be beneficial to reflect on the past year and think about what the year ahead may bring.

I will write more about the wider health system crisis and the need for long-term strategy and vision instead of a series of quick fix solutions that are destined for failure in future blogs. However, today, I want to take the opportunity to reflect on a number of issues facing us in 2023.

After having the privilege of leading the 175th anniversary of DsPH celebrations last year, I am mindful that we should keep the culture of proper and proportionate celebration and recognition of good work within our organisation – not only does sharing our successes have the potential to improve all our practice, it is a way of attracting the attention of future public health professionals – something we must focus on. For, as DsPH, we are merely custodians of what we do to improve and protect the health of our populations, and we must make it attractive for others to pick up.

With this in mind, I would like 2023 to be the year that we really get to grips with the recruitment and retention issues facing public health, and indeed the wider health system.

We need to inspire the next generation to not only see the benefit in a population approach, but to follow in the footsteps of Dr William Duncan, the UK’s first real DPH, and help us put it into practice. This means embedding public health approaches in local authorities and the NHS through bodies like the Integrated Care Systems, in order to connect prevention and treatment. It means we have to focus on the evidence of what works and will take true collaboration with our partners – new and old – but I’m confident that together we can continue to shape our profession so that it will attract the next generation of DsPH.

In the meantime, what should our priorities be this year? And what public health issues will come to the fore?

Public health has, of course, been deluged with health protection concerns for the last three years – something that looks set to continue, at least in the short term, with high numbers of infection spreading throughout the community.

Whether it is Covid-19 or flu, strep-A or any one of the illnesses currently circulating, one thing is clear – it is vitally important that we don’t forget the lessons learned during the height of the pandemic. Indeed, the upcoming public inquiry provides an invaluable opportunity to examine all aspects of the pandemic and DsPH, through ADPH, are fully committed to supporting its work in whatever way we can to honour all those whose lives have been – and continue to be – affected.

The cost of living crisis too is an issue which shows no sign of ending soon. So many reports over Christmas showed the stark reality of those who are most affected by the rise in prices, not just of fuel, but food and goods in general and the knock on effect to people’s health is indisputable.

As local leaders for the nation’s health, DsPH will continue to work alongside partners in their local authorities, local businesses and the community and voluntary sector to find respite and solutions, for example through the support of school nurses, warm banks, addiction treatment services or another of the many initiatives DsPH and their teams commission.

ADPH meanwhile, will continue to advocate nationally for policy that puts people’s health first – good work which will give people job security; restrictions on marketing and advertising for the most unhealthy food; planning legislation that encourages healthy places and spaces – there is so much more we can do as a nation which, while it won’t change the price of goods and services, will enable people to make healthier choices more easily and affordably.

On this, I had the pleasure of taking part in Jamie Oliver’s ‘takeover’ of BBC Radio 4’s Today programme in the run up to the New Year and was hugely impressed with my interviewer – the Chair of BiteBack 2030’s Youth Board, Luke Hall. I learned a lot from talking with him before the interview. He shared with me his true insight into the commercial determinants of health – how industry can affect people’s choices to such an extent that their health is put at risk – and how they shape our food choices.

We see such tactics from so many industries – including food, tobacco, alcohol and gambling and we know that legislating against them works. It is not a nanny state to protect people from this, nor is it freedom when a commercial company is able to decide what food supply you can access. We need to call out the libertarian arguments that lead to protecting profit at the expense of people’s health as if profit, not health, were our highest good.

Tobacco is an excellent example with smoking rates having plummeted as a result of marketing restrictions and legislation to ban smoking – but even there, there is much more to do (and with the 2030 smokefree ambition now just seven years away, I am reminded just how much).

Thousands of lives are lost each year for preventable reasons and industry tactics to push tobacco, unhealthy food and gambling – despite harms – are part of what causes these deaths. One of my sincere hopes for the year ahead is that these industry tactics are called out by more and more people and that policymakers are enabled to mitigate against them.

I hope too that 2023 sees a renewed effort to reduce health inequalities. We see time and time again in our work as DsPH that the effects of mental health issues, addiction, obesity and maternal health and wellbeing to name but a few, are felt much more keenly by those living in deprived areas.

Where we are born, which school we go to and what we do for a living should not dictate our health or lifespan and yet, it very much does. ADPH will continue to be on hand to advise policy and decision makers on how to reduce this disparity at a national level, while public health teams across the country will continue to work with partners and stakeholders on the ground to improve people’s lives and lessen this, largely preventable, gap.

Finally, while it is easy to forget the heat of last August as we battle through the winter months with incessant flooding bringing misery to many, I am ever mindful of how soon summer comes round each year and meteorologists are already predicting more unbearably hot temperature spikes.

As I discussed in a previous blog , our job is two-fold – to mitigate the effects of soaring temperatures (and indeed extreme weather of all kinds) and to plan for the future. We simply cannot ignore climate change. Instead, we must look at how to plan our spaces sustainably, learn to treat diseases not usually found in the UK and make travelling on public transport accessible and convenient for all – not just to reduce our carbon footprint now, but to build in sustainable processes for the future.

In the meantime, we need to ensure that we all know how to cope in extreme temperatures – that means learning from other countries and ensuring that public messaging is clear and effective, something that, although we did well last year, can be improved further by even better collaboration with our partners, both nationally and locally.

In fact, it is this collaborative approach that will help with all public health issues – we need shared leadership, ownership and partnership working across all agencies in order to make living longer, healthier lives the norm throughout our society.

Fortunately, DsPH are exceptionally good at identifying the right people to work with on any particular issue and then collaborating with them to improve people’s lives. However, as good at it as we are, we must never become complacent. There is always room to improve and it is something we will continue to work on throughout the coming year (and beyond!) but for now, here’s hoping for a happy, healthy New Year!


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