Public health really is about social justice and reducing health inequality, so it’s about enabling young people, adults, the elderly, the vulnerable, to live happy, fulfilling, healthy lives and that’s why I really like it.
My name’s Claire Mulrenan. I work in public health in Waltham Forest, which is in the northeast corner of London, and my focus is health in schools. So I support schools in creating healthier school environments. One thing I really like about public health is that actually, often the most effective things are the most simple as well. So one thing we’re doing in schools at the moment is something called the daily mile. So we’re encouraging all pupils, within primary school this is, to run or walk a mile a day. Maybe a decade ago this job would have been done by a team of about twelve people. So I’m essentially working across 88 schools, supporting them in putting interventions in place and also getting the basics right, so that’s making sure that they’re teaching students about things like peer pressure and substance misuse. So many of our health behaviours and attitudes are shaped in childhood and adolescence, so actually, if we can intervene early, then we can have a huge impact across somebody’s life. So the reason why I got into public health is probably, at least in part, because of my family background. Both my parents do something that I would say betters the world in many senses. So my mum works as a research scientist for the British Heart Foundation, but, beyond that, I would say that in her day to day life she’d go above and beyond to help people in crisis, be that friends or family. My dad, on the other hand, as I was growing up, was branch secretary for a trade union. So not only did he represent people in court, he also, at the same time, stood in two general elections while I was younger. He wasn’t elected, it was two, very minority, kind of left wing parties, but I think his reason for doing that was a sense of social justice, and he’d often draft me and my sister, when we were younger, to do various canvassing around the place. So I guess this job was my small way of trying to improve the lives of vulnerable people, and I’m also lucky because it combines that belief in social justice with also my academic interests in health. Another bit of work that we’re doing is around oral health. So one of my schools at the moment is organising an Oral Health Week. Oral Health is a huge problem nationally, for under five tooth decay, is actually the number one reason for admissions to hospital. So one of my schools is doing things, like they’ve linked up with a local dentist practice, and they’re coming in and fluoridating kids’ teeth. They’ve done lots of baseline data, so this is one way that we look at impact as well, and that’s revealed that actually, one, a lot of the children aren’t registered with a dentist or have not visited one in the last year, and two, a large number of them are saying that they don’t brush their teeth twice a day. So what we’re hoping is that actually at the end of this intervention we’ll have far greater registrations.
We’re also involving parents in that, because any good health promotion work with young people should involve parents, and obviously it will be the parents that register their kids. And also we’re hoping to see an increase in the number of kids reporting that they’re brushing their teeth twice a day.
I would say that public health is not appreciated enough across the wider sector. Although I’m sure I’m a little bit biased in saying that. I think there is a misunderstanding of what public health is sometimes, but actually public health is a huge field. Part of it’s about health care planning, so it’s not all prevention. So public health is responsible for commissioning things like mental health services within the borough, which are obviously hugely important. I think people also have kind of perceptions around this nanny state. So we see that in the media and where people get up in arms about interventions around wearing seat belts or smoke free environments, when actually those things do have a huge impact on health longer term. One good example is in the area of sexual health. So actually there was a huge drive to put much more investment in sexual health for young people about a decade ago, and actually we’ve seen a huge decrease in levels of teenage pregnancy and the evidence suggests that a lot of that is due to this increased investment, and we know that with sexual health, I think the figure is that for every one pound you spend you save ten pounds in the long run. It’s not always politically popular, because you will only see an impact much later down the line.
I think as well, from a personal perspective, you can’t do work around health without reflecting on your own health and wellbeing, so be that your mental, your physical health. So actually being in this field, I have to reflect on my own wellbeing, and I think, you know, from a selfish perspective, actually that has a positive impact on my life. So at the moment I’m training for a triathlon. An Olympic triathlon. So lots of swimming, biking, and running, although not as much as I should be doing. So just a few years ago, public health used to sit within probably care trusts. Which is part of the NHS. They’ve now moved into local authority. We are experiencing levels of cuts in the same way that local authority services are. It does present opportunities, in terms of looking at how to do things differently, but actually I do find it challenging when I’m expecting teachers to do pieces of work and actually that’s very few resources that I can draw on to support them.
One of the things that I’ve really felt privileged to see, is a lot of the work in action basically. So one of my schools recently won a competition called Beat the Street. So this was run across a number of East London boroughs. It was promoting active travel, so different institutions could sign up, so different schools, and every pupil would get a card, electronic cards which would register as they tapped the box – so as they walked around the borough they would tap these boxes and it would register how far they’d walked. They were competing against schools from Newham and other boroughs across East London and actually they won overall. Talking to the teachers about this and the huge impact that they saw, they said that it had been a complete cultural shift in the attitudes of those people. So, actually, now they’re willing to walk miles, and I think that’s really inspiring to see, and from that bit of work they actually partnered with an Islamic school in Newham. And they decided to organise this charity walk in the Olympic Park. So I was really lucky to be invited along to that, and that was a really inspiring day in many ways, you know, it was about health and well being but actually about social cohesion. This was a Catholic school, so links between a Catholic and Islamic school as well, and I thought being able to go along and see things like that is a real privilege. A lot of my role is supporting the schools, but actually getting to go out and see pupils getting involved, that’s what really excites me.