During work with stakeholders to develop outcomes and focus areas for this JHIP 3 themes naturally emerged.  FHWA recognised  that these  3 themes could support different organisations and services to understand where they could contribute to  improving health and wellbeing in Fife.

1. Reducing Health Inequalities

2. Creating Healthier environments

3. Supporting Healthier lifestyles

The issues relating to the 3 themes are outlined next.

1. Reducing health inequalities

There is a clear correlation between health and life circumstances.   People living in the most disadvantaged life circumstances experience poorest health across a range of indicators such as premature death, healthy life expectancy, and life limiting conditions such as diabetes, coronary heart disease and mental health problems.

Work around improving life circumstances, such as education and training, income, work, environments, physical and mental health, family situation and community links, comes within the remit of a wide range of partnerships, services and organisations.

FHWA will sustain and develop links with partnerships and organisations who work towards reducing the significant inequalities between different groups of people living in Fife, as these have a clear impact on health and wellbeing.

FHWA will work with the Sustainable Communities Group to improve the health and wellbeing of people living in the 20% most disadvantaged neighbourhoods in Fife.

However it is recognised that people living in the most adverse life circumstances are spread across all our communities in Fife and that some people living in rural areas may be disadvantaged by social isolation and difficulty in accessing services.

Therefore, as well as supporting work within most disadvantaged local communities, Fife's JHIP 2007-10 will maintain FHWA's commitment to improving the health and wellbeing of communities of interest - communities who share similar life experiences but may not live in the same area. Some examples are ethnic minority communities, the Deaf community, people with a physical or learning disability or a visual difficulty, and the LGBT (lesbian, gay, bisexual and trans-gender) community.

Communities of interest often experience disadvantage in relation to access to information and services, education and employment opportunities or inclusion within their local community and discrimination in relation to race, disability, gender, sexuality, age, religion or belief.

Reducing discrimination and promoting equality

Work to promote equality and eliminate discrimination plays a central role within community planning. Public sector organisations such as local authorities, NHS and the police also have an individual legal requirement to address discrimination and promote equality within all their functions, including their partnership activities.

It is interesting to note that  research shows that health and wellbeing, in all but the poorest countries, is strongly related to how equal societies are, not how wealthy they are. Many wealthy developed countries exhibit the greatest income inequality and also have higher levels of mental illness. Therefore work to reduce discrimination and promote equality will contribute to reducing health inequalities.

To reduce health inequalities in Fife, JHIP Lead Partners and the groups, organisations and services who are taking forward actions related to focus areas, will need to ensure that they address the needs of individuals and communities who face the greatest barriers to inclusion, and ensure support is targeted  in ways that best meet their needs. This will be monitored through the JHIP Monitoring and Evaluation Framework

Where there are specific health and wellbeing issues in relation to a particular group, for example looked after children, this is highlighted as a focus area within the plan.

However, local action planning and service provision will recognise a much wider range of groups who face health inequalities than referred to within the JHIP.

2. Healthier environments

We believe community planning partner organisations are well placed to strengthen and focus work around creating healthy environments and therefore impact on the health and wellbeing of individuals and communities.

A healthy environment relates to both our physical and social environment in relation to where we live, work and spend time.

It includes factors such as access to open, green spaces and attractive built environments and affordable housing; our feelings of personal safety and security; access to amenities and  services; opportunities for leisure , culture, learning and work; and the relationships we have with family, friends , neighbours, employers and service providers.

A wide range of organisations and services can make a contribution to creating healthier environments in Fife. As well as work to improve housing conditions, school environments, play areas and open spaces in Fife, projects supporting better access  to information, services and facilities and initiatives which focus on community learning and development and cultural and arts based projects have a key role in community wellbeing.

3. Healthier lifestyles

We want to continue to empower individuals and communities to make healthy choices around their physical, social and mental health and wellbeing. However, work in this area should recognise the complex interactions between different aspects of people's lives and the need to look at the individual and all their circumstances, not merely their lifestyle.

Within the context of individual, family and community circumstances it remains important to empower individuals and communities to make healthy choices - including information, support and skills around healthy eating, increasing physical activity, reducing smoking, the problem use of drugs and alcohol, and self-harm and suicide.