A two-year Health Promotion Strategic Framework (HPSF) was developed early in 2018 to address the high rates of certain non-communicable diseases among the Island population. Cardiovascular disease (heart disease and stroke), type two diabetes, respiratory disease, kidney disease, and cancers are the cause of a large proportion of earlier death, chronic illness, and disability.

The 2018-19 strategy focused specifically on the leading modifiable risk factors for these conditions: smoking and obesity (poor diet /insufficient physical activity).

The approach emphasises creating a ‘community environment that enables health’. This means focusing on:

  • What in the community
    environment makes healthier things more
    available or accessible and helps people make healthier choices    , and
    • Addressing things in the community environment that
      make it difficult for people to do healthier things /make healthier choices
    • Developing
      community ‘health literacy’ so that
      they can take advantage of the opportunities created to help them be healthier,
      and to make informed decisions to look after their health

The Health Promotion Strategic Framework 2018-2019 (HPSF) was designed in early 2018 based on local needs assessment and using international evidence on the most effective strategies for these issues.

To support and communicate about the various measures of the HPSF social marketing has been undertaken, under the campaign ‘Saints Together’.

Outcome measures for the period 2018-2019 among the population of St Helena:

  1. To reduce consumption of high sugar drinks; and high fat, high salt, high sugar snack foods
  2. To increase ‘substitution’ of healthier food and drink options to replace the less healthy ones
  3. To increase the number of smokers trying to quit
  4. To increase physical activity participation across the population

A population ‘Health and Lifestyles’ survey to assess the prevalence of lifestyle behaviours relating to the main risk factors was undertaken in April 2018, and repeated in mid-2019.

Progress to date in the period 2018-2019 includes:

Smoking

  • Smoke-Free
    Government Policy established
  • Established
    smoking cessation starter service and Free NRT trial period
  • Community social
    marketing – quitting
  • Proposals to
    strengthen Tobacco Duty and legislation to reduce tobacco use are underway

Food Environment

  • Partnership with major
    importer merchants to develop availability of non-sugar drinks
  • Government
    institutions develop Healthy Food/Drinks policies & practice
  • Work to develop a
    Government-wide catering policy is underway; Primary Schools also developed
    Guidance to Parents and Children for Healthier School Lunches
  • Leading community food
    businesses have modified menus and are promoting healthier options
  • Work with SHG
    Finance is ongoing to support the Sugar Taxation measures to achieve strong
    impact for health [PR EDC April 2019]
  • Community social
    marketing

Government Workforce Wellbeing

  • Example Wellbeing programme
    delivered across government [PR for WWB 2018]
  • Government has
    agreed a Grant of ‘30 minute weekly activity time’ for staff
  • Government now
    allows staff to attend smoking cessation appointments in work time
  • Work is underway
    to embed Workforce Wellbeing into organisational objectives and manager
    responsibilities

Physical Activity

  • Needs Assessment
    to identify strategy to increase population physical activity – walking
  • Short ‘accessible’
    local walks – maps and social marketing

Chronic Disease Management System development

  • A Bid for expert support (partnership with University of Stirling) to train health service staff in Motivational Approaches was successful and will be delivered in October 2019
  • Partnership with public Health England to design a weight management service to fit with health service capacity, and to train staff in managing obesity is underway.

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