introduction

In recent years, NHS Lothian has been working to eliminate or minimise the negative health impacts of many harmful behaviours and activities. This is work done mostly in conjunction with experts from local authorities, the police and voluntary and community sectors. Often this has produced very positive outcomes; reduced rates of HIV infection being a good example. However, what was appropriate twenty years ago may not be relevant now. Patterns of behaviour change. Obesity is a case in point, a relatively minor concern in 1986, is now a major risk to our current and future health. Our knowledge and evidence base improves, for example cognitive behavioural therapy is now a gold standard treatment for depression.

These highlight the very clear way in which improvements in health are achieved by ensuring we have ways that can promote and protect health and provide services when someone is ill or at risk of becoming ill. The evidence suggests that achieving the right balance between effective, high quality health services and interventions that prevent illness and promote health and wellbeing is central to creating long-term sustainable solutions. Such solutions often seen as "virtuous circles" - are not only good for the individual. Economic prosperity is a key feature of sustainable development and communities that can keep well or be helped to recover health when it is lacking are more likely to be economically strong.

The following articles outline new thinking about major public health issues - drugs misuse, sexual health, tobacco use, obesity, mental health and oral health and the ways in which NHS Lothian is trying to address these health problems and help local people and the communities in which they live to keep well.