Joint Strategic Needs Assessment 2015 Test Valley Borough Council Hampshire Public Health Team.
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Transcript of Joint Strategic Needs Assessment 2015 Test Valley Borough Council Hampshire Public Health Team.
Joint Strategic Needs Assessment
2015Test Valley Borough Council
Hampshire Public Health Team
Contents
• Demography – how is our population changing?
• Starting Well – the health and life chances of our children
• Staying Well – the health of our adult population
• Ageing Well – the health of our older population
Population headlines Children (0-19 years) – 27,496 (23.0%) (23.7% England)Older people 65 and over – 24,518 (20.0%) (17.6% England)85 and over – 3,339 (2.8%) (2.4% England)
Total Test Valley Population120,016
Key Issues for Test Valley
Long term conditions /multi-morbidity:• Diabetes • Cardiovascular Disease • Chronic Obstructive
Pulmonary Disease • Mental Health (including
Dementia)• Musculoskeletal
(including Falls/Fractured hips)
Lifestyle risks – activities contributing to poorer health outcomes• Smoking• Obesity • Alcohol• Inactivity• Poor diet
Demographic Growth by 2021 • Aged 0-19 years – increase by 1,956 (7.1%) • Aged 65 and over – increase by 4,756 (19.4%)• Aged 85 and over – increase by 1,579 (47.3%)
Working age: • Healthy carers,• Workplace health• Community Resilience
Health and social inequalities• Education• Employment• Isolation
Life Expectancy and Healthy Life expectancy Gap• Men – 15.5 years• Women – 17.9 years
Demography
Demography• The OADR provides an idea of
the relationship between the working age population compared to those of pensionable age. A higher OADR value indicates a fewer people of working age
• Ratio of people of state pension age is increasing compared to working age population
• By 2025 for every 2 people of working age there will be 1 person of pensionable age in Test Valley
• Variation in Ethnic Groups and diversity across the County – necessitating changing needs
Demography
• Life expectancy is increasing; healthy life expectancy is reducing
Demography
• Life expectancy for women; the increase is much slower, beginning to plateau• Healthy life expectancy is decreasing
Inequality in Test Valley
Gap in life expectancy due primarily to Circulatory disease, Cancer and Respiratory disease in men
Gap in life expectancy due primarily to Circulatory, Respiratory disease and mental and behavioural in women
Scarf Chart showing the breakdown in life expectancy gap between most deprived and least deprived quintiles across Test Valley, by broad cause of death 2010-12
Test ValleyLife expectancy gap between most deprived and least deprived quintiles, by broad cause of death 2010-12
Starting Well• A wide number of factors influence and determine good
health
• No single definitive measure
• Infant and child mortality, and birth weight are good indicators of health now and in the future
Starting Well: Infant and Child Mortality
Child Mortality Hampshire
Child mortality by age band - Hampshire residents - 2012 to 2014Source: ONS Primary Care Mortality Database
Underlying cause of death description (% of total deaths)
Age band
<1 year1 to 4 years
5 to 9 years
10 to 14
years
15 to 19
years0 to 19 years
Perinatal Deaths 62% 3% 0% 0% 0% 32%
Congenital malformations 16% 3% 10% 10% 2% 10%
Diseases of the nervous system 1% 13% 15% 24% 19% 9%
Diseases of the respiratory system 1% 17% 15% 14% 2% 5%
External causes 1% 3% 5% 5% 49% 12%
Neoplasms 1% 27% 45% 19% 11% 11%
Other 19% 33% 10% 29% 18% 20%
Starting Well: Low Birth Weight Births with birth weight less than 2500g as a proportion of live and still births with valid weight, 2008-2012
Source: ONS © Crown Copyright 2013
• Babies born with low birth weight (LBW) at risk of poorer health and developmental issues
• Risk factors for LBW include maternal smoking and deprivation
Starting Well: Healthy Weight• Child weight
good predictor of future health
• 50% increase in excess weight between ages of 5 and 11
• Higher levels of breast feeding linked to better child health
• County and districts have a role in supporting healthy eating and increased activity
Starting Well: Education
Starting Well: Education
• Variation of educational attainment at 5 and 16 years
Achievement of 5 GCSEs (A*-C) including English and Math for 2011/12 (Source DfE)
Source: ONS © Crown Copyright 2013Source: ONS © Crown Copyright 2013
% of Pupils achieving a good level of development at the age of 5 years for 2011/12 - (Source DfE)
• While improving, unemployment for more than 12 months can affect employment chances later in life
• Partnership required with county and district to support longer term unemployed into work
Starting Well: Employment
Starting Well: Injuries
• Need to understand better social and emotional factors affecting young people that impact on these indicators
Starting Well
• Key issues for the Health of Children and Young People – Working with families on minimising excess weight gain to
achieving a healthy weight (improving healthy eating and physical activity)
– Develop and target social and emotional interventions to support emotional wellbeing of children and young people
– Understanding needs of vulnerable children (Children with Disabilities and SEN)
– In Partnership, support vulnerable children improve educational attainment and health
– Supporting long term unemployed young people into education, training and employment
– Maximising the impact of Public Health 0-5 services to improve healthy eating, reducing accidents, identifying families at risk of poorer health and emotional wellbeing
Staying Well
• Prevalence of factors or conditions that cause premature mortality or illness indicate how healthy our population is
• For adults – the main causes of premature death are Cancer, Heart disease
and respiratory disease. – Certain illnesses (e.g. mental health and diabetes) not only
cause morbidity but can also cause significant disability impacting on employment and future wellbeing
Staying Well: Morbidity
Preventable Mortality – plateauing for Test Valley
CCG CHD Recorded Prevalence
CHD Estimated Prevalence
Diabetes Recorded Prevalence
Diabetes Estimated Prevalence
Hyper-tension Recorded Prevalence
Hyper-tension Estimated Prevalence
Hampshire District
West Hampshire
3.4%(1 in 29 )
4.6%(1 in 22)
5.3%(1 in 19)
7.0%(1 in 14)
14.5%(1 in 7)
26.2%(1 in 4)
Test ValleyNew ForestWinchester (part)EastleighEast Hampshire (part)
England 3.3%(1 in 30 )
4.7%(1 in 21)
6.2%(1 in 16 )
7.3%(1 in 14)
13.7%(1 in 7)
24.7%(1 in 4)
Staying well: Potential Years of Life Lost
Conditions of focus:
• CHD – Stroke and IHD
• Cancer – Breast and Colon
• Respiratory – Pneumonia
Staying Well: Mortality (CVD)
• District figures beginning to plateau
• Risk factors include smoking and obesity
Staying Well: Mortality (Cancer)
• Difference between men and women
Staying Well: Mortality (Cancer)
• Malignant Melanoma incidence in Hampshire and Test Valley is high• Disproportionally affects younger adults • 89% preventable
Staying Well: Mortality (Respiratory)
• Rate of mortality plateaued
• Smoking prevalence constant
Staying Well: Diabetes• Poor control and management
of diabetes – leads to complication/disability
• District role is in partnership with Health and County to support healthy lifestyles especially diet and exercise
Staying Well: Mental Health
• Contributing factors to poorer mental health; employment, social exclusion, access to services • Support needed to improve social inclusion and employment chances
Staying Well: Employment
• Data indicates conditions that have greatest impact on need for disability support
Personal Independence Payments (PIP) by Disability – Test Valley
Staying Well: Employment
• A good measure of independence is the number of people with disabilities who are in employment• Partnership between County and Districts needed to support more people with disabilities into
employment
Staying Well• Proportion of working aged population is reducing; pressure on
services and caring
• Reducing healthy life expectancy; focus on improving lifestyles and self management of health conditions, particularly diabetes
• Plateauing levels of Cancer mortality; improving early diagnosis and screening uptake;
• Higher levels of preventable mortality for SMI; improving access to services and social inclusion and employment chances
• Understanding impact of health conditions on disability (Mental health, cancer, neurological conditions, MSK)
Ageing Well• Life expectancy at 65 and disability-free life expectancy at 65 give
us a measure of the health of our older population
• Falls and fractures in older people can lead to loss of independence and death – preventing falls has a major impact on health and wellbeing
• Social isolation and loneliness impact on health and wellbeing particularly for conditions such as dementia – reducing isolation can improve outcomes for all ages but particularly our older population
Ageing Well: Life expectancy
• Life expectancy has been increasing, starting to decline slightly for women• Healthy life expectancy is decreasing
• Rates have decreased but showing a small increase in 13/14 for falls but a decrease in hip fractures
• Absolute numbers will impact on resources/outcomes for older people
Ageing Well: Falls
Ageing Well: Physical Disability
• The UK has one of the highest Excess Winter Death (EWD) rates in Europe• In 2013/14, 78% of EWD in people over 75 years• Fuel poverty and keeping warm, major factor in increasing susceptibility• Link to social isolation and fuel poverty – identification of individuals at risk is key
issue
Ageing Well: Excess Winter Deaths
Ageing Well: Dementia
Focus on • Improving independence and reducing isolation• Prevention
Ageing Well: Isolation% of Pensioners who live alone 2011 Census
Source: ONS © Crown Copyright 2013
% of people over 60 living in pension credit households (IDAOP 2010 DCLG)
Source: ONS © Crown Copyright 2013
• Need to understand scale of the problem and what data sources can help
• Partnership approach needed to develop interventions to reduce impact of isolation
• Strategic use of voluntary sector to support
Ageing Well
• Focus on falls prevention; Return on Investment for evidence-based exercise classes, improving independence (opportunity for joint commissioning)
• Focus on preventable disabilities; blindness (AMD/Reducing Smoking, Diabetic Retinopathy/Screening)
• Focus on impact of social isolation; partnership working on initiatives to reduce impact