Hart District 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 ID: 482277
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Slide1
Joint Strategic Needs Assessment 2015
Hart District Council
Hampshire Public Health TeamSlide2
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 Slide3
P
opulation headlines
Children
(0-19 years) – 22,177 (24.0%) (23.7% England)
Older people 65 and over – 17,427 (19.0%) (17.6% England)85 and over – 2,257 (2.4%) (2.4% England)
Total Hart Population 93,313
Key Issues for Hart
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 outcomesSmokingObesity AlcoholInactivityPoor diet
Demographic Growth by 2021 Aged 0-19 years – increase by 1,035 (4.7%) Aged 65 and over – increase by 3,290 (18.9%)Aged 85 and over – increase by 1,098 (48.6%)
Working age:
Healthy carers,
W
orkplace healthCommunity Resilience
Health and social inequalitiesEducationEmploymentIsolation
Life Expectancy and Healthy Life expectancy Gap
Men –
15.5 years
Women – 17.9 years Slide4
DemographySlide5
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
3 people of working age there will be 1 person of pensionable age in HartVariation in Ethnic Groups and diversity across the County – necessitating changing needsSlide6
Demography
Life expectancy is increasing
Healthy life expectancy is reducingSlide7
Demography
Life expectancy for women; the increase is much slower, beginning to
plateau
Healthy life expectancy is decreasingSlide8
Inequality
Gap in life expectancy due primarily to Cancer and Respiratory disease for men
Gap in life expectancy due primarily to Circulatory
disease and
Cancer for womenScarf Chart showing the breakdown in life expectancy gap between most deprived and least deprived quintiles across Hart, by broad cause of death 2010-12
Hart
Life expectancy gap between most deprived and least deprived quintiles, by broad cause of death 2010-12 Slide9
Starting Well
A
wide number of factors
influence
and determine good healthNo single definitive measure Infant and child mortality, and birth weight are good indicators of health now and in the future Slide10
Starting Well: Infant and Child Mortality
Child Mortality
Hampshire
Child mortality by age band - Hampshire residents - 2012 to 2014
Source: ONS Primary Care Mortality Database
Underlying cause of death description (% of total deaths)
Age band
<1 year
1 to 4 years5 to 9 years10 to 14 years15 to 19 years
0 to 19 yearsPerinatal Deaths62%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 system1%
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%Slide11
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 Slide12
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 activitySlide13
Starting Well: EducationSlide14
Starting Well: Education
Good overall educational attainment at 5 and 16 years
Greater variation at GCSE
Achievement of 5 GCSEs (A*-C) including English and Math for 2011/12
(Source
DfE)Source: ONS © Crown Copyright 2013
Source
: ONS © Crown Copyright 2013% of Pupils achieving a good level of development at the age of 5 years for 2011/12 - (Source DfE)Slide15
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: EmploymentSlide16
Starting Well: Injuries
Need to understand better social and emotional factors affecting young people that impact on theseSlide17
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, supporting vulnerable children improve educational attainment and healthSupporting long term unemployed young people into education, training and employmentMaximising the impact of Public Health 0-5 services to improve healthy eating, reducing accidents, identifying families at risk of poorer health and emotional wellbeingSlide18
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 Slide19
Staying Well: Morbidity
Decreasing preventable mortality – although lower than regional and national figures, starting to plateau in Hart
CCG
CHD
Recorded
PrevalenceCHD Estimated PrevalenceDiabetes
Recorded PrevalenceDiabetes Estimated Prevalence
Hyper-tension Recorded PrevalenceHyper-tension Estimated PrevalenceHampshire DistrictNorth East Hampshire and Farnham2.6%
(1 in 38)3.5%(1 in 29)5.2%(1 in 19) 6.3%(1 in 16) 12.8%
(1 in 8)22.7%(1 in 5) RushmoorHart (part)Waverley (part)North Hampshire
2.6%(1 in 38) 3.6%
(1 in 28)5.7%(1 in 18)
6.2%(1 in 16) 12.3%(1 in 8)
22.9%(1 in 5) Basingstoke and DeaneEast Hampshire (part)Hart (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)Slide20
Staying well: Potential Years of Life Lost
Conditions of focus:
CHD – Stroke and IHD
Cancer – Breast and Colon
Respiratory – Pneumonia Slide21
Staying Well: Mortality (CVD)
District
figures, lower than national and regional figures but beginning to plateau
Risk
factors include smoking and obesitySlide22
Staying Well: Mortality (Cancer)
Significant difference between men and womenSlide23
Staying Well: Mortality (Cancer)
Malignant Melanoma incidence in Hart is high
Disproportionally affects younger adults
89% preventable Slide24
Staying Well: Diabetes
Poor control and management of diabetes – leads to complication/disability
County role is in partnership with Health and Districts to support healthy lifestyles especially diet and exerciseSlide25
Staying Well: Mental Health
Contributing factors to poorer mental health; employment, social exclusion, access to services
Support needed to improve social inclusion and employment chancesSlide26
Staying Well: Employment
Data indicates conditions that have greatest impact on need for disability support
Personal Independence Payments (PIP) by Disability
– HartSlide27
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 employmentSlide28
Staying Well
P
roportion
of working aged population is
reducing; pressure on services and caringReducing healthy life expectancy; focus on improving lifestyles and self management of health conditions, particularly diabetesReducing 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)Slide29
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 populationSlide30
Ageing Well: Life expectancy
Life expectancy at 65 is increasing for men but most recently plateauing for women
Healthy life expectancy for men and women is decreasingSlide31
Falls declining over the last time period, hip fractures marginally increased
Although reducing absolute numbers will impact on resources/outcomes for older people
Ageing Well: FallsSlide32
Ageing Well: Physical DisabilitySlide33
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 DeathsSlide34
Ageing Well: Dementia
Focus on
Improving independence and reducing isolation
Prevention Slide35
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 2013Need to understand scale of the problem and what data sources can helpPartnership approach needed to develop interventions to reduce impact of isolation Strategic use of voluntary sector to supportSlide36
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