Annual Report of the Director of Public Health, 2010-11

Contents of presentation• A profile of Gloucester

• Burden of disease in Gloucester

• Factors affecting the burden of disease:

– The impact of socio-economic factors on health

– Data taken from the social marketing tool HealthACORN.

• Commissioning brief: Looking at ‘what works’ when promoting healthy lifestyle choices

• Summary

The projected shift in numbers and proportions of children, adults

and older people over the next 16 years.

Resident population by age group in Gloucester 2009 and 2025

31102

34961

81415

96602

8543

11953

0% 20% 40% 60% 80% 100%

2009

2025

Yea

r

Percentage of total population

Gloucester 0-19 Gloucester 20-74 Gloucester 75+

Key issues for GloucesterOverall health indicators are similar or better than England average except for:

• Early death rates from circulatory disease (coronary heart disease and stroke)

• Rates of diabetes recorded on GP registers

• Early deaths from respiratory disease

• New cases and early death rates from cancer (including malignant melanoma)

• Rates of anxiety and depression

• Children living in poverty

• Uptake of Chlamydia screening in people aged 15-24 years

Early death rates from circulatory disease

Deaths from CHD in people aged under 75 years 2006-2008 pooled

0

10

20

30

40

50

Ag

e st

and

ard

ised

rat

e p

er 1

00,0

00 p

op

ula

tio

n

District 31 29 40 44 37 28

NHS Gloucestershire 35 35 35 35 35 35

England 42 42 42 42 42 42

Cheltenham CotswoldForest of

Dean Gloucester Stroud Tewkesbury

Source: eJSNA, Compendium of Clinical and Health Indicators, National Centre for Health Outcomes Development (NCHOD)

Rates of diabetes

Prevalence of diabetes in people aged 17 years and over as recorded on GP registers, March 2009

0

10

20

30

40

50

60

70

Rat

e p

er 1

,000

re

gis

tere

d r

esid

ent

po

pu

lati

on

ag

ed 1

7 &

ove

r

District 44 43 57 60 48 55

NHS Gloucestershire 51 51 51 51 51 51

Cheltenham Cotsw oldForest of

Dean Gloucester Stroud Tew kesbury

Source: JSNA, Vital Signs Monitoring March 2009, PCCAG, Quality and Outcomes Framework

Respiratory diseases

Premature deaths from respiratory diseases in people under 75 years old : 2006-2008 pooled

0

2

4

6

8

10

12

14

Ag

e st

and

ard

ised

rat

e p

er 1

00,0

00 p

op

ula

tio

n

District 11.0 6.1 10.5 13.2 9.6 7.7

NHS Gloucestershire 9.7 9.7 9.7 9.7 9.7 9.7

England 12.1 12.1 12.1 12.1 12.1 12.1

Cheltenham Cotsw old Forest of

Dean Gloucester Stroud Tew kesbury

Source: eJSNA, Compendium of Clinical and Health Indicators, National Centre for Health Outcomes Development (NCHOD)

Cancer

Incidence of all cancers 2004-06 pooled

320

340

360

380

400

Ag

e st

and

ard

ised

rat

e p

er 1

00,0

00 p

op

ula

tio

n

District 376 347 365 395 370 369

NHS Gloucestershire 371 371 371 371 371 371

England 372 372 372 372 372 372

Cheltenham CotswoldForest of

Dean Gloucester Stroud Tewkesbury

Source: eJSNA, Compendium of Clinical and Health Indicators, National Centre for Health Outcomes Development (NCHOD)

Mental health

Estimated prevalence of neurotic disorders in people under 75 years

0

50

100

150

200

250

Age

sta

ndar

dis

ed r

ate

per

1,00

0 p

opu

latio

n

District 203 140 145 196 146 143

Gloucestershire 165 165 165 165 165 165

England 164 164 164 164 164 164

Cheltenham Cotsw old Forest of Dean Gloucester Stroud Tew kesbury

Source: eJSNA, Mental Health Observatory, North East Public Health Observatory (NEPHO)

Uptake of Chlamydia screening

Uptake of Chlamydia screening in people aged 15-24 years2008-09

19

20

21

22

23

24

25

Pe

rce

nta

ge

of

ag

e g

rou

p t

es

ted

District 22 24 21 24 23 22

Gloucestershire 22 22 22 22 22 22

England 22 22 22 22 22 22

Cheltenham CotswoldForest of

Dean Gloucester Stroud Tewkesbury

Source: eJSNA, National Chlamydia Screening Programme Vital Signs Indicator, May 2010[1]

[1] The variance in the district and county % data is due to the National Chlamydia Screening Programme using two different denominator sources for the population data.

Key lifestyle factors that influence health and wellbeing

• Smoking and tobacco control

• Physical activity in children and adults

• Healthy eating in children and adults

• Alcohol misuse

Correlations between reported lifestyle behaviours, emotional health and wellbeing and deprivation in children

Conceptual Framework

Source: Fair Society, Health Lives - The Marmot Review – Strategic review of health inequalities in England post 2010

Index of Multiple Deprivation(IMD)and HealthACORN

IMD Three sub domains:• ‘Employment Deprivation’; ‘Living Environment’ &

‘Income deprivation’

HealthACORN:• Group 1 - levels of illness are above average

• Group 2 - based on lifestyle factors

‘Income’ deprivation domain

HealthACORN- Existing problems

HealthACORN- Future Problems

Reported lifestyle behaviours, emotional health and wellbeing and deprivation - Gloucester

Gloucester Index of Multiple Deprivation Domains 2007 Highest level within county for:

HealthACORN More than a third of households with:

LSOAs

Employment Deprivation

Income Deprivation

Living Environment Deprivation

Health Deprivation

Existing Health Problems

Future Health Problems

BARNWOOD 3 BARNWOOD 4 BARNWOOD 5 BARTON AND TREDWORTH 1 BARTON AND TREDWORTH 2 BARTON AND TREDWORTH 3 BARTON AND TREDWORTH 4 BARTON AND TREDWORTH 5 BARTON AND TREDWORTH 6 BARTON AND TREDWORTH 7 ELMBRIDGE 2 GRANGE 3 HUCCLECOTE 2 KINGSHOLM AND WOTTON 1 KINGSHOLM AND WOTTON 2 KINGSHOLM AND WOTTON 3 KINGSHOLM AND WOTTON 4 MATSON AND ROBINSWOOD 1 MATSON AND ROBINSWOOD 2 MATSON AND ROBINSWOOD 3 MATSON AND ROBINSWOOD 4 MATSON AND ROBINSWOOD 5 MATSON AND ROBINSWOOD 6 MATSON AND ROBINSWOOD 7 MORELAND 1 MORELAND 2 MORELAND 3 MORELAND 4 MORELAND 5 MORELAND 6 MORELAND 7 PODSMEAD 1 PODSMEAD 2 QUEDGELEY FIELDCOURT 4 QUEDGELEY SEVERN VALE 2 TUFFLEY 2 TUFFLEY 4 WESTGATE 1 WESTGATE 2 WESTGATE 3

1. Why aim for a smokefree future?

2. Why be more physically active?

3. Why eat well?

4. Why does safe and responsible drinking matter?

5. Why does promoting sexual health matter?

6. Mental health and wellbeing: Why does it matter?

7. Why does sun awareness matter?

Summary• Gloucester has a number of key health issues

• Wider determinants and lifestyle behaviours are often interlinked

• Addressing these will take concerted efforts• There are specific steps that local partners,

alongside health care providers, can take to make a real difference to the health and wellbeing of people in Gloucestershire.