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Rugby CCG (Jan 2012)
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Rugby CCG (Jan 2012)

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Presentation to Rugby Clinical Commissioning Group by the Warwickshire Observatory

Presentation to Rugby Clinical Commissioning Group by the Warwickshire Observatory

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  • Thanks for inviting us along – I’m GW & this is SP - both from Obs Asked to provide statistical health profile & overview for Rugby Borough Felt couldn’t do this in isolation without considering wider socio-determinants of health – reason for Spencer presenting alongside me
  • In terms of today’s pres…before we bombard you with too many facts, figures & stats… For those who might be unfamiliar. Useful to clarify - What is the Obs? –– Who we are? What we do? How can help to inform your future work as a CCG? Most pertinent mix of socio-econ, demog & health data – specific to Rugby Borough – try to provide a detailed profile/overview of borough and its popn Finally – want to tie all this in with our work on JSNA - key mech by which we are trying to bring together all this info -> inform comm decisions/HWB Strategy. JSNA should provide you with the evidence base to commission & direct resources & activity to those areas in greatest need.
  • What is the Obs?
  • What is the Obs? Provide a R&I service to WCC and partners – providing robust evidence base on which key policy-makers/commissioners can make informed decisions Split into 3 teams – now all based in Barrack St, Warwick with PH move to WCC Research Team led by Spencer – focus on d emographic, econ, crime/comm safety analysis, analysis of local surveys/consultations – broad remit – covers many wider socio-determinants of health, Quality of Life in Warwickshire, Census 2011 PH intelligence team – led by myself – based within PH – epidemiological analysis, needs assessments (JSNA), DPH Annual Reports – crossover with research team on socio-determinants Information team – more technical, IT based – developing online LIS for JSNA/GP Practice profiles
  • Hope that’s provided bit of helpful background/context… Clearly - already have good understanding of local health issues… Not expecting to unearth any huge surprises. However, in developing a comprehensive profile of Rugby and its popn - wanted to get you to consider some of wider socio-determinants of health – e.g. education, employment, housing, community safety – chosen to focus on these following discussions with Sue – mentioned getting a better grasp of the underlying socio-demographics & characteristics of the local popn Nicely summarised in this diagram by Dahlgren & Whitehead which you may be familiar with – will loosely form basis for content of pres Handover to SP – contextual/scene-setting info on local popn
  • Rugby currently has a population of 94,200 About 67,000 of that is in main Rugby town Was 87,500 in 1981 – hasn’t increased significantly
  • Summary of the dynamics of population change – combination of natural change and migration, both domestic and international
  • Girl born today has 1 in 3 chance of turning 100. 1 in 4 for a boy.
  • Rugby broadly in line with national trends. Life expectancies at birth increased 3-5 years during last 15 years, trend likely to continue Implications for health and social care Whilst increased length of life is generally a positive outcome, there is an issue around the quality of extra years gained
  • Typically around 600 international migrants moving into borough each year – although a similar number leave Census 2011 on its way – much more detail on these types of datasets
  • Reflects Warwickshire as a whole in many ways – generally low levels of deprivation with some communities of considerable affluence, but also with some pockets of significant deprivation.
  • 58 SOAs in Rugby
  • Gaps widening
  • Area to north of Hollowell Way (Grizedale, Ennerdale, Seathwaite, Keswick Drive) Very young population – risk of problems being compounded, cycle of deprivation
  • Oliver St, Rounds Gardens, Date St, Princes St In contrast to BSLDN, this area has only 15% aged 0 - 15 Above average % pensioners (46%) Brings different issues – fuel poverty, health, adult social care Doesn’t feature on children-based measures such as GCSEs, FSM etc Emphasises the need to avoid a one size fits all approach – tailor interventions to meet the specific local challenges
  • Years of Potential Life Lost (2004 to 2008, Source: ONS) • Comparative Illness and Disability Ratio (2008; Source: DWP) • Acute morbidity (2006/07 and 2007/08, Source: Department of Health) • Mood and anxiety disorders (2008, Source: DWP)
  • Unemployment rate sat between 1.5% and 2% between 2000 and 2008 then economic downturn arrived JSA claimant rate more than doubled, peaking at 3.9% in Rugby during summer 2009 Since fallen to 2.5% but future trend unclear Currently 1635 claimants
  • These figures mask significant variations at the local level…
  • JSA only accounts for one quarter of all individuals dependent on benefits in Rugby… Since 31 January 2011 no new Incapacity Benefit claims have been accepted – replaced by Employment and Support Allowance Employment and Support Allowance provides financial help to people who are unable to work because of illness or disability Carer's Allowance is a benefit to help people who look after someone who is disabled. After being widowed may be able to claim Bereavement Allowance, a taxable weekly benefit paid up to 52 weeks from the date of death
  • Ed = key determinant of future health Refer to QoL report – Community Forum performance Mention NEETs data
  • Moving onto health indicators now… More info available in QoL report, website etc. e.g. housing, consultation
  • Move onto most relevant PH information… Obesity – one of key current/future lifestyle issues. Est prev of adults classed as obese with BMI > 30 – Rugby again fairly typical – in line with County fig. Still almost 1 in 4 adults – equates to nearly 19,000 residents! Clearly one of key PH challenges placing considerable future demands on healthcare services particularly in tandem with growing & ageing popn Analysis of NCMP figs shows 15.6% Year 6 children – stat signif better than Eng avg BUT % of year 1-13 pupils who spend at least 3 hours per week on high quality PE and school sport 2009/10 – stat signif worse than Eng avg
  • Shows rate of alcohol related hospital admissions per 100,000 population – annual increase in every borough/district – but Rugby actually seen largest increase since 2007/08 – approx +75%. From having lowest rate in County in 07/08 – increased to having 2 nd highest rate in County in 09/10 – only behind N&B.
  • Smoking related deaths - Per 100,000 population aged 35 +, directly age standardised rate 2007-2009 – directly related – many more indirectly related
  • In terms of MH chosen to focus on dementia… With a growing & ageing population - Projected to increase from 1,200 sufferers in 2011 to over 2,300 by 2030 (+93.5%) – compares with 90.7% increase across County and +105% in Stratford-on-Avon
  • In terms of teenage conceptions - Rugby – experienced largest fall in under-18 conception rate 98/00 – 07/09 – 33% fall in rate per 1,000 female popn 15-17! However, 3 wards in borough still feature within highest 20% in England – Brownsover South, Newbold & Benn – localised ‘hotspots’! According to ONS, wards with a rate among the highest 20% in England have a 2006-08 under 18 conception rate equal to, or higher than, 53.1 per 1,000 females aged 15-17 years.
  • Want to bring all this together by mentioning JSNA - All the types of data/information we’ve discussed will be incorporated into this Purpose…. Not static paper based doc – dynamic, continually updated, ongoing process incorporating online LIS where you can access data yourselves – but we will provide headline analysis and more detailed NA around key themes identified
  • Way in which we structured JSNA so far – identified following themes - loosely follow life-course approach advocated by Marmot in his recent report on health inequals Identification of themes in terms of: - Resource gap - Demand & Volume – supported by evidence - Significant inequalities - By geography and/or population group Produced 1 page summaries on each theme – snapshot for 2011 but a starting point for further work. Presented to HWBB. Stakeholder conference – 7 th March – invited – key emerging headlines/products
  • Whistle stop tour/only scratching surface and not covered everything but hope it’s been helpful in providing some insight to a more comprehensive overall profile of Rugby and its popn – kick start a discussion Contact details…. Comments/Questions?

Rugby CCG (Jan 2012) Rugby CCG (Jan 2012) Presentation Transcript

  • A Socio-Demographic and Health Overview of Rugby Borough Gareth Wrench – Senior Public Health Intelligence Analyst/Epidemiologist Spencer Payne – Corporate Research Manager Rugby Clinical Commissioning Partnership Group Wednesday 4th January 2012
  • Introduction
    • What is the Observatory?
    • Mix of socio-economic, demographic & health data – Rugby Borough
    • JSNA -> HWB Strategy
  • No, not this
  • Warwickshire Observatory
    • Not stargazers!
    • Strategic Priority:
      • Develop a sound intelligence led evidence base for the needs of WCC, its communities and its partners, and strategically use effective consultation and engagement to help deliver improved customer satisfaction.
    • Physical entity based within WCC
      • Split into 3 teams
  • A Profile of Rugby? The Dahlgren and Whitehead schema of factors that influence health.
  • Introduction
    • Demographics
    • Deprivation
    • Economy & Education
    • Community Safety
    • Mosaic
    population, age profile, life expectancy, ethnicity, migration official indices of deprivation, types of deprivation unemployment, school attainment headline trends household types, characteristics, engagement techniques
  • Demographics
    • Current population = 94,200
    • Was 87,500 in 1981
    • Approximately 67,000 in Rugby Town
    A growing and ageing population…
  • Demographics
    • Growth a mixture of natural increase and migration
    A growing and ageing population… 91,800 2007 total population plus births plus international in-migration minus domestic out-migration minus deaths plus domestic in-migration minus international out-migration 2008 total population + 1,140 - 795 + 4,464 - 4,072 + 492 - 237 92,700 + 345 + 255 + 392
  • Demographics A growing and ageing population…
  • Demographics A growing and ageing population…
  • Demographics Life expectancies on the increase… Rugby Rugby Males England Females England 1991-93 2007-09 73.6 75.3 79.1 78.7 78.1 78.7 82.2 82.6
  • Demographics Ethnicity… Non-white population = 9%
  • Deprivation
    • Rugby is 219 th most deprived local authority district out of 326
    • Masks significant variation at the local level
    • Generally measured at Super Output Area level; communities of around 1,500 people
  • Deprivation
    • There are 32,482 SOAs in England
    • Rugby’s SOAs range from 3,314 th most deprived to 31,916 th
    • Rugby has 2 SOAs in the 20% most deprived nationally
      • Part of Brownsover South
      • Part of Newbold / town centre
  • Deprivation Newbold Benn Brownsover New Bilton Hillmorton Bilton
  • Deprivation Brownsover South Lake District North Town Central Overslade North West Newbold on Avon Overslade North New Bilton East Cattlemarket Whinfield Park Admirals East Church Lawford, Kings Newnham & Long Lawford North Ten Most Deprived Communities in Rugby…
  • Deprivation Varies in nature… Highest IMD ranking Highest unemployment total Highest Council Tax Benefit Claimants with children Highest free school meal claimants Highest lone parent benefit claimants Highest teenage pregnancy 30% aged 0 – 15 Brownsover South Lake District North
  • Deprivation 2nd Highest IMD ranking Lowest household income levels Highest Pension Credit claimants Highest Incapacity Benefit claimants Highest CTB/HB claimants (pensioners) Most deprived in health domain 46% pensioners ‘ Town Central’
  • Deprivation
    • Health Domain
    • More concentrated in urban areas
    • Town Centre SOA is in most deprived 10% nationally
  • Economy & Education Double dip recession…?
  • Economy & Education Widening inequalities…
  • Economy & Education Benefit claimants… All Benefit Claimants 6,560 Jobseekers Allowance 1,635 Jobseekers Allowance ESA / Incapacity Benefits 2,715 ESA / Incapacity Benefit Carers 530 Carers Lone Parents 745 Lone Parents Disabled 555 Disabled Bereaved Bereaved 150 Other income-related benefits 230 Other
  • Economy & Education GCSE Attainment…
    • Percentage attaining 5+ A*-C including Eng & Maths = 65% in Rugby
    • Warwickshire = 59%, England = 55%
    • Significant variations…
      • Dunchurch Community Forum area = 80%
      • Brownsover, Benn & Newbold Community Forum area = 48%
      • Below average performance for looked after children, some ethnic groups and children claiming free school meals
  • Community Safety
    • Four consecutive years of reductions in recorded crime
    - 2% 5,865 6,000 All Crime - 2% 1,022 1,038 Criminal Damage - 3% 718 743 Vehicle Crime + 20% 440 366 Domestic Burglary - 19% 1,079 1,326 Violent Crime % Change Nov 10 – Oct 11 Nov 09 – Oct 10
  • Community Safety
  • Community Safety
    • Good news on violent crime…
    • Down 19% over last twelve months
    • Rugby is the only district/borough to see a reduction
    • More importantly the 'serious violent' element is down 18%
      • (Nov 09 to Oct 10 - 550 vs Nov 10 to Oct 11 - 449)
  • Community Safety
    • Bad news on domestic burglary…
    • up 25% across the county
    • up 19% in Rugby Borough
    • Being targeted both at county level (Burglary Gold Group - led by Police) and at a local level by the Community Safety Partnership
  • Mosaic
    • Household classification system
    • 15 Groups and 69 Types
    • Uses demographic information and data on economic status, health, lifestyles, attitudes, interests and other themes
    • Also provides information preferred methods of accessing information
  • Mosaic
    • Helps understand diversity and need
    • Target resources
    • Identify most effective communication and engagement channels
  • Mosaic A Residents of isolated rural communities B Residents of small and mid-sized towns with strong local roots C Wealthy people living in the most sought after neighbourhoods D Successful professionals living in suburban or semi-rural homes E Middle income families living in moderate suburban semis F Couples with young children in comfortable modern housing G Young, well-educated city dwellers H Couples and young singles in small modern starter homes I Lower income workers in urban terraces in often diverse areas J Owner occupiers in older-style housing in ex-industrial areas K Residents with sufficient incomes in right-to-buy social houses L Active elderly people living in pleasant retirement locations M Elderly people reliant on state support N Young people renting flats in high density social housing O Families in low-rise social housing with high levels of benefit need Groups
  • Mosaic A Residents of isolated rural communities B Residents of small and mid-sized towns with strong local roots C Wealthy people living in the most sought after neighbourhoods D Successful professionals living in suburban or semi-rural homes E Middle income families living in moderate suburban semis F Couples with young children in comfortable modern housing G Young, well-educated city dwellers H Couples and young singles in small modern starter homes I Lower income workers in urban terraces in often diverse areas J Owner occupiers in older-style housing in ex-industrial areas K Residents with sufficient incomes in right-to-buy social houses L Active elderly people living in pleasant retirement locations M Elderly people reliant on state support N Young people renting flats in high density social housing O Families in low-rise social housing with high levels of benefit need Groups & Types A01 - Rural families with high incomes, often from city jobs A02 - Retirees electing to settle in environmentally attractive localities A03 - Remote communities with poor access to public and commercial services A04 - Villagers with few well paid alternatives to agricultural employment
  • Mosaic A Residents of isolated rural communities B Residents of small and mid-sized towns with strong local roots C Wealthy people living in the most sought after neighbourhoods D Successful professionals living in suburban or semi-rural homes E Middle income families living in moderate suburban semis F Couples with young children in comfortable modern housing G Young, well-educated city dwellers H Couples and young singles in small modern starter homes I Lower income workers in urban terraces in often diverse areas J Owner occupiers in older-style housing in ex-industrial areas K Residents with sufficient incomes in right-to-buy social houses L Active elderly people living in pleasant retirement locations M Elderly people reliant on state support N Young people renting flats in high density social housing O Families in low-rise social housing with high levels of benefit need Groups & Types A01 - Rural families with high incomes, often from city jobs A02 - Retirees electing to settle in environmentally attractive localities A03 - Remote communities with poor access to public and commercial services A04 - Villagers with few well paid alternatives to agricultural employment
  • Mosaic
  • Mosaic
  • Mosaic Mosaic Profile: Rugby v Warwickshire
  • Mosaic
    • Nearly 900 variables
    • For example, teenage pregnancy
      • ‘ Average’ Group O teenager seven times more likely to become pregnant than an ‘average’ Group C teenager
    • For example, liver disease
      • Group N residents three times more at risk than Group D household
  • Obesity
    • Children
    • Obese Children (Year 6) = 15.6%
    • -> Statistically significantly better than England average
    • Physically active children = 51.8%
    • -> Statistically significantly worse than England average
    • Adults
    • Obese Adults - Rugby = 24.9% (18,660 adults)
    • Obese Adults - Warwickshire = 25.0% (109,260)
    Key lifestyle issue…
  • Alcohol Continued increases in admissions…
  • Smoking
    • Prevalence – 23.5% of adults
    • Smoking related deaths – 177 per 100,000 population aged 35+
      • -> Statistically significantly better than England average of 216 per 100,000
    • Still largest preventable cause of mortality
    Still a key public health issue…
  • Mental Health Increasing future demand…
  • Teenage Conceptions -> Statistically significantly better than England average A mixed picture…
    • Purpose
    • To identify current and future health & wellbeing needs
    • To establish a shared, evidence-based consensus on key local priorities
    • To form a core element in the commissioning cycle
    • Children
      • Educational Attainment
      • Looked After Children
    • Lifestyle & Reducing Inequalities
    • Vulnerable Communities
      • Disability
      • Safeguarding
    • Long-Term Conditions
    • Mental Wellbeing
    • Ageing
      • Dementia
      • Ageing & Frailty
    Children/Young People Older People General Population Warwickshire JSNA Theme Summaries - 2011
  • Further information
    • Gareth Wrench 01926 413753
    • [email_address]
    • Spencer Payne 01926 412469
    • [email_address]
    • http://warksobservatory.wordpress.com
    • http://www.warwickshireobservatory.org.uk /
    • Any questions?