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North Wales Profile 2011

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North Wales Profile 2011 Authors: Dr Rob Atenstaedt, Consultant in Public Health Medicine; Claire Jones, Public Health Intelligence Specialist; Claire Tiffany, Advanced Public Health Intelligence Analyst; Jo Charles, Associate Public Health Director; Siobhan Jones, Consultant in Public Health; Dr Rachel Andrew, Specialty Registrar in Public Health; Dr Julia Williams, Associate Public Health Director; Dr Angela Tinkler, Consultant in Public Health; Dr Peter Stevenson, Consultant in Public Health Medicine; Dr Stella Botchway, Specialty Registrar in Public Health Date: 13 th February 2012 Version: 1 Publication/ Distribution: Public (Internet) • NHS Wales (Intranet) • Public Health Wales (Intranet) Review Date: N/A Purpose and Summary of Document: This document has been put together to support Betsi Cadwaladr University Health Board and other partner agencies across North Wales. The document provides information and data from a range of sources, including the Public Health Wales Observatory. The profile describes the health and well-being status of the North Wales population and the wider determinants of health, which can impact on individual’s health and well-being. Work Plan reference: N/A Public Health Wales North Wales Profile 2011 Contents 1 INTRODUCTION 6 2 INFORMATION SOURCES 9 3 DATA ANALYSIS 10 3.1 Interpreting maps and charts 11 3.1.1 Interpreting Middle Super Output Area Maps 11 3.1.2 Interpreting Middle Super Output Area Charts 12 4 AGE, SEX & BIOLOGICAL FACTORS 13 4.1 Demography 14 4.1.1 Proportion of the population aged under 18 years 15 4.1.2 Proportion of the population aged 75 years and over 18 4.1.3 Proportion of the population aged 85 years and over 21 4.2 Population Density 23 4.3 Projected changes in total population, 2008 to 2033 24 4.4 General Fertility Rate 27 4.5 Low Birth Weight 30 4.6 Teenage Conceptions 34 4.6.1 Conceptions, under 16 year olds 34 4.6.2 Conceptions, under 18 year olds 36 4.7 Abortion Data 38 4.8 Black and Minority Ethnic Population 38 4.9 Overseas Migrant Population 39 4.10 Welsh Language 40 4.11 Religious Beliefs 41 4.12 Sexual Orientation 41 4.13 People living with a physical/sensory disability 42 5 MORTALITY 44 5.1 Life Expectancy 45 5.1.1 Inequalities in life expectancy 46 5.2 Infant Mortality 48 5.3 Mortality from all causes, all ages 50 5.3.1 Inequalities in all cause mortality, all ages 53 5.4 Mortality from all causes, persons aged under 75 55 5.4.1 Inequalities in all cause mortality, persons aged under 75 58 5.5 Mortality from cancers, all ages 60 Date: 13.02.12 Version: 1 Page 2 of 318 Public Health Wales North Wales Profile 2011 5.5.1 Inequalities in mortality from cancers 63 5.5.2 Cancer survival 66 5.6 Mortality from circulatory disease, all ages 68 5.6.1 Inequalities in mortality from circulatory disease 71 5.7 Mortality from circulatory disease, persons aged 74 under 75 5.8 Mortality from coronary heart disease, all ages 77 5.9 Mortality from respiratory disease, all ages 80 5.9.1 Inequalities in mortality from respiratory disease 83 6 MORBIDITY 86 6.1 Limiting Long Term Illness as reported by adults 86 6.2 Physical Component Summary Score 88 6.3 Dental Health 90 7 UNINTENTIONAL INJURIES 91 7.1 Unintentional injuries in children and young people 92 7.1.1 Unintentional injury related hospital admissions, 0-18 years 92 7.1.2 Unintentional injury related hospital admissions 0-5 years 97 7.2 Unintentional injury related mortality 98 7.3 Unintentional falls 98 7.3.1 Fractures 101 7.3.2 Public health strategies to counter falls and fractures 105 7.4 Road traffic casualties 105 8 MENTAL HEALTH 106 8.1 Prevalence of mental health conditions 107 8.2 Mental and physical health 111 8.3 Suicide 111 8.4 Mental health in children and young adults 115 8.5 Mental health in older people 118 8.6 Mental health service activity 119 9 LIFESTYLE 122 9.1 Nutrition 124 9.1.1 Nutrition & Children & Young People 125 9.1.2 Breastfeeding 126 9.2 Physical Activity 127 9.2.1 Physical Activity & Children & Young People 128 9.3 Overweight & Obesity 130 Date: 13.02.12 Version: 1 Page 3 of 318 Public Health Wales North Wales Profile 2011 9.3.1 Overweight or obese & children & young people 132 9.4 Tobacco 134 9.4.1 Smoking related mortality 135 9.4.2 Tobacco use & children & young people 136 9.4.3 Smoking in Pregnancy 137 9.4.4 Smoking Cessation Services 138 9.5 Alcohol 139 9.5.1 Alcohol use & children & young people 141 9.5.2 Alcohol related hospital admissions 141 9.5.3 Alcohol related mortality 142 9.5.4 Alcohol related crime 144 9.6 Illicit Drugs 145 9.6.1 British Crime Survey results of illicit drug use 145 9.6.2 Illicit drug related hospital admissions 146 9.6.3 Illicit drug use & children & young people 146 9.7 Sexual Behaviour 147 9.7.1 Sexually Transmitted Infections 148 10 FAMILY, FRIENDS & COMMUNITY 151 10.1 Carers 152 10.2 Household Composition 152 10.2.1 People living alone 153 10.2.2 Older people living alone 154 11 DEPRIVATION 155 11.1 Measurement of Deprivation 156 11.1.1 Townsend Index 157 11.1.2 Welsh Index of Multiple Deprivation 157 11.1.3 Free school meal entitlement 158 11.2 Measurement of Deprivation Results 158 11.2.1 Townsend Index 158 11.2.2 Welsh Index of Multiple Deprivation 2008 161 11.2.3 Welsh Index of Multiple Deprivation 2011 163 11.2.4 Comparisons between WIMD 2008 and WIMD 2011 166 11.2.5 Free school meal entitlement 166 11.3 Impact of Deprivation on health 167 11.3.1 National Public Health Service for Wales Report 167 11.4 Wider determinants of health 168 Date: 13.02.12 Version: 1 Page 4 of 318 Public Health Wales North Wales Profile 2011 11.4.1 Tobacco 168 11.4.2 Nutrition 168 11.4.3 Alcohol 169 11.4.4 Illicit drugs 169 11.4.5 Teenage conceptions 169 11.4.6 Work & unemployment 169 11.4.7 Transport 170 11.4.8 Crime 171 12 HEALTHCARE SERVICES & UTILISATION 172 12.1 Primary Care 173 12.1.1 General Medical Practitioners 173 12.1.2 NHS Dental Performers 176 12.1.3 Community Pharmacies 176 12.1.4 Opticians 177 12.2 Secondary Care 178 12.2.1 All hospital admissions, aged under 75 years 178 12.2.2 Emergency hospital admissions, aged under 75 years 182 12.2.3 Elective hospital admissions, aged under 75 years 185 13 IMMUNISATION 188 13.1 Childhood vaccines 189 13.2 Influenza vaccine 195 13.2.1 Seasonal influenza vaccination for pregnant women 196 14 SCREENING 197 14.1 Breast screening 198 14.2 Cervical screening 199 14.3 Bowel screening 200 14.4 Newborn hearing screening 200 15 ADDITIONAL RESOURCES 202 16 REFERENCES 203 17 APPENDICES 206 Date: 13.02.12 Version: 1 Page 5 of 318 Public Health Wales North Wales Profile 2011 1 Introduction Unitary authorities (UA), health boards (HB) and other partners are required to work in partnership to formulate and implement Health, Social Care and Well-being (HSCWB) Strategies at the local level. These strategies should be informed by information and data on the health and well-being status of the local population and on the wider determinants which can impact on an individual’s health and well-being (Public Health Wales Observatory, 2010a). This information can also be used by HBs and UAs for planning services. When conducting a health needs assessment at the local level, it is important to know how health compares at a HB or a UA basis with other geographies in Wales. However, since HSCWB Strategies are required to plan, direct and prioritise health and social care activity within UAs, it is of at least equal importance to understand how health varies inside the local UA area. Sometimes, variation within a local area is greater than between areas (Public Health Wales Observatory, 2010a). A frequent source of frustration is that, often, the data that would be of most interest and relevance in determining health needs and associated priorities either does not exist or is not robust enough to support any firm conclusions. For example, there are not enough teenage conceptions to show meaningful variation within UA areas. Another source of difficulty, and sometimes confusion, is the plethora of geographies available at the sub-unitary authority level. Frequently, these geographies vary over time, making the analysis of aggregate years’ data (often required to make analysis more robust) problematic. There are other geographies that may be useful at the local level but lack digitised boundary files with national coverage. There are others which are consistent and homogeneous across Wales but, sometimes, it is hard to relate them to real areas. To help overcome this, the Observatory has produced an Interactive Atlas of Geographies in Wales designed to give an overview of the different statistical and administrative geographies used in Wales (Public Health Wales Observatory, 2010a). People’s health is determined by the context of their lives and so blaming individuals for having poor health is inappropriate. People are unlikely to be able to directly control many of the determinants of their health. The ‘social determinants of health’ refers to both specific features of, and pathways by which, societal conditions affect health and that can potentially be altered by informed action.
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