Epidemiology & Health Sciences Team (Public Health)

CHILDREN & YOUNG PEOPLE’S HEALTH & WELL-BEING PROFILE (2013) SOUTH & MID OPERATIONAL UNIT SUMMARY

September 2013

CONTENTS:

1–PAGE SUMMARY

APPENDIX 1 GEOGRAPHY AND ABBREVIATIONS

Caveat for 1-page summary – this summary and listing of ‘challenges’, ‘good practice’ and ‘areas for improvement’ are based on our own interpretation of the profiles. Any would-be user of these are encouraged to look at the profile themselves which provides the full range of measures at various levels of detail. Wider determinants Potential for Health Improvement Health Protection Need for Health & Social Care CHILD & YOUNG PEOPLE HEALTH & WELL-BEING PROFILE OF THE SOUTH & MID OPERATIONAL UNIT Population 0-19y = 23%, overall the youngest pop; East Ross & Life expectancy from birth: Across NHS H, Primary immunisation at 2y : Unit averages Looked after children : Over 300 in number, rate of Inv. E have 24% lowest in (M=66y; F=77y) & for all courses similar to NHS H averages but 8.8/1000 aged 21y & under. Slightly lower than NHS H Population 0-19y 10 yr growth 2002-2011: 2.8% ; only unit to highest in & Holm Mains (M= lower than the national ones; rates in Mid average (9.7/1000). By placement area, higher rates in E. have had growth; Within the unit, the districts of Inv E (17%) & 83y); Nairn Rural (M =82y; F=87y) & Ross & Inv. East tend to be higher. Ross and Inv. West (10.7 & 10.5 per 1000 resp'ly). B&SNA (1.7% ) only have grown Culloden/Balloch compared to NHS H Looked after children by age in care : Over one quarter (M=76y; F=81y) Population 0-19y projected 2010-2035: increase by 7.8% for H HPV vaccination S2 girls : Uptake rate of 3rd (27%) are aged under 5 years old, a higher percentage HSCP compared to NHS H 2.1% and 1.6%. Largest Hospitalisation (alcohol-related) 0-19y : dose was 86.5%, higher than the averages than NHS H average of just over one fifth (21%). The growth to be in 5-11y group Unit average lower than NHS H but higher for NHS H & Scotland (83% for both). Rate percentage under 5y was 29% in the South and 23% in the than Scotland. Downward trend since 2007; for B&SNA lower than other districts but Births: Rate & annual numbers increased the most over 10 Mid area. higher in South than Mid area (143/100,000 similar to NHS H average. years; rates highest in districts of E. Ross & Inv. East. Looked after children by Placement type : Almost equal versus 115/100,000) Breastfeeding at 6-8wks: Unit rate (32%) numbers looked after at home with parents and those in Remote/Rural 0-19y : 42% live in settlements of 10,000 -25,000 Hospitalisation (unintentional injuries) 0- similar to NHS H rate (31%). Rate in B&SNA foster care. 13% in residential care, lower than NHS H people; B&SNA have 55% and E. Ross 35% living in remote or 14y : Unit average rate of 1052/100,000 was higher (38%) but lower in E. Ross (21%). average of 16%. very remote rural areas higher than NHS H (886/100,000) & Looked after children receiving aftercare : Just under 70 in Scotland (926/100,000). The rates are Deprivation 0-19y: 2,600 (8% of units 0-19y pop.) live in the Flouride varnishing at 3yr: Unit average rate the unit; 50% aged 15-18y and 50% aged 19-21y. This similar in South and Mid areas. nationally 15% most deprived data zones; in Inv. W (21% of its was 14% compared to NHS H average of profile is similar to H HSCP average but differs from the Child obesity in P1: For the Unit overall, 0-19y pop.); E. Ross (16% of its 0-19y pop) 16%. Higher rates for Mid area (21%), national profile which has twice the number in the under 9% were overweight compared to particularly in E.Ross at 26%. younger age group than the older age group. Income Deprivation 0-19y: 6,500 (20% of units 0-19y pop.) live NHS H average of 10%, Scotland at 9%. Inv. Flouride varnishing at 4yr: Unit average rate Children receiving health & social care who have a in the LA 15% most income deprived data zones; Twice the West recorded the highest in the unit at was 19% compared to NHS H at 21%. Higher learning disability: Just under 200 in the unit (74 in Mid Units average in Inv. W and in E. Ross at around 40% of their 0- 12%. 6% of pupils were recorded as obese rates for Mid area (29%), particularly in area and 113 in South area). The rate per 1000 children 19y populations. or severely obese, a similar proportion to E.Ross at 32%. Lower in South area, aged 21 years & younger is high in E. Ross at 7.1 compared Child Poverty measure: 4,400 (13% of units 0-19y pop.) the averages for NHS H & Scotland. Higher particularly Inv. East at 13% to NHS H average of 4.6. children live in families that meet the HMRC definition. The values tended to be for the Mid area and proportion in E.Ross is 22% and in Inv. West, 18% for Inv. West Children receiving health & social care who have a learning disability: 12% were looked after children in the Educational : 92.5% attained English & maths (SQA level 3), less Unit, compared to the average percentage (17%) for NHS than the national average of 94%; 3% of pupils in E. Ross & Inv. H as a whole. Similar to the NHS H overall profile, the West have Polish as home language and 7 & 9% are with ASNs majority (60%) were identified with a disorder within the in these two districts respectively. autistic spectrum. The unit has the highest number & percentage of younger people in NHS H and this is likely to increase in the next 20 years compared to a possible decrease in the N&W unit. The growth has been mainly in East. Birth rates are highest in E. Ross which has over one fifth of children Challenges: living in families that meet the child poverty criteria. In addition the highest rate of children who have learning disabilities receiving health & social care live in E. Ross. Over one third of E. Ross younger population live in remote or very remote areas which will challenge access to services. The highest rate of looked after children are in E. Ross and Inverness West. The Unit has a high rate of HPV vaccination of S2 girls and the primary immunisation rates at 2 years are high in Mid Ross & Inverness East. Good practice: Flouride varnishing rates are high in the Mid area, particularly in E. Ross. Breast feeding rate in B&SNA is the highest across the unit. The unit has a higher proportion of younger children in care which may be beneficial for achieving longer-term placements or adoption. The breast feeding rate in East Ross is low (21%). The flouride varnishing rate in the South is low, particularly in Inverness East. Areas for improvement: Given the disadvantages of children in East Ross due to the socio-economic circumstances, holistic support for healthy lifestyle changes is needed. The lowest life expectancy in NHS H is for Inv. Merkinch (in the district of Inv. West) and likewise a holistic approach taking account of life circumstances is required.

APPENDIX 1

Geography & Abbreviations These are as exact as possible geographies based on data at datazone level or GP Practice location

Operational Unit Areas Districts/Localities Abreviations Caithness Cat North Sutherland Suth North & West Lochaber Loc West Skye, Lochalsh & Wester Ross SL &WR Badenoch & Strathspey, Nairn & Ardersier B&SNA South Inveness East Inv. East South and Mid Inverness West Inv. West East Ross E. Ross Mid Mid Ross Mid Ross Bute & Cowal B & C Helensburgh & Lomond H & L Argyll & Bute Argyll & Bute Mid Argyll, Kintyre & Islay MAKI Oban, Lorn & the Isles OLI When data is only available at Intermediate (IZ) geography, the following mapping applies BUT the sums of IZs DO NOT define the Districts or areas South Area (South & Mid Operational Unit) Intermediate Geographies (IZs) District Name Abbreviation Name Abbreviation Badenoch & Strathspey Central B & S Cen. Badenoch & Strathspey North B & S N. Badenoch & Strathspey South B & S S. Badenoch & Strathspey, Nairn & Ardersier B&SNA Nairn East Nairn E Nairn Rural Nairn Rural Nairn West Nairn W Inverness Central, & Longman Inv Cen. Inverness Crown & Haugh Inv. Crown Inverness Culloden & Balloch Inv Culloden Inverness Inv. Drakies Inverness Drummond Inv. Drummond Inverness East Inv East Inverness Hilton Inv Hilton Inverness & Slackbuie Inv Inshes Inverness Lochardil & Holm Mains Inv Lochadil Inverness Smithton Inv Smithton Inverness Westhill Inv Westhill Inverness & Inv Ballifeary Inverness & South West Kinmylies Inverness Merkinch Merkinch Inverness Muirtown Inverness West Inv. West Inverness Scorguie Inverness West Rural Inv W. Rural Loch Ness Loch Ness

Mid Area (South & Mid Operational Unit) Intermediate Geographies (IZs) District Name Abbreviation Name Abbreviation Alness Alness Invergordon Invergordon Ross & Cromarty East R & C East East Ross E Ross Seaboard Seaboard Tain Tain Black Isle North B.Isle N Black Isle South B. Isle S Conon & Muir of Ord Conon Mid Ross Mid Ross Dingwall Dingwall Ross & Cromarty Central R & C Central

Other abbreviations

ASN Additional Support Needs CHD Coronary Heart disease COPD Chronic Obstructive Pulmonary Disease CKD Chronic Kidney Disease H HSCP Health & Social Care Partnership area (Highland Council area) HMRC Her Majesty Revenue & Customs LA Local Authority LT conditions Long term conditions NHS H NHS Highland

Summary by: Susan Vaughan (e-mail: [email protected] ) Sara Huc (e-mail: [email protected] ) Epidemiology & Health Sciences, Public Health, Assynt House, Inverness, IV2 3BW

September 2013