Health and Wellbeing in Ayrshire and Arran Volume 1: Current Health Status
Health and Wellbeing in Ayrshire and Arran Volume 1: Current health status
A cross-sectional view of population health in Ayrshire and Arran drawn from ScotPHO profiles, September 2019
AUTHOR: September Alister Hooke 2019
Health and Wellbeing in Ayrshire and Arran Volume 1: Current health status
Public Health Department NHS Ayrshire & Arran
Version no: FINAL REPORT
Prepared by: Dr. Alister Hooke, Senior Public Health Research Officer
Effective from: September 2019
Lead reviewers: Dr. Lynne Hamilton, Consultant in Public Health Medicine
Marlene McMillan, Public Health Programme Lead
CONTENTS
SECTION HEADING PAGE
Introduction to first volume 1
A Life expectancy and mortality 2
B Ill health and injury 4
C Mental health 6
D Behaviours which impact on health 8
E Women’s and children’s health 10
F Immunisations and screenings 12
G Social care 14
H Education 16
I Crime 17
J Economy 18
K Environment 19
L Modal health class 20
Health and wellbeing: DATA TABLES 21 Health and wellbeing in Ayrshire and Arran Introduction to first volume
In this first of two reports,1 data drawn from online ScotPHO area profiles are used to build a cross-sectional picture of the current health status of Ayrshire and Arran. A wide-ranging depiction of population health was compiled using the most up-to-date data available across a selection of key indicators. Comparisons are made with other HSCP areas in Scotland and also with Scotland as a whole. The aim is to promote understanding of the health and wellbeing status of the local population, to highlight where local health improvement efforts or service responses may need to be directed or strengthened, and to support all partner organisations involved in improving population health.
The term EASR appearing in this report denotes, for any measure of population health, the European age-sex standardised rate per 100,000 population (using ESP2013). This takes the relevant measure, e.g., number of patients hospitalised with coronary heart disease, and transforms the measure into a rate allowing comparison of data across geographical areas by taking into account the different gender and age structures of different populations.
Throughout the report, local data at Health and Social Care Partnership (HSCP) or Council area level will be compared with the national equivalent. Currently there are 31 HSCP areas and 32 Council areas across Scotland. In Ayrshire and Arran, there are three HSCP areas which are all coterminous with its three Council areas: these are East Ayrshire, North Ayrshire and South Ayrshire. For simplicity, these will sometimes be referred to as East, North and South in this report.
Finally, all relevant area statistics for various health and wellbeing indicators will be tested against the national comparator and judged to be significantly ‘worse’, ‘better’ or no different from the comparator (see key outlined below). Indication of significant differences will point to potential areas where action may be needed to consolidate gains or redress comparative deficits in local population health.
KEY TO ALL CHARTS APPEARING IN THIS REPORT:
Statistically significantly ‘worse’ than national average Statistically not significantly different from national average Scottish average shown as solid blue Statistically significantly ‘better’ than national average line in all charts:
DATA SOURCE: ScotPHO online profiles; data retrieved at September 2019 LINK: https://www.scotpho.org.uk/comparative-health/profiles/online-profiles-tool
1 Second report available on request via e-mail correspondence to: [email protected]
1 | P a g e
A. Life expectancy and mortality
SEE DATA TABLES A1 AND A2 FOR MORE DETAILS (page 21 of report)
Life expectancy: In the period 2014-2016, male life expectancy (LE) in Ayrshire and Arran was third lowest among Scottish health board areas and significantly below Scotland as a whole, with an estimated deficit locally of 0.5 years (76.6 v. 77.1 years). Within this, North Ayrshire recorded lowest LE result for males at 75.9 years, due to notably reduced male LE in the more deprived parts of Irvine and the Three Towns (Figure 1). In the same period, female LE was third lowest among all Scottish health board areas, with the local deficit being 0.7 years (80.4 v. 81.1 years) and significantly below Scotland overall. Within this, East Ayrshire yielded lowest LE for females at 79.8 years. This was mainly due to reduced female LE in the more income deprived parts of the Kilmarnock area, including Altonhill and Shortlees, as well as deprived parts of rural East Ayrshire, including the Doon Valley area (Figure 2).
Mortality: In the period 2015-2017, Ayrshire and Arran had third highest Scottish death rate (all ages), though local and national figures were not significantly different (EASR: A&A, 1,198.3 v. Scotland, 1,167.1). The East Ayrshire rate (EASR: 1,269.1) was highest locally and significantly worse than Scotland, with Altonhill North, Shortlees and Doon Valley South contributing primarily to this deficit. These were the same areas demonstrating reduced female LE in East Ayrshire, highlighting correspondence between greater area deprivation, higher mortality and reduced life expectancy. Across all Scottish health board areas, all-cause mortality among 15 to 44 year olds was highest in Ayrshire and Arran in the period 2015-2017, notably and significantly exceeding the Scottish average (EASR: A&A, 140.7 v. Scotland, 105.8). The main contribution to this deficit was an unexpectedly high rate observed in South Ayrshire (EASR: 150.5), almost entirely attributable to the high rate observed in the Ayr North Harbour, Wallacetown and Newton South area (EASR: 489.3). Early death rates (<75 years old) from CHD and cancer, however, were not significantly different locally and nationally.
2 | P a g e
FIGURE 1: Male life expectancy in years: by intermediate zone in North Ayrshire,
2014-16
88 86 84 82 80 78 76 74 72 70 68 66 64 62
60
Arran
Dreghorn
Irvine East Irvine
Beith West Beith
Dalry West Dalry
Largs South Largs
Largs North Largs
Irvine Central Irvine
Fairlie & Rural & Fairlie
Kilbirnie North Kilbirnie
Irvine Fullarton Irvine
Saltcoats Central Saltcoats
Irvine Tarryholme Irvine
Ardrossan Central Ardrossan
Beith East & Rural & East Beith
Dalry East & Rural & East Dalry
Irvine Bourtreehill Irvine
Irvine Broomlands Irvine
Springside & Rural & Springside
Stevenston Ardeer Stevenston
Skelmorlie & Rural & Skelmorlie
Stevenston Hayocks Stevenston
Saltcoats North East North Saltcoats
Saltcoats North West North Saltcoats
Ardrossan North East North Ardrossan
Kilwinning Pennyburn Kilwinning
Ardrossan North West North Ardrossan
Irvine Castlepark South Castlepark Irvine
Irvine Castlepark North Castlepark Irvine
Stevenston North West North Stevenston
West Kilbride & Seamill & Kilbride West
Largs Central & Cumbrae & Central Largs
Kilbirnie South & Longbar & South Kilbirnie
Kilwinning Central North & Central Kilwinning
Irvine Girdle Toll & Staneca & Toll Girdle Irvine
Irvine Perceton & Lawthorn & Perceton Irvine Kilwinning Whitehirst Park &… Park Whitehirst Kilwinning Kilwinning West & & Blacklands West Kilwinning
FIGURE 2: Female life expectancy in years: by intermediate zone in East Ayrshire, 2014-16
88 86 84 82 80 78 76 74 72 70 68 66 64 62
60
Darvel
Galston
Drongan
Kilmaurs
Piersland
Shortlees
Newmilns
Mauchline
Auchinleck
New Cumnock New
Cumnock Rural Cumnock
Stewarton East Stewarton
Cumnock North Cumnock
Stewarton West Stewarton
Mauchline Rural Mauchline
Doon Valley South Valley Doon
Doon Valley North Valley Doon
Bellfield & Kirkstyle & Bellfield
New Farm Loch South Loch Farm New
Southcraig & Beansburn & Southcraig
Earlston & Hurlford Rural Hurlford & Earlston
Bonnyton & Town Centre Town & Bonnyton
Altonhill North & Onthank & North Altonhill
Cumnock South & Craigens & South Cumnock
Dean & New Farm Loch North Loch Farm New & Dean
Grange, Howard & Gargieston & Howard Grange,
Northern & Irvine Valley Rural Valley Irvine & Northern
Crosshouse, Gatehead & Kilmaurs… & Gatehead Crosshouse, Altonhill South, Longpark & Hillhead & Longpark South, Altonhill
Kilmarnock South Central & Caprington & Central South Kilmarnock
3 | P a g e
B. Ill health and injury
SEE DATA TABLES B1 AND B2 FOR MORE DETAILS (page 22 of report)
Patients hospitalised with CHD, COPD or asthma: From 2015/16 to 2017/18, rates of patients hospitalised with coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD) or asthma were significantly worse in all three local HSCP areas compared to Scotland, with the exception of asthma in South Ayrshire where local and national rates were not significantly different. With respect to CHD, patient hospitalisation rates in East, North and South Ayrshire were among the top four highest recorded in Scotland (Figure 3). In terms of respiratory disease, patients hospitalised with COPD generated rates in East, North and South which were, respectively, the third, sixth and seventh highest recorded among all 31 Scottish HSCP areas. Across Scotland, asthma figures were also second and fourth highest in North and East Ayrshire respectively, with only the figure in South not significantly different from the national average, though still yielding the sixth highest rate in Scotland as a whole. In addition, figures for all areas in Scotland showed a pattern of entrenched morbidity across the West of Scotland; in particular, Glasgow & Clyde, Lanarkshire and Ayrshire & Arran consistently dominated health board area trends for CHD, COPD and asthma. Clearly socio-economic deprivation is closely linked to this regional effect.
Patients with emergency hospitalisations: From 2015 to 2017, the rate of patients with emergency hospitalisations in Ayrshire and Arran was the highest recorded among all health board areas in Scotland, with rates in East, North and South Ayrshire among the top five HSCP area rates recorded in Scotland (Figure 4); Glasgow City and North Lanarkshire were the two other areas in the top five. A broadly similar pattern was found in multiple emergency hospitalisations among patients aged 65 or over, with the three local areas yielding rates in the top six across Scotland, along with Glasgow, North Lanarkshire and Renfrewshire. Thirteen out of the fifteen HSC localities across Ayrshire and Arran reported emergency hospital hospitalisation rates (all ages and 65+) significantly above (worse than) Scotland, with only Arran and North Coast & Cumbraes reporting rates not significantly different from or significantly below (better than) Scotland. Overall, it is difficult to interpret these results since emergency hospital admissions may be driven by variations in patterns of service usage, as well as reflecting variations in patterns of ill health or injury. Whichever factors have determined these figures, it is clear that local rates are among the highest in Scotland and therefore likely to impose significant pressures on the local acute healthcare system.
Other ill health and injury: Figures for new cancer registrations (2015-17) and road traffic accident casualties (2015-17) were not significantly different locally and nationally, with the exception of the new cancer registrations figure in East which was significantly below (better than) the Scottish average.
4 | P a g e
FIGURE 3: Patients hospitalised with coronary heart disease: EASR per 100,000
population by HSCP area, 2015/16-17/18
550 500 450 400 350 300 250 200 150 100 50
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland
Scottish Borders Scottish
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
FIGURE 4: Patients with emergency hospitalisations: EASR per 100,000 population by
HSCP area, 2015-17
11000 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Scottish Borders Scottish Islands Shetland
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
5 | P a g e
C. Mental health
SEE DATA TABLES C1 AND C2 FOR MORE DETAILS (page 23 of report)
The ScotPHO profiles report on a number of proxy mental health measures, including prescribing, hospitalisation and suicides. However, each of these indicators reflect a range of service related or personal factors which can be unconnected to mental health. Limitations of the data are discussed below.
Population prescribed drugs for mental health conditions: In 2017/18, a greater proportion of people in Ayrshire and Arran were prescribed drugs for mental health conditions compared to other areas in Scotland, and significantly more than Scotland on average (A&A 20.8% v. Scotland 18.8%). Local figures were 21.3% in South, 21.1% in North, 20.1% in East, all significantly above the national average (Figure 5). Interpretation of these statistics is difficult on two accounts: firstly, these drugs are mainly but not strictly administered for the treatment and alleviation of mental health conditions; secondly, these figures may be influenced by the clinical perspectives and judgments of local practitioners as much by prevalence of mental ill health in the local population. As such, it cannot be asserted that mental health problems are more prevalent in Ayrshire and Arran than in other parts of Scotland. What can be asserted, however, is that costs to NHS Ayrshire & Arran on account of these prescribing patterns can be high.
Patients with a psychiatric hospitalisation: From 2015/16 to 2017/18, the rate of patients with a psychiatric hospitalisation was significantly lower in East Ayrshire than in Scotland as a whole, while rates in North and South were not significantly different from the Scottish average (Figure 6). This contrasts with the local prescribing patterns described above. Once again, there is some difficulty in the matter of interpreting these results, primarily because of local service capacities, including the number of hospital beds available locally for psychiatric care. With increasing emphasis on shifting the balance of care toward the community setting, variations in local decisions about where patients are treated and cared for, in the community or in hospital, will undoubtedly be reflected in this data. Thus, as with prescribing data, strict assertions about prevalence of mental health problems in Ayrshire and Arran are not warranted here.
Deaths from suicide: From 2013 to 2017, the rate of deaths from suicide in Ayrshire and Arran was not statistically different from the national average (EASR: A&A, 12.2 v. Scotland, 13.3). Absolute numbers of deaths are generally too small to detect significant differences at HSCP area level, even over a 5-year period. Moreover, death from suicide can involve individuals without a prior recorded history of mental health problems, and so this measure needs to be regarded carefully in the present context.
6 | P a g e
FIGURE 5: Population prescribed drugs for anxiety/depression/psychosis: percentage
by HSCP area, 2017/18
24 22 20 18 16 14 12 10 8 6 4 2
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland
Scottish Borders Scottish
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
FIGURE 6: Patients with a psychiatric hospitalisation: EASR per 100,000 population by
HSCP area, 2015/16-17/18 450
400
350
300
250
200
150
100
50
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland
Scottish Borders Scottish
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
7 | P a g e
D. Behaviours which impact on health
SEE DATA TABLES D1 AND D2 FOR MORE DETAILS (page 24 of report)
Active travel: In 2016/17, active travel to work by adults aged 16 or over was significantly lower in East Ayrshire compared to Scotland on average (EA, 8.1% v. Scotland 14.9%). Figures in South (10.8%) and North (13.4%) were not significantly different from the national comparator. Greater rurality and correspondingly larger distances involved in getting to work in East may explain these results in part.
Smoking: In the period from 2016 to 2017, smoking attributable death rates were found to be significantly higher (worse) in North and East Ayrshire than in Scotland as a whole, while South Ayrshire and national rates were not significantly different (Figure 7). And in 2017, estimates of smoking prevalence among adults 16+ were also higher in North (22%) and East (19%) than in Scotland (18%) while lower in South (15%), though no local rate was significantly different from the national average. Congruence between the two smoking indicators in North and East, with results above the national average, reinforces likelihood of greater health problems linked to smoking being experienced in those areas, while similar congruence in South, with results below the national average, suggest a comparatively reduced problem in that area.
Alcohol and drugs: In 2017/18, alcohol-related hospital stays local rates were significantly higher in North (895 per 100,000 population) and South (758) than in Scotland as whole (676), with rates in East (658) not significantly different from the national comparator. In ranking terms, North was fifth highest in Scotland, South was seventh, and East was thirteenth (of 31 HSCP areas). From 2015/16 to 2017/18, local data for drug-related hospital stays was even more accentuated in ranking terms than that of alcohol-related hospital stays (though absolute numbers relating to the latter still remain well above that of the former). In particular, 3-year average rates of drug-related hospital stays in East, North and South (327, 398 and 243 per 100,000 population respectively) were all significantly higher than the Scottish average (of 181), with North yielding the highest rate across the whole of Scotland for the relevant period (Figure 8). After this, East was third and South seventh highest in Scotland. Considered together, local alcohol- and drug-related hospital figures were reasonably aligned and suggest higher than average prevalence of substance use problems across Ayrshire and Arran compared to Scotland on average. Moreover, local rates were consistently higher in more deprived and urban HSC localities, including Kilmarnock, Irvine and Ayr North. Results also indicated a strong West of Scotland regional effect once again, with Glasgow City, Inverclyde and West Dunbartonshire consistently represented at the top end of the reported figures, along with East, North and South Ayrshire.
8 | P a g e
FIGURE 7: Estimated smoking attributable deaths: EASR per 100,000 population by
council area, 2016-17
550 500 450 400 350 300 250 200 150 100 50
0
Fife
Angus
Moray
Falkirk
Stirling
Highland
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Scottish Borders Scottish Islands Shetland
City of Edinburgh of City
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
Na h-Eileanan Siar h-Eileanan Na
Clackmannanshire
East Dunbartonshire East Dumfries & & Galloway Dumfries West Dunbartonshire West
FIGURE 8: Drug-related hospital stays: EASR per 100,000 population by HSCP area,
2015/16-17/18
450 400 350 300 250 200 150 100 50
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland
Scottish Borders Scottish
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
9 | P a g e
E. Women’s and children’s health
SEE DATA TABLES E1 AND E2 FOR MORE DETAILS (page 25 of report)
Women smoking during pregnancy: From 2015/16 to 2017/18, the percentage of women smoking during pregnancy was significantly higher in North (23.1%) and East (19.1%) than in Scotland as a whole (15.4%), while the South figure (16.8%) did not differ significantly from the Scottish average. This reflects the pattern found for smoking attributable deaths (see Figure 7), demonstrating that impacts of smoking on population health are more extensive in North and East, particularly the former area.
Baby health: From 2015/16 to 2017/18, the percentages of healthy weight babies born in East and North (both 82.9%) were not statistically significantly different from the Scottish figure (83.5%). However, the reported figure in South (79.9%) was significantly below the Scottish average by almost four percent. During the same period, the percentages of babies at the 6-8 week review recorded as being exclusively breastfed were significantly and notably lower in all HSCP areas locally (East 16.4%, North 16.8%, South 21.2%) compared to Scotland as a whole (29.7%) (Figure 9). It is also worth noting that 9 of 13 HSCP areas reporting figures significantly lower than the Scottish average were in the West of Scotland (as evidenced from Figure 9), suggesting that the local pattern may sit within a wider regional pattern.
Child dental health: In 2017/18, the percentage of children in primary 1 classified as having no obvious tooth decay was significantly higher in South Ayrshire than Scotland as whole (74.9% v. 70.4%); however, the figures in East (63.5%) and North (67.6%) were significantly lower than the national average (Figure 10). Urban areas in East and North contributed to these findings, with Kilmarnock, Irvine, Three Towns and Kilwinning generating figures significantly under the national average. In addition, the Southern locality in East produced the lowest figure of 54.6% among all HSC localities in Ayrshire and Arran. Equivalent figures for children in primary 7 showed no real change in East and South which remained, respectively, significantly below and above the Scottish average; but improvement in North was observed from primary 1 to 7, with the latter figure found to be above though not significantly different from the Scottish average. Relevant dental health figures for primary 7 children were: East 63.0%, North 72.5%, South 78.4%, Scotland 71.2%.
Child healthy weight: In 2017/18, the percentage figures for children in primary 1 recorded as healthy weight (BMI in 5% to 95% percentile range) showed that East (76.4%) and North (75.4%) were no different from Scotland (76.5%), and South (78.0%) was significantly higher (better) than Scotland, as was found to be the case with child dental health in South.
10 | P a g e
FIGURE 9: Babies exclusively breastfed at 6-8 week review: percentage by HSCP area, 3-year average, 2015/16-17/18
55 50 45 40 35 30 25 20 15 10 5
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland Borders Scottish
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
FIGURE 10: Child dental health in primary 1 – children without obvious tooth decay: percentage by HSCP area, 2017/18
90
80
70
60
50
40
30
20
10
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland
Scottish Borders Scottish
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
11 | P a g e
F. Immunisations and screenings
SEE DATA TABLES F1 AND F2 FOR MORE DETAILS (page 26 of report)
Immunisation uptake: From 2016 to 2018, all three HSCP areas in Ayrshire and Arran reported significantly higher immunisation uptake at 24 months for 5 in 1 (diphtheria, pertussis, tetanus, polio and hib) compared to the Scottish average (Figure 11). The 3-year average annual uptake results were: East 98.9%, North 98.4%, South 98.8%, Scotland 97.6%. Local results were all high and fairly commensurate, reflecting successful uptake of immunisation for 5 in 1 right across Ayrshire and Arran. During the same period, uptake figures for MMR (measles, mumps and rubella) vaccination were: East 97.2%, North 94.7%, South 96.8%, Scotland 94.6%. Figures in East and South were significantly above, while the figure in North was not significantly different from, the national comparator. At HSC locality level, uptake of 5 in 1 vaccination ranged from 88.5% in Arran (North Ayrshire) to 99.8% in Troon (South Ayrshire), with Arran yielding a rate significantly lower than the Scottish average. Uptake of MMR vaccination ranged from 88.5% in Arran to 98.4% in Girvan & South Carrick Villages in South Ayrshire. The relatively low figures for Arran require some investigation.
Screening uptake: From 2010 to 2012,2 reported breast screening rates locally and nationally among women aged 50 to 70 years were: East 74.0%, North 71.2%, South 77.8%, Scotland 72.5%. East and South rates significantly exceeded, and the North rate fell significantly below, the national comparator. From 2015 to 2017, bowel screening rates among people aged 50 to 74 years old were: East 54.7%, North 54.1%, South 58.8%, Scotland 56.4%. East and North figures fell significantly below, while the South figure was significantly above, the national average (Figure 12). Examination of bowel screening data at HSC locality level revealed that rates were significantly worse than the national comparator in Kilmarnock and the Southern locality in East Ayrshire. In North Ayrshire, all HSC localities yielded uptake rates lower (worse) than Scotland except Arran and North Coast & Cumbraes which yielded significantly higher (better) rates (60.1% and 59.5% respectively). And only Ayr North in South Ayrshire produced a rate significantly worse than Scotland, also generating the lowest figure in Ayrshire and Arran as a whole (at 47.2%). These results highlight a clear link between greater levels of socio- economic deprivation and reduced levels of uptake of bowel screening. And Figure 12 further shows a pronounced West of Scotland effect yet again.
2 More recent data for breast screening were not available from the ScotPHO profiles at September 2019.
12 | P a g e
FIGURE 11: Immunisation uptake at 24 months - 5 in 1 vaccination: percentage by
HSCP area, 3-year average, 2016-18
100 99 98 97 96 95 94 93 92 91
90
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Scottish Borders Scottish Islands Shetland
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
FIGURE 12: Bowel screening uptake among people aged 50 to 74 years old: percentage
by HSCP area, 3-year average, 2015-17
70
60
50
40
30
20
10
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland
Scottish Borders Scottish
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
13 | P a g e
G. Social care and housing
SEE DATA TABLES G1 AND G2 FOR MORE DETAILS (page 27 of report)
Children looked after by local authority: In 2017, the highest local rate of children looked after by local authority was 22.2 per 1,000 in North Ayrshire, relative to the population of children aged 0 to 18. This compares to the Scottish average of 14.3 per 1,000. Though lower than the rate in North, rates in East and South were also above the national average, at 16.1 and 18.4 per 1,000 respectively. However, it was not possible to determine if local rates were significantly different from the national rate.
Adults with incapacity or severe disability: Council area data was available for adults claiming: (1) incapacity benefit; or (2) severe disability allowance; or (3) employment and support allowance. Figures for percentage of adults in receipt of this state support in 2016 were: East 6.9%, North 7.4%, South 5.9%, Scotland 6.1%. Figures were significantly higher in East and North, but significantly lower in South, than Scotland (Figure 13). Area deprivation has likely contributed to this pattern.
Single adult dwellings: Single adult dwellings are dwellings subject to a Council Tax discount of 25 per cent, including those with: (1) a single adult; or (2) one adult living with one or more children; or (3) one or more adults who are 'disregarded' for Council Tax purposes. Percentages of dwellings falling into this category in 2018 were 37.9% in East, 40.1% in North, 37.1% in South, and 37.4% in Scotland as a whole. Computation of significant differences could not be determined between areas. At HSC locality level, percentages of single adult dwellings ranged quite broadly from 28.3% in Arran to 43.6% in the Three Towns. It is worth noting that North reported highest levels of single adult dwellings, adults on incapacity benefit etc., and looked after children, with these raised levels undoubtedly due to relatively higher income deprivation across North compared to East and South (see Figure 17 in Section J below).
Older people with high levels of care needs: Council area data was also available for older people with high levels of care needs, defined as people aged 65+ who are: (a) receiving 10+ hours of home care (purchased or provided by a local authority); or (b) resident in a Care Home; or (c) resident long-term in NHS hospital. In 2017, the percentages of people 65+ classified in this way were: East 29.9%, North 31.3%, South 35.8%, Scotland 35.2%. East and North figures were significantly below, and the South figure not significantly different from, the Scottish average (Figure 14). The comparatively raised level in South likely reflects the comparatively older population resident in that area.
14 | P a g e
FIGURE 13: Adults claiming incapacity benefit/severe disability allowance/employment
and support allowance: percentage by council area, 2016
11 10 9 8 7 6 5 4 3 2 1
0
Fife
Angus
Moray
Falkirk
Stirling
Highland
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland
Scottish Borders Scottish
City of Edinburgh of City
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
Na h-Eileanan Siar h-Eileanan Na
Clackmannanshire
East Dunbartonshire East Dumfries & & Galloway Dumfries West Dunbartonshire West
FIGURE 14: People aged 65 or over with high levels of care needs who are cared for at
home: percentage by council area, 2017
55 50 45 40 35 30 25 20 15 10 5
0
Fife
Angus
Moray
Falkirk
Stirling
Highland
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland Borders Scottish
City of Edinburgh of City
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
Na h-Eileanan Siar h-Eileanan Na
Clackmannanshire
East Dunbartonshire East Dumfries & & Galloway Dumfries West Dunbartonshire West
15 | P a g e
H. Education
SEE DATA TABLES H1 AND H2 FOR MORE DETAILS (page 28 of report)
Secondary school children: In 2014/15, secondary school attendance rates - based on school half days attended - in the three local HSCP areas were all good but significantly below Scotland on average, with point differences between areas being marginal (East 91.2%, North 91.1%, South 90.7%, Scotland 91.8%). In 2015/16, the percentage of children leaving secondary school with at least one qualification at SCQF Level 6 was significantly lower in East (56.8%) than Scotland on the whole (61.6%), while the rate in North (59.3%) was statistically indistinguishable from, and that in South (65.0%) statistically higher than, the national average (Figure 15).
Working age adults: In 2013, the percentage of working age adults aged 16 to 64 having no or low qualifications - defined as SCQF Level 4 or less – was notably lower (better) in South at 11.2%, with East and North proportions higher and fairly similar at 18.0% and 17.0% respectively. This compares to an average Scottish figure of 12.6% (statistical differences between areas were not carried out). Looking across indicators, working age adult and secondary school leaver qualification results were complementary and consistently better in South Ayrshire, while noting in this context that South is also relatively less socio-economically deprived than East and North.
FIGURE 15: Secondary school leavers with at least one SCQF Level 6 qualification:
percentage by council area, 2015/16
90
80
70
60
50
40
30
20
10
0
Fife
Angus
Moray
Falkirk
Stirling
Highland
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland Borders Scottish
City of Edinburgh of City
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
Na h-Eileanan Siar h-Eileanan Na
Clackmannanshire
East Dunbartonshire East Dumfries & & Galloway Dumfries West Dunbartonshire West
16 | P a g e
I. Crime SEE DATA TABLES I1 AND I2 FOR MORE DETAILS (page 29 of report)
Crime rate: In 2017, the crime rate was lowest in South (27.4 crimes recorded per 1,000 population) and quite a bit higher in East (32.9) and North (33.1). The South figure was significantly below, and East and North figures significantly above, the Scottish average (30.5) (Figure 16). At HSC locality level, the highest crime rates were found in Ayr North (52.0), Kilmarnock (43.7), Irvine (40.8) and the Three Towns (39.1), highlighting elevated occurrence of crime in more deprived and urban parts of Ayrshire and Arran.
Other crime-related data: Data was also available for violent crimes and domestic abuse recorded in 2016/17, and for drug offences recorded in 2017/18. In all instances, crude rates of these incidents, reported per 10,000 population, were significantly lower in South Ayrshire than Scotland as a whole. On the other hand, significantly elevated reports were found for domestic abuse in North and drug crimes in East; however, these two areas were indistinguishable from Scotland overall in respect of violent crimes. Moreover, drug crime in North was significantly lower than, and domestic abuse in East undifferentiated from, respective Scottish levels. Finally, local rates of adults serving time in prison were significantly raised above the Scottish average in 2014, with point differences between local and national rates fairly substantial – 216.3 per 100,000 adults 16+ in East, 261.5 in North, 207.7 in South, and only 161.9 across Scotland.
FIGURE 16: Crime rate: crude rate of crimes per 1,000 population by HSCP area, 2017
55 50 45 40 35 30 25 20 15 10 5
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland
Scottish Borders Scottish
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire 17 | P a g e
J. Economy SEE DATA TABLES J1 AND J2 FOR MORE DETAILS (page 30 of report)
Population income deprived: In 2017, the percentage of the population classified as income deprived – that is, based on the income domain of the Scottish Index of Multiple Deprivation – was significantly higher in all three local HSCP areas compared to Scotland as a whole (Figure 17). This sits within a wider pattern of income deprivation across the West of Scotland (as clearly evidenced from Figure 17). On close examination, among the 15 HSC localities in Ayrshire and Arran, seven yielded percentages not significantly worse than the national comparator: these were the Northern locality in East Ayrshire, Arran and North Coast & Cumbraes in North Ayrshire, along with Prestwick, Troon, Ayr South & Coylton and Maybole & North Carrick Villages all situated in South Ayrshire.
Other economic indicators: Data for working-age adults in relation to employment deprived (in 2017/18) and those claiming out-of-work benefits (in 2016) followed the same essential trends, locally and nationally, to that of income deprivation, revealing strong correspondence across these various economic indicators. Exceptions to this were found in relation to 2016 data for children in low income families and for people 60+ claiming pension credits, with South Ayrshire data significantly, and respectively, better or no different from national comparators.
FIGURE 17: Population income deprived: percentage by HSCP area, 2017
22 20 18 16 14 12 10 8 6 4 2
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Scottish Borders Scottish Islands Shetland
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries
West Dunbartonshire West Clackmannanshire & Stirling & Clackmannanshire
18 | P a g e
K. Environment
SEE DATA TABLES K1 AND K2 FOR MORE DETAILS (page 31 of report)
People living in ‘access deprived’ areas: In 2017, the percentage of people in East Ayrshire living in 15% most ‘access deprived’3 areas (data zones) in Scotland was significantly higher than the national average (16.5% v 15.0%), with residents in the predominantly rural parts of the Northern and Southern localities situated in East Ayrshire contributing to this result. On the whole, residents of North and South Ayrshire experienced significantly reduced access deprivation (10.1% and 13.1% respectively) compared to Scotland as a whole (Figure 18).
Other environmental attributes: In 2017, the percentage of the population living within 500 metres of a derelict site was significantly elevated (worse) in North (39.7%) and South Ayrshire (32.5%) compared to Scotland (29.8%). In contrast, the figure in East (26.2%) was significantly below (better) than the national average. Finally, East Ayrshire was the only local HSCP area where a significantly reduced percentage of residents surveyed in 2017 described their neighbourhood as ‘a very good place to live’ compared to the Scottish average (44.4% v. 57.0%). Residents in North and South were happier, particularly in South where 63.6% rated their neighbourhoods as ‘very good’, while 49.6% in North indicated similarly.
FIGURE 18: People living in 15% most ‘access deprived’ areas: percentage by HSCP area,
2017
80 70 60 50 40 30 20 10
0
Fife
Angus
Moray
Falkirk
Highland
Edinburgh
Inverclyde
Midlothian
Dundee City Dundee
East Lothian East
Glasgow City Glasgow
East Ayrshire East
West Lothian West
Argyll & Bute & Argyll
Renfrewshire
Western Isles Western
Aberdeen City Aberdeen
Aberdeenshire
Orkney Islands Orkney
South Ayrshire South
North Ayrshire North
Perth & Kinross & Perth
Shetland Islands Shetland
Scottish Borders Scottish
South Lanarkshire South
North Lanarkshire North
East Renfrewshire East
East Dunbartonshire East
Dumfries & & Galloway Dumfries West Dunbartonshire West
Clackmannanshire & Stirling & Clackmannanshire
3 The SIMD provides a relative measure of deprivation which means that the main output from SIMD - the SIMD ranks - can be used to compare data zones by providing a relative ranking from most deprived (rank 1) to least (rank 6,505). The SIMD can then be used to identify Scotland's most deprived small areas in relation to its composite domains, including geographical access to services, by applying a cut-off such as 15%.
19 | P a g e
L. Modal health class
SEE DATA TABLE L1 FOR MORE DETAILS (page 32 of report)
As a way of summarising and condensing the wide array of health information contained in this report, five key health indicators were selected and combined across HSC localities in Ayrshire and Arran to provide a single concise and ‘global’ measure of population health. The five key indicators were: (1) deaths all ages; (2) patients hospitalised with CHD; (3) alcohol- related hospital stays; (4) drug-related hospitals stays; and (5) women smoking during pregnancy. The combined measure adopted was simply the modal (or most common) statistical outcome relating to comparison of local and national data. This measure, referred to here as the modal health class, can assume three values - worse than, better than, or no different from Scotland – depending on the modal outcome across the five indicators. In practice, all HSC localities were assigned clear-cut values with no clashes or ties to confuse the issue.
On examination, it was found that 7 out of 15 HSC localities generated modal health class values indistinguishable from Scotland, while 8 out of 15 were found to be worse than Scotland on the whole. Those identified as worse than Scotland were as follows:
Kilmarnock East Ayrshire Southern East Ayrshire Garnock Valley North Ayrshire Irvine North Ayrshire Kilwinning North Ayrshire Three Towns North Ayrshire Ayr North & Former Coalfields South Ayrshire Girvan & South Carrick Villages South Ayrshire
Moreover, the above HSC localities (n=8) were also those found to be significantly worse than Scotland in terms of percentage of population classified as income deprived, while the remaining HSC localities (n=7) in Ayrshire and Arran were either significantly undifferentiated from or better than Scotland with respect to levels of income deprivation.
These results reveal that comparatively diminished levels of health and wellbeing are widely distributed across Ayrshire and Arran, with a concentration of problems located in the more socio-economically deprived parts of Ayrshire and Arran and predominantly, though far from exclusively, affecting urban areas (6 out of 8 HSC localities in this category were urban). Thus the challenge as ever in Ayrshire and Arran remains, as it does elsewhere across Scotland and particularly in the West of Scotland, to continue finding effective and innovative ways of improving the health of our local populations, especially in the more income deprived areas.
20 | P a g e
Health and wellbeing: DATA TABLES DATA SOURCE: ScotPHO online profiles; data retrieved at September 2019 LINK: https://www.scotpho.org.uk/comparative-health/profiles/online-profiles-tool
KEY TO ALL DATA TABLES BELOW:
Statistically significantly ‘worse’ than national average Statistically not significantly different from national average Statistically significantly ‘better’ than national average
EASR = European age-sex standardised rate per 100,000 population (using ESP2013)
A. Life expectancy and mortality
NOTE: Life expectancy data unavailable at HSC locality level
TABLE A1: Life expectancy and mortality by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND Male life expectancy Years 2014 - 2016 76.5 75.9 77.5 77.1 Female life expectancy Years 2014 - 2016 79.8 80.5 80.8 81.1 Deaths all ages EASR, 3-yr 2015 - 2017 1,269.1 1,223.1 1,112.7 1,167.1 All-cause mortality (15-44) EASR, 3-yr 2015 - 2017 133.9 139.8 150.5 105.8 Early deaths from CHD (<75) EASR, 3-yr 2015 - 2017 66.3 64.3 51.6 53.0 Early deaths from cancer (<75) EASR, 3-yr 2015 - 2017 161.1 168.6 154.1 160.2
TABLE A2: Mortality by HSC locality: EASR, 3-yr average, 2015-2017
Deaths All-cause Early deaths Early deaths HSCP all ages mortality from CHD from cancer area HSC locality (15-44) (<75) (<75) Kilmarnock 1,311.1 137.9 66.9 152.9 EAST Northern 1,078.9 95.2 46.2 147.3 AYRSHIRE Southern 1,348.6 157.2 81.4 180.0 Arran 936.4 131.6 43.3 132.9 Garnock Valley 1,227.6 145.2 74.1 158.5 NORTH Irvine 1,259.4 114.6 78.4 172.0 AYRSHIRE Kilwinning 1,445.7 165.2 72.2 162.3 North Coast & Cumbraes 972.1 122.4 34.9 142.9 Three Towns 1,421.0 164.2 67.2 203.3 Ayr North & Former Coalfield Communities 1,452.4 204.8 93.5 156.8 Ayr South & Coylton 1,053.2 146.9 32.2 155.4 SOUTH Girvan & South Carrick Villages 1,298.1 249.6 84.9 157.8 AYRSHIRE Maybole & North Carrick Communities 1,009.8 159.8 48.1 156.6 Prestwick 1,062.5 103.4 43.6 157.9 Troon 983.8 101.6 44.7 144.4
21 | P a g e
B. Ill health and injury
TABLE B1: Ill health and injury by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND
New cancer registrations EASR, 3-yr 2015 - 2017 585.9 668.0 607.3 631.8 Patients hospitalised with EASR, 3-yr 2015/16 - 2017/18 468.0 480.0 475.7 381.2 CHD Patients hospitalised with EASR, 3-yr 2015/16 - 2017/18 365.0 320.2 289.0 247.0 COPD Patients hospitalised with EASR, 3-yr 2015/16 - 2017/18 127.6 131.0 109.7 92.3 asthma Patients with emergency EASR, 3-yr 2015 - 2017 9,685.3 9,893.7 9,451.2 7,601.0 hospitalisations Patients (65+) with multiple EASR, 3-yr 2015 - 2017 6,578.5 6,277.3 6,502.5 5,422.3 emergency hospitalisations Road traffic accident EASR, 3-yr 2015 - 2017 66.9 69.4 67.2 59.2 casualties
TABLE B2: Ill health and injury by HSC locality: EASR, 3-yr average
Patients Patients (65+) with with multiple Patients Patients emergency emergency hospitalised hospitalised hospital- hospital- HSCP with CHD with COPD isations isations area HSC locality 1 1 2 2 Kilmarnock 442.9 352.8 9,804.9 6,235.3 EAST Northern 450.7 258.4 9,057.6 6,317.2 AYRSHIRE Southern 515.9 457.5 10,058.5 7,159.7 Arran 322.3 167.2 6,907.3 5,297.5 Garnock Valley 461.8 285.8 9,465.1 6,293.6 NORTH Irvine 562.2 421.2 10,981.7 7,273.5 AYRSHIRE Kilwinning 423.5 406.2 11,072.8 7,492.6 North Coast & Cumbraes 383.0 115.5 7,583.7 4,277.2 Three Towns 538.3 420.5 10,767.5 6,878.1 Ayr North & Former Coalfield Communities 538.5 509.8 11,687.9 7,063.7 Ayr South & Coylton 445.1 218.7 8,821.3 6,073.2 SOUTH Girvan & South Carrick Villages 526.2 277.1 8,708.7 6,646.2 AYRSHIRE Maybole & North Carrick Communities 441.6 321.9 10,172.4 6,688.9 Prestwick 471.8 254.2 8,748.4 6,569.1 Troon 465.9 259.7 9,486.3 6,286.5
1 2015/16 - 2017/18 2 2015 - 2017
22 | P a g e
C. Mental health
TABLE C1: Mental health by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND Population prescribed Percentage 2017/18 20.1 21.1 21.3 18.8 drugs for anxiety … 1 Patients with a psychiatric EASR, 3-yr 2015/16 – 2017/18 207.2 281.1 259.9 262.0 hospitalisation
Deaths from suicide EASR, 5-yr 2013 - 2017 10.7 14.8 10.9 13.3
1 Population prescribed drugs for anxiety/depression/psychosis
TABLE C2: Mental health by HSC locality
Population prescribed drugs for anxiety/ Patients with a depression/ psychiatric Deaths from HSCP psychosis hospitalisation suicide area HSC locality 1 2 3 Kilmarnock 19.1 202.9 13.6 EAST Northern 17.6 164.1 7.3 AYRSHIRE Southern 23.3 242.6 9.5 Arran 16.7 185.5 26.5 Garnock Valley 20.5 237.6 14.1 NORTH Irvine 23.4 355.4 14.9 AYRSHIRE Kilwinning 21.6 221.8 15.3 North Coast & Cumbraes 16.8 199.3 14.1 Three Towns 22.1 317.3 13.3 Ayr North & Former Coalfield Communities 25.5 450.6 18.2 Ayr South & Coylton 20.2 259.1 12.9 SOUTH Girvan & South Carrick Villages 24.2 168.8 4.9 AYRSHIRE Maybole & North Carrick Communities 19.4 179.4 3.4 Prestwick 20.7 180.3 9.0 Troon 18.6 231.0 8.9
1 Percentage, 2017/18 2 EASR, 3-yr average, 2015/16 - 2017/18 3 EASR, 5-yr average, 2013 - 2017
23 | P a g e
D. Behaviours which impact on health
NOTE: Active travel to work and smoking data unavailable at HSC locality level
TABLE D1: Behaviours by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND Active travel to work (16+) a 2016/17 8.1 13.4 10.8 14.9 Smoking attributable deaths b 2016 - 2017 402.4 391.7 296.3 336.8 Smoking prevalence (16+) a 2017 21.8 19.2 15.2 18.0 Alcohol-related mortality c 2013 - 2017 18.3 20.8 14.1 20.2 Alcohol-related hospital stays d 2017/18 658.0 894.9 758.1 676.3 Drug-related hospital stays e 2015/16 - 2017/18 326.8 397.9 242.7 180.5
MEASURE: a = Percentage of adult (16+) population b = EASR, 2-yr average c = EASR, 5-yr average d = EASR e = EASR, 3-yr average
TABLE D2: Alcohol- and drug-related hospital stays by HSC locality
Alcohol-related Drug-related HSCP hospital stays hospital stays area HSC locality 1 2 Kilmarnock 678.5 431.5 EAST Northern 572.0 176.8 AYRSHIRE Southern 693.6 271.8 Arran 406.2 104.0 Garnock Valley 874.0 383.2 NORTH Irvine 1069.5 476.2 AYRSHIRE Kilwinning 694.7 312.9 North Coast & Cumbraes 571.7 160.1 Three Towns 1079.9 516.8 Ayr North & Former Coalfield Communities 1418.7 611.2 Ayr South & Coylton 572.9 140.4 SOUTH Girvan & South Carrick Villages 992.0 175.1 AYRSHIRE Maybole & North Carrick Communities 576.1 223.9 Prestwick 506.4 135.0 Troon 649.1 148.2
1 EASR, 2017/18 2 EASR, 3-yr average, 2015/16 - 2017/18
24 | P a g e
E. Women’s and children’s health
TABLE E1: Women’s and children’s health by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND
Teenage pregnancies a 2015 - 2017 25.3 23.1 21.1 21.6 Women smoking during b 2015/16 - 2017/18 19.1 23.1 16.8 15.4 pregnancy Healthy birth weight b 2015/16 - 2017/18 82.9 82.9 79.9 83.5 Babies exclusively breast- b 2015/16 - 2017/18 16.4 16.8 21.2 29.7 fed at 6-8 week review Child dental health in c 2017/18 63.5 67.6 74.9 70.4 primary 1 Child dental health in c 2017/18 63.0 72.5 78.4 71.2 primary 7 Child healthy weight in d 2017/18 76.4 75.4 78.0 76.5 primary 1
MEASURE: a = EASR, 3-yr average, females aged 15-19 c = Percentage without obvious decay b = Percentage, 3-yr average d = Percentage with BMI in 5% to 95% percentile range
TABLE E2: Women’s and children’s health by HSC locality
Babies Women exclusively Child smoking breastfed at Child dental healthy during 6-8 week health in weight in HSCP pregnancy review primary 1 primary 1 area HSC locality 1 1 2 3 Kilmarnock 19.0 15.0 63.3 75.3 EAST Northern 15.6 25.2 74.9 77.0 AYRSHIRE Southern 21.5 12.1 54.6 77.7 Arran 16.0 44.3 76.0 74.1 Garnock Valley 22.6 20.5 66.1 78.2 NORTH Irvine 26.6 11.5 65.8 74.2 AYRSHIRE Kilwinning 24.1 16.4 59.7 74.7 North Coast & Cumbraes 10.2 30.5 86.0 76.2 Three Towns 24.5 13.7 63.7 75.2 Ayr North & Former Coalfield Communities 26.1 11.3 68.6 75.2 Ayr South & Coylton 11.4 26.0 83.1 78.1 SOUTH Girvan & South Carrick Villages 30.2 23.5 67.4 68.0 AYRSHIRE Maybole & North Carrick Communities 14.4 21.7 66.2 75.6 Prestwick 10.3 25.3 79.4 76.5 Troon 11.6 24.1 73.9 89.3
1 Percentage, 3-yr average, 2015/16 - 2017/18 2 Percentage without obvious decay, 2017/18 3 Percentage with BMI in 5% to 95% percentile range, 2017/18
25 | P a g e
F. Immunisations and screenings
NOTE: Breast screening uptake data unavailable at HSC locality level
TABLE F1: Immunisations and screenings by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND Immunisation uptake at 24 a 2016 - 2018 98.9 98.4 98.8 97.6 months: 5 in 1 Immunisation uptake at 24 a 2016 - 2018 97.2 94.7 96.8 94.6 months: MMR Breast screening uptake b 2010 - 2012 74.0 71.2 77.8 72.5
Bowel screening uptake c 2015 - 2017 54.7 54.1 58.8 56.4
MEASURE: a = Percentage of children aged 24 months, 3-yr average b = Percentage of women aged 50-70, 3-yr average c = Percentage of people aged 50-74, 3-yr average
TABLE F2: Immunisations and screenings by HSC locality
Immunisation Immunisation uptake at uptake at Bowel 24 months: 24 months: screening HSCP 5 in 1 MMR uptake area HSC locality 1 1 2 Kilmarnock 98.7 96.8 54.6 EAST Northern 98.7 97.0 57.3 AYRSHIRE Southern 99.3 98.1 53.0 Arran 88.5 88.5 60.1 Garnock Valley 97.9 94.9 52.7 NORTH Irvine 98.5 94.1 51.5 AYRSHIRE Kilwinning 99.2 95.4 53.8 North Coast & Cumbraes 99.2 95.3 59.5 Three Towns 98.7 95.4 52.7 Ayr North & Former Coalfield Communities 97.9 96.1 47.2 Ayr South & Coylton 98.3 96.1 62.1 SOUTH Girvan & South Carrick Villages 99.6 98.4 61.3 AYRSHIRE Maybole & North Carrick Communities 98.9 97.0 57.1 Prestwick 99.2 96.7 60.1 Troon 99.8 97.9 61.5
1 Percentage of children aged 24 months, 3-yr average, 2016 - 2018 2 Percentage of people aged 50-74, 3-yr average, 2015 - 2017
26 | P a g e
G. Social care and housing
NOTE: Only data for single adult dwellings available at HSC locality level
TABLE G1: Social care and housing by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND Children looked after by Crude rate per 1,000 2017 16.1 22.2 18.4 14.3 local authority 1 population aged 0-18 Adults claiming incapacity % of adults aged 16+ 2016 6.9 7.4 5.9 6.1 benefit … 2 claiming benefit % of dwellings with 25% Single adult dwellings 1 2018 37.9 40.1 37.1 37.4 Council Tax discount People aged 65+ with high % in need receiving 2017 29.9 31.3 35.8 35.2 levels of care needs … 3 10+ hours of home care
1 No differences can be calculated between local and national data for this indicator 2 Adults claiming incapacity benefit/severe disability allowance/employment and support allowance 3 People aged 65 and over with high levels of care needs who are cared for at home
TABLE G2: Single adult dwellings by HSC locality
Single adult HSCP dwellings area HSC locality 1, 2 Kilmarnock 40.1 EAST Northern 34.6 AYRSHIRE Southern 37.4 Arran 28.3 Garnock Valley 41.2 NORTH Irvine 41.3 AYRSHIRE Kilwinning 39.2 North Coast & Cumbraes 36.5 Three Towns 43.6 Ayr North & Former Coalfield Communities 43.3 Ayr South & Coylton 34.9 SOUTH Girvan & South Carrick Villages 36.6 AYRSHIRE Maybole & North Carrick Communities 32.9 Prestwick 36.7 Troon 36.5
1 Percentage of dwellings subject to a Council Tax discount of 25 per cent, 2018 2 No differences can be calculated between local and national data for this indicator
27 | P a g e
H. Education
NOTE: Data for education indicators unavailable at HSC locality level
TABLE H1: Education by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND % of all secondary Secondary school school half days 2014/15 91.2 91.1 90.7 91.8 attendance attended School leavers with 1 or % of all school leavers more qualification at SCQF with at least one 2015/16 56.8 59.3 65.0 61.6 Level 6 SCQF 6 qualification Working age adults with % of adults 16-64 with low or no educational no or low qualifications 2013 18.0 17.0 11.2 12.6 qualifications 1 (SCQF 4 or lower)
1 No differences can be calculated between local and national data for this indicator
28 | P a g e
I. Crime
NOTE: Only data for crime rate available at HSC locality level
TABLE I1: Crime by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND
Crime rate a 2017 32.9 33.1 27.4 30.5
Domestic abuse b 2016/17 110.3 123.4 89.8 108.8
Violent crimes b 2016/17 11.7 12.5 9.8 13.3
Drug crimes b 2017/18 65.8 45.8 44.9 59.7
Prisoner population c 2014 216.3 261.5 207.7 161.9
MEASURE: a = No. of recorded crimes, crude rate per 1,000 population b = No. of recorded incidents, crude rate per 10,000 population c = EASR, adults 16+
TABLE I2: Crime rate by HSC locality
HSCP Crime rate area HSC locality 1 Kilmarnock 43.7 EAST Northern 17.7 AYRSHIRE Southern 29.0 Arran 7.5 Garnock Valley 30.8 NORTH Irvine 40.8 AYRSHIRE Kilwinning 30.9 North Coast & Cumbraes 19.7 Three Towns 39.1 Ayr North & Former Coalfield Communities 52.0 Ayr South & Coylton 28.4 SOUTH Girvan & South Carrick Villages 21.4 AYRSHIRE Maybole & North Carrick Communities 26.4 Prestwick 16.8 Troon 15.9
1 No. of recorded crimes, crude rate per 1,000 population, 2017
29 | P a g e
J. Economy
NOTE: Data for out-of-work benefits and pension credits unavailable at HSC locality level
TABLE J1: Economy by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND
Population income deprived a 2017 15.5 17.3 12.6 12.2 Working-age population b 2017/18 13.6 15.3 11.8 10.6 employment deprived Working-age population claiming b 2016 13.4 14.6 11.2 10.6 out-of-work benefits Children in low income families c 2016 20.8 23.5 16.6 16.7 People claiming pension credits d 2016 6.9 6.4 4.9 5.5 (aged 60+)
MEASURE: a = Percentage b = Percentage, adults 16-64 c = Percentage, children aged <20, families receiving out-of-work benefits or child tax credits d = Percentage, adults 60+
TABLE J2: Economy by HSC locality
Working age population Population employment Children in low HSCP income deprived deprived income families area HSC locality 1 2 3 Kilmarnock 16.4 13.6 21.4 EAST Northern 11.3 10.3 14.8 AYRSHIRE Southern 17.4 16.0 23.8 Arran 7.4 6.4 6.2 Garnock Valley 17.2 14.8 22.4 NORTH Irvine 19.6 16.1 27.1 AYRSHIRE Kilwinning 18.1 14.7 23.5 North Coast & Cumbraes 9.5 9.6 11.6 Three Towns 21.1 19.6 27.7 Ayr North & Former Coalfield Communities 23.4 20.6 30.6 Ayr South & Coylton 8.7 8.9 10.4 SOUTH Girvan & South Carrick Villages 17.7 13.9 23.5 AYRSHIRE Maybole & North Carrick Communities 12.8 11.8 16.2 Prestwick 9.2 8.7 10.2 Troon 9.2 8.8 12.8
1 Percentage, 2017 2 Percentage, adults 16-64, 2017/18 3 Percentage, children aged <20, families receiving out of work benefits or child tax credits, 2016
30 | P a g e
K. Environment
NOTE: Data for neighbourhood rating unavailable at HSC locality level
TABLE K1: Environment by HSCP area
Indicator Measure Period EAST NORTH SOUTH SCOTLAND People living in 15% most ‘access Percentage 2017 16.5 10.1 13.1 15.0 deprived’ areas Population within 500 metres of a Percentage 2017 26.2 39.7 32.5 29.8 derelict site Adults rating neighbourhood as ‘a very Percentage 2017 44.4 49.6 63.6 57.0 good place to live’ surveyed
TABLE K2: Environment by HSC locality
People living in 15% most Population ‘access deprived’ within 500m of HSCP areas derelict site area HSC locality 1 1 Kilmarnock 14.6 21.9 EAST Northern 19.1 17.3 AYRSHIRE Southern 17.2 38.4 Arran 43.2 16.1 Garnock Valley 7.4 56.0 NORTH Irvine 7.5 19.5 AYRSHIRE Kilwinning 14.4 49.3 North Coast & Cumbraes 22.3 17.8 Three Towns 0.0 67.7 Ayr North & Former Coalfield Communities 0.0 62.1 Ayr South & Coylton 12.4 11.3 SOUTH Girvan & South Carrick Villages 24.6 64.4 AYRSHIRE Maybole & North Carrick Communities 52.7 45.2 Prestwick 7.2 43.1 Troon 9.1 0.0
1 Percentage, 2017
31 | P a g e
L. Modal health class
TABLE L1: MODAL HEALTH CLASS - Modal health class denotes the most common outcome – worse than/not different from/better than national average – across five key health indicators for each HSC locality; population income deprived also shown for comparison.
KEY:
Statistically significantly ‘worse’ than national average Statistically not significantly different from national average
Statistically significantly ‘better’ than national average
Women Patients Alcohol- smoking Population Deaths all hospitalised related Drug-related during income MODAL HSCP ages with CHD hospital stays hospital stays pregnancy deprived HEALTH CLASS area HSC locality (a) (b) (c) (d) (e) (f) (a) – (e) Kilmarnock EAST Northern AYRSHIRE Southern Arran Garnock Valley NORTH Irvine AYRSHIRE Kilwinning North Coast & Cumbraes Three Towns Ayr North & Former Coalfield Communities Ayr South & Coylton SOUTH Girvan & South Carrick Villages AYRSHIRE Maybole & North Carrick Communities Prestwick Troon
32 | P a g e