Aug 2012 Local Authority Portraits a product of the Essex Joint Strategic Needs Assessment (JSNA)

The borough of Castle Point is situated on the coastline of south east Essex and has an area of approximately 17.3 square miles. It benefits from good links to London such as the Fenchurch Street Railway line, the dual carriageways of the A13 and

Contains Ordnance Survey data the A127, which links within half © Crown copyright and database right 2010 an hour to the motorway of the M25. Castle Point as an area has a long history but is essentially modern in character, there are a few older buildings still remaining although major re-development took place mainly between the two world wars. Whilst there has been major residential re-development in the area there still remains large areas of public open space and woodland. Facilities in the area include excellent schools, modern shopping centres and leisure facilities.

Projected population by Essex local authority by selected age bands (1,000s) Local 2010 2035 2010 2035 % Authority 0-19 20-64 65+ 0-19 20-64 65+ % 65+ % 65+ change Castle Point 20.3 49.7 19.1 21.6 49 32.2 21.4% 31.3% 9.9% Essex 330.8 809.7 254.6 384.4 897.0 443.0 18.2% 25.7% 7.4%

The Castle Point borough population is projected to increase from just over 89,000 people to nearly 103,000 people by 2035. The number of residents living in the borough who are aged 65 and over is expected to increase from 19,100 people to over 32,000. This takes the proportion of people in this age bracket from 21.4% of the boroughs population to nearly a third of the residents by 2035. This is the second highest percentage change of the Essex local authorities, Essex highest: 12.4% , Essex lowest: 4.5% .

15% of Castle Point borough adults are smokers, (Essex highest: 24% Braintree, Essex lowest: 10% ). This rises to 23% in the routine and manual groups of the borough (Essex highest: 33% , Essex lowest: 21% Maldon).

There has been a 11% average rise in the rate of admissions to hospital with alcohol related conditions for Castle Point borough residents. (Essex highest: 15% Harlow, Essex lowest: 7% Brentwood). In 2002/03 704 Castle Point borough people per 100,000 population were admitted compared with 1,676 people per 100,000 population in 2010/11.

The number of teenage conceptions (women aged under 18) was 46 in the Castle Point borough, this equates to 27 conceptions per 1,000 women aged under 18 (Essex highest: 44/1,000 , Essex lowest: 11/1,000 Brentwood), in 2010.

Just under 3 out of 10 adults in the borough are obese, 28% (Essex highest: 28% Castle Point, Essex lowest: 17% ). 18% of 10/11 year old children were obese the borough (Essex Highest: 22% Harlow, Essex lowest: 13% Brentwood).

Fewer than 1 in 5 of the boroughs adults are doing enough physical activity to benefit their health, 18% (Essex highest: 19.4% , Essex lowest: 9% Tendring).

24% of those in managerial Vs only 16% in routine and manual employment in the borough are physically active at these levels.

Organised competitive physical activities are undertaken by 17% of Castle Point borough adults (Essex highest: 17.6% Rochford, Essex lowest: 9.8% Basildon). 1 Physical activity is undertaken as part of a club membership for around /4, 25% of the boroughs adults (Essex highest: 32% Brentwood, Essex lowest: 18% Basildon).

51% of the Castle Point borough is classified as green space (Essex highest: 93% Uttlesford, Essex lowest: 51% Castle Point). Some questions for commissioning: How to encourage everyone to be physically active? What are the health and social care implications for an ageing population with long term conditions? How to reduce smoking prevalence and inequality and tackle increasing alcohol and obesity problems?

1,345 the number of people aged over 65 thought to have dementia in Castle Point - this figure is estimated to rise to 2,666 by 2030. The rising number of people with dementia will impact on future housing stock where consideration needs to be given to the availability of supported and sheltered housing and for care homes.

the number of Castle Point 25,700 borough residents who are estimated to have high blood pressure this is 35% or over a third of those aged 16 and over (Essex highest: 39% Tendring, Essex lowest: 28% Chelmsford)

Coronary Heart Disease in the under 75’s, 2008-2010:

97 the number of Castle Point borough residents who died prematurely from CHD, 26 people per 100,000 population (Essex highest: 43/100,000 Harlow, Essex lowest: 22/100,000 Uttlesford)

Directly age-standardised rates (DSR) per 100,000 population

The latest survey of Essex residents estimates:

15 % of the borough would not know where to go for information on staying healthy (Essex highest: 16% Harlow, Essex lowest: Uttlesford 8%).

8.2% of the Castle Point borough rate their general health as bad or very bad (Essex highest: 8.7% Basildon, Essex lowest: 2.6% Uttlesford).

43% of the boroughs population report having a long-standing illness, disability or infirmity (Essex highest: 45% Tendring, Essex lowest: 31% Chelmsford).

Some questions for commissioning: How to ensure vulnerable people are able to access the most appropriate services? How to ensure early disease identification, intervention and management? How to ensure people have access to information on services in their locality?

The general level of educational attainment within a population is closely associated with the overall health of that population. The long-term demographic and health problems for a child born into a family with traditionally low standards of educational attainment may be severe, affecting health choice behaviour and service provision uptake into adulthood. The factors associated with low achievement are levels of parental unemployment, single parent households, having parents with low educational qualifications, being persistent truants and eligibility for free school meals. Young people with no qualifications are more likely to not be in education, employment or training post 16. Pupils at the end of Key Stage 4 In 2010/11, 60% of Castle achieving 5+ A*-C grades including English and Maths Point secondary school pupils achieved five or more

GCSEs at grades A*-C

including English and Maths, which is higher than the Essex average. This is an improvement

on the previous year when it was 54% and makes it the sixth

highest out of all the boroughs in Essex. 6.5% of half days in state funded secondary schools in the Castle Point borough were missed in 2010/11 due to authorised and unauthorised absences, the fourth highest in Essex. 7.7% of which are persistent absentees.

Young people who attend school regularly are more likely to get the most they can out of their time at school, and are therefore more likely to achieve their potential, and less likely to take part in anti-social or criminal behaviour. Reducing truancy and exclusion levels are therefore important.

Adult qualifications: In 2010 15.2% of the adult population of Castle Point had no qualifications, which is higher than the average of 11.1% and a 1.6% decrease from 2007. Those with no qualifications are more at risk of not being in paid work and of receiving lower rates of pay. There are also long term implications for reduced

earnings potential. Only 21.7% of the

borough population have a level 4

qualification or higher, which is lower

than the England average of 33.5%.

Reducing the proportions of young people who are not in education, employment or training (NEET) has been a key youth policy for the past fifteen years and remains an important concern. The outcomes associated with becoming NEET include teenage pregnancy and earlier parenting, more serious drug use and mental and physical health problems. Other outcomes associated include post 18 unemployment, more insecure and lower paid employment, youth offending and homelessness.

187 is the number of young people in Castle Point who were NEET in March 2012, which is 5.6% of the 16-18 year old population (Essex highest: 7.2% Tendring, Essex lowest: 3.9% Brentwood, Essex average: 5.6%).

Some questions for commissioning: How to ensure that the population achieves its potential? How to support children and families to reduce absenteeism? How to ensure the promotion and access to lifelong learning opportunities?

Health and employment are intimately linked, and long term unemployment can have a negative effect on health and wellbeing. Unemployment leads to loss of income, which affects standards of living. The long-term effects can include depression and anxiety, a loss of identity, and reduced perceptions of self-worth. In addition, work can play an important role in social networks and the complex interactions between the individual and society, as work is an integral part of modern day social networking.

In 2010/11 the unemployment rate in over 16 year olds in Castle Point was estimated to be

an 84% increase since 2006/07 but lower than the England average of 7.5%. The highest in 7%, Essex was Tendring with 9.4% and the lowest was both Uttlesford and Brentwood with 4.8%. The trend

of increasing unemployment over the last few years is a reflection of the economic downturn.

Some questions for commissioning: How to provide opportunities for a wide skill mix of employment? How to stimulate the local economy?

Note that some of the lifestyle data may differ from those presented earlier in the report due to varying data sources

Health inequalities are differences in health outcomes between different population groups. As described in the Marmot Review, actions targeting health inequalities are often directed at the “social gradient in health”, that is at the particular areas or population groups which are a proxy for deprivation. Population groups are characterised by differences in social group, age, gender, ethnic group, and geographical area. To improve health and reduce inequalities, we need to consider all the factors that influence health these are known as the wider determinants of health. The public sector can best contribute to reducing inequality by coordinating actions to optimise the determinants of health.

This ‘tartan rug’ table shows for each Middle Super Output Area (MSOA) in the local authority the value for each key indicator and whether it is significantly different from the England average.

Middle Super Output Areas (MSOA) Castle Point 010 has significantly worse outcomes for a number of the indicators listed in the table. MSOAs 008, 011 and 012 also perform significantly

worse on several of the metrics.

Some questions for commissioning: How to reduce inequalities within the locality? Expectancy 80.1 81.3 82.3 78.7 82.0 82.8 83.1 79.9 79.4 78.3 77.5 79.0 76.9 79.0 79.1 material isreproduced with the permission theof Controller of HMSO. C2008001229 ONS, Super Output Area Boundaries. Crown copyright 2004. Crown copyright © Crown copyright and database right2010 Contains Ordnance dataSurvey  Key: Males (years) Life 83.7 83.4 79.5 82.5 83.4 80.7 83.3 88.9 79.9 86.6 84.8 85.1 82.8 83.2 82.3

Females (years)  

559.6 484.0 673.6 516.1 499.6 546.8 468.3 394.8 683.0 402.2 377.2 427.2 503.5 510.0 553.4 s s All age all cause- persons better ignificantly worse ignificantly 672.2 588.1 714.9 527.0 607.1 604.4 551.9 515.8 717.8 488.0 429.0 508.4 577.4 603.0 656.0 All age all cause- males

444.1 389.3 628.3 514.2 397.4 491.3 397.0 288.6 648.2 338.3 331.9 368.6 437.4 434.7 467.2 All age all cause- females

303.9 228.0 317.3 279.2 229.4 228.9 204.8 195.9 200.8 212.6 176.1 196.6 232.8 243.9 280.9

<75 years all cause- persons England than than England England than 388.8 311.8 369.7 243.9 348.9 295.2 310.3 258.3 243.3 246.0 222.1 233.5 290.0 296.7 345.5 <75 years all cause- males 219.9 150.8 271.2 312.1 117.7 168.5 120.9 133.5 162.6 185.6 136.4 164.3 180.6 194.8 219.5 <75 years all cause- females 100,000 per (DSR Mortalitypopulation) Rates 63.5 42.8 74.0 62.9 53.9 49.6 35.0 50.2 42.4 47.7 31.2 40.1 49.9 55.8 67.2

(higher for population indicators) population for (higher

Circulatory disease <75 year indicators) population for (lower

olds - persons 111.8 113.3 87.2 63.4 85.3 55.8 75.8 76.7 66.9 63.6 60.9 74.4 77.7 81.2 95.1 Circulatory disease <75 year

olds - males #N/A #N/A 41.1 24.8 40.5 44.7 43.4 25.9 19.2 34.1 24.6 32.3 40.9 5.1 8.3 Circulatory disease <75 year

olds- females 108.2 121.7 128.7 114.1 114.4 112.9 103.2 104.1 103.5 110.1 97.8 65.7 72.4 95.0 99.4 Cancer <75 year olds - person 135.4 158.4 141.6 110.5 149.9 121.7 116.9 115.1 113.4 121.9 72.7 84.3 89.9 85.7 93.1 Cancer <75 year olds - males 116.1 150.4 107.8 103.6 106.4 80.7 85.8 84.9 84.3 51.2 57.3 91.1 94.1 94.6 99.2 Cancer <75 year olds - females 188.4 189.6 259.7 254.2 180.9 170.8 121.8 107.8 192.6 187.5 181.2 165.7 181.6 185.7 210.6 Smoking attrbutable-

persons

304.9 283.0 317.7 329.0 229.5 245.8 215.0 186.4 268.9 258.5 224.9 263.2 258.7 276.2 303.6 Smoking attrbutable- males  105.6 118.3 207.6 204.1 139.2 109.9 131.5 127.0 144.6 120.6 116.0 137.5 52.2 43.5 90.7

Smoking attrbutable- not s females 24.0 14.2 13.3 16.6 10.6 35.7 10.1 36.0 26.1 10.3 17.0 19.7 24.4 7.7 4.7

Respiratory <75 year olds - different ignificantly person #N/A 14.2 11.6 14.7 10.8 18.1 11.7 5.2 5.1 4.7 5.5 5.0 5.0 8.1 9.1 COPD <75 year olds - person #N/A #N/A 20.8 10.0 17.9 14.4 17.6 10.3 14.6 7.8 9.2 5.5 4.4 5.7 9.4 Liver disease <75 year olds - person

Transport impacts on the health of a population via a number of factors including injuries, physical activity undertaken, air pollution and access to services. The last of these involves people traveling for basic necessities such as work, education, healthcare and purchasing food.

The affordability and accessibility of driving a car has increased over the past 30 years and this has heavily influenced planning decisions to be car focussed. However, there is still a significant proportion of the population without car access whom are reliant on public transport, cycling and walking.

Average minimum travel time to reach the nearest key services1 by public transport/walking (minutes):

1An average of the minimum travel times to Employment centres, Primary schools, Secondary schools, Further Education, GPs, Hospitals and Food stores

At 19 minutes the Braintree borough has the 3rd At 19 minutes the Castle Point borough has the longest average travel time by public transport or walking 2nd longest average travel time by public transport or to reach key services. This is probably reflective walking to reach key services. This is probably of the rural nature of the area but will possibly impact of the reflective of the rural nature of some areas but will accessibility of services to some of the most vulnerable possibly impact of the accessibility of services to some of populations in the borough. the most vulnerable populations in the borough.

1 Around a /5 of those on job seekers allowance in the borough are unable to access employment centres by public transport or walking. This may present barriers to future employment opportunities for those without access to a car.

Latest travel to work data from the Tracker survey shows that in Castle Point around 58% of workers travel 30 minutes or less to work (Essex highest: 77% Harlow, Essex lowest: 58% Castle Point). 96% of Castle Point residents live within an hour’s commute of their work.

Some questions for commissioning: How to ensure that some of the most vulnerable populations in the district are able to access key services?

The relationship between housing and health is a recognised association but a complex one. A number of elements in and around the home can impact on health and wellbeing and will be influenced by other determinants of health such as education, employment and infrastructure. Specific housing related issues affecting health are indoor pollutants, cold, damp, housing design, overcrowding, accessibility, neighbourhood safety, social cohesion and housing availability.

With an increasing ageing population, local housing policies will need to cater for an increase in demand for supportive housing units (22,000 short fall likely across Essex).

Percentage of households fuel poor (2009) by lower super output area.

5% - 8% 15.7% of the 9% - 10% Castle Point 11% - 13% boroughs 14% - 15% households 16% - 17% 18% - 19% were deemed 20% - 22% fuel 23% - 25% poor 26% - 29% 30% - 44% (spending more than 10% of income to heat the house) in 2009. With increasing energy prices the situation is likely to get Contains Ordnance Survey data © worse. Crown copyright and database right 2010 ONS, Super Output Area Boundaries. Crown copyright 2004 C2008001229 The percent is a modelled estimate and is influenced by rurality due to the nature of access to mains gas and the reliance on oil in these communities.

63, the number of excess winter deaths compared to the rest of the year in the Castle

Point borough – ratio 23% i.e. over 1 in 5 additional deaths (Essex highest: 25% Brentwood, Essex

lowest: 10% Maldon).

1.03, the number of homeless and in priority need households per 1,000 of Castle Point borough households in 2010/11 (Essex highest: 4.09/1,000 Harlow, Essex lowest: 0.37/1,000 Uttlesford).

At 1%, Castle Point has the lowest proportion of housing association stock in Essex (Essex highest: 17% Braintree, Essex lowest: Castle Point 1%).

Some questions for commissioning: How to support older people with their housing needs? How to promote all to access their entitled benefits to help heat their homes? How to support families and vulnerable groups in housing crises?

The following have been identified as key areas to consider in setting local priorities

 Agencies should work in collaboration to ensure that people live in decent, affordable houses, ensuring that the policy on housing development supports independent living especially with a growing older population (with increasing dementia care needs) and provide adequate support to reduce fuel poverty in rural and more deprived areas (and help reduce winter deaths).

 Action to reduce disparities in educational achievement at an early stage can contribute to a reduction in young people who are NEET and can reduce health inequalities, whilst enhancing young people’s ability to make informed healthy choices.

 Better engagement with local communities to improve quality of life with effective strategies to promote healthier lifestyles (high obesity rates), to reduce the health and social care impact of people living with long term conditions and to improve access to local services for people who do not have their own means of transport.

 Agencies should ensure integration of work around benefits take-up, unemployment (e.g. improving skills and qualification) and health and wellbeing promotion.

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