Health and Wellbeing in Bristol 2018 Joint Strategic Needs Assessment (JSNA) 2018 data profile www.bristol.gov.uk/jsna Bristol, North Somerset and South Gloucestershire www.bristol.gov.uk Clinical/jsn Commissioninga Group JSNA 2018 data profile report Table of Contents Table of Contents 3.14 Deprivation headlines ...................... 39 Table of Contents ................................... 1 Children & Young People’s Health ........ 40 Summary points ...................................... 40 Foreword from the Co-chairs of the Bristol Health and Wellbeing Board .................. 3 4.1 Low birth weight ................................ 41 JSNA 2018 Executive Summary ............ 4 4.2 Infant mortality ................................... 42 Introduction ............................................. 4 4.3 Breastfeeding .................................... 43 JSNA 2018 Summary .............................. 4 4.4 Smoking during pregnancy ................ 44 Bristol JSNA 2018 - Summary data points 4.5 Disabled children ............................... 45 from each section............................... 7 4.6 Chronic Childhood Illnesses .............. 46 Map of Bristol wards and CCG sub-locality 4.7 Healthy Weight .................................. 48 areas .................................................. 14 4.8 Dental health ..................................... 50 Life Expectancy ...................................... 15 4.9 Childhood Immunisations .................. 51 Summary points ...................................... 15 4.10 Injuries ............................................ 54 2.1 Life Expectancy for Bristol ................. 15 4.11 Teenage pregnancy ........................ 56 2.2 Life Expectancy within Bristol ............ 16 4.12 Lifestyle behaviours of Young 2.3 Life Expectancy Gap ......................... 17 People ............................................... 57 2.4 Healthy Life Expectancy .................... 18 Wider Determinants ................................59 2.5 Healthy Life Expectancy Gap ............ 19 Summary points ...................................... 59 2.6 Global Burden of Disease .................. 20 5.1 Deprivation ........................................ 60 2.7 Premature Mortality ........................... 21 5.2 Income deprivation ............................ 61 Population .............................................. 23 5.3 Child Poverty ..................................... 63 Summary points ...................................... 23 5.4 Education .......................................... 64 3.1 Bristol population overview ................ 23 5.5 Pupil Absence ................................... 67 3.2 Population changes ........................... 25 5.6 Special Educational Needs (SEN) ..... 68 3.3 Population diversity ........................... 27 5.7 Children Social Care ......................... 70 3.4 Births ................................................. 28 5.8 Not in Education, Employment or 3.5 Population projections ....................... 29 Training (NEET) (or Not Known) ........ 72 3.6 Carers ............................................... 30 5.9 Young Offenders ............................... 73 3.7 People with Long-term health problems 5.10 Employment .................................... 74 or disability ......................................... 31 5.10.1 Employment and health ................ 76 3.8 People with Learning Disabilities and 5.11 Housing ........................................... 77 Autism ................................................ 32 5.12 Homelessness ................................. 79 3.9 Gypsy, Roma & Travellers ................. 33 5.13 Fuel Poverty .................................... 81 3.10 Lesbian, Gay, Bisexual and Transgender people (LGBT) .............. 34 5.15 Internet connectivity ........................ 83 3.11 Migrant Health Needs ...................... 35 5.16 Social Isolation ................................ 84 3.12 Gender - headlines .......................... 36 5.17 Air pollution ................................... 85 3.13 Ethnicity - headlines ........................ 38 5.18 Promoting Healthy Urban Environments ..................................... 87 www.bristol.gov.uk/jsna Page | 1 JSNA 2018 data profile report Table of Contents 5.19 Crime .............................................. 88 9.2 Self-harm .......................................... 127 5.20 Sexual violence and harassment ..... 90 9.3 Suicide Rates .................................... 128 5.21 Domestic Abuse .............................. 91 9.4 Physical health of people with poor 5.22 Female Genital Mutilation (FGM) ..... 92 mental health ..................................... 129 5.23 Community Assets .......................... 93 9.5 Mental Wellbeing ............................... 130 Healthy Lifestyles .................................. 94 9.6 Emotional Health and Wellbeing of Children & Young People ................... 131 Summary points ...................................... 94 9.7 Perinatal mental health ...................... 133 6.1 Physical activity ................................. 95 Older People ............................................134 6.2 Healthy Weight .................................. 96 Summary points ...................................... 134 6.3 Healthy eating ................................... 97 10.1 Dementia ......................................... 135 6.4 Smoking ............................................ 98 10.2 Falls ................................................ 137 6.5 Alcohol .............................................. 100 10.3 Excess Winter Deaths ..................... 139 6.6 Substance misuse ............................. 102 10.4 Adult Social Care ............................ 140 Health Protection and Sexual Health .... 104 10.5 Delayed Transfer of Care (DToC) .... 142 Summary points ...................................... 104 10.6 End of life care ................................ 143 7.1 Sexual Health .................................... 105 Public Feedback ...................................... 144 7.2 Chlamydia ......................................... 106 7.3 HIV .................................................... 107 7.4 TB (Tuberculosis) .............................. 108 7.5 Flu Immunisations ............................. 109 7.6 Antimicrobial Resistance (inc antibiotics) .......................................................... 110 Long Term Conditions ........................... 111 Summary points ...................................... 111 8.1 Prevalence of common long-term conditions .......................................... 112 8.2 Premature mortality from cancer and cardiovascular diseases ..................... 113 8.3 Cardiovascular Disease..................... 114 8.4 Cancer .............................................. 116 8.5 Diabetes ............................................ 118 8.6 Respiratory Disease .......................... 119 8.7 Liver Disease .................................... 121 8.8 Musculoskeletal (MSK) ...................... 122 8.9 Neurological conditions ..................... 123 8.10 Preventable mortality ....................... 124 Mental Health and Wellbeing ................. 125 Summary ................................................. 125 9.1 Anxiety and depression ..................... 126 www.bristol.gov.uk/jsna Page | 2 Foreword from the co-chairs of the Bristol Health and Wellbeing Board A joint foreword from the co-chairs of the Bristol Health and Wellbeing Board: Dr Alison Bolam Marvin Rees – NHS Bristol, North Somerset – Mayor of Bristol & South Gloucestershire CCG Bristol is often described as a vibrant, Life expectancy in Bristol has increased by 1.9 innovative and progressive place to live, years for men and 1.7 years for women in the a city of opportunity. It frequently tops past 10 years. However overall life expectancy the lists of the best places to live in the for men in Bristol remains significantly worse UK, receiving accolades and recognition. than the England average. In addition healthy life expectancy (the average number of However, we know that this is only part years a person would expect to live in good of the truth. health) shows significant gender difference Many in the city experience a very different and over the last two years this has dropped reality because of their economic, health, significantly for men. housing and social conditions. The Joint People living in the most deprived areas Strategic Needs Assessment (JSNA) will help experience worse health outcomes us define our priorities by showing us our than people living in the least deprived progress and where our biggest challenges areas. Obesity, alcohol misuse and poor lie. This is vital if we are to tackle inequalities. mental health remain major public health Bristol’s reputation and increasing popularity challenges with the most deprived being is reflected in its growing population, which disproportionally affected. We know it is far has risen at a faster rate than the national easier to support someone early on, than average. By 2026 we project there will be provide crisis interventions later on, so early 10,900 additional children, so we must intervention must be a priority. ensure they have the best possible start If we don’t tackle health inequalities and the in life, and in turn make Bristol a city of wider determinants of population health opportunity for all. such as poverty, education and crime, then Within the data there is opportunity to we will be unable to