Public Health Report 2011

Cumbria 2011 The Annual Report of the Director of Public Health Allerdale / Carlisle / Copeland / Eden / Furness / South Lakeland / / Health in Numbers 2 Health Protection in Cumbria: Health in Numbers ■ Cumbria is England’s ■ There are approximately ■ In 2008/09 the alcohol- second largest county, 15,000 children under 16 harm related hospital representing 48% of the years old (16% of the admissions rate was 1811.2 land mass in the North population), living in per 100,000 population, West, with an estimated income deprived which was higher than the population of 495,000 households. This is lower rate for England at 1582.4. ■ 51% of the total than the national average ■ The current conception population in Cumbria live of 21%. rate of 41 per 1,000 girls in rural communities, ■ 247 people were killed or under 18 years of age is compared with 19% in seriously injured in road above the national figure England traffic accidents in Cumbria of 40 girls per 1,000. ■ Cumbria has 24 specific during 2009. ■ The life expectancy at birth communities (super output ■ In October 2010, the rate for males is 78.1 years areas) that are in the 10% of unemployment in which is 0.2 years above most deprived in England Cumbria was 2.4% (7,525 the national average. For and Wales, of which seven claimants) compared to the females the life expectancy are in the worst 3%. This national rate of 3.9%. The is 81.7 years which is 0.3 means that approximately claimant count fell by 70 years less than the national 16% of the Cumbria between September and average. population lives in areas October 2010. ■ There were 21,006 patients which officially rate as ■ Around 10% of 4/5 year included on the GP among the most deprived olds and 19% of 10/11 year diabetes register in in the country. olds in Cumbria were 2008/09, accounting for ■ There were 5326 deaths classed as being obese in 4.9% of the Cumbria and 5080 live births in 2008/09. population. This is the 2009. ■ There were 1,516 deaths same as the national ■ In early 2010 the average from all causes of cancer in average. house price in Cumbria was 2009. This gives a rate of ■ In 2009 there were 18 £171,632 compared to the 306 deaths per 100,000 deaths under one year old national average of people. in Cumbria, an infant £214,003. ■ The mortality rate from mortality rate of 3.5 deaths ■ In 2009 the average suicide and injury of per 1,000 births compared household income in undetermined intent for to a national average of Cumbria was £30,637, 2006 to 2008 was 9.9 per 4.7 deaths. compared with the 100,000 population. This is ■ In 2008/09 there were national average of significantly higher than 3,114 people registered £34,884. the rate for England at 7.8. with a GP with a diagnosis of dementia. / Contents 3 Contents: Foreword 4 Introduction 6 Section 1 Emergency Planning 10 Section 2 Infection Prevention 18 Section 3 Vaccination 32 Section 4 Screening Programmes 42 Section 5 Injury and Violence 50 Section 6 Healthy Workplace 58 Section 7 Health Protection and Hard to Reach Groups 62 Section 8 Sustainable Energy 68 Section 9 Review of Last Year’s Recommendations 76 Section 10 Conclusions and Recommendations 80 Acknowledgements & Contact Details 82 / Forword 4 Foreword: This is my fourth annual If we are to see a real improvement in people’s health, we need to support our report on the health of people communities in their aspirations to lead in Cumbria. Given the series healthier, happier and longer lives by taking of serious and tragic incidents more control over lifestyle choices and self- management of long-term conditions. It is that have affected Cumbria also necessary to strive for comprehensive over the last year, I have uptake of public health screening and preventive medicine programmes. chosen the theme of Health Protection for my report this Improving the public’s health, resilience to year. illness and strengthening the community response to hazards to health is our priority, yet we need a strong and protected public Health Protection is the area of Public Health health system to tackle these priorities. practice that deals with external hazards and threats to health, as well as communicable The recently launched White Paper ‘Healthy diseases. Lives, Healthy People’ outlines plans to put the role of public health on a sound footing in We know that more lives could be improved if society, and sets out plans to ring-fence the there was a greater emphasis on helping public health budget so that it is used to people to stay healthier for longer and being tackle the key causes of preventable ill-health. equipped with the skills to make the right health choices. This White Paper spells out one of the biggest changes in the delivery of public health since There are many influences on our health, yet the inception of the NHS over fifty years ago, broadly they can be categorised as the three with plans to hand power back to a public pillars of health, which are the biology we health department which will sit alongside inherit from our parents, the environment in local authorities rather than within primary which we grow up and live and the care trusts. This follows the government’s behaviours which link the environment and previous announcements within the Health biology. All of these areas can be influenced White Paper in July that GP Consortia will take by effective health protection measures, over the commissioning and budgetary education and encouragement to make control of local health services, and primary behavioural change. care trusts will be closed down by 2013. However, the return of public health to its role in local government will only be one part of the organised efforts of society for health and well-being. / Foreward 5 “we need a strong and protected public health system” Clinicians, whether based in the community or in hospital, have important opportunities to contribute to public health, as our experience in Cumbria over the past four years has demonstrated. We need to build on this through our local GP Consortia in the years ahead. The establishment of Public Health England as a nationally accountable service with a remit for preventative programmes such as screening and vaccinations, as well as health emergency planning, will be the third arm of a robust set of arrangements which will be coordinated nationally and at a local level by the Board of Health and Wellbeing. The wider determinants of health – economic status, education opportunities, employment, housing and environment – are integral to our efforts, therefore reforms will involve the public sector, NHS, social care, education, transport, environment and industry in ensuring that we have a unified approach to improving health. The intention is for us all to become more focused on helping people to improve their With the new proposals and greater local own health and reduce the number of people flexibility, we will be able to move away from dying prematurely. The gross inequality in life a centralised focus, and further focus on the expectancy and ill health between different needs of our local communities, tackling areas and groups within the county is priority areas in Cumbria and using the best unacceptable to a society that places great insights of social psychology and health store on being fair. protection to make further inroads into improving the lives of people in Cumbria. Dr John R Ashton CBE Director of Public Health & County Medical Officer, Cumbria / Introduction 6 Introduction: Last year my annual report These changes mean that for Recent events including the focused on mental health, mental health services, the swine flu pandemic of 2009, from infancy to adulthood link between mental and Cumbria Floods – November and into old age. I outlined physical health will be 2009, the Keswick School bus what is known about mental strengthened. There will be crash – May 2010, devastating health and wellbeing in greater integration with GP shooting incident in Cumbria, what can affect a and other community health Whitehaven – June 2010, and person’s mental health and services – leading to better our coldest winter for 100 gave recommendations on access and seamless care years have left a lasting mark how support services could be between community services on our communities. In improved and enhanced. This and mental health, drug, addition we also saw the included a recommendation alcohol and learning disability failure of the breast screening for mental health services to support in the county. service in North Cumbria, be further embedded into which has emphasised the primary care to create a closer, The opportunities for importance of quality control more integrated and holistic integration of mental health in programmes such as this. health service. services are particularly important, given our ageing Each of these events has wide This recommendation now population in Cumbria and ranging implications for looks set to become a reality, increase in cases of dementia public health, both physical as health services provided by and other types of brain and psychological, and all NHS Cumbria will soon join failure. required a coordinated and forces with Cumbria multi agency response from Partnership NHS Foundation There is much to be done – organisation across the Trust – the provider of mental creating a holistic service county, yet it is the response health services for the county. cannot be achieved overnight, of our communities that has This change follows but it is the right approach if been a real testament to the announcements made in the we are to see real and long strength within Cumbria.

Load more