Epidemiology & Health Sciences Team (Public Health)

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

September 2013

CONTENTS:

1–PAGE SUMMARY

APPENDIX 1 GEOGRAPHY AND ABBREVIATIONS

Caveat for 1-page summary – this summary and listing of ‘challenges’, ‘good practice’ and ‘areas for improvement’ are based on our own interpretation of the profiles. Any would-be user of these are encouraged to look at the profile themselves which provides the full range of measures at various levels of detail. Wider determinants Potential for Health Improvement Health Protection Need for Health & Social Care CHILD & YOUNG PEOPLE HEALTH & WELL-BEING PROFILE OF THE NORTH & WEST OPERATIONAL UNIT Population 0-19y = 21%, compared to NHS H of 21.5% Life expectancy from birth: Unit for males Primary immunisation at 2y : Unit averages Looked after children : Over 100 in number, rate of Population 0-19y 10 yr growth 2002-2011: Decrease of 9% 73-81y & 74-83y for females. Lowest for for all courses similar to NHS H averages but 6.9/1000 aged 21y & under compared to NHS H average (NHS H of 4.5%). Decrease was lowest in (2.1%), both in Cathness S , Wick N, Wick S (73y lower than the national ones of 9.7/1000. By placement area, highest rate in SL&WR highest in (13%) males, 74-76y females) highest in . E&N (8.4/ 1000). (81y male) & & Skye NW, (83y Births: Unit rate similar to NHS H (59/1000). Higher rate HPV vaccination S2 girls : Uptake rate of 3rd Looked after children by age in care : Overall the majority females). (65/1000) for . Unit rate 19% increase from 2002 (by dose was 83.5%, similar to averages for NHS were aged 5-11y. Compared to NHS H average, the 33% in North area & by 7% in West area). Hospitalisation (alcohol-related) 0-19y : H & (83% for both). Rate for proportions in the North area were younger (26% under Unit rate (236/100,000) higher than NHS H Lochaber (79.5%) was lower than other 5y) and in the West, older (18% under 5 y). Remote/Rural 0-19y: 35% live in v. remote small towns & 65% average and higher in the North area (296 districts and Caithness rate was the highest in v.remote rural areas. 57% of Caithness & 54% of Lochaber per 100,000). (89%). live in small towns: 100% of Sutherland & SL&WR live in v. Looked after children by Placement type : Compared to Breastfeeding at 6-8wks: Unit rate (29%) remote rural areas. NHS H average profile there was relatively more in foster Hospitalisation (unintentional injuries) 0- compared to NHS H (31%). Rate in SL&WR care (46% vs 31%) and fewer in other community Deprivation 0-19y: 645 (4% of units 0-19y pop.) live in the 14y : Unit average rate of 663/100,000 was high (49%) but low in Caithness (17%). placements (17% vs 24%). nationally 15% most deprived areas, all are in Caithness, lower than NHS H (886/100,000) & Scotland Looked after children receiving aftercare : Just under 24 in equivalent to 11.6% of it's 0-19y pop. (7.2% for NHS H). (926/100,000). Year to year variation Flouride varnishing at 3yr: Unit average rate the unit; 50% aged 15-18y and 50% aged 19-21y. This compounds comparisons. Access Deprivation 0-19y: Unit has the highest proportion was 11% compared to NHS H average of profile is similar to H HSCP average but differs from the Child obesity in P1: For the Unit overall, living in these areas at 27% compared to 13% for NHS H. Over 16%. Lower rates for West area (9%) and in national profile which has twice the number in the 11% were overweight compared to NHS H 50% (n=2,000) in SL&WR are in these areas. Sutherland (2%). younger age group than the older age group. average of 10% and Scotland at 9%. Child Poverty measure: 2,125 (13% of units 0-19y pop.) Flouride varnishing at 4yr: Unit average rate Children receiving health & social care who have a Caithness & Lochaber recorded the highest children live in families that meet the HMRC definition. The was 18% compared to NHS H at 21%. Higher learning disability: Under 70 in the unit (40 in North and in the unit at 12%. 6% of pupils were proportion in Caithness is higher than the NHS H average of rates for Caithness (28%), lower in West 28 in West area). The rate per 1000 children aged 21 years recorded as obese or severely obese, similar 15.4% (n =860). area (15%) and for Sutherland (5%) & younger is lower than NHS H average, (3.9 vs 4.6). Rates proportion to the averages for NHS H & are lower in all districts other than Sutherland (7.2). Educational: Home language was 1.6% Polish in Lochaber & 3% Scotland. Higher values tended to be for the Gaelic/Scottish in SL≀ rate of ASN in Lochaber highest in West area. the unit 6.4% (vs 5.2% for H HSCP). Proportion of school leavers Children receiving health & social care who have a unemployed highest in Caithness & Sutherland at 10.5 & 9% learning disability: 16% were looked after children in the compared to 8% for H HSCP. Unit, compared to the average percentage (17%) for NHS H. More than a half (54%) were identified with a disorder within the autistic spectrum. More than one quarter of the units children & young people live in the most access deprived areas and for the SL&WR district, over one half are accessed deprived. This means that services are not easily accessible, mental health may be at risk and health problems may not be picked up early Challenges: or management of conditions not optimal. The district of Caithness has a higher than average child poverty measure, 12% live in the nationally most deprived areas and has lower life-expectancy from birth than the average for the Health Board. Lower than average unemployment in School leavers in the North and a high rate with Learning disabilities in Sutherland. High rate of HPV vaccination and in flouride varnishing at 4y in Caithness. Good practice: High rate of Breast feeding in SL&WR

Problems due to alcohol misuse in the North area as indicated by hospitalisation rates Caithness breast feeding rates are low; Areas for improvement: Flouride varnishing rates in Sutherland district and in the West area are low. Rates of HPV vaccination low in Lochaber

APPENDIX 1

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

Operational Unit Areas Districts/Localities Abreviations Caithness Cat North Sutherland Suth North & West Lochaber Loc West Skye, Lochalsh & SL &WR & Strathspey, Nairn & Ardersier B&SNA South Inveness East Inv. East South and Mid West Inv. West East Ross E. Ross Mid Mid Ross Mid Ross Bute & B & C Helensburgh & Lomond H & L & Bute Argyll & Bute Mid Argyll, & MAKI Oban, Lorn & the Isles OLI

When data is only available at Intermediate (IZ) geography, the following mapping applies BUT the sums of IZs DO NOT define the Districts or areas

North Area (North & West Operational Unit) Intermediate Geographies (IZs) District Name Abbreviation Name Abbreviation Caithness North East Cat NE Caithness North West Cat NW Caithness South Cat S East Thurso E Caithness Cat Thurso West Thurso W Wick North Wick N Wick South Wick S Sutherland East Suth E Sutherland North & West Suth N&W Sutherland Suth Sutherland South Suth S

West Area (North & West Operational Unit) Intermediate Geographies (IZs) District Name Abbreviation Name Abbreviation Lochaber East & North Loc E&N Lochaber West Loc W Lochaber Loc Fort William North Ft W N Fort William South Ft W S Lochalsh Lochalsh Ross & Cromarty North West RCNW Ross & Cromarty South West RCSW Skye Lochalsh & Wester Ross SL&WR Skye North East Skye NE Skye North West Skye NW Skye S Skye South

Other abbreviations

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

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

September 2013