Hertfordshire’s Director of Public Health Annual Report 2018/19 A summary of the health of our population across the county Preface Jim McManus, Hertfordshire Director of Public Health Welcome to my Annual Report for 2018/19! It provides a snapshot of the state of our population’s health – both in Hertfordshire as a whole and in the county’s ten districts and boroughs. There’s also a supplement containing charts for each of the indicators in Public Health England’s local Health Profiles, showing how we compare with similar local authorities and how our districts and boroughs compare with Hertfordshire as a whole. page 2 Hertfordshire’s Public Health Service About us our profile our mission our vision Sitting within Hertfordshire To work to with our partners and A healthy and happy County Council, we have around stakeholders across the system Hertfordshire: every resident is 65 staff working across the three to improve health outcomes and born as healthy as possible and domains of public health: health reduce inequalities in lives a full, happy, healthy life. improvement, health protection Hertfordshire. and healthcare public health. page 3 Hertfordshire’s population Our county overall is… Large Well-off Unequal Ageing Hertfordshire has a mix of Hertfordshire is relatively Although the general The proportion of older urban and rural communities, affluent and benefits from a standard of living is high, people in Hertfordshire is with over 1.1 million thriving economy and highly there are pockets of increasing and this is set to residents living in a range of skilled working age deprivation across all ten of continue over the next 20+ large and new towns, market population Hertfordshire’s districts and years, bringing new towns and villages significant variations in challenges for the health outcomes between districts. and social care sectors page 4 The health of our population by local authority area Clickable chapter list Hertfordshire County East Hertfordshire Council District Council 1 Page 7 4 Page 22 Broxbourne Borough Hertsmere Borough Council Council 2 Page 12 5 Page 27xx Dacorum Borough North Hertfordshire Council District Council 3 Page 17 6 Page 32 page 5 The health of our population by local authority area Clickable chapter list St Albans City & District Watford Borough Council Council 7 Page 37 10 Page 52 Stevenage Borough Welwyn Hatfield Council Borough Council 8 Page 42 11 Page 57 Three Rivers District Council 9 Page 47 page 6 The health of our population: Hertfordshire County Council The health of our population: Hertfordshire Overview Health in summary Health inequalities The health of people in Hertfordshire is Life expectancy is 7.2 years lower for men generally better than the England and 5.4 years lower for women in the most average. deprived areas of Hertfordshire than in the least deprived areas. Hertfordshire is one of the 20% least deprived counties/unitary authorities in Stevenage and Watford generally tend to England; however, about 11% (24,800) of have poorer health outcomes than other children live in low income families. districts in the county. Life expectancy for both men and women is higher than the England average. page 8 The health of our population: Hertfordshire Key numbers Smoking in pregnancy Diabetes 805 new mothers were smokers 28.5% of diabetics aged 17+ were at the time of delivery in 2016/17 estimated to be undiagnosed in 2017 Childhood obesity Self-harm 1,881 schoolchildren in Year 6 There were 1,215 emergency were obese in 2016/17 hospital admissions for intentional self-harm in 2016/17 Physical activity Hip fractures 31.5% of adults (aged 19+) were There were 1,225 emergency not physically active in 2016/17 admissions for hip fracture in people aged 65+ in 2016/17 page 9 The health of our population: Hertfordshire Statistically significant trends in key indicators Getting better Getting worse • Cancer diagnosed at early stage • Obese children (aged 10-11) • Smoking status at time of delivery • Violent crime • Under 18 conceptions • Children in low income families (under 16s) • Employment rate (aged 16-64) • New sexually transmitted infections (STIs) page 10 The health of our population: Hertfordshire Key improvements to aim for Increasing physical activity and tackling child obesity Reducing violent crime Reducing smoking in vulnerable groups Diagnosing unrecorded diabetes page 11 The health of our population: Broxbourne Borough Council The health of our population: Broxbourne Overview Health in summary Health inequalities The health of people in Broxbourne is Life expectancy is 7.7 years lower for men generally better than the England and 4.5 years lower for women in the most average. deprived areas of Broxbourne than in the least deprived areas. About 15% (2,800) of children live in low income families. Waltham Cross and Rosedale & Bury Green wards experiences a number of Life expectancy for both men and women poorer health outcomes than other wards is higher than the England average. in the borough. page 13 The health of our population: Broxbourne Key numbers Smoking in pregnancy Diabetes 69 new mothers were smokers at 25.9% of diabetics aged 17+ were the time of delivery in 2016/17 estimated to be undiagnosed in 2017 Childhood obesity Self-harm 216 schoolchildren in Year 6 were There were 82 emergency obese in 2016/17 hospital admissions for intentional self-harm in 2016/17 Physical activity Hip fractures 36.1% of adults (aged 19+) were There were 100 emergency not physically active in 2016/17 admissions for hip fracture in people aged 65+ in 2016/17 page 14 The health of our population: Broxbourne Statistically significant trends in key indicators Getting better Getting worse • Cancer diagnosed at early stage • Violent crime • Children in low income families • Employment rate (aged 16-64) (under 16s) • Under 18 conceptions page 15 The health of our population: Broxbourne Key improvements to aim for Increasing physical activity and tackling child obesity Reducing violent crime Reducing smoking in vulnerable groups Reducing unemployment page 16 The health of our population: Dacorum Borough Council The health of our population: Dacorum Overview Health in summary Health inequalities The health of people in Dacorum is Life expectancy is 7.8 years lower for men generally better than the England and 5.1 years lower for women in the most average. deprived areas of Dacorum than in the least deprived areas. About 12% (3,300) of children live in low income families. Several wards, including Grovehill, Highfield, Hemel Hempstead Town and Life expectancy for both men and women Adeyfield West, experience a number of is higher than the England average. health outcomes than the borough as whole. page 18 The health of our population: Dacorum Key numbers Smoking in pregnancy Diabetes 99 new mothers were smokers at 31.2% of diabetics aged 17+ were the time of delivery in 2016/17 estimated to be undiagnosed in 2017 Childhood obesity Self-harm 222 schoolchildren in Year 6 were There were 182 emergency obese in 2016/17 hospital admissions for intentional self-harm in 2016/17 Physical activity Hip fractures 27.7% of adults (aged 19+) were There were 161 emergency not physically active in 2016/17 admissions for hip fracture in people aged 65+ in 2016/17 page 19 The health of our population: Dacorum Statistically significant trends in key indicators Getting better Getting worse • Cancer diagnosed at early stage • Violent crime • Children in low income families (under 16s) • Statutory homelessness • Smoking status at time of delivery • Under 18 conceptions • New sexually transmitted infections (STIs) • Employment rate (aged 16-64) page 20 The health of our population: Dacorum Key improvements to aim for Increasing physical activity Reducing violent crime Reducing smoking in vulnerable groups Diagnosing unrecorded diabetes page 21 The health of our population: East Hertfordshire District Council The health of our population: East Hertfordshire Overview Health in summary Health inequalities The health of people in East Hertfordshire Life expectancy is 4.8 years lower for men is generally better than the England and 4.9 years lower for women in the most average. deprived areas of East Hertfordshire than in the least deprived areas. East Hertfordshire is one of the 20% least deprived districts/unitary authorities in Several wards, such as Hertford Sele, England; however, about 8% (2,100) of experience a number of poorer health children live in low income families. outcomes than the district as a whole. Life expectancy for both men and women is higher than the England average. page 23 The health of our population: East Hertfordshire Key numbers Smoking in pregnancy Diabetes 92 new mothers were smokers at 33.6% of diabetics aged 17+ were the time of delivery in 2016/17 estimated to be undiagnosed in 2017 Childhood obesity Self-harm 194 schoolchildren in Year 6 were There were 79 emergency obese in 2016/17 hospital admissions for intentional self-harm in 2016/17 Physical activity Hip fractures 26.7% of adults (aged 19+) were There were 164 emergency not physically active in 2016/17 admissions for hip fracture in people aged 65+ in 2016/17 page 24 The health of our population: East Hertfordshire Statistically significant trends in key indicators Getting better Getting worse • Children in low income families (under 16s) • Employment rate (aged 16-64) • Under 18 conceptions • Violent crime • New sexually transmitted infections (STIs) page 25 The health of our population: East Hertfordshire Key improvements to aim for Increasing physical activity Reducing violent crime Reducing smoking in vulnerable groups Diagnosing unrecorded diabetes page 26 The health of our population: Hertsmere Borough Council The health of our population: Hertsmere Overview Health in summary Health inequalities The health of people in Hertsmere is Life expectancy is 9.3 years lower for men generally better than the England and 6.3 years lower for women in the most average.