Older people health and wellbeing profile Cheshire and Warrington December 2020 Public Health Institute, Faculty of Health, Liverpool John Moores University, 3rd Floor Exchange Station | Tithebarn Street | Liverpool L2 2QP| [email protected] | www.ljmu.ac.uk/phi Contents Infographic ............................................................................................................................ 1 Introduction ........................................................................................................................... 2 Population ......................................................................................................................... 3 Mortality and excess winter deaths .................................................................................... 5 1. Optimise Health and Reduce Risks Early ....................................................................... 6 2. Improve Wellbeing & the Wider Determinants of Health ................................................. 7 Deprivation ........................................................................................................................ 7 Carers ............................................................................................................................... 7 Living alone ....................................................................................................................... 8 Social isolation and loneliness ........................................................................................... 8 3. Reverse or Live Well with a Long-term Condition ......................................................... 10 4. Enhance Care & Support ............................................................................................. 12 Older people living in care homes .................................................................................... 12 Interpretation guide ............................................................................................................. 15 Data sources ....................................................................................................................... 15 Appendices: Population numbers and projections aged 65+by local authority..................... 16 References ............................................................................................................................. Older People Health Profile 2020, Cheshire & Warrington PHI LJMU 1 Acknowledgements This work was commissioned by the Cheshire and Merseyside Directors of Public Health, through the Cheshire and Merseyside Public Health Intelligence Network and Champs Public Health Collaborative (Cheshire and Merseyside). It was based partly on the Cheshire and Merseyside Profile of Older People (those aged 65 and over) by Sharon McAteer, Public Health, Halton Borough Council, March 2020 Matthew Ashton, Director of Public Health for Liverpool, leads the Public Health Intelligence Network with support from Sharon McAteer (Halton), and the wider network. Their role in the Intelligence & Evidence Service involves setting the work programme, providing strategic direction and facilitating collaborative links between the Champs Public Health Collaborative, the Public Health Institute, LJMU and the wider public health community. They also contribute to editing and final approval of reports, alongside Lisa Jones, Reader in Public Health, LJMU who manages the Champs Intelligence & Evidence Service. Thanks to Doris Hain of Public Health England for fingertips support. Authors: Janet Ubido,Cath Lewis, Lisa Jones (LJMU PHI) and Sharon McAteer (Halton BC). For more information please contact: Public Health Institute, Liverpool John Moores University, email: [email protected]. Older People Health Profile 2020, Cheshire & Warrington PHI LJMU 2 Population & mortality Older people in Cheshire & Warrington A comparison to England, 2020 Population: Just over 1 in 5 (21.6%) of the population in Cheshire and Warrington are aged 65 and over 1. Optimise health — more than in LCR, the North West and & reduce risks England. Causes of death, ages 65+: 10.2-13.0 y* 11.6-12.1 y* 41.8% 75.7% 62.7% 78.2% 895 Cardiovascular disease: high rate in Warrington Healthy life ex- Health checks Flu vaccinations Bowel cancer Breast cancer Alcohol hospital pectancy (age 40-74 y) (age 65+ y) screening screening admissions Respiratory: high rates in Warrington and (per 100,000, Good capacity age 65+ y) Cheshire West & Chester Cancer: better or similar to England Mental health (dementia): high rate in 2. Improve wellbeing & Warrington wider health determinants Excess winter deaths, ages 85+ High levels in Cheshire East 33.3% 45.4% 12..9% 97.6% 8.6% to 12.1% * Social isolation Social isolation Living alone Winter fuel Older people carers who have as care users who have (age 65+ y) payments living in much social contact as much social (age 65+ y) deprivation Key as they would like contact as they would (age 65+ y) like Statistical significance compared to England: (age 65+ y) Better 3. Live well with long Declining capacity term conditions Similar 3.5% 13.1% 5.8% 3.1% 9.1% 0.9% Worse Coronary heart Long term Severe knee Common Dementia QOF Severe hip * average not available disease conditions arthritis arthritis mental disorder prevalence (age 65+ y) This work was commissioned through the Cheshire and Merseyside Public Health Intelligence Network and Champs Public Health Collaborative. Based on 4. Enhance care the latest published data as of September 2020. & support For more information & data sources please contact: [email protected] 0.4% 6.3 9.7 669 57.7% 1.9% 2,451 End of life care Nursing home Care home beds Admissions to Service users Offered Falls Icons from www.flaticon.com and venngage.com beds (per 100, residential & satisfied with reablement on emergency Frail / low capacity / Frail (per 100, age 75+ y) nursing homes care hospital admissions age 75+ y) (per 100,000, (age 65+ y) discharge (per 100,000, age 65+ y) (age 65+ y) age 65+ y) Introduction This Older People’s health and wellbeing profile for Cheshire and Warrington is one of a series of profiles that are being produced on behalf of Champs for the Cheshire and Warrington and Liverpool City Region (LCR) sub-regions. The first in the series was a Children and Young Person’s profile (links: CYP LCR & CYP Cheshire & Warrington). Profiles for Vulnerable Groups in Cheshire and Warrington and LCR are due to be published in early 2021. The Older People’s profile begins with an overview of the population and mortality in Cheshire and Warrington amongst those aged 65 and over. Comparisons are made with the wider area of Cheshire and Merseyside and with England. The profile then goes on to provide local data organised around the four domains used in the Public Health England (PHE) Productive Healthy Ageing Profiles1. 1. Optimise Health and Reduce Risks Early 2. Improve Wellbeing & Wider Determinants of Health 3. Reverse or Live Well with a Long-term Condition 4. Enhance Care & Support PHE based these domains on work by the WHO, as illustrated in Figure 1: Figure 1: Public Health Framework for Ageing (source: PHE, 20191, Figure 1, p.7) The aim of this profile is to provide a set of indicators that describe key issues relevant to older people’s health as they age, including risk and protective factors, early interventions, health outcomes, identification of need, and health and social care1. The profile will support the exploration of inequalities and inform actions to improve health outcomes. The Older People Health Profile 2020, Cheshire & Warrington PHI LJMU 2 information provided can be used to support development of joint strategic needs assessments, public health planning, and assessment of the overall impact of public health interventions in relation to older people1. It should be noted that some health topics, such as falls prevention and social isolation, will span different domains. Population Figure 2: % of population aged 65+, region and sub region, 2019 Cheshire and Merseyside has higher proportions of older people, both males and 21.57 Cheshire & Warrington 22.80 females, than the North West or England 20.28 (Figure 2). Proportions are especially high in 19.97 Cheshire and Warrington, with more than 1 Cheshire & Merseyside 21.29 18.60 in 5 (21.57%) aged 65 and over. 18.73 North West 19.98 The differences remain across the age 17.45 groups, where in Cheshire and Warrington 18.39 England 19.74 there are markedly larger proportions of 17.02 older people in each five year age group over 65 compared to England and the North 0 5 10 15 20 25 % West (Figure 3). persons female male based on ONS pop data mid-2019 Figure 3 % of total population aged 65+, by 5 year age group, 2019 based on ONS mid-2019 population data Cheshire and Warrington Cheshire & Merseyside female male female male 65-69 5.73 65-69yrs 5.66 5.53 5.44 70-74 5.98 70-74yrs 5.80 5.41 5.23 4.35 75-79yrs 3.95 3.97 75-79 3.52 3.27 80-84yrs 2.76 3.13 80-84 2.50 3.47 85+yrs 2.12 3.25 85+ 1.92 6 4 2 0 2 4 6 6 1 4 % % North West England female male female male 5.07 65-69yrs 4.86 5.19 65-69yrs 5.10 5.09 70-74yrs 4.78 5.18 70-74yrs 4.97 75-79yrs 3.75 75-79yrs 3.34 3.65 3.24 2.88 80-84yrs 2.29 2.83 80-84yrs 2.28 2.98 85+yrs 1.75 3.09 85+yrs 1.86 6 4 2 0 2 4 6 6 4 2 0 2 4 6 % % Older People Health Profile 2020, Cheshire & Warrington PHI LJMU 3 Figure 5: Population projections in Cheshire and Warrington Figure 4: % of population aged 65+, by local Population aged 65 and over as a % of all authority,