Living Well for Longer in Cheshire East The Annual Report of the Director of Public Health 2012-2013 Contents Figures ..................................................................................................................................................... 5 Maps ....................................................................................................................................................... 7 Tables ...................................................................................................................................................... 8 Foreword ............................................................................................................................................... 10 Chapter One – A Call To Action ............................................................................................................. 14 Key Facts About Premature Mortality in Cheshire East .................................................................... 16 Conclusion ......................................................................................................................................... 24 Key Findings ...................................................................................................................................... 25 Chapter Two – Introducing Proportionate Universalism in Cheshire East ........................................... 26 Conclusion ......................................................................................................................................... 36 Key Findings ...................................................................................................................................... 37 Chapter Three - Cancer ......................................................................................................................... 39 Preventing Cancer ............................................................................................................................. 43 Cancer Screening Programmes ......................................................................................................... 49 Awareness and Early Diagnosis ......................................................................................................... 50 Conclusion ......................................................................................................................................... 52 Key Findings ...................................................................................................................................... 52 Chapter Four – Cardiovascular Disease ................................................................................................ 54 The Causes of Cardiovascular Disease .............................................................................................. 56 NHS Health Checks ............................................................................................................................ 58 Managing Risk in Primary Care ......................................................................................................... 59 Better Early Management and Prevention in the Community ......................................................... 60 Familial hypercholesterolemia ...................................................................................................... 60 Atrial fibrillation ............................................................................................................................ 60 Stroke ............................................................................................................................................ 61 Heart attack care ........................................................................................................................... 62 People Living with Cardiovascular Disease ....................................................................................... 63 Conclusion ......................................................................................................................................... 63 Key Findings ...................................................................................................................................... 63 Chapter Five – Other Main Causes of Premature Death ...................................................................... 65 2 Lung Disease ......................................................................................................................................... 65 Early Deaths from Respiratory Disease ............................................................................................. 66 Asthma .............................................................................................................................................. 69 Chronic Obstructive Pulmonary Disease ........................................................................................... 71 Conclusion ......................................................................................................................................... 74 Key Findings ...................................................................................................................................... 75 Liver Disease – A Growing Epidemic ..................................................................................................... 77 Deaths from Liver Disease ................................................................................................................ 77 An Overview of Liver Disease ............................................................................................................ 78 Effective Interventions to Reduce Harm From Alcohol .................................................................... 81 Key Findings ...................................................................................................................................... 81 Chapter Six – Road Traffic Accidents and Suicide ................................................................................. 83 Road Traffic Accidents .......................................................................................................................... 83 Road Traffic Accidents in Cheshire East ............................................................................................ 84 Road Traffic Accident Hospital Admissions ....................................................................................... 86 Road Use in Cheshire East ................................................................................................................. 87 Interventions ..................................................................................................................................... 89 Conclusion ......................................................................................................................................... 92 Key Findings ...................................................................................................................................... 93 Suicide ................................................................................................................................................... 94 Hospital Admissions due to Self-Harm ............................................................................................. 94 Early Deaths due to Suicide in Cheshire East .................................................................................... 95 Improving Mental Health and Wellbeing: Effective Interventions ................................................... 97 Recommendations for Healthcare Commissioners and Providers ................................................... 97 Conclusion ......................................................................................................................................... 98 Key Findings ...................................................................................................................................... 98 Chapter Seven – Mental Health and Premature Death ...................................................................... 100 Cheshire East: Depression and Anxiety Disorders .......................................................................... 100 Cheshire East: Psychoses ................................................................................................................ 100 Conclusion ....................................................................................................................................... 104 Key Findings .................................................................................................................................... 104 Chapter Eight - Vision .......................................................................................................................... 106 3 References .......................................................................................................................................... 108 Appendix One: Premature Mortality, Directly Standardised Rate per 100,000, Males aged under 75, 2009-11 ............................................................................................................................................... 112 Appendix Two: Premature Mortality, Directly Standardised Rate per 100,000, Females aged under 75, 2009-11 ........................................................................................................................................