Locality Public Health Plan: Data Summary Exeter (CCG Eastern Locality) 2013/14 The Exeter Public Health plan is a mechanism for monitoring and prioritising health and well-being issues across the Exeter city area. Page 1 of 35 North East & West (NEW) Devon Clinical Commissioning Group and its Localities Table 1: Summary figures for NEW Devon clinical commissioning group Page 2 of 35 Public Health Annual Report 2012-13 Executive Summary The Devon Public Health Annual Report 2012-13 outlines that the areas of health and wellbeing where the greatest impact can be made on health inequality are: 1. Reducing smoking 2. Increase the proportion of the population at a healthy weight 3. Detecting and treating diseases earlier such as heart disease, high blood pressure diabetes and cancers 4. Targeting preventative interventions at those vulnerable groups with the worse health, including those who may be at risk of domestic or sexual violence and abuse 5. Investing in the health and wellbeing of all children and young people 6. Improving mental health and emotional wellbeing and preventing loneliness 7. Increasing income levels and employment, and reducing poverty 8. Improving the quality and warmth of housing 9. Reducing misuse of substances including alcohol and drugs 10. Helping people in their neighbourhoods to live healthier and happier lives The priorities chosen for improving the health and wellbeing of the Exeter population are: 1: Increasing levels of Physical Activity 2: Reduction in Alcohol misuse 3: Reducing falls and cold homes 4: Health of the most disadvantaged Page 3 of 35 The Health Profile for Exeter 2013 highlights: incidence of malignant melanoma, hospital stays for self harm, acute sexually transmitted infections, Alcohol specific hospital stays (Under 18) and violent crime as being significantly worse than the England rate. Link: Exeter Health Profile The Devon Health and Wellbeing pages provide further information in the Joint Strategic Needs Assessments (JSNA) for the Eastern locality and The Exeter city council area as well as GP practice profiles. Link: Devon Health and Wellbeing Pages –JSNA Exeter Health and Wellbeing Board is producing an Exeter Health and Wellbeing Strategy with an associated action plan to monitor progress against the chosen health and wellbeing priorities. This will be published in due course on the Exeter City Council Website. Demographics Population Growth Exeter city area has a population of 122,770 (June 2010). This breaks The population of Exeter is predicted to increase by 15833 people down to 62504 females and 60266 males. between 2011 and 2026, a rise of 12.6% Figure 2: Exeter population projection by age group. Data Figure 1: Exeter population pyramid compared to Devon (June source: Jan 2010 DCC population projections 2010) Data source: Patient and Practitioner Services Agency. Population Pyramid - Exeter Population - 2011 Population Projection, Exeter, 2011 to 2021 140,000 The table and population pyramid below show the population broken down by age and sex for the area against England. The age and gender of your population can have a significant impact on their health and social care needs. 123,351 120,000 117,063 Population Pyramid (% compared to England) Age Group Female Male 75 and over 11,277 85+ 1.9 0.8 0-4 3281 3426 9,570 80-84 1.6 0.9 5-9 2644 2879 60 to 74 16,544 75-79 100,000 14,947 1.7 1.3 10-14 2635 2703 70-74 1.9 1.5 15-19 4315 4255 65-69 2.2 1.9 20-24 7171 7144 60-64 2.7 2.5 80,000 25-29 4478 4467 55-59 2.6 2.4 30-34 3980 4129 50-54 2.9 2.8 76,107 35-39 3530 3763 60,000 74,978 45-49 3.3 3.2 15 to 59 40-44 3.2 3.2 40-44 3744 3760 35-39 3.0 3.2 45-49 3917 3771 40,000 30-34 3.4 3.5 50-54 3370 3295 25-29 3.8 3.8 55-59 3083 2806 20-24 6.1 6.1 60-64 3190 2960 15-19 3.7 3.6 20,000 65-69 2525 2278 10-14 2.3 2.3 70-74 2196 1798 00 to 14 19,422 5-9 2.3 2.5 17,568 75-79 1937 1511 0-4 2.8 2.9 0 80-84 1889 1110 Year 2011 Year 2012 Year 2013 Year 2014 Year 2015 Year 2016 Year 2017 Year 2018 Year 2019 Year 2020 Year 2021 8 6 4 2 0 2 4 6 8 85+ 2190 933 Exeter England Total 60075 56988 The city area has a much higher proportion of people in the younger age brackets particularly 20-24. This reflects the high student population due to the university. Page 4 of 35 Ageing Population The Exeter 85+ population is currently 2.62% which is slightly ahead of England which will be like Exeter in 2017. The figure below demonstrates the differences. Figure 3: Scaled comparison of the 85 and over population in Exeter Devon and England 2012 Page 5 of 35 Deprivation Deprivation is a significant factor for health inequalities. Figure one shows the most deprived areas of Exeter. Figure 4: Areas above the national average for deprivation in Exeter. Source: Office for National Statistics 2012 Page 6 of 35 National Urban National Overall National Rural Urban Rural Overall 28 26 24 22 20 18 16 14 12 Exeter has higher levels of urban deprivation than 10 both Devon and the South West 8 6 4 2 0 Exeter Devon South West South Figure 5: Urban deprivation for Exeter compared to Devon and the South West Page 7 of 35 Percentage of Population Income Deprived by Year, Exeter 14.0% 12.0% 10.0% The trend in deprivation over time follows the 8.0% South West and England rate and shows an 6.0% increase in deprivation in terms of income and employment following the recession 4.0% 2.0% 0.0% 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Exeter 12.0% 11.1% 10.7% 10.1% 10.0% 9.4% 9.1% 9.3% 8.9% 9.1% 10.2% South West 8.7% 8.5% 8.0% 8.0% 8.1% 7.9% 7.8% 8.1% 8.0% 8.0% 9.8% England 10.1% 9.6% 9.4% 9.2% 9.4% 9.1% 9.1% 9.3% 9.3% 9.5% 11.1% Figure 6: Income deprivation by year Percentage of Children Income Deprived by Year, Exeter 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Exeter 20.2% 20.1% 18.9% 18.1% 18.3% 17.5% 17.4% 17.8% 17.2% 17.1% 19.1% South West 13.6% 13.3% 12.2% 12.2% 12.5% 12.6% 12.3% 12.6% 12.7% 12.2% 14.0% England 15.9% 15.5% 15.2% 15.0% 15.4% 15.3% 15.1% 15.2% 15.2% 15.2% 16.9% Figure 7: Children income deprived by Figure 8: Population Employment year deprived by year Page 8 of 35 Health Inequalities Average life expectancy for the Exeter locality is 82.6 years; this is higher than the Devon average of 82 and the national average of 80.2 yrs. However there are marked differences between the least and most deprived areas in the city at lower super output area (LSOA) representing a gap of 16.8 years for Exeter. The biggest impact in reducing health inequalities in the Eastern locality area NHS Devon and partner agencies would be made by focusing on interventions which will impact most on the top five conditions contributing to the gap in life expectancy. These are Coronary heart disease, other cancers, road traffic accidents, chronic obstructive pulmonary disorder and lung cancer. For the Exeter City area the difference in life expectancy between the most and least deprived quintile could be most greatly impacted by action on Circulatory Disease, Cancer and respiratory disease. Smoking prevalence in the city is higher than the Devon average with areas of higher deprivation and high concentration of routine and manual workers, such as St David’s, Newtown & St James , Mincinglake, Pinhoe, Whipton Barton and Priory demonstrating prevalence rates of up to 25% compared to the Devon Average of 18.5%. Gap in Life Expectancy Figures 9 & 10 below show the gap in life expectancy between the most deprived 10% of the district’s population and the least deprived 10%. Female Gap in Life Expectancy (Years) Male Gap in Life Expectancy (Years) 8.0 10.0 7.0 9.0 8.0 6.0 7.0 5.0 6.0 4.0 5.0 3.0 4.0 3.0 2.0 2.0 1.0 1.0 0.0 0.0 2001- 2002- 2003- 2004- 2005- 2006- 2001- 2002- 2003- 2004- 2005- 2006- 05 06 07 08 09 10 05 06 07 08 09 10 Exeter 7.0 6.3 5.1 4.7 4.4 4.4 Exeter 6.1 6.1 6.0 6.7 7.9 7.5 Devon 3.4 3.0 2.8 2.7 2.5 2.8 Devon 5.3 5.0 5.1 5.1 5.1 5.4 England 5.5 5.6 5.7 5.9 5.9 5.9 England 8.4 8.4 8.7 8.8 8.8 8.9 Figure 9: Female life expectancy Figure 10: Male life expectancy gap gap in years in years There is a gap of 16.8 years between the LSOA with the longest life expectancy (Gallows Bridge area, 90.4 years) and the shortest (Priory Road area in Polsloe, 73.6 years).