21st ANNUAL PUBLIC HEALTH REPORT FOR STOCKPORT 2012/13 1 Contents The report is broken down in to levels and sections. There are three levels: Level 1 contains a one page summary followed by a five page overview in which each chapter of the report is summarised in a paragraph, each section on a page. Level 2 is 32 pages in length and each chapter is summarised in one or two pages. Level 3 is 196 pages in length and contains the full report. Within each level there are five sections: Section A describes and considers an overview of the health of the people of Stockport. Section B covers the diseases which cause death and disability in Stockport. Section C explores the major risk factors for disease, death and disability so we understand how we can address the issues described in section B Section D looks at these issues as part of the life-cycle, considering the health of children through to healthier aging. Section E summarises our response; how we are addressing the causes of ill-health and reducing health inequalities for the people of Stockport. Within level 2 of the report there are two key chapters: Recommendations highlights the key messages of this report for organisations Advice to individual citizens of Stockport highlights the key message to individuals A full content list follows on pages 3, 4 and 5, and you can access any level and section of the report by clicking the chapter name in the content list. Each page contains a “return to contents” button to enable you to return to this list and navigate to other levels and sections of the report easily. 2 Return to contents Contents .................................................................................................................................................. 2 LEVEL 1 (OVERVIEW) SUMMARY ............................................................................................................ 7 LEVEL 1 (OVERVIEW) INTRODUCTION .................................................................................................... 8 LEVEL 1 (OVERVIEW) SECTION A: THE HEALTH OF THE PEOPLE ............................................................. 8 LEVEL 1 (OVERVIEW) SECTION B: DISEASES CAUSING DEATH AND DISABILITY ..................................... 9 LEVEL 1 (OVERVIEW) SECTION C: THE MAJOR RISK FACTORS CAUSING DISEASE, DEATH AND DISABILITY ............................................................................................................................................. 10 LEVEL 1 (OVERVIEW) SECTION D: THE LIFE CYCLE ................................................................................ 11 LEVEL 1 (OVERVIEW) SECTION E: THE STRATEGIC RESPONSE .............................................................. 12 LEVEL 2 (KEY MESSAGES) INTRODUCTION ............................................................................................ 15 LEVEL 2 (KEY MESSAGES) SECTION A: THE HEALTH OF THE PEOPLE .................................................... 16 2.1. ILL HEALTH IN BRITAIN AND STOCKPORT ............................................................................... 16 2.2. INEQUALITIES ......................................................................................................................... 17 2.3. THE HEALTH OF STOCKPORT COMMUNITIES ......................................................................... 18 LEVEL 2 (KEY MESSAGES) SECTION B: DISEASES CAUSING DEATH AND DISABILITY ............................. 20 2.4. HEART DISEASE AND CANCER ................................................................................................ 20 2.5. RESPIRATORY DISEASE ........................................................................................................... 22 2.6. INJURIES ................................................................................................................................. 23 2.7. MENTAL ILLNESS .................................................................................................................... 24 2.8. MUSCULOSKELETAL DISEASE ................................................................................................. 25 LEVEL 2 (KEY MESSAGES) SECTION C: THE MAJOR RISK FACTORS FOR DISEASE, DEATH AND DISABILITY ............................................................................................................................................. 26 2.9. HYPERTENSION ...................................................................................................................... 26 2.10. SMOKING ............................................................................................................................... 27 2.11. DIET ....................................................................................................................................... 28 2.12. PHYSICAL ACTIVITY ................................................................................................................. 29 2.13. ALCOHOL ............................................................................................................................... 30 2.14. WELLBEING ............................................................................................................................ 31 2.15. SAFETY AND HEALTH PROTECTION .................................................................................... 31 LEVEL 2 (KEY MESSAGES) SECTION D: THE LIFE CYCLE ......................................................................... 33 2.16. HEALTH OF CHILDREN AND YOUNG PEOPLE .......................................................................... 33 2.17. HEALTH AND WORK ............................................................................................................... 34 2.18. HEALTHY AGEING ................................................................................................................... 35 LEVEL 2 (KEY MESSAGES) SECTION E: THE STRATEGIC RESPONSE ....................................................... 36 2.19. RESILIENT COMMUNITIES ...................................................................................................... 36 2.20. EARLIER DIAGNOSIS ............................................................................................................... 37 2.21. CHANGE IN THE HEALTH SERVICE .......................................................................................... 38 2.22. CHALLENGES FOR THE NHS .................................................................................................... 39 2.23. PREVENTION – THE CORNERSTONE OF PUBLIC SECTOR REFORM .......................................... 40 2.24. A COUNTRY CITY – TOWARDS A GREENER STOCKPORT ......................................................... 41 2.25. THE HEALTH AND WELL BEING STRATEGY .............................................................................. 42 2.26. RECOMMENDATIONS ............................................................................................................ 44 3 Return to contents LEVEL 3 (FULL ANALYSIS) INTRODUCTION ............................................................................................ 49 LEVEL 3 (FULL ANALYSIS) SECTION A: THE HEALTH OF THE PEOPLE .................................................... 52 3.1. ILL HEALTH IN BRITAIN AND STOCKPORT ............................................................................. 52 3.2. INEQUALITIES ........................................................................................................................ 58 3.3. THE HEALTH OF STOCKPORT COMMUNITIES ....................................................................... 62 LEVEL 3 (FULL ANALYSIS) SECTION B: DISEASES CAUSING DEATH AND DISABILITY ............................. 77 3.4. HEART DISEASE AND CANCER ............................................................................................... 77 3.5. RESPIRATORY DISEASE .......................................................................................................... 83 3.6. INJURIES ................................................................................................................................ 86 3.7. MENTAL ILLNESS ................................................................................................................... 93 3.8. MUSCULOSKELETAL DISEASE .............................................................................................. 100 LEVEL 3 (FULL ANALYSIS) SECTION C: THE MAJOR RISK FACTORS FOR DISEASE, DEATH AND DISABILITY ........................................................................................................................................... 101 3.9. HYPERTENSION ................................................................................................................... 101 3.10. SMOKING ........................................................................................................................ 105 3.11. DIET ................................................................................................................................. 115 3.12. PHYSICAL ACTIVITY .......................................................................................................... 118 3.13. ALCOHOL ......................................................................................................................... 126 3.14. WELL BEING ..................................................................................................................... 129 3.15. SAFETY AND HEALTH PROTECTION ................................................................................