JSNA Phase 5

Domestic Violence

There has been a substantial increase in reported domestic violence in recent years.  In the period 2005 – 2009, the number of incidents reported to the police in Cambridgeshire has risen by more than 41.9%. 

The Independent Domestic Violence Advocacy Service received 324 high-risk referrals from the Constabulary in 2005.  In 2008/09 that figure was 1,536 – this change is likely to reflect changes in referral behaviour as well as needs.

Concerns include under reporting, and the availability of services to support victims and where possible prevent further incidences.

Long Term Conditions

Nationally there are estimated to be 15 million people living with one or more long term health conditions (LTCs) with prevalence and severity increasing with older age.  These conditions are often lifestyle related and rates are generally greater amongst populations experiencing higher levels of deprivation. 

Examples of common LTCs include diabetes, heart disease, long term respiratory disease and stroke.  Improving the health of people suffering from a long term condition through lifestyle interventions such as stopping smoking, increased physical activity, and healthier diet can help stabilise conditions, reduce the need for health and social care, and enhance the quality of life.  There are opportunities to further incorporate preventive services into patient pathways for people with LTCs.

Screening

The purpose of screening is to identify disease at an early stage, with the result that early treatment leads to better health outcomes. Local NHS screening programmes are well established and generally meet national targets for the numbers of people screened.

There is insufficient information about access to screening for people in vulnerable and hard to reach groups.

Dental and Oral Health

Information about dental and oral health is collected at a regional level.  The most recent adult data for the East of England indicates that oral health is improving in adults of working age particularly among the younger age group up to 45 years.  However for those who do have decay or gum problems, disease can be very extensive and for many people in older middle age, dental needs can be very complex.  The vulnerable and socio-economically disadvantaged groups are more likely to be at risk of poor dental and oral health.  Adults who smoke, use alcohol, are binge drinkers or are obese are more likely to suffer from periodontal disease and mouth cancer.

Drug Misuse

Drug misuse is when a person regularly takes one or more drugs to change their mood, emotion or state of consciousness.  Their affect on health is well documented and recent studies have emphasised the diversity of effects and the impact of new drugs.

Although there are primary prevention interventions for drug misuse, most of these target young people and not those of working age.  Prevention for the working age population is mostly secondary and occurs when individuals access the treatment service.  A concern for Cambridgeshire is that an estimated one third of the drug using population does not access any services.

Smoking

Tobacco use remains the leading cause of preventable morbidity and mortality worldwide.

Smoking causes a range of illnesses, including respiratory disease, cancer, circulatory disease and diseases of the digestive system.  Smoking is harmful not only to smokers but also to people around them.  Infants of parents who smoke are more likely to suffer from serious respiratory infections. It is a major cause of health inequalities. 

Addressing smoking is through Tobacco Control Initiatives that includes both the provision of Stop Smoking Services and wider efforts to create smoke free environments.

The prevalence of smoking varies markedly between socio-economic groups.  Smoking prevalence is higher in more deprived populations and amongst the routine and manual group of workers.

Smoking is the single most modifiable risk factor for adverse outcomes in pregnancy.

 

Alcohol

Hazardous drinking of alcohol is defined as a pattern of drinking which brings about the risk of physical or psychological harm. Harmful drinking is a subset of hazardous drinking and is described as a pattern of drinking that is likely to cause physical and psychological harm.  Consumption of alcohol above the recommended limits (21 units per week for males and 14 units per week for females) is known to be harmful to health. Nationally over the last decade there are indications that there has been an increase in adverse health outcomes associated with alcohol.

A local telephone survey in 2009 found that about 30% of men drank more than the recommended limit. Overall, Cambridgeshire as a county compares well to the national average on statistics for alcohol misuse and harm, but Cambridge City is above the national average for a number of indicators including hospital admissions specifically caused by alcohol, aspects of alcohol related crime, and binge drinking.

Physical Activity

Physical Activity includes all forms of activity, such as everyday walking or cycling, active play, work-related activity, active recreation, dancing, gardening and playing active games, as well as organised sport. Measuring levels of physical activity is complex depending on whether participation in sport is measured or a wider definition that includes other measures.

Adults should aim to be active daily.  Over a week, activity should add up to at least 150 minutes (2½ hours) of moderate intensity activity in bouts of ten minutes or more. 

 

Sexual Health

Sexual health includes sexually transmitted infections (STIs), contraception, abortion and reproductive health.  Sexual health need requires an holistic understanding.  For example if there is a high teenage conception rate then there is high risk of an increase in sexually transmitted infections and abortion.

The numbers of people living with HIV in Cambridgeshire has increased since 2004 reflecting to a large degree better treatment methods.

Nationally there is also a concern with a high level of late HIV diagnoses which compromises treatment and potentially could increase the spread of the disease.

Nationally the highest burden of sexually transmitted disease is borne by women, commercial sex workers, gay men, men who have sex with men (MSM), teenagers, young adults and black and ethnic minorities (BME).  A better understanding in Cambridgeshire of the sexual health needs of these groups especially vulnerable populations is required.

The Cambridgeshire teenage conception rate has been consistently and significantly lower than the national and East of England rate since the launch of the Teenage Pregnancy Strategy in 1999.

There were 740 sexual offences recorded in Cambridgeshire during 2008-2009 with 755 recorded sexual offences in Cambridgeshire in 2009-2010, representing a 2% increase year on year.  The Cambridgeshire and Peterborough Sexual Assault Referral Centre provided services to 330 people in 2010 of which, 112 of those clients were from Cambridgeshire. 

 

Access to Services

Cambridgeshire is predominantly a rural county and access to all services is limited in many areas especially in more deprived areas where car ownership is more limited.

The full JSNA contains links to detailed maps that demonstrate the patterns and inequalities that are present in Cambridgeshire.

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