Cambridgeshire Insight – Health and Wellbeing – Local Public Health Intelligence

Annual Public Health Report

The Director of Public Health has a statutory duty to produce an annual public health report looking at the health of the community in which they work. These reports are aimed at the general public as well as Councillors and health professionals and are a key opportunity to engage the community and health professionals with key issues affecting the local area. Cambridgeshire County Council and Peterborough City Council have a joint Director of Public Health, Dr Jyoti Atri, and a report is produced for each area.

Cambridgeshire

The Cambridgeshire Annual Public Health Report 2019 focusses on the new Index of Deprivation (IoD) (2019), which reviews the social, economic and environmental circumstances of communities nationally. Since there is a very close relationship between social and economic deprivation and poor health, information in the IoD (2019) is key to understanding the health and wellbeing of Cambridgeshire residents.

The second focus of the report is an update on recent trends in the lifestyles and health behaviours of local residents, which are likely to impact on future health and wellbeing.

Peterborough

The Peterborough Annual Public Health Report 2019 focusses on the new Index of Deprivation (IoD) (2019), which reviews the social, economic and environmental circumstances of communities nationally. Since there is a very close relationship between social and economic deprivation and poor health, information in the IoD (2019) is key to understanding the health and wellbeing of Peterborough residents.

The second focus of the report is an update on recent trends in the lifestyles and health behaviours of local residents, which are likely to impact on future health and wellbeing.

Previous Reports

Peterborough

The Peterborough Annual Public Health Report, 2018 focuses on two topics where new information is available. For the first time, the national Health Profile for England (2018) includes achapter about Health and Early Years and Section 2 of this report reviews similar information for Peterborough about the health and development of children aged under five.

Cambridgeshire

The Cambridgeshire Annual Public Health Report 2018 focuses on two topics where new information is available. For the first time, the national Health Profile for England (2018) includes a chapter about Health and Early Years and Section 2 of this report reviews similar information for Cambridgeshire about the health and development of children aged under five.

The Cambridgeshire Annual Public Health Report, 2017 concentrates on the wider social and environmental factors affecting our health and wellbeing, and key lifestyle and health behaviours.

The Cambridgeshire Annual Public Health Report 2015/16 looked at health issues at a local level, providing a series of ‘health maps’ of the county broken down into individual electoral wards. It also provides brief case studies of what can be done at community level to support healthy lifestyles and wellbeing.

The Cambridgeshire Annual Public Health Report 2014/15 looked at changes and trends in public health outcomes over recent years. Understanding which outcomes are improving and which are deteriorating helps to identify emerging problems and target resources to address them.

Annual Public Annual Health report 2013-2014

Peterborough

Previous reports for Peterborough can be found at: https://www.peterborough.gov.uk/healthcare/public-health/annual-public-health-report/

Cambridgeshire_and_peterborough - Health - UTLA - Cambridgeshire

Cambridgeshire

Self-reported health

	Count	%	Count	%	Count	%
	Cambridgeshire		East of England		England
Very bad health	5,453	0.9	60,383	1	660,749	1.2
Bad health	19,715	3.2	212,830	3.6	2,250,446	4.2
Fair health	73,386	11.8	752,324	12.9	6,954,092	13.1
Good health	215,746	34.7	2,060,157	35.2	18,141,457	34.2
Very good health	306,910	49.4	2,761,271	47.2	25,005,712	47.2

General health is a self-assessment of a person's general state of health. People were asked to assess whether their health was very good, good, fair, bad or very bad. This assessment is not based on a person's health over any specified period of time.

Day-to-day activity limited

	Count	%	Count	%	Count	%
	Cambridgeshire		East of England		England
Day-to-day activities limited a lot	40,621	6.5	434,168	7.4	4,405,394	8.3
Day-to-day activities limited a little	54,406	8.8	542,346	9.3	4,947,192	9.3
Day-to-day activities not limited	526,183	84.7	4,870,451	83.3	43,659,870	82.4

People were asked to assess whether their daily activities were limited a lot or a little by a health problem, or whether their daily activities were not limited at all.

Self-reported wellbeing

ONS measure individual/subjective wellbeing based on four questions included on the Integrated Household Survey:

Overall, how satisfied are you with your life nowadays?
Overall, how happy did you feel yesterday?
Overall, how anxious did you feel yesterday?
Overall, to what extent do you feel the things you do in your life are worthwhile?

General fertility rate

	Cambridgeshire	East of England	England
General fertility rate - Female - 15-44 yrs	6,648	56.2	67,409	60.7	610,505	57.7

Breastfeeding initiation rate

The breastfeeding initiation rate measures the percentage of mothers who give their babies breast milk in the first 48 hours after delivery.

Low birth weight of term babies

	Cambridgeshire	East of England	England
% of all live births at term with low birth weight	158	2.5	1,604	2.5	16,534	2.8

This is live births with a recorded birth weight under 2500g and a gestational age of at least 37 complete weeks as a percentage of all live births with recorded birth weight and a gestational age of at least 37 complete weeks.

Prevalence of overweight (including obese) among children

Children are classified as overweight (including obese) if their BMI is on or above the 85th centile of the British 1990 growth reference (UK90) according to age and sex.

Fruit and vegetable consumption at age 15

	Cambridgeshire	East of England	England
Average number of portions of fruit consumed daily (WAY survey)	2.4	2.4	2.4
Average number of portions of vegetables consumed daily (WAY survey)	2.5	2.4	2.4

Smoking prevalence at age 15

	Cambridgeshire	East of England	England
Current smokers (WAY survey)	8.2	8.9	8.2
Regular smokers (WAY survey)	5.2	5.7	5.5
Occasional smokers (WAY survey)	3.1	3.2	2.7

Adult fruit and vegetable consumption

	Cambridgeshire	East of England	England
Average number of portions of fruit consumed daily (16+ years)	2.5	2.5	2.5
Average number of portions of vegetables consumed daily (16+ yrs)	2.8	2.7	2.7

Adult physical activity

Physically active is defined here as doing at least 150 moderate intensity equivalent (MIE) minutes physical activity per week in bouts of 10 minutes or more in the previous 28 days. Physically inactive is defined as doing less than 30 MIE minutes physical activity per week in bouts of 10 minutes or more in the previous 28 days.

Successful completion of drug treatment

	Count	%	Count	%	Count	%
	Cambridgeshire		East of England		England
Successful completion of drug treatment - opiate users (18-75 yrs)	81	6.9	797	6.9	9,908	6.7
Successful completion of drug treatment - non-opiate users (18-75 yrs)	176	33.1	1,577	33.9	19,717	37.1

This is the number of users that left drug treatment successfully (free of drug(s) of dependence) who do not then re-present to treatment again within 6 months as a percentage of the total number of users in treatment.

Adults with a learning disability who live in stable and appropriate accommodation

This is the percentage of adults with a learning disability who are known to their local council, who are recorded as living in their own home or with their family.

Admission episodes for alcohol-related conditions

This is admissions to hospital where the primary diagnosis is an alcohol-attributable code or a secondary diagnosis is an alcohol-attributable external cause code, as a directly age standardised rate per 100,000 population.

Emergency hospital admissions for intentional self-harm

Self-harm is defined as an intentional act of self-poisoning or self-injury irrespective of the type of motivation or degree of suicidal intent. However, following an episode of self-harm, there is a significant and persistent risk of suicide which varies markedly between genders and age groups.

Hip fractures in people aged 65 and over

	Cambridgeshire	East of England	England
Males	173	309.1	2,038	370.6	16,805	367.8
Females	481	742.5	5,113	784	41,893	767.1

This is emergency hospital admission for fractured neck of femur in persons aged 65 and over as a directly age standardised rate per 100,000. Hip fracture is a debilitating condition – only one in three sufferers return to their former levels of independence and one in three ends up leaving their own home and moving to long-term care.

Health related quality of life for adults aged 65 and over

	Cambridgeshire	East of England	England
Average health status score for adults aged 65+	0.8	0.7	0.7

Health status is derived from responses to Q34 on the GP Patient's Survey, which asks respondents to describe their health status using the five dimensions of the EuroQuol 5D (EQ-5D) survey instrument:

Mobility
Self-care
Usual activities
Pain / discomfort
Anxiety / depression

This indicator assesses whether health-related quality of life is changing over time, while controlling for potential measurable confounders (age, sex, long-term conditions, caring responsibility, etc...).

Life expectancy at birth

This is the average number of years a person would expect to live based on contemporary mortality rates. For a particular area and time period, it is an estimate of the average number of years a newborn baby would survive if he or she experienced the age-specific mortality rates for that area and time period throughout his or her life. Figures are calculated from deaths from all causes and mid-year population estimates, based on data aggregated over a three year period.

Healthy life expectancy at birth

This is a measure of the average number of years a person would expect to live in good health based on contemporary mortality rates and prevalence of self-reported good health. The prevalence of good health is derived from responses to a survey question on general health. For a particular area and time period, it is an estimate of the average number of years a newborn baby would live in good general health if he or she experienced the age-specific mortality rates and prevalence of good health for that area and time period throughout his or her life. Figures are calculated from deaths from all causes, mid-year population estimates, and self-reported general health status, based on data aggregated over a three year period.

Mortality rate from causes considered preventable in Cambridgeshire

	Count	Per 100,000	Count	Per 100,000	Count	Per 100,000
	Cambridgeshire		East of England		England
Males (2015 - 17)	1,648	170.3	17,180	189.7	169,588	207.3
Females (2015 - 17)	1,093	113	11,619	124.7	111,080	132.5

The basic concept of preventable mortality is that deaths are considered preventable if, in the light of the understanding of the determinants of health at the time of death, all or most deaths from the underlying cause (subject to age limits if appropriate) could potentially be avoided by public health interventions in the broadest sense.

Infant mortality in Cambridgeshire

	Count	Per 1,000	Count	Per 1,000	Count	Per 1,000
	Cambridgeshire		East of England		England
Infant mortality - Rate of deaths in infants aged under 1 year per 1,000 live births (2015 - 17)	72	3.3	696	3.2	7,734	3.9

Infant mortality is an indicator of the general health of an entire population. It reflects the relationship between causes of infant mortality and upstream determinants of population health such as economic, social and environmental conditions. Deaths occurring during the first 28 days of life (the neonatal period) in particular, are considered to reflect the health and care of both mother and newborn.

Under 75 mortality rate from causes considered preventable

	Count	Per 100,000	Count	Per 100,000	Count	Per 100,000
	Cambridgeshire		East of England		England
Under 75 mortality rate from cardiovascular diseases considered preventable	595.0	33.5	6,434.0	38.4	64,127.0	42.1
Under 75 mortality rate from cancer considered preventable	1,080.0	60.8	11,738.0	70.1	108,980.0	71.6
Under 75 mortality rate from liver disease considered preventable	178.0	10.0	2,078.0	12.4	23,170.0	15.2
Under 75 mortality rate from respiratory disease considered preventable	260.0	14.6	2,545.0	15.2	26,075.0	17.1

Mortality rate from a range of specified communicable diseases, including influenza

	Count	Per 100,000	Count	Per 100,000	Count	Per 100,000
	Cambridgeshire		East of England		England
Mortality rate from a range of specified communicable diseases, including influenza	226.0	11.7	1,674.0	9.1	16,738.0	10.1

Suicide rate in Cambridgeshire

	Count	Per 100,000	Count	Per 1,000	Count	Per 1,000
	Cambridgeshire		East of England		England
Suicide rate - Males (10+ yrs) (2016 - 18)	111	13	1,206	15.2	10,592	14.7
Suicide rate - Females (10+ yrs) (2016 - 18)	39	4.5	402	4.9	3,455	4.6

This is the age-standardised mortality rate from suicide and injury of undetermined intent per 100,000 population. Suicide is a significant cause of death in young adults, and is seen as an indicator of underlying rates of mental ill-health.

Excess winter deaths in Cambridgeshire

	Count	%	Count	%	Count	%
	Cambridgeshire		East of England		England
Excess winter deaths index - males aged 85+ (Aug 2014 - Jul 2017)	193	22.8	2,437.5	28.8	18,380	26.8
Excess winter deaths index - females aged 85+) (Aug 2014 - Jul 2017)	396	31.7	4,219.5	31.5	34,421	30.9

Excess Winter Deaths Index is the excess winter deaths measured as the ratio of extra deaths from all causes that occur in all those aged 85 and over in the winter months compared with the expected number of deaths, based on the average of the number of non-winter deaths in those aged 85 and over. The number of excess winter deaths depends on the temperature and the level of disease in the population as well as other factors, such as how well equipped people are to cope with the drop in temperature.

Provision of unpaid care

	Count	%	Count	%	Count	%
	Cambridgeshire		East of England		England
Provides no unpaid care	561,034	90.3	5,249,374	89.8	47,582,440	89.8
Provides 1 to 19 hours unpaid care a week	41,313	6.7	395,865	6.8	3,452,636	6.5
Provides 20 to 49 hours unpaid care a week	6,785	1.1	71,815	1.2	721,143	1.4
Provides 50 or more hours unpaid care a week	12,078	1.9	129,911	2.2	1,256,237	2.4

A person is a provider of unpaid care if they look after or give help or support to family members, friends, neighbours or others because of long-term physical or mental ill health or disability, or problems related to old age. This does not include any activities as part of paid employment. No distinction is made about whether any care that a person provides is within their own household or outside of the household, so no explicit link can be made about whether the care provided is for a person within the household who has poor general health or a long-term health problem or disability.

Average difficulties score for all looked after children

	Cambridgeshire	East of England	England
Average difficulties score for all looked after children aged 5-16 who have been in care for at least 12 months on 31st March	14.9	15.3	14.2

Data is collected by local authorities through a strengths and difficulties questionnaire (SDQ) and a single summary figure for each child (the total difficulties score), ranging from 0 to 40, is submitted to the Department for Education through the looked after children return (SSDA903). A higher score indicates greater difficulties (a score of under 14 is considered normal, 14-16 is borderline cause for concern and 17 or over is a cause for concern).

Adult social care users and carers who have as much social contact as they would like

There is a clear link between loneliness and poor mental and physical health. This measures the percentage of respondents to the Adult Social Care Users Survey who responded "I have as much social contact as I want with people I like".