Welcome to the overarching 2023 Joint Strategic Needs Assessment (JSNA) for Cambridgeshire and Peterborough.
This is an overview of the population and health in our area based on the latest available data, reflecting the 2021 Census. We are aware that it does not include every available piece of information on every health and care topic; the aim here is to give an overview and highlight the most important data. Subsequent JSNAs will go into more depth on specific topics.
What is a JSNA? Please see a short explanation here.
This web-based JSNA is a new approach for Cambridgeshire and Peterborough. We have produced interactive dashboards with visualisations that allow the user to choose the information of most interest to them, and because health varies across our area, the dashboards present the data at district council level wherever possible. These visualisations also allow the user to compare areas in Cambridgeshire and Peterborough to other similar areas across England (known as ‘nearest neighbours’). The text that accompanies the dashboards highlights the key points in the data but does not describe every piece of data for all our areas.
Each dashboard can also be opened in a separate window and users can select the information they wish to see. There is a user guide available here that explains how to use the dashboards, with some information about the data sources used.
The data presented here is the latest information available in summer 2023. This JSNA will not be updated as and when new information is available, but it will be revisited and updated in around two years’ time. A range of topic-specific in depth JSNAs and reports will be published in the interim. Please see here for a list of planned future work, and links to previous analysis on Insight.
The JSNA covers two main areas – population demographics, and overall health data. If you would like the headline information please see below where we present our top four key facts and recommendations about our area – but please note that this is an overview. The full web-based JSNA can be accessed starting with the contents page and contains a lot of additional information that should be of interest to many users. We have also produced separate executive summaries for Cambridgeshire and for Peterborough, and a summary for each of our district and city council areas. Please see here.
Four key facts and recommendations
1. Fast growth with more to come. The last ten years have seen very substantial growth across our area, particularly in the largest cities of Cambridge and Peterborough which both saw more than a 17% increase in population between 2011 and 2021. The growth rates in Cambridge and Peterborough were among the highest in England.
Across Cambridgeshire and Peterborough there were 89,683 more people in the 2021 Census than in 2011 (11.1% growth overall). The growth was driven by migration into our area, and the difference between births and deaths.
The number of births exceeds the number of deaths in both Cambridgeshire and Peterborough, and in the most recent year we have data for (2021) the difference was just 1,613 additional people. The difference between births and deaths is important but not the main cause of population growth; migration into our areas from within and beyond the UK is substantial and it seems likely this is the most important driver of population growth. The Census data for 2021 shows that in the year prior to Census day in March 2021, 12,234 people moved to Cambridgeshire and Peterborough from outside the UK (please note the data does not cover how many people moved out of the area).
In the next twenty years, predictions are for more growth; South Cambridgeshire is likely to have the most rapid growth of all our areas with predicted growth of 37% by 2041.
Recommendation: Many more people means more demand for services. All service plans need to take account of recent substantial growth and additional future growth, bearing in mind that Cambridgeshire and Peterborough have high numbers of people moving here from outside the UK.
2. Big changes to the age structure of our population. Across Cambridgeshire and Peterborough the number of people aged 65 or over grew by 26% between 2011 and 2021. Forecasts suggest that by 2031, the number of people aged 65 or over will grow by a further 26% with much of this growth in the over-80s age bands.
However, there has also been significant growth in the numbers of children and young people in our two big cities; in Peterborough the number of under-15s grew by 24% in the ten years between 2011 and 2021, and in Cambridge it increased by 17%. The number of babies born to our residents has actually fallen slightly over this period, so the higher number of children in our cities is most likely due to families moving here from elsewhere. The number of children is forecast to increase substantially in South Cambridgeshire by 2031, increasing by 12.1% on the 2021 baseline, with smaller increases in other rural areas, but in Cambridge and Peterborough it is forecast to fall.
Recommendation: The increasing numbers of older people should encourage the whole system in Cambridgeshire and Peterborough to focus on prevention of ill health and disease, in order to reduce future demands on healthcare and other services. This is wider than just an NHS responsibility, it requires all parts of the public sector to enable healthy living and disease prevention.
Recommendation: The large recent increases in the numbers of children in our cities, and future increases in our rural areas, needs to be recognised and planned for by all parts of the public sector; early years, education, healthcare and children’s social care.
3. Patches of poorer health. Cambridgeshire and Peterborough is a large area with the population approaching one million residents, and measures of health for Cambridgeshire usually compare quite well with the England average (Peterborough tends to compare poorly). However, Cambridgeshire comprises five district council areas, and residents’ health varies considerably across these areas. Generally speaking, residents in Fenland and in Peterborough have the poorest health, and South Cambridgeshire tends to have the best health. Despite Cambridge’s image as a beautiful and affluent place, the city’s health is not always as good as elsewhere in the area. Inequalities in health linked to deprivation are common, and when the data allows us to look at smaller areas within our districts and cities, it is clear there are patches of very poor health in some areas, whether this is measured by life expectancy, hospital admissions, or deaths. The patches of poorer health are most common in Fenland and Peterborough but also occur in north Cambridge and in parts of Huntingdonshire.
The geographical differences can be surprisingly large. The highest rate of mortality over the last five years was seen in a small area in Fenland and is over six times higher than the lowest rate which was seen in a small area in Cambridge (there is of course considerable statistical uncertainty around estimates for small areas). Life expectancy has a clear and strong association with an area’s overall deprivation, for both men and women.
However, most of our population who are in poor health live outside the most deprived areas, and most deaths also occur outside the most deprived areas. There are struggling households everywhere, even in areas that are not considered deprived as a whole. Focusing on those relatively few areas where area-level deprivation is high and health outcomes are very poor risks missing opportunities to improve the health of everyone in Cambridgeshire and Peterborough.
Recommendation: All services across the public sector need to take account of how health and need varies across our areas, without overlooking the majority of residents who live outside the most at risk areas.
4. Many overall health indicators have not improved. Life expectancy and healthy life expectancy have seen little improvement over the last ten years. Overall death rates (all age all cause mortality) fell between 2017 and 2019 in Cambridgeshire and Peterborough alike but then rose in 2020 due to deaths from COVID-19. The proportion of people responding to the Census who say their health is poor has not changed in the last ten years. Similarly, there have been no improvements in health inequalities linked to deprivation.
We are not unique in this: the experience in Cambridgeshire and Peterborough for these health indicators reflects the patterns seen in England as a whole. However, we have not reached some kind of natural limit; for example, comparable countries have higher life expectancy that continues to improve (Life Expectancy – Our World in Data). The explanation for this lack of progress locally and nationally is likely to be complex and is beyond the scope of this JSNA, though the report here raises some interesting points. What is happening to life expectancy in England? | The King’s Fund (kingsfund.org.uk)
Recommendation: We should aim to turn the curve on these high-level measures of health, and this will require a much greater focus on prevention for all our residents, from infancy to later life. Improving health behaviour and addressing the wider determinants of health is key, but this needs to be part of all public sector services and planning and not just seen as the responsibility of healthcare .
Users can start reading the full JSNA here and read through in order, or go straight to particular sections of interest through the links below or the contents page.
We welcome comments, questions and feedback, either here or to our team email address phi-team@cambridgeshire.gov.uk.