WHAT DO YOU MEAN BY HEALTH?
WHAT DO YOU MEAN BY HEALTH?
Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. (World Health Organisation)
Throughout this chapter reference is made to Abertawe Bro Morgannwg Health Board (ABMU). This covers the same area as Western Bay.
WHO IS AFFECTED AND HOW?
WHO IS AFFECTED AND HOW?
Evidence shows that where you live and how deprived that area is has a powerful influence on life expectancy. This influence is increased even more depending on gender.
People are affected in terms of their life expectancy and healthy life expectancy.
LIFE EXPECTANCY – is a measure of the average number of years individuals can be expected to live for. HEALTHY LIFE EXPECTANCY – measures, on average, how many years of total life expectancy can be expected to be lived in good health.
In Western Bay, 27% of the so called Lower Super Output Areas (there are 323 such areas, which are small geographical areas for the purpose of collecting statistics) are among the most deprived in Wales.
Life expectancy and healthy life expectancy at birth, males and females, Wales and ABM UHB, 2010-14
People’s health can be affected by a number of things:
CHRONIC CONDITIONS
The burden of illness within communities can be reflected in GP practice disease registers of the number of people being treated for chronic conditions.
LOW BIRTH WEIGHT BABIES
About 6 in every 100 babies born in the United Kingdom have a low birth-weight (under 2,500 grams)*. Low birth-weight is an indicator of infant morbidity (the rate at which people become unwell) and mortality (the rate at which people die) and can lead to chronic diseases/disabilities in adulthood.
SMOKING
Smoking is a significant contributor to respiratory disease including chronic obstructive pulmonary disease, many cancers and exacerbation of asthma. Smoking also has a negative impact on diabetes, cardiovascular disease, blood pressure and heart disease.
Two-thirds of smokers start before the age of 18. Smoking prevalence is highest in the 25-34 age group (24%) and lowest amongst those aged 60 and over (11%).
HEALTHY EATING
A healthy diet is a major component of healthy living.
The healthy eating habits of people in ABMU appear to be declining. Projections suggest that by 2025 around 84% of adults across ABMU will have a poor diet.
PHYSICAL ACTIVITY
Mild physical activity on at least 5 days a week is very good for both physical and mental health. In Western Bay, 28.1% of adults are physically active which is a lower proportion of adults than the Welsh average 29.9%
In 2014, 38% of adults in Western Bay were physically inactive. During this period in Wales the average for adult physical inactivity was 34%
PARTICIPATION IN SPORT
In the 2014 Active Adults Survey, 65% of adults in Western Bay reported participating in sport and physical recreation in the previous four weeks, slightly less than the Wales figure of 72%.
Obese children are more likely to become overweight or obese adults. The health consequences of this in adulthood can include type 2 diabetes, heart disease, some cancers, liver disease and problems with mobility.
OBESITY
The increase in poor diets and physical inactivity has led to an increase in people who are overweight or obese. Obesity is a risk factor for many chronic disorders such as diabetes.
While obesity in Western Bay has remained relatively stable over the last 5 years, it continues to be an issue for the future and exceeds the Welsh average.
We can estimate that there are 99,000 obese adults across Western Bay
ALCOHOL CONSUMPTION
In general, alcohol related hospital admissions fell slightly in Western Bay between 2010-2011 and 2014-2015 for both alcohol-specific (all cases caused by alcohol) and alcohol-attributable conditions (where alcohol is implicated in some but not all cases).
We estimate roughly 172,000 adults across Western Bay will be drinking above guidelines
HARM FROM ILLEGAL DRUGS
The Western Bay area has an estimated prevalence of 11,715 which accounts for 20.1% of the Wales total of 58,000.
In contrast to alcohol-related admissions, admissions for named illicit drugs have risen over the period and are higher for Western Bay than for Wales, with some areas of Western Bay having admission rates substantially higher than for Wales and rising.
SEXUAL HEALTH
Since 2012, there has been a general increase in the number of sexually transmitted infections (STIs) diagnosed in integrated sexual health (ISH) clinics across Wales. The majority of STI diagnoses were reported in 15-24 year olds. In females, median ages were between 20 and 24 years, and 33.5 for syphilis. In males, the median ages were slightly higher, ranging from 23 to 28 years, and 34 years for syphilis. For HIV, the median age in Wales in 2014 was 39 for females and 38 for males.
ORAL HEALTH
Poor oral health starts early in childhood.
A dental survey of 3 year olds was undertaken in 2013-2014, and data shows that the percentage of children in Western Bay with at least one tooth affected by decay is 19.2%, and is higher than the Welsh average of 14.5%.
ANTIBIOTIC RESISTANCE
ABMU Health Board has the highest primary care antibiotic prescribing rate in Wales and the second highest in England and Wales combined.
THINGS PEOPLE TOLD US THAT MATTER TO THEM
THINGS PEOPLE TOLD US THAT MATTER TO THEM
WHAT SUPPORT ARE THEY GETTING?
WHAT SUPPORT ARE THEY GETTING?
The full range of the Health Board’s services can be seen here: http://www.wales.nhs.uk/sitesplus/863/page/39248
There is a range of community and primary care services, as well as specialist hospital services. They include:
INFLUENZA VACCINATION PROGRAMMES
There is a range of immunisation programmes available throughout the life course that contribute to significant disease prevention.
– Those aged 65 and over
– Those aged 6 months and those aged under 65 years in clinical at risk groups
– Pregnant women
– Health care workers with direct patient car
MEASLES, MUMPS AND RUBELLA (MMR) VACCINATION
Evidence would suggest that uptake of vaccinations has improved and is good in younger children but as they get older and move into adolescence uptake decreases.
SUBSTANCE MISUSE SERVICES
Before the Western Bay Area Planning Board was implemented each of the three local authority areas (Bridgend, Neath Port Talbot and Swansea) were responsible for commissioning their own substance misuse services.
Services to help substance users to engage in treatment without having to commit to structured programmes:
Services with structured programmes including for people leaving prison:
Services for individuals with a high level of need:
WESTERN BAY INTEGRATED FAMILY SUPPORT SERVICE
Working with families where there is parental substance or alcohol misuse. It is expected that this service will work with 105 families in Western Bay every year.
FAMILIES FIRST
Families First, a Welsh Government grant funded programme that contributes to improving the outcomes for families and young people also delivers a number of early intervention services.
WHAT CHANGES DO WE NEED TO PLAN FOR?
WHAT CHANGES DO WE NEED TO PLAN FOR?
Evidence suggests that drug and alcohol misuse among patients with mental health disorders must be considered as commonplace rather than exceptional. The provision for this in Wales is at present not satisfactory.
Need to focus on delivering health and social care services aimed at preventing and delaying the need for acute care services and long term care and support solutions.
There is a need to focus on prevention and helping people make informed choices about their lifestyle
Increasing older population with corresponding increase of economically dependent people
Continue work to reduce health inequalities
Increasing use of illicit drugs and the wider impact on society and health and social care in future
Prevention and early intervention must play an important role
WHAT DO YOU MEAN BY PHYSICAL DISABILITY?
WHAT DO YOU MEAN BY PHYSICAL DISABILITY?
Disability is an umbrella term for impairments, activity limitations and participation restrictions. Disability is the interaction between individuals with a health condition and personal and environmental factors, such as: negative attitudes, inaccessible transport and limited social supports. (International Classification of Functioning, Disability and Health).
Under the Equality Act 2010 the term disabled applies to those with a physical or mental impairment that has a substantial and long term negative effect on their ability to do normal daily activities.
WHO IS AFFECTED AND HOW?
WHO IS AFFECTED AND HOW?
During this assessment it has become clear that there is a gap in the data held on those with physical disabilities in Western Bay. Local Authorities do hold disability registers, inclusion on the register is voluntary, therefore the information is not considered a true record of those with disabilities in the region. There are new disability requirements under the Social Services and Wellbeing (Wales) Act 2014, these will be implemented on 1st April 2017.
WHAT SUPPORT ARE THEY GETTING?
WHAT SUPPORT ARE THEY GETTING?
ABMU Health Board provides a wide range of community and primary care services, as well as specialist hospital services, which help support good health and wellbeing in the community and aim to support those who find themselves in need of health care. A full range of the health board’s services can been seen on their website (http://www.wales.nhs.uk/sitesplus/863/page/39248) but a small selection of the services provided by the health board are described in this assessment.
WHAT CHANGES DO WE NEED TO PLAN FOR?
WHAT CHANGES DO WE NEED TO PLAN FOR?
– Persons with disabilities may be more vulnerable to secondary and age related conditions and premature death
– There is a gap in information held about people with physical disabilities. This needs to change to help people access relevant services
– Future planned housing should be built to Lifetime Homes Standards to support healthy aging and promote independence
– Organise health care through primary and community care services rather than just around hospitals
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