Meeting documents
Cabinet
Wednesday, 7th June, 2006
Appendix
Summary and Recommendations from `The Health of the People of Bath and North East Somerset - 2005'
1. The health of people in Bath and North East Somerset as a whole is good in comparison with the rest of the country. For example, the life expectancy of a baby born around 2001 is 77.9 and 82.7 for a boy and a girl respectively which is 2-3 years more than in England and Wales. The premature death rate (death before the age of 75 years) is 20% and 17% lower than the national average for heart disease and cancer respectively.
2. Despite this, there are marked inequalities in our population. The composite measure `Index of Multiple Deprivation' shows this for social and material attainment (Figure 2) and this mirrors similar differences in health. People living in the fifth of electoral wards with the lowest index (most deprived) have a lower life expectancy by 4.6 years than those living in the most affluent wards
(Figure 9); this striking gap between poor and well off is also seen for other measures, for example death rates from the major killers (Figure 7).
Inequalities in health have many causes, including modifiable life style factors - it is estimated that half of the lower life expectancy among poorer people can be accounted for by their much higher tendency to smoke (see page 25). However, it is clear that policies which alleviate poverty and aim to improve the life chances of people will have the best and longest lasting effect.
3. Improving health in the population requires people to make healthy choices and also action on a broad front to make these choices possible. This means that health has to form part of the routine business of many agencies and not just that of the health service (page 16). Working in partnership should become the norm and the Bath and North East Somerset Public Health Partnership should establish specific health improvement goals and aspirations which are then adopted by the main public sector and other agencies in the area - in particular, the health service and the council.
4. Obesity is a major factor in the development of many diseases (see page 21) and the recent increase in the population is striking and alarming (Figure 13). At school entry, 19% and 9% of children are overweight and obese respectively (see glossary for definitions). Most adults over the age of 35 years are overweight and between 12% and 25% are obese - predictably, the prevalence of obesity varies depending on people's social and economic standing.
The local public health partnership has launched a new initiative - `Shaping Up' (page 24) - which aims to help people eat well and take much more exercise. People themselves must make their own decisions but society as a whole can make it easier for them. All agencies from schools to transport planning departments need to build ways to promote an active life into their work. Employers should think of ways to enable staff to keep active and regard any costs as a good investment in the health and productivity of their workforce.
5. Smoking in general is in decline except among the less well off where it is stubbornly common and young women of all social groups where it is on the rise. The environment will change soon with the introduction of legislation to protect non smokers from passive smoke inhalation and this will also further encourage smokers to quit. It is essential that we continue the PCT's successful service for quitters and also press for more smoke-free public places.
6. Sexually transmitted diseases are becoming more common (Table 3). This represents substantial ill health in the population but worryingly, also points to the extent to which people engage in unprotected sex and hence expose themselves to other more dangerous infections such as HIV. New approaches to sexual health and rapid access to treatment services are planned and need investment in 2006/07.
7. Another alarming trend in the population is the increasing use of alcohol and of excessive alcohol consumption. Reducing the harm it causes is the aim of a new strategic review which is under way in the area (page 35). Treatment services locally are barely adequate and more help is needed for those whose drinking is manifestly a problem - this will need investment and concerted action to bring about.
8. Communicable disease and environmental hazards are monitored by several bodies - the PCT, the council and the Health Protection Agency (an independent organisation created for the purpose). New and existing infectious diseases are potential threats (pages 40-45) but the current situation is manageable.
9. The two main population screening programmes - for cancer of the cervix and cancer of the breast - are expanding at present and satisfactory in terms of their quality and performance (page 48).