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Health of People in St Helens

 The JSNA (Joint Strategic Needs Assessment) shows the current and future health needs of the people in St Helens. 

What is a Joint Strategic Needs Assessment (JSNA)?

A Joint Strategic Needs Assessment (JSNA) is a process that looks at the current and future health, care and wellbeing needs of St. Helens residents to inform and guide the planning and commissioning of health, wellbeing and social care services. The JSNA in St. Helens brings together information from many different sources and partners relating to the population of St. Helens.

The statutory responsibility for compiling a JSNA is shared between St.Helens Council and St. Helens Clinical Commissioning Group (CCG) via St. Helens People’s Board.  The Department of Health has provided a statutory guidance document for JSNA’s.

The JSNA is intended to do the following;

  • Investigate wider social factors that have an impact on health and wellbeing, factors such as poverty, housing and employment
  • Look at the health of the population, what behaviours affect health and wellbeing such as smoking, diet and exercise
  • Provide a common overview of health and care needs for the local community
  • Identify health inequalities
  • Provide evidence of effectiveness of health and care interventions
  • Document current service provision
  • Identify gaps in health and social services and unmet needs.

 

The JSNA takes information and data relating to the population, e.g. population numbers, smoking levels, life expectancy, causes of mortality, etc., and collates, analyses and evaluates this population-level data. This provides an overview of need in the Borough and helps to identify areas of concern and to highlight key achievements.

The Joint Strategic Needs Assessment (JSNA) is currently being revised and rewritten. A summary of the Early Years and Maternity and the Children and Young People chapters are available, see below.

Whilst our JSNA is in the process of being refreshed, Public Health England (PHE) have recently published their latest Health Profiles for Local Authority areas. The Health Profiles cover areas including the wider community, children and young people's health, adult health, disease and poor health, life expectancy and health inequality.

Who is the JSNA for?

The main audience for JSNA are health and social care commissioners. However, it is intended to be used by a wide variety of people and groups to prepare bids and business cases, to ensure voluntary and community groups can meet their community’s needs and represent their views, to assist in the future development of services and to access local health and wellbeing information, plans and commissioning recommendations.

The JSNA is a continuous process and is updated as new information becomes available.

As each chapter of the JSNA is revised and re-written the chapter report will be published on info4St.Helens. The following chapters are available, see below.

JSNA 2018 - Life Expectancy, Mortality and  Long Term Conditions

Life expectancy and mortality may be considered as the key measures of public health. Increasing life expectancy brings its own challenge, as an older population means more people potentially living with long-term conditions, increasing pressure on health care and social care services. The information provided will be of interest to commissioners and providers of services to best meet current and future need in order to improve quality of life and reduce demands on health and social care services.

Key Findings

  • Life expectancy at birth for both men and women (2014-16) is significantly below the national average (77.5 years for men in St. Helens compared to 79.5 years across England; 81 years for women in St. Helens compared to 83.1 years across England).

 

  • After witnessing long-term increases in life expectancy, albeit at a rate below the national increases, since 2011-13 life expectancy in St. Helens has seen small decreases (by 0.4 years for men and 0.6 years for women).

 

  • There is significant inequality in life expectancy across different wards in St. Helens, with 9 years difference between the highest and lowest wards for men and 7 years difference for women.

 

  • Mortality rates in St. Helens for both men and women are slightly higher than the North West average but significantly higher than the national average. The long term trend in mortality in St. Helens is downward; however the inequality in mortality rates between men and women, with male mortality higher than female, has remained at a similar level over the last 20 years.

 

  • Cancers account for the highest rate of deaths in St. Helens, approximately 25% of all deaths in 2017. However, cancer rates in both men and women have decreased in 2017 from the previous year. The rates of early death due to cancers are double in the highest ward (Parr) compared to the lowest (Rainford).

 

  • Cardiovascular disease is the second biggest cause of death in St. Helens, accounting for 24% of all deaths and 21% of premature deaths before the age of 75.

 

  • St. Helens’ mortality rate for liver disease for the period 2014-2016 was the fifth highest in the country out of all upper tier and unitary local authorities.

 

  • Based on information on GP registers, 18% of the population of the population are recorded as having high blood pressure, the highest prevalence amongst all Clinical Commissioning Groups across Cheshire and Merseyside.

 

For a more detailed analysis of the key areas in relation to adult lifestyles please refer to the JSNA 2018 – Life Expectancy, Mortality and Major and Long Term Conditions Report.

JSNA 2018 - Adults' Lifestyles

A wide range of factors can impact on an individual’s health and wellbeing. Lifestyle factors such as alcohol, smoking, substance misuse and obesity also have a large impact on health.

 This chapter of the strategic assessment explores adult lifestyle factors to determine the level of need and to gain a better understanding of adult health and wellbeing in St. Helens.

 Many of the health harms from these issues are proportionally greater in St. Helens than found nationally and long-term trends are of increasing concern in some areas, such as obesity.

Key Findings

  • Alcohol specific mortality for men and women is higher in St. Helens than national and North West averages. The trend for females has been reducing since 2010-12, but male mortality has seen a growing trend since 2011-13.

 

  • St. Helens mortality rate from chronic liver disease for the period 2014-16 is the seventh worst of all 152 upper tier local authorities in the country and significantly higher than the national and regional average for both males and females.

 

  • Mortality attributable to smoking in St. Helens is significantly higher than the national average. Smoking prevalence in St. Helens, although continuing to reduce remains slightly higher than national and regional averages.

 

  • Not far short of 3 quarters (72.1%) of the adult population in St. Helens are overweight or obese, the highest percentage of all North West authorities.

 

  • Just under a third of all adults in St. Helens (29%) do less than the recommended 30 minutes of moderate intensity physical activity per week.

 

  • St. Helens has an estimated 1,386 opiate or crack cocaine users in 2014/15 and rates per 1,000 population higher than the North West and England.

 

  • The diagnosis rate for sexually transmitted infections in St. Helens in 2016 at 645 cases per 100,000 population was significantly lower than the national average rate of 750 per 100,000.

 

  • The diagnosis rate in St. Helens in 2016 for chlamydia in young people aged 15-24 years (2,114 per 100,000) was significantly higher than the England rate (1,882).

 

For a more detailed analysis of the key areas in relation to adult lifestyles please refer to the JSNA 2018 – Adults’ Lifestyles Report.

JSNA 2017 - Demographics and Wider Determinants of Health

The health of local people is affected by a wide range of factors, some of which include:

  • Socio-economic aspects (e.g. economy, employment)
  • environmental conditions, (e.g. air quality)
  • living and working conditions (e.g. housing)
  • social connectedness and support
  • crime and community safety
  • access to healthcare
  • individual lifestyles factors (e.g. smoking, physical activity)
  • factors intrinsic to the individual, such as age, sex and genetics

 

Key Findings

  • Helens has an ageing population. It is predicted that the number of people in their 80s will almost double, whilst residents over 90 years will more than triple by 2039. An ageing population is likely to increase the incidence of disease linked to older age and increase demands on health and social care.

 

  • There are high levels of relative deprivation in St. Helens, which is the 36th most deprived local authority area in England out of 326.

 

  • Relative levels of employment and income deprivation are particularly pronounced, with St. Helens ranked respectively as the 16th and 38th most deprived authority in England.

 

  • 70% of the working age (16-64 years) population are in employment, lower than regional and national averages.

 

  • Almost 40% of people not in work are economically inactive due to long-term sickness, much higher than the national average of 21%.

 

  • Over 26% of children in St. Helens are living in poverty, with stark differences between Wards. The worst affected Ward is Parr with 43% of children in poverty. The lowest poverty rate is in Rainford at 5%.

 

  • Low pay can be a key contributor to poverty and ‘in-work’ poverty is a growing issue. Almost 31% of jobs in St. Helens are paid less than the Living Wage Foundation living wage, much higher than the national average of 23%.

 

  • Private rented housing has increased in recent years and levels of disrepair within this sector of the housing market are estimated at 36%, increasing the potential for poor health outcomes for tenants.

 

  • Crime rates within St. Helens are generally lower than those of our statistical neighbours. However, local perceptions of community safety show that around a quarter of people do not feel very or fairly safe within their neighbourhood, which can impact negatively on health. Reducing the incidence of violence against the person and in particular domestic violence and its impact on children are key issues.

 

For a more detailed analysis of the key areas of demography and the wider determinants of health, please refer to the JSNA 2017 - Demographics and Wider Determinants of Health report.

JSNA 2017 - Maternity and Early Years

Giving every child the best start in life is a key recommendation from ‘Fair Society, Healthy Lives’ (2010). This report from Marmot highlights the need to reduce inequalities by ensuring children during the early years of life are provided with the physical, intellectual and social skills necessary to develop into healthy and resilient children and adults.

This chapter of the strategic assessment explores maternal and early years’ health in St. Helens. It will provide an overview of need in the Borough and highlight both areas of improvement and of concern.

Key findings

  • Smoking in pregnancy increases the risks of miscarriage, premature birth, still birth and low birth-weight. The rate of smoking during pregnancy has decreased in recent years, although rates remain higher than regional and national averages.

 

  • In 2014/15, the rate for admissions for gastroenteritis in infants under 1 year old in St.Helens was more than double the England rate (PHOF, 2017). Breastfeeding, good hygiene, a healthy diet, support for young parents and increased awareness of home management of illnesses can reduce hospitalisation for the condition.

 

  • Breastfeeding rates are improving slowly. However, they still remain below the England and regional averages. Breastfeeding rates vary by ward; the most deprived wards have the lowest breastfeeding rate.

 

  • For the majority of vaccination programmes, St.Helens performs better than the England rate.

 

  • Infant mortality in St Helens is the lowest in the North West and the national average.

 

For a more detailed analysis of the key areas of maternal and early year’s health, please refer to the JSNA 2017 - Maternity and Early Years Report.

JSNA 2017 - Children and Young People

Giving every child the best start in life is a key recommendation from ‘Fair Society, Healthy Lives’ (2010). This report from Marmot highlights the need to reduce inequalities by ensuring children during the early years of life are provided with the physical, intellectual and social skills necessary to develop into healthy and resilient children and adults.

This chapter of the strategic assessment explores the health and wellbeing of children and young people in St. Helens from educational attainment to lifestyle factors and hospital admissions. It will provide an overview of need in the Borough and highlight both areas of improvement and of concern.

Key findings

  • Alcohol harm to young people in St. Helens remains significant. Latest data showed St. Helens had the 6th highest rate in the North West of alcohol-specific admissions to hospital, higher than all neighbouring authorities.

 

  • The level of self-harm is a significant local issue. In 2015/16, St. Helens had the third highest rate in England.

 

  • St. Helens has a high rate of admissions due to mental health problems, the second highest in Merseyside and above both North West and England averages.

 

  • Hospital admissions for unintentional and deliberate injuries for children and young people are high locally. Admissions for children aged 0-14 years is 18th highest in England and admissions for those aged 15-24 years is third highest in England.

 

  • High levels of children in need and looked after children. Safeguarding children locally remains a significant challenge.

 

  • The health implications of domestic abuse can be short term or long term and the impact of domestic violence (DV) cannot be underestimated. In 2015/16, over 50% of assessments of child need found a risk due to DV.

 

  • In 2015, there were 87 under-18 conceptions, the lowest number in St. Helens since 1998. Although, the overall trend is downwards, rates remain higher than national and North West rates.

 

  • The number of young people smoking in St. Helens is decreasing and is now lower than the regional average.

 

  • Being a healthy weight is important for a child’s personal development and wellbeing. Between Reception and Year 6, an increase is seen in all weight categories in St. Helens and in comparison to England, St. Helens children are significantly more likely to be obese.

 

  • 1 in 3 children aged 5 years in St. Helens have decayed, missing or filled teeth, higher than the national average.

 

  • There are growing numbers of children and young people with special educational needs and disability. The number of children on an Education, Health and Care plan or Statement of Special Educational Needs has increased year on year since 2013.

 

For a more detailed analysis of the key areas affecting children and young people, please refer to the JSNA 2017 - Children and Young People Report.

 

JSNA 2015

Please see below the links for the 2015 documents:

Older People and Vulnerable Adults

Health Inequalities

Public and Patient Voice

Healthcare Usage

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