Lifestyle factors targeted to balance Hertfordshire’s health inequalities
Although Hertfordshire is often thought of as affluent, considerable variations exist in smaller areas of the county. New targets have been set to reduce health inequalities in the county’s most deprived areas and will focus particularly on lifestyle factors. However, research shows that affluence does not protect against the effects of poor lifestyle choices. Education is needed to help people choose healthier options.
1. Tackling Health Inequalities
Life Expectancy at birth: the latest data shows that males in Watford had the shortest life expectancy at 77.4 years. Significantly less than the East of England regional average, Watford was also lowest with its females at 80.8 years. Three Rivers had the longest life expectancy; with females at 82.9 and males at 79.9. This is statistically higher than male regional and national averages.
1. Tackling Health Inequalities: Indicator HE1 - Life Expectancy in Hertfordshire, 2004-2006
Infant Mortality in children less than one year: in St Albans and East Herts this was significantly less than the 2004-06 national average. Welwyn Hatfield and Watford had the highest rates; 5 and 4.6 infant deaths respectively per 1,000 live births, compared to 2.6 deaths in St Albans and East Herts.
Mortality from accidents: North Herts had the highest rate of mortality from accidents; statistically higher than national, regional and county averages. Broxbourne had the lowest rate; being statistically lower than national, regional and county averages.
All cause mortality: Three Rivers, East Herts and Broxbourne males were significantly below regional and national averages. There was not as much variation in all cause mortality amongst females.
1. Tackling Health Inequalities: Indicator HE2 - Mortality in Children Under 1 Year, Infant Mortality per 1,000 live births in Hertfordshire, 2004-2006
2. Reducing the number of people who smoke
Smoking is a major determinant of poor health as smokers are more likely to suffer from circulatory diseases and certain types of cancers than nonsmokers. High smoking prevalence is also linked to deprivation so reducing smoking is a high priority for Hertfordshire and is a National Health Service key commitment in the Cancer Plan published in 2000.
2. Reducing the number of people who smoke: Smoking prevalence - Model Based Estimates of Current Smoking (%) in adults in Hertfordshire, 2004 - 2006 (with changes over QoL 2006 reported figures shown in colour)
Source: National Statistics, via East & Northern Hertfordshire PCT November 2008 Health Surveys for England 2003 to 2005 The information Centre for Social Care, 2007
download and view this data in excel - disclaimer
Prevalence of smoking: Model-based estimates for 2003-05 report that again Stevenage had the highest smoking prevalence at 29.2%. Statistically higher than national, regional and county averages, this is also higher than the figures we reported in 2006 and showed the greatest increase. As these figures relate to the period prior to the smoking ban, it will be interesting to note any changes after 2007.
Attributable mortality: Stevenage, Welwyn Hatfield and Broxbourne were the areas with the highest percentage of deaths due to smoking among females during 2005-7. They are also all areas with high deprivation. Amongst males, Broxbourne and East Herts had the highest percentage of deaths.
2. Reducing the number of people who smoke: Attribultable Mortality - Smoking Attributable Deaths (% of all deaths) in Hertfordshire, aged 35+, 2006
Circulatory disease mortality: between 2004-6 Stevenage and Watford had the highest rates at over 80 per 100,000 standard population amongst the under 75s. Three Rivers and East Herts had the lowest rates of all circulatory disease mortality; lower than national and regional averages.
Coronary Heart Disease: in the same period and age group Stevenage and Watford, together with North Herts, were shown to have the highest rates of death due to smoking-related diseases amongst males. Stevenage’s rate was also statistically above national and regional averages whilst St Albans had a lower rate than national and regional averages. In females, Watford, Broxbourne and North Herts were highest but Hertsmere and St Albans had rates lower than national and regional averages.
Cancer mortality: in 2004-6 Welwyn Hatfield and Watford under 75s had the highest male rates in the county whilst Dacorum had the highest female rates.
3. Reducing obesity, improving diet & nutrition
Reception Class (ages 4-5): in the National Child Measurement Program 2006/07 Stevenage, Broxbourne and Hertsmere had the highest levels of Childhood Overweight and Obesity1.
Year 6 (ages 10-11): results for older children were a little different with Watford Stevenage, Broxbourne having the highest levels2.
4. Increasing physical activity
The Active People Survey 2005-6 found the area in the county with the lowest percentage of residents to participate in at least 30 minutes of exercise three times a week was Broxbourne for both sexes with females at 16% and males at 20%. In Stevenage and Welwyn Hatfield the participation rates were also shown to be lower than the county averages.
4. Increasing physical activity - Adults taking part in 30 mins moderate activity at least 3 days a week in Hertfordshire, 2006-8
5. Improving sexual health
Data was lacking in this area, however, the Human Papilloma Virus vaccine is now being given to girls aged 12-13 in the county to prevent cervical cancer.
7. Reducing harm and encouraging sensible drinking
Dacorum and Watford had the highest rates of male alcohol-specific deaths in the county. Followed by St Albans, this supports recently published data4 that this lifestyle requires a range of approaches and that is not always a casualty of deprivation or social class. Whilst some data3 suggests little change in behaviour after 2005, the number of alcohol-related deaths in Britain have doubled in the past 16 years3. Other data suggests alcohol consumption has been rising throughout the UK with clear evidence of increasing deaths from alcohol-related diseases and concerning trends in young people.4
7. Reducing harm and encouraging sensible drinking - Alcohol Specific Mortality in Local Authorities of Hertfordshire(DSR), 2006
1 Relates to the National Indicator NI 55 and 2 NI 56.
3 General Household Survey 2007: available at www.statistics.gov.uk
4 The Burden of Disease and Illness in the UK April 2007
Data for 6. Improving mental health and well-being was not provided