HARINGEYS PUBLIC HEALTH INTELLIGENCE TEAM November 2015 2 - - PowerPoint PPT Presentation

HEALTH AND UNEMPLOYMENT IN HARINGEY

HARINGEY’S PUBLIC HEALTH INTELLIGENCE TEAM

November 2015

HaringeyStat

haringey.gov.uk

Setting the scene

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HaringeyStat

haringey.gov.uk

• Robust evidence showing positive impact of employment on physical health

and mental wellbeing;

• Potential financial gains to health system from positive employment
• utcomes;
• Those in employment place less demand on GP appointments,

medication and hospitalisation;

• Employment helps with self-management of Long Term Conditions

and other chronic conditions;

• Reduces inequalities and worklessness as a root cause of complex and

multiple disadvantages.

The case for change

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HaringeyStat

haringey.gov.uk

• 2.23 million wider-London new job openings between 2010 and 2020 and

Haringey is part of this network with excellent transport links however local job offer per population is ranked low (in the bottom 15 LAs in the UK).

• 84,000 workforce jobs or 0.45 for every working age resident in Haringey;

lower than London (0.93) and national (0.80) averages) .

• Haringey has higher unemployment rate (7.1%) than London (6.6%) and Great

Britain (5.2%) and significantly more residents on out of work benefits (11.3%) than the London average (9%).

• Levels of workless households (19%) are also higher than the London average

(15%).

Haringey’s labour market

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HaringeyStat

haringey.gov.uk

Haringey occupations

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Managerial, Professional and Associate professional: 52% Admin and Skilled trades:17% Service, Sales, Process and Elementary: 31%

HaringeyStat

haringey.gov.uk

Haringey sought occupations of benefit claimants v Job Centre vacancies

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Biggest sought

• ccupation and

vacancy gaps in Managerial and Sales roles. Vacancies for Skilled Trade and Associate Professional & Tech jobs doesn't match sought

• ccupation

demand.

NB: Only a proportion of total job market vacancies will be advertised through the Job Centre. Estimates suggest up to 70% of all job openings are never formally advertised.

HaringeyStat

haringey.gov.uk

Economically inactive population in Haringey

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HaringeyStat

haringey.gov.uk

Around 1 in 4 working age (16+) Haringey residents are economically inactive

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9th highest overall economic inactivity rate in London (2015)

Around double the amount of women (1 in 3) are economically inactive compared to men.

HaringeyStat

haringey.gov.uk

Who are Haringey’s economically inactive cohort?

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25% (45, 900)

• f working age

population in Haringey is economically inactive Others are parents looking after young family (third), students

(37%) and retired (7%)

One third of

those claiming out

• f work benefits

HaringeyStat

haringey.gov.uk

Out of work benefits claimant rate – 4th highest in London

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Haringey 11.3% (21,350) London 9%

Haringey’s out of work benefit claimant rate has decreased by 28% from 2010, but remains well above the London rate.

HaringeyStat

haringey.gov.uk

Out of work benefits claimants by ward

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Northumberland Park (11) has the highest rate of out

• f work benefit claimants at

24%, followed by

Tottenham Green (15) at

19% and Tottenham Hale

(16) at 18%. The lowest rate is found in both Crouch End (4) and Muswell Hill (9) at 5%. 13 wards have a higher proportion of out of work benefit claimants than the Haringey average (11.3%). The highest rates of out of work benefits claimants are situated in the east.

HaringeyStat

haringey.gov.uk

Overrepresentation of 45+ out of work benefit claimants

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50% men 50% women

Younger age groups Under 25s, 25-34s, 35-44s under-represented Older age groups 45-54s, 55-59s, 60-64s

• ver-represented

HaringeyStat

haringey.gov.uk

Participation in volunteering by age

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In addition, or instead of employment, volunteering can be an important part of personal lives and communities. However after the age of 49, participation reduces incrementally with increased older age (National). Volunteering has been shown to be associated with decreased depression, a 23% reduction in mortality risk for 55+ volunteers and increased social engagement with the community.

Formal & Informal volunteering

HaringeyStat

haringey.gov.uk

Job Seekers Allowance (JSA)

Unemployment benefit paid by the Government of the United

Kingdom to people who are unemployed and actively seeking work. It is part of the social security benefits system and is intended to cover living expenses while the claimant is out of work.

Employment Support Allowance (ESA) Out-of-work welfare benefit paid in the United Kingdom to people who are having difficulty finding work because of their long-term illness or disability.

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Out of work benefit definitions

HaringeyStat

haringey.gov.uk

Work Capability Assessment

Health-related employment benefits

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Incapacity Benefit, Severe Disability Allowance, Income Support

ESA

In 2008... ESA Support group

more severe disablement/incapacity. Payment of this is not limited to 12 months

ESA Work-related activity group

Payment of this is limited to 12 months

Not eligible

Low level health related problems and directed to JSA

HaringeyStat

haringey.gov.uk

Job Seekers Allowance (JSA)

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Short term, if enough

NI was paid when employed (6 month maximum and supported to actively seek job).

Long term

If not enough NI is paid and working less than 16 hours (indefinite).

JSA

There could be a large number of those who have low-level health issues but are not recognised/supported and who get worse and tip over to ESA (particularly developing mental health conditions due to unemployment).

HaringeyStat

haringey.gov.uk

JSA rates decreasing but ESA/Incapacity Benefit claims remain consistent

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Mirroring national trends, JSA claimants have decreased in the last 3 years – while ESA/IB claimants have remained constant.

6.7% ESA / IB 3% JSA 12,770 Claimants 5,600 claimants (Feb 2015)

HaringeyStat

haringey.gov.uk

Most ESA/IB claims are long term

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Around 70%

• f all ESA/IB

claimants are long-term claimants, one year and over. 49% of claims are for two years or more. Total number of Haringey ESA/IB/SD claimants Feb 2015: 12,770

HaringeyStat

haringey.gov.uk

Long term ESA and JSA claimants by age

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41% of all 45-49 year old

JSA claimants have been claiming for over 1 year, compared to 16% of 25- 29 year olds.

85% of all 45-54 year old

ESA claimants have been claiming for over 1 year, compared to 66% of 16- 24 year olds.

HaringeyStat

haringey.gov.uk

Over-representation of ‘Mixed’ ethnic group ESA claimants

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Mixed ethnic minority groups (include white/black Caribbean; white/black African and white/Asian) are the most common ESA claimants at

35%, despite only

accounting for 5% of the estimated working age population. White ethnic groups (include White other) are under-represented. 33% of all claimants vs 62% of the working age population

HaringeyStat

haringey.gov.uk

Unemployment and health-related problems

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HaringeyStat

haringey.gov.uk

Around 1/2 ESA/IB claims are for mental health conditions (primary)

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Most common claims are for ‘Mental or behavioural disorders’ (46%). The 2nd most common condition is ‘Musculoskeletal system and connective tissue’ (14%). The 3rd most common is ‘Clinically undefined conditions’ (11%).

The claimants are classified by the primary claim condition cited: comorbidities are not captured and some claimants will have several conditions.

HaringeyStat

haringey.gov.uk

Health related unemployment

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1, 782 ESA claimants have MSK problems

5, 920 ESA/IB claimants have mental ill health 12, 730 ESA/IB claimants 5, 600 JSA claimants 21, 770 out of work benefit claimants 45,900 economically inactive 180, 000 working age population in Haringey

HaringeyStat

haringey.gov.uk

• Over 3,500 people with serious mental illness and a further 16,000

with common mental ill health are registered with local GPs;

• Approximately 47,000 of the registered population have one or more

long-term conditions and almost 40% of those have co-morbidity;

• Almost 10% of GP-surveyed population reported back problems and

arthritis, joint problems (respectively), while only 0.15-0.45% on GP registers have rheumatoid arthritis and osteoporosis.

Diagnosed health conditions related to unemployment in Haringey

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HaringeyStat

haringey.gov.uk

The impact of co-morbidity

AF-atrial fibrillation; CeVD - cerebrovascular disease; CHD - coronary heart disease; CKD - chronic kidney disease; CLD - chronic liver disease; COPD - chronic obstructuve pulmonary disease; Dep - chronic depression; DM - diabetes; HF - heart failure; SEMI - severe mental illness.

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CHD & CeVD Dep & CLD CHD & AF DM & CLD DM & COPD DM & cancer CHD & CKD DM & CKD Dep & CHD CHD & HF CHD & COPD Dep & cancer SEMI & DM Dep & COPD

Dep & DM

CHD & DM Dep & SEMI

Frequent combinations of comorbidities in adults

HaringeyStat

haringey.gov.uk

Inequalities in employment

• utcomes for people with

health problems

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HaringeyStat

haringey.gov.uk

3.2% 4.1%

Adults in secondary mental health services in paid employment

Severe mental illness and employment rate

Haringey is below the England and London average, for both males and females (2014/15)

HaringeyStat

haringey.gov.uk

People with all mental and neurological problems in employment

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6th worst employment rate in London (28%) for people with depression, learning, mental health or neurological problems. “Unemployed men have a 78% higher risk

• f death” (DoH, 2015)

HaringeyStat

haringey.gov.uk

People with learning disability in employment

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6% of adults (18- 64 years) with learning disabilities in paid employment 8th lowest in London. More men with learning disabilities (7%) in paid employment than women (4%).

HaringeyStat

haringey.gov.uk 30

Long-term health condition employment gap - 17% 3rd highest in London Serious mental health illness employment gap - 65% 17th highest in London Learning disabilities employment gap - 63% 13th highest in London

17% 63% 65%

Difference between unemployment in general population and those with health problems

HaringeyStat

haringey.gov.uk

What are we doing locally?

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HaringeyStat

haringey.gov.uk

• Work Programme
• Healthy Workplace Charter
• Welfare Hubs in GP practices
• Employment workshops in IAPT
• Individual Placement and Support

Haringey’s local initiatives

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HaringeyStat

haringey.gov.uk

Haringey’s Work Programme job outcomes

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27% of all claimants achieve a job outcome in Haringey, slightly higher than both the national/ London average of 26%. 7% of ESA claimants (health related unemployment) achieve a job

• utcome, below the

England average (10%).

HaringeyStat

haringey.gov.uk

• Haringey Council is working towards excellence and promoting

across businesses

• CCG is working towards accreditation
• One of the criteria is to make workplace supportive for people

with chronic health issues and create opportunities for this cohort of people

Healthy Workplace Charter

34

HaringeyStat

haringey.gov.uk

Welfare Hubs in GP practices

• Located in 5 health centres across the borough (4/5 in east Haringey);
• The service targets at risk groups and majority of patients have

LTC/disability/mental health problems;

• The client socio-demographic profile in 2014 included:
• 58% Female, 42% male; 87% BME; 64% Unemployment
• Low household income (43% <£400/month, 28% £400-559/month);
• Links with IAPT
• Evaluation study underway, preliminary data is promising.

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HaringeyStat

haringey.gov.uk

Individual Placement and Support

• Twining Enterprise started delivery in Haringey in July 2015
• 2 Employment Specialists integrated into Early Intervention Service

(EIS) & Recovery and Enablement Teams (RET) - secondary care.

• 35 are engaged, with 5 jobs created to date
• IPS evidence-based model
• Based on 8 Principles, including client-centred, paid-work focus,
• ngoing in work support, employer engagement.

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HaringeyStat

haringey.gov.uk

• Haringey is part of London-wide job market and a variety of jobs

are available in near reach;

• Over 20% of Haringey’s population is economically inactive and
• ver 11% claim out of work benefits;
• People over 45 years of age claiming work-related benefits are
• ver-represented relative to their share of the working age

population;

• Mental illness (46%) and musculoskeletal conditions (14%) are the

most common conditions recorded for those claiming health- related work benefits;

Key points

37

HaringeyStat

haringey.gov.uk

• 3rd highest gap in London for employment rate of those with LTCs vs the

general population;

• Stark inequalities in employment rates between those with health problems

and general population, ESA claimants locally referred to Haringey’s Local ‘Work Programme’ have poorer employment outcomes than national average

• is it due to complex health needs, co-morbidities and lack of targeted,

focused support?

• A number of initiatives locally – how integrated are they in mainstream health

services?

• Are we promoting Healthy Workplace Charter to ensure employers locally can

support people with chronic health needs?

Key points

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