Health in Enfield: Measuring Success Joint Health and Wellbeing - - PowerPoint PPT Presentation

Health in Enfield: Measuring Success

Joint Health and Wellbeing Board

Public Health Intelligence

www.enfield.gov.uk

Striving for excellence

Gayan Perera Evie Lodge

Enfield’s population is growing

• Total population in Enfield in 2019 = 339,471 people
• Over the next 5 years, the overall population in Enfield is

projected to grow by 4.6%

• Upper Edmonton has the largest projected growth (35.7%),

this may be due to the Meridian Water development.

5000 10000 15000 20000 25000 30000 Bowes Bush Hill Park Chase Cockfosters Edmonton Green Enfield Highway Enfield Lock Grange Haselbury Highlands Jubilee Lower Edmonton Palmers Green Ponders End Southbury Southgate Southgate Green Town Turkey Street Upper Edmonton Winchmore Hill Projected number of people

Ward name

Five Year Population Projections in Enfield

2019 2024 Projected Population Percentage Change Between 2019 and 2024 Ward % Increase/ change Upper Edmonton 35.7% Cockfosters 13.6% Highlands 10.7% Southgate Green 7.8% Grange 6.5% Ponders End 3.9% Bush Hill Park 3.0% Winchmore Hill 2.8% Lower Edmonton 1.9% Palmers Green 1.7% Town 1.5% Southgate 1.2% Edmonton Green 1.1% Haselbury 0.7% Bowes 0.6% Turkey Street 0.5% Enfield Lock 0.4% Enfield Highway 0.2% Southbury 0.1% Chase

• 0.3%

Jubilee

• 1.3%

Enfield 4.6%

Enfield Key demographics

North Constituency Edmonton Constituency East Constituency

• Oldest population (16,303) of

people aged over 65

• Highest life expectancy at birth
• Most wards have significantly

higher life expectancy than England overall.

• Youngest population
• Highest number of older

people living in deprivation

• High proportions of children

living in poverty (significantly worse than England overall) Highest scores on the Index

• f Multiple deprivation

(2015)

• Lowest life expectancies in

Enfield

• Highest proportion of

people from Black and Minority Ethnic Backgrounds

• Most wards have similar or higher

life expectancy than England

• verall.
• High proportions of children living in

poverty (significantly worse than England overall)

Five key Diseases in Enfield

7,477 people

recorded with coronary

heart disease

(2.3%) [2017/18]

7,265 people

recorded as having

cancer (2.3%)

[2017/18]

3,511 people

Recorded with

COPD (1.1%)

[2015/16]

19,261 people

16+ estimated to have a common

mental disorder

(19.3%) [2017]

19,821 people

18+ diagnosed with type 2

diabetes

(8.0%) [2017/18]

More than 50% of Deaths in Enfield

Circulatory disease – coronary heart disease, stroke, heart failure, high

blood pressure

Cancer – (1) lung cancer; (2) bowel cancer; (3) breasts and prostate cancers

[2014]

Respiratory disease – including flu, pneumonia, COPD, infections

Major behaviours causing ill health

How are we going to measure success

• Overarching indicators
• Priority 1: Healthy Diet
• Priority 2: Being Active
• Priority 3: Being Smoke Free
• Priority 4: Being Socially Connected
• Long term indicators

Overarching Indicators

Overarching Indicators Gap in male life expectancy between the most and least deprived areas of Enfield Gap in female life expectancy between the most and least deprived areas of Enfield Overweight and obese children (4 to 5 year olds) Overweight and obese children (10 to 11 year olds)

Map of Female Life Expectancy

Life expectancy (LE) in Enfield

• Life expectancy at birth in Enfield significantly better than England averages, however still

wide variation within the borough.

• 6.3 years difference in Female LE between the highest and lowest (Highlands and

Haselbury: 87.2years, Upper Edmonton 80.9 years)

• 7.8 years difference in male LE between the highest (Highlands: 83.4years, Upper

Edmonton 75.6 years)

80.3 years 84.5 years

[2015-2017, ONS]

Healthy Life expectancy (HLE)

• Over 15 years lived in ‘poor health’ in Enfield
• Gap in LE and HLE is wide in more deprived areas
• Females in Edmonton Green live 28 years in ‘poor health’

65.1 years 65.5 years

[2015-2017, ONS]

Data Source: Office for National Statistics

Overarching indicators

Prevalence of Excess Weight Among children

.

National Child Measurement Programme 2017/18

One in Four children in

Reception Year is overweight

• r obese in Enfield (24.9%)

Recent trend is decreasing

Two in Five children in

Year 6 is overweight or

• bese in Enfield (41.1%)

Recent trend is increasing

Child overweight (including obesity)/excess weight: BMI ≥ 85th centile of the UK90 growth reference

There are high proportions of overweight and obese children in Enfield. The percentage of excess weight in children in Enfield is significantly higher than in England overall.

Prevalence of excess weight by ward

Reception Year Year 6

Overarching Indicators

Overarching Indicators Current Target for 2023 Gap in male life expectancy between the most and least deprived areas of Enfield 7.48 years (2015/17) Close the gap by 20% by 2023 Gap in female life expectancy between the most and least deprived areas of Enfield 5.2 years (2015/17) Close the gap by 20% by 2023 Overweight and obese children (4 to 5 year olds) 24.9% (2017/18) Halt the increase of overweight/obese children by 2023 Overweight and obese children (10 to 11 year olds) 41.1% (2017/18) Halt the increase of overweight/obese children by 2023

Priority 1: Healthy Diet Indicators

Priority 1 Indicators Number of fast food outlets in Enfield Healthy Catering Commitment – Number of food outlets signed up Local plan of how to restrict unhealthy fast food outlets Healthy Schools award Overweight and obese children (4 to 5 year

• lds)

Overweight and obese children (10 to 11 year

• lds)

Overweight and obese adults

Priority 1: Healthy Diet

Fruit and Veg:

3 out of 5* adults (58.7%) eat the recommended ‘5-a-day

305 fast food outlets in Enfield

[2019]

* Based on self-report data from the Active lives survey [2017/ 2018]

Both the consumption of fruit and veg and the numbers of fast food outlets per 100,000 population is similar to in London and England overall

Priority 1: Healthy Diet

24.9 41.1 56.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 Reception year (4-5 years) Year 6 (10-11 years) Adults (18 years +)

Percentage %

Excess weight over the Life course (Prevalence of Overweight and Obesity)

Enfield London England

Three in Five adults in Enfield are

• verweight (38%) or obese (19%)

The reported 2017/18 percentage of overweight and obese adults in Enfield is significantly lower than in England overall. In the past few years the percentage of adults with excess weight in Enfield (2016/17 - 61.4%, 2015/16 – 63.5%) has been similar to the overall percentages in England.

2017/18 Adjusted excess weight calculations: based on self-reported height and weight data (adjusted using associations derived from Health Survey for England data 2012-2014)

Priority 1: Healthy Diet

Priority 1: Healthy Diet Indicators

Priority 1 Indicators Current Target for 2023 Number of fast food outlets in Enfield 305 (2019) Halt the increase Healthy Catering Commitment – Number of food outlets signed up 92 (Jul 2019) Increase by 20% Local plan of how to restrict unhealthy fast food outlets

• Guidelines/ Regulations adopted

Healthy Schools award 77 schools registered (88%) 53 bronze 27 silver 7 gold 85 schools registered (96%) 60 bronze 35 silver 10 gold Overweight and obese children (4 to 5 year

• lds)

24.9% (2017/18) Halt the increase of

• verweight/obese children

Overweight and obese children (10 to 11 year

• lds)

41.1% (2017/18) Overweight and obese adults 56.7% (2017/18)

Priority 2: Being Active Indicators

Priority 2 Indicators 150 minutes or more physical activity a week (Enfield adults) Less than 30 minutes of physical activity a week (Enfield adults) Cycling once per week as a means of transport for utility purposes (Enfield adults) Walking for travel once per week (Enfield adults) Daily Mile - Number of Enfield Schools taking part

Based on adjusted, self-report data from the Active lives survey [2017/18]

Enfield London England Walked for travel 27.4% 35.2% 22.9% Cycled for travel 1.2% 4.7% 3.3%

A quarter of Enfield adults

(26.4%) are physically inactive*

This is significantly worse than the England average (22.2%)

Percentage of people who walked1 or cycled2 for travel, at least three days per week 2016/17

*Physically inactive is defined as: Less than 30 minutes of physical activity a week The (broad) activities included in the physical activity estimates are; sporting activities, fitness activities, cycling for leisure and sport, cycling for travel, walking for leisure, walking for travel, creative or artistic dance and gardening.

Priority 2: Being Active

Priority 2: Being Active (at age 15*)

1 in 8 (12.4%) 15yr olds in Enfield meet the recommended amount of Physical Activity (60mins/ day).

Similar to the proportion in England overall (13.9%)

70.9% are sedentary for 7 hours (or more) per day

* Based on self-report data from the What About YOUth (WAY) survey, 2014/15

Similar to the proportion in England (70.1%)

Priority 2: Being Active Indicators

Priority 2 Indicators Current Target for 2023 150 minutes or more physical activity a week (Enfield adults) 63.0% (2017/18) Increase to 70% by 2023 Less than 30 minutes of physical activity a week (Enfield adults) 26.4% (2017/18) Decrease to 20% by 2023 Cycling once per week as a means of transport for utility purposes (Enfield adults) Less than 5% (2016/17) *this includes Cycle Enfield Data Increase to 10% by 2023 Walking for travel once per week (Enfield adults) 51.3% (2016/17) Increase to 60% by 2023 Daily Mile - Number of Enfield Schools taking part 43 (2019) Increase to 60 by 2023

Priority 3 Indicators: Being Smoke Free

Priority 3 Indicators Enfield adults who smoke Schools that have implemented stop smoking at school gates Enfield mothers who smoke at the time of delivery Enfield residents (18+) with a long- term mental health condition who smoke

Over 34,000

Enfield adults smoke (13.7%) [2018]

33.8%

• f adults with long-term

mental condition in Enfield smoke [2017/18]

1 in 14

Enfield mothers smoke during pregnancy. Increasing trend and the 4th worst in London Smoking prevalence in Enfield is similar to the national (14.4%) and London (13.9%) average.

70%

• f smokers in England

said they would like to quit smoking 896

Deaths in Enfield attributable to smoking (214.7 per 100,000). Significantly lower than the national rate (262.6 per 100,000) [2015-2017]

£60.5M

Estimated costs of smoking in Enfield 3.5% of 15 year olds

in Enfield are current smokers (smoke more than one

cigarette a week)

Significantly lower than England (8.2%) & London (6.1%) [2014/15]

Priority 3: Being Smoke Free

Priority 3 Indicators: Being Smoke Free

Priority 3 Indicators Current Target for 2023 Enfield adults who smoke 13.7% (2018) Under 12% by 2021 Under 10% by 2023 Schools that have implemented stop smoking at school gates 10 (2019) Increase to 20 schools by 2023 Enfield mothers who smoke at the time of delivery 7.5% (2017/18) <5% of mothers smoking at the time

• f delivery

Enfield residents (18+) with a long- term mental health condition who smoke 33.8% (2017/18) Reduce smoking prevalence to 30% by 2021 25% by 2023

Priority 4 Indicators: Being Socially Connected

Priority 4 Indicators Percentage of adult social care users who do not have as much social contact as they would like (18+) Percentage of adult carers who do not have as much social contact as they would like (18+)

More than half of adult social care service users do not have as much social contact as they would like

[ASCOF 2017-18]

Priority 4: Being Socially Connected

One in Ten Households (10.8%) in Enfield are single occupied households (33,359 households). England = 12.8% London = 12.8%

[census 2011]

Risk of Loneliness (aged 65+)

Map Source: Age UK using census 2011 data

3.9%

• f Enfield households are

persons aged 65 years and

• lder living alone

(12,108 households)

[census 2011]

Priority 4: Being Socially Connected

Priority 4 Indicators Current Target for 2023 Percentage of adult social care users who do not have as much social contact as they would like (18+) 56.7% (2017/18) Reduce by 10% by 2023 Percentage of adult carers who do not have as much social contact as they would like (18+) 63.0% (2016/17) Reduce by 10% by 2023

Long Term Conditions Indicator Current Target for 2023 Cancer Screening Breast Cancer – Percentage of eligible females (aged 53-70) screened at least once in the previous 36 months 72.1% (2018) England = 74.9% Cervical Cancer – Percentage of eligible females (aged 25 to 64) screened within previous 3.5 years 68.8% (2018) England = 71.4% Bowel Cancer – Percentage of eligible people (aged 60-74) screened in the previous 30 months 53.2% (2018) England = 59.0% Diabetes Diabetes diagnosis rate People formally diagnosed with diabetes, as a proportion of the estimated number of people with diabetes in Enfield 81.7% (2018) Aim 1 – to close the gap (i.e. get everyone diagnosed to get accurate prevalence data). This requires the CCG to case find. Aim 2 – to reduce recorded prevalence from 81.7% to 90% COPD COPD diagnosis rate Percentage of Enfield patients on the COPD register (all ages), compared to estimated prevalence of COPD in Enfield 1.1% of patients on COPD register (QOF 2017/18). Estimated that 2.4% of the population in Enfield have COPD (2015). Close the gap between patients registered and estimated prevalence by 10% Hypertension Hypertension diagnosis rate Percentage of Enfield patients with established hypertension (all ages), compared to estimated prevalence of hypertension in Enfield 13.2% of people in Enfield (all ages) are diagnosed with hypertension (QOF 2017/18). Estimated that 20.5% of people (aged 16+) have hypertension. Close by 10% - document Caveat – exclude under 16-year

• lds QOF

Indicators: Long Term Conditions

Thank you

Any Questions? Gayan.Perera@enfield.gov.uk Evie.Lodge@enfield.gov.uk