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Welcome and Introduction

Welcome and Introduction. Rani Dhir MBE Chair West Dunbartonshire Community Health Partnership. Purpose of Event and Wider Context. Tom Divers Chief Executive NHS Greater Glasgow and Clyde. Health Needs Assessment Dr Linda de Caestecker, Director of Public Health. Key Results.

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Welcome and Introduction

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  1. Welcome and Introduction Rani Dhir MBE Chair West Dunbartonshire Community Health Partnership

  2. Purpose of Event and Wider Context Tom Divers Chief Executive NHS Greater Glasgow and Clyde

  3. Health Needs AssessmentDr Linda de Caestecker, Director of Public Health

  4. Key Results • The population • Life expectancy and causes of death • Health behaviours • Chronic diseases • Cancer • Child health • Mental health • Service utilisation • Conclusions

  5. West Dunbartonshire population projection 1996 – 2015, all ages

  6. Projected percentage change (2004-based)Council area 2004 - 2024 25 20 15 10 5 0 Percentage change -5 -10 -15 -20 -25 -30 Fife Moray Angus Falkirk Stirling Dumfries & Highland Midlothian Inverclyde Eilean Siar Galloway East Lothian SCOTLAND Dundee City Argyll & Bute Renfrewshire Glasgow City Scottish Borders East Ayrshire West Lothian Aberdeen City North Ayrshire Aberdeenshire South Ayrshire Orkney Islands Dunbartonshire West Perth & Kinross Dunbartonshire East Shetland Islands North Lanarkshire Edinburgh, City of South Lanarkshire East Renfrewshire Clackmannanshire

  7. Age structure of council areas, 2005 GRO mid-year (% of population under 16, 16-44, 45-64 and 65+ years)

  8. West Dunbartonshire population projection 1996 – 2015, by age group

  9. 2004 Based Household & Population Projections: West Dunbartonshire (Source: GROS)

  10. Demography • 91,300 population • 7.67% of NHS Greater Glasgow and Clyde • Decrease of 4.7% from 95,870 in 1995 • Further 8% predicted decrease by 2024 • Small predicted increase in 65+ yrs of 1,556 • 6% increase in number of households

  11. Scottish Index of Multiple Deprivation • Whole of Scotland divided into 6505 areas – “datazones” of about 769 people • Multiple deprivation measured by 7 characteristics: current income, employment, health, education, geographic access to services, housing and crime

  12. Percentage of West Dunbartonshire, Glasgow City and NHS Greater Glasgow & Clyde residents living in 5% and 20% most deprived areas of Scotland

  13. SIMD 2006Datazones in the worst 15% in Scotland

  14. Male life expectancy at birth (years) : West of Scotland Council Areas vs Scotland 1991-1993 to 2003-2005 Source: Office for National Statistics

  15. Female life expectancy at birth (years); West of Scotland Council Areas vs Scotland; 1991-1993 to 2003-2005 Source: Office for National Statistics

  16. All-cause deaths by council area: directly age/sex standardised rates per 100,000 population, 2005 - GROS Scotland

  17. Comparative SMR 2003-2005

  18. Liver cirrhosis age standardised mortalityrates among men aged 15-74 years in Scotland, NHS Greater Glasgow and West Dunbartonshire in the context of maximum, minimum and mean rates for 16 Western European countries.

  19. Perinatal Deaths : West Dunbartonshire

  20. West Dunbartonshire Health & Wellbeing

  21. Perception of Health & Illness • 69% positive perception • Less positive than Greater Glasgow (80%)

  22. Dental Health 5% of 45-54 year olds with no natural teeth by the year 2010 (Source: Towards a Healthier Scotland) • 9% with no natural teeth • Compared to 6.6% in Greater Glasgow.

  23. Health Behaviours - Smoking • 40% current smokers • Over half of smokers are heavily addicted • 20% of 15 year olds are regular smokers

  24. Health Behaviours - Alcohol • Health and Wellbeing Survey: 34% of men exceed the weekly alcohol limit. (25% in Greater Glasgow, 27% in Scotland) • 18% of women exceed the weekly alcohol limit. (11% in Greater Glasgow,14% in Scotland).

  25. Health Behaviours – Binge Drinking • More men (48%) than women (28%) reported binge drinking (Greater Glasgow 39% and 19%)

  26. Health Behaviours – Physical Activity • 47% of respondents had a minimum of 30 minutes of physical activity on 5 or more days of the week or 20 minutes of strenuous activity on 3 or more days of the week (58% in Greater Glasgow).

  27. Diet, exercise and obesity • Only 23% are eating 5 fruit and vegetables per day • Average number of portions 3 per day • 16% with a BMI over 30.

  28. Overall • Poorer health and wellbeing than the rest of Greater Glasgow • 106/112 indicators same as or worse than Greater Glasgow (mainly worse) • Greater Glasgow is not great!

  29. Problem drug use • 1,185 people with problem drug use in West Dunbartonshire (2.2%) • 551 drug injectors in West Dunbartonshire (1.0%) • Glasgow City 3.3% and 1.32% • Scotland 1.84% and 0.67% • Over 20% of 15 year olds responded they had used drugs in the last month

  30. Chronic Diseases

  31. Diabetes • Type 1 diabetes is due to inadequate insulin and is thought to be infectious in origin and influenced by genetics. • Type 2 diabetes is associated with a resistance to insulin related to excess intake of alcohol, sugar and calories, too little exercise and overweight/obesity. • There is significant under-diagnosis of Type 2 diabetes.

  32. Diabetes • Diabetes prevalence rising in Scotland, Greater Glasgow and WDCHP • Assumed to be related to the rise in alcohol consumption, and overweight/obesity • WDCHP residents suffer from diabetes more often than their Greater Glasgow and Scottish counterparts according to primary care information (3.6%)

  33. Chronic Obstructive Pulmonary Disease (COPD) • COPD is the fourth commonest killer in Scotland (5% of deaths). • 80-90% of COPD is caused by smoking. • Recent study: as many as 13% of Britons over 35 years of age have (salivary or x-ray) evidence of COPD and most of these have never been given a diagnosis. • Recent study suggested that 25% of smokers will develop COPD. • Primary Care information shows that WDCHP has a 17% higher prevalence of COPD (2.1%) than does Scotland (1.8%), in keeping with the higher prevalence of smoking.

  34. Chronic Lower Respiratory Diseases, age standardised mortality rates Males, all ages Scotland, NHS Greater Glasgow, Glasgow City and West Dunbartonshire Council area Directly standardised to Western European population

  35. Chronic lower respiratory diseases, age standardised mortality rates Females, all ages Scotland, NHS Greater Glasgow, Glasgow City and West Dunbartonshire Council areaDirectly standardised to Western European population

  36. Hospital discharges with chronic lower respiratory diseases (in first or second diag position) Age standardised mortality rates, males NHS Greater Glasgow, Glasgow City and West Dunbartonshire area Directly standardised to Western European population

  37. Hospital discharges with chronic lower respiratory diseases (in first or second diag position) Age standardised mortality rates, females NHS Greater Glasgow, Glasgow City and West Dunbartonshire area Directly standardised to Western European population

  38. Age-standardised incidence of CHD rates per 100,000 for males - Scotland, Greater Glasgow,West Dunbartonshire and Glasgow City. 1996-2005

  39. Age-standardised incidence of CHD rates per 100,000 for females - Scotland, Greater Glasgow,West Dunbartonshire and Glasgow City. 1996-2005

  40. Age-standardised Acute MI incidence rates per 100,000 for males - Scotland, Greater Glasgow,West Dunbartonshire and Glasgow City. 1996-2005

  41. Age-standardised Acute MI incidence rates per 100,000 for females – Scotland, Greater Glasgow,West Dunbartonshire and Glasgow City. 1996-2005

  42. Age-standardised Cerebrovascular Disease incidence rates per 100,000 for males - Scotland, Greater Glasgow, West Dunbartonshire and Glasgow City. 1996-2005

  43. Age-standardised Cerebrovascular Disease incidence rates per 100,000 for females - Scotland, Greater Glasgow, West Dunbartonshire and Glasgow City. 1996-2005 n=894 n=1241 n=136 n=7003

  44. Summary of CHD and CVD epidemiology • Most regions show clear decline for all indices. • In 2005, for the first time, there were more new cases of acute MI and CHD in WD females than WD males. • From 2002, the rate of new cases of acute MI has been increasing for WD females. • CHD incidence rate in WD females in 2005 returned to that for 1996.

  45. Prevalence of chronic conditions from primary care information • COPD - 2.1% - lower than GG • Stroke - 2.2% - higher than GG • CHD - 4.9% - higher than GG • Hypertension - 13.5% - higher than GG

  46. Cancer

  47. 10 most common cancers in men and women, 1998-2002

  48. Cancer Needs Prevention is better than cure • Reducing cigarette smoking • Reducing alcohol use • Reducing obesity • Increasing physical activity • Increasing fruit and vegetable intake • Participation in cervical, breast, and colorectal cancer screening programmes

  49. Child Health

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