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Maternity Needs Assessment for East Sussex. Presentation for the Health Overview and Scrutiny Committee, 17 th May, 2007. A. Population estimates and projections. Population Population projections General fertility rate.
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Maternity Needs Assessment for East Sussex Presentation for the Health Overview and Scrutiny Committee, 17th May, 2007
A. Population estimates and projections • Population • Population projections • General fertility rate
Table 1. Total population and women of child bearing age by PCT and district.
C. Population profile Key points from Table 3 Hastings and St Leonards PCT has the highest proportion of: • unemployment • people of non-white ethnicity • people with no qualifications • lone parent households with dependent children and the lowest proportion of owner-occupation and access to a car or van Source Census 2001
D. Access Key points from Table 4 • Hastings has the largest number of single parent families of the five districts • 50% of single parent families in Hastings have no access to a car or van compared with 39% in Eastbourne • Approximately 1,500 single parent households in Hastings have no car or van compared with 1,000 in Eastbourne.
E. Deprivation.Why deprivation is important in assessing maternal and infant needs • Low birth weight is associated with increased illness and mortality in the first year of life & thro’ childhood • Smoking, obesity and teenage pregnancy are key areas to reduce health inequalities in infant mortality • There are social class trends in stillbirth and low birth weight (higher in unskilled occupations or sole reg.) • The Confidential Enquiry into Maternal Deaths(2000-2) found women from the poorest backgrounds were 20 times more likely to die than a woman from a professional group; women from ethnic minority groups were three times more likely to die; 30% of the poorest women did not book until they were 5 months pregnant.
E. Deprivation Analysis of deprivation by small areas • Income Deprivation Affecting Children Index (IDACI) • Super-output areas (SOAs) have a population of approximately 1,500. • IDACI is percentage of children in a SOA living in families in receipt of benefits or on the lowest income.
Key points from Table 5 • We divided the super output areas into four deprivation categories • In category “a” less than 25% of children are living in the poorest families • In category “d” more than 45% of children are living in the poorest families • Ten out of 14 of the most deprived (category “d” small areas were in Hastings. (2 Wealden, 1 Eastbourne, 1 Rother) • If categories “c” and “d” are combined: 19/34 of the most deprived small areas are in Hastings. (7 Eastbourne, 4 Rother, 3 Wealden, 1 Lewes)
Mapping of hospital catchment areas by deprivation (IDAC categories) • Eastbourne with Southern Wealden was used as a proxy for the EDGH catchment • Hastings and Rother was used as a proxy for the Conquest catchment • Four times as many women, of child bearing age, live in the most deprived small areas of the Conquest catchment versus EDGH • Five times as many babies (2003-5 births) in the most deprived small areas were born in the Conquest catchment compared with EDGH.
Summary of key findings • There is greater deprivation of Hastings women of childbearing age compared with Eastbourne women • There is a reduced ability to access services in the Hastings population • There is evidence of increased maternal risk factors such as young age, smoking, late booking and obesity in women booking at the Conquest compared with EDGH • The local data suggests broadly similar health outcomes for the existing obstetric units.
