By Waseem Mohamed and Sam Lake
An annual report into public health in County Durham has revealed that despite improvements and local policy efforts, overall health in the County remains worse than the England average, with high levels of health inequalities and deprivation being the main driving factors.
The report written by Director of Public Health Amanda Healy reveals that County Durham lags behind the rest of England on several health indicators, both in early and adult life. In early life, 16.8% of newborns are delivered by mothers who smoke regularly, while breastfeeding rates for babies aged 6-8 weeks are only at 27.8%, nearly half the England average of 48%. Long-term illness is another area where the County performs poorly – 14.1% of residents experience long-term mental health problems, while 24.5% of older adults suffer from long-term health or disability issues.
The report also notes the high levels of deprivation across age groups – 21.6% of children, 16.5% of adults and 17% of pensioners live in deprivation, which is partly explained by the lower employment rate among 16-64 year olds (71.4% in Durham compared to 76.2% in England). This all results in the County’s life expectancy being lower than average, although the report stresses that there are inequalities within County Durham for many of these measures such as life expectancy.
As well as providing data, the report looks into the local response and impacts of the Covid-19 pandemic, and provides an update on the work the Public Health team are doing to improve health outcomes in seven key target areas, ranging from giving children the best start in life, to producing a healthy workforce. “Working with communities and empowering communities’ results” is a key part of this strategy.
The report highlights how County Durham has developed the Local Management Outbreak Plan and Local Tracing units to respond to increasing levels of Covid-19 cases in the community. It also praises the efficiency of the vaccine rollout in the county, with the “milestone of vaccinating all the priority groups 1-9 by the middle of April 2021”, and notes the “very positive and above average take up of the vaccine in County Durham” at the time the report was being written.
While vaccinations are having a positive impact on reducing the direct impacts of Covid-19, the report acknowledges that “the wider health impacts are still unfolding”. There has been a marked increase in the demand for mental health support with particularly high demand for children’s mental health services. There is a higher risk of social isolation, and there have been “both positive and negative” changes to people’s drinking, eating and physical activity habits.
In addition to managing the ongoing threat of Covid-19, the report places particular focus on three main priorities for improving general health in County Durham – promoting positive behaviours, high quality drug an alcohol services and better quality of life through integrated care.
To promote positive behaviours, the policies adopted are the introduction of the Active 30 scheme in schools to help children get their recommended daily 30 minutes of exercise, work to reducing exposure to second-hand smoke and increase awareness about the risks of alcohol.
It is hoped that Active 30 will tackle high rates of child obesity in County Durham – two in five children are classed as obese in year six, above the national average. School closures caused by Covid-19 had halted many of these exercise sessions, but education settings are keen to roll out the scheme again with 76 schools signing up to the scheme in 2020/21.
Meanwhile, County Durham is keen to reduce second-hand inhalation of smoke, which costs the NHS around £23.3m per year. The County launched its “Second-hand Smoke is Poison” campaign in 2020, and has noticed a positive increase in the number of people seeking help with their smoking habits through the Smokefree scheme. The County has also relaunched the “Alcohol – Not the Answer” campaign in February 2021 in response to increasing rates of police incidents due to drug and alochol related issues (3.5% of crimes in 2020/21 compared to 2.8% in 2019/20).
The second target, developing high quality drug and alcohol services, also sees three main policies being implemented: to support people needing help, to work with families to help them with drug and alcohol issues, and to promote awareness about sensible levels of alcohol intake.
The Drug and Alcohol Recovery Service continues to provide tailored help towards specific groups and problems, with the report noting its achievements in ensuring help “is accessible for those most in need”. Furthermore, the Drink Coach website was launched, giving people the tools to “assess their own alcohol consumption levels”. From January to March 2021, 2359 people visited the site, with 1467 completing the Alcohol Use Disorders Identification Test (AUDIT).
The Annual Report also highlights that women and children have been underrepresented in support offerings in the past. To remedy this, the Women’s Recovery Academy Durham has been established, “providing interventions for issues key to women’s wellbeing”, while the “What’s the Harm?” campaign is aimed at children and their families, seeking to educate them about the dangers of underage drinking. Between May and July 2021, the campaign garnered 33,063 clicks and over 49,000 post engagements via Facebook.
The final priority action area, relating to “better quality of life through integrated health and care services”, has been impacted both positively and negatively by the pandemic.
On the one hand, growing public consciousness of the importance of vaccinations has meant that over 72% of over 65s have now had their flu vaccine, reflecting a broader national trend. However, the report also recognises the negative effects that isolation and shielding has had on mental health. To combat loneliness, a social prescribing approach has been used to provide more personalised support, and has helped over 5000 of County Durham’s most clinically vulnerable throughout the pandemic.
The Council is additionally seeking to tackle long-term illness by participating as one of ten pilot regions for the “We are Undefeatable “programme, which seeks to help those with long-term conditions integrate fitness and exercise into their everyday lives. Moreover, the Macmillan “Joining the Dots” campaign has been harnessed to simplify and streamline cancer treatment for patients in County Durham.
The full report can be accessed here.
Image Credit – James Tillotson