1. South West Public Health Observatory The South West sustainability challenge Paul Brown Acting Director South West Public Health Observatory

2. Overview Sustainability & public health What are the challenges in the South West – workshop areas –Environmental –Societal –Health –Sustainability Overarching challenges in the South West –Demographics –Economy –Transport –Tourism

3. South West Public Health Observatory Sustainability and Health Agenda 21: ‘Human beings are at the centre of concern for sustainable development. They are entitled to a healthy and productive life in harmony with nature’. ‘the primary health needs of the world’s population are integral to the achievement of the goals of sustainable development’. United Nations Conference on the Environment and Development (UNCED) in Rio de Janeiro in 1992(UNCED 1992). Principle 1 p 1

4. South West Public Health Observatory Sustainability and Health Sustainability South West: Fundamentally, sustainability is about nothing less than the survival of people and planet into the future Source: http://www.sustainabilitysouthwest.org.uk/what2.html

5. South West Public Health Observatory Sustainability and Health UKPHA 14th Annual Public Health Forum March 2006 "Creating Healthy Sustainable Communities: bridging the gap between democracy, design and delivery".

6. South West Public Health Observatory Sustainability and Health “Public health professionals have a lot in common with people who work in sustainable development. We are all committed to seeing improvements in health and wellbeing that benefit people today and in the future.”

7. South West Public Health Observatory Sustainability and Health “Public health professionals have a lot in common with people who work in sustainable development. We are all committed to seeing improvements in health and wellbeing that benefit people today and in the future.” Lead article in ph.com – the newsletter of the Faculty of Public Health March 2006 Environmental Sustainability and Public Health Jonathon Porritt CBE, Chair, UK Sustainable Development Commission

8. South West Public Health Observatory Sustainability and Health Sustainability South West: Source: http://www.sustainabilitysouthwest.org.uk

9. South West Public Health Observatory Sustainability IN health health is an industry, mainly focused on health services, with its own: resource requirements, economically beneficial outcomes, waste products, and potential for environmental pollution. main concern is the ever-increasing resource demand. Health equity & economics Source: http://www.sustainability.dpc.wa.gov.au/docs/BGPapers/CohenDouglasThomas.pdf

10. South West Public Health Observatory Challenges in the South West

11. South West Public Health Observatory Challenges in the South West Environmental Challenges – –climate change, El Nino, Gulf Stream, –European Community Common Agricultural Policy, fisheries policy, –industrial heritage, –natural heritage. The South West has over 60% of England’s heritage coast. Agriculture remains an important industry for many rural areas.

12. South West Public Health Observatory Challenges in the South West Societal Challenges –tourism, –ageing population, migration trends, –coastal infrastructure, –structural employment change, –inequality, –substance misuse.

13. South West Public Health Observatory Health Challenges: –bathing water quality and sewerage, –air quality and transport, –drinking water resources, –healthcare, –leisure and recreation. Challenges in the South West

14. South West Public Health Observatory Sustainability Challenges: –fisheries and food production, –inter regional travel, –tourism and local economy, –waste and recycling, –spatial planning. Challenges in the South West

15. South West Public Health Observatory Demographics Overarching Issues

16. South West Public Health Observatory Population Density Source: 2001 Census 210 people per km 2

17. South West Public Health Observatory Population Density Source: 2001 Census

18. South West Public Health Observatory Population Density – SW region Source: 2001 Census 210 people per km 2

19. South West Public Health Observatory Population Density – within 10km of coast Source: 2001 Census 320 people per km 2

20. South West Public Health Observatory Population Density – within 5km of coast Source: 2001 Census 367 people per km 2

21. South West Public Health Observatory Population Projections Source: Second Blooming - www.swpho.nhs.uk

22. South West Public Health Observatory Migration: Mature Adults Source: Second Blooming - www.swpho.nhs.uk

23. South West Public Health Observatory "Old age is not so bad when you consider the alternatives." Maurice Chevalier (1888–1972)

24. South West Public Health Observatory Economy Overarching Issues

25. South West Public Health Observatory Economy Overall employment rates are high, with 79% of the working age population in employment But… one of the smaller economies of the English regions with a figure for Gross Value Added (GVA) of almost £79 billion, just over 9% of the total for England. The South West’s GVA per head is about 9% less than the overall figure for England. The three main generators of wealth in the region are: –Real estate, renting and business activities (22% of GVA 2003) –Manufacturing (15% of GVA 2003) –Wholesale/retail (12% of GVA 2003) Source: http://www.gosw.gov.uk/gosw/docs/220636/309014/swkeyfacts

26. South West Public Health Observatory Average earnings in the South West are low. –The median annual gross pay is £17,600, England (£19,300). – There are substantial sub-regional variations; Torridge’s median annual pay is £11,900, the lowest in UK where data is available, while the equivalent in Tewkesbury is £22,008. The average house price in the region (£202,396 – Q3 2005) is slightly higher than the English average (£197,201). Leading to affordability issues. –The average house price in the region is around 10 times the average annual salary (it was about 8 times higher nationally). –In Dorset and Cornwall & the Isles of Scilly it was around 13 times higher. Economy Source: http://www.gosw.gov.uk/gosw/docs/220636/309014/swkeyfacts

27. South West Public Health Observatory Transport Overarching Issues

28. South West Public Health Observatory Transport it takes almost an hour less to travel by car from the north of the region to Scotland than it does to travel from the north of the region to the tip of Cornwall. South West residents are more likely to make their journeys by car and less likely to travel by public transport than the average for England. 78% of the region’s employees travel to work by car or motorcycle (Eng 72%), 5% travel by public transport (Eng 14%) and 16% either walk or cycle to work (Eng 13%). People in the South West have some of the least accessible bus services in England with only 82% living within a 13 minute walk of an hourly service (Eng 90%). There is a growing demand for air travel within the region. The number of passengers at South West airports in 2004 increased by 25% on the previous year’s total (Eng increase 8%). Source: http://www.gosw.gov.uk/gosw/docs/220636/309014/swkeyfacts

29. South West Public Health Observatory Tourism Overarching Issues

30. South West Public Health Observatory Tourism Tourism is a key industry in the South West, which accounts for around : –20% of England’s domestic tourist trips –8% of overseas visits to England. –estimated £4,103 million in expenditure to the region's economy in 2004. –estimated 26 million staying visitors each year Source: http://www.gosw.gov.uk/gosw/docs/220636/309014/swkeyfacts

31. South West Public Health Observatory Seasonal pattern of emergency admissions in the South West – non residents Data source: Hospital Episode Statistics

32. South West Public Health Observatory Road traffic collisions Data source: Hospital Episode Statistics 1999 - 2004

33. South West Public Health Observatory Challenges in the South West - summary Huge population growth over the last 20 years, outstripped every other region – predicted to continue – population ageing Joined by some 26 million staying visitors each year. Population and activity concentrated around our 700 miles of coastline. Economy – low income/high house prices Transport – currently unhealthy & not sustainable

34. South West Public Health Observatory Challenges in the South West - summary Can we continue growing while improving health in our communities and protecting the environment? What is the road map for this sustainable future?

35. South West Public Health Observatory Thank you Paul.Brown@swpho.nhs.uk www.swpho.nhs.uk