Annual Public Health Report 2015/16 Growing Up in Redbridge Gladys Xavier – Deputy Director of Public Health

The annual report is the DPH’s professional statement about the health of local communities, based on sound epidemiological evidence, and interpreted objectively. The annual report is an important vehicle by which DPHs can identify key issues, flag up problems, report progress and, thereby, serve their local populations. It will also be a key resource to inform local inter-agency action.

Update on key priorities and actions from last year (2014/15) Still births Cancer survival Communicable disease Excess winter deaths Physical activity

Surveillance 2015/16 Changing population. Life expectancy. Cardiovascular disease. End of Life Care. Context – Transition to integrated Adult Social Care and Community Health Service model for Redbridge with opportunities for embedding prevention and early intervention to address needs.

Part A: Health Surveillance Report

Population projections by age group, 2011-2026 Source: GLA2014 round of demographic projections. Larges percentage increases in children and in people aged over 65 years. Between 2016-21 1100 more children aged 0-4 5300 more children aged 5-14 7300 more adults aged 25-44 5200 more adults aged 45-64 3400 more adults aged 65 and over

Population change by ward All wards recorded some growth since the 2011 census – Clementswood had the highest growth rate (20%) Clayhall had the lowest (3.4%). Loxford has the highest population density in the borough with 14000 persons per square kilometre

Life expectancy at birth Whilst LE at birth is steadily increasing borough wide there is variation between wards: Barkingside – highest for males and females Loxford – only ward where LE at birth is significantly below England average – Men Aldborough – only ward … - women

Healthy Life Expectancy

Cardiovascular disease (CVD) CVD is the most common cause of preventable death among Redbridge residents – 500 deaths per year. Risk factors can be behavioural (smoking, diet, physical activity) and non behavioural (ethnicity, high blood pressure, age).

Diabetes prevalence Prevalence of diabetes is greater among ethnically diverse communities and areas of higher deprivation. Slide shows observed prevalence (diagnosed in primary care) and expected (undiagnosed).

NHS Health Checks Programme Aims to prevent long term conditions and identify certain types of dementia. Adults between 40 and 74 who have no diagnosed long term condition. National target of 20% eligible population to be offered health check – this was achieved in Redbridge.

Part B: Growing up in Redbridge The Adults of the Future Marmot review ‘disadvantage starts before birth and accumulates throughout life. Action to reduce health inequalities must start before birth and be followed through the life of the child. Only then can the close links between early disadvantage and poor outcomes throughout life be broken’. Chapter covers conception to transition to adulthood and age 25. CYP chosen this year due to our work in commissioning Integrated 0-19 Healthy Child Programme Service.

Action across the life course Source: Fair Society, Healthy Lives (The Marmot Review) Report focuses on how having the best start in life enhances opportunities for good wellbeing throughout a persons lifespan

Prebirth Maternal health influences foetal development during pregnancy e.g. Healthy behaviours – smoking, alcohol, substance use, diet, exercise, healthy weight, sexual health. Early access to antenatal services Mental wellbeing Social support Life chances are influenced even before a child is conceived – opportunities for early support. What are we doing? Maternal obesity – women with BMI >30 offered specialised diet and exercise advice and referral to dietician Smoking – referral to cessation services Substance misuse – priority for treatment services Future – public awareness of maternal wellbeing & early access to antenatal care.

Birth to five: The best start in life Birthweight Breastfeeding Immunisation Injuries Emotional wellbeing The report covers the following factors and what we are doing across the borough to support families and young children

Levels of Obesity Measured by National Childhood Measurement Programme 2014/15 10.8% Reception year and 23.2% Year 6 students were identified as obese (similar to London trends). Increase in obesity most significant among children with ‘Black’ ethnicity. Higher prevalence of obesity and excess weight in areas of higher deprivation. What are we currently doing? We have a range of initiatives in line with the Redbridge Obesity Strategy including: • Work to support re-procurement of healthy balanced school meals • Supporting schools with high rates of obesity • Proactive follow up of children who are overweight or obese • A range of children’s weight management programmes targeting different age groups • Building ten outdoor gyms in local parks What do we need to do in the future? We will work with partners to: • Create an environment that facilitates healthy eating and physical activity • Provide residents with the knowledge, skills and opportunities to eat healthily and undertake physical activity • Support families with children who are overweight or obese to reduce their Body Mass Index (BMI) and maintain a healthy weight. This will be achieved through a range of activity across the borough, including: • Working closely with planners to ensure regeneration work facilitates good health and wellbeing, and opportunities are taken to improve the availability of healthy food and promote physical activity, including active travel. • Providing training on healthy eating to people working in health and social care settings and in the community. • Continuing to support schools with high rates of obesity. • Workshops on healthy eating; and a variety of physical activity opportunities for all ages.

Mental wellbeing Good mental health essential to enable young people to reach potential – education, social life, family life and progression to adulthood. What are we doing currently? We are working closely with the CCG to implement the CAMHS Transformation Plan. The Transformation Plan covers all aspects of children’s mental wellbeing.   What do we need to do in the future? The CAMHS Transformation Plan will be implemented over the next 4 years and states that ‘we want children, young people, their parents, and all professions who work with them to be aware of local services and of how to access extra support where there are identified additional needs. Further, where those needs are indicative of underlying mental health conditions, support must be easily accessed and interventions be timely, evidence based, and delivered by friendly, caring professionals’. The Plan will be implemented in partnership with schools, North East London Foundation Trust, the Voluntary Sector, parents and young people.

Growing up in Redbridge: The Adults of the Future Factors that shape our parents lives, development during pregnancy, and what happens to us during childhood shape our wellbeing during adulthood. We know that for many health and wellbeing issues early identification and effective support can prevent problems extending into adulthood. The challenge To ensure that in Redbridge we work with the whole system to plan for and meet the changing and sometimes complex needs of our children and young people.