Health and Wellbeing

Download a PDF of the report here Health and Wellbeing

It is beyond the scope of this report to look in detail at all aspects of physical and mental health and wellbeing in Devon, and beyond the scope of the Foundation to support many aspects of these issues. Data on a variety of aspects of public health is available from the respective local authorities, through their joint strategic needs assessment publications, which draw on national datasets. We have highlighted just a small number of significant elements, in particular those that have a bearing on other aspects of social life, or that relate to non-biomedical issues such as unpaid caring, living with long-term ill-health or disability, or health inequalities. See also the separate report on loneliness and social isolation.

Life expectancy

There are substantial variations in life expectancy within the county: there is a gap of around 15 years between life expectancy in central Ilfracombe compared with leafy areas of East Devon. These variations often, though not always, correlate with levels of deprivation. The charts below show what is known as the Slope Index of Inequality for differences in life expectancy between the most deprived areas (on the left) and the least (on the right), expressed in number of years, for both males and females. The variations, even within relatively small geographic areas, are dramatic. It is likely to be less accurate in a sparsely populated area, but nevertheless, it would appear that the correlation between deprivation and life expectancy is much lower in West Devon than in the unitary authorities.

Inequalities in life expectancy for plymouthInequalities in Life Expectancy for Plymouth

Inequalities in life expectancy for torbay

Torbay

Inequalities in life expectancy for west devon

West Devon

North Devon stands out for its strikingly high prevalence of smoking: twice the national average. Plymouth has the highest rate of overweight adults.

Unpaid Carers

Although the rise in life expectancy appears to be slowing, it is clear that an ageing population faces potential challenges with the number of people requiring social care and support. Unpaid carers, usually family and friends, carry the vast majority of this burden; unpaid adult carers in the UK provide care estimated to be worth at least £57 billion. In general, Devon has a higher than average number of people providing unpaid care to relatives or friends. Particular hotspots are Torbay and Plymouth - in Torbay, 3.6% of the population report providing 50 or more hours of unpaid care per week, against a national average of 2.4%. Incidences of unpaid caring are typically higher in areas of greater deprivation. Claimant rates for Disability Living Allowance are uniformly high, but those for Attendance Allowance, payable to those aged over 65+ in need of significant support with personal care and supervision, are relatively low other than in Torbay. 

Carers might support someone with personal care, with taking medication, or with wider tasks such as shopping and cleaning, or accompanying someone to appointments. Caring responsibilities can have a significant impact on the income-generating capacity of individuals, as well as potentially on physical and mental wellbeing, and relationships. For children, caring duties can interfere with their education, and can influence their aspirations for the future. But much caring work goes on under the radar. Three in four carers feel their role is not properly understood or valued by their community, and many found it difficult to balance their caring role with continuing education, accessing healthcare, and avoiding isolation. Problems are often particularly acute for older carers.

Unite – Carers in Mid-Devon have been working to support unpaid carers since 2003. They provide a telephone advice line, and a range of support groups and activities for carers, including children and young adults, as well as a volunteer visiting scheme, memory and dementia cafes, and support for ex-carers who have been bereaved.

Mental Health

Parts of Devon are associated with higher than average incidences of poor mental health. Again, these tend to correlate with areas of higher deprivation (see table). Suicide and self-harm are considerably higher risks for people suffering from personality disorder, depression and eating disorders. Emergency hospital admissions for intentional self-harm are almost double the national average in Torbay and Torridge, and above average in Exeter, Plymouth, North Devon and Teignbridge. Suicide rates per 100,000 people are 14.3 in Exeter, and 15.7 in Torbay, against a national average of 9.6.

 

Per 100,000 population

England

185

Exeter

212

Teignbridge

212

Plymouth

273

North Devon

333

Torridge

358

Torbay

363

Emergency admissions for intentional self-harm, 2016/7

 

Per 100,000 population

England

13.7

Plymouth

16.9

Torbay

18.6

People reporting depression/anxiety, 2016-17

Although it is from 2012, this report into mental health challenges in Plymouth is detailed and wide-ranging, examining the various elements that can support good mental health, such as employment and access to green space.

Flying Fish is a small charity based in Barnstaple which supports the recovery of those experiencing mental ill health through art. Members meet weekly in the project’s studio to come together, paint and socialise. Many members had no artistic experience before joining the group, and have discovered their creativity along the way. The project supports those who often have spent long periods in mental health units. Flying Fish facilitates art education, trips, and exhibitions to help develop members’ skills, and the benefits they derive from the group.

Physical and Learning Disability

people with a limiting long term illness aged 16-64

People with a limiting long-term illness, aged 16-64.

216,000 people in Devon reported living with a long-term illness or disability that affected their day-to-day activities in the 2011 census – that’s around a fifth of the population, and comparable with national figures. For those of working age, our figures are a little higher than average (see heat map above), and, again, unevenly distributed, roughly in line with general deprivation. Interestingly, older people in Devon are relatively healthy, with below-average rates of long-term illness in the over-65s in many areas.

The Countryside Mobility Scheme run by Living Options Devon provides off-road mobility scooters for rent at a network of over 50 locations across the region, allowing disabled people to enjoy the countryside with their family and friends. Locations include National Trust properties, nature reserves, and trails. There’s even one on Lundy Island!

One way in which long-term illness or disability can affect daily life is through access to employment (and there is a strong link between employment and enhanced quality of life). Nationally, 49.2% of adults with disabilities are in employment compared to 80.6% of people aged 16-64 who do not have a disability. The figures can be even worse for those with a learning disability. The National Autistic Society reports that nationally 16% of autistic adults are in full time work. In 2017-18, 8.6% of adults with a Learning Disability were in paid employment in Devon County, 5.5% in Plymouth and only 3.8% in Torbay, compared with a national average of 6%. Employment rates for men are generally higher than for women, and markedly so in Plymouth (source: NHS Digital).

The Turning Tides Project is a Community Interest Company based in Crediton, with a mission to provide inclusive opportunities for people with learning disabilities or autism to participate in arts, music, sport and other activities. TTTP runs a wide variety of jam sessions and inclusive sporting opportunities. They have their own skittles team, and have recently taken over management of the Crediton Station tea rooms. TTTP also works with local businesses to help improve employment opportunities for people with learning disabilities or autism, and with individuals to support their journey to employment with training, work experience, interview skills, CV writing and more. TTTP generates income through offering training and evaluation services, and can provide event catering through the tea rooms venture.

Excess Winter Deaths

Excess winter deaths (that is, the number of additional deaths occurring in winter as opposed to other times of the year) is expressed through the excess winter deaths mortality index – excess winter deaths divided by non-winter deaths, expressed as a percentage. Here are Devon’s figures, which vary significantly:

England

21.2

Plymouth

12.9

Torbay

19

East Devon

25.8

Exeter

15.2

Mid Devon

22.4

North Devon

14.9

South Hams

20.8

Teignbridge

18.3

Torridge

10

West Devon

10.9

Excess Winter Deaths Mortality Index, 2016-17

Excess winter deaths are closely associated with older people, and with cold homes, and therefore is linked to fuel poverty (though this is not obvious statistically, as the figures are inaccurate in rural areas), but does not have a close correlation with deprivation.

Resources

The different local authorities have slightly different approaches to collecting and presenting information on health:

Devon County. Public Health produces a series of comprehensive Joint Strategic Needs Assessment profiles, combining data on aspects of health, education, etc. This can be viewed by district, ward and community. http://www.devonhealthandwellbeing.org.uk/jsna/profiles/. There is also an annual public health report, with a different focus every year: http://www.devonhealthandwellbeing.org.uk/aphr/.

Torbay. This Joint Strategic Needs Assessment report provides a Baywide overview, with profiles broken down by town and ward also available.

http://www.torbay.gov.uk/DemocraticServices/documents/s50293/JSNA%20Appendix%201.pdf

Plymouth. Their JSNA is organised according to topic:

https://www.plymouth.gov.uk/publichealth/factsandfiguresjointstrategicneedsassessment/ourjsnatopics

The Plymouth Report includes an overview of other topics such as transport, housing and the economy: https://www.plymouth.gov.uk/publichealth/factsandfiguresjointstrategicneedsassessment/plymouthreport

Other sources

Health and Wellbeing in Rural Areas, Local Government Association with Public Health England, 2017.

Building Carer Friendly Communities, Carers Week, 2016.

Living Options periodically carry out pieces of research on aspects of disability in Devon. www.livingoptions.org

Healthwatch Devon publishes reports on a range of health-related topics: https://healthwatchdevon.co.uk/reports/

 

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