Older people’s health & wellbeing

Norfolk has an ageing population. Between 2022 and 2032 Norfolk’s total population is projected to increase by just over 70,000, with the number of residents aged 65 or over increasing by around 48,000. As a result, the proportion of Norfolk’s population aged aged 65 or over will rise from 25% in 2022 to 28% in 2032. In 2022 Norfolk had the 15th highest proportion of residents aged 65 or over of all upper-tier local authorities in England.^[1] In 2023 North Norfolk had the highest proportion of people aged 65 and over in Norfolk (34%), while Norwich had the lowest proportion (15%).^[2]

By 2040, the number of people aged 85+ is expected to rise by 67%, reaching nearly 52,900.^[1] This shift will require planning for new accommodation and care facilities. The growing elderly population will likely increase demand for nursing homes and palliative care.

In 2022/23, social isolation among adult social care users was higher in Norfolk than across England as a whole.^[3]

1. www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/datasets/localauthoritiesinenglandtable2
2. www.norfolkinsight.org.uk/population/reports/#/view-report/9925e741b4b449c090dd87016ce0eae9/E07000149/G2
3. fingertips.phe.org.uk/search/isolation#page/1/gid/1/pat/6/ati/502/are/E10000020/iid/90280/age/168/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1

Mental health and wellbeing is an important factor at any age for staying generally well and active. One risk factor for poor mental health among older people is loneliness and social isolation, although, this issue can affect anyone, regardless of age. Older people that are facing bereavement, caring for a partner, living alone, digitally exclusion, reduced mobility/ transport and/or have long-term health conditions are at particular risk of experiencing loneliness.

In 2021, across England and Wales, of those aged 65-69 around 24% of females and 20% of males lived alone, but among those aged 85-89 around 43% of males and 56% of females lived alone.^[4] People living in deprived areas are more likely to be lonely than people living in non-deprived areas. It has also been shown that people living in deprived urban areas, or areas where crime is a problem, can be just as lonely as people living in deprived rural areas. In 2021/22 to 2022/23, 6.4% of all adults in Norfolk reported that they felt lonely often or always.^[5] Also, only 46% of all adult social care users in Norfolk in 2023/24 reported that they had as much social contact as they would like.^[6]

Between 2019 and 2023 there were 102 suicides among those aged 65+ in Norfolk; the directly standardised rate of suicide among those aged 65+ in Norfolk is similar to the English average.^[7]

In 2023/24, 1% of all GP patients in Norfolk were recorded as having dementia, higher than the rate for England as a whole.^[8] In 2019, the proportion of those aged 65+ in Norfolk suffering from dementia was just over 4%.^[9]

Outcomes for older people in Norfolk are generally good. The directly standardised rate of emergency admissions for injuries related to falls in people aged 65 and over was similar to England as a whole for the period 2021-24, but there were still 1,431 emergency admissions for hip fractures in the financial year 2023/24. Across Norfolk as a whole there were nearly 49,000 emergency hospital admissions for people aged 65 and over in the financial year 2023/24.^[10] Flu can increase someones risk of hospital admission. In Norfolk, 81.4% of those aged 65-years and over (equivalent to 188,000 people) were immunised against flu in 2023/24.^[11]

Older people frequently live with long-term conditions like heart disease, arthritis, diabetes, and dementia, often managing multiple conditions at once. These conditions can be managed with medication and other treatments, but can affect daily life, mental health, and overall well-being.^[12]

Norfolk’s population is set to increase during the next decade, with more significant increases among older age groups. Norfolk already has a higher proportion of over 65s than many other local authorities in England and older people are more likely to have complex dental care needs due to treatment patterns earlier in their lives.^[13][14]

There is a well established link between deprivation and poor oral health. Vulnerable people are more likely to seek dental treatment only when they have a problem, rather than engaging in regular preventative care. Health promotion targeted and drop-in style services are particularly needed in areas of deprivation.

In Norfolk 34% of the adult population was seen by an NHS dentist in the 24 months before April 2024 compared to 40% for England as a whole.^[15] While 35% of patients aged 65+ in Norfolk and Waveney have not tried to see an NHS dentist in the last 2 years because they prefer to see a private dentist this still leaves a significant proportion of the population who are not accessing services for regular checks and prevention.^[16]

In 2021, across England and Wales, of those aged 65-69 around 24% of females and 20% of males lived alone, but among those aged 85-89 around 43% of males and 56% of females lived alone.^[17] A UK survey found that 63% of adults aged 55+ agreed that they want to remain in their home for the long-term and 90% want to live independently for as long as possible.^[18] Key factors supporting wellbeing in later life include participation in meaningful activities, physical activity, receiving care/support and having positive social interactions.^[19]

More people die during the winter months than during the summer months; the majority of Excess Winter Deaths occur among the 75+ age group. Factors leading to Excess Winter Deaths include winter temperatures, how well people are able to cope with low temperatures, disease levels in the local area, such as seasonal flu, and falling over, whether at home or elsewhere. In 2021/22, winter deaths among all age groups in Norfolk were around 10% higher than in non-winter months, while for those aged 85+ winter deaths were almost 15% higher than in non-winter months. Both of these figures are similar to those for England as a whole.^[20][21]

End of life services aim to support people approaching the end of their life to live as well as possible until they die. In 2023, just under 70% of those who died in England were aged 75 or over. In Norfolk this proportion was higher at approximately 75%, with around 8,100 deaths among those aged 75 or over in 2023,^[22] under half the deaths of these people aged 75+ occurred in hospital.^[23] There were roughly 2,800 deaths of individuals aged under 75 in Norfolk in 2023.^[22]

In Norfolk, there are estimated to be just over 81,500 unpaid adult carers in 2023.^[24] Caring affects people from all walks of life, at all ages, living in the smallest village or larger towns and cities. The value of the unpaid care provided by carers in the UK was estimated to be around £184 billion per year in 2021/22.^[25] In England the 2021 census showed that more than half of carers are female and just under half of carers are over 55, with almost a quarter aged 65 and over.^[26]

The health and wellbeing of carers is also reported to be affected by the extent of caring. Across England and Wales in 2021, 1 in 4 carers reported ‘not good health’ after adjusting for age compared with fewer than 1 in 5 non-carers. In 2023, almost half of carers felt depressed, while 79% felt stressed or anxious and 54% said their physical health had suffered due to the responsibilities of caring.^[27]

Norfolk Safeguarding Adults Board annual report 2024-25 reported neglect & acts of omission as the most common type of abuse, more women than men were likely to be at risk.^[28] The Beacon pilot programme was delivered in Norfolk between 2016 and 2021. This brought survivors, specialist domestic abuse organisations and commissioners together to develop a new way of working and saw a 76% reduction of physcial abouse, 85% felt safer on completion of the programme and 82% saw an improvement in their wellbeing.^[29]