Across the life course there are factors which influence health and wellbeing of people and the need for services. Some of these are personal modifiable risk factors such as smoking, alcohol, obesity, exercise and healthy diet. In Norfolk it is estimated that smoking, alcohol and obesity contribute about 23,000 hospital admissions per year. Although smoking prevalence is declining, smoking is still the biggest driver of avoidable poor health. The area with the highest smoking prevalence is Breckland.
Addressing factors that people can do something about will help reduce the prevalence of long term conditions and reduce demand on services helping free up valuable resources. However, in Norfolk there are over 81,000 people who have a common mental health disorder and that is expected to increase by 1,400 between now and 2025. The ultimate expression of poor mental health is suicide and this occurs across all age bands, not just young people. In Norfolk suicide is similar to England, the number of emergency hospital stays for self-harm is better than England.
2013 | Norfolk County Council
Under 75 mortality rates generally for Norfolk residents is better than for England across the measured causes. Although life expectancy is 7.0 years lower for men and 4.5 years lower for women in the most deprived areas of Norfolk then the least.
It is estimated that modifiable risk factors such as smoking, consuming too much alcohol, obesity, poor diet and lack of exercise contribute in excess of 23,000 hospital admissions each year. The area with the highest smoking prevalence is Breckland. Alcohol related harm as well as self-harm hospital stays are worse than the average for England. However smoking, cardiovascular disease and cancer related deaths are better than the average for England.
Estimated levels of excess weight in adults are similar to England average as is the recorded level of diabetes. Screening for cancer within Norfolk is generally better than England recent trend for screening is getting worse.[13-15] The percentage of the population who have been offered and receive an NHS health check is better than the England average.[16,17]
Mar-14 | Norfolk County Council
Long term conditions
Mar-14 | Norfolk County Council
Exercise, activity & diet
Levels of excess weight are worse than those on average for England with approximately two out of three adults in Norfolk are overweight or obese which contributes to health issues such as heart disease, high blood pressure, strokes and diabetes. Just over 66% of adults (19+) are physically active, doing at least 150 “equivalent” minutes of at least moderate intensity physical activity per week similar to the England average.
Norfolk has a high rate of residents whom meet the recommended “5-a-day” on a “usual day” measure at just over 61% where the rate for England is just over 57%. Rates of early deaths from cardiovascular and respiratory diseases are better than the average for England although Cancer are slightly higher.
Drugs & alcohol
Smoking prevalence continues to fall with the level of current smokers in Norfolk is similar to England. Smoking prevalence is influenced by a number of demographic factors, Norfolk has a Tobacco Control Strategy revised in March 2016. Admission episodes for alcohol-related conditions – narrow definition is worse for Norfolk than England. The age group with the highest admission episodes is that of the 40-64 year old and although within this group males have a higher rate. For this age group Norfolk is worse than England.
Cannabis is the most commonly used drug by adults in the UK, fewer younger people are using heroin, and the population in treatment for heroin problems is getting older. Cocaine and ecstasy remain popular and ‘Legal highs’ pose dangers to users because new substances are rapidly appearing on the market. ‘Prescription only’ or ‘over the counter’ drugs are also substances included in addiction. Monitoring the prescription, abuse and withdrawal from certain prescription drugs has implications for primary healthcare, both in terms of practice and budgets.
2013 | Norfolk Drug and Alcohol Partnership
Criminal justice system
Norfolk has three prisons; HMP Bure, HMP Norwich and HMP Wayland. Offenders are more likely to smoke, misuse drugs and/or alcohol, suffer mental health problems, report having a disability, self-harm, attempted suicide and die prematurely compared to the general population. The links between poor health and reoffending have been documented along with the links with drugs and alcohol, housing and employment. Norfolk’s level of reoffending as a percentage of those who reoffend is similar to the national level, however first time offenders rate is higher than the national figure.
2014 | Norfolk County Council
Domestic abuse is an incident or pattern of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 years or over, who are or have been intimate partners or family members, regardless of gender or sexuality. This can encompass, but is not limited to, psychological, physical, sexual, financial or emotional and also includes honour-based violence, forced marriage and female genital mutilation.
Domestic abuse is generally under reported but accounts for 14% of total crimes for year ending March 2018. Domestic abuse can be the cause of depression and other mental health issues in women, contributing to self-harm and attempted suicide. The cost of treating physical and emotional health of victims of domestic abuse victims themselves is £47 billion.
Crime & sexual exploitation
Homelessness includes those households who are defined as statutorily homeless within the Housing Act 1996 and Homelessness Act 2002 (families with dependent children, pregnant women and adults who are assessed as vulnerable), however non-statutory homeless include single or couples without dependents who are sleeping rough, living in supported accommodation or are deemed as “hidden homeless” often sleeping on friends or family sofas.
It is estimated that there has been a 30% rise in rough sleeping nationally from 2014 to 2015, Norwich has the highest rate with South Norfolk the lowest. Statutory homelessness is currently highest in Great Yarmouth and north Norfolk, lowest in South Norfolk. However non-statutory homeless which includes single or couples without dependents who are sleeping rough, living in supported accommodation or are deemed as “hidden homeless” often sleeping on friends or family sofas. It is estimated that there has been a rise of 73% in rough sleeping nationally from 2014 to 2017.
In Norfolk, there are estimated to be just under 100,000 unpaid adult carers who look after a family member or friend. Caring affects people from all walks of life, at all ages, living in the smallest village or the larger towns and cities. Carers UK has estimated that the care provided in Norfolk by our local adult carers would cost £1.9 billion a year if it had to be paid for by public services. More than half of carers are female, the majority of carers are over 50; just under 40% are aged 50-64 and just under 30% are 65 and over.
There is an increased demand on the Carers of older people with Long-term conditions. The health and wellbeing of carers is also reported to be affected by the levels of caring, with Carers who care for someone for more than 50 hours a week twice as likely to be in poor health as non-carers. Carers UK report “Alone and caring” reveal 8 out of 10 carers have felt lonely or isolated as a result of their caring responsibilities. 57% had lost touch with friends and family and 38% of carers in full time employment have felt isolated from other people at work.