Health Profile - Aberdeenshire

Health Profile - Aberdeenshire

Contents

1. Introduction

2. The Health Profile Data

3. Brief Summary of Findings

4. Aberdeenshire Profile

(4.1) Demographic Profile

(4.2) Socio-Economic Profile

(4.3) Mortality

(4.4) Morbidity

(4.5) Births in Grampian Hospitals 1999/2000

(4.6) Health Topic/Lifestyle Profile

5. Areas within Aberdeenshire

6. Aberdeenshire Area Profiles

(6.1) Banff and Buchan

(6.2) Buchan

(6.3) Formartine

(6.4) Garioch

(6.5) Marr

(6.6) Kincardine & Mearns

7. National and Local Health Priorities and Targets

Appendix A Key to acronyms used in the health profile

Health Profile - Aberdeenshire Contents

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Index of Tables, Graphs and Maps

Tables

4

Table 4a 1999 Population Estimates for Scotland, Grampian, Aberdeenshire

Table 4b Employment in Aberdeenshire

Table 4c Housing Tenure in Aberdeenshire

Table 4d Primary 5-14 Performance

Table 4e Secondary 5-14 Performance

Table 4f SCE Standard Grade Examination Results 1998-99

Table 4g SCE Higher Grade Examination Results 1998-99

Table 4h Percentage of Authorised Absences 1999-2000

Table 4i Deaths by Cause 1999 - All Ages

Table 4j Deaths by Cause 1999 - Under 75s

Table 4k SMR for Selected Causes 1999 - All Ages

Table 4l Deaths by Cancer 1999 - All Ages

Table 4m Infant Deaths 1999

Table 4n Drug Related Deaths in Grampian

Table 4o Cancer Survival Rates Based on Patients Diagnosed Between

1991 and 1995

Table 4p Summary of Hospital Inpatients Discharges 1999-2000

Table 4q New Outpatient Attendances 1999/2000

Table 4r Inpatient and Day Case Discharges 1999/2000

Table 4s Mental Illness Hospitals and Psychiatric Units Admissions 1999

Table 4t Mental Illness Hospitals and Psychiatric Units Discharges 1999

Table 4u Births in Grampian Hospitals 1999/2000

Table 4v Discharges Due to Accidents 1999/2000 Grampian Residents

Table 4w Targets for Road Traffic Accidents

Table 4x Summary of Targets

Table 4y Drinking Status Grampian Adult Lifestyle Survey (GALS)1998

Table 4z Alcohol Consumption Levels GALS 1998

Table 4aa Number of Units of Alcohol Consumed in Last Seven Days Grampian

Youth Lifestyle Survey 1998

Table 4ab Healthy Eating Categories GALS 1998

Table 4ac Healthy Eating Categories by Sex GALS 1998

Table 4ad Support and Advice to Improve Eating Habits GALS 1998

Table 4ae 'Have you ever taken drugs?' GALS 1998

Table 4af Types of Drugs Taken GALS 1998

Table 4ag Employment Status of Drug Users Scottish Drugs Misuse Database

Table 4ah Types of Drug Taken Grampian Youth Lifestyles Survey 1998

Table 4ai Reported Numbers of HIV and AIDS Cases Grampian 1997-2000

Table 4aj Number of Cases of Viral Hepatitis A, B and C in Grampian

Table 4aj New Sexually Transmitted Infections in Grampian 1999-2000

Table 4ak Teenage Pregnancy Rates in Grampian 1997-99

Table 4al Discussing Sex Grampian Youth Lifestyle Survey 1998

Table 4am Mean Number of Decayed, Missing and Filled Teeth per Child

Table 4an Percentage with "Caries Experience" - Teeth

Table 4ao Regular Physical Activity GALS 1998

Table 4ap Smoking Status GALS 1998

Table 4aq Quantity of Cigarettes Smoked GALS 1998

Table 4ar Smoking During Pregnancy 1997-99

Tables

Table 4as Smoking Status Grampian Youth Lifestyle Survey 1998

Table 4at Issues Which Cause Problems GALS 1998

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Table 6a Population Estimates for Banff & Buchan

Table 6b Hospital Inpatient Discharges 1990-2000

Table 6c New Outpatient Attendances 1999-2000

Table 6d Inpatient and Day Case Discharges 1999-2000

Table 6e Deaths by Cause (Under 75s)

Table 6f Deaths by Cause (75s and over)

Table 6g Drinking Status GALS 1998

Table 6h Alcohol Consumption Levels Lifestyle Survey 1994

Table 6i Diet Categories GALS 1998

Table 6j Regular Physical Activity GALS 1998

Table 6k Smoking Status GALS 1998

Table 6l Quantity of Cigarettes Smoked GALS 1998

Table 6m Population Estimates for Buchan

Table 6n Summary of Hospital Inpatient Discharges 1999-2000

Table 6o New Outpatient Attendances 1999-2000

Table 6p Inpatient and Day Case Discharges 1999-2000

Table 6q Deaths by Cause (Under 75s)

Table 6r Deaths by Cause (75s and Over)

Table 6s Drinking Status GALS 1998

Table 6t Alcohol Consumption Levels in Last Seven Days GALS 1998

Table 6u Diet Categories GALS 1998

Table 6v Regular Physical Activity GALS 1998

Table 6w Smoking Status GALS 1998

Table 6x Quantity of Cigarettes Smoked GALS 1998

Table 6y Population Estimates for Formartine

Table 6z Summary of Hospital Inpatient Discharges 1999-2000

Table 6aa New Outpatient Attendances 1999-2000

Table 6ab Inpatient and Day Case Discharges 1999-2000

Table 6ac Deaths by Cause (Under 75s)

Table 6ad Deaths by Cause (75s and Over)

Table 6ae Drinking Status GALS 1998

Table 6af Alcohol Consumption Levels in Last Seven Days GALS 1998

Table 6ag Diet Categories GALS 1998

Table 6ah Regular Physical Activity GALS 1998

Table 6ai Smoking Status GALS 1998

Table 6aj Quantity of Cigarettes Smoked GALS 1998

Table 6ak Population Estimates for Garioch

Table 6al Summary of Hospital Inpatient Discharges 1999-2000

Table 6am New Outpatient Attendances 1999-2000

Table 6an Inpatient and Day Case Discharges 1999-2000

Table 6ao Deaths by Cause (Under 75s)

Table 6ap Deaths by Cause (75s and over)

Table 6aq Drinking Status GALS 1998

Table 6ar Alcohol Consumption Levels in Last Seven Days GALS 1998

Tables

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Table 6as Diet Categories GALS 1998

Table 6at Regular Physical Activity GALS 1998

Table 6au Smoking Status GALS 1998

Table 6av Quantity of Cigarettes Smoked GALS 1998

Table 6aw Population Estimates for Marr

Table 6ax Summary of Hospital Inpatient Discharges 1999-2000

Table 6ay New Outpatient Attendances 1999-2000

Table 6az Inpatient and Day Case Discharges 1999-2000

Table 6aaa Deaths by Cause (Under 75s)

Table 6aab Deaths by Cause (75s and over)

Table 6aac Drinking Status GALS 1998

Table 6aad Alcohol Consumption Levels in the Last Seven Days GALS 1998

Table 6aae Diet Categories GALS 1998

Table 6aaf Regular Physical Activity GALS 1998

Table 6aag Smoking Status GALS 1998

Table 6aah Quantity of Cigarettes Smoked GALS 1998

Table 6aai Population Estimates for Kincardine and Mearns

Table 6aaj Summary of Hospital Inpatient Discharges 1999-2000

Table 6aak New Outpatient Attendances 1999-2000

Table 6aal Inpatient and Day Case Discharges 1999-2000

Table 6aam Deaths by Cause (Under 75s)

Table 6aan Deaths by Cause (75s and Over)

Table 6aao Drinking Status GALS 1998

Table 6aap Alcohol Consumption Levels in Last Seven Days GALS 1998

Table 6aaq Diet Categories GALS 1998

Table 6aar Regular Physical Activity GALS 1998

Table 6aas Smoking Status GALS 1998

Table 6aat Quantity of Cigarettes Smoked GALS 1998

Graphs

4i Age Distribution of Grampian Population 1999

4ii Population Projections - under 75s

4iii Population Projections - 75s and over

4iv Household Income 1998

4v Income Support 1999

4vi Incapacity Benefit 1999

4vii Job Seekers Allowance 1999

4viii School Leavers Destination 1999/2000

4ix Directly Standardised Mortality Rates for Cancer (Under 75s)

4x Directly Standardised Mortality Rates for IHD (Under 75s)

4xi Directly Standardised Mortality Rates for Stroke (Under 75s)

Maps

4a Local Unemployment by District Ward 2000

6a Map of Aberdeenshire Administrative Areas

Health Profile - Aberdeenshire Contents

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1. Introduction

This report, has been produced jointly by Aberdeenshire Council and Health Promotions, (NHS Grampian), to provide an indication of the health and well-being of the population of Aberdeenshire.

Aberdeenshire is a large rural area covering 2,428 miles with a population of 227,440 (1999). There are eleven towns ranging in size from 3,700 to 17,800 people.

Defining Health and Well-being

Health encompasses physical, mental, emotional, and social well-being as well as the absence of disease. The following definition has been adopted from the World Health Organisation (1984).

Defining Health Promotion

Health promotion is an umbrella term for a wide range of activities that enhance health and well-being by positively influencing the main determinants of health. Due to the fact that good health is defined as more than just absence of disease, health promotion plays an important part in increasing people's state of health.

The Main Determinants of Health

An analysis of the factors which determine and influence health, show that the main determinants can be categorised under 8 key headings. (See Figure 1)

Fig. 1 The Main Determinants of Health

Within the headings from the above model, examples of main determinants are as follows:

Social Environment - household structure, unemployment

Educational Environment - exam performance, post-school education, lifelong learning

Population Dynamics - births, deaths, teenage pregnancy, life expectancy

Biological Environment (modified from Genetic Endowment) - genetic pool, family tree

Health and Social Service Use (modified from Health Care) - GP/dental consultations, immunisation, screening uptake, hospital admissions

Individual Response : Behaviour - smoking, alcohol/drug use, exercise, diet

Biological - blood pressure, cholesterol, allergies

Physical Environment - climate, air quality, access to shops/leisure facilities

Health and Function - need for care/support

Well-being - satisfaction with home and workplace

Prosperity - patterns of spending, employment/unemployment, housing tenure

Disease - hospital morbidity, chronic illness, sickness absence from work

Many inter-related elements contribute to and determine health and well-being. For example, living on a low income can prevent people from obtaining the basic necessities which are essential to health such as warmth, housing and food. The clear link between deprivation and ill-health is reinforced by environmental factors such as damp or sub-standard housing or exposure to health hazards such as pollution, where the impact on mental and physical health has been well demonstrated.

The link between deprivation and ill-health can also be reinforced by poorer access to health services, charges for prescriptions and lower quality health services. Health and social services are not always distributed in relation to need. Studies have shown that lower social class patients are less likely to receive specialist referrals and receive less information voluntarily from GPs.

Poverty also restricts social life and this isolation from social supports can leave people feeling very low and powerless, whereas access to social networks and resources such as health care and leisure facilities can help to protect against illness and promote health. Where social, environmental or economic circumstances reduce opportunities, individuals are more vulnerable to illness, disability and early death. People living with poverty are also more likely to have limited access to affordable food and to be able to sustain a healthy diet. In such settings, risky behaviours are more likely to have serious implications for health.

Social relationships are also very important to health. A lack of these affects mental and physical health and reduces the quality of life. Where people have good social support, adequate income and relative protection from environmental hazards, they are more likely to stay healthy.

A Joint Health Strategy "Promoting Healthy Communities" has recently been developed between Aberdeenshire Council and Health Promotions (NHS Grampian). The key aims of the Health Strategy are to improve the health and well-being of the people of Aberdeenshire and to minimise the health inequalities that exist in Aberdeenshire. The Health Strategy highlights the importance of the contribution that local authorities can make to the main determinants of health through their role in housing, social work, education and recreation, transport, planning and environmental health and economic development.

This Health Profile provides the baseline information from which progress in the implementation of the health strategy will be monitored and evaluated. However it must be recognised that improvements in health are long term and that it will be essential to identify intermediate indicators.

The Health Profile provides an indication of the health, or maybe more appropriately the extent of ill health, in Aberdeenshire. The profile reveals pockets of health inequalities throughout Aberdeenshire which appear to be linked to rural deprivation, poverty, lack of economic opportunity and social exclusion. Recent studies suggest that these elements are more acutely felt and further exacerbated where the gap between the more affluent and the poor is greater.

The challenge in the development of the Joint Health Strategy "Promoting Healthy Communities" was to ensure that a co-ordinated and collaborative approach was taken to improve health and address the health inequalities highlighted in this Health Profile. This will be achieved through the development of policies and initiatives which will have a positive impact on the main determinants of health and will improve ‘life circumstances’ and ‘lifestyles’ across Aberdeenshire.

The Health Profile has been designed to enable updated and new information to be added when available and to ensure that it remains a current, user-friendly and widely-used tool. For example, the findings of the 2001 NHS Grampian Adult Lifestyle Survey will update the current lifestyle profile within this report.

Health Profile - Aberdeenshire Section 1 - Introduction

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2. The Health Profile Data

This document provides information, compiled from a variety of sources which enables comparisons between Aberdeenshire and the rest of Scotland. In addition information has been collated to enable comparisons between different areas within Aberdeenshire.

To this end the Health Profile has been developed in two sections. The first section represents an overall profile for Aberdeenshire, comparing the picture of health in Aberdeenshire with the rest of Scotland and includes:

·  a demographic profile

·  a socio-economic profile

·  mortality data

·  morbidity data

·  a lifestyle profile

The second section of the Health Profile contains six Area Profiles which have been developed for the six areas within Aberdeenshire. These profiles include:

·  a demographic profile

·  a socio-economic profile

·  mortality data

·  morbidity data

·  a lifestyle profile

·  qualitative information - access to services/key local issues

In compiling the health profile, the need to work in partnership has been clearly demonstrated. Data, information and resources from both NHS Grampian and Aberdeenshire Council have proved invaluable. The information within the profile has been collated from a range of sources, including: Grampian Adult and Youth Lifestyle Surveys 1998, 1999 Annual Report of the Registrar General for Scotland, Scottish Health Statistics 2000 and Scottish Drugs Misuse Database 1999/2000.