Public Health Walessub-Regional Health Needs Profile: Flintshire & Wrexham
Public Health WalesSub-regional health needs profile: Flintshire & Wrexham
Map of Flintshire & its GP Clusters (Localities)
Flintshire UA / North East Flintshire / North West Flintshire / South Flintshire
Geography / Flintshire covers an area of 437 square kilometres.
Flintshire has a population of 350 people per square kilometres; this is the highest population density in North Wales. / 94% of patients (57,080 people) registered with North East Flintshire GP Cluster live in an urban area; 3.4% (2,050 people) live in a rural area (small town/fringe); 2% (1,390 people) live in a rural area (village/hamlet/isolated dwellings). / 76% of patients (29,600 people) registered with North West Flintshire GP Cluster live in an urban area. 24% of patients (9,230 people) live in a rural area (village/hamlet/isolated dwellings); 1% (220 people) live in a rural area (small town/fringe). / 33% (16,090 people) of patients registered with South Flintshire GP Cluster live in an urban area; 42% (20,440 people) live in a rural areas (small town/fringe); 25% (12,120 people) live in a rural area (village/hamlet/isolated dwelling).
Population / Flintshire has a resident population of 153,240.
19%of the population (28,410 people) are aged 0 to 15 years; 62% (95,489 people)are aged 16 to 64 years; 19% (29,341 people) are aged 65 years and over; and 2% (3,187 people) are aged 85 years and over. / 61,100 patients are registered with North East Flintshire GP cluster area.
17% (10,440) patients registered with North East Flintshire GP Cluster are aged 65 years and over.
2% (1,210) patients registered with North East Flintshire GP Cluster are aged 85 years and over. / 36,800 patients are registered with North West Flintshire GP Cluster.
19% (6,970 people) are aged 65 years and over.
2% (830 people) are aged 85 years and over. / 48,720 patients are registered with South Flintshire GP Cluster.
20% (9,920 people) are aged 65 years and over.
2% (1,160 people) are aged 85 years and over.
Deprivation / 4% of LSOAs in Flintshire (5,876 people) are in the 10% most deprived LSOAs in Wales; 11% of LSOAs (15,109 people) are in the 20% most deprived; 17% (25,723) are in the 30% most deprived; and 32% (47,570 people) are in the 50% most deprived LSOAs in Wales. / The proportion of North East Flintshire GP cluster patients who reside in each fifth of deprivation:
Most deprived: 13% (7,680 people)
Next most deprived: 18% (10,700 people)
Middle: 10% (6,200 people)
Next least deprived: 30% (17,920 people)
Least deprived: 30% (18,020 people) / The proportion of North West Flintshire GP cluster patients who reside in each fifth of deprivation:
Most deprived: 19% (7,530 people)
Next most deprived: 26% (9,970 people)
Middle: 9% (3,540 people)
Next least deprived: 30% (11,670 people)
Least deprived: 16% (6,340 people) / The proportion of South Flintshire GP cluster patients who reside in each fifth of deprivation:
Most deprived: 3% (1,470 people)
Next most deprived: 4.1% (1,990 people)
Middle: 19% (9,400 people)
Next least deprived: 22% (10,800 people)
Least deprived: 51% (25,000 people)
Welsh Language / 13% of Flintshire’s population aged 3 years and over are able to speak Welsh (19,340 people). This is lower than the averages for North Wales (35%) and Wales (19%).
Map of Wrexham & its GP clusters (Localities)
Population Projection, Wrexham, 2011 to 2036
A summary of the demographics of Wrexham
Wrexham UA / South Wrexham / West & North Wrexham / Wrexham Town
Geography / Wrexham UA covers an area of 504 square kilometres.
Population density of Wrexham is 271 residents per square kilometre. / 62% (29,500 people) registered with South Wrexham GP cluster live in an urban area; 19% (8,890 people) live in a rural area (small town/fringe); 19% (8,890 people) live in a rural area (village/hamlet/isolated dwellings). / 52% (20,770 people) registered with West & North Wrexham GP cluster live in an urban area; 36% (14,100 people) live in a rural area (small town/fringe); 12% (4,630 people) live in a rural area (village/hamlet/isolated dwelling). / 90% (46,770) patients registered with Wrexham Town GP cluster live in an urban area; 6% (3,150 people) live in a rural area (village/hamlet/isolated dwelling); 3.5% (1,800 people) live in a rural area (small town/fringe).
Population / Wrexham has a resident population of 136,399.
19% of the population (26,233 people) are aged 0 to 15 years; 63% (85,342 people) are aged 16 to 64 years; 18% of the population (24,824 people) are aged 65 years and over; and 2% of the population (3,078 people) are aged 85 years and over. / 53,150 patients are registered with South Wrexham GP cluster.
19% (9,990 people) are aged 65 years and over.
3% (1,330 people) are aged 85 years and over. / 39,830 patients are registered with West & North Wrexham GP cluster.
18% (7,030 people) are aged 65 years and over.
2% (820 people) are aged 85 years and over. / 51,180 patients are registered with Wrexham Town GP cluster.
17% (8,800 people) are aged 65 years and over.
2% (1,220 people) are 85 years and over.
Deprivation / 6% of LSOAs in Wrexham (7,690 people) are in the most deprived 10% in Wales; 14% (19,790 people) are in the 20% most deprived; 29% (39,860 people) are in the 30% most deprived; and 44% (58,740 people) are in the 50% most deprived LSOAs in Wales. / The proportion of South Wrexham GP cluster patients who reside in each fifth of deprivation:
Most deprived: 9.7% (4,620 people)
Next most deprived: 27.6% (13,100 people)
Middle: 20.1% (9,550 people)
Next least deprived: 21.9% (10,370 people)
Least deprived: 20.4% (9,680 people) / The proportion of West & North Wrexham GP cluster patients who reside in each fifth of deprivation:
Most deprived: 15% (5,900 people)
Next most deprived: 13% (5,220 people)
Middle: 20% (7,720 people)
Next least deprived: 23% (8,960 people)
Least deprived: 30% (11,690 people) / The proportion of Wrexham Town GP cluster patients who reside in each fifth of deprivation:
Most deprived: 21% (10,670 people)
Next most deprived: 15% (7,820 people)
Middle: 22% (11,320 people)
Next least deprived: 20% (10,170 people)
Least deprived: 23% (11,770 people)
Welsh Language / 13% of Wrexham’s population aged 3 years and over are able to speak Welsh (16,659 people). This is lower than the averages for North Wales (35%) and Wales (19%).
Our Statement of Need
Heath priorities / Summary assessment of health need for the North Wales Population / Current Status for the population of
North Wales / Current Status for the population of
Flintshire / Current Status for the population ofWrexham
Reducing health inequalities / Life expectancy at birth in North Wales is comparable to Wales. Life expectancy in North Wales increased between 2001- 2005 and 2005- 2009 from 76.4 years to 77.3 years for men and from 80.6 years to 81.5 years for women.
Differences in life expectancy between the least and most deprived communities in North Wales have remained broadly consistent over the last 10 years.
Variation in health outcomes among groups in the population sharing protected characteristics (age, gender reassignment, sex, race, disability, pregnancy and maternity, sexual orientation, religion/belief).
The NHS has a crucial role in reducing this gap by ensuring appropriate access to services and working with local partners to tackle the underlying causes of inequality. / The average boy born in the most deprived area is likely to live just over 7 years less than the average boy born in the most affluent area, and likely to spend 14 additional years in poorer health. Life expectancy at birth for females living in the mostdeprived areas in North Wales is over 5 years less than the leastdeprived areas and likely to spend 13 additional years in poorer health.
11.9% of the population are in the most deprived fifth of areas in Wales, compared to an average of 19.2% across Wales.There is substantial variation in deprivation locally, ranging from 27.5% to 3% of the population living in the most deprived fifth. / The average boy born in the most deprived area of Flintshire is likely to live just over 7 seven years less than the average boy born in the most affluent area, and likely to spend just over 14 additional years in poorer health. Females living in the most deprived areas in Flintshire are likely to live almost 7 years less than the average girl born in the most affluent parts of the county and likely to spend just over 13 additional years in poorer health.
3.9% of Flintshire’s population live in the 10% most deprived LSOAs in Wales. / The average boy born in the most deprived area of Wrexham is likely to live just over 9 years less than the average boy born in the most affluent area, and likely to spend over 16 additional years in poorer health. Females living in the most deprived areas of the county are likely to live 8 years less than the average female born in the most affluent area, and just over 15 additional years in poorer health.
5.8% of Wrexham’s population live in the 10% most deprived LSOAs in Wales.
Early Years / Foundations for all aspects of human development laid down before birth and in early childhood (0-5 years)
Strong economic case demonstrates that early interventions pay back costs many times over.
Later interventions are considerably less effective where good early foundations are lacking. / There are around 7,800 live births a year in North Wales.
27% of pregnant women have a BMI over 30.
7% of babies in North Wales are born pre-term (less than 37 weeks)
5% of singleton babies in North Wales are low-birth weight (less than 2500g).
Infant mortality rates in North Wales are higher than Wales (4.7 per 1000 births compared to 4.4 per 1000). Wales rates are higher than in England and considerably higher than many European countries
59% of babies in North Wales are breast fed at birth compared to 56% across Wales.
26% of children aged 4 and 5 years in North Wales are overweight or obese, the same as the Wales average. In North Wales and Wales, 27% of boys and 26% of girls are overweight or obese.
19% of children and young people aged under 20 years in North Wales live in poverty, compared to the Wales average of 22.2%. / There are around 1,700 live births a year in Flintshire.
7% of babies in Flintshire are born pre-term (less than 37 weeks).
6% of singleton babies born in Flintshire are low-birth weight (less than 2500g).
Infant mortality rates in Flintshire are 4.5 per 1,000 births.
52% of babies in Flintshire are breastfed at birth.
In Flintshire, 25% of children aged 4 to 5 years are overweight or obese; 26% of boys and 25% of girls.
17% of children in Flintshire live in poverty. / There are around 1,730 live births a year in Wrexham.
7% of babies in Wrexham are born pre-term (less than 37 weeks).
6% of singleton babies born in Wrexham are low-birth weight (less than 2500g).
Infant mortality rates in Wrexham are 4.1 per 1,000 births.
60% of babies in Wrexham are breastfed at birth.
In Wrexham, 25% of children aged 4 to 5 years are overweight or obese; 25% of boys and 25% of girls.
20% of children in Wrexham live in poverty.
Chronic and Long Term Conditions including Cardiovascular Diseases and Cancer / The largest causes of death and premature death.
All associated with poorer quality of life.
All are largely preventable.
Diseases which generate substantial activity and consume large amounts of NHS resources.
Multi-morbidity (having more than one long term condition) is increasingly the norm.
Higher prevalence in disadvantaged communities. / Almost half of all adults over 16 in Betsi Cadwaladr University Health Board report living with at least one chronic illness.
Cardiovascular disease causes around 2,190 deaths per year in North Wales. 152 per 100,000 population of North Wales die from a cardiovascular disease, which is lower than the average for Wales (157 per 100,000 population).
Cancer accounts for about 30% of all deaths in men and 25% of all deaths in women. Cancer causes around 2,040. 166 per 100,000 population of North Wales die from cancer, which is lower than the average for Wales (173 per 100,000 population).
The numbers and percentages of patients in North Wales GP practices registered as having one of the main chronic conditions:
Hypertension: 111,150 (16%)
Asthma: 46,850 (7%)
Diabetes: 34,680 (5%)
CHD: 29,720 (4%)
COPD: 16,770 (2%)
Epilepsy: 4,980 (1%)
Heart failure: 6,750 (1%)
Total: 250,900 (36%) / Flintshire has a cardiovascular disease mortality rate of 154 per 100,000, which is around 409 deaths per year. The rate for Flintshire is above the average for North Wales (152 per 100,000 population) but below the Wales average (157 per 100,000 population).
Flintshire has a cancer related mortality rate of 166 per 100,000 population, which is around 400 deaths per year. The rate for Flintshire is the same as the North Wales rate and lower than the average for Wales (173 per 100,000 population).
The total number and percentage of patients registered in a Flintshire GP Cluster practices as having one of the mainchronic conditions:
Asthma: 9,920(7%)
Hypertension: 22,970 (15%)
CHD: 5,890 (4%)
COPD: 3,120 (2%)
Diabetes: 7,390 (5%)
Epilepsy: 900 (1%)
Heart failure: 1,210 (1%)
Total: 51,400 (35%) / Wrexham has a cardiovascular disease mortality rate of 145 per 100,000, which is around 360 deaths per year. The rate for Wrexham is below the averages for North Wales (152 per 100,000 population) and Wales (157 per 100,000 population).
Wrexham has a cancer related mortality rate of 167 per 100,000 population, which is around 358 deaths per year. The rate for Wrexham is just above North Wales rate (166 per 100,000 population) and lower than the average for Wales (173 per 100,000 population).
The total number and percentage of patients registered in Wrexham GP Cluster practices as having one of the main chronic conditions:
Asthma: 9,970 (7%)
Hypertension: 23,050 (16%)
CHD: 5,790 (4%)
COPD: 3,400 (2%)
Diabetes: 6,900 (5%)
Epilepsy: 1,080 (1%)
Heart failure: 1,290 (1%)
Total: 51,480 (36%)
Mental Health and Learning Disabilities / Mental illness is a leading cause of suffering, economic loss and social problems. It accounts for over 15% of the disease burden in developed countries.
Largest single area of NHS spend.
Strong association with health inequalities.
Leading cause of suffering, economic loss and social problems. / In North Wales, around 92,265 people have one of the common mental disorders; 13% of males and 20% of females. These include mental conditions that cause emotional distress and interfere with daily function, but do not usually affect insight or cognition.
10% of 5 to 16 year olds in North Wales (8,830 children) have a mental health disorder; the average across Wales is also 10%.
The number of people aged 18 or above predicted to have a learning disability is estimated to rise from around 12,900 in 2013 to around 13,700 by 2030. / In Flintshire, around 20,210 people aged 16 years and over have a common mental disorder.These include mental conditions that cause emotional distress and interfere with daily function, but do not usually affect insight or cognition.
10% of 5 to 16 year olds in Flintshire (2,035 children)have a mental disorder.
The number of people aged 18 years and over predicted to have a learning disability is estimated to rise from just over 2,800 in 2013 to just over 2,900 by 2030. / In Wrexham, around17,960 people aged 16 years and over have a common mental disorder.These include mental conditions that cause emotional distress and interfere with daily function, but do not usually affect insight or cognition.
10% of 5 to 16 year olds in Wrexham (1,780 children) have a mental disorder.
The number of people aged 18 years and over predicted to have a learning disability is estimated to rise from around 2,500 in 2013 to around 2,950 by 2013.
Frailty, including Dementia / Frailty can be defined as ‘Decline in several physiological systems which collectively results in a vulnerability to sudden health changes triggered by relatively minor stressors’. This includes decline in both physical and mental capabilities.
Rising life expectancy reflected in growing numbers of older people in whom frailty is more likely.
Frailty – especially in older people – generates significant use of NHS and social care services.
Integrated service provision and closer working between health and social services can lead to improved independence and help maintain people in their own homes/ communities. / The prevalence of frailty increases steadily with advancing years, and is estimated to affect around 25% of those over the age of 85.
In BCU HB, 3% of the population are aged 85 years and over. There is a large variation locally, ranging from 2% to 4%
The North Wales population aged over 85 is estimated to be 24,690 by 2020, with 1 in 4 affected by frailty.
More than 800 people over the age of 65 are admitted to our hospitals with hip fractures each year (495 per 100,000 population). / The prevalence of frailty increases steadily with advancing years, and is estimated to affect around 25% of those over the age of 85.
In Flintshire, 2% of the population are aged 85 years and over; the lowest proportion across North Wales.
The number of people living in Flintshire aged 85 years and over is expected to rise from 3,380 in 2013 to 4,460 by 2020 and 7,440 by 2030.
In Flintshire, around 185 people aged 65 years and over are admitted to our hospitals with hip fractures each year (601 per 100,000 population). / The prevalence of frailty increases steadily with advancing years, and is estimated to affect around 25% of those over the age of 85.
In Wrexham, 2% of the population are aged 85 years and over.
The number of people living in Flintshire aged 85 years and over is expected to rise from 3,130 in 2013 to 3,920 in 2020 and 6,170 by 2030.
In Wrexham, over 100 people aged 65 years and over are admitted to our hosp0itals each year with hip fractures (394 per 100,000).
Key Factors Which Support Good Health
The major population health assets and why they are important
Current Status for the population of
North Wales / Current Status for the population of
Flintshire / Current Status for the population of
Wrexham
People do not smoke / Smoking is a risk factor for all major causes of death and ill-health, and a key factor in inequalities in health outcomes.
Reductions in smoking are followed by reductions in disease.
There is variation in smoking rates across North Wales, and within different population groups. / 21% of adults in North Wales reported being a smoker in 2012+13 compared to 23% in 2011+12.
33% of women in Wales are recorded as smoking before or during pregnancy. / 20% of adults in Flintshire reported being a current smoker in 2012+13. This is down from 22% in 2011+12. / 21% of adults in Wrexham reported being a current smoker in 2012+13; this is down from 23% in 2011+12.
People maintain a healthy weight for their height by eating healthily and exercising regularly / Obesity and overweight is a major risk factor in developing a number of chronic conditions including diabetes, musculo-skeletal disorders and some cancers.
Obesity and overweight is a cause of premature mortality.
Obesity levels are rising, and are highest in Wales compared to the rest of the UK.
Over a quarter of children aged 4 to 5 years in North Wales are overweight or obese. / The percentage of adults in North Wales who are overweight or obese (Body Mass Index (BMI) 25 or over) has increased slightly from 56% in 2011+12 to 57% in 2012+13.
21% of adults reported being obese in North Wales in 2012+13, which is lower than the average for Wales (23%).
36% of people in BCU report eating the recommended levels of fruit and vegetables each day, which is significantly higher than the average for Wales (33%).
30% of adults in North Wales reported being active on 5 or more days a week in 2012+13. 32% of adults reported having no active days, which is lower than Wales (34%). 32% of adults in North Wales reported having no active days, compared to 34% across Wales. / 56% of adults in Flintshire reported being overweight or obese in2012+13; this is a small decline from 57% in 2011+12.
21% of adults in Flintshire reported being obese in 2012+13; this is a slight decline from 22% in 2011+12.
33% of adults in Flintshire reported eating the recommended guidelines of fruit and vegetables; this is an increase from 31% in 2011+12.
32% of adults in Flintshire report being active on 5 or more days a week in 2012+13; this has increased from 28% in 2011+12. 32% of adults reported having no active days. / 60% of adults in Wrexham reported being overweight or obese in 2012+13; this is an increase from 58% in 2011+12.
25% of adults in Wrexham reported being obese in 2012+136; this is an increase from 22% in 2011+12.
33% of adults in Wrexham reported eating the recommended guidelines of fruit and vegetables; this is a fall from 37% in 2011+12.
27% of adults in Wrexham reported being active on 5 or more days a week in 2012+13; this has declined from 30% in 2011+12. 35% of adults reported having no active days.
People do not drink alcohol above recommended levels. / Excessive Alcohol consumption is a risk factor for the biggest causes of premature death
Health issues from excessive alcohol consumption are preventable / In 2012+13, 43% of adults reported drinking alcohol above the recommended guidelines, compared to 42% across Wales.
26% of adults in North Wales reported binge drinking.
43% of young people aged 16 to 24 years in North Wales are drinking alcohol above recommended levels. / 44% of adults in Flintshire reported drinking alcohol above the recommended levels in 2012+13; this is the highest across North Wales.
29% of adults in Flintshire reported binge drinking in 2012+13; this has increased slightly from 28% in 2011+12. / 43% of adults in Wrexham reported drinking alcohol above the recommended levels in 2012+13.
25% of adults in Wrexham reported binge drinking in 2012+13; this is a slight drop from 26% in 2011+12.
People have positive Mental Well-Being / Positive mental well-being is a key protective factor against mental illness.
Positive mental health leads to better outcomes in physical health, health behaviours, educational performance, employability and earnings, and crime reduction. / In 2011, people in North Wales generally reported being happier and more satisfied with life, and less anxious than the Wales and UK population.
The mean SF-36 mental component summary score for adults in North Wales is 50.4, which is higher the average for Wales (49.6). Locally, scores range from 49.3 to 51.4. A higher score indicates better health or wellbeing. / The mean SF-36 mental component summary score for adults in Flintshire is 50.7. A higher score indicates better health or wellbeing. / The mean SF-36 mental component summary score for adults in Wrexham is 49.3. A higher score indicates better health or wellbeing.
People are protected through Vaccination and Immunisation programmes. / After clean water, vaccination is the most effective public health intervention in
the world for saving lives and promoting good health.
Consequences of low levels of uptake of childhood vaccination can be severe.
Childhood vaccine coverage is not yet reaching all Target levels across North Wales.
Flu vaccination levels are below the national targets.
Effective vaccination will reduce illness particularly. in frail people / Childhood vaccination coverage in North Wales has steadily improved over the last few years.
85% of 4 year olds in North Wales are up to date with immunisations compared to 82% across Wales.
Uptake for 3 complete doses of HPV vaccine in North Wales is 88% compared to the Welsh average of 87%.
Uptake of the flu vaccination by people aged 65 years and over in North Wales is 71% compared to 68% across Wales. 54% of people aged under 65 years who are ‘at risk’ received the vaccination compared to 51% across Wales. / 85.6% of 4 year olds in Flintshire are up to date with immunisations.
Uptake for 3 complete doses of HPV vaccine in Flintshire is 90%.
Uptake of the flu vaccination by people aged 65 years and over in Flintshire is 73%, which is above the averages for North Wales (71%) and Wales (68%). 56% of people aged under 65 years who are ‘at risk’ received the vaccination compared to 53% across North Wales and 51% across Wales. / 88% of 4 year olds in Wrexham are up to date with immunisations.
Uptake for 3 complete doses of HPV vaccine in Wrexham is 89%.
Uptake of the flu vaccination by people aged 65 years and over in Wrexham is 74%, which is above the averages for North Wales (71%) and for Wales (68%). 58% of people aged under 65 years who are ‘at risk’ received the vaccination compared to 53% across North Wales and 51% across Wales.
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