ONE WARRINGTON: ONE FUTURE
WHERE EVERYONE MATTERS                                                                

A SUSTAINABLE COMMUNITY STRATEGY
FOR WARRINGTON 2009 TO 2030

HEALTHY AND ACTIVE

Where people can enjoy good health and wellbeing

Key strengths

Overall life expectancy in Warrington is improving for both men and women due to improvements in diet and exercise levels over the last five years.

Access times for health services have also improved in recent years. Waiting times for community health services such as speech therapy which are generally poor across the North West have also reduced and GP services are of high quality.

Collaborative and joint working across the partnership, particularly between social care and health services has improved considerably over recent years and is making an impact on some important measures of health. For example, teenage pregnancy rates have fallen and all young mothers have a named specialist Connexions advisor who contacts them regularly and targets support to their individual needs.

There is a good understanding of the ambitions and aspirations of older people and Warrington performs well in helping older people to remain independent for as long as possible.

Since 2001 reported levels of consumption of at least five portions of fruit and vegetables a day have increased by 10%, poor diet behaviour has reduced by 5% and exercise levels have increased by 4%.

Results from the national ‘Active People Survey’ suggest that approximately 23% of Warrington people regularly take part in sport; a similar picture to national averages. Although a social class gradient is apparent in Warrington in terms of participation, this is not as steep as the national gradient. Satisfaction with sport provision within Warrington is very high, with over 73% of respondents reporting that they are happy with local provision.

Challenges and opportunities

The key health challenge facing Warrington is to improve life expectancy and mortality rates from the current position below national averages for England, with a focus on reducing the health inequality gap. Although mortality rates are improving locally, the pace of improvement has not been as great as that of England over recent years. The major contributors to reduced life expectancy in Warrington are circulatory, respiratory and digestive diseases.

The key determinants of Warrington’s below national average position are the stark health inequalities that exist between areas of affluence and deprivation in the borough. Despite some positive trends, the gap in the death rate between inner and outer areas of the borough is 22% and this has not improved over the past eight years. Premature mortality from circulatory disease shows wide variation across Warrington, with central Warrington 47% above the national average and south Warrington 10% below the national average.

The pattern is similar for most diseases with highest rates in the most deprived areas. The map opposite shows how levels of disadvantage relating to poor health or disability vary across the borough. There is a concentration north of the river, with disadvantage most severe in the inner wards, Birchwood and Burtonwood & Winwick.

Warrington has a higher prevalence of coronary heart disease, diabetes, chronic obstructive pulmonary disease and asthma than the England average. The forecast increase in our ageing population is likely to have a considerable impact on the prevalence of many such chronic conditions.

Smoking-related hospital admissions cost approximately £3 million per year in Warrington. There is considerable variation in smoking prevalence across the town and analysis suggests more deprived populations are not accessing Stop Smoking services to the same extent as more affluent groups.

The prevalence of obesity has risen since 2001 with approximately 53% of residents classed as overweight and 18% obese. Variations which follow the pattern of deprivation are again apparent across the town.

Childhood obesity levels are rising in common with the England average. Overall there appears to be a greater proportion of overweight and obese children in year 6 compared to reception year. A similar pattern linked to areas of deprivation is apparent.

Alcohol-related admissions to Accident and Emergency are a key concern and are linked to the prevailing drinking culture which impacts on safety in the town centre. Warrington has one of the highest alcohol-related admission levels in the country with death rates from liver disease for women being nearly twice the national average.

There has been a marked increase in the percentage of people drinking alcohol to unsafe levels since 2001. Variation within Warrington for this type of drinking is not as wide as for the other health determinants and does not follow the usual deprivation patterns. Levels are highest for people living in south Warrington and lowest in the west of the borough. However there are massive differences in the health consequences of alcohol use between the richer and poorer areas of Warrington.

During 2006/7 alcohol related admissions were 44% higher in the 20% most deprived areas of Warrington and these areas demonstrate between two and three times greater loss of life attributable to alcohol.

With an increasing ageing population there is a need to ensure that older people are helped to maintain their independence, dignity and healthin later life. Maintaining the independence of vulnerable groups such as people with learning difficulties, physical disability and mental health needs is also a key priority.

It is clear from all of the evidence highlighted above that health issues are a major challenge and that despite the best efforts of partners little impact has been made over recent years in terms of Warrington’s comparative health position. The successes in reducing hospital and community health waiting times, however, now present the opportunity for diversion of a greater proportion of local health service resources to focus on the prevention agenda. This, combined with better community intelligence, improved targeting of initiatives and neighbourhood involvement in preventative service design should, over time, lead to the improvements we desire.

Our priorities for action

Priority	Things we will do
Reduce premature mortality rates to below the England average	- Review and expand services to manage obesity and smoking cessation - Review and implement alcohol harm reduction strategy - Implement strategy for sport, physical activity and health - Work with communities to encourage healthy lifestyles and increase the take-up of the Healthy Lifestyles programme - Work with local schools and colleges to promote healthy lifestyle to pupils and staff - Introduce an innovative GP centre
Reduce health inequalities across Warrington	- Develop a joint health inequality strategy which will target health improvement initiatives in disadvantaged areas - Develop an intelligence collaborative and data observatory to accurately assess health and social care needs - Ensure a joined up approach across the partnership to tackle deprivation as the key ill-health determinant - Establish Orford Park sport, leisure and health facilities - Develop childhood and adult obesity strategies - Increase the number of children's centres
Support elderly and vulnerable people to live independently	- Develop and implement an older people's strategywhich includes addresssing long term health and social care needs for the borough as well as the wider implications of an ageing population -Increase the number of older people involve in health and fitness programmes - Increase awareness and challenge the stigma of mental health issues by working across education and in the workplace - Develop schemes to support vulnerable people into employment - Undertake a mental health needs assessment - Develop a nursing intermediate care unit at Houghton Hall - Improve arrangements for data sharing across partner agencies to meet the needs of vulnerable people

Our long term targets

By 2030, the average life expectancy at birth will be in the highest 25% nationally.

Closing the gaps

By 2030, we will have no more than 5 SOAs in the worst 10% nationally on the health deprivation and disability index.

How will we know we are making progress?

The following measures will help us keep track of progress:

• Life expectancy at birth (male and female) and the gap between:
  • Warrington and the rest of England
  • the most deprived areas and the rest of the borough.
• All-age all-cause mortality rate*
• Obesity amongst:
  • Adults*
  • Primary school children.*
• Participation in sport*
• Alcohol-harm related hospital admission rates*
• Under 18 conception rate*
• Substance misuse by young people*
• Smoking prevalence in adults and young people*
• Independence for older people through rehabilitation/intermediate care.

* will also be monitored at area/neighbourhood level to focus our improvements on ‘closing the gaps’.

Project and action plans relevant to this ambition are set out in:

• Warrington Primary Care Trust (PCT) Operational Plan 2008/09 to 2010/11
• Warrington PCT Strategic Commissioning Plan
• Alcohol Harm Reduction Strategy
• Health Inequality Strategy
• Vibrant and Active
• Older Persons’ Mental Health Strategy
• Strategy for an Ageing Population
• Children and Young People’s Plan
• Neighbourhood Plans
• Local Development Framework.

How you can help

• Make changes to your lifestyle by walking more and doing more physical activity
• Stop smoking and drink sensibly
• Reduce the amount of salt in your diet
• Make sure children and young people in your care have access to healthy food and take part in physical activity
• Making the most of cultural and recreational opportunities
• Eat at least five portions of a variety of fruit and vegetables every day

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