Welcome and Introduction
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Welcome to my Annual Report for 2009. The main body of the report this year presents an overview of the health status of the 7 Community Assemblies in Sheffield. The establishment of Community Assemblies is a major new initiative undertaken by Sheffield City Council. The assemblies have responsibilities devolved to them for making decisions which affect services in their areas. As part of this, they have scope to take decisions which will impact on the health of the population they serve. It is therefore important that Community Assemblies should be fully informed about the health of those populations.
All the information on the health of the community assembly populations is available on this website. Information is available in both tabular and graphical form.
For each Community Assembly, the Public Health Consultant lead for that assembly has analysed the data available and identified the most important health issues. These analyses are the bulk of the report. In each case, recommendations are made to the Community Assembly as to what each should consider investing in to further improve the health of the local population.
Last year, my annual report was a vehicle for publishing the Joint Strategic Needs Assessment (JSNA). I have not done that again this year because the JSNA is developing as a continuing process by which our joint stock of needs assessment work is continually being expanded. A position statement will be published this autumn, and the full range of needs assessments will be available on-line. Work included in the JSNA will inform the revision of NHS Sheffield’s Strategy, Achieving Balanced Health 3.
The health of Sheffield
Mortality rates continue to fall and life expectancy continues to increase in Sheffield, as shown in the table below. This is of course absolutely to be welcomed.
| Health Outcome | Sheffield | England |
|---|---|---|
| Male life expectancy at birth (years) | 77.2 | 77.7 |
| Female life expectancy at birth (years) | 81.2 | 81.8 |
| Early deaths from heart disease and strokes per 100,000 population | 83.8 | 79.1 |
| Early deaths from cancer per 100,000 population | 122.6 | 115.5 |
| Infant deaths per 1,000 live births | 6.0 | 4.9 |
| Road traffic injuries and deaths per 100,000 population | 54.3 | 54.3 |
All figures relate to the average over the period 2005-2007
However, last year I reported that the gap in life expectancy between the most deprived quintile (one fifth) of the population and the City average had started to increase for men and was levelling off for women. The latest data shows that for both men and women that gap has stayed constant. This is demonstrated in figures 1 and 2.
Figure 1
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Figure 2
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This is because whilst mortality rates are on average falling, mortality rates in the more deprived parts of the population, particularly in men aged 55 to 70, are not falling as fast as they have done in the past or as fast as elsewhere in the City. Linked to this, we are not making as much progress towards preventing premature death (i.e. below the age of 75 years) as we need to, if we are to meet NHS Sheffield’s ambitious target of saving 400 lives (i.e. avoiding 400 premature deaths) by 2012. Figure 3 shows what progress is being made.
Figure 3
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Recommendation: Work to address the major causes of mortality in the more socio-economically deprived parts of the City should be re-invigorated in order to get the reduction in health inequalities in the City back on track and to hit the target of saving 400 lives. This must in particular include every effort to reduce smoking prevalence, including aggressive actions to reduce the availability of smuggled tobacco.
During the course of this year, the new H1N1 strain of the influenza virus – swine flu – has emerged and caused a pandemic. There were many cases in Sheffield in July, but numbers fell substantially through August. With the start of the new school term, the number of cases in children has increased again, and it is clearly possible that this may be the start of a second wave of infection. It remains the case that this is a new strain of influenza, to which the vast majority of the younger population have no immunity. It is therefore likely that during the course of the coming “flu season” we will see large numbers of people being infected. Although the majority of people suffer a relatively mild self limiting illness, a small minority need hospital care, and of these a number are likely to die.
We are therefore working hard to ensure that the health and social care system in the City is as well prepared as possible for this likely second wave of infection. Key to this will be a vaccination programme (once a vaccine is available) but everyone can contribute to minimising spread of infection through personal hygiene measures.
Recommendation: All front line health and social care staff should take up the offer of vaccination when it is available, as should those vulnerable members of the public who are in priority groups. For all of us, personal hygiene remains of paramount importance: - ‘Catch it, bin it, kill it.’
As is customary, this report also contains an update on actions taken following the recommendations made in previous year’s reports. There is one issue which I highlighted in my annual report in 2006 which remains a major concern and is arguably the largest single public health threat to human populations for the medium and longer term 1 . Although climate change has moved well up the national and health agendas over the last 3 years, all the evidence is that we are not, collectively, doing enough to address it.
During the course of this year the NHS nationally has started to address this, and NHS Sheffield has adopted a carbon management plan. Sheffield City Council has led the development of the City's Carbon Reduction Framework which sets out a route map for emissions reduction in the medium term. The City has seen a reduction in carbon emissions since 2005, but sustained effort will be needed in both the short and medium term to ensure continuing progress. And we all need to do much more by way of reducing our own carbon emissions, both as individuals and as organisations, if catastrophic global warming is going to be prevented.
Recommendation: As a first step, I recommend that everyone should calculate their own carbon footprint, and find ways to reduce it. One possible step to doing this would be to sign up to the 10:10 initiative.
I hope you enjoy reading this report, and find it useful. As always, any comments as to its content would be welcomed.
Dr Jeremy Wight
Sheffield Director of Public Health
September 2009
Acknowledgements
As always the Director of Public Health Annual Report is the product of a lot of hard work by many people. In addition to the individual contributions made by the Public Health Consultants credited in the Profiles of Health section, I wish to acknowledge the contributions made by Louise Brewins, John Skinner, Ann Richardson, Ashley King, Georgina Anderson, Emma Hollingworth and Amy Benson.
Contact
Dr Jeremy Wight
Director of Public Health
