The Healthier Well-being Goal contained within the Well-being of Future Generations (Wales) Act 2015 describes Wales as:
Social well-being can broadly encompass being healthy and actively engaged with life and with other people and having the ability to exercise control over these factors.
Social well-being will be broken down into 5 sub-themes:
Having a good network of family and friends
Being active or keeping fit (being healthy)
Being happy or content
Having more time to spend on activities and being with family and friends
Activities being affordable
The World Health Organisation defines health as:
Good health is a vital component of wellbeing and should be seen as a resource or an asset that helps us lead our everyday lives. It provides us with the physical and emotional resilience we need to cope with difficult times and live satisfying lives.
Life expectancy is a measure of the average number of years individuals can be expected to live for and healthy life expectancy measures how many years of that life, on average, can be expected to be lived in good health; both are seen as indicators of how healthy a population is.
Many factors may influence the health of a population, such as:
People living in Neath Port Talbot ( NPT ) are living longer and the average life expectancy for people living in the borough is now 77.0 years for men and 81.2 years for women. However, this is low when compared to 78.3 and 82.3 years for men and women respectively across Wales and there is also substantial variation in life expectancy across the County Borough area.
People living in NPT are also spending more years living in good health than they have done in the past, with healthy life expectancies of 61.9 years for men and 62.4 years for women. Again, this is significantly lower than the Welsh average of 65.3 years for men and 66.7 years for women.
The difference in life expectancy between males living in the least deprived and most deprived areas of NPT is 6.2 years and the gap in healthy life expectancy is even larger at 16.9 years; however, unlike Wales as a whole, these gaps have noticeably narrowed since the 2005-9 period.
The difference in life expectancy between males living in the least deprived and most deprived areas of NPT is 7.4 years, with a healthy life expectancy gap of 18.4 years. Unfortunately, for women the gap between those living in the most and least deprived areas appears to have increased over recent years. Evidence suggests that this is because women living in the most deprived areas of NPT have not seen the improvements in life expectancy over time that men and women living in less deprived areas have enjoyed.
Over three quarters (77.7%) of adults living in NPT felt their health was either good or very good, which is very similar to the average across Wales (Census, 2011).
Conditions and illnesses that are felt to be limiting a person’s lifestyle and ability to work, especially over the longer term, are an important measure of the health of a community.
In NPT 72% of working age adults consider themselves to be free from a limiting long term condition; this is actually significantly lower than the average for Wales.
A separate survey found that those in the local area who had a long term health condition were also less likely to be in work than those with similar limitations from other areas of Wales; there was an 18% gap between employment rates with those with and without a long term condition in NPT, compared to a 12% gap on average across Wales.
The proportion of the population registered with a GP who experience a range of significant chronic conditions is generally slightly higher for the NPT area when compared with the local Health Board area as a whole (also containing Swansea and Bridgend). Levels of hypertension and diabetes are noticeably higher here than the average for the health board.
“Mental health is a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her own community”.
Mental health disorders are very common. In Wales, 1 in 4 adults will experience some kind of mental health problem or illness within their lifetime, 2 in 100 people will have a severe mental illness such as schizophrenia or bipolar disorder (Together for Mental Health, 2012)
Satisfaction with your own life is an important measure of mental wellbeing, taking into account an individual’s personal perspective of their life; within working age adults in NPT the proportion of people who were satisfied with their own lives (81.4%) was close to the Welsh Average (82%).
Access to healthcare services is a very important aspect of maintaining a healthy population and maintaining the wellbeing of those who may be suffering from ill health.
The levels of healthcare service use among adults in NPT are similar to usage across the health board area and across Wales. In NPT a slightly higher proportion of adults had talked to their GP in the past 2 weeks and a slightly higher proportion had attended an A&E department in the last year; fewer people in NPT had visited their dentist in the last year.
Ensuring good maternal health and a safe caring environment for children, as well as reducing poverty and deprivation are essential for a good start in life. In Wales, Adverse Childhood experiences (ACEs), such as child maltreatment and/or living in a household affected by parental separation, domestic violence, mental ill health, alcohol, drug abuse or in the incarceration of a parent are associated with:
Over half of the violence and drug abuse
Over a third of teenage pregnancies
Nearly a quarter of current adult smoking
In NPT 30% of children live in poverty, this is greater than the Wales average of 26%
The number of children in care of social services in NPT is 135 per 10,000 children aged under 18, this has risen sharply from 88 per 10,000 in 2006
The World Health Organization says: The two public health interventions that have had the greatest impact on the world’s health are clean water and vaccines. Vaccinations are a safe and effective way to ensure the community, especially babies and children, are protected against disease.
Childhood vaccination rates for NPT are above the recommended 95% for all vaccinations given to those under a year old. However by the time they reach the age of 4 years, only 85.4% of children were up to date in the schedule of vaccinations in 2015/16.
There are a number of vaccinations available to protect against disease. Influenza (flu) vaccine protects against the flu virus. A flu vaccination programme for children is gradually being introduced in Wales.
In NPT 63.8% of people aged 65 years and older had the flu vaccine. This is around 18,000 out of around 29,000 people who were entitled to receive the vaccine. This is lower than the Wales average (66.1%)
Out of 17,156 people in clinical risk groups (such as those with conditions like diabetes, heart disease, respiratory disease) who were entitled to have the vaccine, only 7,609 people were vaccinated (44.4%), and lower than the Wales average (46.2%)
Of children in NPT aged 2-3 years, 43.4% received their flu vaccination; this is lower than the Wales average 44.9%. Compared to last year’s uptake however this is a great improvement, where in 2015-16 it was 28% uptake.
There is good evidence that adopting four or more healthy behaviours can reduce the risk of diabetes by 72%, vascular diseases by 67%, dementia by 64% and cancers by 35%, when compared with those who have less than two healthy behaviours.
In the ABM area, 13% of those aged over 16 have four or more healthy behaviours.
Obese children are more likely to become overweight or obese adults. Children who are obese may experience more social and emotional problems than children of a healthy weight.
Data from the latest population survey in 2014-2015 indicates that a slightly higher percentage of children in NPT are overweight (15.1%) compared to surrounding areas. 11.8% of children in NPT are obese.
The proportion of babies in NPT (32%) exclusively breastfed at 10 days following birth is significantly lower than Wales (44%).
The rising burden of obesity in adults is a major public health concern. The increase in poor diets and physical inactivity has led to an increase in people who are overweight or obese.
Obesity levels in NPT have been rising over the past ten years. 26% of adults in NPT are classed as obese. This is significantly higher than the Wales average (22%).
Similarly the levels of overweight/obesity has increased and been consistently above the Wales average. 62% of the NPT adult population is classed as overweight/obesity compared to the Wales average of 58%.
At the current level of increase, it is predicted that obesity rates will continue to rise in the future and by 2035 approximately 72,000 adults NPT will be obese.
Not enough adults or children are physically active enough to protect their health. To stay healthy, adults should try to be active daily and should do at least 150 minutes of moderate activity (such as fast walking) every week, and strength exercises on two or more days a week that work all the major muscles.
Physical activity contributes to well-being and is essential for good health.
40% of adults in NPT are not physically active on any day of the week. This is considerably higher than the Wales average (34%).
Only 26% of adults in NPT are physically active to the recommended guidelines (5 days or more a week). This is lower than the Wales average (30%).
Adults in NPT are physically active on average for only 2.1 days per week.
A healthy diet is a major component of healthy living. The Welsh Health Survey includes measurement of a healthy diet which is defined as the consumption of five or more portions of fruit and vegetables the previous day.
The healthy eating habits of people in NPT appear to be declining. Only 27% of adults reported to have eaten five or more portions of fruit/vegetables on the previous day. This is below Wales (33%).
By around 2025, the eating habits of people is predicted to decline even further, with approximately 13% of people not consuming enough of a healthy diet to benefit their health.
Smoking is a significant contributor to respiratory disease including chronic obstructive pulmonary disease and the exacerbation of asthma, and many cancers.
Although smoking rates are falling in Neath Port Talbot, 21% of adults in the county still smoke. This is higher than the average number of smokers in bordering counties (Bridgend 18%, Swansea 17%) and in Wales as a whole (20%).
Alcohol consumption is associated with many chronic health problems including mental ill health, as well as social problems such as crime, assault and domestic violence.
Of the NPT population 13% report very heavy alcohol consumption on a day in the past week (14% Wales), with 23% reporting binge (heavy) drinking (25% Wales). Heavy drinking increases the risk of unemployment and contributes to working days lost due to absences from work, job loss and reduced employment opportunities.
Whilst alcohol consumption above recommended guidelines appears to have fallen across NPT over the last five years, 36% of the population in NPT drink above the recommended level. This is lower than Wales (41%).
Alcohol related hospital admissions are marginally higher in NPT than in Wales.
There are more alcohol related deaths in the most deprived areas.
The illegal and / or hidden nature of much substance misuse that occurs in society makes is hard to measure its prevalence amongst the population.
The Welsh Government’s National Database for Substance Misuse provides details of the rate of referrals to treatment services in Wales.
In 2014-15 there were 2004 referrals in NPT with drugs and/or alcohol as the main problem.
737 of these were females; with the majority being males (1267).
The average age of individuals referred was 41 years of age.
64% of people experiencing substance misuse issues, also had issues with employment and were not in work.
7% had housing problems and 33% experienced Mental health issues.
During November 2015-october 2016 there were 27 Non-Fatal Overdoses and 10 fatal overdoses.
The rate for hospital admissions for poisoning episodes by a named illicit drug in Neath Port Talbot (143 per 1000 people) were 19.2 per cent above the Wales age standardised rate for 2014-15.
The age standardised admissions rate for named illicit drugs has risen in NPT by 13.5 per cent over the past five years.
Age standardised rate for admission following poisoning by a named illicit drug, 2010-11 to 2014-15, selected geographies. Source: Patient Episode Database Wales, Substance Misuse Programme, Public Health Wales
Safety is a wide-reaching concept, covering many familiar ideas such as:
Living in an area that is unsafe, or is felt to be unsafe, can have many negative effects on wellbeing.
Neath Port Talbot contains a wide and varied range of safety risks, including industrial sites such as Tata Steel, BOC, Vale Inco, the UK’s largest Biomass Power Plant and the 320,000 square metres Intertissue Paper Mill. Alongside this, NPT also has a deep water harbour and numerous Coastal and Inland Waterways, the M4 Motorway, high speed rail links, and extensive forested areas – all of these provide both safety challenges and wellbeing assets.
Crime, both perceived and actual, forms an important component of community safety and can contribute substantially to how individuals feel about their community as well as their personal wellbeing.
In the NPT area, 79% of people reported that they felt safe when walking around their local area after dark; this rose to 94% of people feeling safe in their homes after dark.
The rate of reported crimes in the NPT area is noticeably higher than the average rate for Wales.
The Crime Commissioner’s Compass Survey for 2016-17 asked residents of NPT what they felt the biggest crime related problems were in their area; traffic issues were the most commonly raised, with rubbish and litter, and drugs and alcohol, also featuring highly
The Safer Neath Port Talbot report, South Wales Police quarterly performance report, compares the number of reported crimes in the area during the period of July to September in 2015 to the number of reported crimes during the same period in 2016.
The report highlights that there were 748 incidents of violence against a person during the 3 month period in 2016, compared to 652 incidents during the same period in 2015. However, the number of these that were recorded as being domestic related decreased form 288 in 2015 to 265 in 2016.
During the same period, 35 Hate Crimes were recorded in 2016 – this is significantly higher than the 14 cases reported in the same period the previous year. In both years the majority of these were racially motivated.
There was a significant reduction in the number of domestic burglaries reported during the period July-September 2016 compared to the same period the previous year (58 compared to 130).
Over the same periods there appears to have been a slight decrease in the number of incidents of drug trafficking reported (13 during July-Sept 2015 compared to 11 during July-Sept 2016) but a small increase in the number of possession offences (61 during July-Sept 2015 compared to 70 during July-Sept 2016).
Fires, road traffic collisions and other similar incidents are unpredictable disaster that can result in severe injuries and deaths, as well as in the physical destruction of homes, businesses, communities and the natural environment.
Across NPT, during the period 2013-16, there were 5664 incidents involving the Fire and Rescue Services, including 696 property fires, 461 road traffic collisions (RTC) and 813 special service calls.
During these incidents 332 individuals requiring hospitalisation with an additional 523 people injured but not requiring hospital treatment; sadly, 26 individuals lost their lives. Road traffic collisions were by far the largest cause of injury.
To help in reducing these figures, from 2013, Mid & West Wales Fire & Rescue Service and its many partners have delivered over 20,000 home fire safety checks and since 2016 many communities within NPT have received a new home safety check, supported by a wide range of partners within NPT area, which incorporates safety advice including flooding awareness, crime prevention, slips, trip and falls and smoking cessation in an attempt to improve the well-being of the householder as a whole. School’s education and multi-agency partnership working for road safety and grass fires continue across the county.
Welsh Government statistics suggest that the number of people killed or seriously injured on the roads in the NPT area has risen since 2012.
In 2014, 40 people were killed or seriously injured on the roads in the NPT area, with a further 284 people receiving less severe injuries. Of these, 8 pedestrians and 7 pedal bike users were killed or seriously injured, and a further 26 pedestrians and 16 cyclists received other injured.
A minority of road traffic accidents involve drivers that test positive for alcohol on a breath test. Within the NPT area the proportion of drivers who are tested and have a positive result has declined slightly from 5.1% in 2012 to 2.4% in 2014.
77% of households in NPT had access to the internet in 2014-15; although this figure is likely to be rapidly increasing.
The dominant form of housing tenure in NPT continues to be owner-occupier. By 2036 the total number of households in NPT is projected to increase by 6,247 and single person households are projected to grow by 18.2%. But for aged 65+ the number of single person households is predicted to increase by +31.2% by 2035.
How will Social Well-being be affected by Future Trends?
By applying the 2014 Welsh Health Survey prevalence rates to the predicted population size in 2035, and assuming no change to the prevalence rates, the following cautious projections can be made:
The number of obese adults in NPT is projected to rise by almost 2,000 (2.7%) to around 72,000 in 2035.
The prevalence of diabetes in adults across NPT is projected to rise by nearly 300 between 2015-2035 to 10,387.
The number of adults in NPT receiving community based services is projected to rise by approximately 1500 (33%) between 2015-2035.
28% of the NPT population reported that their day-to-day activities are limited a lot or a little by long-term health problems or disability; this is the highest rate in Wales.
The proportion of adults eating a healthy diet (5 or more portions of fruit and vegetables a day) is predicted to decline from 27% in 2014 to 13% in 2025.
The number of people aged 75+ with a limiting long-term illness in NPT is projected to increase from 5,461 in 2015 to 8,947 by 2035 – a 63% increase.
A 50% increase in the number of people ages 65+ in NPT unable to carry out at least one mobility activity on their own is projected by 2035. A 41% increases is anticipated around continence, and a 46% increase in those requiring support to perform household tasks and manage self-care. The largest increases are amongst those aged 80+.
Over 17,000 people aged 65+ years have been predicted to be living alone in the NPT area by 2035, an increase of 33%.
By 2036, the total number of households in NPT is projected to increase by 6,247.
Tel: 01639 763418
Tel: 01639 763418