Health and Disability 2011 Census

Somerset headlines from the 2011 Census

• 5.1% of the Somerset population (26,945 people) described their health as bad or very bad. This is in line with the South West average and slightly below the figure for England and Wales (5.6%).
• Just under 100,000 people in Somerset (18.8% of the population) said they had a longterm condition or disability which limited their day-to-day activities a lot or a little.
• Almost 41,000 of them were aged 16-64 (12.7% of that age group in Somerset). The proportion is on a par with both regional and national averages.
• Those in West Somerset are more likely than anywhere else in the county to consider their health bad or very bad, or to have a limiting disability or condition. This is unsurprising given the district’s high proportion of elderly people.
• Even amongst the 16-64 age group, the proportion for West Somerset is the highest in Somerset.
  Almost 1 in 3 people in Minehead North ward said their activities were limited in this way and the same ward had the fewest percentage of residents in very good health (35%) in Somerset.
• Wards with the healthiest residents tended to be those with high concentrations of armed forces (such as Yeovilton) and major new housing developments (such as Taunton’s Nerrols Farm and Yeovil’s Houndstone).
• Those in the Gypsy & Traveller ethnic group were three times as likely as the average Somerset resident to be in bad or very bad health. This is in line with the national picture.
• 13,317 working-age residents (3.5% of those aged 16-74) described themselves as economically inactive because of long-term sickness or disability. Proportions were much higher in parts of Highbridge, Taunton and central Glastonbury.
• Long-term illness or disability accounted for 12% of all economically inactive 16-74 year-olds, down from 13.5% in 2001.
• There are nearly 9,000 households (3.9% of all households in Somerset) containing at least one adult with a long-term disability or health condition and dependent children.
• Bridgwater’s Sydenham and Hamp areas contained notable concentrations of such households.
• At 14.7 per 1000 usual residents, Taunton Deane had one of the highest proportions in the country of people living in a medical or care communal establishment.
• Taunton Deane was unlike most other local authorities in that most of those living in a medical or care establishment were in a private care home with nursing.

• Health and Disability in Somerset Census Briefing Note
  Overview of the self-reported health and disability of Somerset residents, based on the results of the 2011 Census

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Further Analysis: Illness and self-reported health

Introduction

Whereas most health data are derived from the diagnosis of conditions, some information is available on how well people in Somerset feel.  This is an important supplement to ‘medical’ information on health because it indicates well-being and personal resilience.  The table below compares the percentage of people who reported their health as being ‘good’ or ‘very good’ in the 2011 census with those who said that they do not have any long term illness or disability.

Current  self-reported health in Somerset

Source: ONS Census 2011

It can be seen that the percentages for each are very close to each other, as they are for England as a whole.  The percentage of people without long term illness and percentage in ‘good’ or ‘very good’ health are closely related to the average age of the district.

For all Somerset districts the rank of people feeling well is the same or higher than the percentage without long term illness or disability.  This is related to Somerset’s position as a relatively prosperous area: the greatest positive differences between the two percentages are in the most prosperous districts of the Home Counties.  Local authorities where people tend to feel worse than their actual health condition suggests are generally the poorer areas, especially those in inner London.

Age 65+ Good health vs long-term condition

Census data for small areas show the same close relationship between having a long term condition and reporting ill health.  The figure shows the proportion of people with long term conditions, plotted against the proportion of people saying their health is ‘good’ or ‘very good’, for LSOAs in Somerset.  It is not, though, a perfect relationship and clearly some communities have more people having a long term condition or illness, but feeling well, and some have the reverse.  Areas labelled in black are those where more people report their health to be good than their actual health condition would suggest.  The education and income domains of the Index of Multiple Deprivation both provide additional explanation of the patterns with people in the areas with higher education levels and income reporting better health than would be expected.  The higher social capital of prosperous neighbourhoods is reflected in a better feeling of health as well.

Self-reported health and age

Unsurprisingly, older people tend to report worse health than younger people.  This is shown in the figure using information collected in the 2011 census.  It can also be seen that whilst the level of ‘good’ or ‘very good’ health reported was very high, and varied little, for people under about 35, beyond this age there is a difference in how fast health deteriorates.  In the poor inner London borough of Tower Hamlets, fewer than 50% of the population describes their health as ‘good’ or ‘very good’ at the age of 60; in the wealthy Hampshire district of Hart more than 50% of the people describe their health as ‘good’ or ‘very good’ even by the age of 80.  Incomes, and lifestyle factors such as smoking and drinking, explain the difference.  All Somerset districts show a population generally reporting better health at all ages than the England average.

The relatively small numbers of people living in each Lower Super Output Area mean that the age groups used to show self-reported age have to be combined so that people cannot be identified from the statistics.  The figure shows the percentage of people aged under 16, 16-49, 50-64 and 65 plus who report their health as ‘good’ or ‘very good’ for Somerset as a whole, and four selected LSOAs.  Nerrols Farm, just east of Taunton, reports the highest percentage of the total population describing their health as ‘good’ or ‘very good’. It is a new housing area with a younger population structure than the county as a whole, and the large proportion of younger people, who are ‘naturally’ in good health, gives it this profile.  The Alfred’s Tower area of Somerset, near the Wiltshire border, has the highest proportion of older people reporting their health as good.  Highbridge North East has a relatively older population, which gives it the lowest level of self-reported good health; Bridgwater Hamp West has a very young population structure, pushing up the average, but among older people this area reports the worst health in the county.

Implications for commissioning

This analysis shows, unsurprisingly, that ill health and a feeling of ill health are both greater in older people and in more deprived communities.  It suggests that addressing social inequality can not only improve health but individual’s resilience in the face of ill health.