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Third Sector Public Health
Workshop...Older People
Thursday 6th March 2014
Jim McManus, Director of Public Health

Thanks to Jo Mackenzie, Stephany Villanueva, Raj
Nagaraj, Mark Jordan and Joel Bonnet for developing these
slides
www.hertsdirect.org
Think Intelligence, Think Intelligently
Background
• Voluntary groups make an important contribution to
improving and protecting the health of the population –
from targeted work with vulnerable people to selfmanagement and direct interventions. Public Health skills
and capacity, joined with the voluntary sector’s
connections and “can do” mindset could produce a major
improvement in the health of Hertfordshire and also help
integrate care for people across all sectors.
• The workshops will be an excellent opportunity for the
voluntary sector to contribute to policy development, build
relationships, and discuss new commissioning
arrangements.
www.hertsdirect.org
Think Intelligence, Think Intelligently
About the workshops
• four workshops to explore the role the voluntary
sector can play influencing the development of
public health policy and delivering services.
– Wednesday, 26 February, 14:00 – 16:30: Public Health and
Younger People
– Thursday, 6 March, 09:30 – 12:00: Public Health and Older
People
– Tuesday, 11 March, 14:00 – 16:30: Public Health and Long
Term Conditions
– Tuesday, 18 March, 09:30 – 12:00: Public Health and Mental
Health

www.hertsdirect.org
Think Intelligence, Think Intelligently
Workshop Questions
• Each workshop will consider four questions:
– What is the scope of public health, and what contribution can
the voluntary sector make to service delivery, policy
development, campaigning and tackling health inequalities?
– How can the voluntary sector help improve resilience, selfmanagement and secondary prevention, and so help reduce
unnecessary hospital admissions?
– How can the voluntary sector be better commissioned to
deliver public health interventions? How can relationships
between the voluntary sector and commissioners (DH, local
public health commissioners, GPs, and others) be improved?
– What scope is there to apply commissioning innovations such
as payment by results or a Total Place approach to public
health commissioning?
www.hertsdirect.org
Think Intelligence, Think Intelligently
Hertfordshire Population (2012)

www.hertsdirect.org
Think Intelligence, Think Intelligently
Life expectancy at 65 (years)

Life Expectancy
Male and female life expectancy at 65,
Hertfordshire and East of England, 2004-06 to 2008-2010
22
21
20
19
18
17
2004-06

2005-07

2006-08

2007-09

2008-10

Hertfordshire: Female

East of England: Female

Hertfordshire: Male

East of England: Male

Source: ONS

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Think Intelligence, Think Intelligently
Life expectancy and Deprivation
Life expectancy and disability free life expectancy in Hertfordshire
90
85

Age

80
75
70
65
60
55
30.0

25.0

20.0

15.0

10.0

5.0

0.0

Deprivation
Index of Multiple Deprivation (higher number = high deprivation)

Life expectancy

Disability free life expectancy
Sources: EMPHO/LHO, 2006-10; ONS 1999-2003; DCLG, 2010

www.hertsdirect.org
Think Intelligence, Think Intelligently
Deprivation

www.hertsdirect.org
Think Intelligence, Think Intelligently
Population Projections
Hertfordshire: number and % increase in over 65s
350,000

80%
Hertfordshire total number of persons 65+

300,000

70%

% increase since 2010

60%

250,000

50%

200,000

40%
150,000

30%

100,000

20%

50,000

10%

0

0%
2010

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Think Intelligence, Think Intelligently

2015

2020

2025

2030

2035
Long-term conditions

Long-Term Conditions Projections
14,000
12,000

# Of People

10,000
8,000
6,000
4,000
2,000

N Herts.

E Herts.

Brox.

Think Intelligence, Think Intelligently

Stev.

Dac.

St Alb.

H.mere
Herts Valleys CCG

Three R.

W.ford

2020

2016

2012

2020

2016

2012

2020

2016

2012

2020

2016

2012

2020

2016

2012

2020

2016

2012

2020

Wel Hat.

East & North Herts CCG

www.hertsdirect.org

2016

2012

2020

2016

2012

2020

2016

2012

2020

2016

2012

0
Long Term Conditions

Long Term Health Problem or Disability by Health by Age

Percentage of Population (%)

60
Hertfordshire: Bad
or very bad health

50

40

Hertfordshire: Dayto-day activities
limited a lot

30

England: Bad or
very bad health

20
England: Day-today activities
limited a lot

10

0
0 to 15

16 to 24

25 to 34

35 to 49

50 to 64

Age

www.hertsdirect.org
Think Intelligence, Think Intelligently

65 to 74

75 to 84

85 and over
Dementia
People aged 65 and over predicted to have dementia, by
age, projected to 2020, Hertfordshire
18,000
16,000
14,000
90+

Number of people

12,000

85-89

10,000

80-84

8,000

75-79

6,000

70-74

4,000

65-69

2,000
0
2012
Source: www.poppi.org.uk

www.hertsdirect.org
Think Intelligence, Think Intelligently

2014

2016

Year

2018

2020
Falls
3,000
East of England
Hertfordshire

2,500
2,000
1,500
1,000
500

Source: www.injuryprofiles.org.uk

www.hertsdirect.org
Think Intelligence, Think Intelligently

District

Three Rivers

Welwyn Hatfield

St Albans

Dacorum

Hertsmere

E Hertfordshire

Watford

Broxbourne

N Hertfordshire

0
Stevenage

DSR per 100,000 population

Hospital admissions due to falls, 65 years and over,
directly standardised rate per 100,000 population,
Hertfordshire, by district 2010/11
Physical Activity
Adults with no physical Activity during the week - Hertfordshire
80.0%
70.1%

71.0%

70.0%

70.0%
60.0%

53.7%

50.0%

50.3%

50.0%
40.0%

36.3%

38.7%

34.4%

30.0%
20.0%
10.0%
0.0%
16 to 34

35 to 54
2007/08

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Think Intelligence, Think Intelligently

55+

16 to 34

35 to 54
2008/09

55+

16 to 34

35 to 54
2009/10

55+
Obesity
Projection of Older people with a BMI of 30+ [Hertfordshire]
100%
8.9%

9.1%

9.4%

9.9%

10.3%

12.3%

12.1%

12.0%

12.1%

11.9%

19.0%

18.5%

17.6%

17.6%

18.4%

90%
80%
70%
60%
50%

80-84
23.6%

24.0%

25.4%

28.4%

28.3%

40%

75-79
70-74
65-69

30%

20%

85+

36.2%

36.3%

35.5%

32.1%

31.1%

2012

2014

2016

2018

2020

10%
0%
Source: POPPI, 2012

www.hertsdirect.org
Think Intelligence, Think Intelligently
Thanks!
• Jim.mcmanus@hertfordshire.gov.uk

www.hertsdirect.org
Think Intelligence, Think Intelligently

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Herts third sector public health workshop older people

  • 1. Third Sector Public Health Workshop...Older People Thursday 6th March 2014 Jim McManus, Director of Public Health Thanks to Jo Mackenzie, Stephany Villanueva, Raj Nagaraj, Mark Jordan and Joel Bonnet for developing these slides www.hertsdirect.org Think Intelligence, Think Intelligently
  • 2. Background • Voluntary groups make an important contribution to improving and protecting the health of the population – from targeted work with vulnerable people to selfmanagement and direct interventions. Public Health skills and capacity, joined with the voluntary sector’s connections and “can do” mindset could produce a major improvement in the health of Hertfordshire and also help integrate care for people across all sectors. • The workshops will be an excellent opportunity for the voluntary sector to contribute to policy development, build relationships, and discuss new commissioning arrangements. www.hertsdirect.org Think Intelligence, Think Intelligently
  • 3. About the workshops • four workshops to explore the role the voluntary sector can play influencing the development of public health policy and delivering services. – Wednesday, 26 February, 14:00 – 16:30: Public Health and Younger People – Thursday, 6 March, 09:30 – 12:00: Public Health and Older People – Tuesday, 11 March, 14:00 – 16:30: Public Health and Long Term Conditions – Tuesday, 18 March, 09:30 – 12:00: Public Health and Mental Health www.hertsdirect.org Think Intelligence, Think Intelligently
  • 4. Workshop Questions • Each workshop will consider four questions: – What is the scope of public health, and what contribution can the voluntary sector make to service delivery, policy development, campaigning and tackling health inequalities? – How can the voluntary sector help improve resilience, selfmanagement and secondary prevention, and so help reduce unnecessary hospital admissions? – How can the voluntary sector be better commissioned to deliver public health interventions? How can relationships between the voluntary sector and commissioners (DH, local public health commissioners, GPs, and others) be improved? – What scope is there to apply commissioning innovations such as payment by results or a Total Place approach to public health commissioning? www.hertsdirect.org Think Intelligence, Think Intelligently
  • 6. Life expectancy at 65 (years) Life Expectancy Male and female life expectancy at 65, Hertfordshire and East of England, 2004-06 to 2008-2010 22 21 20 19 18 17 2004-06 2005-07 2006-08 2007-09 2008-10 Hertfordshire: Female East of England: Female Hertfordshire: Male East of England: Male Source: ONS www.hertsdirect.org Think Intelligence, Think Intelligently
  • 7. Life expectancy and Deprivation Life expectancy and disability free life expectancy in Hertfordshire 90 85 Age 80 75 70 65 60 55 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Deprivation Index of Multiple Deprivation (higher number = high deprivation) Life expectancy Disability free life expectancy Sources: EMPHO/LHO, 2006-10; ONS 1999-2003; DCLG, 2010 www.hertsdirect.org Think Intelligence, Think Intelligently
  • 9. Population Projections Hertfordshire: number and % increase in over 65s 350,000 80% Hertfordshire total number of persons 65+ 300,000 70% % increase since 2010 60% 250,000 50% 200,000 40% 150,000 30% 100,000 20% 50,000 10% 0 0% 2010 www.hertsdirect.org Think Intelligence, Think Intelligently 2015 2020 2025 2030 2035
  • 10. Long-term conditions Long-Term Conditions Projections 14,000 12,000 # Of People 10,000 8,000 6,000 4,000 2,000 N Herts. E Herts. Brox. Think Intelligence, Think Intelligently Stev. Dac. St Alb. H.mere Herts Valleys CCG Three R. W.ford 2020 2016 2012 2020 2016 2012 2020 2016 2012 2020 2016 2012 2020 2016 2012 2020 2016 2012 2020 Wel Hat. East & North Herts CCG www.hertsdirect.org 2016 2012 2020 2016 2012 2020 2016 2012 2020 2016 2012 0
  • 11. Long Term Conditions Long Term Health Problem or Disability by Health by Age Percentage of Population (%) 60 Hertfordshire: Bad or very bad health 50 40 Hertfordshire: Dayto-day activities limited a lot 30 England: Bad or very bad health 20 England: Day-today activities limited a lot 10 0 0 to 15 16 to 24 25 to 34 35 to 49 50 to 64 Age www.hertsdirect.org Think Intelligence, Think Intelligently 65 to 74 75 to 84 85 and over
  • 12. Dementia People aged 65 and over predicted to have dementia, by age, projected to 2020, Hertfordshire 18,000 16,000 14,000 90+ Number of people 12,000 85-89 10,000 80-84 8,000 75-79 6,000 70-74 4,000 65-69 2,000 0 2012 Source: www.poppi.org.uk www.hertsdirect.org Think Intelligence, Think Intelligently 2014 2016 Year 2018 2020
  • 13. Falls 3,000 East of England Hertfordshire 2,500 2,000 1,500 1,000 500 Source: www.injuryprofiles.org.uk www.hertsdirect.org Think Intelligence, Think Intelligently District Three Rivers Welwyn Hatfield St Albans Dacorum Hertsmere E Hertfordshire Watford Broxbourne N Hertfordshire 0 Stevenage DSR per 100,000 population Hospital admissions due to falls, 65 years and over, directly standardised rate per 100,000 population, Hertfordshire, by district 2010/11
  • 14. Physical Activity Adults with no physical Activity during the week - Hertfordshire 80.0% 70.1% 71.0% 70.0% 70.0% 60.0% 53.7% 50.0% 50.3% 50.0% 40.0% 36.3% 38.7% 34.4% 30.0% 20.0% 10.0% 0.0% 16 to 34 35 to 54 2007/08 www.hertsdirect.org Think Intelligence, Think Intelligently 55+ 16 to 34 35 to 54 2008/09 55+ 16 to 34 35 to 54 2009/10 55+
  • 15. Obesity Projection of Older people with a BMI of 30+ [Hertfordshire] 100% 8.9% 9.1% 9.4% 9.9% 10.3% 12.3% 12.1% 12.0% 12.1% 11.9% 19.0% 18.5% 17.6% 17.6% 18.4% 90% 80% 70% 60% 50% 80-84 23.6% 24.0% 25.4% 28.4% 28.3% 40% 75-79 70-74 65-69 30% 20% 85+ 36.2% 36.3% 35.5% 32.1% 31.1% 2012 2014 2016 2018 2020 10% 0% Source: POPPI, 2012 www.hertsdirect.org Think Intelligence, Think Intelligently