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JSNA – Borough Summary

Introduction:

The Barnet Joint Strategic Needs Assessment (JSNA) is the evidence base for understanding population-level need in Barnet. It has been designed to support and inform joined up decision making and commissioning by Barnet Council and Health Partners, alongside the wider public and voluntary sectors, and private sector service providers.

The purpose of a JSNA is to allow the local partnership to improve the health and wellbeing of the population and to reduce disproportionality across the Borough; leading to better outcomes, improved services meeting the needs of the population and better lives for people who live in Barnet. The JSNA is a shared evidence base across partners in the Health and Wellbeing Board (HWBB) and wider public services, enabling alignment of activity and resources around common issues and need across the Borough.

This summary report sits alongside a refreshed JSNA, which is more interactive and allows users to access greater levels of information about the Borough and how it compares to London and England averages. The format of this JSNA also provides an opportunity to understand internal variation across the Borough, through analysis by gender, ward, area committee and deprivation quintiles.

The structure of the JSNA aligns to the Barnet Plan and the Joint Health & Wellbeing Strategy, sitting alongside the three sections of the Barnet Plan:

  1. People
  2. Places
  3. Planet

The measures in each section, where possible, align with the measures which have been identified through each of the workstreams as gauges of progress against objectives within the plan. There are also additional measures which will have an impact on these objectives, as drivers to delivery. To summarise the key statistics, an infographic is also available as part of each section.

Complimenting the JSNA, are ward level insight profiles which provide a local picture of the population and their needs. These summary profiles have been developed using the Local Insight Tool* (https://barnet.communityinsight.org/).

*The Local Insight Tool provides additional borough and national information presented through a map and reports, alongside local service level data where provided.

About the Borough:

Barnet is the largest Borough in London, as measured by its population; the population is estimated by the ONS in 2020 to be 399,000 and is estimated to grow by 5.2% over the next 10 years.

Whilst the population of Barnet is generally similar in age to that of London, it is younger than the England average. Key statistics for our population demographics are:

  • The population aged 65 and over in Barnet is around 58,000, and this is expected to grow by around a quarter in the next 10 years.
  • The population of Children and Young people aged 0-17 is currently estimated to be around 85,300, this is expected to remain similar over the next 10 years.
  • The working age population age 18-64 is currently estimated to be around 255,500 and is expected to slightly increase by 2.5% in the next 10 years.

The dependency ratio for Barnet is expected to reduce slightly from 1.9 to around 1.8 in 2030; indicating the dependent population is growing slightly faster than the working age population. This may lead to a greater demand for services to support older populations living in the Borough.

Barnet is a very diverse place to live, currently 48% of the population is not White; this diversity is expected to continue and grow.

Life Expectancy for both males and females in Barnet has continued to increase, a female born in Barnet in 2020 can expect to live to around 86 years, and for a male, life expectancy is around 83 years. However, Healthy Life Expectancy (the years a person can expect to live in good health) has reduced over the last few years. In Barnet, for both males and females, healthy life expectancy is around three quarters of life expectancy; suggesting for males around 21 years of their life will not be lived in good health and for females it is 22 years. This again could lead to a greater demand for services to support older populations living in the borough.

Family Friendly:

Creating a Family Friendly Barnet, enabling opportunities for our children and young people to achieve their best.

Disproportionality:

We know that children who grow up in poverty are likely to suffer poorer health outcomes throughout their lives compared to children who do not. When it comes to the socio- economic circumstances, in Barnet, in 2018, 12.6% of children were living in relative poverty, significantly lower than the comparable rates for London (16.9%) and England (18.2%). For the same period, 10.7% of children were living in absolute poverty in Barnet. Again, this is considerably lower than comparable rates for London (14.1%) and England (15.1%). Whist this is generally positive there are pockets of deprivation in areas of the Borough.

There were over 5,000 children classified as in need during 2018 across the borough. Although this equates to a lower rate than the London average, the rate in Barnet is increasing. In 2018 there were around 6,600 pupils eligible for Free School Meals (FSM) across both primary and secondary schools. This is likely to have increased during the COVID-19 pandemic.

The Barnet Public Health team addresses health inequalities as part of the work it undertakes and targets actions to those children, young people and their families in greatest need, where appropriate, through localised programmes for support and action.

Early Childhood & Maternal Health

In 2019 there were 4,618 babies born in Barnet. The infant mortality rate in 2017-19 was 2.7 per 1,000 live births which was the eighth lowest infant death rate in London. It is estimated the number of children across Barnet will decrease by 7,000 over the next 20 years, with the number of babies being born slowly declining over the last few years (1.6% lower than in 2018 and 4.2% lower than in 2017).

The proportion of women receiving a 6–8-week health visitor review in Barnet was low prior to 2020/21 and therefore breastfeeding data was unreliable. Based, on locally available data, the proportion of mothers who continue with breastfeeding, as measured at 6-8 weeks,  is higher in Barnet at 57% than the England average of 48% (although the England average is likely to underrepresent the true figure). A new infant feeding strategy, co-produced with LBB’s partners, is in development and aims to increase breastfeeding rates across the borough.

Vaccinations

The childhood immunisation programme is well established and is designed to provide protection to children and the wider population from vaccine preventable diseases, which can be deadly or have long term impacts. It is generally accepted that a population uptake of up to 95%  is needed to provide high levels of population protection and reduce the incidence of these conditions. Generally, for childhood immunisations, in Barnet, the uptake is less than 90% and for some vaccines lower than 85%.  The uptake varies for different vaccines and dosages.   An action plan is in place to increase uptake of childhood immunisation.

School age

Barnet Public Health supports all educational settings to be healthy environments and communities through promoting the Healthy Early Years London and Healthy Schools London Award schemes. 118 schools and 96 early years settings have registered for the scheme, with many having received awards.

The National Child Measurement Programme (NCMP) is a nationally mandated public health programme. It provides the data for child excess weight indicators in the Public Health Outcomes Framework (PHOF) and is part of the government’s approach to tackling childhood obesity. The risk of obesity in adulthood and risk of future obesity-related ill health, are greater as children get older. The measurements are taken for children in Reception and Year 6.

In 2019/20, Barnet was the seventh lowest London borough for overweight, including obesity prevalence in Reception aged children, with a rate of 19.1%. This is lower than the overall rate for London (21.6%) and significantly below the England rate (23%). For the same period and measurement for Year 6 children, Barnet was the fourth lowest London borough with a prevalence rate of 34.2%. The comparable rate for London and England was 38.2% and 35.2% respectively.

Barnet has a comprehensive programme of action supporting healthy weight management from early years, through school ages to adolescents. Middlesex University is working with Barnet Public Health to research how we can improve physical literacy within primary school children. Additionally, the Mayor’s Golden Kilometre scheme encourages physical activity within the school day. Barnet has a Healthy Weight Strategy with an intervention pathway from birth to adulthood for those who need additional support.

Children with poor mental health are more likely to have lower educational attainment, which is further influenced by their family socio-economic circumstances. In 2020, 2.61% of Barnet school pupils were identified as having social, emotional, and mental health needs. This is marginally higher than the overall rate for London (2.49%), and slightly lower than the England average (2.7%).

When it comes to their attainment, during 2018/19, in Barnet, 74.3% of children achieved a good level of development at the end of Reception. This is above the overall average for London (74.1%) and England (71.8%). For the same period, 63.3% of children who received Free School Meals (FSM) achieved a good level of development at the end of Reception in Barnet schools. This is slightly lower than the overall London rate, (64.1%) but significantly higher than the England average (56.5%).

Healthy:

A place with fantastic facilities for all ages, enabling people to live happy and healthy lives

Mortality:

In 2020, there were 2,942 deaths of Barnet residents, an increase of 27% (627 additional deaths) compared to 2019. Of these, 517 deaths had a mention of COVID-19 on the death certificate. Around 70% (2,092 deaths) were in those aged 75 and over, resulting in approximately a third (850 deaths) classed as premature.

The biggest cause of premature mortality in Barnet is cancer, which accounts for around 40% of deaths under the age of 75, around 98 per 100,000 population, and is lower than the London and England average. Similarly, the rate of deaths in those under the age of 75 for cardiovascular and respiratory diseases are also lower than the London and England averages.

Early diagnosis of cancers through screening programmes and population awareness of symptoms, alongside equitable access to treatment can help to reduce premature mortality for cancers. In 2019, around 57% of cancers across Barnet residents were diagnosed in the early stages This is similar to the average seen in London and England. However, this was a slight reduction compared to 2018, whereas the London and England averages both increased slightly during the same period.

Diagnosing and managing the conditions which may lead to cardiovascular disease, such as diabetes and high blood pressure (hypertension), is important to reducing early deaths. In Barnet, around 4,500 people (16% of those expected to be diabetic) are potentially diabetic and undiagnosed. This is a higher percentage than the London and England picture and an area of potential focus for the emerging NHS Integrated Care Partnership. For hypertension, around 37,000 people are perhaps undiagnosed, which is around 40% of the expected figure and higher than the London and England averages, which are both around 33%.

Lifestyle:

In 2019-20, over half (57%) of adults in Barnet were estimated to be overweight (i.e., a Body Mass Index (BMI) larger than or equal to 25). This proportion whilst higher than the London average (55.7%), was lower than the England average (62.8%).

Around a quarter of adults in Barnet (23.7%), took part in less than 30 minutes of moderate physical activity per week, during 2019-20. Similar to the London average (23.8%) but higher than the England average (22.9%).

The levels of smoking in Barnet continue to fall and there are several estimates of smoking prevalence. We know smoking levels are higher in more deprived areas and among those with routine and manual occupations. This creates a level of disproportionality across the wards in Barnet.

Admissions for alcohol related conditions using the broad definition as defined by Public Health England and alcohol related mortality in Barnet is lower than the London and England average.

Mental Health

The rate of suicide in Barnet in 2017-19, was lower than the London and England average, equating to 66 residents of Barnet taking their own lives during these three years. Reducing suicides is a priority for Barnet and a dedicated Suicide Prevention Lead is in post.

The rate of admissions for intentional self-harm in Barnet for 2019-20 was higher than the London average but lower than England. There were 350 residents of Barnet admitted to hospital for intentional self-harm during this period.

Wider Determinants

The rate of domestic abuse related crimes in Barnet for 2019-20 was higher than the London and England average.

Thriving:

A place fit for the future, where all residents, businesses and visitors benefit from improved sustainable infrastructure & opportunity.

Thriving town centres, are a well-supported framework for supporting residents seeking to achieve their economic potential and opportunities for residents to participate in their communities, supporting others and helping to develop the voluntary organisations which we work with are important factors.  The economic position of residents is central to achieving good health and wellbeing.

Out of work Benefit Claimants:

The number of Out of Work Benefit Claimants has more than doubled in the past fifteen months and is equal to 6.6% of Barnet’s population, which is lower than London’s average of 7.4%. The wards with the highest number of claimants are Colindale, Burnt Oak and Child’s Hill. An Employment & Skills Strategy has been developed to address this increase.

Percentage of people aged 16-64 in employment:

The number of people who are in employment (either as an employee, self-employed, in government employment and training programmes or an unpaid family worker) and are of working age (16-64), has been gradually rising in Barnet over the last few years which has been consistently lower than London and England averages; in 2019/20 75.1% of the working age population in Barnet were in employment, equal to London’s average, but lower than England’s average (76.2%).

16–17-year-olds not in education, employment or training (NEET) or whose activity is not known:

Young people who are NEET, are at a greater risk of a range of negative outcomes, including poor health, depression, or early parenthood. This measure is included to encourage services to work together to support young people, particularly the most vulnerable, to engage in education, training, and work. The percentage of 16–17-year-olds NEET is consistently lower in Barnet, and in 2019 it dropped further to 1.52%. This is lower than London’s 4.2% and England’s 5.5%.

In Work Benefit Claimants:

The number of Universal Credit (UC) Claimants has more than doubled in the past fifteen months and is equal to 9.9% of Barnet’s population claiming UC. As with those claiming out of work benefit claimants, the most affected wards are Colindale, Burnt Oak and Child’s Hill.  However, for this measure, the additional wards of Hendon, Golder’s Green and West Hendon are closely behind.

Employment rate gap:

The gap in employment between those with:

  • long-term health condition and the overall employment rate in 2019/20, was lower in Barnet (9.5%) compared to the London (11.5%) and England (10.6%) averages.
  • learning disability and the overall employment rate in 2019/20 is lower in Barnet (66.7%) compared to the London (68.1%) and England (70.6%) averages.
  • in contact with secondary mental health services and the overall employment rate in 2019/20 in Barnet (68.1%) is equal to London’s and higher than England’s (67.2%) average.

Mean score of the 14 Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) statements at age 15

The WEMWBS is formed of statements covering a range of feelings and attitudes towards life. When it was last measured in 2014-15, Barnet had higher levels of satisfaction of life than London and England averages. People with higher well-being are known to have lower rates of illness, recover more quickly, live longer, and generally have better physical and mental health. It is felt that economic measures e.g., Gross Domestic Product (GDP) whilst necessary, are not sufficient to reflect a nation’s overall progress or well-being.

Clean Safe & Well Run

A place where our streets are clean and anti-social behaviour is dealt with, so residents feel safe. Providing good quality, customer friendly services in all that we do.

Crime:

Property Crimes cover areas such as burglary and vehicle offences. The rates of these crimes in Barnet are slightly higher than the rate seen in London. For burglary offences in 2020-21, the rate in Barnet is 6.6 per 1,000 population compared to 6.2 in London. The rate of vehicle offences in Barnet is 12.1 per 1,000 population compared to 11.2 in London. There is variation within the Borough for burglary offences, e.g., Garden Suburb (9.1 per 1,000 population) has the highest rate while East Barnet has the lowest (3.7 per 1,000 population). For vehicle offences, West Hendon (18.2 per 1,000 population) has the highest rate and Burnt Oak (8.4 per 1,000) the lowest.

Personal Crimes such as violence or sexual offences in Barnet are generally lower than the London rate. For violence offences, the rate per 1,000 population in 2019-20 for Barnet was 18.9 compared to 24.9 in London and was the third lowest in London. For sexual offences in 2019-20, Barnet had the second lowest rate in London at 1.3 per 1,000 population compared to 2.0 in London.

When it comes to re-offending rates, the percentage of offenders who re-offend within 1 year stands at 28.5% in London and 29.1% for England; Barnet is the seventh lowest borough in London with a 25.9% reoffending rate. However, when measuring the average number of re-offences per re-offender Barnet is seen as the twelfth highest London borough with the average number of re-offences per re-offender equal to 3.6 which is slightly higher than London’s average of 3.4 but lower than England’s average of 4.0.

Environmental:

There are several direct and indirect links between exposure to noise and health and wellbeing outcomes. Exposure to noise can cause disturbance and interfere with activities, leading to annoyance and increased stress. Furthermore, there is increasing evidence that long term exposure to elevated levels of noise can cause direct health effects such as heart attacks and other health issues. In 2018/19 Barnet had the fifth lowest rate of complaints about noise at 5.1 per 1,000 population compared to London’s 17.0 and England’s 6.8 per 1,000 population. The percentage of the population of Barnet, exposed to road, rail and air transport noise of:

  • 55 dB(A) or more during the night-time’ equates to 18.4%, making Barnet the ninth highest borough in London, where the average is 15.9% and significantly higher than England’s average of 8.5%
  •  65dB(A) or more, during the daytime’ equates to 14.6% making Barnet the eleventh highest borough in London, where the average is 12.1%and significantly higher than the England average of 5.5%.

Air pollution in the form of fine particulate matter, is calculated as an annual concentration of human-made fine particulate matter at an area level. In 2019, Barnet had a value of 11.1 (µg/m3), making it the twelfth lowest borough, compared to the London average of 11.4 (µg/m3) and England average of 9.0 (µg/m3).

A further indicator measuring air pollution refers to the fraction of mortality attributable to particulate air pollution and is calculated through mortality burden associated with long-term exposure to anthropogenic particulate air pollution at current levels, expressed as the percentage of annual deaths from all causes in those aged 30+; during 2019, 6.3% of Barnet deaths (twelfth lowest in London) were attribute to this, compared to 6.4% across London and 5.1% across England.

Fuel Poverty:

In 2018 the percentage of households across the borough who were experiencing fuel poverty (based on the ‘Low income, high cost’ methodology) were 11.8%, compared to 11.4% across London and 10.3% across England.

Text Last Updated: 09.09.21