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JSNA – Healthy

Barnet will be a place with fantastic facilities for all ages, enabling people to live happy and healthy lives.

Mortality

All age all-cause Mortality

All age, all-cause mortality is a measure of the number of deaths for people resident within a particular geography. A mortality rate (in this case per 100,000 population) is calculated to allow comparison between areas of different population sizes and with different gender and age make ups. Comparison with similar local authorities is helpful as it can trigger discussions about why there are different levels of outcomes locally.

The trend for deaths from all causes, all ages in Barnet has been reducing for recent years, with the exception of 2020 which saw an increase in part due to the COVID-19 pandemic. The rate in Barnet is lower than that seen in England and London. The rate varies considerably between the borough’s wards, with Coppetts having the highest levels and Garden Suburb the lowest.

Under 75 Preventable Mortality

The basic concept of preventable mortality is that deaths are considered preventable if, in the light of the understanding of the determinants of health at the time of death, all or most deaths from the underlying cause (subject to age limits if appropriate) could mainly be avoided through effective Public Health and primary prevention interventions. Preventable deaths from all causes, all ages overlap with but are not the same as ‘treatable’ deaths from all causes, all ages, which include causes of death that could potentially be avoided through effective healthcare interventions, including secondary prevention and treatment.

The rate of preventable deaths from all causes, all ages in Barnet is lower than that seen in London or England and has continued to decrease in recent years.

Under 75 CVD Mortality

Cardiovascular disease (CVD) is one of the major causes of deaths, leading to around 34,000 deaths per annum in those aged under 75 in England. There have been huge gains over the past decades in terms of better treatment for CVD and improvements in lifestyle. However, to ensure that there continues to be a reduction in the rate of premature mortality from CVD, there needs to be concerted action in both prevention and treatment.

The rate of CVD deaths for those aged under 75 in Barnet (51.1 per 100,000 population) is lower than that seen in London (69.1) or England (70.4) and has continued to decrease in recent years.

Under 75 Cancer Mortality

Cancer is one of the major causes of deaths in under 75s in England. In England there are around 167,000 deaths per annum from Cancer in all ages, with around 62,000 of these in those aged under 75.

The rate of cancer mortality for those aged under 75 in Barnet (98.9 per 100,000 population) is lower than that seen in London (117.4) and England (129.2) and has continued to decrease in recent years.

Under 75 Respiratory Mortality

Respiratory disease is one of the top causes of death in England causing around 16,500 deaths in those aged under 75. Smoking is the major cause of chronic obstructive pulmonary disease (COPD), one of the major respiratory diseases. This measure will focus public health attention on prevention of smoking and other environmental factors that contribute to people getting respiratory disease.

The rate of respiratory deaths for those aged under 75 in Barnet (17.4 per 100,000 population) is lower than that seen in London (29.9) or England (34.2) and has continued to decrease in recent years.

Mortality from Communicable Diseases

Prevention of the spread of communicable diseases is an important issue for Public Health. There is evidence that rapid identification, treatment and prevention of spread can reduce deaths.

The rate of deaths from communicable diseases in Barnet is lower than in London and England. In recent years the rate has been largely unchanged.

Mental Health

Premature deaths for people with long-term and severe mental health illness (SMI)

Better mental health is a key priority for the NHS. The NHS’s aim is to reduce inequalities in premature deaths for people with long-term and severe mental health problems. This indicator contributes to measuring the disproportion and will support delivery of the commitments. Furthermore, people with a long-standing mental health problem are twice as likely to smoke, with the highest rates among people with psychosis or bipolar disorder. When compared with the general patient population, patients with SMI are at a substantially higher risk of obesity, asthma, diabetes, chronic obstructive pulmonary disease (COPD) and cardiovascular disease. People with SMI make more use of secondary urgent and emergency care, and experience higher premature death rates.

The rate of premature deaths in people with a serious mental illness is lower in Barnet than that seen in England.

Suicide Rate

Suicide is a significant cause of deaths in young adults and is seen as a measure of underlying rates of mental ill-health. Suicide is a major issue for society and a leading cause of years of life lost. Suicide is often the end point of a complex history of risk factors and distressing events, but there are many ways in which services, communities, individuals and society can help to prevent suicides.

In the most recently available data, the suicide rate in Barnet is lower than London and England. Due to small number the rate can vary year on year in Barnet, but it appears that generally the rate is largely consistent.

Self-Harm Admissions

Self-harm admissions monitor the extent of intentional self-harm which requires emergency admission to hospital (approx. 99% of hospital admissions for intentional self-harm are emergencies). Moreover, this measure supports Public Health programmes aiming to reduce the risk of self-harm. It helps to stimulate discussion and encourage local investigation, and to lead to improvements in data quality and quality of care.

The rate of admissions for intentional self-harm in Barnet is higher than the London average but lower than that seen in England. In recent years, the rate in England and Barnet has been largely consistent whilst the London rate has been falling.

Healthcare

Falls and Hip Fractures

Falls are the largest cause of emergency hospital admissions for older people, and significantly impact on long term outcomes, e.g., being a major stimulant for people moving from their own home to long-term nursing or residential care. Hip fracture is a debilitating condition – only one in three sufferers return to their former levels of independence and one in three ends up leaving their own home and moving to long-term care. Hip fractures are almost as common and costly as strokes and their frequency is rising. In the UK, about 75,000 hip fractures occur annually at an estimated health and social cost of about £2 billion a year.

The rate of admissions for a fall in those aged 65 and over is slightly higher in Barnet than in London and England, and in recent years the rate has increased whilst the rates for England and London have been largely consistent.

Diagnosis of Cancer at Stage 1 or 2

The stage at diagnosis is a measure of how much a cancer has grown and spread, with advanced stages meaning the cancer is bigger or has spread to other parts of the body (metastasis) and where this occurs patient outcomes are worse for later stages. The data can be used to provide information to a wide range of patient and professional groups; plan services aimed at early detection and diagnosis of cancer; and inform cancer research. Additionally, as there are often different treatment options at an advanced stage at diagnosis these data can inform understanding of cancer treatment services.

The percentage of cancers diagnosed at stage 1 or 2 in Barnet is slightly higher than the London and England average. On average, over 40% of cancers are now diagnosed at stage 1 or 2. In recent years the percentage in Barnet has been consistent while there appears to be some improvement in London.

Diagnosis Gaps

Timely diagnosis of a condition enables people, their carers and healthcare staff to plan accordingly, and work together to improve health and care outcomes. This can involve providing medication, additional support or a combination of these to support a slowdown in the progression of the disease or to prevent adverse events from the condition. Within the JSNA we look at the Diagnosis Gaps for:

  • Diabetes
  • Hypertension
  • Dementia

The diagnosis gap for Diabetes and Hypertension in Barnet is greater than the London and England average.

The Dementia diagnosis gap in Barnet is lower than that seen in London and England.

Flu Vaccination (Age 65+)

Influenza (also known as Flu) is a highly infections viral illness spread by droplet infection. Vaccination coverage is the best measure of the level of protection a population will have against vaccine preventable communicable diseases. Immunisation is one of the most effective healthcare interventions available, and flu vaccines can prevent illness and hospital admissions among older and vulnerable populations. Increasing the uptake of flu vaccine in older people should contribute to easing winter pressures on primary care services and hospital admissions.

Flu vaccine uptake in Barnet is around the London average but lower than the England average. In 2019-20 there was a slight increase in uptake in Barnet.

Lifestyle choices

Alcohol Admission Episodes (Broad) & Related Mortality

Alcohol consumption is a contributing factor to hospital admissions and deaths from a diverse range of conditions. Alcohol misuse is estimated to cost the NHS about £3.5 billion per year and wider society £21 billion annually. Alcohol-related admissions can be lowered through local interventions to reduce alcohol misuse and harm.

The rate of alcohol admission episodes is increasing in Barnet although it remains below the London and England averages. Alcohol related mortality is also lower in Barnet than the England and London average but the trend in recent years has been decreasing.

Adult Obesity

Obesity is recognised as a major determinant of premature mortality and avoidable ill health.

The percentage of adults in Barnet who are believed to be overweight is slightly higher than the London average but lower than that seen in England. In Barnet there is an increasing trend while in London the percentage has been consistent.

Physically Inactive Adults

Physical inactivity is the 4th leading risk factor for global mortality accounting for 6% of deaths globally. People who have a physically active lifestyle have a 20-35% lower risk of cardiovascular disease, coronary heart disease and stroke compared to those who have a sedentary lifestyle. Regular physical activity is also associated with a reduced risk of diabetes, obesity, osteoporosis, colon and breast cancer and with improved mental health. In older adults, physical activity is associated with increased functional capacities.

Around a quarter of adults in Barnet are counted as physically inactive, which means they do less than 30 minutes of physical activity per week. In Barnet the percentage has risen slightly in the last couple of years which is also the case for England and London.

Smoking

Smoking is the highest cause of preventable ill health and premature mortality in the UK. Smoking is a major risk factor for many diseases, such as lung cancer, chronic obstructive pulmonary disease (COPD) and heart disease. It is also associated with cancers in other organs, including lip, mouth, throat, bladder, kidney, stomach, liver and cervix. Smoking is a modifiable behavioural risk factor; effective tobacco control measures can reduce the levels of smoking in the population.

Levels of smoking have been decreasing in Barnet as well as in London and England. In Barnet it is estimated that just over 10% of the population are active smokers, although it is known that smoking levels in more deprived populations are higher. There is variation by ward within Barnet with Garden Suburb estimated to have the highest levels and Burnt Oak the lowest levels.

Drug Misuse Mortality

Drug misuse is a significant cause of premature mortality in the UK. Almost one in nine deaths registered among people in their 20s and 30s in England and Wales in 2014 were related to drug misuse. Deaths from drug misuse substantially increased in England in 2013 and 2014, with a 42% total increase over these two years. Consequently, there is considerable political, media and public interest in these figures. Local authority action, including the quality and accessibility of the drug services they commission and how deaths are investigated and responded to has an impact on drug misuse death rates. Including this sub-measure alongside those on treatment outcomes will help local authorities and others to consider the impact of treatment in addiction to recovery outcomes.

The rate of deaths from drug misuse in Barnet is lower than in London and England. The trend in Barnet has been consistent.

Wider determinants

Domestic Abuse

Domestic abuse means as an incident or pattern of incidents of controlling, coercive, threatening, degrading and violent behaviour, including sexual violence, in the majority of cases by a partner or ex-partner, but also by a family member or carer. Tackling domestic abuse as a public health issue is vital for ensuring that some of the most vulnerable people in our society receive the support, understanding and treatment they deserve.

The rate of domestic abuse related crimes in Barnet is generally similar to the London average and has followed the same trend. The rate in England is rising.

Homelessness

The definition of homelessness means not having a home. You are homeless if you have nowhere to stay and are living on the streets, but you can be homeless even if you have a roof over your head. The reasons people can become homeless range from drug and alcohol issues, bereavement, or experience of the criminal justice system, to the wider determinants of health such as inequality, unemployment, and housing supply and affordability.

In Barnet the rate of families owed a duty for housing under the Homelessness Reduction Act is higher than the London and England average. No trend data is currently available for this measure.


Text Last Updated: 09.09.21