THE PREVALENCE OF SMOKING, OBESITY, AND HIGH BLOOD ... · SMOKING, OBESITY, AND HIGH BLOOD PRESSURE IN PLYMOUTH FOR THE THREE YEAR PERIOD 2013-14 to 2015-16 Author: Public Health,

THE PREVALENCE OF SMOKING, OBESITY, AND HIGH BLOOD PRESSURE IN PLYMOUTH FOR THE THREE YEAR PERIOD

2013-14 to 2015-16

Author: Public Health, Office of the Director of Public Health, Plymouth City Council

Date: March 2018 (v1.0)

This profile is produced as part of Plymouth’s Joint Strategic Needs Assessment.

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Document information

Document status Final

Author Public Health

Document version 1.0

Original document date March 2018

Amendment record

Version Date Reason(s) for change Pages affected

Public Health

Office of the Director of Public Health

Plymouth City Council

Windsor House

Plymouth

PL6 5UF

Tel: 01752 307346

[email protected]

Date: March 2018 (v1.0)

Prepared by: Carol Harman

For queries relating to this document please contact [email protected]

Acknowledgements: We are grateful to those colleagues and partners that have contributed to

this report.

© Public Health 2018

mailto:[email protected]

mailto:[email protected]

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Contents

1. Introduction .......................................................................................................... 4

2. Data extraction and cleaning .............................................................................. 6

3. The geographies used in this report .................................................................. 8

4. Key findings, 2015-16 ......................................................................................... 11

5. Results by neighbourhood ................................................................................. 12

5.1 Referrals ............................................................................................................................... 12

5.2 Risk factor prevalence ....................................................................................................... 13

5.3 Individual risk factor prevalence ..................................................................................... 14

5.4 Trends in individual risk factor prevalence ................................................................... 16

6. Results by electoral ward .................................................................................. 20

6.1 Referrals ............................................................................................................................... 20




7. Results by deprivation group ............................................................................ 26

7.1 Referrals ............................................................................................................................... 26




8. Results by designated Children’s Centre area ................................................ 31

8.1 Referrals ............................................................................................................................... 31




9. Results by Livewell Southwest locality ............................................................ 37

9.1 Referrals ............................................................................................................................... 37




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1. Introduction

This report contains analysis of data extracts of adult Plymouth GP patient referrals to

Derriford Hospital covering the three one-year periods 1st April 2013 to 31st March 2014,

1st April 2014 to 31st March 2015, and 1st April 2015 to 31st March 2016. The data is

managed by the Devon Referral Support Service (DRSS), formally known as the Tamar

Referral and Appointments Centre (TRAC) in Plymouth.

The report considers the key public health indicators (risk factors to health) of smoking

status, Body mass index (BMI) and blood pressure (BP) at referral date. These indicators are

measured as part of the referral process and are not the reasons for referrals. This data

should assist in forecasting the level of public health interventions required across the city.

This report focuses on the referrals of Plymouth residents with three valid risk factor

measurements. These are defined as follows:

i) Smoking is categorised as: smoker; non-smoker. Smoking was considered to be

a risk factor.

ii) Body Mass Index (BMI) is categorised as: underweight (<18.5kg/m2); healthy (18.5 <

25); overweight (25 < 30); obese (>30). Obesity was considered to be a risk

factor.

iii) Blood pressure (BP) is categorized as: normal (systolic < 120 mm Hg AND diastolic

< 80 mm Hg); pre-hypertension (systolic 120-139 OR diastolic 80-89); hypertension stage 1 (systolic 140-159 OR diastolic 90-99); hypertension stage 2 (systolic >= 160

OR diastolic >=100). High blood pressure (hypertension stage 1 or stage 2)

was considered to be a risk factor.

Throughout this report 95% confidence intervals are included. They are shown as the '+/-'

figures in brackets or the error bars in graphs. Confidence intervals are included to show

how representative the results of these surveys are of the population as a whole. If the

confidence intervals for two values do not overlap, then it is said that there is a significant

difference between them.

This report includes trend information over the past three years and features information

that has been analysed by neighbourhood, electoral ward, deprivation group, designated

Children’s Centre and Livewell Southwest locality.

Potential uses of the report include:

Aiding decision makers across the city; the information can be used as a basis for the

development of strategies to improve the health of people in Plymouth and for the

commissioning of services according to the needs of the population.

Providing evidence that can be used in the preparation of bids and business cases.

Assisting service providers considering future development of their services.

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This report highlights the variation that exists across Plymouth with regard to the risk

factors experienced by the referred adult patient population. Overall the more deprived

areas tend to have higher proportions of people who experience one or more risk factors.

This relationship is apparent at neighbourhood, electoral ward, deprivation group,

designated Children’s Centre and Livewell Southwest locality levels. Therefore from a

‘place’ perspective resources should be targeted at the most deprived areas of the city in order to address these variations.

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2. Data extraction and cleaning

Note: The 2015-16 referral data contains GP referrals only (any referrals made by dentists/opticians

are not included).

For each financial year child referrals and duplicate records were removed from the raw

dataset of patient referrals based on matches across all of the following fields:

ePEX number or UBRN_var (a unique reference number given by the clinical

administration system and assigned per patient referral)

medical speciality

age band

referral date

referring GP practice

The total number of adult patients (based on unique codes) in the remaining records was

counted. Those that were referred only once and those referred on two or more occasions

were differentiated. The total number of referrals for those referred twice or more was

also calculated.

Records with missing, invalid, or null postcodes were removed to leave only those with valid

Plymouth postcodes (allowing linkage to the Plymouth city geographies). Some patients

were referred to more than one speciality on the same day. This resulted in duplicate

records of the risk factor measurements (smoking status, BMI, and BP) for these individuals.

These same-day duplicates were also removed. If an individual patient was referred on

separate days these records were included.

Finally, records with missing or invalid health risk factor measurements for smoking status

and/or BMI and/or BP were filtered out to leave the records on which further analysis was

performed.

This report focuses on the 26,911 Plymouth resident referrals of adults in 2015-16

highlighted in bold in Table 1. Analysis of trends will also be based on the equivalent 2013-

14 and 2014-15 values.

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Table 1: Stages in the data extraction and cleaning process

2013-14 2014-15 2015-16

Total adult patient records listed 59,409 59,462 45,007

Number of duplicates* 143 225 9

Records remaining 59,266 59,237 44,998

Total individual adult patients 46,505 45,906 35,346

Patients referred once 36,522 35,558 27,999

Patients referred twice or more 9,983 10,348 7,347

Total referrals from those referred twice or more 22,887 23,904 17,007

Plymouth based adult patient records** 57,117 56,900 32,774

Number of same-day patient duplicate risk factor

measurements*** 10,786 14,828 5,854

Plymouth based records remaining 46,331 42,072 26,920

Plymouth based records with three valid risk factors

measurements recorded**** 37,175 33,803 26,911

* Duplicates based on matches across ePEX number/UBRN_var, medical speciality, referral date, and

referring practice. ** Those with valid Plymouth postcodes allowing linkage to geographical areas. *** Duplicates based on matches across referral date, ePEX number/UBRN_var, BMI, BP, and smoking status

(i.e. those patients referred to more than one speciality on the same day and therefore having the same

health measurements). **** Records with missing or invalid smoking status and/or BMI and/or BP removed.

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3. The geographies used in this report

Information in this report is presented for the following five geographic divisions of

Plymouth:

The 39 neighbourhoods

The 20 electoral wards

The five neighbourhood deprivation groups

The 16 designated Children’s Centre areas

The four Livewell Southwest localities

A small area-based approach is an appropriate technique for examining variations in health

and health-determinant information. Such an approach provides valuable information to

those organisations which have major responsibilities for both commissioning and providing

services, and which consequently require a good understanding of the patterns and trends in

health status and its determinants. Using the Plymouth neighbourhood geography makes it

possible to understand the complex picture of health at a local level. As well as existing in

their own right, the 39 Plymouth neighbourhoods can be grouped together to form the 20

electoral wards, the five neighbourhood deprivation groups, the 16 designated Children’s

Centres areas, and the four Livewell Southwest localities. Plymouth's neighbourhood and

Livewell Southwest locality boundaries are shown in Figure 1 whilst Table 2 shows the

neighbourhoods that make up each of the 20 electoral wards.

Figure 1: Plymouth by neighbourhood and Livewell Southwest locality

Contains Ordnance Survey data © Crown copyright and database rights 2017

Contains Ordnance Survey data © Crown copyright and database rights 2018

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Table 2: Plymouth electoral wards by neighbourhood

Electoral

ward Neighbourhood

Electoral

ward Neighbourhood

Budshead

Derriford West & Crownhill Plympton

Chaddlewood Chaddlewood

Whitleigh Plympton

Erle

Plympton St Maurice &

Yealmpstone

Compton Higher Compton & Mannamead Plympton St

Mary

Colebrook, Newnham, &

Ridgeway

Mutley Woodford

Devonport

Devonport Plymstock

Dunstone

Elburton & Dunstone

Keyham Goosewell

Morice Town Plymstock

Radford

Plymstock & Radford

Drake Greenbank & University Turnchapel, Hooe, &

Oreston

Lipson & Laira Efford

Southway

Southway

Lipson & Laira Tamerton Foliot

Eggbuckland Eggbuckland Widewell

Manadon & Widey St Budeaux

Barne Barton

Ham Ham & Pennycross

St Budeaux & Kings

Tamerton

North Prospect & Weston Mill St Peter

& the

Waterfront

City Centre

Honicknowle Ernesettle Stonehouse

Honicknowle Stoke

Ford

Moor View

Estover, Glenholt & Derriford

East Stoke

Leigham & Mainstone Sutton &

Mount Gould

East End

Peverell Beacon Park Mount Gould

Peverell & Hartley

Deprivation measures attempt to identify communities where the need for healthcare is

greater, material resources are fewer and exacerbated by lower literacy levels, result in less

capacity to cope with the consequences of ill-health. People are therefore deprived if there

is inadequate education, unsatisfactory housing, unemployment, insufficient income, poor

health, and low opportunities for enjoyment. A deprived area is conventionally understood

to be a place in which people tend to be relatively poor and are relatively likely to suffer

from misfortunes such as ill-health.

The Index of Multiple Deprivation 2015 (IMD 2015) is the current official measure of

deprivation. However as it is not routinely available at neighbourhood level, analysis has

been carried out by Plymouth City Council’s Office of the Director of Public Health to

produce IMD 2015 scores for each of the city's 39 neighbourhoods. The results of this analysis are shown in Figure 2.

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Figure 2: IMD 2015 scores for the Plymouth neighbourhoods

As well as producing information on a locality basis, Public Health also produce information

for five deprivation groups. These groups are based on combinations of neighbourhoods

sorted according to their IMD 2015 score. The eight neighbourhoods with the highest IMD

2015 scores are grouped together to make the 'most deprived' group and the eight

neighbourhoods with the lowest IMD 2015 scores are grouped together to make the 'least

deprived' group. The three intervening groups are referred to as 'upper middle', 'middle' and

'lower middle'. The neighbourhoods which together make up the most deprived and least

deprived neighbourhood groups are shown in Table 3.

Table 3: Neighbourhoods in the most deprived and least deprived groups

Group Neighbourhood Group Neighbourhood

Most

deprived

1. Devonport

Least

deprived

32. Plymstock & Radford

2. Stonehouse 33. Goosewell

3. Morice Town 34. Chaddlewood

4. Barne Barton 35. Higher Compton & Mannamead

5. East End 36. Colebrook, Newnham & Ridgeway

6. North Prospect & Weston Mill 37. Woodford

7. Ernesettle 38. Peverell & Hartley

8. Whitleigh 39. Elburton & Dunstone

0

10

20

30

40

50

60

70

Bar

ne B

arto

n

Beac

on P

ark

Chad

dle

wood

City

Centr

e

Cole

bro

ok, N

ew

nham

& R

idge

way

Derr

iford

West

& C

row

nhill

Devo

nport

Eas

t End

Efford

Egg

buck

land

Elb

urt

on &

Dunst

one

Ern

ese

ttle

Est

ove

r, G

lenholt &

Derr

iford

Eas

t

Ford

Goose

well

Gre

enban

k &

Univ

ers

ity

Ham

& P

ennyc

ross

Hig

her

Com

pto

n &

Man

nam

ead

Honic

know

le

Keyh

am

Leig

ham

& M

ainst

one

Lip

son &

Lai

ra

Man

adon &

Wid

ey

Mori

ce T

ow

n

Mount

Gould

Mutley

Nort

h P

rosp

ect

& W

est

on M

ill

Peve

rell

& H

artley

Ply

mst

ock

& R

adfo

rd

Ply

mpto

n S

t. M

auri

ce &

Yeal

mpst

one

South

way

St. B

udeau

x &

Kin

gs T

amert

on

Sto

ke

Sto

nehouse

Tam

ert

on F

olio

t

Turn

chap

el,

Hooe &

Ore

ston

Whitle

igh

Wid

ew

ell

Woodfo

rd

Ply

mouth

IMD

2015 s

co

re

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4. Key findings, 2015-16

Of the 26,911 people referred 52.2% experienced one or more of the risk factors (i.e. they

smoked, and/or were obese, and/or had high blood pressure). Therefore, 47.8% did not

experience any of the public health risk factors.

Overall 40.5% of people experienced one risk factor, 10.8% of people experienced two risk

factors, and 0.9% of people referred experienced all three of the risk factors.

On a neighbourhood basis the presence of one or more risk factors ranged from 37.6% in

Peverell and Hartley to 63.9% in Morice Town.

On a ward basis the presence of one or more risk factors ranged from 40.0% in Peverell to

61.4% in Devonport.

On a deprivation group basis the presence of one of more risk factors ranged from 44.1% in

the least deprived group to 58.9% in the most deprived group.

On a designated Children’s Centre level the presence of one or more risk factors ranged

from 40.0% in Popin to 61.0% in Tamar FOLK.

On a Livewell Southwest locality basis the presence of one or more risk factors ranged

from 45.1% in the East to 57.0% in the West.

Since 2013-14 the overall percentage of people referred who were smokers has increased by 2.0% (from 16.3% to 18.3% in 2015-16).

The percentage of people referred who were smokers followed a clear deprivation gradient

(2013-14 to 2015-16).

Since 2013-14, the percentage of people referred who were categorised as obese has

decreased by 1.0% (from 32.3% to 31.3% in 2015-16).

The percentage of people referred with high blood pressure (Stage 1 or Stage 2

hypertension) has decreased by 0.3% to 15.2% (from 15.5% in 2013-14).

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5. Results by neighbourhood

5.1 Referrals

Table 4: Referrals by neighbourhood (numbers; percentages; rates per 10,000 population)

2015-16

Neighbourhood Referrals (number) Referrals (%) Referrals (rate)

Barne Barton 472 1.8 1,130 (±102.0)

Beacon Park 449 1.7 989 (±91.5)

Chaddlewood 642 2.4 850 (±65.8)

City Centre 504 1.9 795 (±69.4)

Colebrook, Newnham & Ridgeway 540 2.0 620 (±52.3)

Derriford West & Crownhill 557 2.1 1,092 (±90.7)

Devonport 684 2.5 1,054 (±79.0)

East End 679 2.5 1,244 (±93.6)

Efford 883 3.3 1,197 (±79.0)

Eggbuckland 653 2.4 1,074 (±82.4)

Elburton & Dunstone 939 3.5 1,110 (±71.0)

Ernesettle 556 2.1 1,199 (±99.6)

Estover, Glenholt & Derriford East 885 3.3 1,084 (±71.4)

Ford 582 2.2 1,176 (±95.5)

Goosewell 504 1.9 1,094 (±95.5)

Greenbank & University 805 3.0 1,108 (±76.5)

Ham & Pennycross 795 3.0 1,200 (±83.4)

Higher Compton & Mannamead 980 3.6 1,050 (±65.8)

Honicknowle 1,006 3.7 1,124 (±69.5)

Keyham 606 2.3 1,079 (±85.9)

Leigham & Mainstone 441 1.6 958 (±89.4)

Lipson & Laira 612 2.3 1,079 (±85.5)

Manadon & Widey 844 3.1 1,128 (±76.1)

Morice Town 327 1.2 1,165 (±126.3)

Mount Gould 852 3.2 1,139 (±76.5)

Mutley 292 1.1 1,010 (±115.9)

North Prospect & Weston Mill 756 2.8 1,190 (±84.8)

Peverell & Hartley 900 3.3 987 (±64.5)

Plympton St. Maurice & Yealmpstone 800 3.0 856 (±59.4)

Plymstock & Radford 919 3.4 1,121 (±72.5)

Southway 804 3.0 1,241 (±85.8)

St. Budeaux & Kings Tamerton 1,014 3.8 1,188 (±73.1)

Stoke 1,029 3.8 1,212 (±74.1)

Stonehouse 1,135 4.2 1,248 (±72.6)

Tamerton Foliot 364 1.4 1,215 (±124.8)

Turnchapel, Hooe & Oreston 597 2.2 1,241 (±99.5)

Whitleigh 795 3.0 1,054 (±73.3)

Widewell 371 1.4 1,081 (±110.0)

Woodford 338 1.3 698 (±74.4

Plymouth 26,911 100.0 1,062 (±12.7)

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Of the 26,911 referrals in 2015-16, 1,135 (4.2%) were residents of the Stonehouse

neighbourhood Table 4). This compares with only 292 (1.1%) from Mutley. The age

standardised referral rate was highest in Stonehouse (1,248 per 10,000 population) and

lowest in Colebrook, Newnham and Ridgeway (620 per 10,000 population).

5.2 Risk factor prevalence

Of the 26,911 people referred, 47.8% did not smoke, were not obese, and did not have high

blood pressure (i.e. they did not experience any of the public health risk factors). This

ranged from 62.4% in Peverell and Hartley to 36.1% in Morice Town.

Figure 3: Prevalence of one or more risk factors by neighbourhood (%), 2015-16

Overall 52.2% of people referred experienced one or more risk factors. On a

neighbourhood basis the presence of one or more risk factors ranged from 37.6% in

Peverell and Hartley to 63.9% in Morice Town. Other neighbourhoods with high values

include Efford (63.8%), North Prospect and Weston Mill (63.6%) and Barne Barton (61.7%).

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Figure 4: Prevalence of all three risk factors by neighbourhood (%), 2015-16

Overall 0.9% of people referred experienced all three risk factors. This ranged from zero in

Ford and Woodford to 2.4% in North Prospect and Weston Mill. Other neighbourhoods

with high values include Barne Barton (2.3%), East End (1.9%), and Keyham (1.7%).

5.3 Individual risk factor prevalence

Figure 5: Referrals who were smokers by neighbourhood (%), 2015-16

Overall 18.3% of people referred were smokers. This ranged from 7.2% in Elburton &

Dunstone to 30.1% in Barne Barton. Other neighbourhoods with high values include

Devonport (29.5%), Whitleigh (29.2%) and North Prospect and Weston Mill (27.8%).

Figure 6: Referrals who were obese by neighbourhood (%), 2015-16

Perc

en

tage

15

Overall 31.3% of people referred were categorised as obese in 2015-16. This ranged from

19.2% in the City Centre to 42.2% in North Prospect and Weston Mill. Other

neighbourhoods with high values include Efford (40.4%), Honicknowle (39.4%), and Ham and

Pennycross (37.9%).

Figure 7: Referrals who had high blood pressure by neighbourhood (%), 2015-16

Overall 15.2% of people referred had high blood pressure (Stage 1 or Stage 2 hypertension)

in 2015-16. This ranged from 10.1% in City Centre to 22.9% in Widewell. Other

neighbourhoods with high values include Derriford West and Crownhill (19.0%), Estover,

Glenholt and Derriford East (18.8%) and Higher Compton and Mannamead (18.7%).

Perc

en

tage

P

erc

en

tage

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5.4 Trends in individual risk factor prevalence

Since 2013-14 the overall percentage of people referred who were smokers has increased

by 2.0% (from 16.3% to 18.3%) in 2015-16. The percentage of those referred who were

categorised as obese has decreased by 1.0% (from 32.3% in 2013-14 to 31.3% in 2015-16). A

similar but smaller decrease over the same time period has been seen for those who had

high blood pressure (Stage 1 or Stage 2 hypertension) from 15.5% to 15.2%.

On a neighbourhood level from 2013-14 to 2015-16:

Figure 8 shows the increase in the percentage of smokers in 33 out of 39

neighbourhoods (85%) from 2013-14 to 2015-16. Goosewell showed the biggest

increase (getting worse) of 6.5% (from 11.2% to 17.7%) followed by Lipson and Laira

with an increase of 6.4% (from 16.8% to 23.2%). In contrast Stonehouse showed the

biggest decrease (getting better) of 2.8% (from 27.1 to 24.3%) followed by the

neighbourhoods of Ernesettle and Tamerton Foliot with a decrease of 2.1% (from

21.3% to 19.2% and 16.1 to 14.0 respectively).

Figure 9 shows a decrease in the percentage of referred people categorised as obese

in 28 out of 39 neighbourhoods (72%) from 2013-14 to 2015-16. City Centre

showed the biggest decrease (getting better) of 8.2% (from 27.4% to 19.2%). The

neighbourhood of Lipson and Laira showed the biggest increase (getting worse) of

4.1% from 30.9% to 35.0%.

Figure 10 shows a decrease in the percentage of referred people with high blood

pressure (getting better) in 21 out of 39 neighbourhoods (54%) from 2013-14 to

2015-16. City Centre showed the biggest decrease (getting better) of 4.4% (from

14.5% to 10.1%). The neighbourhood of Mutley showed the biggest increase (getting

worse) of 4.2% from 10.2% to 14.4%.

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Figure 8: Trend in referrals who were smokers by neighbourhood (%), 2013-14 to 2015-16

18

Figure 9: Trend in referrals categorised as obese by neighbourhood (%), 2013-14 to 2015-16

19

Figure 10: Trend in referrals with high blood pressure by neighbourhood (%), 2013-14 to 2015-16

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6. Results by electoral ward

6.1 Referrals

Table 5: Referrals by ward (numbers; percentages; rates per 10,000 population), 2015-16

Of the 26,911 referrals in 2015-16, 1,639 (6.1%) were residents of the St Peter and the

Waterfront ward. This compares with only 642 (2.4%) from the Plympton Chaddlewood.

Stoke and Plympton St Mary had the highest (1,197 per 10,000 population) and lowest (651

per 10,000 population) referral rates respectively.



blood pressure (i.e. they did not experience any of the public health risk factors). On a ward

basis this ranged from 38.6% in Devonport to 60.0% in Peverell.

Ward Referrals (number) Referrals (%) Referrals (rate)

Budshead 1,352 5.0 1,074 (±57.3)

Compton 1,272 4.7 1,030 (±56.6)

Devonport 1,617 6.0 1,081 (±52.7)

Drake 805 3.0 1,108 (±76.5)

Efford & Lipson 1,495 5.6 1,147 (±58.1)

Eggbuckland 1,497 5.6 1,099 (±55.7)

Ham 1,551 5.8 1,194 (±59.4)

Honicknowle 1,562 5.8 1,150 (±57.0)

Moor View 1,326 4.9 1,038 (±55.9)

Peverell 1,349 5.0 988 (±52.7)

Plympton Chaddlewood 642 2.4 850 (±65.8)

Plympton Erle 800 3.0 856 (±59.4)

Plympton St Mary 878 3.3 651 (±43.1)

Plymstock Dunstone 1,443 5.4 1,111 (±57.3)

Plymstock Radford 1,516 5.6 1,161 (±58.4)

Southway 1,539 5.7 1,191 (±59.5)

St Budeaux 1,486 5.5 1,165 (±59.2)

St Peter & the Waterfront 1,639 6.1 1,063 (±51.5)

Stoke 1,611 6.0 1,197 (±58.4)

Sutton & Mount Gould 1,531 5.7 1,183 (±59.2)

Plymouth 26,911 100.0 1,062 (±12.7)

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Figure 11: Prevalence of one or more risk factors by ward (%), 2015-16

Overall 52.2% of people referred experienced one or more risk factors. On a ward basis

the presence of one or more risk factors ranged from 40.0% in Peverell to 61.4% in

Devonport. Other wards with high values include St Budeaux (61.0%), Ham (60.5%) and

Efford and Lipson (60.3%).

Figure 12: Prevalence of all three risk factors by ward (%), 2015-16

Overall 0.9% of people referred experienced all three risk factors. This ranged from 0.2% in

Plymstock Dunstone to 1.6% in Sutton and Mount Gould. Other wards with high values

include Ham (1.5%), Honicknowle (1.5%), and St Budeaux (1.4%).

22

6.3 Individual risk factor prevalence Figure 12: Referrals who were smokers by ward (%), 2015-16

Overall 18.3% of people referred were smokers. This ranged from 9.3% in Plympton St

Mary to 26.6% in Devonport. Other wards with high values include St Budeaux (25.2%), St

Peter and the Waterfront (23.0%) and Efford and Lipson (22.9%).

Figure 13: Referrals who were obese by ward (%), 2015-16

23


22.5% in Peverell to 40.0% in Ham (Figure 14). Other wards with high values include

Honicknowle (38.9%), Efford and Lipson (38.2%) and St Budeaux (37.0%).

Figure 14: Referrals who had high blood pressure by ward (%), 2015-16

Overall 15.2% of people referred had high blood pressure (Stage 1 or Stage 2 hypertension).

This ranged from 12.0% in Sutton and Mount Gould to 18.7% in Moor View. Other wards

with high values include Southway (18.5%), Compton (17.7%) and Eggbuckland (17.1%).







On a ward level from 2013-14 to 2015-16:

Figure 16 shows the increase in the percentage of smokers in 18 out of 20 wards

(90%) from 2013-14 to 2015-16. The neighbourhoods of Efford and Lipson and

Budshead showed the biggest increase (getting worse) of 4.2% (from 18.7% to

22.9%). In contrast St Peter and the Waterfront showed the biggest decrease

(getting better) of 1.5% (from 24.5 to 23.0%) followed by Plympton St Mary with a

decrease of 0.2% (from 9.5% to 9.3%).

Figure 17 shows a decrease in the percentage of referred people categorised as obese in 15 out of 20 wards (75%) from 2013-14 to 2015-16. Plympton

Chaddlewood showed the biggest decrease (getting better) of 4.4% (from 34.0% to

24

29.6%). The ward of Efford and Lipson showed the biggest increase (getting worse)

of 3.0% from 35.2% to 38.2%.

Figure 18 shows a decrease in the percentage of referred people with high blood pressure in 11 out of 20 wards (55%) from 2013-14 to 2015-16. The wards of

Devonport and Ham showed the biggest decrease (getting better) of 2.4% (from

16.1% to 13.7% and 18.3% to 15.9% respectively). The wards of Moor View and

Drake showed the biggest increase (getting worse) of 2.6% (from 16.1% to 18.7%

and 10.6% to 13.2% respectively).

Figure 15: Trends in referrals who were smokers by ward (%), 2013-14 to 2015-16

Figure 16: Trend in referrals categorised as obese by ward (%), 2013-14 to 2015-16

25

Figure 18: Trend in referrals with high blood pressure by ward (%), 2013-14 to 2015-16

26

7. Results by deprivation group

7.1 Referrals

Table 6: Referrals by deprivation group (numbers; percentages; rates per 10,000 population), 2015-16

Neighbourhood deprivation group Referrals (number) Referrals (%) Referrals (rate)

Most deprived 5,404 20.1% 961 (±25.6)

Upper middle 6,641 24.7% 1,565 (±37.6)

Middle 4,469 16.6% 1,072 (±31.4)

Lower middle 4,635 17.2% 1,024 (±29.5)

Least deprived 5,762 21.4% 969 (±25.0)

Plymouth 26,911 100.0% 1,062 (±12.7)

Of the 26,911 referrals in 2015-16, the highest numbers (6,641) were from the upper

middle group of neighbourhoods, representing 24.7% of the overall total. This compares

with only 4,469 (16.6%) from the middle group. The upper middle and the most deprived

group of neighbourhoods had the highest (1,565 per 10,000 population) and lowest (961 per

10,000 population) referral rates, respectively.


As already stated, of the 26,911 people referred, 47.8% did not smoke, were not obese, and

did not have high blood pressure (i.e. they did not experience any of the public health risk

factors). On a deprivation group basis this ranged from 42.7% in the upper middle group to

55.9% in the least deprived group.

Figure 19: Prevalence of one or more risk factors by deprivation group (%), 2015-16

27

Of the people that were referred 52.2% experienced one or more of the risk factors. On a

deprivation group basis the presence of one or more risk factors ranged from 44.1% in the

least deprived group to 58.9% in the most deprived group (Figure 19).

Figure 20: Prevalence of all three risk factors by deprivation group (%), 2015-16

Overall 0.9% of people referred experienced all three of the risk factors. This ranged from

0.5% in the least deprived group to 1.4% in the most deprived group.


Figure 21: Referrals who were smokers by deprivation group (%), 2015-16

Overall 18.3% of people referred were smokers. On a deprivation group basis this ranged

from 10.9% in the least deprived group to 26.7% in the most deprived group.

28

Figure 22: Referrals who were obese by deprivation group (%), 2015-16


26.9% in the least deprived group to 35.2% in the upper middle group.

Figure 23: Referrals who had high blood pressure by deprivation group (%), 2015-16


This ranged from 14.0% in the most deprived group of neighbourhoods to 16.4% in the

lower middle group.

29







On a deprivation group level from 2013-14 to 2015-16:

All deprivation groups showed an increase in the percentage of smokers from 2013-14 to 2015-16 (Figure 24). The middle group showed the biggest increase of 2.5% (from

16.4% to 18.9%). The least deprived group showed the smallest increase of 1.4% (from

9.5% to 10.9%).

The percentage of people referred who were categorised as obese increased

(between 2013-14 and 2014-15), then decreased in all deprivation groups in 2015-16.

The biggest decrease (getting better) of 2.0% (from 28.9% to 26.9% between 2013-14

and 2015-16), was seen in the least deprived deprivation group (Figure 25).

Figure 26 shows a decrease in the percentage of referred people with high blood pressure in three out of five neighbourhood deprivation groups (60%) from 2013-14

to 2015-16. The most deprived group showed the biggest decrease (getting better) of

1.6% (from 15.6% to 14.0%). The middle group showed the biggest increase (getting

worse) of 1.7% (from 13.3% to 15.0 %).

Figure 24: Trend in referrals who were smokers by deprivation group (%), 2013-14 to 2015-

16

30

Figure 25: Trend in referrals categorised as obese by deprivation group (%), 2013-14 to

2015-16

Figure 26: Trend in referrals with high blood pressure by deprivation group (%), 2013-14 to

2015-16

31

8. Results by designated Children’s Centre area

8.1 Referrals

Table 7: Referrals by designated Children’s Centre area (numbers; percentages; rates per

10,000 population), 2015-16

Children’s Centre Referrals (number) Referrals (%) Referrals (rate)

Crownlands 1,497 5.6 1,099 (±55.7)

D.E.L.L. 1,495 5.6 1,147 (±58.1)

Four Woods 1,562 5.8 1,150 (±57.0)

Green Ark 1,713 6.4 1,146 (±54.3)

Lark 1,551 5.8 1,194 (±59.4)

Manor Street 1,639 6.1 1,063 (±51.5)

Morice Town 1,515 5.6 1,133 (±57.1)

Nomony 2,336 8.7 1,154 (±46.8)

Plum Tree 2,320 8.6 763 (±31.0)

Plymbridge 1,326 4.9 1,038 (±55.9)

Plymstock 2,959 11.0 1,137 (±41.0)

Popin 1,349 5.0 988 (±52.7)

Southernway 1,539 5.7 1,191 (±59.5)

Sweet Peas 1,272 4.7 1,030 (±56.6)

Tamar FOLK 1,486 5.5 1,165 (±59.2)

Whitleigh 1,352 5.0 1,074 (±57.3)

Plymouth 26,911 100.0 1,062 (±12.7)

Of the 26,911 referrals in 2015-16, the highest numbers (2,959) were from Plymstock

Children’s Centre area, representing 11.0% of the overall total. This compares with only

1,272 (4.7%) from Sweet Peas Children’s Centre. Lark and Plum Tree Children’s Centre

areas had the highest (1,194 per 10,000 population) and lowest (763 per 10,000 population)

referral rates respectively.



blood pressure (i.e. they did not experience any of the public health risk factors). On a

designated Children’s Centre level this ranged from 39.0% Tamar FOLK to 60.0% in Popin.

32

Figure 27: Prevalence of one or more risk factors by designated Children’s Centre area (%),

2015-16

Overall 52.2% of people referred experienced one or more risk factors. On a designated

Children’s Centre level the presence of one or more risk factors ranged from 40.0% in

Popin to 61.0% in Tamar FOLK. Other Children’s Centre areas with high values include Lark

(60.5%), D.E.L.L. (60.3%), and Four Woods (59.3%).

Figure 28: Prevalence of all three risk factors by designated Children’s Centre area (%),

2015-16

Overall 0.9% of people referred experienced all three of the risk factors. This ranged from

0.3% in Plymstock to 1.5% in Lark and Four Woods. Other Children’s Centre areas with

high values include Nomony (1.4%), Tamar FOLK (1.4%) and Whitleigh (1.3%).

33

8.3 Individual risk factor prevalence Figure 29: Referrals who were smokers by designated Children’s Centre area (%), 2015-16

Overall 18.3% of people referred were smokers. On a designated Children’s Centre level

this ranged from 10.8% in Plymstock to 25.2% in Tamar FOLK. Other Children’s Centre

areas with high values include Manor Street (23.0%), D.E.L.L. (22.9%) and Lark (22.9%).

Figure 30: Referrals who were obese by designated Children’s Centre area (%), 2015-16


22.5% in Popin to 40.0% in Lark. Other Children’s Centre areas with high values include

34

Four Woods (38.9%) and D.E.L.L. (38.2%).

Figure 31: Referrals who had high blood pressure by designated Children’s Centre area (%),

2015-16


This ranged from 12.4% in Nomony to 18.7% in Plymbridge. Other designated Children’s

Centres with high values include Southernway (18.5%) and Sweet Peas (17.7%).

35







On a designated Children’s Centre level from 2013-14 to 2015-16:

Figure 32 shows an increase in the percentage of smokers in 15 out of 16 designated

Children’s Centres (94%) from 2013-14 to 2015-16. D.E.L.L. showed the biggest

increase (getting worse) of 4.2% (from 18.7% to 22.9%). Manor Street was the only

designated Children’s Centre area to show a decrease (getting better) of 1.5% (from 24.5% to 23.0).

Figure 33 shows a decrease in the percentage of referred people categorised as

obese in 13 out of 16 designated Children’s Centres (81%) from 2013-14 to 2015-16.

Plymbridge showed the biggest decrease (getting better) of 4.1% (from 35.5% to

31.4% between 2013-14 and 2015-16). D.E.L.L. showed the biggest increase (getting

worse) of 3.0% (from 35.2% to 38.2% between 2013-14 and 2015-16).

Figure 34 shows a decrease in the percentage of referred people with high blood pressure in eight out of 16 designated Children’s Centres (50%) from 2013-14 to

2015-16. Lark showed the biggest decrease (getting better) of 2.4% (from 18.3% to

15.9%). Plymbridge showed the biggest increase (getting worse) of 2.6% (from 16.1%

to 18.7%).

Figure 32: Trends in referrals who were smokers by designated Children’s Centre (%),

2013-14 to 2015-16

36

Figure 33: Trend in referrals categorised were obese by designated Children’s Centre (%),

2013-14 to 2015-16

Figure 34: Trend in referrals with high blood pressure by designated Children’s Centre (%),

2013-14 to 2015-16

37

9. Results by Livewell Southwest locality

9.1 Referrals

Table 8: Referrals by Livewell Southwest locality (numbers; percentages; rates per 10,000

population), 2015-16

Locality Referrals (number) Referrals (%) Referrals (rate)

East 5,279 19.6 932 (±25.1)

North 7,276 27.0 1,109 (±25.5)

South 6,507 24.2 1,057 (±25.7)

West 7,849 29.2 1,157 (±25.6)

Plymouth 26,911 100.0 1,062 (±12.7)

Of the 26,911 referrals in 2015-16, the highest numbers (7,849) were from the West

locality, representing 29.2% of the overall total. This compares with only 5,279 (19.6%) from

the East locality. The West and East localities also had the highest (1,157 per 10,000

population) and lowest (932 per 10,000 population) referral rates respectively.



blood pressure (i.e. they did not experience any of the public health risk factors). On a

Livewell Southwest locality basis this ranged from 43.0% in the West to 54.9% in the East.

Figure 35: Prevalence of one or more risk factors by Livewell Southwest locality (%), 2015-

16

38

Of the people that were referred 52.2% experienced one or more of the risk factors. On a

Livewell Southwest locality basis the presence of one or more risk factors ranged from

45.1% in the East to 57.0% in the West.

Figure 36: Prevalence of all three risk factors by Livewell Southwest locality (%), 2015-16

Overall 0.9% of people referred experienced all three of the risk factors. On a Livewell

Southwest locality basis this ranged from 0.4% in the East to 1.1% in the North locality.


Figure 37: Referrals who were smokers by Livewell Southwest locality (%), 2015-16

Overall 18.3% of people referred were smokers. On a Livewell Southwest locality basis this

ranged from 11.4% in the East to 22.9% in the West.

39

Figure 38: Referrals who were obese by Livewell Southwest locality (%), 2015-16


28.0% in the South to 34.1% in the West locality.

Figure 39: Referrals who had high blood pressure by Livewell Southwest locality (%), 2015-

16


This ranged from 13.8% in the South to 17.2% in the North locality.

40







On a Livewell Southwest locality basis from 2013-14 to 2015-16:

All Livewell Southwest localities showed an increase in the percentage of smokers

from 2013-14 to 2015-16 (Figure 40). The South locality showed the biggest increase

of 2.3% (from 16.6% to 18.9%). The West locality showed the smallest increase of

0.9% (from 22.0% to 22.9%).

The percentage of people referred who were categorised as obese increased between

2013-14 and 2014-15, then decreased in all Livewell Southwest localities in 2015-16.

The biggest decrease (getting better) of 1.4% (from 34.9% to 33.5% between 2013-14

and 2015-16) was seen in the North locality (Figure 41).

Figure 42 shows a decrease in the percentage of referred people with high blood pressure in half of the Livewell Southwest localities (50%) from 2013-14 to 2015-16.

The West locality showed the biggest decrease (getting better) of 1.3% (from 16.0% to

14.7%). The North locality showed the biggest increase (getting worse) of 0.5% (from

16.7% to 17.2%).

Figure 40: Trend in referrals who were smokers by Livewell Southwest locality (%), 2013-14

to 2015-16

41

Figure 41: Trend in referrals categorised as obese by Livewell Southwest locality (%), 2013-

14 to 2015-16

Figure 42: Trend in referrals with high blood pressure by Livewell Southwest locality (%), 2010-11 to 2012-13

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