annual report of the director of public health · produced an annual report of the director of...

Annual Report of the Director of Public Health

Brighton & Hove 2010

Nelson Mandela

Mrs Rosa Parks

Helen Keller

Simon Weston

Christy Brown

Group Captain Bader

Emmeline Pankhurst

Nelson MandelaSouth African anti-apartheid leader of the ANC, who spent 27 years imprisoned for his beliefs. Following his release in 1990, Nelson Mandela led his party in the negotiations that led to multi-racial democracy. Awarded the Nobel Peace Prize in 1993, he was elected to the Presidency from 1994 to 1999 where he promoted truth and reconciliation.

Douglas BaderDespite the loss of both legs in a flying accident in 1931, Douglas Bader fought with the RAF in WWII including the Battle of Britain. He was shot down over France and became a POW making several escape attempts leading to his eventual incarceration in Colditz. After the war he campaigned for the disabled for which he earned a knighthood in 1976.

Christy BrownAcclaimed Irish author, painter and poet, Christy Brown was raised in

poverty with almost total paralysis from cerebral palsy. He could not speak intelligibly and could only move his left foot. Despite this he learnt to write and paint with his foot, publishing his autobiography “My Left Foot” in 1954.

Simon WestonFormer soldier in the Falklands War, Simon Weston suffered 46% burns including severe facial disfigurement. Reconstructive surgery included over 70 major operations. He has since campaigned for charities supporting people with disfigurements and is active in supporting troops and veterans.

Helen KellerDeaf and blind for most of her childhood, Helen Keller was taught to communicate by the blind teacher Anne Sullivan. She became the first deaf-blind person to achieve a Batchelor of Arts degree in the 1900s and went on to become a

prolific author, political activist and an outspoken opponent of war.

Emmeline PankhurstEmmeline Pankhurst led the British suffragette movement eventually winning women the right to vote. An advocate of direct action, “deeds, not words” she spent time in prison as a result of her campaigns. When votes for women aged over 30 years were introduced in 1918 she founded the Women’s Party, dedicated to promoting women’s equality in public life.

Rosa ParksAfrican – American Rosa Parks sparked the civil disobedience movement by her refusal to give up her seat on a bus to a white passenger in1955. This led to the Montgomery Bus Boycott. Through her actions, she became a symbol of the USA civil rights movement.

Sir Winston ChurchillWinston Churchill’s refusal as Prime Minister to consider defeat, surrender or a compromise peace inspired British resistance, especially at the start of WWII when Britain stood alone against Hitler. Through his determined leadership and inspiring speeches, he led Britain to victory against Nazi Germany. He achieved this despite bouts of severe depression.

Tanni Grey ThompsonTanni Grey Thompson won 16 Paralympic medals during her career, including 11 gold, set over 30 world records and won the London Marathon wheelchair event six times between 1992 and 2002. Since retiring she has actively supported many sporting and volunteer charities.

Oprah WinfreyOprah Winfrey was born into poverty and hardship. While growing up she experienced rape, teenage pregnancy and death of a baby son. She went on

to become a major American TV host, actress, producer and philanthropist.

Mahatma GandhiCalled the “Father of India”, Mahatma Gandhi championed the use of non-violent civil disobedience as a means of winning independence from colonial rule for India. He experienced as a result several periods of imprisonment. Ghandi also used fasting as a means of protesting and swore always to speak the truth.

Christopher ReeveChristopher Reeve achieved stardom through his acting, including the Superman movies. In 1995, following a horse-riding accident he became quadriplegic and dependent on a wheelchair and breathing apparatus. Despite this, he actively lobbied in support of people with spinal chord

injuries and promoted stem cell research. He founded the Christopher Reeve Foundation and Research Centre.

Ernest ShackletonAn intrepid and famous Antarctic explorer from the early twentieth century, Shackleton showed extreme resilience during his ill-fated sea navigation of the Antarctic. His boat “Endurance” became trapped and crushed by the pack ice. After a harrowing open boat crossing and mountain climb to reach a whaling station on South Georgia, Shackleton succeeded in saving the lives of all his crew.

Aung San Suu Kyi Leader of the Burmese pro-democracy movement, Aung San Suu Kyi’s National League for Democracy party won the general election in 1990. Prior to this win she had been placed under house arrest by the military government and this continued for almost twenty one years until her release in 2010.

Winston Winston Churchill

Tanni Grey Tanni Grey Thompson

Oprah Oprah Winfrey

Mahatma Mahatma Gandhi

Christopher Christopher Reeve

Ernest Ernest Shackleton

Aung San Aung San Suu KyThompson

Annual Report of the Director of Public Health

Brighton & Hove 2010

Dr Olu Elegbe Public Health Practitioner, NHS Brighton & Hove

Kate Gilchrist Head of Public Health Research and Analysis, NHS Brighton & Hove

Dr Paul Hine FY2 Public Health Doctor, NHS Brighton & Hove

AuthorsAnnie Alexander Public Health Programme Manager, NHS Brighton & Hove

David Brindley Health Promotion Specialist, NHS Brighton & Hove

Dr Katie Cuming Specialist Registrar and General Practitioner, NHS Brighton & Hove

Lydie Lawrence Public Health Improvement & Development Manager, NHS Brighton & Hove

Martina Pickin Public Health Improvement Principal, NHS Brighton & Hove

Miranda Scambler Public Health Research & Analysis Specialist, B&HCC and NHS Brighton & Hove NHS Brighton & Hove

Dr Tom Scanlon Director of Public Health, NHS Brighton & Hove and B&HCC

Dr Peter Wilkinson Consultant in Public Health, NHS Brighton & Hove

Contributors

Nicky Alldis Systems Administration Manager, City Services, Brighton & Hove City Council (BHCC)

Kim Aumann Director of ART, Amaze Research and Training

Maggie Baker Attendance Strategy Manager/LADO/Education Welfare Service, Children’s Services, BHCC

Steve Barton Lead Commissioner, Children, Youth & Families, Children’s Services, BHCC

Tasha Barefield Parenting Services Manager / Parenting Team, Children’s Services BHCC

Sam Beal Healthy Schools Team Manager, Children’s Services, BHCC

Linda Beanlands Commissioner Community Safety/Commissioning - Community Safety, BHCC

BHCC Communities and Equalities Team

BHCC Economic Development & Enterprise Team

BHCC Housing Team

Paula Black Head of Analysis and Performance, BHCC

Kim Bowler Business Improvement & Projects Manager/Youth Offending Service, Children’s Services, BHCC

Paul Brewer Head of Performance, Children’s Services, BHCC

Finola Brophy Manager, Lifelines

Dr Kath Browne Principal Lecturer, School of Community & Technology, University of Brighton

Eleri Butler Senior Policy Development Officer / Community Safety Secondments, BHCC

Nicky Cambridge People and Place Coordinator, BHCC

Kerry Clarke Strategic Commissioner, Children’s Services, BHCC

Kevin Claxton Resilience Manager

Sarah Colombo Childcare Strategy Manager - Information & Workforce Development, Children’s Services, BHCC

Ruth Condon Community Safety Manager - Performance/Monitoring & Performance, BHCC

Ros Cook Assistant Director, Amaze

Thurstan Crockett Head of Sustainability and Environmental Policy, BHCC

Mark Cull Project Leader, Right Here

Peter Dale Project Adviser, Older People’s Programmes, BHCC

Sean de Podesta Project Leader, Brighton & Hove Neighbourhood Care Scheme

Rima Desai Strategic Commissioner, Children’s Services, BHCC

Chris Dorling Public Health Information Specialist, NHS Brighton & Hove

Katherine Eastland Performance Analyst, Children’s Services, BHCC

Daniel Elliott Senior Information Officer, Children’s Services, BHCC

Mary Evans Commissioner Communities & Equality, BHCC

Terri Fletcher Director, Safety Net

Rob Fraser Head of Planning Strategy

Catherine Gill Project Coordinator (Moving Voices), South East Dance

David Golding Senior Research Officer, BHCC

Barbara Hardcastle Public Health Specialist, NHS Brighton & Hove

Doreen Harrison PA to Director of Public Health

Prof Angie Hart Professor of Child, Family & Community Health, University of Brighton

Susie Haworth School Meals Manager

Steve Healey Head of School Admission &Transport, Children’s Services, BHCC

Liz Hegarty Public Health Administrator, NHS Brighton & Hove

David Higgins Project Manager, Young Carers’ Project

Alistair Hill Consultant in Public Health, NHS Brighton & Hove

Rachel Hollingdale Health Promotion Dietician, Brighton & Hove Food Partnership

Kerry Hone Creative Services, BHCC

Lisa Joliffe Young Carers’ Project

Anna-Marie Jones Performance Analyst, Children’s Services, BHCC

Dr Katherine E Johnson Principal Lecturer in Psychology, University of Brighton

Michelle Kane Health Promotion Specialist, NHS Brighton & Hove

Dan Lawson Health Development Officer, Albion in the CommunityAlbion in the CommunityAlbion in the Communit

Kate Lawson Head of Health Promotion, NHS Brighton & Hove

Sheila Killick Adult Carers’ Team Manager, Carers’ Centre

Jane MacDonald Commissioner Market Development, BHCC

Sally McMahon Head of Libraries & Information Services, City Services, BHCC

Kate Mason FY2 Public Health Doctor, NHS Brighton & Hove

Nora Mzaoui Development Worker Health and Support, Novas Scarman (Can Do Health)

Dr Anjum Memon Consultant in Public Health, NHS Brighton & Hove

Clare Mitchison Public Health Specialist, NHS Brighton & Hove

Tim Nichols Head of Environmental Health, Licensing & Public Safety

Stephen Nicholson Lead Commissioner HIV & Sexual Health, NHS Brighton & Hove

Alison Nuttall Strategic Commissioner, Children’s Services, BHCC

Tina Owens Senior Youth Worker, Children’s Services, BHCC

Sarah Oxenbury Exclusions Development Officer, Children’s Services, BHCC

Caroline Palmer Crime and Disorder Analyst, Partnership Community Safety Team, BHCC

Caroline Parker Head of Service, Sure Start / City Early Years & Childcare, Children’s Services, BHCC

Terry Parkin Strategic Director (People), BHCC

Kristiina Parkinson Commissioner for Community Services, NHS Brighton & Hove

Valerie Pearce Head of City Services, BHCC

Tamsin Peart Joint Commissioner Carers’ Services

Daryl Perilli Performance Analyst, Children’s Services, BHCC

Carolyn Phelps Partnership Manager. Sussex, Kent & Surrey. Pensions, Disability and Carers Service (PDCS)

Sarah Potter Operational Manager Housing Adaptations, Housing Strategy, BHCC

Andrew Renaut Principal Transport Planning Officer, BHCC

Andy Staniford Housing Strategy Manager, BHCC

Jen Stear Coordinator, Older People’s Programme

Gil Sweetenham Lead Commissioner Schools, Skills and Learning, Children’s Services, BHCC

Carolyn Syversen Health Promotion Specialist, NHS Brighton & Hove

Sarah Tighe-Ford Equalities Co-ordinator, BHCC

Duncan Tree National Development and Policy Manager, Community Service Volunteers (CSV)

Rachel Travers Amaze

Sam Warren City neighbourhood Coordinator, BHCC

Emma Welsh LGBT Youth Support Worker, Allsorts

Chris Wilson Senior Research Officer & LINk Contract Manager, BHCC

Pam Windsor Carers’ Centre, Senior Support and Outreach Worker

Becky Woodiwiss Health Promotion Specialist, NHS Brighton & Hove

Matthew Wragg Policy Development Officer / Central Policy Development Team, BHCC

Vanessa Wright Nurse Consultant for Looked After Children, Children’s Services, BHCC

Foreword

Executive Summary

1 Resilience in context .................................................................................. 12

2 The theory of community resilience .......................................................... 20

3 Mapping resilience in Brighton & Hove ..................................................... 26

4 Resilience in children and young people ................................................... 60

5 Resilience in working age adults ............................................................... 78

6 Resilience in older people ........................................................................... 96

7 (a) Resilience in lesbian, gay, bisexual & transgender communities ..... 114

(b) Resilience in carers ............................................................................... 130

8 Case studies: resilience initiatives in Brighton & Hove .......................... 142

9 Building resilience in Brighton & Hove .................................................... 150

Appendix:

Indicator definitions for the Wellbeing and Resilience Measure (WARM) .......... 162

This has been quite a year for public health This has been quite a year for public health and the NHS. Sweeping changes have been announced with health service commissioning responsibilities passing in 2013 to consortia of general practitioners; strategic health authorities and primary care trusts coming to an end in 2012 and 2013 respectively; primary care trusts already merging into cluster arrangements; the Health Protection Agency, the National Treatment Agency and Public Health Observatories preparing to come together with other organisations under the umbrella of Public Health England; health and wellbeing boards being set up to oversee the delivery of health and social care at a local level; and local public health directorates moving from primary care trusts where they have been located since 2002 to local authorities.

This latter shift will in fact not constitute too much of a change for us in Brighton & Hove, as the public health team has worked across the city council and NHS Brighton and Hove with some co-location for many years. In fact, this is the sixth time that we have jointly produced an Annual Report of the Director of Public Health. It remains a statutory duty for

directors of public health to produce an annual independent assessment of local public health. With the advent of the joint strategic needs assessment (JSNA), much of the information that would in the past been published in these reports is now published elsewhere. In Brighton & Hove, the public health directorate has overseen the production of an increasingly comprehensive joint strategic needs assessment and a dynamic portfolio of individual needs assessments, summarised annually for the Local Strategic Partnership and available for public consumption via the BHLIS website.

Given the role of the joint strategic needs assessment in informing the commissioning of health, social care and, no doubt, in the future other public services and even some third sector and business developments, it is important that the Report of the Director of Public Health provides some added value. I have tried to do this in recent years by taking a particular focus, such as locality commissioning, the needs of children and young people, and last year a historical overview of the major public health problems we face in Brighton & Hove. This year, the focus is on community resilience.

There are a number of reasons for adopting this approach: the current financial climate with cuts in public funding and a requirement to do more with less; a Coalition Government policy of ‘localism’; the ‘Big Society’ initiative; and an emerging realisation that in order to tackle local public health problems more effectively, we need to engage more effectively with local populations and harness the assets that exist therein. So, rather than expressing public health issues in the usual terms of population needs, this report describes both the public health vulnerabilities and assets that exist within Brighton & Hove, and suggests how the assets might be employed to address some of the vulnerabilities. In that sense it is a much more solution-focused report.

This has required a completely different approach from the various team members who have contributed to this report, and I am aware that I have tested their personal resilience to varying degrees in the course of its production. I would like to thank Katie Cuming, Peter Wilkinson, Kate Gilchrist, Lydie Lawrence, Martina Pickin, Annie Alexander, Miranda Scambler, David Brindley and Olu Elegbe who all led specific contributions, and who were

required by me, on more than one occasion, to revisit their draft contributions in order to describe this resilience with greater clarity. I know too, that this required considerable collaboration with colleagues, particularly officers in the city council, but also partners in the wider statutory, third and business sectors who often had the detailed knowledge of what was happening on the ground. A full list of contributors is included, and I am grateful to them all (and I apologise if anyone has been missed out).

The timeframe of this report is a little later than is usual. This has simply been a consequence of the late Easter break and the May election which necessitated a period of purdah. The timescales for the report have been executed as planned and I would like to thank the ever-creative production team at Kings House for their usual prompt, professional and friendly assistance.

Each year this report throws up one or two names to whom I am particularly obliged. On this occasion I would like to single out Barbara Hardcastle, Public Health Specialist and Kate Gilchrist, Head of Public Health Research and Analysis. Together, the three of us formed a

small steering group and oversaw the scoping, editing, proofing and eventual publication of the report. Barbara played the key role in making sure the report came in on time; that it was properly collated and proofed - no small feat - and she was methodical and unstinting in her efforts. Kate, with her encyclopaedic knowledge of data, datasets and the relevant published literature led the analysis, using the Wellbeing and Resilience Measure (WARM) adapted, by herself and Dr Paul Hine, for local use. It is not overstating the case to say that without Kate, I would have struggled to get this project off the drawing board. I owe them both a considerable debt of gratitude, and probably a long holiday too.

I hope then that this report will avoid one of the criticisms that is sometimes levelled at public health, namely that we are experts at describing problems, but not always so smart when it comes to solving them. This report contains both problems and solutions. There is considerable resilience out there and I hope that this report will result in us all using it, to the benefit of everyone who lives and works in Brighton & Hove.

Dr Tom Scanlon Director of Public Health, NHS Brighton & Hove and B&HCC

FOREWORD I 7

This Annual Report of the Director of Public Health explores community resilience in Brighton & Hove. Previous reports have Brighton & Hove. Previous reports have discussed local public health issues in the context of the needs of the local population. This report seeks to identify areas of both strength and weakness.

The logic underlying this approach stems from the current period of economic hardship with reductions in public sector funding, and the prevailing political policy of localism and making better use of untapped resources. It is also very much the case, as is demonstrated in this report, that we have many local assets that could be better used to resolve longstanding public health issues.

The research base for the concept of community resilience is in its infancy and the concept is used more with regard to individuals rather than populations. Nevertheless there is some published literature. For the purposes of this Report the Wellbeing and Resilience Measure (WARM), produced by a partnership of the London School of Economics, the Local Government Improvement and Development Agency (formerly IDeA) and the Young Foundation has been used to map out community resilience across the city and within different groups.

The WARM tool allows us to describe resilience in terms of assets and vulnerabilities with regards to ten different components: regards to ten different components: life satisfaction; education; health; material wellbeing; strong and stable families; belonging; local economy; public services; crime and anti-social behaviour; and infrastructure.

This report explores these ten different components and scores the city on a red, amber or green (RAG) rating with regard to how it compares with the rest of the country. In addition, individual wards are scored on a RAG rating, with the comparison being how they fare with regard to other wards within Brighton & Hove. There is further analysis by three different age groups: children and young people; working age adults; and older people. The resilience of two special groups is also described: carers and the lesbian, gay, bisexual and transgender (LGBT) communities.

LIFE SATISFACTIONSatisfaction with living in Brighton & Hove is high. This is the case for working age adults and yet more so for older people. Many people from LGBT communities move to the city because it is perceived as LGBT-friendly. There is a strong correlation between satisfaction

with Brighton & Hove and affluence, with the with Brighton & Hove and affluence, with the strongest levels of satisfaction in the more strongest levels of satisfaction in the more affluent electoral wards. However, even in affluent electoral wards. However, even in some deprived wards there are high levels of life satisfaction.

EDUCATIONBrighton & Hove scores amber overall in the WARM tool analysis, with the assets of a low proportion of residents without any qualifications and a high proportion of residents with highest level qualifications. But there are also several vulnerabilities: many of the highly educated residents are migrants to the city; there are poor results at GCSE level; and relatively low transition by schoolchildren into further education. The distribution of educational resilience across the community is strongly correlated with affluence levels.

Primary school achievement is good, but the relatively low achievement at secondary school level has wider implications in terms such as higher risks of involvement in drug and alcohol use, in crime and anti-social behaviour and teenage pregnancy. There is a resilience building programme in place in local schools although this has not been formally evaluated. There is considerable scope for building more on the educational assets in the city including

EXECUTIVE SUMMARY I 9

the local universities, and the highly educated adult and older people workforce.

HEALTHBrighton & Hove scores an amber rating overall for the component of health. Within the city there are areas of strong health resilience which are closely correlated with the areas of affluence. The same pattern of health assets and vulnerabilities presents in young people, working age adults and older people. This reflects the importance of cultural and behaviour patterns and lifestyle choices.

The population is generally more fit, with a relatively good diet and lower levels of obesity. However, there are relatively high rates of tobacco, alcohol and substance misuse, and higher rates of sexual health and mental health problems. Initiatives which address these issues across the community and across generations, and which take a local holistic approach to health, are likely to improve resilience in this area.

MATERIAL WELLBEINGBrighton & Hove scores an amber rating in this respect, with assets of a relatively low exposure

to debt, and benefit claimants who are for the most part claiming for short periods of time. Vulnerabilities include higher numbers of claimants for income support and incapacity benefit, and residents who are exposed to debt at relatively high levels compared to the average for England. Across different parts of the city, the picture of material wellbeing is as expected with some exceptions, such as Westbourne.

While the overall picture that emerges in Brighton & Hove is one where although material wellbeing is generally good, certain groups such as children living with single parents, older people and many carers struggle. In terms of building material resilience, one measure that should be pursued, and with some haste, is to make sure that vulnerable residents, who are entitled to benefits, receive those benefits.

STRONG AND STABLE FAMILIESOverall Brighton & Hove scores an amber rating with the assets of relatively low proportions of lone parent and carer claimants but the vulnerability of a relatively high proportion of divorced residents. Relatively large proportions of elderly people in the city live alone and are potentially socially isolated. There is no subjective measure in this component, and while low claimant rates may reflect low need, as has been illustrated, they may also reflect low take up and a resultant persisting need.

10 I EXECUTIVE SUMMARY

A significant barrier to building strong and stable families is the presence of domestic violence. In Brighton & Hove, there are relatively high levels of substance misuse, mental health problems and domestic violence. Among the LGBT communities high levels of domestic violence are reported. Improved measures to tackle domestic violence, alcohol and substance misuse, identified in the local commissioning pilot work, should go some way to building resilience in this area.

BELONGINGMany people choose to come and study, live and work in Brighton & Hove, and satisfaction rates with living here are high. However, the belonging component is the only one in the WARM analysis where the city as a whole scores a red rating. Younger adults in particular feel less involved in the community. There is variation across the city with residents of Portslade, Withdean and Rottingdean scoring higher on belonging, while residents in the electoral wards of St Peter’s and North Laine score the lowest of all. Many carers feel lonely and isolated.

Research shows that when there are high levels of involvement in civil society, and where people feel part of local decision-making, there is a greater sense of belonging. Initiatives which help communities to embrace diversity by establishing horizontal and vertical links within and between communities also

create a sense of belonging. Volunteering is another excellent means of fostering this aspect of resilience. As young adults in particular do not feel this sense of belonging, there is scope for local universities to engage more with third sector organisations in order to achieve this.

LOCAL ECONOMYThe local economy is the only WARM component where Brighton & Hove is rated green. There is good accessibility to employment with short travel times, high numbers of job vacancies and a high number of small industries. Within the city the central wards with high numbers of vacancies and good transport links do best in this respect. The strong and diverse small business sector

means that Brighton & Hove is less vulnerable to the effects of business failures in large employers. Business satisfaction rates with the city as a location are high. There is a good range of organisations, some funded by the local authority, which support business development in the city.

While this is a green rated aspect of resilience it is not an area without some risk. There is a shortage of high quality business accommodation in the city. Most telling of all, the majority of new jobs created locally do not actually go to residents who have grown up in Brighton & Hove. This vulnerability ties in very strongly with other aspects of resilience and again emphasises the need to improve education opportunities and to create stronger and more stable families.

EXECUTIVE SUMMARY I 9

PUBLIC SERVICESIn its report A Council the City Deserves the local authority has stated that it wants to see a rise in levels of satisfaction with the public sector. The city scores amber overall for the public service aspect of resilience. By virtue of its compact size, most public services are near where people live, however there are relatively low levels of satisfaction across the board and with regard to city council, GP, local hospital and dental services.There is some encouragement. Residents are satisfied with public transport services, they consider that NHS services are improving and many vulnerable residents and older people feel that local services make an effort to respond to their concerns.

There is research which shows how to increase public satisfaction with local services. It is important to treat local communities with trust and respect; to recognise and release local capabilities, and to listen and involve people (residents and front line workers). Even in times of economic hardship, if services are delivered in this sort of way, satisfaction with local services can improve.

CRIME AND ANTI-SOCIAL BEHAVIOUROverall the city scores amber in this component,with the assets of a relatively low fear of crime and below average burglary offences. However, the overall crime, anti-social behaviour, violent crime and child and

wellbeing crime scores are all relatively high. The picture across electoral wards in the city is in keeping with the deprivation profile. Although the overall crime rate is falling, it has fallen much less than it has across Sussex and nationally. There is some inconsistency, with relatively high levels of perceptions of safety in some areas while objective evidence suggests otherwise; in other wards the converse is true. Young people are more likely than older people to be victims of crime. There is evidence of continued hate crime against members of the LGBT communities, especially in more deprived parts of the city.

Among some residents there is a perception that their views are not properly considered by the police. However, this is an area where there is strong partnership working, and numerous crime and anti-social behaviour initiatives in the city particularly around housing and alcohol consumption. Some early results, for example with regard to addressing anti-social behaviour in children and adults, are encouraging.

INFRASTRUCTUREInfrastructural resilience comprises features such as transport, schools and hospitals as well as community facilities. Overall the city is rated as amber in this component. Residents express high levels of satisfaction with the parks and green spaces in the city (this includes the beaches), while the condition of the city’s housing comprises a vulnerability. With the

exception of Moulsecoomb and Bevendean electoral wards, residents living on the outer parts of the city centre tend to have more resilience in terms of infrastructure.

Housing stands out as the priority for Brighton & Hove in terms of infrastructure. The many problems with housing have been alluded to several times in this report. It affects all ages and many vulnerable groups, such as carers. There are some innovative initiatives to address the city’s housing problems, however it is clear that much more remains to be done.

This report has sought to focus on problem solving as much as it has sought to identify where problems can be (and sometimes have been) solved with better community engagement. There are many people already engaged in building resilience in Brighton & Hove, and many more initiatives than have been described in this report.

The challenge is for us to work much better with the local population and with partners, and if necessary to take some risks in order to harness the considerable strengths and assets that exist in Brighton & Hove to the benefit of all.

Chapter 1

Chapter 1 I RESILIENCE IN CONTEXT I 13

RESILIENCE IN CONTEXTPrevious Reports of the Director of Public Health have focused on local needs and sought to identify areas where these were not being met. This report is quite different. This Annual Report of the Director of Public Health is unusual in that it is focused on resilience.

INTRODUCTION The concept of resilience is by no means new, but recent years have seen a growing body of academic research, as well as support for strengthening the resilience of individuals, families and communities from across the public health, social, economic and political arenas. Greater resilience has the potential to realise benefits not just in terms of physical and mental wellbeing, but also in terms of economic development. So at a time of particular pressure on the nation’s finances, the idea of increasing resilience is very attractive to health agencies, local authorities, the voluntary sector, business and not least of all, governments.

Many of the data sources used in previous reports are also analysed in this one. However, this time they are explored for the purpose of identifying both strengths and assets rather than solely focusing on frailties and vulnerabilities. The intention is not to ignore the public health problems that exist in Brighton & Hove, and this report does not steer completely clear of describing some of the needs we all know exist, but rather it is with the purpose of

better identifying the solutions to public health problems; solutions that to some extent lie in our own resilient hands.

Resilience will be a new concept for some readers and so the theories behind it and the tools that might be used to measure it are explored in Chapter 2. Chapters 3 to 7 are devoted to measuring and describing resilience in Brighton & Hove. This is a local report however, that uses routine data and not a piece of academic research, so there are inevitably some caveats around the picture of resilience as it is described in Brighton & Hove. Chapter 8 includes some case studies of interventions aimed at promoting resilience in the city and an analysis of how effective, or otherwise, these have been. The final chapter describes how the evidence uncovered in this report might be put to some productive use.

This first chapter seeks to place resilience in the context of related concepts such as social capital, and is a summary of the political, social, economic and academic discussion that surrounds this increasing pursuit of resilience.

POLITICALThe Labour Government elected in 1997 sought to prioritise combating poverty and social exclusion by, among other measures, establishing a Social Exclusion Unit (SEU) within the Cabinet Office. That unit described social exclusion as “a shorthand label for what can happen when individuals or areas suffer from a combination of linked problems such as unemployment, poor skills, low income, poor housing, high crime environments, bad health and family breakdown.” 1

The SEU developed strategies aimed at increasing social capital to combat social exclusion. These included measures targeted at reducing teenage pregnancy and empowering communities to renew neighbourhoods physically and socially. 2 In the latter years of the Labour Government it was the Civil Contingencies Secretariat that led a programme of resilience work.3 A Community Resilience Programme was set up to support communities in combating threats and hazards and to encourage effective dialogue between communities and the practitioners recruited to

14 I Chapter 1 I RESILIENCE IN CONTEXT

support them. The programme also aimed to increase the understanding of risk so that, for example in local emergencies, communities would be better able to mobilise and sustain self reliance.

The present Coalition Government’s policy focus on resilience has been expressed through the ‘Big Society’: a concept with the aim of putting more power and opportunity into the hands of local people. Better resilience, it is argued, will be achieved by encouraging people to take an active role in their

used to provide finance for the initiative. Volunteering and involvement in social action is to be encouraged, there will be a ‘Big Society Day’ and regular community involvement will be a key element of civil service staff appraisals. A National Citizen Service will provide 16-year-olds with the chance to develop the skills needed to be active and responsible citizens.

‘Localism’ is key to the Government’s approach and local authorities will be given greater powers and financial autonomy on housing and planning. Public sector workers will be encouraged to become “their own bosses” and thereby deliver better services; they will be able to form employee-owned co-operatives and bid to take over statutory-run services.

Alongside the Big Society initiative the police have begun to publish local crime data statistics every month, so the public can get accurate information about crime in their neighbourhoods. The Prime Minister has stated that although economic growth, as expressed through Gross National Product (GNP) is the most urgent priority, there is a need for a better measure of national progress. The Government has therefore signalled its intention to introduce a ‘Happiness Index’ to gauge the happiness of the population. The Office for National Statistics will carry out the survey with the first official Happiness Index due to be released in 2012. 4, 5

communities, giving those communities more powers, and enabling local co-operatives, charities and social enterprises to run local services. Through the Big Society initiative it is envisaged that communities might also save some local facilities threatened through financial pressures, by taking them over from state-run services.

The Big Society initiative encompasses the training of neighbourhood organisers and groups, particularly in the most deprived areas. Funds from dormant bank accounts will be

Southwark Circle has a discount club for members who enjoy eating out.


SOCIALSocial cohesion as described in the concept of ‘social capital’ has been identified as critical for societal prosperity and sustainable development. The World Bank has been at the forefront of much of the discussion. 6 Social capital is defined by the World Bank as “the institutions, relationships, and norms that shape the quality and quantity of a society’s social interactions, not just the sum of the institutions which underpin a society.” It comprises the social networks and associated community norms that promote wellbeing and productivity. It might be summed up as the glue that binds communities together.

There is increasing evidence that high levels of social capital in populations promote health and lower morbidity and mortality. Conversely, it has been demonstrated that a widening gap between rich and poor lowers levels of trust and social cohesion resulting in increased mortality.

The broadest view of social capital acknowledges the impact that the social and political environment has in shaping social structure. This perspective extends the concept of social capital to include the political regime, the law, the court system, and civil and political liberties. The capacity of various social groups to act in a community’s interest depends to a degree then upon the level of support they receive from the State and the private sector. The State in turn depends upon social stability and widespread popular

support. Both the economic and social sectors prosper when representatives of governments, the corporate sector and civil society create institutions through which communities can pursue common goals.

There are many examples of where statutory organisations have recognised the importance of social capital when working with communities to improve local services. In 2007 the then Government published Putting People First, a vision for transforming adult social care with the aim of giving people more choice and control over the support services they required. 7 Some local authorities have developed these proposals into a programme for increasing social capital with an emphasis on prevention. A good example is provided by the Southwark Circle, a membership organisation which acts as a social network for teaching and learning and for providing help with practical tasks. Members can earn tokens by helping out fellow members or buy tokens with which they can “purchase” help from Neighbourhood Helpers. 8 A glass half full: how an asset approach can improve community health and wellbeing comes from the national Local Government Improvement and Development programme (formerly IDeA) and describes an approach which provides the opportunity for dialogue between local people and work practitioners on the basis of both having something to offer each other. 9

The focus on positive community attributes such as its capacity, skills and knowledge, rather than just negative factors, provides for new ways of improving health and tackling inequalities. This approach increases social capital and community action and ultimately can improve local services.

Southwark Circle encourages people to help out


ECONOMICUnemployment damages the health and wellbeing of individuals and communities. Unemployed people and their families are at increased risk of premature death and even job insecurity on its own can be prejudicial. 10 The number of people whose jobs are threatened or lost increases during recessions and economic downturns. The recent global economic recession and the subsequent fiscal policy have tested the resilience of individuals and communities. The UK recession began in April 2008, and was the longest UK recession on record. During 18 months of recession, public borrowing increased to an estimated £178 billion and output fell by six percent. Figure 1.1 illustrates the impact of the recent recession on unemployment in the UK. 11,12

The Audit Commission has produced a ‘life cycle’ model for recessions with three distinct waves. 13 First, an ‘economic’ wave is described as a relatively short period where economic output declines, firms fail or reduce staff numbers, unemployment rises quickly and real incomes fall. The second ‘social’ wave lasts longer and while output growth returns, job losses continue. Unemployment remains high, bringing with it housing, health and domestic problems. The third ‘unequal recovery’ wave occurs when the economy expands and unemployment has passed its peak. Investment and economic development return, but not all areas benefit. Some

communities continue to decline, while others bounce back. The scope of local business and employment opportunities defines the extent of recovery but, as recognised by the World Bank, resilient communities are best prepared to recover most quickly from economic recession.

ACADEMICThe aim of Fair Society, Healthy Lives, also known as The Marmot Review, was to identify the evidence most relevant to underpinning future policy and practice to tackle health inequalities in England. 14 Marmot clearly states that avoidable health inequalities are the result of social inequalities and that reducing

Figure 1.1: Unemployed people and Jobseeker’s Allowance claimants in the UK 1992–2010

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Num

ber

(mill

ions)

Unemployment: Dec 2010 2.51m

Claimant count: Dec 2010 1.46m

Source: ONS

in their community can give people added control over their lives with the potential to contribute to their own and others’ wellbeing.

There are also links between the inequalities and climate change agendas. Improving air quality and access to recreational facilities and green space can all contribute to reducing inequalities as well as helping to create sustainable communities.

To deliver The Marmot Review’s key policy objectives will require co-ordinated action across central and local government, the NHS, the third and private sectors and community groups. These groups need to work together to develop effective local services and systems which are focused on improving health equity and building resilience.

The public health White Paper Healthy Lives, Healthy People 15 was the Government’s response to the Fair Society, Healthy Lives Review. The White Paper speaks of freeing up local government and communities to improve the health and wellbeing of their population through strengthening self-esteem, confidence and personal responsibility, positively promoting healthier behaviour and lifestyles and making healthy choices easier. Like public health White Papers before it, Healthy Lives,


the gap in inequalities is a matter of social justice. The report makes recommendations regarding actions across the social determinants of health throughout the life course and on several points specifically highlights the need to develop resilience and build social capital.

The Marmot Review argues that economic growth is not the most important measure of a country’s success and that the fair distribution of health, wellbeing and sustainability are more important goals. Part of this vision is to create conditions in which individuals can take control of their own lives, and so it puts the empowerment of individuals and communities at the heart of action required to reduce inequalities. Some communities need to increase their capacity and capability through development while others need to overcome the barriers to community participation.

Six policy objectives are identified for reducing inequalities in the review:

Give every child the best start in life•

Enable all children young people and adults •to maximise their capabilities and have control over their lives

Create fair employment and good work •for all

Ensure a healthy standard of living for all•

Create and develop healthy and •sustainable places and communities

Strengthen the role and impact of ill health •prevention

The review illustrates the strong association between the wellbeing of individuals and communities and the social networks to which they belong. Strong ties within communities are a source of resilience and provide a buffer against risks such as poor health, economic constraints and other difficulties. Participating

Sir Michael Marmot


Healthy People places great emphasis on ensuring a good start in life for children.

The economic recession, the greater emphasis on emergency planning, and the Government’s prioritisation of localism and the Big Society have combined to raise the profile and pursuit of community resilience. Within public health, the recent review of inequalities has reinforced the view that social justice and not economic growth should be considered the most important measure of a country’s success and that to truly tackle inequalities requires a broad partnership aimed at empowering communities and the individuals within them.

The following chapter in this report considers the current evidence for the impact of resilience on health and wellbeing. Subsequent chapters describe the picture of resilience in Brighton & Hove and potential strategies for increasing this.

Brighton Unemployed Families Project Play Centre.


References:

1. Social Exclusion Unit. What is social exclusion? 1998 www.cabinet-office.gov.uk/seu/index/march_%202000_%20leaflet.htm . (accessed December 2010).

2. Social Exclusion Unit. A New Commitment to Neighbourhood Renewal. www.neighbourhood.statistics.gov.uk/HTMLDocs/images/NationalStrategyReport_tcm97-51090.pdf (accessed April 2011).

3. Civil Contingencies Secretariat. www.cabinetoffice.gov.uk/content/civil-contingencies-secretariat (accessed January 2011).

4. BBC News. The Happiness Index; 2010. www.bbc.co.uk/news/uk-11833241 (accessed December 2010).

5. BBC News. The Happiness Index; 2010. www.bbc.co.uk/news/uk-politics-11756049 (accessed December 2010).

6. The World Bank. Social Capital; 2010. web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTSOCIALDEVELOPMENT/EXTTSOCIALCAPITAL/0,,contentMDK:20185164~menuPK:418217~pagePK:148956~piPK:216618~theSitePK:401015,00.html (accessed December 2010).

7. Department of Health. Putting people first. Department of Health; 2007 www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_081119.pdf (accessed April 2011).

8. Southwark Circle; 2010. www.southwarkcircle.org.uk/ (accessed December 2010).

9. Improvement and Development Agency. A glass half-full: how an asset approach can improve community health and wellbeing. IDeA; 2010. www.idea.gov.uk/idk/aio/18410498 (accessed April 2011).

10. Wilkinson R and Marmot M. Editors. The Solid Facts. The World Health Organisation. Denmark; 1998.

11. BBC News. Unemployment figures. 2010. www.bbc.co.uk/news/10604117 (accessed December 2010).

12. BBC News. The Economy; 2010. news.bbc.co.uk/1/hi/8479639.stm (accessed December 2010).

13. The Audit Commission. When it comes to the crunch: how councils are responding to the recession. The Audit Commission; 2009. www.auditcommission.gov.uk/SiteCollectionDocuments/AuditCommissionReports/NationalStudies/whenitcomestothecrunch12aug2009REP.pdf (accessed April 2011).

14. Marmot M. Fair Society, Healthy Lives: Strategic Review of Health Inequalities in England post 2010. The Marmot Review; 2010.

15. Department of Health. Healthy Lives, Healthy People: our strategy for public health in England. London: The Stationery Office; 2010.

Chapter 2

Chapter 2 I THE THEORY OF COMMUNITY RESILIENCE I 21

THE THEORY OF COMMUNITY RESILIENCE Strengthening community resilience involves recognising the strengths or assets within that community, building on these, and using them to help address the vulnerabilities that hamper a community’s capacity and capability to do well in the face of difficult times.

INTRODUCTIONResilience is the defining characteristic of individuals and communities that do better than expected in the face of adversity (Table 2.1). Much of the literature refers to the resilience of individuals. Individual resilience focuses on the strengths or assets that contribute to a good outcome for that person despite the odds. Assets contributing to individual resilience have been described as intrinsic characteristics within the person such as temperament, social and problem solving skills; and extrinsic enabling assets such as educational opportunities and good support from others, which may promote the development of resilience through the life course. 1

This report is concerned with community resilience. Definitions and theories of community resilience vary both within and between different disciplines. It is a more recent concept and less widely described than individual resilience. For the purposes of this report the following definition has been selected:

“Community resilience means the capacity of communities to respond positively to crises. It is the ability of a community to adapt to pressures and transform itself in a way which makes it more sustainable in the future. Rather than simply ‘surviving’ the stressor or change, a resilient community might respond in creative ways that fundamentally transform the basis of the community.” 2

The resilience of a community is influenced by its social relationships, networks and social capital. These affect its ability to cope during difficult times. Strengthening community resilience involves recognising the strengths or assets within that community, building on these, and using them to help address the vulnerabilities that hamper a community’s capacity and capability to do well in the face of difficult times. This is different to many approaches to assessing and assisting communities which focus more on identifying gaps in services or needs.3

Table 2.1: The development of resilience

Adversity / risks

Outcome Low High

Positive Favourable Resilience: experience unexpected of life positive outcome

Negative Unexpected Risk and negative vulnerability outcome

Source: Bartley M, 2006

Communities can be geographically defined, for example in a town, city, valley or locality. They may be defined by ethnicity or language, religion or belief, a feeling of belonging to a community structure or group such as a school, church, interest group or local industry. Many people or families may identify with one, more than one, or none of the communities present within an area. Recognising and measuring community resilience in a non-place

Havana, Cuba

Collective resources – e.g. self-help groups, •credit unions, community safety schemes

Economic resources – e.g. levels of •employment; access to green, open spaces

Cultural resources – e.g. libraries, art centres, •local schools. 7

Friedli also describes ‘environmental capital’: structural factors and features of the natural and built environment that enhance community capacity for wellbeing; and ‘emotional and cognitive capital’ as resources that buffer stress and / or determine outcomes and contribute to individual resilience and capability. 8

EVIDENCE FOR BETTER POPULATION HEALTH OUTCOMES THROUGH IMPROVED RESILIENCE AND SOCIAL CAPITALSome places exhibit more resilience than others. For example, certain countries such as Sri Lanka, Cuba or Costa Rica; or areas of countries such as Kerala in India have demonstrated comparatively good health outcomes despite relatively poor economic indicators. 9

Within the UK, areas experiencing a prolonged period of economic hardship but with more resilient characteristics have been shown to have lower age-specific death rates than other deprived areas with less resilient characteristics. It should be noted that death rates in the

22 I Chapter 2 I THE THEORY OF COMMUNITY RESILIENCE

based ‘community’ raises its own challenges. Within this report, communities are described both geographically and by certain groups.

The Young Foundation, one of the partners which developed the tool used in this report to measure resilience, describes how the approach of trying to understand how a range of assets allows successful adaptation in some individuals can be extended to communities, based on the premise that ‘place matters.’ 4

SOCIAL AND OTHER FORMS OF CAPITAL Social capital, as has been discussed in Chapter 1, is a key component of community resilience. It represents the degree of social cohesion in communities and refers to the processes between people that establish networks, norms, social trust, and facilitate co-ordination and co-operation for mutual benefit. 5 Five key dimensions have been described by the World Bank: groups and networks; trust and solidarity; collective action and cooperation; social cohesion and inclusion and information and communication. These networks and associated community norms promote wellbeing and productivity; social capital has been summed up as the glue that binds communities together. Horizontal and vertical ties are necessary. Horizontal ties give communities a sense of identity and common purpose. However, without vertical ties crossing social divides such as ethnicity or socio-economic status, horizontal ties alone can lead to the pursuit of narrow interests, and impair the access of some groups to information and employment opportunities which would otherwise be of great benefit to the whole community. 6

The following types of resources have been described as components of social capital, and are thereby important factors contributing to the development of community resilience:

Social resources – e.g. informal •arrangements between neighbours or within a faith community


resilient deprived areas were still, however, higher than those both in less deprived areas and the British average. 10 Possible protective factors for a community include fewer residents moving away when the economic situation declines, a shared identity, industrial history, social bonds and networks. 1

There is some evidence that social capital is a protective factor. A systematic review and meta-analysis of social relationships and their effect on health showed that stronger social relationships seemed to have a protective effect on survival. 11 Some UK based research has

shown that residents living in areas with greater levels of participation and integration into society and higher levels of trust and tolerance/ respect were less likely to have poor self-reported health. This research described the size effect of living in a neighbourhood with low trust as being the equivalent of 15 years extra in age in terms of self-rated health. 12

However the research base on community resilience is still quite limited and even within the published research that exists, much of it explores how communities respond to specific events or disasters.

BUILDING RESILIENCE THROUGH THE LIFE COURSEThe building of resilience may be considered a process rather than a static state. In other words, resilience can be improved at any stage of life. Within this report resilience through the life course is described; among children and young people, working age adults, older people and other groups. To consider resilience within these particular groups as part of the community is important because experiences at each life stage will influence resilience later in life. Individuals and communities may start off with certain resilience assets but it is with life experiences resilience develops further. The Whitehall II study showed how, for individuals, experiences in early life in terms of close relationships, bonding and parenting

influenced outcomes into adulthood in terms of resilience shown in the workplace. 1

Likewise, communities may be seen to go through different processes with population influxes, economically hard or good times and the outcomes, in terms of community resilience, may be different depending on the time elapsing and other factors. ‘Adaptive resilience’ uses crises and setbacks as opportunities, in contrast to ‘survival resilience’ which concerns the ability to absorb shock. 4

An issue of some debate in the field of resilience concerns the establishment of a longer term desirable outcome. So, for a community living through difficult economic times, is the focus on avoiding adverse health and social outcomes while continuing to live in poverty or is it about escaping from poverty altogether?1

Resilience is less about risk factors and the best ways for a community or individuals to deal with that risk factor; and more about how certain assets within groups, communities and individuals enable them to cope better on exposure to the risk and produce a better outcome. Vulnerabilities present within the individuals and groups make them more susceptible to the risk.

Children at a TAKEPART International Festival of Sport event at Yellowave Beach Sports Venue, Brighton in 2010.

24 I Chapter 2 I THE THEORY OF COMMUNITY RESILIENCE

However, neither resilience nor vulnerability are universal or constant.

THE MEASUREMENT OF COMMUNITY WELLBEING AND RESILIENCEStudies of resilience in individuals or specific groups often focus on one specific outcome, such as educational attainment. For example, poorer children who were assessed as having above average reading skills at five years of age are performing less well by the age of 16 years than those from an economically privileged background who performed less well when aged five years. 1 Much of the research into resilience in young people considers risk factors or vulnerabilities such as a difficult family situation or alcohol or substance misuse, and measures specific outcomes that may indicate greater or lesser resilience.

Measuring resilience and the factors associated with resilience, or its absence, within a community involves considering a wide range of factors that may promote, represent or threaten resilience in a diverse community setting. This is a very different approach to the concept of individual resilience. It involves the assessment of the wellbeing, vulnerabilities and factors promoting resilience within the individuals, families, networks and structures in local communities. Challenges in measuring the ‘general resilience’ in a population or community include the fact that the assets and

vulnerabilities may be unknown, unmeasured or extremely difficult to measure.

TOOLS TO MEASURE COMMUNITY RESILIENCEA number of tools have been developed in recent years to assess community resilience. The Mental Wellbeing Impact Assessment Toolkit has been developed as part of the broader health impact assessment process. 13 This toolkit aims to help those planning policies or programmes to consider the potential impact of any changes on mental wellbeing, including resilience and community assets. Potential positive and negative impacts are considered, looking at individual, community and/or organisation levels.

Individual factors considered include: emotional wellbeing; ability to understand, think clearly, and function socially; beliefs and values; learning and development and a healthy lifestyle.

Community/organisation factors assessed include:

Trust and safety e.g. belief in reliability of •others and services, feeling safe where you live or work;

Social networks and relationships e.g. contact •with others through family, groups, friendships, neighbours, shared interests, work;

Emotional support e.g. confiding •relationships, provision of counselling support;

Shared public spaces e.g. community •centre, library, faith settings, cafés, parks, playgrounds, places to stop and chat;

Sustainable local economy e.g. local skills •and businesses being used to benefit local people, buying locally, using ‘Time Banks’ (a means of exchanging skills and resources through ‘banking’ time credits);

Arts and creativity e.g. expression, fun, •laughter and play.

A community resilience project in Canada has developed a tool for assessing resilience in local communities under the four domains of people, resources, organisations and community process. The idea is that the profile or ‘portrait’ of community resilience will help set priorities and then select strategies and tools to strengthen resilience within the community. 14

Experian has developed a tool to measure the resilience of an area covering the four themes of business, people, community and place. This measure has additional weighting on the business indicators and has a focus on the economic, business and employment status of a geographical area. 15


In all of these tools there are issues around definition, measurement and mapping. Non-spatial communities such as those defined by ethnicity or community may be harder to map than those which are geographically defined. 4

Nevertheless, tools such as these can be useful when considering strategies or policies which may directly or indirectly impact on resilience. In fact, the Local Government Improvement and Development programme (formerly IDeA) suggest that a Joint Strategic Assets Assessment, in addition to the Joint Strategic Needs Assessment, should be used to give a fuller picture of the local potential as well as the gaps. 16

The Wellbeing and Resilience Measure (WARM) used in this report provides a framework for measuring wellbeing and resilience at a very local level. It assesses three domains: individual self; social supports and networks; and systems and structures in the local community. It has been adapted slightly to widen the scope of measurement of resilience in Brighton & Hove. The methodology is discussed more fully in Chapter 3. The purpose of mapping resilience assets and vulnerabilities in this report is so that policy makers and public sector workers within the city can work better with local communities to identify solutions to their problems, improve the quality of life of the community, and build resilience to help protect against current and future hard times. 4

References and web links:

1. Bartley M (ed) Capability and Resilience: Beating the Odds. ESRC Human Capability and Resilience Network. UCL Department of Epidemiology and Public Health 2006.

2. Australian Social Inclusion Board. Building inclusive and resilient communities. Australian Government. June 2009.

3. Morgan A, Ziglio E. Revitalising the evidence base for public health: an assets model. IUHPE – Promotion and Education Supplement 2 2007; 14:17-22. 4. Mguni N, Bacon N. Taking the Temperature of Local Communities. The Wellbeing and Resilience Measure. Local Wellbeing Project. The Young Foundation 2010.

5. World Health Organization. Health Promotion Glossary. Geneva 1998. www.who.int/hpr/NPH/docs/hp_glossary_en.pdf (accessed April 2011).

6. World Bank website. Overview social capital. 2011. go.worldbank.org/C0QTRW4QF0 and go.worldbank.org/K4LUMW43B0 (accessed April 2011).

7. Health Development Agency. Choosing Health Briefings. Social Capital. June 2004 HDA Briefing No. 24. www.nice.org.uk/niceMedia/documents/CHB21-social-capital.pdf (accessed April 2011).

8. Friedli L. Mental Health, resilience and inequalities. World Health Organization; 2009.

9. CSDH. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization; 2008.

10. Tunstall H, Mitchell R, Gibbs J, Platt S, Dorling D. ‘Is economic adversity always a killer? Disadvantaged areas with relatively low mortality rates’ Journal of Epidemiology and Community Health 2007;61:337-343.

11. Holt-Lunstad J, Smith TB, Layton JB. Social Relationships and Mortality Risk: A Meta-analytic Review. PLoS Med 2010 July 7 (7).

12. Stafford M, Bartley M, Marmot M, Boreham R, Thomas R and Wilkinson R. Social capital for health: issues of definition, measurement and links to health. Health Development Agency. March 2004. Chapter 7, Neighbourhood social cohesion and health: investigating associations and possible mechanisms in (Chapter 7). Health Development Agency. March 2004.

13. Cooke A, Friedli L, Coggins T, Edmonds N, O’Hara K, Snowden L, Stansfield J, Steuer N and Scott-Samuel A. The mental well-being impact assessment toolkit. 2nd Ed. London: National Mental Health Development Unit; 2010.

14. Community Resilience Project Team. The Community resilience Manual. Making Waves Vol 10, No 4. www.cedworks.com/files/pdf/free/MW100410.pdf (accessed April 2011).

15. Experian. Understanding Resilience. Background information – West Midlands. Experian Limited 2010. September 2010. publicsector.experian.co.uk/Products/~/media/Publications/Resilience/Experian_resilience_BBC%20West%20Midlands.ashx (accessed April 2011).

16. Improvement and Development Agency (now Local Government Improvement and Development). A glass half-full: how an asset based approach can improve community health and well-being. Local Government Association; 2010.

Associated useful links

www.ucl.ac.uk/capabilityandresilience/beatingtheoddsbook.pdf www.socialinclusion.gov.au/LatestNews/Documents/Buildingcommunityresiliencebrochure.pdf

www.apho.org.uk/resource/view.aspx?RID=95836

Chapter 3

Taking the temperature of local communities. Wellbeing and Resilience Measure (WARM) illustration courtesy of The Young Foundation.

Chapter 3 I MAPPING RESILIENCE IN BRIGHTON & HOVE I 27

MAPPING RESILIENCE IN BRIGHTON & HOVEWARM sets out a new approach to measuring the wellbeing and resilience of people and communities by using data that is already available to look at communities in a new way.

INTRODUCTIONChapter 2 of this report describes some of the tools available for measuring resilience and why we have chosen to use The Wellbeing and Resilience Measure (WARM) in Brighton & Hove.

The WARM tool came out of the Local Wellbeing Project, an initiative involving The Young Foundation, London School of Economics Centre for Economic Performance and the Local Government Improvement and Development Agency (formerly IDeA).1

WARM sets out a new approach to measuring the wellbeing and resilience of people and communities by using data that is already available to look at communities in a new way. It starts from the assumption that the key to resilient neighbourhoods is boosting local assets, while also tackling vulnerabilities. It enables us to identify a community’s strengths, such as levels of social capital, confidence, and quality of local services or

proximity to employment as well as its vulnerabilities such as isolation, crime and unemployment; and to make more informed decisions about where to direct limited resources.

There are five stages to the WARM tool and we have conducted the first two for this report, with some elements of stage three, which will help to inform planning and action in the future:

1. Measuring wellbeing looking at three domains:

Self:• the way people feel about their own lives

Supports:• the quality of social supports and networks within the community

Systems and structures:• the strength of the infrastructure and environment to support people to achieve their aspirations and live a good life.

infrastructure within the systems and structures domain, has been separated, and is now a single component under the supports domain. It was felt that combining belonging and infrastructure together brought less sensitivity when examining what sense of belonging local residents had.

Figure 3.1: The domains and components of the wellbeing and resilience measure (WARM) (adapted for Brighton & Hove)

Source: Wellbeing and Resilience Measure (WARM) – The Young Foundation

METHODOLOGYFor the purposes of this report we have gathered data on the different components identified in the WARM case studies. These resilience assets and vulnerabilities have been mapped at electoral ward level. There are limitations in what can be measured and therefore included so the results should not be looked at in isolation but used to inform the knowledge base; as well as a resource for planners and communities to support and build resilience assets and to reduce the impact of vulnerabilities.

Two factors not included in the framework are gender and age, both of which influence resilience and life satisfaction, but with limited scope for external influence. Women tend to report higher levels of subjective wellbeing than men and subjective wellbeing tends to be U-shaped; higher in younger and older members of the population and lower in those of working age. 2 Following the exploration of resilience at city and electoral ward level, Chapters 4–6 of this report look at specific groups across the life course; children, working-age adults and older people. Two other significant groups in the city; the lesbian, gay, bisexual and transgender (LGBT) community and carers are also considered in terms of resilience assets and vulnerabilities in Chapter 7.

28 I Chapter 3 I MAPPING RESILIENCE IN BRIGHTON & HOVE

2. Measuring resilience by mapping assets and vulnerabilities in the community.

3. Benchmarking to draw out local trends.

4. Planning – using the data from stages one to three to inform communities, commissioners and local partnerships about what is working well, and where further interventions are needed.

5. Taking action – creating or redesigning local services to ensure that they respond effectively to local wellbeing and resilience.

The tool looks at both individual wellbeing; that is how people subjectively experience the quality of their lives, and community wellbeing; the extent to which local services and infrastructure have the capacity to support wellbeing. It draws then on both objective and subjective measures. For example, taking into account both perceived levels of crime and anti-social behaviour alongside reported crime data.

Domains and components of WARMFigure 3.1 shows the components within the three domains of ‘self’, ‘supports’ and ‘systems and structures’. These components have been slightly modified for the purposes of this report. The component ‘belonging’, which in the WARM tool was combined with

Self •Lifesatisfaction •Education •Health •Materialwellbeing

Supports •Strongandstablefamilies •Belonging

Systems and •Localeconomystructures •Publicservices •Crimeandanti-social behaviour •Infrastructure


Each of the components in the WARM tool is made up of a number of indicators, based upon local and national data sources. In this report each component is then given a rating based upon the following classification:

The city as a whole is given a rating for each component as is each electoral ward. There are disadvantages in mapping at electoral ward level as many communities do not neatly fit into administrative boundaries. However, data availability precludes a more complex mapping exercise and mapping at these levels can still give an informative picture and identify where communities have resilience assets and vulnerabilities. A full explanation of all the indicators used in the various components is included in Appendix 1.

The city level red / amber / green ratings are calculated based upon comparison with England while the electoral ward level ratings are based on comparisons to Brighton & Hove. So, even though the city as a whole may not score well for a particular component, individual wards may still perform well, and vice versa.

In compiling this report we were also keen to explore how the city might have changed over recent years. Sadly, much of the data used in the WARM tool is not available at ward level over time. Where data are available for individual components, trend data are presented at city level.

The main datasets used for WARM are the Child Wellbeing Index 2009; Index of Multiple Deprivation 2007 and 2010; i Core Accessibility Indicators – Department of Work and Pensions; National Indicator dataset; Neighbourhood Statistics; Nomis labour statistics and the Place Survey. Some of these indicators will cease to be available in the future, for example the Place Survey has been discontinued nationally. However, some new data will inevitably be collected and data from the 2011 Census will be available from 2012. The 2011 Census will provide a resource of small area information. This resilience mapping

should not then be considered a one-off exercise and new data should continue to be built into the measure to give greater understanding of how resilience and wellbeing in the city is changing in response to initiatives put in place by the statutory and voluntary sector.

Through the work of The Young Foundation, particular data gaps have been identified and four key questions are recommended for collection at a local level in order to enrich the picture of resilience and wellbeing. These are:

How many people can you rely on to help •in times of need?

Overall, how would you describe the •quality of your life?

In the area where you live, would you •intervene to help a child who was being hurt in the street?

How confident do you feel?•

Red Indicators are consistently below average

Amber Indicators are in line with averages or mixed performance

Green Indicators are consistently above average

Crime

i At the time of writing the report only domain and sub domains of the Index of Multiple Deprivation (IMD) 2010 were available. These have been used within this report. However where indicators are based upon underlying indicators from the IMD, these were not published at the time of writing so the indicators from the IMD 2007 are used in the report.

component as while satisfaction with local area is related to higher life satisfaction, it cannot be used as a replacement.

Picture across the cityThere is a strong association between satisfaction with the local area and deprivation


COMMUNITY RESILIENCE IN BRIGHTON & HOVE

Self domain

Life satisfaction

Context“Resilience and wellbeing are inextricably linked. The ability to make decisions, to overcome challenges, to ask for help, the story that we tell ourselves when we fail, are all resilient behaviours that impact on wellbeing, either positively or negatively. Additionally, positive feelings of wellbeing associated with resilience can in turn lead to higher levels of subjective wellbeing.” 3

Indicators within the component There was only one suggested indicator for the life satisfaction component, a question from the Place Survey: “All things considered, how satisfied are you with your life as a whole nowadays?” In other words, “How happy are you?” Unfortunately this question was not asked as part of the Brighton & Hove Place Survey. However, evidence from the WARM project shows that liking your neighbourhood is the factor most strongly related with life satisfaction; people who like their present neighbourhood are twice as likely to have good life satisfaction. 1 In the 2008 Brighton & Hove Place Survey respondents were asked “Overall, how satisfied or dissatisfied are you with your local area as a place to live?” This

has therefore been used in this report.

City ratingIn Brighton & Hove 86% of respondents were very or quite satisfied with their local area, higher than England 80% and the South East 83%. We have not rated the city in this

R2 = 0.4928

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1070

Figure 3.2: Correlation between Index of Multiple Deprivation (2007) and overall satisfaction with local area as a place to live (Place Survey 2008), Brighton & Hove wards

Source: Index of Multiple Deprivation (IMD) 2007, Communities and Local Government and Place Survey 2008

R2 = 0.4928

60

65

70

75

80

85

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95

100

0 5 10 15 20 25 30 35 40 45 50

IMD 2007

Re

sid

en

ts v

ery

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8)

St Peter's and

North Laine

South

Portslade

Central

Hove

0

65

1070


(Figure 3.2). More affluent wards have higher levels of satisfaction with their local area. However, this is not the case for all wards, suggesting factors other than deprivation influence satisfaction. The highest levels of satisfaction are found in Hove Park (95%), Rottingdean Coastal (95%), Wish (93%) and South Portslade (93%) (Map 3.1).

Unexpected assets and vulnerabilitiesSouth Portslade and Central Hove have the fourth and fifth highest satisfaction but are the eleventh and seventh most deprived wards (of 21) in the city. Portslade was a Neighbourhood Renewal Area from 2001 to March 2008 when the national Neighbourhood Renewal Funding ended. Conversely St Peter’s and North Laine is the ward with the lowest level of satisfaction in the city but does not rank highest in deprivation (6th most deprived).

ImplicationsSatisfaction with the local area is then clearly more than just about affluence and what it is that makes a particular part of Brighton & Hove a good place to live in the face of apparent deprivation is at this point a matter of conjecture. This finding however merits some consideration and should be explored further in any future surveys undertaken in the city.

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade

Hollingbury& Stanmer

East Brighton

Wish

Moulsecoomb& Bevendean

Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide

Dotted Eyes © Crown copyright and/or database right 2009.All rights reserved. Licence number 100019918

Place Survey - Overallsatisfaction with localarea as a place to live

90.0 - 95.0

84.1 - 89.9

76.0 - 84.0

Map 3.1: Overall satisfaction (very or quite satisfied) with local area as a place to live (Place Survey 2008) in Brighton & Hove wards

Source: Place Survey 2008


Education

ContextAs levels of education increase, so does wellbeing. However, whether this is due to education or the outcomes that are generally associated with education (employment, income and better health) is subject to some debate. Traits such as motivation or family background are also associated with wellbeing. 4

Indicators within the component

Five GCSEs A*–C grades including English •and Maths (2009)

Adults (25–54 years) with no or low •qualifications rate – Index of Multiple Deprivation (2007)

Not staying on post 16 years rate – Index of •Multiple Deprivation (2007)

Working age population qualified to at •least level 2 or higher (2009): no data at ward level

Working population qualified to at least •level 4 or higher (2009): no data at ward level

Child Wellbeing Index Education Score (2009)•

City rating

Amber Assets: Low proportion of people without qualifications and high proportion with the highest qualification levels.

Vulnerabilities: Poor results at GCSE level.

There is a divide for Brighton & Hove in education assets and vulnerabilities, with assets focused in the working age population (higher levels of qualifications) but vulnerabilities concentrated in younger residents of the city (poorer GCSE attainment). The former is likely to be due to the city attracting a high number of both university students, who remain in the city after their course, and professionals. The latter finding indicates relatively poor educational attainment among secondary school children in the city.

Of 150 local authorities in England ii, Brighton and Hove is ranked 14th (1=best) for the proportion of those aged 16-64 years qualified to at least level 4iii in 2009 5 but ranked 132nd for GCSE attainment iv in 2009/10v. The city sits behind only Haringey, Islington and Lewisham with the greatest discrepancy

ii Note that the Isles of Scilly and City of London excluded as information not available on both educational attainment and working age qualifications.

iii Level 4 qualification is NVQ level 4, BTEC Professional Diplomas or certificates of higher education

iv 5+ GCSEs at A*-C grade including English and mathsv Provisional figurevi Indicators used in trend in educational resilience and wellbeing are 5 GCSEs

A*-C grades including English and maths (2004/05 – 2009/10) and adults (16-64 years) qualified to at least level 4 or higher (2004 - 2009).

vii Provisional figureviii Note that the Isles of Scilly and City of London excluded as information not

available on both educational attainment and working age qualifications.

between high working age qualifications and low GCSE attainment.

Trend vi GCSE attainment in Brighton & Hove has improved, from 45% in 2004/05 to 49% in 2009/10 vii but in relation to improvements around the country, and hence in terms of ranking by local authority in England,

Figure 3.3: Brighton & Hove local authority ranking (of 150 local authorities where 1=best) for working age qualifications 2004–2009 and GCSE attainment 2004/05–2009/10

Source: Annual population survey and Department for Education

73

81

85

98

126

132

10

16

15

13

17

14

0 25 50 75 100 125 150

2004

2005

2006

2007

2008

2009

Rank (of 150)Best Worst

Working agequalified to level 4 or

aboveGCSE attainment


performance has been consistently falling; from 73rd (of 150 viii, where 1 is the best) in 2004/05 to 132nd in 2009/10 (Figure 3.3). This is the second greatest fall in rankings in the country with a drop of 59 places, behind only Suffolk (65 places). The average rate of improvement across England over the five years has been over twice that of Brighton & Hove. The proportion of adults aged 16–64 years qualified to at least level 4 has risen from 38% in 2004 to 43% in 2009 in the city and from 26% to 30% in England. In terms of ranking, Brighton & Hove has held a stable position between 10th and 17th.

Picture across the cityMap 3.2 shows the rating for the education component for wards across the city. Those areas with the lowest rating are concentrated in the east of the city and North Portslade. East Brighton, Hollingbury and Stanmer, Moulsecoomb and Bevendean, North Portslade and Woodingdean have vulnerabilities for young people and the working age population. Moulsecoomb and Bevendean ward is the most vulnerable in the education component of resilience in the city. Brunswick and Adelaide, Central Hove, Goldsmid and Preston Park, Rottingdean Coastal, Stanford, Wish, and Withdean have no vulnerabilities for education.

Unexpected assets and vulnerabilitiesWhile most wards with a red rating are clustered in the east of the city, North Portslade also fares poorly when compared

with the city as a whole. The rate of adults with low or no qualifications is considerably higher in North Portslade (49%) compared with the average rate for the city (33%) and England (42%). The percentage of students attaining A*–C grade, including English and

Maths, at GCSE is also significantly lower than for the city and the proportion of students not staying on in education after the age of 16 years (30%) is considerably higher than Brighton & Hove (23%), though only slightly above England (27%).

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


RAG rating - Education

1

2

3

Map 3.2: Education component rating for wards in Brighton & Hove, 2010

Source: NHS Brighton and Hove Public Health Directorate based upon the Wellbeing and Resilience (WARM) tool


ImplicationsThe fact that the improvement in secondary educational attainment in the city is falling behind most other areas in the country is of great concern. The impact of this on the wellbeing and resilience of young people in the city should not be underestimated and improvement in educational outcomes needs to be a key priority not just for secondary schools but for education partners across the city, such as local universities and colleges and third sector organisations.

This low level of attainment contrasts starkly with the high levels of working age qualifications. There is thus a widening discrepancy, or even inequality, between the children in our secondary schools and the population coming to the city because of the further educational opportunities it affords. Chapters 6 and 7 of this report also discuss the relatively high qualifications of older people as well as the LGBT community living in Brighton & Hove. The opportunities to build educational resilience afforded by the existence of two universities within the city, and the presence of a highly educated adult population should be better harnessed so that school children can aspire to the same educational achievements as the adults who live here.

Health

ContextHealth, both physical and emotional, greatly enhances resilience and has a larger impact on life satisfaction and wellbeing than both employment status and marital status. 6 Research also shows that a positive outlook is strongly associated with subjective wellbeing. 4


% of households with one or more person •with a limiting long term illness (2001)

Years of Potential Life Lost Indicator (2007)•

Child Wellbeing Index Health and disability •score (2009)

% of people who reported good health •(2008)

Comparative Illness and Disability Ratio – •Index of Multiple Deprivation (2007)

Measure of Adults Suffering from Mood or •Anxiety Disorders – Index of Multiple Deprivation (2007)

City rating

Amber Assets: High self reported health

Vulnerabilities: Poor mental health, health and disability and years of life lost scores

Self perceived health is an important indicator of resilience and life satisfaction; those with good self perceived health over the last year are 1.6 times more likely to show good life satisfaction. 1 For this reason perceived health is considered alongside other more objective measures of health. Brighton & Hove scores highly for perceived health, but has vulnerabilities in objective health measures.

In the Brighton & Hove Place Survey of 2008, 80% of people reported they were in good or very good health compared with 76% in England. As at the 2001 Census, the city had a similar proportion of households containing a person with a limiting long term illness (31% in Brighton & Hove and 34% in England). For the rest of the indicators Brighton & Hove compares poorly with England and in particular for the measure of adults suffering from mood or anxiety disorders.


ward 81% of people thought that their general health was good or very good and a lower proportion said that they had a limiting long term illness, but the ward has a poor health score in the Index of Multiple Deprivation and the third highest years of potential life lost (a measure of early death) in the city.

Conversely, Rottingdean Coastal has the third best overall illness and disability score in the city; a slightly lower proportion of households contain people with limiting long-term illness; a lower proportion of adults suffer mental health disorders and years of potential life lost is lower than the Brighton & Hove average. However, in spite of these objective measures of good health, a lower percentage of people report good health. This may be related to the older age structure in that ward.

ImplicationsSelf reported health in the city is good, and arguably better than would be expected given the measures of objective health and wellbeing. This suggests that there is an element of health resilience in the city. If people perceive their health to be good, then this presents an opportunity still to actively engage them in the pursuit of better health.

Picture across the cityMap 3.3 shows the overall rating for the health component for wards in Brighton & Hove. There is a mixed picture with a third of wards having a green rating for this domain. Queen’s Park, Moulsecoomb and Bevendean, East Brighton, Goldsmid and Hangleton and Knoll all have red ratings.

Unexpected assets and vulnerabilitiesAs health outcomes are strongly related to deprivation it is no surprise that the poorer ratings for this component are seen in the most deprived areas of the city. However, there are areas of the city where self reported health is better than expected given more objective outcomes measures. For example, in Regency

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


RAG rating - Health

1

2

3

Map 3.3: Health component rating for wards in Brighton & Hove, 2010

Source: NHS Brighton and Hove Public Health Directorate based upon the Wellbeing and resilience (WARM) tool


Claimants aged 18–24 years (average %) •(May 2010)

Child Wellbeing Index material wellbeing •score (2009)

Income Deprivation Affecting Older People •Index (IDAOPI) (2010)

Total County Court Judgements (2005)•

Average value of County Court Judgements •(2005)

Average Weekly Household Total Income •Estimate (2007/08)

City rating

Amber Assets: Relatively low exposure to debt. Claimants for short duration.

Vulnerabilities: Higher claimants for income support and incapacity benefit. When exposed to debt is at higher levels.

Once again, the city shows a mixed picture with regard to material wellbeing. It has higher claimants of income support and incapacity benefit but generally residents are claimants of Jobseeker’s Allowance (JSA) for short periods (less than a year). There is a similar child material wellbeing score and slightly higher income deprivation for older people. Average weekly earnings are just above the level in Great Britain.

While there is relatively low exposure to debt as measured by County Court Judgements (CCJs), when exposed, debts are at higher financial levels with the average value in Brighton & Hove around £3,200 compared with around £2,000 in England.

Trend ix

Whilst the number of JSA claimants in the city is less than half the number it was in 1992 (15,908 claimants), it has risen considerably since 2008 from 4,463 to 7,243 claimants in 2010. The claimant rate x in Brighton & Hove has been consistently higher than both England and the South East since 2002 and the most recent figures are the highest since 2000 (Figure 3.4). However, the ranking for Brighton & Hove has improved from 95th out

Material wellbeing

ContextThe relationship between income, resilience and wellbeing is complex. The increase in wellbeing from having more material wealth tends to level off once a certain income level is met (the ‘Easterlin effect’). 2 Relative income has a much stronger effect than absolute income on wellbeing. 4 Research shows that being unemployed has a large impact on levels of wellbeing and can lead to a loss in sense of control. 2,7


Income support (August 2009)•

Incapacity Benefits (August 2009)•

Claimants for Less than 12 Months – % of •Jobseeker’s Allowance (JSA) claiming for less than 12 months (November 2010)

Income Index (2010)•

Claimant count (May 2010)•

Claimants aged 50 years or over (average •%) (May 2010)

ix Indicators used for the trend in the material wellbeing domain are: Jobseeker’s Allowance claimant count; Claimants for less than 12 Months – % of JSA less than 12 months and; Average Weekly Household Total Income Estimate.

x As a proportion of the resident population aged 16-64 years


of 152 local authorities (1=the best) in April 2008 to 79th in 2009 and 74th in 2010, which implies that the increase locally is not as bad as across many other local authorities in the country and that Brighton & Hove therefore has more resilience than other areas. Arguably, the city is more resilient now than during the mid 1990s recession where the claimant rate was well above the national rate with one in ten claiming JSA up to 1996.

Across Brighton & Hove, the South East and Great Britain there has been an increasing trend in the proportion of JSA claimants who claim for a period of less than a year (Figure 3.5). This has been consistently lower in the city than the region and nationally but the figures are now similar. In Brighton & Hove this was at its lowest point in April 1997 (50%) and rose to a high of 87% in January 2009, when it fell and rose again to 84% in January 2011. The fall between 2009 and 2010 in Brighton & Hove was to a lesser degree than nationally and in the South East, which again might indicate some resilience with the potential for a relatively quick recovery from the recent recession.

Figure 3.4: All people claiming JSA – long time-series April 1992 to April 2011, Brighton & Hove, the South East and England (% is a proportion of resident population of area aged 16-64 years)

Source: ONS claimant count with rates and proportions

0

2

4

6

8

10

12

14

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

%

Brighton and Hove South East England

Since 2002, gross weekly pay for a full time worker in Brighton & Hove has risen by £112 from £410.50 to £522.60 per week in 2010 (Figure 3.6); an increase of 27% (26% in the South East). In 2010, Brighton & Hove was ranked 113 of 323 xi (1=best) district or unitary local authorities in terms of weekly income. This position has improved slightly since 2006 when Brighton & Hove was ranked 129th of 316 district or unitary authorities with information available.

Picture across the cityMap 3.4 shows the overall rating for the material wellbeing component. This component is highly related to deprivation as many of the indicators are drawn from the Index of Multiple Deprivation.

Whilst Westbourne does not rank highly in terms of deprivation it does receive a red rating for material wellbeing, mainly due to lower levels of household income, higher incapacity benefit claimants, the highest rate of long term JSA claimants and the highest proportion of claimants aged 50 years or over. Westbourne also has a higher score for the Income Deprivation Affecting Older People Index. All of these factors however, reflect the older population of the ward.

0

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100

Apr-92

Apr-93

Apr-94

Apr-95

Apr-96

Apr-97

Apr-98

Apr-99

Apr-00

Apr-01

Apr-02

Apr-03

Apr-04

Apr-05

Apr-06

Apr-07

Apr-08

Apr-09

Apr-10

%

Brighton and Hove South East Great Britain

Figure 3.5: Jobseeker’s Allowance claimants (proportion of all JSA claimants claiming for less than 12 months), Brighton & Hove, the South East and Great Britain April 1992 to January 2011

Source: ONS claimant count - age and duration


xi This information comes from the Office for National Statistics annual survey of hours and working and is not available for all areas.

ImplicationsThe city is more resilient now than during the mid 1990s recession. The recent local increase in JSA claimants is not as bad as across many local authorities in the country and therefore Brighton & Hove appears to be demonstrating more material wellbeing resilience than other areas. The proportion of claimants who are claiming for less than a year is now similar to national levels, from a much worse position in the past. After a fall, this figure is improving once more and at a greater rate than nationally which might again indicate the city has more resilience with regard to the recent recession.

It is worth noting the higher financial value of CCJs. Whilst there are lower total numbers, the higher value might indicate that more people are managing higher debts given the economic and job prosperity seen in Brighton & Hove. A downturn in the economic climate could then push these people into unmanageable debt at potentially high levels.


Figure 3.6: Gross weekly pay - all full time workers, 2002 – 2010 Brighton & Hove, the South East and Great Britain (Median earnings in pounds for employees living in the area)

Source: ONS annual survey of hours and earnings - resident analysis

0

100

200

300

400

500

600

2002 2003 2004 2005 2006 2007 2008 2009 2010

Gro

ss w

ee

kly

pa

y (

£)



Supports domain

Strong and stable families

Context“Strong social relationships, networks and bonds are key to promoting community identity and building resilience and wellbeing.” 8 Relationships with family, friends, neighbours, colleagues and the wider community also support individuals and build resilience. 9 Engaging in supportive relationships, be that with other family members, friends, work colleagues and people in the local community is related with greater life satisfaction. 6 People who are married report higher levels of wellbeing than those who are separated. However, co-habiting couples, people who are widowed and people who have been divorced for some time report higher levels of wellbeing than people who have separated or recently divorced.

Having a high proportion of carers is considered within WARM as a vulnerability, as studies show that being a carer is associated with lower life satisfaction and depressive symptoms, as well as reduced wellbeing resulting from a loss of autonomy and related to the number of hours spent caring. 4

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


RAG rating - Well Being

1

2

3

Map 3.4: Material wellbeing component rating for wards in Brighton & Hove, 2010




People aged 16 or over living in households: •Not living in a couple: Divorced (%) (2001)

Households with no adults in employment: •With dependent children (%) (2001)

One person: Single pensioner households •(%) (2001)

Married couple households: •With dependent children (%) (2001)

Lone parent households: With dependent •children (%) (2001)

Lone parent claimants (August 2009)•

Carer claimants (August 2009)•

City rating

Amber Assets: Lower proportion of lone parent and carer claimants.

Vulnerabilities: High proportion of divorced residents.

In addition to the assets and vulnerabilities above, Brighton & Hove has a similar proportion of single pensioner households and workless family households to England. While the city has a higher proportion of divorced

Picture across the cityMap 3.5 shows the overall rating for strong and stable families. Those wards with red ratings in the east of the city have vulnerabilities in terms of lone parents,

residents, the evidence suggests it is those who are recently separated or divorced who have particularly low levels of wellbeing; this is not however extractable from routine data.

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


Map 3.5: Strong and stable families component rating for wards in Brighton & Hove, 2010



divorced residents and households with dependent children with no adults in employment. Only three wards scored green ratings, and these are clustered together in the more affluent areas of the city. These do well due to higher proportions of married couple households with children in addition to lower proportions of groups linked with lower life satisfaction.

Unexpected assets and vulnerabilitiesIn Westbourne vulnerabilities are very high levels of single pensioner households, a higher proportion of divorced residents and a lower proportion of married couples with children. Some of these relate to the older population of the ward.

ImplicationsThis component is based entirely on objective measures and does not capture subjective experiences of strong and stable families which would offer deeper insight into the resilience of families in the city. In addition, much of the data is based upon the 2001 Census so there are limitations in what it offers in terms of a picture of strong and stable families in Brighton & Hove. There will be an opportunity to update the data once 2011 Census data becomes available. In addition, this is then an aspect of resilience which should be better explored in future local surveys.

Belonging

ContextSocial capital, trust and participation in decision making are strong indicators of resilience in local communities. People who are involved in voluntary and community activities are reported to have higher levels of subjective wellbeing, and areas with high levels of involvement increase the wellbeing of people living in the area who are not members of such organisations. 10 Communities reporting higher levels of trust in each other also report higher levels of wellbeing. Participation in local decision making increases wellbeing, in part due to the fact that decisions are then more likely to reflect the wishes of local people. 11 Both statutory and voluntary organisations can facilitate opportunities for local decision making. 1,2


% of people who feel that they belong to •their neighbourhood (2008)

% who have given unpaid help at least •once per month over the last 12 months (2008)

A member of a group making decisions on •local health or education services (%) (2008)

A member of a decision making group set •up to regenerate the local area (%) (2008)

A member of a decision making group set •up to tackle local crime problems (%) (2008)

A member of a tenants’ group decision •making committee (%) (2008)

City rating

Red Assets: None

Vulnerabilities: A low proportion of people feel a sense of belonging to their neighbourhood. Low proportion of people part of decision making groups.

Belonging is the only domain which receives a red rating for Brighton & Hove. While the city has similar levels of volunteering to England xii

it has lower proportions of people who feel a sense of belonging to their neighbourhood or who are members of decision making groups.

xii There are approximately 19,200 volunteer positions, giving 57,600 per week of volunteer hours (an annual salary equivalent of £24million) (Taking Account: an economic and social audit of the third sector in Brighton and Hove’ September 2008).


This may be linked to the city having a young, transitory population who may be less likely to be involved in their community.

Picture across the cityMap 3.6 shows the overall rating for belonging. Although when compared to national data the city overall has a red rating, with regard to comparisons within Brighton & Hove, there is only one ward with a red rating for this component: St Peter’s and North Laine. One reason for the lower sense of belonging there might be that with the proximity to the train station, more residents in this area commute to London for work: of the population of St Peter’s and North Laine aged 16-74 years working in the week before the 2001 Census, 12% travelled 60km or more to work compared with 8% for the city as a whole. It is also interesting to note that, as discussed in the life satisfaction component, St Peter’s and North Laine ward scores the lowest level of satisfaction in the city with regard to the local area as a place to live. This lack of satisfaction with local area and the absence of a sense of belonging are likely to be related.

Unexpected assets and vulnerabilitiesPortslade, Rottingdean Coastal and Withdean have green ratings for this component; this may be because the population here is less transitory than in central areas, but perhaps

Map 3.6: Belonging component rating for wards in Brighton & Hove, 2010


Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


RAG rating - Belonging

1

2

3


also because there are physical boundaries between these areas and the city centre. So there would appear to be a more clearly defined sense of neighbourhood. Research evidence points to the importance of contact between individuals living in close proximity, and the creation of local identity in building a successful community. One key factor is the presence of physical boundaries that promote a geographical identity.8 These factors are clearly absent in St Peter’s and North Laine.

The large number of wards with an amber rating masks some important differences in the indicators for this component. For example, in East Brighton there is a relatively high sense of belonging and higher rates of volunteering; both of which are assets in building community resilience. However, there is a low proportion of residents being involved in decision making organisations; a vulnerability in terms of resilience. So overall the ward receives a rating of amber. In East Brighton community resilience could be fostered by greater efforts to involve residents in decision making. The importance of such efforts is further emphasised by Brighton & Hove having the fourth highest ranking of all local authorities in the country in terms of residents wanting to be involved in decisions which affect their local area (Place Survey 2008).

ImplicationsBrighton & Hove has a young, transient population, less likely to feel a part of, and be actively involved in the community. More work is required to develop ways of engaging local populations, and in particular young people to foster a sense of belonging to the community. Reviewing the city’s volunteering strategy with a view to encouraging volunteering from particular groups and in particular communities might help. In addition, creating a sense of identity through for example the redevelopment of London Road and the establishment of a new open market, could go some way to both developing a sense of belonging and increasing satisfaction with the St Peter’s and North Laine area.

Systems and structures domain

Local economy

ContextEmployment, strong local networks and low commuting times all contribute to resilience and wellbeing, and tend to exist when there is a vibrant local economy. 4


Travel time to nearest employment centre •by walking / public transport (2009)

% target population within 20 minutes by •composite mode (2009)

VAT based local units by employment size •band (0–4 employees) (Count) (2007)

VAT based local units by employment size •band (20+ employees) (Count) (2007)

Vacancies – summary analysis (notified •vacancies) (November 2010)

Distance travelled to work•


City rating

Green Assets: Good accessibility and low walking / public transport travel time. High number of vacancies and high number of small industries.

Vulnerabilities: None

Local economy is the only component which receives a green rating for Brighton & Hove as a whole. The city benefits from its small size and short travel times by foot or on public transport to the economic centres. The average travel time to the nearest employment centre is seven minutes; half of what it is nationally.

In terms of community resilience, higher numbers of vacancies are an asset as they indicate opportunities for employment and a thriving business sector within a local area. The high numbers of small industries and vacancies in Brighton & Hove means that there are opportunities for employment, self employment and investment in the city. The definition used for large businesses is based upon employing 20 or more people and while the city performs well on this there are in fact

few very large private employers. Amex, the largest private employer with over 2,000 employees, is currently building more office space.

With so few large employers and a low manufacturing base, 93% of the working population in the city are employed in the service industry (Table 3.2, below). The public

Table 3.2: Employee jobs by industry, Brighton & Hove, the South East and Great Britain 2008

Employee jobs by industry Brighton & Brighton & South East Great Britain Hove Hove (employee jobs) (%) (%) (%)

Manufacturing 3,400 2.9 8.1 10.2Construction 3,200 2.7 4.5 4.8Services 111,000 93.1 85.7 83.5Distribution, hotels & restaurants 28,600 24.0 24.6 23.4Transport & communications 5,600 4.7 5.9 5.8Finance, IT, other business activities 31,900 26.8 24.0 22.0Public admin, education & health 36,100 30.3 25.6 27.0Other services 8,700 7.3 5.6 5.3Tourism-related† 14,200 11.9 8.2 8.2Total employee jobs 119,300 - - -

Source: ONS annual business inquiry employee analysis.† Tourism consists of industries that are also part of the services industry.Notes: % is a proportion of total employee jobs. Employee jobs excludes self-employed, government-supported trainees and HM Forces

sector is the largest single employment sector with 30% of the workforce (2008 figures). The current and future public sector workforce reductions will then have wider implications for the local economy’s resilience. The breadth of the service industry is both an asset in that it attracts tourism but also a vulnerability as there is a lack of other employment sectors should the service industry perform poorly.


TrendWhile Brighton & Hove has a resilient economy with high numbers of vacancies, the average number of vacancies per month has actually fallen each year since 2008 when there was an average of 1,843 unfilled job centre vacancies to 1,036 for January to February 2011 (Figure 3.8). This would indicate that resilience of the local economy has reduced in the city over the past three years. However this picture has also been seen regionally and nationally.

Bringing vacancy figures together with Jobseeker’s Allowance (JSA) claimant figuresmeans we can look across the local economy and material wellbeing components of wellbeing and resilience. Figure 3.7 shows that the average number of JSA claimants per unfilled job centre vacancy in Brighton & Hove has risen from 2.7 in 2008 to 6.1 in January and February 2011. This higher ratio means that it has become increasingly difficult for those who are unemployed to find a job in the city. This is not unique to Brighton & Hove, as the South East and Great Britain also saw increases in this ratio, noticeably in 2009. However the South East and Great Britain saw subsequent reductions which were not mirrored in Brighton & Hove.

0

1

2

3

4

5

6

7

2006 2007 2008 2009 2010 2011

Year

Avera

ge n

um

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of

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d v

acancie

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Figure 3.7: Average Jobseeker’s Allowance claimants per unfilled job centre vacancy, Brighton & Hove, South East and Great Britain 2006-2011

Note: 2011 average is based upon January and February 2011 Source: Jobcentre Plus vacancies


Picture across the cityMap 3.8 shows the overall rating for the local economy component for electoral wards in Brighton & Hove, as for the rest of this chapter, this comparison is in relation to the rest of the city, not England. Woodingdean and North Portslade perform relatively poorly due to geographic distance from employment, but this is still much better than England. Wish and Westbourne fare poorly due to few local vacancies and/or businesses, but are adjacent to wards with high numbers of vacancies, suggesting this would not present a great limitation for residents.

Unexpected assets and vulnerabilitiesUnsurprisingly, the city centre wards perform well on this component, but so to do the wards on the corridor out of the city. This is both due to the travel links in to the city but also vacancies and small business in those areas. Queen’s Park also has a green rating due to a high number of people working less than 2km from work. Walking and public transport travel time to nearest employment centre is very short, and 100% of residents live within 20 minutes. Queen’s Park also has the third highest number of vacancies of Brighton & Hove.

1,409

1,725

1,843

1,230

1,131

1,036

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

2006 2007 2008 2009 2010 2011

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Figure 3.8: Average monthly unfilled job centre vacancies (number), Brighton & Hove 2006–2011

Note: 2011 average is based upon January and February 2011 Source: Jobcentre Plus vacancies


ImplicationsOverall the city scores a green rating for local economy resilience as it benefits from its small size, relatively good public transport links and high numbers of vacancies. Although not included in the calculation of this component, the proximity and ease of travel to London is itself an economic asset for Brighton & Hove residents.

However, the number of job vacancies has been falling each year since 2008. The number of Jobseeker’s Allowance (JSA) claimants per vacancy is also higher than the South East. So it is more difficult for unemployed residents to find work in Brighton & Hove. Furthermore, while the South East and Great Britain has seen recent improvements in the ratio of JSA claimants to vacancies, this has not been the case in Brighton & Hove. In addition, the public sector is the largest single employment sector with 30% of the workforce (2008) so any reduction in this workforce would have potentially significant implications for the local economy’s resilience. Together these factors mean that the city’s economic resilience may be under threat. This is explored further in the working age chapter.

Attracting other large private employers to the city to balance the dominance of the service and small business sector is therefore important in further developing the city’s economic resilience.

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


Map 3.7: Local economy component rating for wards in Brighton & Hove, 2010



Public services

ContextResearch on resilient relationships suggests that the quality of public service responses to people facing problems is a key determinant of resilience, and that public services also influence social characteristics impacting on resilience such as community norms, networks, cohesion and cooperation. 12


Satisfaction with each of the following •public services in your local area (very satisfied or fairly satisfied) (2008): Local police; Fire and rescue; GP; Local hospital

Travel time to nearest GP by walk/public •transport (2009)

% of target population weighted by the •access to GPs by walking / public transport (2009)

Number of Further Education institutions •within 30 minutes by walking / public transport (2009)

Number of primary schools within 15 •minutes by walking / public transport (2009)

City rating

Amber Assets: Close proximity to public services.

Vulnerabilities: Relatively low levels of satisfaction with public services.

Due to the small size of the city and good transport links Brighton & Hove scores well on accessibility of GP practices, primary schools and further education by foot or on public transport.

However respondents to the 2008 Place Survey in Brighton & Hove were less satisfied across all the public services listed above than in England as a whole. Satisfaction was higher among people who had used the service in the previous 12 months than for all respondents.

Picture across the cityMap 3.8 shows the overall rating for the public services component for wards in Brighton & Hove. Many wards receive an amber rating for this component and access to services in terms of distance does not seem to correlate with satisfaction.

Unexpected assets and vulnerabilitiesRottingdean Coastal does worse on this component due to lower satisfaction with, and accessibility to GP services and fewer accessible primary schools but it should be noted that this is in relation to the city as a whole, and it remains better than England in terms of accessibility.

There are a high number of wards with an amber rating for this component due to disparity between satisfaction with services and travel/access issues. For example in Moulsecoomb and Bevendean, people have relatively high satisfaction with public services and there is shorter than average walking or public transport time to further education facilities. However, there is relatively poor geographic access to GP services, and a low number of accessible primary schools compared with other wards in the city. Woodingdean, North Portslade, and Patcham, have the highest levels of satisfaction, but have scores which are among the lowest for access and walking or public transport time.

ImplicationsIn terms of resilience, it is insufficient to assume that good access to services is in itself enough. Good accessibility also requires services to be of high quality and to provide satisfaction to the public. Getting this equation right has been a focus of the city council and NHS Brighton and Hove in recent years and will provide an additional challenge in the face of increased public sector financial pressures.

xiii Includes domestic burglaries and burglaries of buildings other than dwellings


Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


Map 3.8: Public services component rating for wards in Brighton & Hove, 2010


Crime and anti-social behaviour

ContextEvidence shows that being a victim of crime and fear of crime and anti-social behaviour can lead to reductions in victims’ levels of self-worth, life satisfaction and can result in victims developing a negative outlook and becoming so risk adverse to the extent that they withdraw from the community. This withdrawal may further increase fear, at the expense of potentially good relationships with others in the community. 7


Child Wellbeing Index Crime score (2009)•

How safe or unsafe do you feel when •outside in your local area during the day? (safe) (2008)

How safe or unsafe do you feel when •outside in your local area after dark? (safe) (2008)

All crime offences (October 2009)•

Burglary offences • xiii (August 2010)

xiv Sometimes referred to as ‘violence against the person’ (does not include sexual offences or robberies)

xv BCS Comparator Crimes are a subset of police recorded total crime which are equivalent to the sort of crimes recorded through the British Crime Survey


Anti-social behaviour incidents •(October 2009)

Violent crime offences • xiv (October 2009)

City rating

Amber Assets: General fear of crime low and below average domestic burglary offences.

Vulnerabilities: Poorer overall crime, anti-social behaviour and violent crime rates and child wellbeing crime score.

The city does well on feelings of safety but less so for objective measures of crime and for crime levels weighted for those at risk aged 0-15 years (Child wellbeing crime score).

In the 2008 Place Survey 93% of respondents in the city felt safe during the day and 62% at night compared with 88% and 51% in England respectively. For all British Crime Survey (BCS) comparator crimes xv in 2009/10 Brighton & Hove ranked 310 out of 374 local authorities (where 1 is the best) and for violent crime 311. The rankings for domestic burglary, at 253 out of 374 authorities were slightly

Total crimeper 1,000 population

Burglaryper 1,000 households

Antisocial behaviour incidents

per 1,000 populationViolent crime

per 1,000 population

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2007/8 2009/10 2007/8 2009/10 2007/8 2009/10 2007/8 2009/10

Brighton & Hove Sussex England & Wales

Figure 3.9: Crime rates, Brighton & Hove, Sussex and England and Wales 2007/08 and 2009/10

Source: Police recorded crime data compiled by the Home Office and supplied as supplementary tables to annual ‘Crime in England and Wales’ reports (2008 and 2010) and Police recorded ASB incident data (NSIR ASB data 2009/10)

better and the rate at 10.4 per 1,000 households was below that of England and

Wales (11.6), but considerably higher than Sussex (5.5). There is no ranking available for


anti-social behaviour incidents but with a rate of 79.5 per 1,000 population, Brighton & Hove is above both Sussex and England and Wales (64.6 and 64.9 per 1,000 population). In 2009/10 there were 20,179 reported incidents of anti-social behaviour recorded by the police in the city.

TrendThe total crime rate (for comparator crimes) fell by 9% in the city from 2007/08 to 2009/10, though this is less than the 18% fall across Sussex and 19% fall in England and Wales. There was a 1% increase in the burglary rate in the city over the same period

compared with a 13% fall across Sussex and an 8% fall in England and Wales, though the number of crimes from April 2010 to February 2011 is lower.

Brighton & Hove has seen some improvement in regard to violent crimes; the rate fell by 27% between 2007/08 and 2009/10 compared with 22% across Sussex and 11% in England and Wales (Figure 3.9). There appears also to have been some improvement with regard to perceptions of anti-social behaviour. Table 3.3 shows the percentage of respondents who felt that various anti-social behaviour issues were a fairly or very big

problem in their local area. This table compares the results from the Best Value Performance Indicators (BVPI) survey (2003 and 2006), the City Views survey in 2007 and the Place Survey in 2008. For all of the listed anti-social behaviour issues, the percentage of respondents who thought them a fairly or very big problem has decreased since 2003. Perceptions of people being drunk or rowdy in public places, for example, has decreased from 64% of respondents in 2003, to 34% of respondents in 2008. In 2003 63% of respondents thought that vandalism, graffiti or other deliberate damage was a fairly or very big problem in their local area; by 2008 this had decreased to 28%. 13

Source: Best value performance indicators, City Views Survey and Place Survey from Brighton & Hove Community Safety Partnership.

Table 3.3: Percentage of Brighton & Hove respondents feeling that various anti-social behaviour issues are a fairly or very big problem in their local area (1,400 < n < 2,200)

BVPI 2003 BVPI 2006 City Views 2007 Place Survey 2008 (n=1500-1900) (n=1400-1750) (n=1450-1950) (n=1850-2200)

Noisy neighbours or loud parties 24.9 25.6 22.3 18.4Teenagers hanging around the streets 46.6 47.4 32.9 27.0Rubbish or litter lying around 62.1 58.0 51.4 40.5Vandalism, graffiti and other deliberate damage 63.0 52.0 37.4 28.1People using or dealing drugs 70.0 55.6 38.6 29.8People being drunk or rowdy in public places 63.9 49.2 37.2 33.9Abandoned or burnt out cars 41.4 18.6 10.8 6.7


Picture across the cityMap 3.9 shows the overall rating for the crime and anti-social behaviour component for wards in Brighton & Hove. In general, this domain of resilience appears to be related to overall deprivation levels.

Unexpected assets and vulnerabilitiesAgain, it is important to look at the detail of assets and vulnerabilities when mapping individual wards. Of those wards rated amber, in five of the wards, this is due to consistently average scores. However, in three wards in the city centre (Goldsmid, St Peter’s and North Laine, and Queen’s Park) this is due to a disparity between low subjective feelings of safety that contrast with low objective child wellbeing index crime scores and low numbers of crime. Conversely, three wards on the outskirts of the city (Patcham, North Portslade, and South Portslade), have high subjective feelings of safety, but higher crime scores. East Brighton, Moulsecoomb and Bevendean, and Hollingbury and Stanmer have crime and anti-social vulnerabilities across the board when compared with the city as a whole.

The disparity between the perception and the reality in Brighton & Hove, is perhaps strongest with regard to crime and anti-social behaviour. The Brighton & Hove Partnership Community Safety Team undertook a ward level analysis of

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


RAG rating - Crime

1

2

3

Map 3.9: Crime and anti-social behaviour component rating for wards in Brighton & Hove, 2010 Woodingdean should be amber


Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


RAG rating - Crime

1

2

3


the gap between perceptions of anti-socialbehaviour issues from the 2008 Place Survey and related reported incidents for various types of anti-social behaviour issues xvi in 2009. 13

They found that North Portslade and Brunswick and Adelaide wards had perceptions which were worse than the relative number of recorded incidents for all types of anti-social behaviour analysed. By contrast, there were wards where perceptions were better than the level of recorded incidents. Hangleton and Knoll had perceptions which were better than the level of recorded incidents for drunk and rowdy behaviour in public places, drug using and drug dealing, teenagers hanging around and vandalism and graffiti. East Brighton had perceptions which were better than the level of recorded incidents for drug using and drug dealing, teenagers hanging around, vandalism and graffiti and noisy neighbours.

ImplicationsPerceptions of anti-social behaviour issues have consistently improved since 2003, and while it is not the case that actual levels of crime have changed to the same degree, it still suggests improved resilience within the city. There have been improvements in crime rates, with the exception of burglary, in the city and this

success needs to continue to be built upon as the rate of improvement has been slower than in Sussex and England and Wales. The high incidence of anti-social behaviour incidents within the city is likely to impact adversely on the resilience of the local population and should be a focus for further action.

Infrastructure

ContextInfrastructure contributes to the establishment of resilient communities, and includes good housing, transport links, proximity (and quality) of services such as primary schools, GP surgeries and local hospitals. In this sense it is related to the public services component of the WARM tool. Also important are local parks and green spaces that allow communities to come together.


Barriers to Housing and Services Score – •Index of Multiple Deprivation (2010)

Difficulty of access to owner occupation – •Index of Multiple Deprivation (2007)

Child Wellbeing Index Housing score (2009)•

Housing In Poor Condition score – Index of •Multiple Deprivation (2007)

Homelessness index – Index of Multiple •Deprivation (2007): no data at ward level

How satisfied are you with parks and open •spaces. – All very or fairly satisfied (2008)

City rating

Amber Assets: High satisfaction with parks and green spaces.

Vulnerabilities: Condition of housing. Poor score for barriers to housing and services.

Satisfaction with parks and green spaces was added locally as an indicator because of its association with resilience. This is the only subjective indicator included in this component of resilience. Within the city 82% of respondents to the 2008 Place Survey were very or fairly satisfied with parks and open spaces compared with 69% in England. The city has considerable infrastructure vulnerabilities associated with housing with poor scores for all wards on barriers to housing and services.

xvi Perceived drunk and rowdy behaviour versus alcohol related anti-social behaviour incidents; Perceived using or dealing drug problems versus drug related anti-social behaviour incidents; Perceived problem with teenagers

hanging around versus youth rowdy nuisance incidents; Perceived problems with vandalism and graffiti versus criminal damage offences and; Perceived problems of noisy neighbour versus domestic noise complaints to Brighton & Hove City Council.


and green spaces than England, with the exception of Moulsecoomb and Bevendean which is equal to England. The highest scores are found close to the city’s largest public park, Preston Park.

Unexpected assets and vulnerabilitiesMost wards with a red rating are clustered along the central, coastal part of the city. The wards of Brunswick and Adelaide, Central Hove and Regency have high barriers to housing and services scores. It is interesting to note that with the exception of South Portslade and Wish in the West, the wards on the seafront do not report higher levels of satisfaction with parks and open spaces than the city average.

ImplicationsMost of the wards with a red rating are clustered along the central seafront of the city. Despite the poor condition of housing, prices remain high here, contributing to the increased barriers to housing. This indicates that this is a desirable place for residents to live, perhaps due to proximity to facilities in the centre of town, or the seafront. These points raise the question of whether residents value the seafront as an open space or rather that they do not see it as “supported by Brighton & Hove City Council” (part of the survey question).

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


RAG rating - Infrastructure

1

2

3

Map 3.10: Infrastructure component rating for wards in Brighton & Hove, 2010


Picture across the cityMap 3.10 shows the overall rating for the infrastructure component for wards in Brighton & Hove. With the exception of Moulsecoomb and Bevendean, the wards on

the outside of the city centre tend to have more resilience assets and less vulnerabilities than city centre wards in terms of infrastructure. Residents from all wards within the city report higher satisfaction with parks

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide


RAG rating - Infrastructure

1

2

3


COnCLuSIOnS AnD rECOMMEnDATIOnSThe picture that emerges from this resilience and wellbeing mapping exercise is complex. The city scores well on local economy but there are still vulnerabilities which stem from the reliance on the service sector and current pressures on public sector employment. There is a need then to encourage greater economic diversity in Brighton & Hove. Overall however, it seems that the city is well placed to emerge from the recent recession in a strong position.

Although rated amber overall, education stands out as an area where there is a discrepancy between the highly educated adult population, and the relatively poor performance in schools as measured by GCSE success. The growth in recent years of the local universities with accompanying increase in student numbers does not seem to have been accompanied by improvements in standards in local secondary schools. This discrepancy might be remedied to some degree by drawing on the resilient assets to address the apparent ‘disconnect’ as manifested by local

educational vulnerabilities. More informal and formal connections between secondary and tertiary education establishments with, for example joint training and development for local teachers and lecturers, and exchanges between school and university students could help build educational resilience across the city.

Belonging is the only component that is rated as red which will come as a surprise to many residents of Brighton & Hove who enjoy living here, feel a sense of pride in the city and celebrate the inclusive reputation that it enjoys. To address this, more thought needs to be given as to how younger adults in particular can take a greater role in the various decision making bodies that exist in Brighton & Hove and how particular groups, such as the residents of St Peter’s and North Laine ward, can develop a geographical sense of community. Plans for the London Road area including the Open Market development may help, although the recent recession will have some effect on the extent of development. Bringing more young adults

into the decision making processes of the city will require some innovative thinking as the traditional methods of engaging the community have not worked as they should have with this group.

There is a degree of inconsistency between perception and reality which is manifested most evidently with regard to crime and anti-social behaviour but which may also be the case with regard to the components of health and public services. Self-reported health in the city is arguably better than would be expected given the measures of objective health and wellbeing. This suggests an element of health resilience that can be tapped into in the pursuit of better health. With regard to public services, while some in the public sector might be inclined to draw residents’ attention to improvements in services and reductions in crime and anti-social behaviour where there is a perception to the contrary, it is also the case that some local residents are under the impression that that levels of crime and anti-social behaviour are better in their local area than objective


measures would suggest. The key then is not to look for ways of convincing people that things are good but rather to set out objectively to provide demonstrably good services.

This chapter has explored resilience at the population level in the city and at electoral ward level. The following chapters explore the concept of resilience with regard to particular groups and explore some of the components highlighted in this chapter in more detail.


Brighton & Hove ward level assets and vulnerabilities

Self Supports Systems and structures Systems and structures

Domain Life Education Health Material Strong Belonging LocalLocal PublicPublic Crime andCrime and Infra-Infra- satisfaction wellbeing and stable economy economy services services anti-social anti-social structurestructure families behaviourbehaviour

Brighton & HoveBrighton & Hove

Brunswick and AdelaideCentral HoveEast BrightonEast BrightonGoldsmidHangleton and KnollHangleton and KnollHanover and Elm GroveHollingbury and StanmerHollingbury and StanmerMoulsecoomb and BevendeanNorth PortsladePatchamPreston ParkQueen’s ParkQueen’s ParkRegencyRegencyRottingdean CoastalRottingdean CoastalSt. Peter’s and North LaineSouth PortsladeStanfordWestbourneWishWithdeanWoodingdeanWoodingdean


References:

1. Mguni N, and Bacon N. Taking the temperature of local communities The Wellbeing and Resilience Measure (WARM): Local Wellbeing Project. London: The Young Foundation; 2010.

2. Bell D. Annexes in Quality of Life and Well-being: Measuring the benefits of culture and sport: Literature review and thinkpiece. Edinburgh: Scottish Executive; 2005.

3. Dolan P, and White M. ‘How can measures of subjective well-being be used to inform public policy?’. Perspectives on Psychological Sciences 2007; 2:1 pp 71–85.

4. Dolan P, Peasgood T and White M. ‘Do we really know what makes us happy? A review of the economic literature on the factors associated with subjective wellbeing’. Journal of Economic Psychology 2008; 29:1 pp 94–122.

5. Office for National Statistics. Annual Population Survey; London: Office for National Statistics; 2009.

6. Donovan N and Halpern D. Life Satisfaction: The state of knowledge and implications for government. London: Cabinet Office Strategy Unit; 2002.

7. Bacon N, Brophy M, Mguni N, Mulgan G and Shandro A. The State of Happiness. London: Young Foundation; 2010.

8. Bacon N. Never Again: Avoiding the mistakes of the past.London: The Young Foundation; 2010.

9. Mulgan G, Ali R and Norman W. Sinking and Swimming. London: The Young Foundation; 2009.

10. Helliwell J. Well-being and Social Capital: Does suicide pose a puzzle? Harvard University: Conference on wellbeing and social capital; 2003 cited in Bell D. Annexes in Quality of Life and Well-being: Measuring the benefits of culture and sport: Literature review and thinkpiece. Edinburgh: Scottish Executive; 2005.

11. Research based on referenda in Switzerland, in Donovan N and Halpern D. Life Satisfaction: The state of knowledge and implications for government. London: Cabinet Office Strategy Unit; 2002.

12. Friedli L and Carlin M. Resilient Relationships in the North West: What can the public sector contribute? Manchester: NHS Northwest and the Department of Health; 2009.

13. Brighton & Hove Community Safety Partnership, Public Confidence in the Police and other Local Services in Brighton & Hove; 2010.

Chapter 4

Chapter 4 I RESILIENCE IN CHILDREN AND YOUNG PEOPLE I 61

RESILIENCE IN CHILDREN AND YOUNG PEOPLEThe concept of resilience in children embraces the ability of children to cope effectively with pressures, disappointments, adversity and trauma.

INTRODUCTIONThere is good evidence that children cope better if they have a positive relationship with a competent adult, if they are good learners and problem-solvers, if they engage with other people, and if they have areas of competence that they themselves value and are valued by society. 1 Some of these characteristics can be taught, and if we can build resilience in children, over the longer term we can build resilient communities.

In recent years UK governments have sought to establish greater resilience in the population. Some of this is discussed in Chapter 1 but it is worth noting specific initiatives with regard to children. A Social Exclusion Task Force review in 2007 established resilience building as part of universal service provision. 2 In the same year in its Children’s Plan, the Department for Children, Schools and Families (DCSF) now the Department of Education (DE) emphasised the importance of building resilience.3 The need to foster children’s and young adults’ social and emotional skills was highlighted in Aiming high for young people: a ten year strategy for

positive activities. 4 Programmes like the Social and Emotional Aspects of Learning (SEAL), the Targeted Mental Health in Schools Project (TaMHS) and the UK Resilience programme (UKRP) were introduced into primary and secondary schools (The UKRP was piloted in three local authorities but not Brighton & Hove).

In Brighton & Hove with support from the Healthy Schools Team, 100% of schools implemented the SEAL programme; a whole school approach to developing children’s social, emotional and behavioural skills. As part of a three year DCSF funded project, TaMHS has been implemented in 12 schools with the aim of improving the early identification and support of children with mental health issues. In 2008, national guidance and training on social and emotional development in early years settings was introduced across the city. 5 Children’s centres have been key settings for a number of family-based resilience promoting initiatives.

The new Coalition Government has confirmed its commitment to maintaining a universal

network of Sure Start children’s centres, but with a new focus on families with the greatest need. The Big Society initiative includes a national citizen service whereby all 16-year-olds will take part in programmes that promote social mixing, help the transition to adulthood and promote community engagement and resilience.6

LOCAL DEMOGRAPHIC CONTEXTAlthough Brighton & Hove is a young city, this feature stems from a high proportion of young adults. There are relatively fewer children and teenagers compared to regional and national figures. An estimated 256,300 residents live in Brighton & Hove, of whom 54,972 are aged 0-19 years, representing 21.5% of the total population. This compares to 24.1%, in the South East and 23% in England. 7 There are similar proportions of boys and girls. Figure 4.1 illustrates the relative proportions of children and young people in Brighton & Hove, the South East and England (ONS 2009). The school age population forms a relatively low proportion of the children and young people population in Brighton & Hove.

62 I Chapter 4 I RESILIENCE IN CHILDREN AND YOUNG PEOPLE

At electoral ward level, Hollingbury and Stanmer is the ward with the highest percentage of children and young people in Brighton & Hove (32.2% of the total population) whereas Regency has the lowest percentage of children and young people (8.3%).8 The School Census 2009 indicates that 4,093 local pupils (15.3%) come from ethnic minority backgrounds.9

Population projections suggest that by 2019, whilst the greatest increase in population numbers will be in the 25-34 and 50-59 age groups, there will also be an increase in the number of children aged 0-14 years, from 38,300 in 2009 to 41,300 in 2019.

A relatively high proportion of children live in households with no working adults (23% compared to 17% nationally). Many local children (22%) are raised in poverty (as defined by children living in families on less than 60% of national median income) and despite recent improvements, teenage conception rates remain relatively high. There are very high levels of looked after children (LAC); 486 as of 28th February 2011 excluding respite, which is a rate of 99 per 10,000 in the city compared to a national average of 70.2 per 10,000. The 2011 Ofsted and Care Quality Commission Inspection report confirmed that these numbers are appropriate and reflect the city’s needs. There are an estimated 500 carers aged 8-17 years. The resilience of carers is discussed in Chapter 7. The full range of needs of children and young people

0%

1%

2%

3%

4%

5%

6%

7%

0-4 year olds 5-9 year olds 10-14 year olds 15-19 year olds

% o

f to

tal popula

tion

Brighton & Hove South East England

Figure 4.1: Children and young people in Brighton & Hove, the South East and England. (ONS mid-year estimates 2009)

Source: Office of National Statistics mid year estimates, 2009

are discussed in detail in the 2011 JSNA Summary 8 and won’t be repeated here. Similarly, the many measures put in place to address these needs are reported in the Brighton & Hove Children and Young People’s Plan 2009-2012.9

RESILIENCE IN CHILDREN AND YOUNG PEOPLE IN BRIGHTON & HOVEThis section builds on the WARM asset and vulnerability data discussed earlier in Chapter 3 and describes further evidence for resilience in


children and young people with reference to local survey data, in particular the Tellus 4 Survey 10 and the Safe and Well at School Survey (SAWSS).11

The Tellus 4 Survey 2010 was the fourth round of a national self-completion survey for children in Year 6 (10-11 years), Year 8 (12-13 years) and Year 10 (14-15 years).10 It covered the five areas of the Every Child Matters framework (Be healthy; be safe; enjoy and achieve; make a positive contribution and achieve economic wellbeing). Under the new Coalition Government, the Tellus surveys are being discontinued. A total of 970 local pupils from 11 primary and two secondary schools took part in the latest survey, although 447 of these came from one secondary school. The results should be interpreted with this response pattern in mind. The data are also analysed by deprivation using the Income Deprivation Affecting Children Index (IDACI) scores as well as by academic year.

The 2010 Brighton & Hove Safe and Well School Survey (SAWSS) 11 was developed from the previous Safe at School Survey (SASS). This online questionnaire asked children in Years 4-6, 7-9 and 10-11 about their health and wellbeing and included questions on bullying. It is recommended that the results are used by schools to inform the Personal, Social and Health Education (PSHE) and Citizenship curriculum. In Brighton & Hove a total of 10,114 children took part in the 2010 survey (55% of the school cohort).

Self Domain

Life satisfactionIn the Tellus 4 survey in Brighton & Hove, 68% of children reported that they felt happy with their life compared to 67% at national level and 65% for comparator areas. Twenty percent stated that they felt neither happy nor unhappy and just 8% said they do not feel happy. All these figures were roughly similar to national and comparator area scores.Carers of looked after children are asked to complete a ‘Strengths and Difficulties’ questionnaire on behalf of every looked after child. There is a specific question about happiness but the total scores are collated, and so it is not possible to comment on the life satisfaction / happiness of looked after children as perceived by their carers. The overall collated scores for Brighton & Hove looked after children are comparable with national pooled scores. Currently, there are no specific measures on life satisfaction for children with disabilities; another group with recognized complex needs.

Life satisfaction assets in children and young people

The limited information available suggests •that children in Brighton & Hove are no less or more happy with life than their counterparts nationally.

Life satisfaction vulnerabilities in children and young people

Although there are data on the happiness •of looked after children, these are not currently collated in a way that this can be assessed.

There are no data available on the life •satisfaction of disabled children in Brighton & Hove.

EducationResilient children perform better academically, behave better in school, and are more employable on leaving school.12 In the education domain of the Child Wellbeing Index,13 Brighton & Hove is ranked as 251 out of 353 local authorities (where 1 is best). Academic performance in early years and primary schools is strong. In 2010, 62% of children in their final term of Reception Year achieved a good level of attainment compared to 56% nationally. At Key Stage 2 (Year 6 / age 11 years), 84% of pupils achieved level 4 and above in English and in Maths respectively compared to 81% nationally; 40% achieved level 5 in English compared to 32% nationally; and 40% achieved level 5 in Maths compared to 35% nationally.14 The 2011 Ofsted Inspection Report confirmed the strength of early years and foundation stage education provision in Brighton & Hove.15


However, as has been discussed to some degree in Chapter 3, the relative position of Brighton & Hove secondary schools compared to nationally is lower at Key Stage 4 (Years 10-11, age 16 years), with 49% of pupils achieving 5 or more A*-C grade GCSEs including English and Maths compared to 55% nationally.14 Figure 3.3 in Chapter 3 illustrates the recent deteriorating trend for GCSEs attainment.

Education outcomes are relatively poor for children eligible for free school meals and for looked after children. This is documented in the 2011 JSNA.8 Nationally, the gap in achievement between those eligible and not eligible for free school meals has been consistent for the past five years; the same is true in Brighton & Hove though the figures are much poorer (Figure 4.2).

This poor attainment at GCSE level is not simply an issue of academic qualification and has many repercussions. Young people who are not in education, employment or training (NEET) include, in the main, 16 to 18-year-olds who have left school with low levels of qualifications. These children are more likely to become a teenage parent, and are at risk of depression and poor health. They are also more likely to become a ‘first time entrant’ to the criminal justice system. More of these children come from low income families and they are more likely than other children to have been in care at some time. In Brighton

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Figure 4.2: Percentage of pupils achieving five or more A*-C grades at GCSE including English and Maths, in Brighton & Hove and England and Wales, by free school meal eligibility

Source: Department of Education

& Hove, over the period 2009 to 2010, the rate of NEETs has decreased from 8.7% to 7.4%. However, despite this reduction the NEET figure remains higher than in the South East (5%) and nationally (6%).16

The Social and Emotional Aspects of Learning (SEAL) programme began in primary schools in 2005 and in secondary schools in 2007. The programme promotes the development of the social and emotional skills that underpin


positive behaviour, attendance and achievement. It therefore has a potentially important part to play in building resilience. An audit tool is available for schools to evaluate individually the impact of SEAL. However, the data are not currently collected by the city council and so its impact cannot be properly assessed.

Data from the SAWSS show that permanent exclusions dropped from 42 in 2005/06 to six in 2009/10. During the same period fixed term exclusions also dropped from 2,580 to 2,349.11 In conjunction with the Alternative Centre for Education (ACE), which offers outreach support in schools or in specialist centres, the city council supports alternatives to exclusion for pupils. Although following the same time frame, whether these improvements in exclusion rates are due to the introduction of the SEAL progamme is not clear. Bullying is discussed further under the health domain.

The public health directorate is currently working with city council colleagues to explore the academic performance of children and young adults across the city in more detail, with particular reference to reducing educational inequalities. Local headteachers are now working together as a taskforce in a combined effort to improve attainment at GCSE level across the city. There are opportunities then: with strong information and intelligence support; a collective willingness from educational leaders to

improve; a new academy at Falmer; the presence of two universities and a highly educated adult population; to build on what is considerable academic resilience, and establish Brighton & Hove as a city of academic excellence.

Education assets in children and young people

Recent years have seen a fall in the •number of children permanently excluded from school.

Academic performance for Early Years and •Key Stage 2 is strong.

Implementation of the SEAL programme in •Brighton & Hove has been high.

Education vulnerabilities in children and young people

Overall academic performance in •secondary schools is significantly below the national average.

The SEAL programme, which would •provide some measure of the development of resilience in schools, has yet to be formally evaluated.

HealthIn the health domain of the Child Wellbeing Index,13 Brighton & Hove ranks 241 out of 353 local authorities. The health domain is based on emergency admissions (0-18 years), outpatient attendances (0-18 years) and disabled living allowance recipients (0-16 years).

Mental healthBullying has a significant negative impact on mental health. The Tellus 4 Survey found that 44% of children and young people in Brighton & Hove experience bullying compared to 46% nationally and 51% in comparator areas. The SAWSS reported that 76% of pupils in Years 4-6 (9-11 year olds), 81% of pupils in

Young people from Sussex Central YMCA’s Right Here project


Years 7-9 (12-14 year olds) and 86% of pupils in Years 10-11 (15-16 year olds) said they had not been bullied during the current term. Eighty-four percent of children in Years 4-6, 69% of children in Years 7-9 and 54% of children in Years 10-11 thought their school was dealing well or very well with bullying. It is interesting to note that this confidence with how schools deal with bullying is in the opposite direction to the proportion of children in the same age groups reporting bullying as being a problem.

Over the period 2005-2010, the Safe at School surveys and recently the SAWSS showed a decrease from 26% to 17% among secondary schools and a decrease from 33% to 24% among primary schools of children reporting that they had been bullied during the term (Figure 4.3). However, the Community Safety, Crime Reduction and Drugs Strategy 2008-11 performance report suggests there has been an increase in racist and hate-motivated bullying incidents recorded by schools in the 2009/10 academic year compared with 2008/9.17 This latter finding may reflect improved recording following training of headteachers.

The SEAL programme includes a programme to tackle bullying.5 Locally, there are other initiatives that also address bullying such as the ‘Playground Buddies’ scheme in 32 primary schools, delivered as part of the Protective Behaviours Safety Awareness programme by

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Figure 4.3: Trends in bullying in Brighton & Hove

Source: Safe at School, and Safe and Well at School Surveys 2005-2010

Safety Net, a local charity. Over the period 2006-2010 the proportion of pupils reporting that their school is good at dealing with bullying has risen from 55% to 64% for secondary school pupils and from 79% to 84% for pupils in primary schools. An evaluation of the Playground Buddy scheme

reported that 18 out of 20 staff and 16 out of 20 children felt it made a difference to the playground feeling safer. It is not possible to attribute improvements in bullying rates to any one intervention and the reduction probably reflects a number of initiatives and the combined efforts of many people.

Alcohol and substance misuse and smokingPrevious Annual Reports of the Director of Public Health have drawn attention to the public health toll as a result of alcohol and substance misuse among local children and adults. This is an area of vulnerability for the city as a whole. In Brighton & Hove, 19% of Years 7-9 pupils report having had an alcoholic drink in the past week. Among pupils in Years 10-11, 45% report that they drink but do not get drunk, while 12% report getting drunk every time they drink.11 Alcohol intoxication has a considerable impact on accident and emergency services although data recording has not been strong. In addition, each year over 40 under 18-year-olds actually require a hospital admission due to alcohol.

Drug use among young people is much higher in the city than nationally: 24% of those sampled in Brighton & Hove have used drugs compared to 9% in England and 10% in comparator areas.10 Cannabis is the illegal substance of choice for most young people. There were 163 young people in drug or alcohol treatment during 2009/10, the majority for either cannabis or alcohol.22 There are on average 30 attendances per month at the Royal Sussex County Hospital as a result of drug or alcohol misuse by young people aged 13-18 years.

The number of clients accessing RU-OK?, the specialist treatment service for young people

Dylan of Goldstone Primary School won a prize for his healthy eating pasta recipe in 2011.

Launched in 2008 and externally funded for three years, TaMHS was implemented in 12 local schools to improve pupils’ mental and emotional health.18 The University of Sussex’s evaluation of TaMHS will be published shortly.

Dental healthA range of factors including socio-economic deprivation and lifestyle are associated with poor oral health. Approximately 80% of all dental disease is found in 20% of children.19 The mean number of teeth per child aged five years that were decayed, missing or filled (DMF score) as measured in the academic year 2007/08 was 2.6. This is lower than for the South East Region (3.3) and nationally (3.4). The percentage of children aged five years with dental decay is 17.5% in the city which is lower than the South East Region (22.4%) and nationally (27.5%).20

Diet, physical activity and obesityResults from the National Child Measurement Programme suggest that children in Brighton & Hove are less overweight and obese than children nationally. In 2009/10, 15.5% of Year 6 children (10-11 years) were obese and 14.7% were overweight; and in Reception Year (4-5 years) 8.5% of children were obese and 12.4% were overweight. Although not a statistically significant decrease, the prevalence of obese children in Year 6 has fallen from 17.7% in the 2008/09 academic year and is significantly lower than nationally (18.7%).21

The most recent data on consumption of fruit and vegetable from SAWSS suggests that 47% of children in Years 7-9 and 10-11 are eating three portions of fruit and vegetable a day, and 30% are eating more than five portions a day. Much local work is undertaken to improve the standards of schools meals and their take up. A Food in School Pilot is underway in five schools to improve the quality of the dining environment as a whole. Initial evaluation in one school found that the uptake of school meals increased from 22% to 37% over the six month period of the pilot.



with substance misuse problems, has increased from 168 clients (142 under 18) in 2007-08 to 219 in 2009-10 (162 under 18). The majority of referrals (42%) originate from the Youth Offending Service.22

Smoking too seems to be much more prevalent among children in Brighton & Hove compared to other areas. In the Tellus 4 survey, 7% of pupils reported smoking more than six cigarettes a week compared to 3% nationally and 3% in comparators areas. In the SAWSS, 6% of Years 10-11 pupils (aged 15-16 years) reported smoking regularly and would like to give up, while 21% of children in Years 4-6 (aged 9-11 years) said they had smoked a cigarette (more than one puff) in the past seven days.

Teenage pregnancy and sexual healthLike alcohol, substance misuse and tobacco use, sexual health is an area where there are more vulnerabilities than assets in Brighton & Hove. Teenage pregnancy rates have long been relatively high although recent years have seen a reduction in the number of births to teenage mothers which fell from 188 in 2008 to 172 in 2009. The under 18 conception rates fell by 24.1% between 1998-2009 from 48.1 per 1000 girls aged 15-17 years (187 conceptions) to 36.5 per 1000 (149 conceptions).23 The proportion of conceptions leading to a termination has fluctuated from 53% in 1998, to a peak of 62% in 2007, and the current rate is 52%. Around 11% of teenage mothers have a second teenage birth.

During 2009/10, 22.6% of young people aged 15-24 years were screened for chlamydia (outside of GUM settings) against a national target of 25%, an increase from 19% in 2008/09 against a target of 17%. The positivity rate for Brighton & Hove in 2009/10 (4.4%) was lower than for England overall (6%). Screening rates in Brighton & Hove have been higher than the England average (15.9% in 2008/09 and 22.1% in 2009/10). 24

DisabilityThe health needs and challenges faced by children with disabilities are explored in the JSNA on Children with Disabilities 2010,25 which has informed the development of the city’s Commissioning Strategy’s Transformation Plan for Children with Disabilities.26 Caring for a disabled child affects the whole family and this is discussed further under the Strong and Stable Families section as well as in Chapter 7 in the section on carers.

Healthy SchoolsThe Healthy Schools programme aims to embed the health and wellbeing of pupils and staff in the school curriculum. Healthy Schools must meet criteria in four core themes: personal, social and health education (PSHE); healthy eating; physical activity; and emotional health and wellbeing (including bullying). A national enhanced Healthy Schools model was introduced in 2009 with a stronger focus on impacts and outcomes. Schools are required to include an outcome which targets more

vulnerable students. The Coalition Government has confirmed that the Healthy Schools programme will continue. SAWSS is being used locally to measure some of the impact of the Healthy Schools programme. Students reported that among all the different PSHE lessons they found those on drug, alcohol and tobacco misuse the most useful.

Health assets in children and young people

All Brighton & Hove schools have Healthy •Schools status with a number working towards Enhanced Healthy Schools status.

Levels of bullying in schools, although not •insignificant, are lower than in comparator areas and there are various anti-bullying programmes which appear to be having a positive effect.

The prevalence of obesity in Year 6 children •is lower than nationally and appears to be falling.

Children in Brighton & Hove have better •dental health than nationally.

Although still relatively high, teenage •conceptions and births are declining.


Health vulnerabilities in children and young people

Substance, alcohol and tobacco misuse •is considerably higher among children and young people in Brighton & Hove than nationally.

Material wellbeingIn the material wellbeing domain of the Child Wellbeing Index, which includes children aged 0-15 years living in households in receipt of both in-work and out-of-work means-tested benefits, Brighton & Hove is ranked 280 out of 353 local authorities.

A total of 10,555 children and young people in Brighton & Hove are raised in poverty (as defined by number of children living in less than 60% of national median income), which is equivalent to 22% of the total population of children and young people under the age of 20 years. East Brighton has the highest proportion of children and young people living in poverty (46%) and Withdean (6.6%) the lowest. The level of child poverty in Brighton & Hove is slightly higher than the national average (England, 20.9%) but much higher than the South East regional average (14.5%), although Portsmouth (24%) and Southampton (26.5%), nearby cities within the same region, have higher levels. The majority of children and young people in poverty in the city live in families where parents receive out of work

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Figure 4.4: Lone parent claimants of benefits (% of working age population aged 16-64 years) Brighton & Hove, South East and Great Britain. August 1999 to August 2010

Source: Department of Work and Pension: benefit claimants - working age client group (from NOMIS www.nomisweb.co.uk)

benefits (77.5%). This is very close to the national picture (76.4%). In 2010, 16.4% of pupils in local secondary schools were eligible for free school meals; slightly higher than nationally (15.4%).27

Lone parent families account for the majority of children and young people living in poverty (72.8%); again this is slightly higher than the national picture (68.2%).27 As of August 2010 there were 2,730 lone parent claimants of


benefits in Brighton & Hove; 1.5% of the population aged 16-64 years. This is between Great Britain (1.7%) and South East (1.3%) rates. However, as shown in Figure 4.4, this proportion has fallen considerably since August 1999 when there were 4,410 lone parent claimants in the city.27

Material wellbeing assets for children and young people

There has been a steeper decrease in the •trend in lone parent out of work benefit claimants in Brighton & Hove compared to national figures. This could indicate improved material wellbeing resilience of lone parents in the city.

Material vulnerabilities assets for children and young people

Almost a quarter of local children and •young people aged less than 20 years live in poverty; roughly in line with national figures but much higher than the South East average.

Supports domain

Strong and stable familiesGood parenting is essential for children’s development and wellbeing and this in turn benefits wider community resilience. The last 50 years have seen an increase in the rate of family break-ups.12 Recent JSNAs 8 have

explored the public health issues that are related to parenting capacity, family relationships, and ultimately to children’s health, wellbeing and resilience. Young offenders living in Brighton & Hove are almost twice as likely to have witnessed violence in the family home than the whole population.28 The 2001 Census reported that the divorce rate for Brighton & Hove was 7.25% (4.49% in Stanford Ward and 10.02% in East Brighton) compared to 5.85% nationally, however these data are somewhat dated. The 2011 Census will provide up to date information on the number of single parent households in the city.

The impact of caring for children with disabilities was discussed in the Children with disabilities JSNA in 2010.25 Consequently, one of the core outcomes of the local authority Commissioning Strategy’s Transformation Plan for Children with Disabilities is to help to support children in their own homes in part by building resilience in parents and carers. Amaze is a local information, advice and support service for parents and carers of children and young people with special needs. A high percentage of disabled children live in households with low incomes and Amaze supports parent carers to apply for Disability Living Allowance (DLA) for their children.

A number of support initiatives are in place as part of the local Parenting Support Strategy launched in 2008,28 with many delivered

through the network of 15 designated children’s centres. These include the ‘Triple P’ Positive Parenting Programme, volunteering opportunities, a post-natal depression group and support for teenage parents and looked after children. A total of 544 parents received a Triple P intervention in 2008-9 and 452 parents (83%) made parenting improvements.9 The Family Support Service at the Brighton Unemployed Family Centre Project supports unemployed parents with children aged ten years or under. An evaluation by the University of Brighton found that 91% of respondents felt more confident as a result of their engagement with the centre, 84% felt they had increased their skills, and 78% felt that they had enhanced their future life chances.29

Tarner Children’s Centre, East Brighton


Family counselling and mediation is also available and the Sussex Central YMCA, the Youth Offending Service (YOS) has a parenting manager, and the Family Intervention Project (FIP) has for the past five years, worked with families with ‘complex needs’. Eighty-two percent of FIP families have been involved with children’s services and 44% of children were on child protection plans at the time of, or subsequent to the referral. A high number of the mothers are offenders, some in prison. Outcomes of the programme have included increased parenting capacity and fewer incidents of domestic violence among many others.17 The Families and Schools Together programme (FAST) designed to build protective factors and enhance children’s resilience showed a positive trend in overall family relationships (23%) and a significant improvement (25%) in parents’ relationship with their child, when piloted in one large city school.30

Strong and stable family assets for children and young people

The need to support parenting has been •recognised by the statutory and voluntary sectors and there are many local programmes and initiatives to support parenting skills and family relationships. Where evaluation exists, it suggests that these are helping to improve parenting capacity.

Strong and stable family vulnerabilities for children and young people

The high levels of domestic violence, •mental health, substance misuse and teenage conceptions have an adverse impact on family relationships and stability.

A higher proportion of local residents are •divorced compared to nationally, although the data are old.

BelongingParticipation and volunteering in the community raises children’s educational achievements, improves behaviour and also helps them develop social networks and foster a sense of belonging.12 There is evidence that children and young people in the city are an asset in terms of volunteering and taking part in group activities. According to the Tellus 4 survey, 66% of local children and young people reported taking part in group activities outside school lessons such as sports, arts or a youth group. This is higher than the national level (60%) and comparator areas (60%).10

The most frequently identified barriers to participation were a lack of local activities and the expense of taking part. The Tellus 4 national report highlighted that children and young people who were of Asian or Asian British origin, or in the ‘other’ ethnic groups category were less likely to have participated in group activities in the previous four weeks; 47% and 50%

respectively, compared to overall 60%. Those eligible for free school meals are less likely than others to participate in activities in the previous four weeks (54%), compared to overall (60%).10 Furthermore, non-participants are linked to higher levels of vulnerability and to risk taking. 31

The city has a Volunteering Strategy ‘Joining the Dots’.32 Most schools in the city have a school council or forum, many have student governors and citywide there is an elected Youth Parliament. With 40 members elected each year, the Youth Council gives young people, including those from vulnerable groups, the chance to contribute to decisions made about services. Twenty-seven looked after children aged less than 16 years participate currently in the ‘Listen Up Care Council’ and 15 participate in the ‘16+ Advisory Board’; a group of young people who have left care, or are soon to leave care. There are nine children and young people with disabilities participating in the Aiming High Advisory Group. Programmes run by third sector organisations such as the Sussex Central YMCA ‘Right Here’ project also provide participation and belonging opportunities for young people.33

Good friendships are important for young people to build a sense of belonging. The SAWSS survey found that 97% of pupils in Years 7-9 and 98% in Years 10-11 felt they have one or more good friends at school. Ninety-two percent and 93% respectively have one or more good friends outside the school environment.11


Belonging assets for children and young people

A relatively high number of local children •and young people take part in activities which promote a sense of belonging.

There are many statutory and voluntary •sector opportunities in the city for children and young people to positively participate.

In local surveys high numbers of children •and young people have reported having good friendships both in and out of schools. Although there are no comparator data, this represents an asset.

Belonging vulnerabilities for children and young people

Nationally, children and young people from •certain ethnic minority groups and lower income families are less likely to participate in group activities.


Local economy Employment among young people however plays an important role in the transition to adulthood even if it has little impact on the overall economy.12 There are no reliable national or local figures for children and young people who work. The Connexions

Employability service aims to identify and support young people aged 16 years and over who are not in education, employment or training (NEET) including those who have a statement of Special Educational Needs. The impact of this work is largely monitored through the NEET figures discussed earlier in the education component of this chapter. Current public sector financial pressures will see a reduction in the Connexions service which may impact adversely on this work.

Public services There is a lack of good data on children and young people’s satisfaction with local public services. This is an important omission. For example, the Place Survey does not include residents under the age of 18 years.34 The city does invest in services for children, sometimes where other areas don’t. The free swimming initiative is an example of this, which despite public sector funding pressures remains available in Brighton & Hove for children under the age of 12 years. Uptake has been proportionately better among children from more deprived backgrounds.35

In other areas such as school transport, the city’s investment is on par with other unitary authorities. Children who live beyond the statutory home to school distance have bus passes, however as Brighton & Hove is fairly compact, relatively few qualify on distance grounds. Families on a low income (defined by entitlement to free school meals) have a lower

distance threshold. Assistance is provided to children with special educational needs for the school journey. Public services assets for children and young people

Investments in public services for children •and young people have been relatively good and for services at a higher level than nationally.

Public services vulnerabilities for children and young people

Current pressures on public funding will •impact on range of services provided.

Crime and anti-social behaviourThe most common offences committed by young people are violence against the person; theft (mainly shoplifting) and criminal damage. In the crime domain of the Child Wellbeing Index, Brighton & Hove ranks 224 out of 353 local authorities. The crime domain is based on overall police recorded crime data on burglary, theft and criminal damage, weighted for proportion of at risk population aged 0-15 years. There is strong evidence that building resilience in children and young people reduces crime. Studies have found that young offenders have often gone through a major life crisis.36

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seven months of 2010/11 there were 9,831 police recorded incidents of social disorder, of which 2,038 were related to youths. Compared with the same period in 2009/10, youth social disorder was down by 4.3%.17 These are however, very preliminary data.

There are many statutory and voluntary sector initiatives in the city to address crime and disorder among young people; some mentioned earlier in this section. Safety Squads is an initiative to involve children aged 8-13 years in improving safety in their local community. Children take part in peer training, and awareness-raising as well as fundraising for improvements in their communities, such as equipment for their local park. The ‘Young People’s Hangleton and Knoll Project’ provides positive activities to young people aged 13-19 years on Fridays and Saturdays. Evaluation by the University of Brighton found that there were improvements in young people’s confidence and wellbeing, a reduction in anti-social behaviour and an enhancement of community cohesion.38

Crime and anti-social behaviour assets for children and young people

There are several initiatives across the city •aimed at reducing offending behaviour. Some early results are encouraging however a long term impact has not yet been demonstrated.

Crime and anti-social behaviour vulnerabilities for children and young people

The crime score from the Child Wellbeing •Index is relatively high.

Available local data do not show any •apparent clear trend in crime and anti-social behaviour among children and young people.

InfrastructureGood quality housing is important for building wellbeing and resilience, but housing in Brighton & Hove represents a particular vulnerability for children and adults. On the housing domain of the Child Wellbeing Index, Brighton & Hove is ranked at 259 out of 353 local authorities. The indicators relating to children are overcrowding, shared-accommodation, homelessness and quality of housing.

The city faces well documented housing challenges; high prices, high rents, the quality of both council and private sector stock, as well as a high proportion of private rented accommodation.39,40,41

Access to leisure and recreation is linked to children and young people’s wellbeing and resilience.12 The Tellus 4 survey found that

Between 2008 and 2010 there was a decline in the number of police recorded crimes involving children and young people aged less than 18 years (Figure 4.5). The number of offences fell by 10% (86 offences) and

Figure 4.5: Offences and disposals as recorded by the Youth Offending Service in Brighton & Hove, 2008/09 – 2009/10

Source: Brighton & Hove Youth Offending Service

disposals (offences dealt with within the criminal justice system) fell by 12% (80 disposals).37 However, unconfirmed data from the current performance year suggests that these figures have risen.17

Recent figures suggest a fall in youth disorder offences. The Community Safety, Crime Reduction and Drug Strategy 2008-11 performance report reported that in the first


21% of children were of the view that local parks and play areas were very good, while 46% thought them fairly good. This is comparable to national figures. Forty-three percent of children said they use local public transport sometimes and 63% reported feeling quite safe when travelling by public transport. When children were asked why they do not use public transport, only 1% reported that there isn’t any where they live and 7% reported that it cost too much; again, these figures are comparable to national results.

Infrastructure assets for children and young people

According to the • Tellus 4 survey, the levels of satisfaction with access to parks and play areas are high, and comparable to the national average.

Infrastructure vulnerabilities for children and young people

There is poor access to good quality •affordable housing in Brighton & Hove.

COnCLuSIOnS AnD rECOMMEnDATIOnS This section has highlighted some key assets and vulnerabilities with regard to building resilience in children and young people in the city.

There is some evidence to suggest that most children feel happy living in Brighton & Hove. There is a strong sense of belonging among children in the city, in contrast to the findings of the adult population reported elsewhere in this report, with good participation in a range of activities including volunteering. However, there appears to be a relative lack of engagement from children and young people from ethnic minority backgrounds or who are relatively economically worse off. This dichotomy runs the risk of creating a group of children and young people who feel different and excluded. It represents a resilience vulnerability that could and should be addressed by making participation easier for poorer children. We know from free school meals information that children who are eligible by virtue of economic deprivation may not still take up a particular benefit. In this respect the free swimming initiative, which is open to all children but which targets poorer children in particular, is building resilience in the city.

In terms of the health of children and young people, there are several assets which will build resilience with relatively good dental health, improving levels of healthy weight and healthy diets. Levels of bullying, although not insignificant, appear to be less than in comparator areas and the measures that have been put in place to tackle bullying also seem to be having some effect. The Healthy Schools programme and SEAL initiative may be important in driving many of these improvements. There is a homophobic bullying strategic group in the city, but that doesn’t include other types of bullying. This could be addressed by extending the remit of this group so that it addresses other types of bullying.

There are many vulnerable children in the city with high levels of looked after children, high numbers of children on child protection plans and high numbers of teenage parents, although this latter number is decreasing. The Ofsted and Care Quality Commission review confirmed that the numbers of children on child protection plans and being looked after were appropriate. Certainly there are high levels of substance and alcohol misuse among parents and children; and the same is true for tobacco. It is also true that there has not been


a Serious Case Review with regard to a child from Brighton & Hove since 2008. The Care Quality Commission identified the health programme for looked after children programme as a particular strength.The relatively high misuse of alcohol and substances among children and young people in Brighton & Hove represents an important vulnerability and probably reflects the higher levels of misuse among adults. Efforts to address this issue then cannot be divorced from measures in the general population. The recent creation of an Alcohol Strategy Board has seen the first comprehensive approach across the city to address alcohol with a co-ordinated programme of proposals to address cultural understanding and behaviour, licensing, sales, policing and services for people with alcohol problems. This is a real opportunity, which could provide a breakthrough in tackling a longstanding public health problem.

Schools and children centres have a critical role to play in building resilience both at individual child and family levels. In Brighton & Hove much has been achieved through the implementation in all schools of the Healthy Schools Programme, and through the implementation of programmes like SEAL

and the Protective Behaviours programme, among many others. The city council should undertake to examine the impact of the SEAL programme to monitor its effects across the city. The primary care trust and city council should continue to invest in the Healthy Schools programme and similarly monitor its impact. The level of child poverty, while only slightly higher than nationally, comprises a resilience vulnerability for the city. This is being addressed through the Child Needs Poverty Assessment 2011 which has made a series of recommendations to improve family circumstances including decent family housing, raising aspirations and educational attainment, among others.

The trend in crime and disorder among children and young people is not clear. The work underway to make the city a place where teenage years are safe and where young people can make successful transition to adulthood, encompassed in the new Youth Service Strategy 20011-2014 (in development), will require close monitoring for impact.

The city will also need to consider how it will obtain meaningful and ongoing information regarding children and young people’s

wellbeing and resilience in the light of the discontinuation of many national surveys. There is already a gap with regard to data from children and young people on their satisfaction with local services. The statutory sector should explore more novel ways of obtaining children’s views such as the targeted use of social network media.

The component that perhaps stands out most in this section is education. While performance in early years settings and primary schools is very encouraging, secondary school performance is falling. Given the importance of education in building future resilience against, for example, teenage pregnancy, substance misuse and participation in crime, this represents an important vulnerability. More work is required on how the educational assets of a highly educated adult workforce and the presence of further education establishments can be harnessed to address the education vulnerabilities in Brighton & Hove. If the city can get the education of its children and young people to the highest standards, then many of the other factors which play an important role in building resilience will improve as a consequence.


References:

1. Raising Resilient Children Foundation. www.raisingresilientkids.com. (accessed March 2010).

2. Cabinet Office Social Exclusion Task Force. Families at risk: background on families with multiple disadvantages. London; The Cabinet Office. Social Exclusion Task Force; 2007.

3. Department for Children, Schools and Families. The Children’s Plan: Building brighter futures. London; The Stationery Office; 2007.

4. Department for Children, Schools and Families. Aiming High for Young People: A ten year strategy for positive activities. London: Department for Children, Schools and Families; 2007. 5. Excellence and Enjoyment: social and emotional aspects of learning. London: Department for Children, Schools and Families; 2009. 6. Department for Education. National Citizen Service. www.education.gov.uk/childrenandyoungpeople/youngpeople/nationalcitizenservice/a0075357/national-citizen-service (accessed April 2011).

7. Office for National Statistics. Mid-year estimates 2009.

8. NHS Brighton and Hove. Joint Strategic Needs Assessment Summary; 2011. www.bhlis.org/resource/view?resourceId=878 (accessed March 2011).

9. Brighton & Hove City Council. Children and Young People’s Plan 2009/12. www.brighton-hove.gov.uk/index.cfm?request=c1152923 (accessed March 2011).

10. Department for Education Tellus 4 national report. 2010. Available from: www.education.gov.uk/publications/eOrderingDownload/DCSF-RR218.pdf (accessed March 2011).

11. Brighton & Hove City Council. Children’s Services performance data team. Safe and well at school survey; 2011. Unpublished data.

12. Bacon N, Brophy M, Mguni N, Mulgan J, Shandro A. The State of Happiness. Can public policy shape people’s wellbeing and resilience? London: The Young Foundation; 2010.

13. Department for Communities and Local Government. Child Wellbeing Index 2009. www.communities.gov.uk/publications/communities/childwellbeing2009.(accessed April 2011).

14. Brighton & Hove City Council. Children’s Services performance data team. Unpublished data.

15. Ofsted School Inspection Reports. www.ofsted.gov.uk/Ofsted-home/Inspection-reports/Schools (accessed April 2011).

16. Department for Education. Strategies for 16 to 18 year olds not in education, employment or training (NEET). www.education.gov.uk/16to19/participation/neet/a0064101/strategies-for-16-to-18-year-olds-not-in-education-employment-or-training-neet. (accessed April 2011).

17. Brighton & Hove City Council. Brighton and Hove Community Safety, Crime Reduction and Drugs Strategy 2008 -2011. www.safeinthecity.info/files/Community%20Safety%20Strategy%202008-11,%20second%20revision.pdf. (accessed April 2011).

18. Brighton & Hove City Council Learning Platform Hub Pier 2 Peer. Brighton TaMHS. www.school-portal.co.uk/GroupHomepage.asp?GroupID=936381. (accessed April 2011).

19. Department of Health. Choosing better oral health: An oral plan for England. London: Department of Health; 2005. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4123251. (accessed April 2011).

20. South East Public Health Observatory. www.sepho.org.uk/viewResource.aspx?id=9509 (accessed March 2011).

21. Department of Health. National Child Measurement Programme. data.gov.uk/dataset/national_child_measurement_programme (accessed March 2011).

22. National Drug Treatment Monitoring Service. www.ndtms.net/

23. Office for National Statistics. Conception statistics for England and Wales. www.statistics.gov.uk/StatBase/Product.asp?vlnk=15055&Pos=1&ColRank=2&Rank=272. (accessed April 2011).

24. Health Protection Agency. National Chlamydia Screening Programme data tables. www.chlamydiascreening.nhs.uk/ps/data/index.html (accessed April 2011).

25. Brighton & Hove City Council. Joint Strategic Needs Assessment for Children and Young People with disabilities and complex health needs, 2010. www.bhlis.org.resource/view?resourceld=858. (accessed March 2011).

26. Brighton & Hove City Council. Children Services Commissioning Strategy for Children with Disabilities. 2011.

27. Office for National Statistics. Nomis official labour market statistics. Benefit claimants – working age client group. www.nomisweb.co.uk/Default.asp (accessed April 2011).

28. Brighton & Hove City Council. Brighton and Hove parent support strategy 2008 – 2011. www.brighton-hove.gov.uk/index.cfm?request=c1197274 (accessed April 2011).

29. Stone, J. An evaluation of volunteer opportunities offered by Brighton Unemployed Centre Family Project. Health and Social Policy Research Centre, University of Brighton; 2008. www.bucfp.org/vol/Volunteer%20opportunities%20at%20BUCFP%20follow-up%20report.pdf (accessed March 2011).

30. NHS Brighton and Hove. Joint Strategic Needs Assessment Summary 2010. www.bhlis.org/profiles/profile?profileId=23#iasProfileSection2 (accessed March 2011).


31. Brighton & Hove City Council Children’s Services. Youth Service commissioning joint strategic needs assessment. Forthcoming: May 2011.

32. Brighton & Hove City Council. Joining the dots: a triple impact volunteering strategy for Brighton and Hove 2010 – 2015. www.brighton-hove.gov.uk/downloads/site2020/30th_march_2010_lsp_meeting/BHSP_(10)_09_City_Volunteering_Strategy_-_Joining_the_dots.pdf. (accessed April 2011).

33. Sussex Central YMCA. Right Here Brighton and Hove. right-here-brightonandhove.org.uk/. (accessed March 2011).

34. Brighton & Hove City Council. Place survey summary report; 2009. consult.brighton-hove.gov.uk/portal/lsp/place/. (accessed April 2011).

35. Brighton & Hove City Council. Free swimming initiative uptake data. www.bhlis.org/dataviews/view?viewId=95 (accessed April 2011).

36. Centre for Confidence. The resilience factor. www.centreforconfidence.co.uk/pp/overview.php?p=c2lkPTUmdGlkPTAmaWQ9MTE5 (accessed April 2011).

37. Brighton and Hove Youth Offending Service. www.brighton-hove.gov.uk/index.cfm?request=c1138922

38. Hyde S, Robinson C. Young People’s (Youth Sector Development Fund) Hangleton and Knoll Project: External evaluation final report. Brighton: University of Brighton; 2011.

39. Brighton & Hove City Council. Health Impact Assessment of the Brighton and Hove housing strategy – healthy homes, healthy lives, healthy city 2009 – 2014. www.brighton-hove.gov.uk/downloads/bhcc/HIA_Housing_Strategy_Report_(Final).pdf (accessed April 2011).

40. Brighton & Hove City Council. Youth Homelessness Strategy 2007 – 2010. www.brighton-hove.gov.uk/downloads/bhcc/Youth_Homelessness_Strategy.pdf (accessed April 2011).

41. Brighton & Hove City Council. Brighton & Hove housing needs survey final report, 2005. www.brighton-hove.gov.uk/downloads/bhcc/Final_Report.pdf (accessed April 2011).

Chapter 5

Chapter 5 I RESILIENCE IN WORKING AGE ADULTS I 79

RESILIENCE IN WORKING AGE ADULTSIt is during the working age period of life (18-65 years) that many of life’s most significant events usually occur: employment, unemployment, marriage, divorce, property ownership, parenthood, grandparenthood, children leaving home, disease onset, the death of a loved one.

INTRODUCTIONThere are many times when we might be vulnerable to a lack of resilience and equally many opportunities to develop resilience.

The term ‘working-age’ denotes the importance attributed to employment during this period. For all age groups, employment generally makes people healthier; in fact not working is a risk factor for common mental health disorders such as depression. The recent recession saw unemployment levels reach 2.5 million in December 2010. Young people have been particularly hard hit with almost 25% of 16-24 year olds currently unemployed. The lifting of the default retirement age could further exacerbate youth unemployment.1,2 Adults in employment can also be adversely affected during times of economic stress. Research suggests that the deleterious effects of job insecurity on health and wellbeing are almost comparable to the effects of unemployment.3

Having a family, like having paid work, is associated with life satisfaction, health and

wellbeing, as it provides the opportunity for strong, supportive relationships. Single parenthood and divorce on the other hand are associated with social isolation, which in turn is linked to lower levels of health. Economic pressure, low income, poor housing conditions and overcrowding are all associated with increased levels of family distress, less effective parenting skills, and a higher risk of separation and divorce.4

The current Welfare Reform Bill, intended to reduce the complexity of the welfare system and increase incentives for work, will see the end of all existing welfare-to-work schemes and the introduction of a universal credit. Jobseeker’s Allowance claimants who are aged less than 25 years will be referred to a new programme within six months, and all Incapacity Benefit claimants will be reassessed for ‘readiness to work’. Would-be entrepreneurs are to be supported through a programme called ‘Work for Yourself’, and local work clubs where unemployed people can gather to exchange skills, will be established.5

There is good evidence to show that lower levels of education and skills equate with lower levels of employment and civic engagement. UK governments have for many years promoted lifelong learning. The current reform of adult learning and skills, set out in Skills for Sustainable Growth continues to prioritise those with low literacy and numeracy skills, but with a stronger focus on young people. Apprenticeship and vocational qualifications schemes will be reshaped, employers will be given more incentives to develop the knowledge and skills of their employees, and adult education providers will be encouraged to be more responsive to local people.6

LOCAL DEMOGRAPHIC CONTEXTBrighton & Hove has a large working age population: in fact 64.5% of the population is aged 20-64 years. Figure 5.1 shows that the resident population in Brighton & Hove is much younger than in the South East and England. The largest group is the 20-29 year old age band. With two universities, the city

80 I Chapter 5 I RESILIENCE IN WORKING AGE ADULTS

has a 32,000 strong student population; many will have moved to the area to study, and many will remain after graduation.

The proportion of women of childbearing age is high (48%) compared to the South East (39%) and England (40%), although the fertility rate (annual live births per 1,000 females aged 11-49 years) is lower (53) than the England and Wales average (63) and has been below national rates for over a century. In Brighton & Hove, fertility rates are lower in younger women and higher in older women compared to the South East and nationally. The trend for women to postpone having their first child until later appears to be particularly marked in Brighton & Hove.7

The number of births per year is projected to increase by 3.0% from 2009 to 2020 (to 3,400 births per annum), similar to the projected 2.5% increase in the South East and a 2.8% increase in England.7 Figure 5.2 shows that the overall population is predicted to increase over the next ten years, with the highest projected increases being in the working age groups of 25-34 years and 50-59 years.

0%

5%

10%

15%

20%

20-29 year olds 30-39 year olds 40-49 year olds 50-64 year olds

% o

f to

tal p

op

ula

tio

n


Figure 5.1: Population profile, 20 to 64 year olds in Brighton & Hove, the South East and England

Source: Office of National Statistics mid year estimates, 2009


The MOSAIC profile suggests that the largest group in the city is “educated, young single people living in areas of transient populations” (30%); this group is more likely to have resilience assets; while the 10.1% of households that comprise “people living in social housing with uncertain employment in deprived areas” are more likely to have more vulnerability factors. 7

RESILIENCE IN WORKING AGE ADULTSThis section builds on the WARM asset and vulnerability data discussed earlier in this chapter and considers further evidence for resilience in working age adults.

Self domain

Life satisfactionAccording to the 2008 Place Survey, residents in Brighton & Hove are generally happy with their local area as a place to live compared to other local authorities. However, residents in deprived areas, council-housing tenants (there is some overlap between these two groups), those who rent from a Housing Association, and LGBT residents have lower levels of life satisfaction.7 Satisfaction with the local area appears to be a little lower in those of working age (85% very / quite satisfied) compared to older people (89% very / quite satisfied).8

15,000 10,000 5,000 0,000 5,000 10,000 15,000

0-4

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10-14

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20-24

25-29

30-34

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45-49

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80-84

85+

Age-b

and

Brighton & Hove Population

Males MYE 2009 Females MYE 2009 ONS Projection, 2020 (2008 based)

Figure 5.2: Population pyramid for Brighton & Hove (2009 mid-year estimate and 2020 population projection).

Source: Office of National Statistics mid year estimates 2009 and 2008 based projections


Life satisfaction assets in working age adults

Local residents report high levels of •satisfaction from living in Brighton & Hove.

Life satisfaction vulnerabilities in working age adults

More deprived groups and the LGBT •community have lower levels of life satisfaction.

EducationThere is strong evidence that adult education improves healthy living and mental wellbeing, reduces the use of health services, increases civic participation including voting and even reduces racism. These wider benefits from learning are realised through the development of personal characteristics, skills, and social interactions. They are proportionally greater for adults who are more educationally disadvantaged.9

Brighton & Hove has one of the most highly qualified adult populations in the country. Nearly half the working age population have the equivalent of a degree or higher; many resident graduates come from the two local universities. Just 8.2% of the working age population has no qualifications, compared to 12.4% of Great Britain and 8.9% of those

living in the South East.10 The Experian economic resilience survey ranks Brighton & Hove as the highest local authority district in the region in relation to the ‘people’ measure, as a result of its highly qualified population.11,12

Brighton & Hove City Council supports adult learning in partnership with several learning providers in the city, who provide community-based short courses and workshops as well as information, advice and guidance. Through the provision of opportunities in schools, and other community venues with free crèche support, ‘family learning’ is targeted at those who have not been engaged in formal learning for the last three years, especially parents and those who do not have a full level 2 qualification.13

Current reforms to adult learning and skills policy will likely reduce the number of services while seeking to target those that remain more at: people with low levels of literacy and numeracy; low educational attainment; those who are the disadvantaged; and young people. The focus on getting people into employment will increase.

Education assets in working age adults

Brighton & Hove has a highly educated •working age adult population.

The city has two universities. •

The city supports adult learning with many •initiatives targeted at more deprived populations.

Education vulnerabilities in working age adults

Changes in national policy may reduce the •opportunities for adult learning.

As is also discussed elsewhere in this report, •the educated adult workforce is to a large degree imported by way of students from outside enrolling in local universities and often staying on post graduation. Local residents educated to lower levels will likely struggle to compete with more educated migrants for employment.

Linda Wells enrolled on an Adult Learner recycled textiles course – and now has her own website.


HealthBrighton & Hove is ranked 269 out of 375 districts for ‘health’ in the Place Profiles Summary score.14 Many of the health issues facing working age adults in Brighton & Hove are well described in the city’s Joint Strategic Needs Assessment.7 These include: increasing rates of sexually transmitted infections, high mental health needs with high rates of suicide, alcohol and substance misuse, and relatively higher levels of cancer deaths. Several commissioning strategies and programmes of work are in place in an effort to address these issues, targeting the more deprived areas where health, wellbeing, and levels of resilience are generally lowest.

However, as well as health vulnerabilities, the working age population of the city also has health resilience. More local people eat the recommended five portions of fruit and vegetables daily (33% of men and 47% of women in Brighton & Hove, compared to 13% of men and 15% of women nationally), and fewer (7%) were found to be overweight or obese, compared to nationally (24% of women and 21% of men). Smoking levels have also declined over the past 25 years. However, healthy diet and healthy physical activity levels are lower in the unemployed, smokers and those living in more deprived areas.15

Health assets in working age adults

Diet as measured by fruit and vegetable •consumption, is relatively good.

Health vulnerabilities in working age adults

Lifestyle and illness patterns associated •with a younger population, such as substance misuse and sexually transmitted infections, constitute significant public health problems in Brighton & Hove.

The unemployed, smokers and those •living in deprived areas are generally less fit and eat less healthily than other working age residents.

Material wellbeingDuring the financial year April 2009 to March 2010, the employment rate in Brighton & Hove was 71.6%; higher than the national rate (70.3%) but lower than that of the South East (74.5%). The unemployment rate, defined as the percentage of the working age population not able to get a job and who would like to be in full-time employment, was 7.3%; higher than in the South East (5.4%) and nationally (5.6%). The rate is the same for males and females locally, whereas in the South East and nationally it is 2% higher in females.7

Overall, 8% of the working age population in Brighton & Hove receives Jobseeker’s Allowance (JSA) and/or Employment and Support Allowance (ESA), compared with 5% in the South East and 7% in Great Britain. The number of long-term JSA claimants has increased in recent years.7 Since the 2008/09 recession, the rate of increase in JSA claimants has been fastest amongst people under the age of 25 years.

Worklessness is concentrated in particular neighbourhoods and there has been little evidence of success in ‘closing the gap’ between the most disadvantaged areas and the rest of the city. Trends in JSA claims are discussed in Chapter 3 and illustrated in Figures 3.4 and 3.5.

Average earnings are lower in Brighton & Hove than in the South East (£536.60) but higher than Great Britain (£491.00). Full time females earn an average of £467.10 per week compared to £527.30 per week for males in the city; a 13% difference. This difference (13%) however, is much lower than across Great Britain (25% or the South East 30%).7 Brighton & Hove’s ranking in terms of gross weekly pay has improved slightly in recent years as shown in Figure 3.6 in Chapter 3 of this report.17

As well as work being a factor that promotes resilience, a high level of resilience is in turn associated with greater effectiveness at work. Hence increasing resilience can improve


productivity.17 With an eye for greater productivity, as well as the health of workers, a growing number of companies are actively promoting the emotional resilience of their employees. Many simple interventions incur little or no additional cost for profound effects.18 In Brighton & Hove, the Federation of Small Businesses (FSB) has teamed up with the mental health charity Mind, and published guidance to help small firms improve their employees’ mental health and wellbeing.19

Social enterprises are: “businesses with primarily social objectives whose surpluses are reinvested in the business and local community, rather than maximising profits for shareholders and owners” are an increasingly important part of the UK’s economic and social landscape. 20 In Brighton & Hove, there are around 100 social enterprises, with a collective turnover of around £18 to £21million, employing around 1,250 people, 7% of whom are from disadvantaged groups. The top three declared social aims of social enterprises locally are; education (42%); community development (35%); and employment or training for disadvantaged groups (33%), which means that the social enterprise sector has the potential to build resilience in the city as well as enhance economic development.21

Material wellbeing assets in working age adults

The difference in pay rates between men •and women is lower in Brighton & Hove than it is regionally or nationally.

An established strong social enterprise •sector has the potential to build economic resilience in the city.

Material wellbeing vulnerabilities in working age adults

The city has high rates of unemployment •and uptake of Jobseeker’s Allowance, particularly in young people.

Average pay rates in Brighton & Hove are •lower than regionally and nationally.

Supports domain

Strong and stable familiesAccording to the 2001 Census, 23% of households in Brighton & Hove have dependent children; 27% of which are lone parent households, compared to the South East (18%) and England and Wales (22%). The number of people claiming out of work benefits fell from 4,000 in 2001, to 3,300 in 2008, and 2,800 in 2010. Changes in eligibility criteria have been a factor in reducing the number of lone parent claimants.16

Brighton & Hove has fewer married couple households with dependent children; 11.6% compared to 19% in the South East and 17.6% in England and Wales, but similar proportions of co-habiting couples with dependent children. The city has a high proportion of people who are single (never married), ranking 18th out of 376 local authority areas. The percentage of divorced residents locally (9.5%) is also higher than in the South East (8.2%) and England and Wales (8.2%) while the proportion who have remarried is lower (Brighton & Hove 6%, South East 8.3%; national 7.4%).21 The picture in the city then, is one of fewer married couples and more lone parents.

Brighton & Hove has a higher than average numbers of families with a range of risk factors for child poverty, including disabilities, mental health problems, alcohol and drug misuse, and domestic violence.23 As discussed earlier, domestic violence can have profound effects on children. The British Crime Survey indicates that more than 200 women in Brighton & Hove experience domestic violence each week. Since 2007, there have been four domestic violence related homicides. Levels of domestic violence in the city reflect national trends, although domestic violence continues to be under-reported. To date there has been insufficient investment in preventing domestic violence, and victims report that local services failed to identify them soon enough or respond to their needs. A comprehensive

needs assessment was recently completed and a summary of the results presented to the council cabinet. A city wide commissioning plan to tackle domestic violence will be implemented in 2011/12.24

Strong and stable family assets in working age adults

No community resilience assets were identified with regard to strong and stable families in this chapter.

Strong and stable family vulnerabilities in working age adults

Brighton & Hove has a high proportion of •lone parent households.

There are relatively fewer married couple •households than nationally, but a similar proportion of co-habiting couple households with dependent children.

There is a relatively high proportion of •divorced residents, and more single people living alone, which may make them more vulnerable to social isolation.

A significant proportion of the local •population experiences domestic violence and services do not currently meet the needs of victims.

BelongingSocial isolation increases the risk of cardiovascular disease, poor mental health and premature mortality. High levels of social capital contribute to community resilience.25

Brighton & Hove ranks 290th out of 352 local authorities in terms of the proportion of the population that feels a very/fairly strongly sense of belonging to the immediate neighbourhood.8 This is confirmed by the Experian economic resilience survey, which ranks Brighton & Hove as 251 out of 324 local authorities in relation to the ‘community’ measure, with the city performing particularly badly on social cohesion (in addition to claimant count and life expectancy).11,12 ‘Belonging’ is the only component of the WARM tool for which the city as a whole is rated ‘red’.

Feelings of belonging locally increase with age; they tend to be much lower in working age adults (49.5%) than in older people (72.5%). People who rent from a private landlord are less likely to feel that they belong to their immediate neighbourhood than other residents.8 However, Brighton & Hove is a tolerant city where people from different backgrounds report getting on well together.

Findings for the ‘belonging’ component in Brighton & Hove are mixed. A local survey found that levels of social capital were higher in more affluent areas of the city than in

poorer areas. Even so, a third of people living in deprived areas had taken some form of action to resolve a local problem in the previous three years. Furthermore, people living in the Sure Start and New Deal areas of East Brighton were also more likely than other Brighton & Hove residents to speak to a neighbour every day. Two thirds of people, whether deprived or affluent, said they could ask someone for help in the community if they were ill in bed. Women were more likely to do so than men, as well as more likely to have been involved in an organisation in their local area.26 The Place Survey found that council tenants are more likely than the rest of the population to feel that they can influence decisions in their local area and residents in more deprived areas are more likely than other residents to report that they feel that their interests are being promoted.8


Residents planting bulbs in Whitehawk


As discussed throughout this report, volunteering supports wellbeing, builds social capital and resilience in communities, and provides a pathway for many to employment.25,26 Although a key plank of the Big Society initiative, more than 20 million people 27,28 in England already volunteer at least once a month; this is equivalent to half the adult population.27 Those aged 45 years and over are more likely than other age groups to volunteer 29 or help others.28 In Brighton & Hove, 24% of residents report having volunteered (informally),30 at least once a month, during the past 12 months compared to 23% nationally.8

A thriving local third sector of around 1,600 organisations employs around 8,000 people, provides 19,200 volunteer positions and contributes £96million to the annual local economy.29,31 The majority of local volunteers are between 25 and 59 years old (69%); and female (66%). Nationally, equal numbers of men and women volunteer. The third sector group, ‘Impetus’ operates a City Volunteer Centre advising on good practice with regard to the recruitment, management and retention of volunteers. There is also a strong tradition of ‘community activism’ locally, although many may not identify themselves as volunteers or that they are volunteering.30,32 The city council

has established a grants scheme to help local charities survive the current financial climate.31,33 Strengthening communities and involving people is a priority theme in Brighton & Hove Local Strategic Partnership’s Sustainable Community Strategy.32,34

A major problem with evaluating community development work is that it has typically focused on outputs (participating numbers, hours worked etc) and not outcomes. The local Social Returns on Investment (SRoI) pilot33 found that 90% of those volunteering 21 or more hours per month felt that they could influence local decision-making, and 100% felt that they had gained skills, confidence and knowledge. Interestingly, 66% said these changes were directly supported by their community development worker. Furthermore, 94% felt a sense of belonging to their neighbourhood.35 The ‘Strengthening Communities Review’, which began in 2010, will guide future commissioning, and the SRoI outcomes will be utilised as a baseline to measure future performance.36

Belonging assets in working age adults

There is a thriving and supportive third •sector in Brighton & Hove.

Community development work locally has •demonstrably improved the knowledge, skills, confidence, engagement and sense of belonging in participants.

Brighton & Hove Volunteer Centre


Belonging vulnerabilities in working age adults

Social cohesion and feelings of belonging •are relatively low in Brighton & Hove, partly due to the higher proportion of working age adults.

Levels of social capital are lower in the •more deprived areas of the city, particularly among young people.

Levels of volunteering may decline as a •result of financial pressures, which in turn may impede the city’s ability to deal with the current financial crisis.


Local economyAs discussed in Chapter 3, the economy in Brighton & Hove is strong. It is the only component of the WARM tool for which the city as a whole received a ‘green’ rating. In Experian’s analysis of economic resilience, Brighton & Hove ranked 79th out of 324 local authorities for the business domain.11,12 The city has received high satisfaction ratings for its status as a business location. According to Place Profiles, it is in the top 20% of districts in terms of: the contribution it makes to the economy; the proportion of knowledge-based employment (where graduates make up at least 25% of the workforce); the extent of its enterprise culture; and the skills and

qualifications of the workforce. 14 However, it is ranked in the bottom 40% of districts in terms of employment / unemployment levels,17 and while between 2001 and 2008, 8,600 more jobs were created in the city, this resulted in just 1,800 fewer out of work benefit claimants.14,16,17

There are approximately 9,500 VAT registered businesses in Brighton & Hove. However, just six employers have more than 1,000 employees and 85% of local businesses employ fewer than ten people.37 The largest employer in Brighton & Hove is the city council, followed by Brighton and Sussex University Hospitals Trust. The city has many service sector jobs but few large businesses, the largest of which is American Express.10

The city has the highest rate of self-employed workers in the South East (12.9%).37 The size and depth of its creative community is one of Brighton & Hove’s particularly distinctive qualities. In 2007 creative industries were one of the fastest growing sectors in the local economy, growing at 5% per annum, twice the overall UK growth rate.38 However, there is a shortage of business accommodation locally.39

Six business sectors have been identified that could contribute most to economic growth in the city: digital media; creative industries; environmental technologies; financial services; manufacturing (including food and drink) and

health technologies. While the recession has had a negative impact on two-thirds (65%) of these priority businesses, most of the impact has been small. Around one in six (18%) has actually taken on more staff in the previous two years and 40% have seen their turnover increase.40

Brighton & Hove City Council seeks to support local businesses through a range of practical and financial measures. In addition, a number of partner organisations, such as the Federation of Small Businesses; The Brighton and Hove Chamber of Commerce; Hove Business Association; Brighton and Hove Business Community Partnership; Sussex Enterprise; Wired Sussex and the University of Brighton, also actively support local businesses. The Sussex Innovation Centre (SInC) at the University of Sussex supports technology and knowledge based companies; currently 80 high-growth companies are based there.41

The city has recently become part of a new enterprise area, the ‘Coast to Capital Local Enterprise Partnership’ (LEP), which aims to create 100,000 private sector jobs over a 25-year period. The city has had more success in creating jobs growth and employment than other areas of the LEP, however most (78%) jobs have not been filled by local residents.16

The City Employment and Skills Plan (CESP) 2011-14, “Better Skills, better jobs, better lives” identifies three priorities for the next three years: to promote the city’s employment


and skills; to create at least 6,000 new jobs by 2014; and to ensure that local residents are equipped to compete for jobs in the city’s labour market.16

Local economy assets in working age adults

Overall, the city has a thriving economy and •relatively high levels of economic resilience.

There is a diverse range of local businesses •that, by and large, appear to be weathering the recent financial storm.

Business satisfaction rates with Brighton & •Hove as a location for doing business are very high.

With two universities and a medical school, •Brighton & Hove maintains a highly qualified population.

A range of business development •organisations, including the local authority, support business development in the city.

Local economy vulnerabilities in working age adults

The relatively few large businesses in the •city make it vulnerable should existing large businesses decide to re-locate.

d

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decenthousing

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Figure 5.3: Priorities for working age adults in Brighton & Hove.

Source: Place Survey, 2008, Department for Communities and Local Government

There is a shortage of high-quality business •accommodation in the city.

Most of the new jobs that have been •created locally have not gone to local residents.

Public servicesFigure 5.3 illustrates the priorities identified by working aged adults who took part in the 2008 Place Survey. Traffic congestion and a lack of activities for teenagers were identified as the problems most need of improvement.

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Over 80% agreed that their local NHS helped to improve their health and wellbeing and that of their family, but only 51% that the local NHS and social services work well to provide a ‘joined-up’ service.42

Public services assets working age adults

Council tenants, women and black and •minority ethnic groups feel that local services respond to their concerns.

Residents are satisfied with local public •transport services.

Satisfaction rates with NHS services •are improving.

Public services vulnerabilities working age adults

There are relatively low levels of •satisfaction with council, GP, local hospital and dental services.

The NHS and social services are not •perceived by the public as providing a joined-up service.

Crime and anti-social behaviourBoth crime and fear of crime impact adversely on physical and mental health. Young households and the unemployed are at higher risk of being burgled and of being victims of violence.43

Crime and perceptions of crime are discussed in some detail in Chapter 3. For all British Crime Survey comparator crimes in 2009/10, Brighton & Hove ranked 310 out of 374 local authorities (where 1 is the best), and for violent crime 311.44 The total crime rate in Brighton & Hove appears now to be falling (9% in 2009/10 compared to the previous year), although as discussed in Chapter 3 the rate of reduction is lower than in the Sussex (18%) or England (19%). (Figure 3.9) Perceptions of anti-social behaviour and safety in the city have also improved. Where concerns remain, these are with regard to the city centre, the east of the city and the more deprived areas. The city ranked poorly (344 out of 352 local authorities) in terms of the percentage agreeing that the police and other local public services seek people’s views about anti-social behaviour and crime in their local area. However, residents in the most deprived areas did think their views were being sought, and believed that public services are working to make their area safer. Over 90% of working age adults said they felt safe in their local area in the day and more than two thirds said they felt safe after dark.8

The most important priorities for working age adults were clean streets and levels of crime.8

As discussed in Chapter 3, Brighton & Hove residents were less satisfied with public services than in England as a whole. Levels of satisfaction were however, higher among people who had actually used a service in the previous 12 months. Council housing tenants (as well as BME groups) were more likely to feel that local public services do not treat all people fairly, nor treat them with respect. However, despite this and even though they reported that anti-social behaviour was a problem in their local area, council tenants, women and BME groups also felt that local services acted on their concerns.9 With regard to transport services however, Brighton & Hove ranks second out of 352 local authorities for the percentage satisfied with local transport information and eleventh in terms of percentage satisfied with local bus services.8

The city was in the bottom 20% of local authorities in terms of satisfaction with GP and local hospital services, and the lowest 40% for dentists.9 As discussed in Chapter 6, satisfaction levels are higher among older people. The 2009 NHS Public Satisfaction Survey did show that 81% thought their local NHS provides them with a good service, an increase on the 2008 survey. One in three said health services had improved in the past few years and half that they had stayed the same.


The Partnership Community Safety Team supports residents in dealing with crime and community safety issues. It includes staff working specifically in the areas of racial harassment, LGBT hate crime, disability hate crime, domestic violence and anti-social behaviour. There is also a local anti-social behaviour team, made up of police officers, a solicitor, caseworkers, and other support workers, and a Family Intervention Project (FIP) to deal with anti-social behaviour. Brighton & Hove was granted a Designated Public Places Order (DPPO) in 2003 to enable the police to confiscate alcohol from drinkers behaving in an anti-social way. This is part of a wider strategy which includes regular police patrols in hot spot areas, outreach workers who assist street drinkers into accommodation and treatment, and clinical interventions for individuals whose behaviour causes intimidation and harassment to members of the public.

Crime assets in working age adults

Crime rates, although high, fell last year, •albeit lower than across Sussex and in England as a whole.

Perceptions of anti-social behaviour and •safety in the city are improving.

Local residents in Brighton & Hove have •relatively greater feelings of safety at night.

There is strong partnership working locally •to deal with crime and disorder problems, and the designated public place order has enabled the police to work more effectively as part of a wider strategy to reduce street drinking and help street drinkers.

Crime vulnerabilities in working age adults

There are high rates of crime locally.•

Younger people in more deprived areas are •more likely to fear violence in their area.

There is a perception by residents that their •views are not sought, by police and others, with regard to anti-social behaviour and crime issues in their local area.

InfrastructureThe physical environment plays a huge role in enabling people to live healthier lives, to build resilience and in reducing inequalities. Brighton & Hove is ranked 17 out of 376 districts on overall score for amenities; density of national heritage sites and listed buildings, availability of cultural amenities, café culture, retail floor space, and employment in hotels and restaurants; indicating a standard of local amenities that is in the top 20% of districts nationally. However, within this high ranking, as well as clear assets, there are some well recognised vulnerabilities.14

HousingThe problems associated with housing in Brighton & Hove have been discussed briefly in Chapter 4 with regard to children and young people, and are discussed in more detail in Chapter 6 with regard to older people. Last year’s Report of the Director of Public Health looked at the issue of housing in Brighton & Hove over the last 100 years.

The city is ranked 268 out of 338 districts on housing affordability score, putting the city in the bottom 40% of districts nationally, and 402 out of 408 districts on the average household size, placing it in the lowest 20% of districts nationally.14 Brighton & Hove has a lower proportion of owner-occupied dwellings (62%) compared to England (71%). Social housing makes up 15% of all dwellings; 11% owned by Brighton & Hove City Council and 4% by housing associations. The private rented sector makes up 23% of dwellings compared to 11% in England, making it the 6th largest privately rented sector in the country. The proportion of houses in ‘multiple occupation’ is 10% of housing stock compared to 2% nationally, although a large part of this reflects the student population; 5% of dwellings contain households with fuel poverty compared to 6.1% in England; and the average energy efficiency level is 51 compared to 46 for England.45


In the last Census in 2001, the city compared badly with other similar areas in terms of the percentage of dwellings reaching the decent homes standard. Among council housing stock 39.5% are designated as non-decent homes, while in the private sector it is 35%. However, due to its size, 85% of non-decent homes are in the private sector. Nationally, 27% of private sector homes are considered non-decent and 15.5% of Registered Social Landlord properties are designated as non decent.46 There are plans to bring all council homes up to decent

homes standard by the end of 2013, but this is more difficult to address in the private sector. However, there is now an obligation for councils to ensure the proportion of vulnerable private sector households in decent homes is above 70% by 2010/11. Poor quality houses are found more often in poor quality environments. One of the goals in the local housing strategy is to “Identify opportunities to improve and develop deprived neighbourhoods”.47 Housing is a priority issue for local residents. (Figure 5.3)

TransportBrighton & Hove is ranked 75 out of 408 districts for its overall connectivity score, placing it in the top 20% of districts nationally on levels of connectivity to intercity rail, motorways and airports.14 The relationship between transport and health, however, is complex. Transport enables access to work, education, social networks and services that can improve people‘s opportunities. Sustainable methods of transport such as walking and cycling bring health benefits through increased physical activity. Transport also contributes to noise and air pollution, as well as congestion and reduced levels of physical activity.48

Brighton & Hove is a national exemplar Cycling Town and between 2006 and 2008 cycling increased by 27%. The seafront cycle lane has one of the highest daily flows of bicycles in the UK. Vehicle ownership in Brighton & Hove (0.9 cars or vans per household) is the lowest in the South East (1.3 cars or vans), comparable to a London Borough, and one of the lowest nationally. Most traffic in the city is locally generated; two thirds of vehicles on the road at any one time are making trips that begin and end within the city.49

Parks and green spacesLiving close to areas of green space – parks, woodland and other open spaces – can

Social Housing at Lindfield Court, The Crestway, Hollingdean.


improve health, regardless of social class.49 In 2008 82.1% of residents were ‘very / fairly satisfied’ with parks and open spaces, compared to 72.6% in the South East and 68.5% in England, with Brighton & Hove ranking 14th of 352 local authorities in England.9 Satisfaction was a little lower in working age adults (81.2%) than older people (85.8%), but frequency of usage was higher (60% as opposed to 42%).8 The Place Profiles ranked the city 59 out of 354 districts for its overall natural environment score, putting it in the top 20% of districts nationally.14

The council owns 4,045 hectares (9,991 acres) of farmland, much of which is subject to secure agricultural tenancies, and currently largely under intensive agricultural use.50 City Parks maintain nearly 2,000 hectares of public green space in and around the city. There are five Green Flag parks, which have been recognised for their environmental standards and the service they provide for their communities. Along with Natural England, the city council’s aim is for everyone to have an accessible natural green space less than 300 metres from their home.

Infrastructure assets in working age adults

Brighton & Hove is an exemplar Cycling •Town with growing levels of cycling, low levels of car ownership and high public transport use.

The city is well connected to rail, road •and airports making it is accessible for tourists and business people.

There are high levels of satisfaction •among residents with regard to parks and green spaces.

Infrastructure vulnerabilities in working age adults

Brighton & Hove has lower levels of •owner-occupation than nationally, and a low supply of affordable housing for rent, particularly family sized homes.

A high proportion of the housing is •designated as ‘non-decent’.

Housing costs are high. •

COnCLuSIOnS AnD rECOMMEnDATIOnSBrighton & Hove adult residents are generally happy with the city as a place to live, but the lack of affordable housing means that many on a low income struggle to put down permanent roots in the city. More affordable family housing is a priority. As well as addressing associated health issues, improvements in housing would improve a sense of belonging among adults, and help build stronger and more stable families.

One of the city’s strengths is its public transport links and the increasing take up of cycling. Another is its parks and green spaces, including the beach area. These all contribute to health resilience. In terms of health, more should be done to encourage workplaces to promote the physical and mental health of their employees. There is good evidence that it increases productivity and reduces sickness absence; and while the perceived costs of this might constitute a barrier for small companies locally, businesses could come together to implement collaborative health and wellbeing initiatives which are in the interests of both the employer and employee.The lack of a sense of belonging particularly among the adult population has been


discussed in Chapter 3. More creative thinking, something the city is renowned for, is required to engage better with residents, particularly working age adults and to involve them with local decision-making.

Perhaps the strongest of Brighton & Hove’s assets is its well-educated population. However, this asset has also become something of a vulnerability. A relative lack of degree level jobs means that graduates are employed in jobs that would otherwise be available for local residents with poorer qualifications. Young people with low skill levels are therefore now particularly vulnerable to unemployment. Improving the employment chances of young people, which is closely linked to improving their educational qualifications, is one of the biggest challenges the city faces in terms of developing community-wide resilience.17

The strength of the local economy is also a great asset to the city, although a lack of high quality business premises makes it difficult to attract new businesses. This will make the creation of new jobs more of a challenge in the future. The Coast to Capital LEP is one mechanism of addressing this.

The links between community development and adult learning and skills could be strengthened; and more could be done to enable those with low skill levels to attain formal volunteering placements, both to develop skills and confidence and as a pathway to employment. More input from the local universities, as has already been alluded to in the context of secondary education, would be beneficial, building on for example, the Community University Partnership Programme (CUPP).

As well as creating jobs, the city needs to ensure that adult learning and skills providers effectively target those with the least ability to secure employment. The social enterprise sector with its focus on social benefit has considerable potential to contribute to the development of economic and social resilience. At a time of economic pressure, when the public sector contribution to the social enterprise sector is at risk, careful thought will be required with regard to what services are in the best long term, self sustaining and resilient interests of the city.


19. Federation of Small Businesses (FSB). FSB and MIND launch guidance on mental health in the workplace. FSB News Release 14th March 2011. www.fsb.org.uk/News.aspx?loc=pressroom&rec=7002 (accessed 15 April 2011).

20. Care Co-ops. Interested in social enterprise. www.careco-ops.org.uk/social-enterprise.php (accessed 15 April 2011).

21. Business Community Partnership. Brighton and Hove Social Enterprise Strategy: Better for people, planet and profit. www.brighton-hove.gov.uk/downloads/bhcc/economicdevelopment/Brighton_and_Hove_Social_Enterprise_Strategy_2008.pdf (accessed 19 April 2011).

22. Brighton & Hove City Council. Census briefing two: demography, 2001. www.brighton-hove.gov.uk/index.cfm?request=b1000175 (accessed 15 April 2011).

23. Brighton & Hove City Council. Brighton & Hove Child Poverty Needs Assessment, 2010-11.

24. Brighton & Hove City Council. Brighton & Hove intelligent commissioning pilot 2010/11. Domestic violence needs assessment. www.bhlis.org/resource/view?resourceId=888 (accessed 19 April 2011).

25. Giles-Corti B. The impact of urban form on public health, paper prepared for the 2006 Australian State of the Environment Committee, Department of the Environment and Heritage, Canberra. www.deh.gov.au/soe/2006/emerging/public-health/index.html (accessed 15 April 2011).

26. Brighton and Hove City Teaching Primary Care Trust and Brighton & Hove City Council. The Annual Report of the Director of Public Health, 2004.

10. Brighton & Hove City Council. Labour market intelligence fact sheets: overview of Brighton and Hove labour market. Employment in Brighton & Hove (pdf 538) www.brighton-hove.gov.uk/index.cfm?request=c1000926 (accessed 19 April 2011).

11. Experian. Understanding resilience: background information – South East. Experian Limited;2010.

12. Experian. Experian resilience data- BBC – Homepage. www.news.bbc.co.uk/nol/shared/spl/hi/uk/10/experian/xls/resilience.xls (accessed 15 April 2011).

13.Brighton & Hove Learning Partnership. Learn stuff: a showcase of adult learning in Brighton and Hove. www.bhlp.org.uk/learnstuff (accessed 15 April 2011).

14. Local Futures. Place Profiles. District profile: An economic, social and environmental summary profile of Brighton and Hove: The Local Futures Group; July 2010.

15. Cleary PD, Mehanic D and Greenly JR in Health Counts: a survey of people in Brighton and Hove. CHHS: University of Kent; 2003.

16. Brighton & Hove City Council. Brighton & Hove City employment and skills plan: better skills, better jobs, better lives, 2011-2014. BHCC; 2011.

17. Business in the Community. Emotional resilience and productivity of the working age population. www.bitc.org.uk/resources/publications/emotional_resilien_1.html (accessed 19 April 2011).

18. Business in the Community. Emotional resilience toolkit: healthy people = healthy profits. www.bitc.org.uk/resources/publications/healthy_people_.html (accessed 19 April 2011).

References:

1. Office of National Statistics. Labour market unemployment rate rises to 8.0 per cent. www.statistics.gov.uk/cci/nugget.asp?id=12 (accessed 18 April, 2011).

2. Politics.co.uk. Unemployment continues to rise. www.politics.co.uk/news/economy-and-finance/unemployment-continues-to-rise-$21386742.htm (accessed 18 April, 2011).

3. Green F. Job Insecurity, employability, unemployment and well-being. School of Economics, University of Kent, Canterbury; 2009.

4. Professor Mel Bartley (Ed). Capability and resilience: beating the odds: UCL Dept of Public Health and Epidemiology on behalf of the ESRC Priority Network on Capability and resilience; 2003-2007.

5. Department for Work and Pensions. Welfare reform. www.dwp.gov.uk/policy/welfare-reform/ (accessed 13 March 2011).

6. Department for Business, Innovation and Skills. Skills for sustainable growth strategy document. www.bis.gov.uk/assets/biscore/further-education-skills/docs/s/10-1274-skills-for -sustainable-growth-strategy.pdf (accessed 19 April 2011).

7. NHS Brighton and Hove Summary Joint Strategic Needs Assessment; 2011.

8. Black P. Brighton & Hove Place Survey 2008: findings and comparator results. Brighton & Hove City Council; 2009.

9 Leon Feinstein, David Budge, John Virhaus and Kathryn Duckworth (eds). The Social and personal benefits of learning: a summary of research findings. Centre for research on the wider benefits of learning (WBL). Institute of education. London; 2008.


27. The Institute for Volunteering Research and Volunteering England. Volunteering works. Volunteering and social policy, September 2007. http://www.volunteering.org.uk/NR/rdonlyres/4D138A1D-022E-4570-9866-B8E3A4F86C20/0/Final_Volunteering_Works.pdf (accessed 18 April 2011). 28. Corporation for National and Community Service, Office of Research and Policy Development. The health benefits of volunteering: A review of recent research, Washington, DC 2007. http://www.vds.org.uk/Portals/0/Documents/Health%20Benefits%20of%20Volunteering%20-%20Review%20of%20Recent%20Research.pdf (accessed 15 April 2011).

29. HM Treasury. The future role of the third sector in social and economic regeneration: final report. http://www.official-documents.gov.uk/document/cm71/7189/7189.asp (accessed 15 April 2011).

30. Ruston D. UK time use survey, volunteers, helpers and socialisers: social capital and time use. Social Analysis and Reporting Division: Office for National Statistics; 2003.

31. Impetus. Joining the Dots: A triple impact volunteering strategy for Brighton and Hove 2010-2015 .Volunteer Centre. volunteeringstrategy.wordpress.com/ (accessed 15 April 2011).

32. Brighton & Hove Community and Voluntary Sector Forum. Taking account: a social and economic audit of the third sector in Brighton and Hove. Summary of key findings, September 2008. www.brighton.ac.uk/cupp/.../c-k.../TAKING_ACCOUNT_FINAL_3.pdf (accessed 15 April 2011).

33. Brighton & Hove Community & Voluntary Sector Forum. Latest news: money available for local charities, 6th April 2011. http://www.cvsectorforum.org.uk/informing/news (accessed 15 April 2011).

34. 2020 Community Partnership. Brighton and Hove sustainable community strategy. www.brighton-hove.gov.uk/index.cfm?request=c1165450 (accessed 15 April 2011).

35. Brighton & Hove City Council. Strengthening communities review, Appendix one: Findings from the review of engaging with neighbourhoods. BHCC Communities and Equalities Team, 2010.

36. Brighton & Hove City Council. Strengthening communities review, Findings report: commissioning: BHCC Communities and Equalities Team; 2010.

37. Brighton & Hove Business Forum. Brighton and Hove economic strategy 2008-2016, socio-economic context, up-dated April 2010.

38. Brighton & Hove City Council. Creative Industries. www.brighton-hove.gov.uk/index.cfm?request=c1136282 (accessed 15 April 2011).

39. Step Ahead Research Ltd. Brighton & Hove Business Survey 2010. Brighton & Hove City Council; November 2010.

40. GVA Grimley Limited. Brighton & Hove business retention and inward investment strategy and implementation plan. Commissioned by Economic Development. Brighton & Hove City Council; March 2009.

41. Brighton & Hove City Council. Support for businesses. www.brighton-hove.gov.uk/index.cfm?request=b1000040 (accessed 15 April 2011).

42. Ipsos MORI. South East Coast Public Satisfaction Survey, 2009. www.southeastcoastfff.nhs.uk/news/documents/2009SHAWordReportFINAL.pdf (accessed 15 April 2011)

43. The Poverty Site. Victims of crime. www.poverty.org.uk/87/index.shtm (accessed 15 April 2011).

44. Sussex Police. Local crime mapping: Brighton and Hove. maps.police.uk/view/sussex/brighton-hove-west-district/ (accessed 15 April 2011).

45. Brighton & Hove City Council. Private sector housing. www.brighton-hove.gov.uk/index.cfmrequest=c308 (accessed 15 April 2011).

46. Brighton & Hove City Council. Private sector house conditions survey. www.brighton-hove.gov.uk/downloads/bhcc/Brighton___Hove_Stock_Condition_Survey_2008.pdf (accessed 20 April 2011).

47. Brighton & Hove City Council. Housing strategy 2009-2014: healthy homes, healthy lives, healthy city, December 2009. www.brighton-hove.gov.uk/index.cfm?request=1188834 (accessed 15 April 2011).

48. Marmot M. The Marmot Review: fair society, healthy lives: strategic review of health inequalities, February 2010. www.idea.gov.uk/idk/core/page.do?pageId=16908107ble (accessed 15 April 2011).

49. Brighton & Hove City Council. Air Quality Action Plan, 2010. www.brighton-hove.gov.uk/downloads/bhcc/airquality/BHCC_AQAP_Consultation.pdf (accessed 15 April).

50. Brighton & Hove City Council. City parks. www.brighton-hove.gov.uk/index.c.fm?request=b1100080 (accessed 15 April 2011).

Chapter 6

RESILIENCE IN OLDER PEOPLEMany of us fear getting old; as individuals we associate ageing with physical frailty, mental decline and social isolation. As a society we worry about the costs and consequences of an ageing population. Over 20% of the population is aged over 60 years with the numbers of very elderly (over 80 years) increasing in particular. This trend is expected to continue.1

INTRODUCTIONTo paint a totally bleak picture of ageing is misleading. For example, recent research has revealed that happiness does not diminish in old age. As discussed in Chapter 3, people’s levels of subjective wellbeing follow a u-shaped curve with feelings of wellbeing at its lowest in middle age then climbing thereafter – a pattern that is consistent in 72 out of 80 countries.2 Growing old is not the same as growing infirm and people can take some control over their ageing. For example, training older people in reasoning and memory can lead to significant improvements in cognitive abilities,3 and leading an active lifestyle has been shown to slow the rate of both physical and cognitive decline.4,5 So as we all get older, there is some cause for optimism.

Just as it is wrong to paint a bleak picture of ageing so it would be incorrect to paint an entirely rosy one. We know that, for example, compared to the rest of the population, older people feel less safe in their neighbourhoods. Some older people faced with the loss of physical and mental faculties also experience

financial difficulties, reduced autonomy and social isolation.6 This latter feature affects in particular older people who are less mobile. The life satisfaction and general wellbeing of older people is reduced when they are isolated, poor, in ill-health, living alone or in unfit housing and rundown neighbourhoods, when they require a carer or live in a care home. Bereavement presents an additional threat to quality of life.7

“Resilience” has been identified as a quality that can be fostered or strengthened to help older people cope with adversity in ageing and achieve greater happiness.8 Social relationships, rather than socio-economic circumstances, are at the heart of resilience at older ages provided they pre-date adversity and are contemporaneous with it. Such relationships work by what is called the ‘enablement of continuity of self’ and perhaps by preventing or minimising stigmatisation. Resilience might even be one factor to explain thriving among the oldest-old; one recent ten-year study found that psychological resources were positively related to “exceptional” ageing.9

Six factors have been identified in research as key influences on the quality of life of older people: support networks, having a role, income / wealth, health, having time and independence.3 Personal relationships and being part of a community are especially critical. So, sometimes the level of support required to significantly enhance the quality of life of older people can be neither costly nor complicated.10,11 Other factors identified as enhancing resilience in older people include: proper nutrition, regular physical exercise, emotional support, hope/optimism, high cognitive functioning, secure green space and engaging in nature, volunteerism, and a satisfying work life.12

There has been a national policy shift towards an adult social care and health service that has prevention, early intervention and enablement at its core,13,14,15,16 as well as choice and control over services through the personalisation agenda.17 This approach has the potential to enhance wellbeing and also save money as demonstrated by the Partnership for Older People Projects (POPPs), where enhanced prevention and early intervention services

Chapter 6 I RESILIENCE IN OLDER PEOPLE I 97

98 I Chapter 6 I RESILIENCE IN OLDER PEOPLE

resulted in savings on emergency bed days and reductions in use of accident and emergency departments.18 However, this vision relies on councils and partners co-operating to tackle the main causes of social care need such as housing and environment, health and mobility problems, social support and social isolation. Funding for such relatively low-level support is at risk in the current financial climate given restricted budgets and growing demands for social care.

LOCAL DEMOGRAPHIC CONTEXTOlder people are the fastest growing population group in England and Western Europe although the proportion of older people living in Brighton & Hove has actually fallen in recent years. Over the last ten years, there has been a fall of more than a quarter of post retirement age residents in the city, the majority of which can be attributed to net out-migration amongst this age group. People aged 65 years and over currently make up 14% of the city’s population compared to 17% in the South East and 16.3% in England as a whole. Figure 6.1 illustrates the age breakdown of the older population in Brighton & Hove.

At the time of the 2001 Census, there were 51,058 people aged 60 years or over living in the city. By 2009 this had fallen to 48,100 and this is expected to decrease further to 47,600 people in 2013. However, thereafter the number of older people is expected to

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Figure 6.1: Age breakdown of older population in Brighton & Hove

Source: Office of National Statistics, mid year estimates, 2010

increase: the population aged 60 years and over is predicted to increase to 58,500 people between the years 2013 and 2029. The number of males and females aged 60 to 74 years is currently roughly equal but this changes as people age further and 68% of people aged 85 years and over are female. This ratio is anticipated to balance out over the

next 20 years as male life expectancy is increasing faster than that of females.19 Figure 6.2 shows the projected older people population profile for Brighton & Hove.In the 2001 Census, 6.6% of the city’s population aged 60 years and over identified themselves as coming from a Black and Minority Ethnic group compared to 12% of

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same time period, the number of residential home places fell by 17%, in line with the national picture, due to more people being looked after at home.22

At the time of the 2001 Census, almost 22,000 people of all ages in Brighton & Hove provided some informal care; more than half (52%) of these were people aged 50 years and over. Even among people aged 85 years and over, 5% provided some form of unpaid care, and half of these carers provided 50 hours or more of care.21

While older people live across all areas of the city, some wards have a higher proportion of older people than others: for example Rottingdean Coastal (28.1%), Woodingdean (23.3%), Hangleton and Knoll (21.7%) and Patcham (21.4%). Hove Park, Westbourne and Wish also have more than 20% of their population of pensionable age. Rottingdean Coastal, which has the highest percentage of older people living within its boundaries, ranks low on the Index of Multiple Deprivation (IMD) score, making it less deprived than most wards in the city and in England. Westbourne has all six of its constituent lower super-output areas (LSOAs) within the most deprived 50% in England, but none within the top 10% of the most deprived. Relative to East Brighton and other deprived parts of the city, the deprivation scores of the wards where higher numbers of older people live are quite low.21

20,800 26,300

26,800 31,000

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2009 2029 Male Female

Over 60s

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5,300

0

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2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

2009 2029

Over 85s

Figure 6.2: Projected population of older people in Brighton & Hove (2009-2029)

Source: Office of National Statistics mid year estimates 2009 and 2008 based projections

the city’s total population. The older population is expected to become more ethnically diverse as the population ages.20

Brighton & Hove has nearly double the national average of independent active older people (14.92% compared to 8.24% for

England) as well as having a smaller proportion of older people with high care needs (2.46% for Brighton & Hove, 3.36% for England).21

In Brighton & Hove between May 2003 and April 2007, the number of nursing home and dual registered places fell by 27%. Over the

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All ages

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2009 2029


Over 60s60 and over 85 and over


RESILIENCE IN OLDER PEOPLE IN BRIGHTON & HOVEThis section builds on the WARM asset and vulnerability data discussed earlier in Chapter 3 and considers further evidence of resilience in older people. There are few recent survey data sets on older people. A lifestyle survey was completed across the city in 2003 and a more detailed older people’s profile based on this was undertaken in Queen’s Park and Hangleton and Knoll wards in 2005/6. Many of the findings discussed in this section come from local strategic documents, such as the Housing Strategy, which are in turn based on Census and previous surveys such as the Place Survey (see also Chapter 3).

Self domain

Life satisfactionOlder people appear to be more satisfied with their local area than those in younger age groups, with those aged between 65-75 years being the most satisfied (91%). Approximately 86% of those aged 50 years and over in Queen’s Park and Hangleton and Knoll enjoy living in their community, 83% see or talk to their neighbours at least once or twice a week, and 63% report that they could ask someone for help if they needed it.23

EducationContinuing education and learning in later life can enhance a person’s social life as well as provide mental stimulation. More than a third of people in their 60s in England and Wales are involved in adult learning. Organisations such as the Open University and the University of the Third Age (U3A) encourage older people’s participation in learning.

Older people in the city have relatively high educational assets. In Brighton & Hove, 18% of those aged 50 to 74 years have higher level qualifications (equivalent to degree level or above) compared to 15% in England. Similarly, 46% of those aged 50 to 74 years in Brighton & Hove do not have any qualifications compared with 50% in England.22

This relatively well-educated older population has the potential to enhance local resilience significantly by, for example, contributing to the formal and informal workforce. Furthermore, it means that mental illness and dementia present less of a threat than they do in other areas of the country where the older population is less well educated. This finding reinforces the need to provide local opportunities for older people to take part in further education opportunities that are suited to their needs and aspirations.

Brighton & Hove has a large number of organisations providing adult learning. These include private companies and voluntary organisations with some supported through the National Skills Agency. U3As are self-help, self-managed, lifelong learning co-operatives for older people no longer in full time work. They provide opportunities for their members to share learning experiences in a wide range of interest groups. The Brighton & Hove U3A has over 400 members attending classes ranging from Scrabble to languages and art appreciation. Most members are aged 60 years or over, and many are either widows or widowers. U3A gives them opportunities for social interaction and continued learning.

Education assets in older people

A relatively high proportion of older people •in Brighton & Hove have higher level qualifications. The proportion of older

“At home this morning” radio programme broadcast by Grey Matters Productions on RadioReverb


people in Brighton & Hove with no qualifications is lower compared with England as a whole.

Brighton & Hove has a large number of •organisations providing adult learning at affordable cost.

Education vulnerabilities in older people

No data identified.•

HealthPoor health, both physical and mental, can reduce older people’s independence and their ability to participate in social activities. The 2001 Census recorded that in England 47% of people aged 60 years and over reported a limiting long term illness that restricted their daily activities or the work they could do. This rose to 73% among those aged 80 years and over. However, much can be done to delay any deterioration in health.16 There is also some local evidence to support the view that those aged 75 years and over may be doing well; 20% of people aged 75 years or over in Queen’s Park and Hangleton and Knoll report being in excellent or very good health.23

Life expectancy at age 65 yearsIn Brighton & Hove, life expectancy at age 65 years is 17.8 years for males and 21.1 years for females, compared with 18.0 and 20.6 respectively for England, an increase from

16.1 for males and 19.8 for females since 2000-2002. However, life expectancies for both males and females in Brighton & Hove are lower than the South East average.

Physical healthThe Brighton & Hove Housing Needs Survey 2005 reported that 27% of people aged 60 years and over reported a support need, rising to 42% among those aged 75 years and over. Of those aged 60 years and over reporting a support need; 10% were wheelchair users, 64% had walking difficulties and 26% had visual / hearing impairments. Issues such as these can affect many aspects of an older person’s life, particularly of their ability to undertake everyday tasks without support or assistance.

Long term conditionsCommon long term conditions include asthma, chronic obstructive pulmonary disease (COPD), diabetes and epilepsy. These and other long term conditions, often referred to as limiting long term illnesses, can result in frequent hospital admission. Although often of lifelong duration, their effects can be mitigated by medication and other therapies as well as by patients taking an active role in their health and wellbeing.

According to the 2001 Census, while the majority of people aged over 50 years in Brighton & Hove think they are in good health, a significant minority (19%) report not being in good health and 39% of older people

report having a limiting long term illness. Healthy life expectancy at age 65 years is similar for males in Brighton & Hove and in England, but longer for females in Brighton & Hove when compared to England. Life expectancy in Brighton & Hove free from significant disability at the age of 65 years ranges from 7.3 years to 11.3 years, and the number of years from age 65 years that people spend with a significant disability ranges from 8.0 to 10.2 across the city. The majority of people aged 75 years and over in Brighton & Hove live with a long term condition, as do a significant proportion of those aged under 75 years (38% of males aged between 65-75 years).21,22


The primary care trust and GP consortium are both split into three localities, east, west and central. The central locality in Brighton & Hove has the youngest population and the lowest prevalence of long term conditions. The west locality, by contrast, has the highest numbers of older people with the largest number of care homes in the city. The prevalence of stroke, diabetes and dementia are also highest in this locality compared to the other localities.

The ‘NHS Health Checks’ programme is aimed at people aged over 40 years in workplace and general practice settings, in an effort to identify early signs of heart disease, diabetes, kidney disease as well as the risk of stroke. Between April 2010 and January 2011 almost 1,100 checks were undertaken in Brighton & Hove, and over 1,100 referrals were made to stop smoking, exercise, weight management and GP services. By identifying conditions at an

early stage and implementing appropriate lifestyle measures, there is potential to build the health resilience of the older population.

The local Adult Social Care Access Point provides a single point of contact for new and existing users of social care services and it gives people better information and advice on the full range of care options.

Mental health The vast majority of older people in Brighton & Hove do not suffer from mental illness or dementia. However, an estimated 9% of older people in Brighton & Hove suffer from mild to moderate dementia and require formal care, and approximately 8% of older people suffer from depression. Prevalence estimates for depression in the National Service Framework for Older People1 suggest that at any one time 10-15% of people over 65 years will have depression and 3-5% a

depressive episode, so local figures are better or there may be hidden mental health needs in Brighton & Hove. It is probably a bit of both. In Queen’s Park, up to 40% of people aged 50 years and over reported feeling sad or depressed for two weeks or more over the course of a year.23 In older people depression needs prompt recognition and treatment because of the greater risk of suicide.16 Brighton & Hove has almost twice the national average of suicides and death from undetermined injury in older people. Most older people cope with significant difficult events, particularly if they have good social support and an active social life. Improving mental alertness through further education, a low alcohol intake and regular physical exercise are also known to build health resilience in older people and protect against depression and dementia. Brighton & Hove has a wide range of such services, so it is important that older people know about and are helped to access them.

Physical activity, diet and weightAccording to the 2008 MOSAIC profile of Brighton & Hove 20 the city has a significantly higher percentage of independent older people with relatively active lifestyles than the England average. Data from the Health Counts survey suggests that older people in Brighton & Hove, especially women, eat more healthily than younger people.23 Physical activity however decreases with age; 40% of those aged 65 to 74 years exercise three or more times a week but by the time people reach 75 years and over only 25% exercise three or more times a week, with

Brighton & Hove Older People’s Olympics, 2010.


42% exercising less than once a month or not at all. Women exercise less than men.23 Illness or disability were cited by 32% of respondents in the Queen’s Park and Hangleton and Knoll survey as the main reasons for not undertaking more physical activity.

Programmes to improve the levels of physical activity among older people need to take account of the limitations that people may have as a result of long term conditions or disability. The free swimming programme for the over-60s was well received and ran from April 2009 to August 2010. However, financial pressures resulted in the scheme being brought to an end. Almost 5,000 local people registered for free swimming and over 59,000 free swims took place. Despite efforts to target

the more deprived, the majority of older people who took part were from more affluent areas in the city. Any new proposal will need to succeed in targeting those most likely to benefit from such initiatives, as was the case with the free swimming initiative for children.

Around 38% of people aged over 50 in the Health Counts Queen’s Park and Hangleton and Knoll survey were overweight, a further 15% were classified as obese, and approximately 38% were within the normal weight range. The majority of those aged over 50 years consume five or more portions of fruit and vegetables in a typical day.23 This suggests that, in contrast to some of the younger population, the over-50s have taken on board a number healthy eating messages – less healthy eaters are of course less likely to survive to an old age.

Alcohol, substance misuse and smokingEvidence shows that people aged 65 years and over are more likely to misuse alcohol compared to other substances. The extent of older people’s drinking is affected by personal, social and economic circumstances, particularly loneliness. Being actively engaged in activities involving others plays an important mediating role for those who might be inclined to drink too much.24 The average weekly consumption of alcohol among the over-50s ranges from 9.3 units to 17.4 units per week, i.e. within recommended limits. However a small but significant proportion of men in Queen’s Park,

(11.7%), have an average weekly consumption of over 35 units, which is well above recommended limits.23 Older people who smoke are less willing to give up, although a higher proportion of people aged 65 years and over who do set a quit date succeed in stopping smoking compared to younger age groups.

These lifestyle findings suggest the need for programmes to help people with alcohol consumption, physical activity, diet and nutrition. Changing long ingrained health-related behaviour is challenging. The Brighton & Hove Health Trainer programme trains local people to support residents with health and health-related issues such as diet, exercise, alcohol, smoking and mental health, and helps them to adopt a healthier lifestyle. Access by older people has been encouraged through links with sheltered housing and hospital services. The development of a new community resource centre for older people at Patching Lodge is a further opportunity to establish or enhance such programmes.

Health assets in older people

Healthy life expectancy and disability-free life •expectancy at age 65 years are higher for females in Brighton & Hove than England.

Brighton & Hove has a significantly higher •percentage of independent older people with relatively active lifestyles than the England average.

Phot

o by

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ther

n N

ews

and

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ures

.


The average older person in Brighton & •Hove appears to have a better diet than the average younger person.

Although older people are less willing to •give up smoking, once they have decided to quit they seem to be more successful than younger age groups.

Health vulnerabilities in older people

In general, the average weekly •consumption of alcohol among the over-50s is within recommended limits. However 12% of men in some areas of the city have an average weekly consumption of over 35 units, which is well above recommended limits.

Brighton & Hove has almost twice the •national average of suicides and death from undetermined injury in older people.

Material wellbeingThe demography profile in this section has illustrated that older people in Brighton & Hove do not, in the main, live in the city’s most deprived electoral wards. However there is evidence that older people living in the city encounter some material wellbeing vulnerabilities that impact on their resilience. Over half the older people in Brighton & Hove live in the 40% most deprived areas for older people in England.25

While about 70% of men aged 50 to 64 years in Brighton & Hove are economically active, the proportion falls to barely over 10% for men aged between 65 and 74 years. The picture is similar for women. Low incomes are associated with housing difficulties, poor diet, inadequate heating in the home and an increased risk of social isolation. The largest source of income for pensioners is ‘benefit income’, which includes state pensions, benefits and occupational pensions. In Brighton & Hove, 13,243 (26%) of people aged 60 years and over are in receipt of means-tested rent or council tax relief, and 12,510 (24%) are in receipt of pension credit. The Index of Multiple Deprivation 2010 shows that across Brighton & Hove 23.6% of older people are affected by income deprivation compared with an average of 20.5% across England. There are large differences across the city ranging from 5% to 52% of older people affected by income deprivation (Map 6.1).26

As people grow older, they typically spend an increasing proportion of their income on food, domestic energy bills, housing and council tax; in households headed by someone aged 75 years or over this amounts to 40% of the weekly expenditure. Older people are thus particularly vulnerable to price increases brought about by inflation. A household is considered to be in fuel poverty if they have to spend more than 10% of their household income on fuel to keep their home in a ‘satisfactory’ condition. In Brighton & Hove,

11.7% of households (13,706 households) were reported as fuel poor; very similar to the level in England (11.5%). 22 Some parts of the city that are considered relatively affluent have vulnerabilities in terms of fuel poverty. This is likely to be related to the older population and the level and type of non-decent housing in those wards. The picture that is painted is of many older people struggling to get by in the midst of relative plenty. This reinforces the need to ensure that older people obtain the benefits that they are entitled to, and to better address the longstanding housing problems in the city.

Local intelligence within the city council’s city services department suggests that many older people do not take up the benefits to which they are entitled. There are increasing efforts to make sure that older people can easily access these benefits. This includes reviewing how libraries and other potential ‘access points’ used by older people work in this respect. There is also potential for linking much more with primary care services and involving GPs more, as has been the case with the recent housing and health initiative.

Material assets in older people

The city services department is working •with public health colleagues to improve the ways in which older people can better access information and support with regard to claiming benefit.


Supports domain

Strong and stable familiesAs previously discussed in this chapter, isolation and lack of social interaction are key factors for poor mental and physical health in older people. The majority of older people overall in Brighton & Hove are either married or live together as a couple: however, once they get to 75 years and over most people have been widowed. Brighton & Hove has a higher percentage of single pensioner households (16%) than the average for England (14.4%) with a range of 10.8% to 21.0% across the city. The majority of people aged 75 years and over live alone.21

This elderly and potentially isolated population represents an important vulnerability with significant effects on health and demands on health and social care services. Measures which provide support to older people living alone, and which bring them into contact with others, improve the resilience of older people faced with later life’s challenges. Brighton & Hove has an enormous range of voluntary and statutory sector services which work to this end.

Older people can play an important role in the extended family and research confirms that being an active grandparent is both a source of pleasure and gives a sense of purpose.27

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide

Dotted Eyes © Crown copyright and/or database right 2009. All rights reserved. Licence number 100019918

IDAOPI 2007

Least deprived quintile

Most deprived quintile

Note: quintiles based on local data

Map 6.1 Older people affected by income deprivation, 2007

Note: The Income Deprivation Affecting Older People Index (IDAOPI) is defined as the percentage of adults aged 60 years or over living in income deprived households.

Source: The Income Deprivation Affecting Older People Index (IDAOPI), Department of Communities and Local Government, Indices of Deprivation 2007

Material vulnerabilities in older people

Some areas that are considered relatively •affluent have vulnerabilities in terms of fuel poverty and low income along with higher levels of housing that is categorised as ‘non-decent’.

Many older people in the city may not •claim some of the benefits to which they are entitled and which would increase their resilience.

Patcham

Withdean

Rottingdean Coastal

Woodingdean

Stanford

Hangleton& Knoll

NorthPortslade


East Brighton

Wish


Goldsmid

PrestonParkSouth

Portslade

Regency

Queen'sPark

Westbourne

Hanover &Elm Grove

CentralHove

St.Peter's

& NorthLaine

Brunswick& Adelaide

Dotted Eyes © Crown copyright and/or database right 2009. All rights reserved. Licence number 100019918

IDAOPI 2007

Least deprived quintile

Most deprived quintile

Note: quintiles based on local data


In 2001 in the UK, almost 90% of people aged 60 years or over were grandparents, and grandparents provided 26% of childcare, making a highly significant contribution to the economy and saving families significant childcare costs. The 2011 Census should provide some data on the role played by grandparents in the city.

Strong and stable family assets in older people

Brighton & Hove has a strong and broad range •of voluntary and statutory sector services which support older people living alone.

Strong and stable family vulnerabilities in older people

Brighton & Hove has a relatively large •proportion of older people living alone and potentially socially isolated.

BelongingEncouraging older people’s active participation and contribution to community groups, schools and other neighbourhood activities can improve their sense of belonging. Studies indicate that older people are usually eager participants in civic and community activities and are more likely than younger people to enjoy living in their area, to be involved in a local organisation, to take action to solve a local problem, to trust people locally and to speak to their neighbours daily.28

Volunteering is an important means for people to contribute to and feel part of the community. Interest in volunteering peaks in the years immediately following cessation of employment and can help with the transition from working life into retirement. Nationally, nearly a quarter of people aged 50 years and over are engaged in formal volunteer activity.15

Older people derive greater mental health benefits from volunteering than younger age groups. It reduces the likelihood of them experiencing depression and increases life satisfaction by improving self-esteem and creating larger social networks. It also has wider benefits by encouraging altruistic behaviour.15 A 2008 survey by the Neighbourhood Care Scheme, a local organisation which recruits local volunteers to support older people, people with physical disabilities and carers found that 62% of volunteers reported feeling generally better, 11% felt less depressed and 39% felt an increase in their self-esteem as a result of their volunteering activities.29 In addition, and increasingly important in today’s financial climate, many services that assist older people increasingly depend upon older volunteers in order to operate effectively and efficiently.

In Brighton & Hove 20% of Place Survey respondents aged 75 years and over have participated in a group which makes decisions affecting their local area compared to 15% of adults in the city.30 A number of local organisations are important in enabling older

people to participate including the Older People’s Council, Brighton & Hove Pensioners Forum, LifeLines, 60+ Action Group and the Tarner Health Action Group.

In Brighton & Hove there are 19,200 volunteer positions, giving 57,600 hours per week, representing a contribution to the city of approximately £24million per annum (if they were paid the same rate as workers in the third sector). While the majority of volunteers (69%) and management committee members (73%) are between 25 to 59 years old, those aged over 60 represent 13% of the total. This is in line with population figures for the age group in the city and equates to nearly 2,500 volunteers. In Brighton & Hove, 66% of volunteers are women compared with 34% of men. This is in contrast to national data which shows no significant difference between men and women who volunteer.15

Religion can help some people to cope with difficult life transitions and can foster good emotional wellbeing for older people.31

The benefits stem from giving people a sense of purpose and continued participation in a social and supportive network. The Integrated Household Survey 2009-2010 indicates that Brighton & Hove has the lowest level of religious belief in the country. However, the data are not broken down by age so it is not possible to draw any conclusions with regard to the resilience gained from religious participation by older people in the city.


Belonging assets in older people

Compared to the city’s total population, •a higher proportion of older people participate in a group which makes decisions affecting their local area.

A significant proportion of older people •contribute through volunteering in Brighton & Hove in line with the national picture.

Several organisations support and enable •older people to participate in civic and community activities in Brighton & Hove.

Belonging vulnerabilities in older people

Any improvements in life satisfaction that •stem from involvement in religion are likely to be low as Brighton & Hove has the lowest level of religious belief in the country.


Public servicesIn recent years, in line with the recommendations of the World Health Organisation’s Active Ageing strategy, and the aspirations of the WHO Healthy City initiative, developing affordable, accessible age-friendly and good quality public services has been a priority for Brighton & Hove.32

A number of local initiatives, some already discussed, support this intention with regard to older people. These include Healthwalks; NHS Health Checks; Health Trainers; Active for Life; Brighton and Hove Albion ‘Ahead of the Game’ which aims to detect cancer in men at its early stages; Women’s Royal Voluntary Service (WRVS) which provides meals on wheels, a home library service; a good neighbours scheme and community transport; Age Concern which has services for older people; Life Lines which supports older people to become more active and involved in their community; Brighton Carers Centre; the Alzheimers Society; Hangleton and Knoll 50+

Steering Group which provides a range of activities, opportunities and facilities for older people; and the Food Partnership which runs a range of inter-generational activities combining cooking and exercise. There are others too.

Brighton & Hove residents aged 65 years and over are more likely than other age groups to be satisfied with public services; including the city council (54%), Sussex Police (63%), local dentists (76%), GP services (92% of residents aged 75 years and over) and local hospitals (85% of residents aged 75 years and over). In addition, residents aged 75 years or over are the most likely to think that public services are working to make areas cleaner and greener (74%).30

It is important that services and benefits are publicised in the right places to ensure that older people access them. While there is a single access point for social care, in general older people have difficulty negotiating the wide range of information sources on services. In order to address this, the city council has just introduced a new service called Council Connect, which aims to help people access council and other services online by providing support through trained volunteers in public libraries. These volunteers help people use online and locally provided information and refer them on to other sources of advice and information if required.

Brighton and Hove Albion Football Club’s ‘Ahead of the Game’ project.


The extensive range of local statutory and voluntary sector services that support older people and build resilience among them, are like other services vulnerable to cuts in public spending. One way to mitigate this risk would be to develop better partnership working between agencies across the city.

Public service assets for older people

Brighton & Hove has a strong and broad •range of voluntary and statutory sector services for vulnerable older people.

Older people in Brighton & Hove are more •likely than younger people to be satisfied with public services.

Public services vulnerabilities in older people

A relatively large proportion of older people •in the city live alone and are more dependent upon public services.

CrimeAlthough older people are more likely to be victims of certain types of crime, such as fraudulent cold calling, most studies have found that overall older people are less likely than younger people to be victims of crime; however they fear crime more.35 In Brighton & Hove in 2009/10, 12% of total crime was committed against people aged 50 years and over, while this age group makes up 29% of the resident

population as a whole,33 with the most common crime types reported by older people being criminal damage and ‘theft other’ offences. Males aged 50 years and over are more likely to be victims of crime than women aged 50 years and over.33

Figure 6.3 opposite shows the percentage of respondents in the Citizens’ Panel 2010 who reported that they had witnessed or experienced crime within the last 12 months, by those aged

under, and over 55. In this survey, we can see that those aged 55 years and over, have much lower victimisation levels for each type of crime than those aged under 55, except for experiences or observations of bogus doorstep callers. Actual violence, threatened violence or robbery features as the most commonly experienced or observed crime in this survey for older people, as well as those aged under 55, followed by criminal damage and harassment.

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Criminal

damage

Harassment Bogus

doorstep

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Figure 6.3: % of respondents who have experienced or observed crime in their local neighbourhood or in the city centre in the past 12 months.

Source: Citizens’ Panel, 2010

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Fear of crime affects the mental health of older people and can undermine their confidence much more than it might in younger age groups.35 It is more common in those living in more deprived areas 35 and in Brighton & Hove, where feelings of safety in local neighbourhoods after dark have increased across all age groups, older people still tend to feel less safe than those in younger age groups.33 The focus for crimes committed against older people is not in the areas of the city where there are concentrations of older people living, rather the hotspot is the city centre, which older people tend to avoid at night.33A small proportion of crimes (5%) in the city in 2009/10 were committed by an offender aged 50 and over, 76% of whom were male. The most common offence types committed by older people are violence against the person offences, followed by theft other offences.33

In 2008, Citizens’ Panel data showed that older people are less likely to report crimes or incidents to the police. However, in 2010, this appears to have changed, and older people seem more willing to report to the police than two years previously. Crime features high on the list of important priorities for older people in Brighton & Hove although it is not identified as an area that needs particular attention when compared to other priority issues (Figure 6.4).30

The percentage of those who feel very or quite safe during the day in their neighbourhoods varies little across age groups but declining feelings of safety after dark in older age groups

are evident, with 45% of those aged 75 years and over in Brighton & Hove feeling unsafe out in their area after dark, compared to 23% of the total population sampled.30

Crime assets in older people

Older people are less likely than younger •people to be victims of crime and less likely to be repeat victims of crime.

Crime vulnerabilities in older people

Older people report a higher fear of crime •than younger adults.

Older people who experience crimes such as •burglary can suffer significant health effects.

Older people on low incomes or in deprived •areas are particularly vulnerable to a high fear of crime.

InfrastructureHousing As has already been discussed in this and previous public health reports, housing has an immediate and long term impact on health, wellbeing and quality of life.14

Figures from the 2001 Census show that home ownership in Brighton & Hove decreases sharply after the age of 85 years although half of residents aged 85 years or more in the city still own their own home (Table 6.1).21

The Brighton & Hove Private Sector House Condition Survey of 2008 identified the strong relationship between age of the head of household and levels of non-decency. The highest rate was where the age of the head of household was aged 85 years and over (Figure 6.5). Cold damp homes that are poorly heated have been linked to ill health and early deaths among older people.

Table 6.1: Home tenure in older people in Brighton & Hove

Tenure Age

Total 60-74 75-84 85+ Owner occupier 72.3% 64.8% 49.4% 67.2%Shared ownership (part rent, part buy) 0.4% 0.4% 0.3% 0.4%Social rented (sheltered and general housing) 15.7% 17.9% 16.6% 16.5%Private rented 8.3% 8.8% 9.1% 8.6%Rent free (e.g. with friends or family) 1.9% 3.4% 3.8% 2.6%Communal establishment (e.g. nursing home or care home) 1.3% 4.6% 20.8% 4.8%

Source: Census 2001



significantly above the South East average.In the recent Housing Needs Survey 10% of people aged 60 years and over reported a need for an adaptation in their house. Of those people, 11.6% needed wheelchair adaptations, 47.9% needed bathroom adaptations and 32.5% needed handrails or grab rails.25 The city council undertakes more than 500 adaptations to homes every year in the private and public sectors. A new joint housing and public health initiative encourages health professionals on home visits and GPs in their surgeries to make referrals to the housing department where a housing problem is resulting in a health problem. Early reports of this initiative are very encouraging.

Local environmentThe quality of the local environment plays an important role in reducing the risks of isolation in older people. In Brighton & Hove people aged 65 years and over find traffic the most problematic in terms of presenting an obstacle to leaving the house, socialising and participating in community life.30 Clean well-maintained streets are also high priorities and road and pavement repair is the issue that those aged 65 years and over consider most needs improving (Figure 6.3), though older people in the city are most likely to think that public services are working to make areas cleaner and greener.

TransportTravelling to services and social groups can be a big problem for older people; 35% of older

Figure 6.4: Non decent homes in Brighton & Hove by age of head of household

Source: Private sector stock condition survey, 2008

33%32%

29%

40%39%

45%

56%

0%

10%

20%

30%

40%

50%

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There are a number of national and local schemes that provide maintenance and repair services as well as housing support and related personal care. The city council helps to fund ‘Anchor Trust Staying Put’, a Home Improvement Agency that employs handypersons to help older people. The council’s trading standards service has a Buy with Confidence Scheme listing

approved local traders. Age Concern Brighton & Hove has a Help at Home Scheme that matches older people and self-employed home helps and gardeners. A national Warm Front grants programme supports people aged 60 years and over to have insulation and central heating installed. Brighton & Hove had the third highest proportion of grants in Surrey and Sussex,


people in Brighton & Hove do not have access to a car, and those who do complain that parking restrictions make it difficult for them to use their cars.25 The 2008 Place Survey identified that public transport was the third most important issue for older people after health services and clean streets (Figure 6.4).30

The introduction of free bus travel has led to a significant increase in older people travelling by public transport. Currently over 80% of residents aged 60 years and over use the council’s concessionary travel system. Older people do express concerns about the speed with which buses start and stop, and Woodingdean, Rottingdean and Eastern Road are deemed to have an inadequate service. In addition, there are other transport services such as Shopmobility and Easy Link community transport. Free transport assists greatly in maintaining social and support networks. However, some older people also need to be assisted and accompanied. This personal social support may be what ultimately decides whether some older people can get out or not.

Infrastructure assets in older people

A number of schemes in the city provide •access to maintenance and repair services as well as some level of care and support.

Older residents feel that public services are •working to make areas cleaner and greener.

Figure 6.5: Priorities for older people in Brighton and Hove

Source: The Place Survey 2008, Department for Communities and Local Government

ab

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a - Wage levels and local cost of living b - Sports and leisure facilities c - The level of pollution d - Community activities e - Facilities for young children f - Job prospects g - Race relations

Free bus travel has helped reduce social •isolation among older people.

Infrastructure vulnerabilities in older people

Brighton & Hove has a relatively high •proportion of ‘non-decent homes’, and the

highest rates are where the head of household is aged 85 years and over.

Some older people require assistance •and support to be able to make use of free travel.

ab

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A number of themes emerge from this section. It is wrong to focus solely on the health of older people if we are seeking to build resilience. Support networks play a vital role, as do giving older people a useful role, ensuring an adequate income and fostering independence. Personal relationships and being part of a community are especially critical. At a time of financial pressures on public funding it is tempting when looking for savings to reduce funding on initiatives that provide such support, as they might seem rather ‘woolly’ when compared to services that support physical needs. However, in the longer term this is likely to produce yet more pressures on public funds as the resilience that protects against future mental and physical health will be compromised. Furthermore the level of public sector financial support required to build future resilience need not be costly or complicated.

There is solid evidence that promoting physical and mental health in older people will prevent or delay the onset of disability. Initiatives which reduce isolation, increase physical activity and provide ‘a little bit of help’ to enable older people to manage pain, illness and disability, pay off in the medium and longer term. It is important however to focus not just on the very elderly but also on the

younger cohort of the older population if future health and wellbeing problems and associated costs are to be reduced.

The ‘whole persons approach’ may seem a bit of a truism but in no group is it more important than in older people. Physical, psychological and social issues cannot be meaningfully addressed in isolation. In addition, the needs of those caring for elderly people, often elderly themselves, are an essential part of any care package.

It is too easy to fall into the trap of accentuating all that can go wrong as people grow old rather than focusing on what goes right and what older people can do. As more people stay fitter for longer, the opportunities for them to develop and lead community initiatives in Brighton & Hove grow. Older people in Brighton & Hove are on the whole active, fit and able, with high levels of education. They are already more involved in how the city makes decisions and delivers services than are young people. As public finances grow tighter it becomes ever more important to harness the good will and capabilities of older people for the benefit of the whole community. They should be encouraged to play a greater role in engaging younger people more in order that a sense of

belonging can be developed across the whole city. They have a wealth of experience and a capacity that should be better harnessed to improve social capital and social inclusion. Cross-generational programmes such as mentoring, befriending, virtual grandparenting and activities and initiatives that engage all age groups build resilience not just for older people, but for the whole community.

COnCLuSIOnS AnD rECOMMEnDATIOnS


References:

1. Department of Health. National service framework for older people. London. 2001.

2. Blanchflower D, Oswald A. Is well-being U-shaped over the life cycle? National Bureau of Economic Research working paper 12935. 2007.

3. Banks J, Breeze E, Lessof C, Nazroo,J. Retirement, health and relationships of the older population in England: The 2004 English Longitudinal Study of Ageing (Wave 2). 2006.

4. Bassey EJ. Physical capabilities, exercise and ageing. Reviews in Clinical Gerontology 1997; 7(4): 289–297.

5. Center for Lifespan Psychology annual report 2003–2004. www.mpib-berlin.mpg.de/sites/default/files/media/pdf/25/lip_report_11.pdf (accessed April 2011).

6. Milne A, Hatzidimitriadou E, Wiseman J. Health and quality of life among older people in rural England: Exploring the impact and efficacy of policy. Journal of Social Policy 2007; 36(3): 477–495.

7. Help the Aged. Quality of life in older age: messages from the growing older programme. London. 2004.

8. Lavretsky H, Irwin MR. Resilience and aging. Aging Health 2007; 2(3): 309-323.

9. Kaplan MS et al. Prevalence and factors associated with thriving in older adulthood: a 10-year population-based study. Journal of Gerontology 2008; 63A(10): 1097-1104.

10. Netuveli G, Wiggins RD, Hildon Z, Montgomery SM, Blane D. Quality of life at older ages: evidence from the English longitudinal study of ageing (wave 1). Journal of Epidemiology and Community Health 2006; 60: 357-363.

11. Raynes N, Clark H, Beecham J (eds) The report of the older people’s inquiry into ‘that bit of help’. The Joseph Rowntree Foundation; 2006.

12. Zautra AJ, Hall JS, Murray KE. Resilience - a new integrative approach to health and mental health research. Health Psychology Review 2008; 2: 41-64 (March).

13. Social Care Institute for Excellence (SCIACE). Putting People First: Making a Strategic Shift to Prevention and Early Intervention; 2008.

14. Brighton & Hove City Council. Healthy homes, healthy lives, healthy city. Older People’s Housing Strategy 2009-2014; 2009.

15. Impetus. Joining the Dots: a triple impact volunteering strategy for Brighton and Hove. 2010-2015; 2010.

16. Surr C, Boyle G, Brooker D, Godfrey M, Townsend J. Prevention and service provision: mental health problems in later life. Centre for Health and Social Care, University of Leeds/Division of Dementia Studies, University of Bradford; 2005.

17. Lee M. Promoting mental health and wellbeing in later life: A first report from the UK enquiry into mental health and wellbeing in later life. Mental Health Foundation and Age Concern. London; 2006.

18. Windle K, Wagland R, Forder J, D’Amico F, Janssen D, Wistow G. National Evaluation of Partnerships for Older People. PSSRU for the Department of Health; 2009.

19. NHS Brighton and Hove. Joint Strategic Needs Assessment. 2011.

20. Experian. MOSAIC Public Sector Dataset. 2008. www.publicsector.experian.co.uk/Products/~/media/ Brochures/MosaicPublicSector_Brochure_051109A.ashx. (accessed April 2011).

21. Office for National Statistics. Census 2001. www.statistics.gov.uk/census2001/op.asp (accessed April 2011).

22. NHS Brighton and Hove/Brighton & Hove City Council. Older People’s Profile and Needs Assessment. 2008.

23. University of Kent. Health Counts: Analysis of a survey of people aged over 50 in Hangleton and Knoll and Queen’s Park. 2005/6.

24. Ward L, Barnes M, Gahagan B. Cheers!? A project about older people and alcohol. Project report. HSPRC, University of Brighton; 2008.

25. Brighton & Hove City Council. Brighton and Hove Housing Needs Survey; 2005.

26. Department for communities and local government. The English Indices of Deprivation 2010 www.communities.gov.uk/publications/corporate/statistics/indices2010%20 (accessed April 2011).

27. Blane D, Wiggins RD, Montgomery SM, Hildon Z, Netuveli J. Resilience at older ages: the importance of social relations and implications for policy. ICLS Occasional Paper Series: Paper No.3. February 2011.

28. World Health Organization. Global age-friendly cities: a guide. 2007. whqlibdoc.who.int/publications/2007/ 9789241547307_eng.pdf (accessed April 2011).

29. Levin JS. Religion, Health and Psychological Wellbeing. Journal of Aging and Health. Vol 10. No 4. 504-531. Nov 1998.

30. Brighton & Hove City Council. Brighton and Hove Place Survey. 2008.

31. Mentoring and Befriending Foundation. Befriending Works, building resilience in local communities. 2011. (accessed March 2011) www.puttingpeoplefirst.org.uk/_library/Resources/BCC/Befriending_Works.pdf

32. World Health Organization. Active ageing: a policy framework. 2002 Geneva.

33. Brighton and Hove Safe in the City Partnership. Community Safety and Older People - scoping report for Brighton & Hove City Council’s Environment & Community Safety Overview and Scrutiny Committee. March 2009, partially updated December 2010.

34. Brighton and Hove Safe in the City Partnership. Older people and community safety – extract from the Strategic Assessment of Crime and Disorder ;2010.

35. Ziegler R, Mitchell DB. Ageing and Fear of Crime: An Experimental Approach to an Apparent Paradox. Experimental Ageing Research 2003; 29(2): 173-187.

Chapter 7a

RESILIENCE IN LESBIAN, GAY, BISEXUAL AND TRANSGENDER (LGBT) COMMUNITIES Resilience is a concept that will strike a chord with many in lesbian, gay, bisexual and transgender (LGBT) communities.

INTRODUCTIONAs Hernández puts it “Resilience is a dynamic process in that it allows individuals, groups or communities to not only overcome adversity but to be strengthened or improved by it, and as such this encompasses the process undergone by lesbians, gays, bisexuals and transgender people to achieve a positive self-assured identity.” 1

Research, confirmed by some local studies, shows that LGBT people are at higher risk than heterosexual people of bullying, abuse, discrimination and exclusion.1,2,3 LGBT people are also at greater risk of mental disorder, substance misuse and dependence, self-harm and suicidal behaviour / ideation than heterosexual people with isolated LGBT people and those on a low income more susceptible than others.4,5

Recent research suggests that some LGBT people are more resilient than others despite these higher risks. For example, the higher risk of mental health issues, suicidal ideation or substance abuse relating to sexuality

orientation or gender identity may be mitigated by protective factors that promote resilience such as ‘family (and friend) connectedness’ or school/work safety.6,7,8

LOCAL DEMOGRAPHIC CONTEXT Unfortunately there is no definitive research into the number of lesbian, gay, bisexual and transgender people who live in Brighton & Hove and the recent Census did not include a question on sexual orientation. Local estimates suggest that there may be 40,000 LGBT people living in Brighton & Hove, over 20% of the city’s population, the city’s largest minority community and the largest concentration of LGBT people in England outside London.9 There are concentrations of LGBT people in certain parts of the city, as there are for ethnic groups or age, but data on the age / gender / ethnicity / geographical location of the LGBT population in the city is difficult to describe as it is not routinely collected.

RESILIENCE IN THE LGBT POPULATION OF BRIGHTON & HOVEThis section builds on the WARM data explored earlier in this report and considers the resilience assets and vulnerabilities of LGBT communities in Brighton & Hove. It uses data from a variety of sources. One of the main sources are the Count me in Too Surveys between 2007 and 2009. This local research was undertaken by members of the LGBT communities and the findings are based on the results from a self-selected survey of 69 focus group attendees and 819 completed questionnaires. Of the questionnaire respondents: the majority (86%) were residents in the city. Just over half were male (56%) with 41% female and 3% defined as other gender categories. This compared to general population figures of 51% female and 49% male in the city.10 The majority of respondents (60%) were aged between 26 and 45 years.3

Additional surveys used for this report include The 2008 Place Survey11 and the 2005 Do It With Pride Survey. 12 The Place Survey provides

Chapter 7a I RESILIENCE IN LGBT COMMUNITIES I 115

116 I Chapter 7a I RESILIENCE IN LGBT COMMUNITIES

data on citizen perspectives focussing on satisfaction with the local area as a place to live. This involved a survey of 2,255 respondents between September and December 2008, 9% (194) of whom identified as LGBT. Three quarters of LGBT respondents were male, and one quarter female; the vast majority (85%) were aged between 25 and 64 years; 40% lived in the most deprived 30% of super output areas (SOAs), and 3% identified as Black and Minority Ethnic (BME) groups. In comparison, 38% of heterosexual respondents were male and 62% female; 70% were aged 25 to 64 years; 27% lived in the most deprived 30% of SOAs and 4% identified as BME.12

The 2005 Do It With Pride Survey was supported by funds from the University of Brighton and Brighton & Hove City Council and explored: social and cultural perceptions of Pride in Brighton & Hove; the economic value of Pride to the city; and the characteristics of LGBT attendees. A total of 7,210 questionnaires were completed on the day of the Pride event in 2004. Of this number approximately 68% were LGB and 29% heterosexual. Equal numbers of LGBT men and women attended the event, however two thirds of the heterosexual respondents were women. Over two thirds of all respondents were visitors to the city. The majority of attendees (65%) were between aged 26 and 45 years, although a quarter were aged 16-25 years. A total of 7% identified as BME.12

Some caution is then required when

comparing findings with information on the general population which comes from more routine data sources. As described above, the demographics of the respondents to each survey vary significantly and may not therefore be representative of the total LGBT population in the city.

Life satisfactionAccording to the 2008 Place Survey, (Figure 7.1) 87% heterosexual and 77% LGBT residents are quite satisfied or very satisfied

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Figure 7.1: Brighton & Hove Place Survey 2008

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Figure 7.2: LGBT bullying incidents in schools

Source: Safe in the City, 2011


with Brighton & Hove as a place to live. Clean streets and low levels of crime are of highest importance to both LGBT and heterosexual people in terms of a good place to live. LGBT people in this research appear to place more importance on shopping facilities, and the need to improve them in the city than heterosexual residents.11

The majority of LGBT people living in Brighton & Hove (over 80%) are happy with where they live. Many people live in Brighton & Hove because of its LGBT friendliness.13 A 2004 survey of Pride attendees found that 75% of LGBT residents and 30% of heterosexual attendees’ decisions to live in the city were influenced by the city’s status as ‘gay capital of the UK’.12

Life satisfaction assets in LGBT communities

A large proportion of LGBT people stay in •Brighton because it is perceived as LGBT friendly in comparison to elsewhere.

Life satisfaction vulnerabilities in LGBT communities

While over three quarters of LGBT people •are happy living in Brighton & Hove, levels of satisfaction with living in the city are less than among heterosexual people.

Education In 2007, the largest UK Survey of LGBT people reported that almost two thirds of young lesbian, gay and bisexual people had experienced homophobic bullying, and that bullying was more common in faith schools where it was also less likely to be reported. Levels of general bullying have been discussed

in the children’s section in this report and caution is required when comparing data collected by different means and from different sources.

Data from the Count me in Too (CMIT) survey suggest that significant numbers of children experience homophobic bullying relating to a


parent’s sexual identity.3 Figure 7.2 suggests that LGBT bullying incidents reported by schools are continuing to rise, particularly in special schools.

Allsorts Youth Project is a voluntary sector group that provides support to young LGBT people within schools in Brighton & Hove through LGBT peers, building resilience in a reciprocal way. Allsorts has identified that many LGBT young people are resilient, sometimes due to having supportive families and friends or encountering a teacher or a youth worker who listened to them. In 2010 Allsorts received the Stonewall Award for Best Community Group for their support work and peer education in schools.16

Local research suggests that Brighton & Hove has a high proportion of well educated LGBT residents.13 Among the 819 LGBT residents sampled in the Count Me In Too survey, only 2% had no educational qualifications compared to 22% of all residents of Brighton & Hove aged 16-74 years.13,17 Just 13% of LGBT respondents in this survey were qualified only as far as GCSE level,13 compared to approximately 35% of the general population of the city.18 Table 7.1 shows that among the 87% of respondents who were educated at AS level or above (compared to 65.3% of the general population of Brighton & Hove18 ) 38% had a first degree or professional qualification.3

Education assets in LGBT communities

There is strong LGBT support and •awareness education within some schools and colleges in the city.

Local survey results suggest that the LGBT •population is highly educated even in comparison to the general population of Brighton & Hove, although this may be a function of the cohort of people most likely to participate in the survey.

Education vulnerabilities in LGBT communities

As discussed in the children’s section, •bullying is an issue in Brighton & Hove schools although several measures are being taken to address this and levels may be falling. There are indications however, of significant levels of bullying in the city relating to sexual/gender identity.

Table 7.1:Highest Educational Qualification among LGBT communities in Brighton and Hove

Frequency Percent Valid percent I have no educational qualifications 18 2.2 2.2GCSE (grades D-G) 21 2.6 2.6GCSE (grades A-C) 65 7.9 8.0A or AS Level 96 11.7 11.8Vocational 93 11.4 11.4Foundation Degree, HND etc. 58 7.1 7.1First Degree 184 22.5 22.6Higher Degree 134 16.4 16.5Professional 123 15.0 15.1Other 21 2.6 2.6Total 813 99.3 100Missing 6 0.7 Total 819 100 Source: Browne, 2007

HealthSlightly fewer LGBT people in the city describe their health as ‘good’ or ‘very good’ (72%) when compared to heterosexual people in the city (76%).11 LGBT people are also over twice as likely to report their health as being ‘bad’ or ‘very bad’ (11%) than heterosexual people in the city (5%), and some groups within LGBT communities, such as those of transgender identity, are more likely to report poorer health.13

DisabilityIsolation, exclusion and access difficulties are problematic for some disabled LGBT people in Brighton & Hove although the overwhelming majority of disabled LGBT people (77%) report positive experiences of living in the city, particularly regarding specific services, venues and public spaces.11,13 LGBT people with a disability or long-term impairment were ten times more likely than their heterosexual counterparts to report feeling unsafe or very unsafe in the city in the daytime. Just 28% of LGBT people with a disability or long-term impairment felt safe or very safe in the city at night, compared to 50% of non-disabled LGBT people19 and approximately 62% of residents in the city.11 This suggests that although there are relatively high levels of LGBT perceived safety in the city in the daytime, this is less so at night and less among disabled LGBT residents.

Sexual healthAccording to the CMIT survey, of the 94% of lesbians, 95% of gay men, and 87% of those identifying as ‘bisexual’, ‘queer’ or ‘other’ who have had sex with someone in the last three years,

those aged 26-35 years are most likely to have had sex in the last three years, with those aged over 55 least likely. Of the 51 people (6%) who have not had sex in the last three years, two thirds feel that not having sex is not respected in LGBT culture.13

Whilst the majority of LGBT people report having had sexual health check ups, 30% of those who have had sex in the past three years say that they have never had a sexual health check up or do not need one. Women, transgender people, those who are disabled or have long-term health impairment, those who have not tested positive for HIV and older LGBT people are all less likely to have had a sexual health check up compared to other LGBT people. Sexual health information is

readily available and is easy to understand, although only 55% of respondents agreed this information was appropriate, diverse and catered to all groups and sexual practices.13

Mental healthMembers of the LGBT communities are at higher risk of mental health issue 4 with research suggesting that discrimination, victimisation and lifestyle factors such as alcohol and drug misuse may affect this risk.20,21,22 In Brighton & Hove, the CMIT research found that almost two thirds of lesbians (65%) and gay men (64%) in the city are in good or very good emotional health.5 However, 14% of the LGBT respondents report suffering from depression, compared to a national prevalence of 5-10%.23


Young people from Allsorts Youth Project about to enjoy dry slope skiing at Bowles Outdoor Centre.


South East England has one of the lowest suicide rates in the country, yet Brighton & Hove has the second highest suicide rate in the country.24 National surveys indicate that suicide risk is increased among LGBT communities and mental health is a top local LGBT health priority (47%) above sexual health issues (41%), issues around drug use (38%) and alcohol use (36%).13 Almost a quarter of those in the CMIT survey reported serious thoughts of suicide over the preceding five years, rising to around 50% for those who were younger, on lower income, isolated, disabled, bisexual or transgender. Local suicide figures are not complete with regard to the recording of sexual orientation although the available data do not confirm that suicide in Brighton & Hove is a higher risk in LGBT communities. This could reflect higher levels of resilience among local LGBT communities or insufficient recording of sexual orientation.

There are many support services for people with mental health issues in the city. MindOUT offers emotional support, peer education and peer advocacy to gain better access to local services and networks. Feedback on the services of MindOUT from local LGBT communities is very positive.

Substance misuseThe British Crime Survey shows that LGBT people are far more likely than the general population to have used drugs across all age groups.25 Local research confirms higher levels

of drug use in the LGBT population compared to the general population of Brighton & Hove, with half of the CMIT sample having taken drugs. This is particularly noticeable among young LGBT people in the city who, in comparison to the general population, are twice as likely to use cannabis, seven times as likely to use ecstasy, and four times as likely to use cocaine or heroin.26 A 2007 systematic review by the National Institute for Mental Health in England found an increased relative risk of alcohol dependence in lesbian, gay and bisexual groups of at least one and a half times higher than the heterosexual population.4 In Brighton & Hove, alcohol consumption among the total population is high. According to the CMIT survey the high levels of alcohol use in the LGBT and heterosexual populations of Brighton & Hove are comparable.27

Health assets in LGBT communities

The majority of disabled LGBT people do •not find it particularly difficult to be an LGBT disabled person in Brighton & Hove and report positive experiences of living in the city, particularly regarding specific services, venues and public spaces.

LGBT-specific support structures and •organisations in the city build confidence and self-esteem to improve mental health and wellbeing, and are valued by the LGBT communities.

Health vulnerabilities in LGBT communities

High numbers of LGBT people report good •health and positive experiences of living in the city, though this is a slightly lower figure than the general population.

There is good national evidence that LGBT •communities are at higher risk of suicide. Brighton & Hove has particularly high suicide rates though no specific link to LGBT status has been identified, however, local recording of sexual orientation in relation to completed suicide is incomplete.

LGBT people are at particularly high risk of •mental health problems which can be linked to factors including abuse, bullying, and issues of discrimination.

There appears to be a culture within local •LGBT populations in relation to not having sexual health checks.

Some members of the LGBT communities •feel under pressure to have sex. There are however, no comparable figures for the heterosexual population.

LGBT people are more likely than the •heterosexual population to have drug misuse issues.


Material wellbeingCMIT research indicates that employment levels of LGBT people in the city appear to be high. Gay men are more likely to have higher incomes than other groups within LGBT communities, with 58% of gay men having an income of over £20,000. This compares to 68% of those identifying as bisexual and 54% of lesbians who have an income of less than £20,000.3 A small sample of transgender respondents (43) were three times more likely to earn less than £10,000, and 11 times less likely to have an income of over £30,000 a year than other LGB identities. The gender divide is seen citywide with males earning on average £527.30 a week; 13% more than female earners in the city at just over £467.10 a week.10 The median household income in the city is £29,950.28

A survey of those attending Pride in 2004

reported that lesbians generally had above average incomes, but not to the same extent as gay men. However, one third of gay men did not fit the ‘pink pound’ profile and 20% of lesbians with incomes under £10k had dependant children. This indicates a much more complex income picture than is often reported in discussions of LGBT spending power.12

Material wellbeing assets in LGBT communities

There are indications of above average •economic activity in the LGBT population of the city, in particular gay men.

Material wellbeing vulnerabilities in LGBT communities

A significant number of people in LGBT •

communities are on low incomes in contrast to the perceived strength of the pink pound.

Transgender people in the city may be more •likely to experience low levels of income than other gender identities.

Strong and stable familiesAccording to the CMIT survey, many LGBT people define their relationship with their family of origin as very good (40%) or good (34%). Worries over family relationships can be particularly relevant for young LGBT people due to a fear of coming out to parents and others. In this respect, peer support networks can be crucial in supporting mental wellbeing. The main support networks for many LGBT people are friends (72.5%) and partners (47%). Although others are also relied upon including siblings, grandparents and carers, it is friends who are most often relied on in times of personal crisis.3

CMIT research indicates that LGBT women in the city are more likely to live with a same sex partner (52%) than gay men (38%). The proportion of LGBT people living with same sex partners has increased since 2000, while the proportion living alone has decreased from 36% in 2000 to 30% in 2007.3

Allsorts members about to go rock climbing at Bowles Outdoor Centre.

Supports domain


Domestic violence is an important issue for LGBT people, with a third of lesbian/gay women and a quarter of gay men reporting having experienced domestic violence or abuse. There are noted differences in experience within LGBT groups, for example, bisexual, transgender, disabled and people with poor mental health are at greater risk of experiencing domestic violence.29 Domestic violence is recognised as being under-reported locally.30,31 CMIT research suggests that less than a quarter of LGBT domestic violence is recorded.30 In 2009/10 there were 3,359 police recorded domestic violence crimes and incidents, an increase in Brighton & Hove of 6% from 2008/09.32

Strong and stable family assets among LGBT people

Research indicates a good level of •support from families of origin, for some LGBT people

There are high levels of reported friend •and partner support for LGBT people in Brighton & Hove.

Strong and stable family vulnerabilities among LGBT people

LGBT people and particularly bisexual •and transgender people are at a high risk of domestic violence, much of which is unreported.

BelongingThe vast majority of LGBT people report that it is easy, or very easy to live in Brighton & Hove as an LGBT person. Most of the LGBT communities have lived elsewhere and consider Brighton & Hove a better place to live.3 LGBT people actually move to Brighton & Hove to engage with the LGBT communities and find a sense of belonging. This movement into the city for community engagement is specific to LGBT identities and can affect the level and type of structural support needed within the city.

The Place Survey found that heterosexual people in the city were more likely than LGBT residents to believe their local area to be a place where people from different backgrounds get on (87% versus 76%).11 Some LGBT people say that they feel marginalised and isolated even within LGBT communities. Isolation is felt particularly amongst black and minority ethnic (BME) groups, bisexual and transgender people, although the greater legislative rights afforded by civil partnerships have meant that more people feel more ‘accepted’. People living in the Kemp Town and St James’s Street area are most likely to be ‘out’ about their sexual identity (67%) compared to across the city as a whole (55%).13

Public and social spaces which feel safe are very important for LGBT people in the city. The wider choice of social spaces for gay people in

Brighton is recognised in comparison to other cities in the UK; the greatest sporadic example of this is the annual Pride event. Most LGBT people (61%) in the city also socialise in ‘straight’ venues and feel comfortable doing so though the majority of people also enjoy local LGBT events and venues. However most of these are exclusive to those aged 18 years and over.13

LGBT people are more likely than heterosexual people in the city to volunteer.11 Over a third of LGBT people volunteer for an LGBT group, and almost half regularly participate in national

The offices of the Brighton & Hove Partnership Community Safety Team during Pride Festival.


LGBT groups.3 There are also high levels of young volunteers across the Allsorts LGBT Volunteering Programme.16 LGBT residents are nearly 40% more likely than heterosexual residents to want to be more involved in council decisions about the local area.11

There are many services for LGBT communities, some unique to Brighton & Hove: Spectrum32 is an umbrella advocacy organisation for local LGBT residents; the Brighton & Hove LGBT Switchboard is one of the oldest in the UK; and GScene is a community magazine for local LGBT residents.

Belonging assets among LGBT people

The majority of LGBT people think •Brighton is a good or very good place to live in comparison to other areas and have often moved to the city to find a sense of belonging.

There are relatively high levels of •volunteering amongst LGBT communities.

The majority of LGBT people also socialise •in ‘straight’ social venues, suggesting greater ‘vertical associations’ across social/sexual divides and a wider sense of belonging in the city.

Brighton & Hove has a number of specific •services that support LGBT communities to feel a sense of belonging in the city

Belonging vulnerabilities among LGBT people

LGBT people are less likely than •heterosexual people to feel that their local area is inclusive for people from different backgrounds living in the city.

There remain significant levels of •marginalisation and isolation for certain LGBT groups, even within the LGBT population.

There is a lack of ‘safe’ social options for •younger LGBT people in the city.

Local economyThe 2010 Equality Act protects LGB employees from discrimination and harassment in the workplace.33 Since 2003, Stonewall have produced a guide to Britain’s top 100 gay-friendly employers. In 2011, Brighton & Hove City Council was placed eighth, the second highest local authority after East Sussex. Brighton and Sussex University Hospitals NHS Trust was within the top five health organisations, which is particularly significant because health and housing were the lowest performing sectors.34

The general impact of LGBT communities on the local economy is hard to quantify, yet a survey of 7,210 people at Brighton Pride in

2004 found that the event significantly contributes to the local economy. Pride was the main motivation for 33,100 day visits and 27,200 longer visits to Brighton & Hove over the Pride weekend and estimates suggest that this event generated about £3.13million income for the city.12

Local economy assets in the LGBT communities

Two local leading organisations are among the •top 100 LGB-friendly employers in the country.

Evidence suggests that the ‘pink pound’ •exists in some sections of LGBT communities and contributes to the local economy, particularly at events such as Pride.

Local economy vulnerabilities in the LGBT communities

As noted in the material wellbeing section, a •significant number of the LGBT communities are on low incomes in contrast to the perceived strength of the ‘pink pound’.

Public servicesLGBT people seem to attribute less importance to health services in the city (29%) than those identifying as heterosexual (39%). LGBT residents are less satisfied with their GP (70%) than heterosexual residents (77%), and also less likely to be satisfied with their dentist (56% compared to 65%).11



In contrast to the 2001 Count Me In research9 the majority of LGBT people are now out to their GP, although gay men are least likely to disclose their sexual identity. This may be related to sexual health and a desire to keep certain sexual health issues “off the record”, or to fear of prejudice relating to sexual/gender identity.13

Perceptions of the police services in Brighton & Hove have also improved in recent years alongside reported changes in police attitudes and practices. Almost twice as many people were of the view that the police were not prejudiced against LGBT people (37%), than believed them to be prejudiced (21%) against LGBT people. Suggestions of further improvements to services included increasing police presence in hate crime hotspots, increasing publicity for convictions of hate crime and LGBT awareness training for police and service providers.19

Four in five LGBT people feel comfortable using mainstream services, although one in four people had experienced “direct or indirect discrimination in the provision of goods, services or facilities” (defined by Equality Act, 2006) in the previous five years.3 Despite its high listing as a gay friendly employer, LGBT communities are one of the communities of interest least likely to be satisfied with services run by the local authority. Prejudice and discrimination have been reported particularly within council housing services and housing associations.11

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Figure 7.3: LGBT hate crimes and crime-related incidents (police crime database)April 2007 to March 2011

Source: Safe in the City, 2011

Public service assets with regard to LGBT communities

LGBT residents are more likely to be out to •their GP than a decade ago.

Perception of police services is improving.•

The majority of LGBT people are •comfortable accessing mainstream services.


Public service vulnerabilities with regard to LGBT communities

Some gay men still do not feel “safe” •being open about their sexual identity with their GP.

LGBT people are the least likely of all •communities of interest to be satisfied with public services run by the city council.

Crime and anti-social behaviourOne third of LGBT people state that they feel safe in all areas of Brighton & Hove compared to nearly two thirds of respondents of the Place Survey who feel safe in their local area after dark.11,19 The areas of least perceived safety are estates on the outskirts of the city (69%) and in the town centre (51%), partly due to fear of homophobia in particular areas of residence associated with large housing estates.11 Approximately one in nine people have experienced some form of abuse, violence or harassment in their neighbourhood due to gender/sexual identities, just under half of whom experienced abuse from a neighbour.19

People living in areas of the city with a high LGBT population, such as Kemp Town and St James’s Street, are least likely to avoid going home due to safety concerns and are also least likely to be victims of crime due to their sexual identity. Those living in social housing are over three times more likely to avoid going home

because of fear of crime than those who own their own homes or privately rent.11

The number of police recorded crimes and incidents has been declining since April 2006. In 2009/10 there were one third less LGBT hate crimes (77) and hate crime related incidents (11) than in 2008/09.35 Police recorded LGBT hate crimes indicate that the majority of offences are committed by a stranger to the victim, and occur on the street. Over 90% of LGBT police recorded crimes were violence against the person offences.36

Figure 7.3 shows, overlaid with a seasonal cycle, a declining trend in LGBT hate crimes and related incidents.15

However, CMIT research indicates that police figures are underestimates and should be read with caution because only a quarter the 73% of respondents who said they had experienced abuse relating to their sexual identity over the last five years had reported the incident, with just half of this number (83) reporting to the police.19

Experience of abuse can test resilience in different ways. Local research shows that LGBT people differentially recognise abuse, with many normalising abuse as a strategy for self-preservation in order to carry on with day-to-day life.36

In recent years a civilian community LGBT liaison officer established by Sussex Police has operated from the Brighton & Hove Anti-Victimisation Unit. The local Partnership Community Safety Team is working to improve community safety for LGBT communities. This multi-agency approach to LGBT safety has been facilitated, in part, by Spectrum the local LGBT forum.37

Crime and anti-social assets with regard to LGBT communities

There are services within Brighton & Hove •which offer peer support and address the effects of abuse.

Crime and anti-social vulnerabilities with regard to LGBT communities

Hate crime is experienced by some •members of LGBT communities and there is a lack of perceived safety, particularly on estates on the outskirts of town where hate crime is perceived to be more common.

Many LGBT people are ‘normalising’ •abuse as an expected part of daily life as a coping strategy.


Figure 7.4: Experience of homelessness by income

Source: Count Me In Too Housing Report, 2008

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five LGBT people in the city have been homeless at some point in their lives. Poorer LGBT people are most likely to have experienced homelessness (Figure 7.4). This group are more likely to have used illegal drugs or used legal drugs without a prescription.38

Some LGBT communities can have particular housing related issues, for example older LGBT people with concerns around suitable LGBT friendly accommodation and care. Research also indicates that one third of LGBT people who have experienced domestic violence become homeless as a consequence. 38

Infrastructure assets with regard to LGBT communities

LGBT people living in privately owned •or rented accommodation in the city are most likely to be happy with their accommodation.

Infrastructure vulnerabilities with regard to LGBT communities

A relatively high proportion of LGBT •residents have been homeless.

One third of LGBT people who have •experienced domestic violence become homeless as a result.

Infrastructure LGBT owner occupation declined between 2000 (54%) and 2006 (48%) with a corresponding rise in private renting in line with national trends.37 Of the estimated 40,000 LGBT people in the city, up to 3,000 people may be in need of housing support.38

A lack of local connection and affordability are the main issues when seeking accommodation in the city. The city council’s “local connection policy” targets services towards local people and therefore will not favour LGBT people who have come to Brighton as a safe and friendly place for LGBT people. Approximately one in

Brighton & Hove has the largest concentration of lesbian, gay, bisexual and transgender people in England outside London. LGBT communities in the city are diverse and it is important to recognise that different aspects of life affect different LGBT groups in different ways. However, there are some issues which appear to be similar across LGBT communities: mental health issues, substance abuse, low income, bullying related to sexual/gender identity, homelessness, hate crime and isolation.

There is evidence of the relative isolation of some LGBT residents even, in some instances, from within their own communities. There is therefore a role for LGBT communities to address equality and public health issues better from within. There are, however, also many assets in local LGBT communities which help to mitigate these risks and which could be harnessed for the greater good.

Brighton & Hove is an LGBT-friendly city in comparison to elsewhere, though there remain issues of hate crime, bullying and harassment. This gay-friendly perception helps foster a sense of community and belonging, and there is evidence that this is taking place both horizontally within LGBT

communities, and vertically across other social groups. This integration is probably central to the rise in LGBT people reporting positive experiences of living in the city. Other protective factors amongst LGBT communities in the city include high levels of support from friends and family, relatively high economic activity, high levels of volunteering and community participation, a clear sense of belonging, and improved engagement with mainstream services and public services such as police and GPs. It may be that this high level of community wide support within Brighton & Hove provides some resilience and protects against some of the issues found in national surveys of the LGBT population.

It appears that the resilience of many sections of LGBT communities has increased in recent years and that this has been promoted through good levels of statutory and voluntary support services and infrastructure within and across LGBT communities in Brighton & Hove. Peer support and awareness education in schools, LGBT-friendly public and social spaces and services; programmes to build self-esteem for all ages and sexual identities; high standards of equality work and LGB-friendly employment in the city all

go to build resilience in the LGBT communities in Brighton & Hove.There are three areas in particular, identified in this section of the report, where there are clear potential opportunities to build resilience through the use of assets within LGBT communities. These are volunteering / belonging, education and the economy. By harnessing these assets, the overall resilience of the whole city could be strengthened to the benefit of the total population.



References:

1. Hernandez, G. G. LGBT Resilience Toolbox. www.lgbtyouthnorthwest.org.uk/wp-content/uploads/2011/02/Resilience-toolbox-by-Gloria-Gil-Hernandez-31.10.071.pdf (accessed 21 April 2011).

2. Csikszentmihalyi, Mihaly. Flow: The Psychology of Optimal Experience. New York: Harper and Row;1990.

3. Browne K. Count Me In Too. LGBT lives in Brighton & Hove initial findings: Academic report. University of Brighton and Spectrum LGBT Community Forum; 2007.

4. NIMHE. Mental disorders, suicide, and deliberate self harm in lesbian, gay and bisexual people: a systematic review; 2007.

5. Browne K and Lim J. Count Me In Too: Mental Health Additional Findings Report;2008.

6. Eisenberg, M.E. & Resnick, M.D. Suicidality among Gay, Lesbian and Bisexual Youth: The Role of Protective Factors. Journal of Adolescent Health.2006; 39(5): 662-668.

7. Fenaughty, J. & Harré, N. Life on the seesaw: a qualitative study of suicide resiliency factors for young gay men. Journal of Homosexuality. 2003; 45(1):1-22.

8. Johnson, K., Faulkner, P., Jones, H., Welsh, E. Understanding Suicidal Distress and Promoting Survival in the LGBT Communities. Brighton & Sussex Community Knowledge Exchange Project; 2007.

9. Webb, D. and Wright, D.Count Me In: Findings from the lesbian, gay, bisexual and transgender community needs assessment 2000. University of Southampton, Southampton; 2001.

10. NHS Brighton and Hove and Brighton & Hove City Council. Brighton and Hove City Wide Needs Assessment Programme: Health and Wellbeing Joint Strategic Needs Assessment Summary; 2011.

11. Brighton & Hove City Council. The Place Survey2008. http://consult.brighton-hove.gov.uk/portal/lsp/place/place08 (accessed 21 April 2011).

12. Browne, K., Church, A., and Smallbone, K. Do it with Pride in Brighton and Hove: Lesbian, Gay, Bisexual and Trans Lives & Opinions: Survey Report: University of Brighton; 2005.

13. Browne K and Lim J. Count Me In Too: General Health Additional Findings Report:University of Brighton and Spectrum; 2008.

14. Hunt, R., and Jensen, J. The School Report: The experiences of young gay people in Britain’s schools. Schools Health Education Unit: Stonewall; 2007.

15. Safe in the City. Community Safety, Crime Reduction and Drugs Strategy, 2008-11: Performance and Activity Report, 2010/11 Quarter 3; 2011.

16. Allsorts Youth Project. Allsorts Annual Report 2009-2010. Brighton & Hove. www.allsortsyouth.org.uk/wp-content/uploads/AnnualReport2010.pdf (accessed 21 April 2011).

17. Office for National Statistics. 2001 Census.

18. Department of Business, Innovation and Skills. Brighton and Hove National Indicator; 2009.

19. Browne K and Lim J. Count Me In Too: Community Safety Additional Findings Report. University of Brighton and Spectrum; 2008.

20. King M, McKeown E, Warner J, Ramsay A, Johnson K, Cort C, Wright L, Blizard R, Davidson O. Mental health and quality of life of gay men and lesbians in England and Wales: a controlled, cross-sectional study. British Journal of Psychiatry 2003; 183:552-558.

21. Meyer I H. Prejudice, social stress and mental health in lesbian, gay and bisexual populations: conceptual issues and research evidence. Psychological Bulletin 2003; 129:674-697.

22. King, M., Semlyen, J., See Tai, S., Killaspy, H., Osborn, D., Popelyuk, D., and Nazareth, I. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry. 2008; 8: 70.

23. Oxford Consultants for Social Inclusion (2007a) Developing Appropriate Strategies for Reducing Inequality in Brighton and Hove – Phase 1 Identifying the Challenge. Inequality in Brighton and Hove. Educe Ltd.

24. Memon, A., and Walker, A. Brighton & Hove suicide prevention strategy 2008-2011 NHS Brighton and Hove; 2010.

25. Nicholas, S., Kershaw, C. & Walker, A. Crime in England and Wales 2006/2007. Home Office; 2007.

26. Home Office (2008) British Crime Survey 2007-2008. Research, Development and Statistics Directorate.

27. NIMHE. Mental disorders, suicide, and deliberate self harm in lesbian, gay and bisexual people: a systematic review; 2007.


28. Browne K, McGlynn N and Lim J. Count Me In Too: Drugs and Alcohol Additional Findings Report: University of Brighton and Spectrum; 2009.

29. Brighton & Hove City Council (2010) Housing Costs Update 2010 Quarter 4: October to December in Housing Strategy 2009-2014: Healthy homes, healthy lives, healthy city; 2010.

30. Browne K. Count Me In Too: Domestic Violence Additional Findings Report: University of Brighton and Spectrum; 2007.

31. HM Government. Call to End Violence Against Women and Girls. Home Office. www.homeoffice.gov.uk/publications/crime/call-end-violence-women-girls/vawg-action-plan?view=Binary (accessed 21 April 2011).

32. Safe in the city. Brighton and Hove Intelligent Commissioning Pilot 2010/11: Domestic Violence Needs Assessment. www.bhlis.org/resource/view?resourceId=888

33. Spectrum Website. www.spectrum-lgbt.org/ (accessed April 2011).

34. Government Equalities Office. Equality Act 2010.

35. Stonewall. Stonewall Top 100 Employers 2011: The Workplace Equality Index; 2011.

36. Brighton & Hove Partnership Community Safety Team. LGBT hate crimes and incidents strategic assessment extract; 2010.

37. Browne, K. A., Bakshi, L., and Lim, J. (in press) ‘It’s Something You Just Have to Ignore’: Understanding and Addressing Contemporary Lesbian, Gay, Bisexual and Trans Safety Beyond Hate Crime Paradigms.

38. Browne K and Davis P. Count Me In Too: Housing Additional Findings Report: University of Brighton and Spectrum; 2008.

39. Brighton & Hove City Council. Supporting People Strategy 2008-2011.


Chapter 7b

RESILIENCE IN CARERS

This section of the report considers the extent of resilience among carers in Brighton & Hove and what more might be done to strengthen this.

INTRODUCTIONA carer is someone who spends a significant proportion of their time providing unpaid support to family or friends, whether it is caring for a relative, partner or friend who is ill, frail, disabled or has mental health or substance misuse problems. A young carer is a child or young person under 18 years providing care, assistance or support to another family member, involving significant or substantial caring tasks and responsibility usually associated with an adult.1

How a carer copes with the specific demands of caring depends upon a number of factors: internal capacity to manage challenges, external support and resources, family support, communication and problem sharing, values and belief systems, and extent of the adversity faced.2 Research on parent carers defines eight requirements which correspond well with the WARM domains discussed in this report:

Self:• personal identity, physical and emotional wellbeing, feeling skilled and informed, the balance between caring and parenting.

Support: • maintaining family life, positive adjustment of siblings.

Systems and structures: • practical and financial resources, service user experiences.3

The 2001 Census, showed that there were six million carers in the UK, who are estimated to save the British economy £87billion a year.4 Carers in the UK are: more likely to be women (60%) than men (40%), most likely aged 45-64 years; about half are in paid employment; just over a quarter retired; and two in five are the sole supporter.5 A UK survey of young carers found that two thirds provide domestic help in the home, half provide general and nursing-type care, over three quarters provide emotional support, and one in ten provide child care. Between 1995 and 2003 some of these caring tasks decreased for young carers, however, the recorded incidence of emotional support given by young carers increased dramatically from 23% to 82%. Within this young carer cohort, girls are more involved in all types of caring tasks, particularly as they

grow up. Half of young carers care for ten hours or less per week, one third for 11-20 hours, and 16% for over 20 hours.6 Nationally, young carers are recognised as being more at risk of health problems (particularly relating to mental health) in later life.6

LOCAL DEMOGRAPHIC CONTEXT There are an estimated 21,800 carers providing informal care in the city (9% of the local population) over 4,000 people of whom care for 50 or more hours a week. More than 4,500 carers in the city have been caring for at least ten years, with twice as many caring for five years or more. A quarter of people aged 50-64 years in Brighton & Hove and almost 500 young people aged 8-17 years are carers. Just a fraction of these numbers receive a Carer’s Allowance, although there has been a rise of 280 people receiving Carer’s Allowance from 2003 (1,360) to 2007 (1,640).1

The greatest number of carers look after a husband/wife/civil partner (42%) followed by

Chapter 7b I RESILIENCE IN CARERS I 131

132 I Chapter 7b I RESILIENCE IN CARERS

adult son/daughter (26%) and parent/In-law (20%). Carers of adult children are likely to be caring for someone with learning disabilities.1 The work done by carers is estimated to save the Brighton & Hove economy at least £223million per annum.7

In Brighton & Hove there are an estimated 360 carers aged 15 years or less,8 and according to Census data, approximately 1,000 aged 16-24 years.4 Among Year 10 pupils, local research suggests that one in five may be looking after someone in their family who has an illness or disability.9 Many young carers are hidden from services, particularly those who are caring for someone with mental health or substance misuse related needs.10

RESILIENCE IN CARERS IN BRIGHTON & HOVEThis section builds on the WARM data explored earlier in this report and considers the resilience assets and vulnerabilities of carers in Brighton & Hove. It uses data from a variety of sources including the local Carers’ Survey in 2009,1 the 2007 Health Related Behaviour Survey,9 information and data from adult social care, and information from the Carers’ Centre and local projects.

The aim of the Carers’ Survey (2009) was to find out what carers in the city need and how best they might be supported. The survey was returned by 516 carers/former carers in the

city, of whom 43% were aged 40-60 years, and 33% aged 61-80 years, suggesting that a large proportion of carers in the city are older people.1 Nationally, 42% of carers are men and 58% women.11 This is reflected in the figures for carers aged 50+ in the city; 43% of whom are men and 57% women, although across the survey as a whole 70% of respondents were female and 24% male. Nearly three quarters of respondents were either retired or not in paid work (73%), and 10% were from Black and Minority Ethnic (BME) groups, slightly lower than city BME estimations of 16%.10

The Carers’ Centre for Brighton & Hove is a registered charity, that was established in 1988 and was one of the first services in the UK to support unpaid carers,12 providing information, support, social opportunities, campaigning and

advocacy to carers in the city. The Carers’ Centre also runs the Young Carers’ Project for carers aged eight to 25 years.

Life satisfactionAccording to a local Carers’ Survey, just over one in five carers feel that they can continue in their current caring role and that their caring responsibilities only have a small impact on their daily life. The majority of carers feel out of control of their daily life, lonely and detached from society, with limited support from their families and friends. This is particularly the case for those who: lived with the person cared for, cared for one person, cared for an adult child, student carers, LGBT carers, BME carers, and those caring for over 50 hours a week.

One in four carers report that caring has a significant impact on their lifestyle, causing stress and health issues. These carers are more likely to be female, and nearly twice as likely to be looking after a son or daughter as those for whom caring had less of an adverse impact. This group is also more likely to care for over 50 hours a week (62% compared to 45%), and to feel as though they are unable to do the things they want to do. Those who report that their caring role has a small impact on their life are nearly 14 times more likely to feel they are able to do the things they want to

Adult carers from The Carers’ Centre for Brighton and Hove.

Self domain


compared to those for whom caring has a significant impact on life.1

The Carers’ Centre for Brighton & Hove runs the Young Carers’ Project which provides: information, support and outreach, 1:1 sessions, group activities and carers needs assessments to young carers. Referrals are taken from anyone in the city, including young carers, with the majority received from schools and children’s services. At the end of December 2010, 94 young carers were supported by the project,13 with approximately 30-40 young carers on the waiting list for the project.14 The Carers’ Centre has a core theme of building self-esteem and resilience. Over half young carers in the project report feeling more self-confident, happy, that they are coping more effectively, doing fewer caring jobs and have more friends to turn to if needing help since joining the Young Carers’ Project.13

Life satisfaction assets among carers

There is good local support for young carers •such as the Young Carers’ Project which has been shown to increase self confidence and happiness among young carers.

Life satisfaction vulnerabilities among carers

Most carers do not feel in control of their lives.•

Those looking after their son or daughter, •or caring for over 50 hours a week, are almost twice as likely to report that their caring role has significant impacts on lifestyle and stress levels.

Education Extrapolation from published research suggests that there may be up to 30 young carers within individual secondary schools.15

Schools and teachers in Brighton & Hove are best placed to identify young carers who may be ‘hidden’ and need recognition and support.10

Many young carers in Brighton & Hove struggle with school attendance and coursework and face potential bullying in school.16 Online research with local young carers suggests that targeted interventions could improve school performance and attendance.17

Research suggests that for one in three young carers, their school is unaware of the caring responsibilities they face. Young carers who

are that little bit older and attend colleges report a more positive experience than young carers in schools as a result of the more flexible and adult-orientated approach to caring roles in comparison to schools.18

A 2004 survey of over 6,000 young carers, the largest survey of its kind in the UK, found that the overall incidence of missed school and educational difficulties for those aged 5-15 years fell from 33% in 1995 to 22% in 2003; with staff being much more aware of difficulties experienced by young carers, and more work happening to raise awareness in schools of the issues. Educational difficulties are however particularly prevalent, for children and young people caring for someone with drug or alcohol issues.6

A young carers’ schools worker has recently been employed by the Carers’ Centre to work with all schools in the city to support young carers by raising awareness, helping schools to develop a young carers policy, training staff, delivering PSHE (Personal, Social, Health and Economic) lessons on carers issues, developing peer support groups and identifying dedicated link staff.19,20 Between October 2010 and April 2011, 12 schools were engaged and 11 link workers identified 91 staff and 126 pupils.14

Education assets among carers

Schools and teachers are well placed to •identify and support young carers.


Education vulnerabilities among carers

Caring responsibilities for young carers •cause educational difficulties and school absence.

For an estimated one in three young carers, •schools are unaware of the caring role that their pupils face.

HealthThe caring role is recognised to impact significantly on mental health, confidence and self-esteem, causing over half of respondents to lose sleep.1 Results from the 2001 Census suggest that carers in the UK are a third more likely than non carers to be in poor health.21

A survey of over 500 carers in Brighton & Hove found that over half the respondents (51%) had a long term illness or disability.1

Reported stress levels among carers varies according to where people live in the city. Residents living in BN41 (Portslade) are seemingly two times less likely to report stress from their caring role than those living in central Brighton, and are also the most likely to inform a GP of their caring responsibilities. Greater levels of stress were reported by: carers with a long term illness/disability, carers living in the centre of Brighton, multiple carers, carers of adult children, carers who cared for longer hours; carers aged under 60 years in comparison to their older counterparts, carers who were self-employed or studying, LGBT

carers, and a greater number of BME carers reported high stress levels than White carers.1

Based on national figures it is expected that over 1,000 carers in Brighton & Hove may sustain a physical injury through their caring role and over 1,000 may require treatment for a stress-related illness. Having time to oneself is the main factor that carers believe would make them happier and healthier (46%), as well as time to socialise (33%), practical support (39%), information on managing stress (26%) and advice and help to manage stress (26%).1

There are several support services for carers in the city. The Carers’ Centre in Brighton & Hove offers information, emotional support, advice and advocacy for all carers, specific support for young carers, events and carers’ forums. Carers’ Centre casework shows that 55% of those accessing the Carers’ Centre report improved mental health and wellbeing and 53% report improved family relationships.19 There are other practical local courses. For example, the Expert Patient Programme ‘Looking After Me’ Course offers a free six-week self-management course for adult carers whose health is affected as a result of their caring role. The Carers’ Centre ‘Positive Caring Course’ helps adult carers caring for another adult with relaxation techniques, stress management and assertive communication to manage their caring role better.19

In April 2011 the Carers’ Card was launched by the Carers’ Centre and Brighton & Hove City Council. Following the same principles as the Amaze Compass Card for children and young people with disabilities in the city, the Carers’ Card offers discounts on services across the city including leisure opportunities, eating out, theatre and performance, wellbeing and workshops, health and fitness and legal services.22

In March 2011 a local carers’ project won a regional improvement and efficiency award. The Integrated Discharge Team, based in Accident and Emergency alongside a social

An active participant in the Young Carers’ Project from The Carers’ Centre for Brighton and Hove.


work team from the Royal Sussex County Hospital, piloted a new approach to make sure patients’ families were supported when a family member had to go into hospital, and after discharge. The project led to better support at times of crisis, shorter stays in hospital and an improvement in carers’ health and wellbeing.23

For carers of older adults with dementia, a dementia care pathway is currently being developed to deliver earlier diagnosis by GPs and earlier support for people with dementia and their carers, including specialist dementia advisors, peer support, respite and crisis support.24 National best practice shows that these early interventions can reduce the risk of carer breakdown, extends the time carers are able to provide care and so delay entry into care homes, and reduce the likelihood of acute hospital admissions.25 There are also alternative support services such as The Buddhist Centre Mindfulness Based Cognitive Therapy Courses.26

Health assets among carers

A number of support services in the city •provide information, activities, coping strategies and support which is improving the health and wellbeing of carers.

Health vulnerabilities among carers

Caring responsibilities have a significant •impact on health and wellbeing of carers,

particularly regarding mental health, lost confidence and low self esteem.

There are insufficient opportunities for •carers to have time away from the caring role. This exacerbates the health and wellbeing problems associated with caring responsibilities.

Material wellbeingCaring can have a serious impact on carers’ finances, with one in five carers in the UK forced to give up work, losing an average of £11,000 income.27 Research suggests that over 300,000 people in the UK who provide unpaid care may be missing out on an estimated £843million a year in unclaimed Carer’s Allowance.28 The financial impact of this is massive, with research suggesting that many carers have had to cut back on buying food, 65% were in fuel poverty and 74% had difficulty paying basic utility bills.29

Seven out of ten carers worry about finances and 60% believe that this directly affects their health.28 Evidence also suggests that family poverty and social exclusion result in some young adult carers using their money to subsidise parent needs.30

In Brighton & Hove, around 40% of the working age population providing unpaid care were economically inactive in 2001, rising to 70% for those providing over 50 hours of care a week. In 2010, just 1,980 people were in receipt of a Carer’s Allowance, to a total value of £5,549,544. According to the Department

for Work and Pensions, the total estimated number eligible for this support is 3,046.28

In Brighton and Hove, children and young people’s services commission the charity Amaze as the cities local support and parent partnership service.31 Several recent national developments sought to help carers stay in, or return to work: The 2006 Work and Families Act gives carers the right to request flexible working hours; New Deal 50 plus and the Education Maintenance Allowance can give financial assistance to help young carers continue to study, and there was an increase in 2007 in the maximum amount that can be earned while claiming Carer’s Allowance. Locally, there are a range of agencies that provide benefits advice for carers including Brighton Housing Trust, the Brighton & Hove Federation of Disabled People’s Disability Advice Centre, Amaze, the council’s welfare rights team and the Pensions Service.

Material wellbeing assets among carers

Several local agencies provide benefits •advice for carers.

Material wellbeing vulnerabilities among carers

Many carers are missing out on the benefits •that might assist them: An estimated third of local eligible carers are not in receipt of a Carer’s Allowance


Strong and stable familiesPeople with high levels of caring responsibility are twice as likely to suffer from poor health as those without caring responsibilities, and are more likely to experience a relationship breakdown. One of the most important needs identified by carers during national consultation was the opportunity to spend time with spouse / partner away from their caring role.32

According to Ofsted, young carers report that two positive aspects of their caring role were their close relationship with their parent / sibling and the benefits of learning to deal with practicalities of life at a young age.18 Nationally young carers are more likely to live in lone parent families where the majority of people (70%) with care needs are mothers, compared to two parent families where almost half of people receiving care are siblings.6

National research suggests that Black and Minority Ethnic (BME) families are less likely to receive support from extended families than White families and are likely to have higher levels of unmet needs.33 Research into the needs of Bangladeshi mothers of disabled children found self help / befriending groups of particular benefit to meeting support needs.34

Qualitative research by Contact a Family (2009) identified the key ways which families of disabled children believed they could be strengthened socially, emotionally and practically (Table 7.2).32

Locally, the 2009 Carers’ Survey found family support to be crucial, with carers who receive family support reporting a better quality of life and better mental health than those without family support. The most important way to improve heath and happiness would be to have time to themselves (46%), time to socialise (33%) and practical support from others (29%).1

Local evidence suggests that 70% of carers who receive counselling at the Carers’ Centre reported increased stability in their relationship or family situation and 80% of carers reported

an improvement in their ability to deal with carer-relationship difficulties.14

Strong and stable family assets among carers

Caring responsibilities can help to •strengthen relationships with parents and siblings and help with learning to deal with the practicalities of life at a young age.

Local services, particularly counselling •support services can improve carer-family relationships.

Table 7.2: Top five ways to improve the lives of disabled children and their families

RANK SOCIALLY EMOTIONALLY PRACTICALLY

1 Opportunity for family A supportive relationship A support package to meet with a partner child’s needs

2 Social time with spouse Seeing a child reach full Regular and reliable short away from caring role potential breaks

3 Play activities specifically for Recognition of value as An education to meet child’s disabled children a carer needs

4 Understanding of disability A good night’s rest and a Benefits from society chance for ‘me’ time

5 A good night’s rest A supportive relationship Childcare with family

Source: Adapted from Bennett, 2009

Supports domain


Strong and stable family vulnerabilities among carers

Many carers are not in receipt of sufficient •family support.

BelongingIn a 2009/10 NHS survey of carers in the UK, 25% said they had less time with friends and 20% had less time for pastimes or hobbies due to their caring responsibilities.5 The Brighton & Hove Carers’ Survey indicates that just 34% of carers are happy with their social situation, while 50% sometimes feel lonely and isolated. Similarly to the national picture, older carers in Brighton & Hove are more likely to feel happy with their social situation and slightly less likely to feel isolated than other age groups. Carers who are self employed (40%) or retired (38%) are happier than other groups regarding their social life. Carers of adult children, aged 40-60 years or who care for longer hours are more likely to feel lonely.1

Experiences of belonging differ for different groups of carers. Research shows that services to support BME carers to engage in their own cultural communities are central to a sense of belonging, and prevent carers being heavily relied upon to support people who don’t speak the language or who have different cultural traditions.34 In March 2011, the Brighton & Hove Carers’ Centre was awarded Big Lottery funds to identify and support carers in the city from Black, Minority Ethnic (BME),

and lesbian gay, bisexual and transgender (LGBT) communities and those living in deprived areas. The project, entitled ‘Reaching OUT’ will run over five years and will employ a specialist development worker and outreach worker.36

Locally, parent carers value the increased resilience, enabling of the continuation of the caring role and realising children and young people’s potential that are afforded through short breaks.37 Young adult carers in the city also identify short break activities as crucial to providing a way to have a break.38

Adult carers also identify respite care as one of the most needed services for carers, with schemes such as the Carers’ Centre coffee mornings improving peer support and social networks for 95% of those attending, with 61% feeling that they were more a part of their local community.39

Younger carers specifically identified peer support as helpful for talking to someone who understands and to whom they feel confident speaking to, and that it would be nice to have an older friend.38 Teen and young adult carers in the city think an online space and a drop in space would be beneficial as a means to communicate and socialise with other carers and as a means to access support, while the majority of younger carers agreed that the drop in space would be helpful but would not use online social spaces.38,40

Belonging assets among carers

There are a number of local services •which, by providing opportunities to socialise and be involved in the local community, increase the sense of belonging among carers.

Belonging vulnerabilities among carers

Approximately half the carers in •Brighton & Hove feel lonely and isolated sometimes because of their caring role.

Public servicesFor carers, trying to access or at times avoid services, can be very time-consuming. However, getting involved and seeking to influence service provision builds strengths such as tenacity, negotiation skills, advocacy skills, expert knowledge, organisational skills and confidence to challenge professional opinions. All of these are essential to building resilience but are to varying degrees dependent upon the opportunities that support people to reach their potential.41

In Brighton & Hove, one example of a service which helps to build resilience in carers is the Parent Carers’ Council (PaCC) which was established in July 2008 to enable parent



carers to consult, inform and be involved in developments in services for children and young people with disabilities in the city. PaCC is supported by a parent participation worker at Amaze. In 2009/10 PaCC had 114 members, 41 of who were attending training and seven of whom were on subgroups and decision making groups.42 Similarly, the city Carers’ Centre delivers the Carers’ Engagement Service to involve and consult carers about service design and delivery of health and social care services, while the Carers’ Voice project enables carers to get involved at different levels depending on personal commitments.42 The Carers’ Survey (2009) found that two thirds of people did not know they could inform their GP of their caring status.1 LGBT carers are over twice as likely to inform their GP that they have a caring role in comparison to heterosexual carers. Access to services through the GP is relatively low in relation to both information and to practical help, although the majority of respondents (84%) last saw their GP in the previous six months or less.1 The Carers’ Centre GP Link Worker Project has so far established Link Workers in 31 GP practices in Brighton & Hove. The project provides carers’ information and awareness training for practice staff, and has established protocols to encourage referrals to the Carers’ Centre.19

Accessibility of services providing breaks from caring is also central to building resilience in

carers in the city. Emergency back-up schemes, respite breaks and money for activities are the services most wanted by carers in Brighton & Hove, along with funding for breaks for the whole family, the opportunity to have a holiday, peer support from other carers, and support services within the local community rather than the city centre.1

In Brighton & Hove the Spot Purchase Budget for carers provides ring-fenced funding to enable an individual approach to breaks and services, often via a direct payment following a carer’s needs assessment.19 A preliminary outcomes evaluation of those in receipt of this

funding shows that, of the 36 respondents, roughly half felt that the funding had made a difference.44

Public service assets for carers

LGBT carers are more likely to inform •their GP that they are a carer than heterosexual carers.

Services in the city facilitate carer •engagement and involvement in service delivery and design which can build resilience and coping strategies in carers

Some services that provide breaks from •caring responsibilities, such as short break and respite services, are vital to carers in the city, and provision has been improved through the Carers’ Grant initiative.

Public service vulnerabilities for carers

The majority of carers are unaware •they should inform their GP that they are a carer.

Crime and anti-social behaviourSafety issues affecting local young carers include bullying, stress caused by a lack of information on the illness or disability of the person cared for, or the impact of parents having substance misuse problems. Approximately 8% of young carers in the city deal with substance misuse as a primary health


condition of the person they care for compared to about 1% of adult carers.45

The Brighton & Hove Partnership Community Safety Team runs a website for young people in Brighton & Hove affected by crime and safety issues. Services such as ‘Patched’ and ‘Oasis’ in Brighton & Hove offer advice and support which help to build young carers resilience when they are in these circumstances. The Patched Crime Reduction Initiative (CRI) offers support to carers of substance misusers. Seventy-five percent of carers who have accessed 1:1 support report that the substance misuser has subsequently accessed support themselves.46 The ‘Young Oasis’ project supports children and young people who have a family member with substance misuse problems with the aim of building their resilience.47

Crime and anti-social assets among carers

There are targeted services in the city •offering specific support to carers of substance misusers.

Crime and anti-social vulnerabilities among carers

Young carers in the city are more likely than •older carers to be dealing with safety issues associated with caring for someone with a substance misuse problem.

Infrastructure Brighton & Hove has the sixth largest private rented sector in the country and as a result there are many more disabled people living in the private rented sector than nationally (14% compared to 6%).47 The local joint strategic needs assessment of physical disability suggests that many dwellings may be unsuitable for adaptation and that some landlords may be reluctant to give permission for any adaptations to be undertaken.49

In addition to this, the hilly geography of many parts of the city means that full wheelchair accessibility can be problematic.50

Transport infrastructure is also crucial for carers with just one third of carers in the city believing that existing transport services support their caring role, while 43% believe that existing transport services are insufficient in terms of cost and accessibility.1

As is the case nationally, much of the local housing stock is unsuitable and in short supply and the costs of adaptation are substantial.37 Local data on the housing needs of disabled children and their parent carers suggests that one in five feel that their current housing is inadequate to meet their needs. Of this number, the greatest perceived need for housing improvement is in the more deprived areas of the city: Moulsecoomb and Bevendean and East Brighton.42

There are some local initiatives in Brighton & Hove to improve access to housing for disabled people of all ages, including: doubling Disabled Facilities Grant expenditure over the last three years; increasing investment in overall adaptations (for all ages); shorter waiting lists due to better use of existing housing stock. In Brighton & Hove the local planning policy requires that all new housing meets the 16 Lifetime Homes criteria to enable “general needs” housing to provide, through simple or cost effective adaptation, solutions to meet the needs of diverse housing.

Infrastructure assets for carers

There are several local initiatives which seek •to improve housing for disabled people and their families.

Infrastructure vulnerabilities for carers

There is a significant and longstanding •shortage of appropriate housing in Brighton & Hove. This increases stress and health pressures on carers.

Local transport services are insufficient for •caring needs.


A number of themes then emerge from this section. There are substantial numbers of carers in Brighton & Hove with approximately 9% of the population estimated to be providing care. The needs of carers vary reflecting time spent caring, caring needs and support networks. Many carers do not feel in control of their lives and are at greater risk of loneliness, isolation, stress as well as lower income, unsuitable housing and educational difficulties. Those carers who spend long hours caring are likely to be economically inactive.

As well as these vulnerabilities, there are protective factors and assets within the third sector, statutory sector and the caring population itself that can help to mitigate these risks. Those carers who feel socially included and more in control of their daily life, and have greater levels of family support report a better quality of life, and many carers, including younger carers, report that they derive some benefits from their caring role. There are considerable public sector vulnerabilities for disabled people and their carers with regard to housing and transport. The problems in the housing sector will not come as news to anyone in the local authority working in this area and recent developments, such as the Brighton Seaside Community Homes initiative, where a group of local tenants, residents and councillors will oversee the refurbishment of 500 homes focusing on the most needy, such as disabled residents, should be watched closely to see if they address some of these concerns.

In many instances, the third sector is working hand-in-hand with fellow third sector organisations as well as the statutory sector in an effort to foster resilience among carers. There is considerable potential for building on this work. The role of the general practitioner stands out as potentially under-utilised. While Carers’ Centre link workers are now based in 31 out of 50 practices in the city, around two thirds of carers are not aware that they should inform their GP of their caring role. While some groups such as the LGBT community have come forward to their GP with details of their caring role, others, such as carers in the BME community are less likely to volunteer this information. Many carers then miss out on the benefits to which they are entitled, and which could make a dramatic difference to their lives. There is scope for linking information on benefits to greater detection of carers within general practice through the Carers’ Centre link workers.

Similarly, in schools there is scope for greater vigilance in identifying those pupils that have caring roles, something that the city has begun to address through the commissioning of a young carers’ schools worker. Considerable sensitivity is required in this as there are likely to be carers who, for a variety of reasons, are scared of revealing that they are caring for a parent or what the nature of the parental needs might be. The skills of the voluntary sector and a greater use of peer carers might go some way to addressing any such hesitancy.

References:

1. Brighton & Hove City Council, Carers Centre, NHS Brighton and Hove. Brighton & Hove Carers’ Survey; 2009.

2. Clarke, P, Kofsky, H and Lauruol, J. To a different drumbeat: parenting a child with special needs. Stroud, UK: Hawthorn Press;1989.

3. Beresford, B. & Sloper, P. Information Needs of Disabled Young People Research Findings in Beresford, B. & Sloper, P. The Information Needs of Chronically Ill or Physically Disabled Children and Adolescents. Social Policy Research Unit, The University of York, York; 2007. 4. Office of National Statistics. Census Data; 2001. NHS

5. NHS Information Centre. Survey of Carers in Households 2009/10. The Health and Social Care Information Centre; 2010. 6. Dearden, C., and Becker, S. Young Carers in the UK: the 2004 report. London: Carers UK; 2004. 7. Carers UK. Valuing Carers – calculating the value of unpaid care. University of Leeds; 2007. 8. Oxford Consultants for Social Inclusion. Developing Appropriate Strategies for Reducing Inequality in Brighton and Hove – Phase 1 Identifying the Challenge. Inequality in Brighton and Hove. Educe Ltd; 2007. 9. Brighton & Hove Healthy Schools Team. Supporting the Health of Young People in Brighton & Hove A summary report of the Health Related Behaviour Survey; 2007. 10. NHS Brighton and Hove and Brighton & Hove City Council. Brighton and Hove City Wide Needs Assessment Programme Health and Wellbeing Joint Strategic Needs Assessment Summary; 2011. 11. Department of Health. Government Information for Carers. www.carers.gov.uk (accessed 18 April 2011). 12. Princess Royal Trust for Carers. The Carers Centre for Brighton & Hove. www.carers.org/local-centre/brighton.



13. Brighton & Hove City Council Adult Social Care. Performance Indicators: Carers Centre for Brighton & Hove; October-December 2010. 14. Carers’ Centre. Young Carers’ Project. Brighton & Hove Carers’ Centre; 2011. 15. Department for Education and Skills. Advice and Guidance to Schools and Local Authorities on Managing Behaviour and Attendance: Groups of pupils at particular risk. www.dfes.gov.uk/behaviourandattendance 16. Brighton & Hove Partnership Community Safety Team, Brighton & Hove City Council and Brighton & Hove Children & Young People’s Trust. The Safe Zone. Young Carers: Safety issues which might come up due to caring for someone. www.thesafezone.co.uk/young_people/carers.php. (accessed 2011). 17. Brighton & Hove Education Online. Bulletin Item: HS/07/07, The Young Carers Project. www.brighton-hove.gov.uk/index.cfm?request=b1121088. (accessed 2011). 18. Ofsted. Supporting young carers. Identifying, assessing and meeting the needs of young carers and their families; 2009. 19. Peart T. Joint Commissioner, Contracts and Commissioning Support , Brighton & Hove City Council and NHS Brighton and Hove. Personal communication. April 2010.

20. Carers’ Centre. Draft Children in Need Funding Report 2010-11; 2011. 21. Carers Scotland. Sick, tired and caring: The impact of caring on health and long term conditions. Carers Scotland; 2011. 22. Brighton & Hove City Council. Carers’ Card: What it is and how to use it; 2011. 23. Brighton & Hove City Council. Social work team wins improvement and efficiency award, wave.brighton-hove.gov.uk/news/mainnews/Pages/Socialworkteamwinsefficiencyaward.aspx (accessed 29th March 2011). 24. Systems Whole Partnership. Brighton and Hove Dementia Modelling: Final Draft report; 2010.

25. Banerjee and Wittenberg. Clinical and cost effectiveness of services for early diagnosis and intervention in dementia. International Journal of Geriatric Psychiatry. 2009. 24(7): 748-754. 26. Brighton and Hove Carers. Mindful health Report; 2010. 27. Carers UK. Campaigning for change. www.carersuk.org/Aboutus/Howwehelp/Campaigningforchange (accessed March 2011). 28. Carers UK. Carers Missing Millions: A report into carers’ unclaimed benefits; 2010. 29. Carers UK. Carers in crisis: A survey of carers’ finances in 2008; 2008. 30. Becker, F., and Becker, S. Young Adult Carers in the UK Experiences, Needs and Services for Carers aged 16-24; 2008. 31. Amaze Brighton and Hove Annual Report 2010: Working with parents of children with special needs 2010. 32. Bennett, E. What makes my family stronger: A report into what makes families with disabled children stronger – socially, emotionally and practically. Contact a Family; May 2009. 33. Littlewood, B., Fearns, D., Nash, A., Smith, R. Respite Care and Short Break Services for Children and Young People with Disabilities in Luton Borough: an Independent Review. The School of Social, Community and Health Studies. Centre for Community Research. University of Hertfordshire; 2009. 34. Khine, G. Meeting the Needs of Families with Disabled Children: What Works & What’s Promising? 2003. In an overview and update of Beresford, B., Sloper, P., Baldwin, S. & Newman, T. What Works in Service for Families with a Disabled Child;1996. 35. The Afiya Trust. Beyond We Care: Putting Black Carers in the Picture. National Black Carers and Carers Worker Network; 2008. 36. Carers’ Centre. Carers’ Centre Scoops Lottery for BME and LGBT carers: www.thecarerscentre.org/2011/03/28/carers-centre-scoops-lottery-for-bme-lgbt-carers/ (accessed 28 March 2011).

37. Scambler, M. Brighton and Hove Children and Young People with Disabilities and/or Complex Health Needs Joint Strategic Needs Assessment. Brighton & Hove City Council and NHS Brighton and Hove; 2010. 38. Brighton & Hove Young Carers’ Project. Knowles Tooth Young Carers Consultation. August 2010. 39. Crossroads Care and The Princess Royal Trust for Carers. Coffee mornings for local carers. www.carershub.org/content/coffee-mornings-local-carers. (accessed 2011). 40. Brighton & Hove Young Carers’ Project. Go Ape Teens and YAC Consultation. August 2010. 41. Canvin K., Marttila, A., Burstrom, B., and Whitehead, M. (2009) Tales of the unexpected? Hidden resilience in poor households in Britain. Social Science and Medicine. 2009. 69: 238-245. 42. Amaze. Compass Database. 2010. 43. Carers’ Centre. Carers’ Centre website Brighton & Hove. www.thecarerscentre.org/ (accessed 2011). 44. Brighton & Hove City Council. Carers Breaks and Services Outcomes Monitoring. 4 April 2011. 45. Carers’ Centre. Annual Report 2010 for Brighton & Hove. 2010. 46.CRI Patched. Support and Services for the families, friends and carers of substance misusers 2004-2009. Communities against drugs; 2010. 47. Welsh, J. Young Oasis: A Therapeutic Approach to the Needs of Children of Substance Misusers, Substance Misuse Management in General Practice. Newsletter Network No 30. September 2010. 48. Brighton & Hove City Council. Private Sector House Condition Survey; 2008. 49. Brighton & Hove City Council and City Teaching Primary Care Trust. Joint Strategic Needs Assessment: Physical Disability; 2009. 50. Brighton & Hove City Council. Brighton and Hove Housing Strategy 2009 – 2014; 2009.

Chapter 8

CASE STUDIES: RESILIENCE INITIATIVES IN BRIGHTON & HOVE There are numerous examples of resilience building cited in this report. This section deals with some of these in a bit more detail.

INTRODUCTIONThe case studies have been selected from a range of settings; third sector, business and the statutory sector and also with regard to some of the different life course stages. Crucial in their selection for further consideration has been the availability of information on how successful or otherwise they have been in building resilience.

CHILDREN AND YOUNG PEOPLE

‘Make a Change’ (MaC) project - Albion in the communityBrighton & Hove is fortunate, not just in having a football team that is in the ascendancy, with the combination of promotion and a new stadium, but also in having a club that is committed to working in, and with, the community. The formal community arm of Brighton and Hove Albion, ‘Albion in the community’ has a long track record of community engagement, has received numerous accolades for its work, and has successfully delivered many public health

interventions over the years, in partnership with the public health directorate. One such programme is the ‘Make a Change’ (MaC) health project.

As discussed in Chapter 4, the most recent figures (2010) show that in Brighton & Hove 8.4% of Reception Year children are obese, rising to 15.5% of children in Year 6. Obesity is a significant factor in lowering health resilience and contributes to substantial disease in later life such as diabetes, coronary heart disease and even some cancers. The prevalence of obesity in Reception and Year 6 children is greater in the more deprived areas of the city than it is in the more affluent areas.

Started in 2009, the MaC project comprises a physical activity and healthy living education programme for school children and young people aged 5-16 years, through a series of breakfast clubs, evening activity sessions and healthy living days. The project has been jointly funded for three years by the Football Foundation (£40,000 a year), the Football League Trust (£25,000 a year) and, in year one,

NHS Brighton and Hove (£40,000 a year), and in years two and three, Brighton & Hove Food Partnership (£20,000 a year).

There are five key objectives for the project:

1. Improve the health and development of young people;

2. Build regular physical activity into young people’s lives;

3. Create incentives to promote healthy living;

4. Promote healthier food choices;

5. Reduce health inequalities.

The project has targeted schools in the more deprived areas of Brighton & Hove in order to maximise impact and reduce inequalities. Among the primary schools who have taken part in the project are Moulsecoomb, Whitehawk, Coombe Road, Goldstone juniors, Mile Oak, and the ACE primary unit.

Chapter 8 I CASE STUDIES: RESILIENCE INTIATIVES I 143

144 I Chapter 8 I CASE STUDIES: RESILIENCE INTIATIVES

There are four work programmes within the MaC project:

‘Make a Change’ breakfast clubsBreakfast clubs have been established in mainstream and special schools across Brighton & Hove with a focus on areas of deprivation (as above). A physical activity and healthy eating course aims to encourage children to build physical activity into their everyday lives, as well starting the day with a healthy breakfast. Five schools have now achieved gold Healthy Choice award status for their breakfast clubs. This recognition means that the breakfast club offers foods which are low in salt, sugar and fat, has a range of healthy options such as fruit readily available, and that staff are aware of good practice such as portion sizes. The Healthy Choice award is

judged and administered by a partnership of the city council and the Brighton & Hove Food Partnership

‘Make a Change’ early evening sessions Evening sessions are aimed at children aged 5-11 years in schools with suitable leisure and sports facilities. Like the breakfast clubs, the sessions are targeted at mainstream and special schools and venues from the more deprived areas of the city. Of the 16 venues where sessions have taken place, 14 are either in the first or second quintile on both the Index of Multiple Deprivation (IMD) and the Child Wellbeing Index (CWI). Children and young people take part in a range of different sporting activities that build physical activity into their lives, and work on a physical literacy programme aimed at building their physical development. Over 500 children have taken part in these sessions.

‘Make a change’ schools programmeThis programme has been taken up by primary, junior and special schools across Brighton & Hove. The programme promotes the benefits of regular physical activity and healthier food choices. Each year ‘Albion in the Community’s’ healthy living coaches go into 25 schools and deliver one hour healthy living workshops to a mixture of different classes and year groups during the school day. The workshops combine physical activity drills, games and challenges along with professionally delivered healthy living messages.

The Get Out And Live (GOAL) programmeThe GOAL programme is aimed at young people aged 12 to 16 years who already have healthy lifestyle knowledge and skills. The courses, delivered by NHS health trainers from ‘Albion in the Community’, seek to familiarise young people with a range of nutritional, physical and mental skills that can provide them with a long term improved lifestyle, thereby building their health resilience. There are group and individual sessions. Activities include team building, fitness testing and a range of physical activities including athletics, football, volleyball and tennis. The GOAL programme has a specific target to work with young people with disabilities and has successfully engaged young people with learning and physical disabilities and who are hearing and visually impaired.

Individual case studyThe ‘Make a Change’ coaching staff met Colin during one of their curriculum time health PE sessions. Colin, who previously led a sedentary lifestyle and was over a healthy weight for a child of his age, was enthused by the games and thoroughly enjoyed the six-week programme. After the celebratory assembly he asked whether there were any opportunities to join clubs that ran out of school hours. The coaches signposted him to one of the ‘Make a Change’ evening clubs. Intially Colin was shy and found it hard to engage fully in these sessions. In the winter term he took part in one of the cooking courses linked to the club

A Make a Change breakfast, with Brighton and Hove Albion FC.


and began to feel more confident. A year and a half on Colin has been involved in the running and planning of the family picnic, taken part in a further cooking course, completed five out of the 15 ‘Make a Change’ challenges, which included encouraging his family to eat healthier, and into the bargain has improved as a footballer.

Since the ‘Make a Change’ project started in Brighton & Hove in 2009, 29 schools and over 2,500 children and young people have taken part. The ‘Make a Change’ project is more than just a short term diet and physical exercise programme. It is an excellent example of how children, many of them from more disadvantaged backgrounds, can be engaged in a longer term initiative to improve their’s and their families’ health, and thereby build greater health resilience in the whole community.

AmazeLaunched in October 1997, Amaze brought together two existing local projects – the Network of Parents, which focused on social care and health matters, and the Parent Link Project, which was a parent partnership project with schools and the local education authority. By merging these initiatives, Amaze was established as a ‘one stop shop’ covering all issues concerned with children’s educational, social and emotional development. Amaze registered as a charity and company limited by guarantee in December 1999 and is managed by a board of trustees made up of parents and professionals who employ a dedicated team of part-time staff. Funding comes from the city council, NHS Brighton and Hove, and Sussex Community NHS Trust, as well as from grants and donations.

Amaze offers advice, information and support to parents and carers of children and young people with special needs in Brighton & Hove. The philosophy of Amaze is that parents are the key to improving the life chances of all children but that the prejudice, disadvantage, ignorance and inequality so often associated with disability inhibits the creation of a positive family experience. By developing the resilience of parents, they will be better equipped to deal with the adversity and obstacles that they face together with their children. The aims of Amaze are to empower parents, to encourage negotiation and collaboration with service providers and to promote a parent-service

provider partnership. To achieve these aims Amaze offers a number of services. Two of these are considered in this section: the ‘Insiders’ Guide’, and the ‘Independent Parental Support Service’.

‘The Insiders’ Guide’ This course aims to build parental resilience by showing parents how they can enjoy raising their children. Parents share their stories with others and celebrate the skills they have acquired. They are encouraged to map out their needs and develop strategies to build their skills and strengthen their resolve. The course is delivered jointly by parents and practitioners and in this way models the need for parents and professionals to work co-operatively towards a common goal.

The course is based on four assertions:

1. Parents are the key to improving child and family outcomes;

2. Parents of children with special needs travel a unique journey;

3. Parents of children with special needs enter an unfamiliar world of disadvantage;

4. When parents and practitioners work together, children reach their maximum potential.

Children get stuck into a Make a Change training session.


‘The Insiders’ Guide’ includes two standardised measurement scales that have been used to evaluate its impact: the ‘Being a Parent Scale’ and the ‘Depression Anxiety and Stress Scale’ (DASS). The questionnaires are filled out by participants at the beginning and end of each ‘Insiders’ Guide’ course. Based on the responses from 31 parents (to date), a number of findings have emerged:

Parent carers record relatively high scores •(moderate to severe) on the ‘Depression Anxiety and Stress Scale’ compared to parents who do not have carer responsibilities.

Parent carers taking part in the course •show improvements in their scores on the ‘Depression Anxiety and Stress Scale’ and on the ’Being a Parent Scale’ by the time they finished the course. Almost 50% of parents taking part show improvement in their ‘Being a Parent’ scale.

This objective improvement is supported by •some of the statements parents make after taking part: “...made me realise I’m not alone and sometimes you’re not as badly off as you think you might be,” “…I felt more confident about tackling things,” and “... it made me realise that there are lots of people out there who can advise through personal experience.”

The Independent Parental Support (IPS) Service This programme aims to build parents’ resilience through one-to-one support to help them understand the education system and work through any difficulties. Parents can access the service through the Amaze helpline, but many are signposted to the scheme by education and other professionals working with their child. The service provides information and advice, and supports parents through their chosen course of action. It is delivered by a part-time coordinator and a team of up to ten volunteer parental supporters. Volunteers receive initial training, followed by ongoing support and supervision from the coordinator.

Parents who use this service come from all areas of the city. A high proportion of participating parents have children with autistic spectrum conditions (40%) and speech and language difficulties (33%). Over half the caseload involves parents who describe their child as having moderate or severe challenging behaviour, although parents of children with moderate learning difficulties are more likely to use the service than parents of children with severe or profound learning difficulties.

Amaze regularly evaluates the IPS service and in 2010 it was decided to evaluate the IPS scheme with regard to its success or otherwise in helping parents build their resilience. The Resilient Therapy (RT) framework, which has

five components (basics; belonging; learning; coping; and core self) was used to assess what parent carers thought about their experience of using the IPS service. The results showed that the vast majority of parents who used the IPS service during 2010 felt that it had helped them to build their resilience across the five components. Parents also reported that they appreciated the help of the Independent Parental Support service when they were experience problems such as when a placement was at risk of breaking down, or when their child was at risk of exclusion.

Amaze is then a good example of an organisation whose core objective is one of resilience building, rather than just service delivery or dealing with need. Greater parental resilience will benefit both parents and children, and in the longer term, will reduce the need for public sector services to intervene.

WORKING AGE ADULTS

Brighton Sheet Metal Based in Hyde Business Park in Bevendean, Brighton Sheet Metal Ltd is a medium sized local company which produces an extensive range of sheet metal products to order. The workforce is predominantly male and the work environment comprises a labour intensive shop floor and some desk based office work. Food and drinks can be bought from the vending machines in the small canteen area and from a


sandwich van that visits every lunch time. The relative isolation of the business park means that the employees spend most of the working day together, and get to know each other well.

A number of health resilience initiatives have taken place with the full support and leadership of the management team. The initiative was led by the management and indeed started after a senior manager developed a back problem which interfered with his ability to come to work. As a result of this and some absenteeism among other members of staff for similar health reasons, through the NHS Primary Care Trust and local Food Partnership, the management invited a community nurse to undertake ‘NHS health checks’ on all the employees. This then, was a chance to reach a group of working men, many of whom would not ordinarily visit their GP or seek out a health professional either for health checks, or even to manage a suspected health problem. For the management it offered the chance to improve the fitness of the workforce with the added benefit of improved productivity.

A total of 28 health checks were conducted in the workplace and, with patient consent, GPs were informed of those identified at higher risk of cardiovascular disease, diabetes, hypertension and hyperlipidaemia. Referrals were also made for smoking cessation, exercise prescriptions and specialist weight management. For several of the workforce

men this led to positive life changing experiences. These ranged from better management of established disease such as diabetes and heart disease, to the diagnosis of unrecognised illness (endocrine and lipid). Twelve men were found to be overweight or obese and were encouraged to take part in the Shape-up programme. The Shape-Up programme helps participants to understand their own eating patterns, balance the type of foods that they eat, reduce the temptation to overeat and build confidence in their ability to become more physically active. This is achieved through eight

weeks of nutrition and activity sessions each lasting 1½ hours. The nutrition sessions deal with the nutrient content of different foods as well as the behavioural aspects of food consumption. The activity sessions are fun-based circuit training sessions for all abilities which aim to build participants’ confidence and fitness levels.

The camaraderie and competition between employees contributed to the support and level of participation in the sessions. A total of 14 workers regularly attended the eight week programme and in this short space of time achieved a combined loss of a 38.15Kg (6 stones) in weight and a reduction of 37.5cm (15 inches) around the waist; equivalent to an average of 3.5kg weight loss and 3.4cm waist loss per person. The time that workers spent on physical activity also improved on a weekly basis, as did the consumption of fruit and vegetables. Several staff reported establishing regular meal patterns as well as lower alcohol consumption. A six-month follow up visit to Brighton Sheet Metal Ltd established that 70% of those who had previously attended Shape-up continued to lose weight and several former participants reported increased physical activity levels. Senior management, who also participated in the programme, reported substantial improvements in productivity with a fall in employee absence levels as a proportion of production hours from 2.11% in 2008 to 1.94% in 2010 – an estimated direct saving of £20,000.

Staff from Brighton Sheet Metal work on getting fit.


The Brighton Sheet Metal Ltd experience is an excellent example of how health, belonging and economic resilience can all be successfully fostered, from one initiative. The success of the project led to the Public Health minister, Anne Milton, visiting the factory in early 2011 and meeting the staff who had so benefited from the various interventions.

OLDER PEOPLE

The Hangleton and Knoll 50+ steering groupThe Hangeton and Knoll Project (HKP) stemmed from a Local Area Agreement (LAA) initiative and associated funding in 2007. The purpose of the funding was to support work with local older people aged 50 years in order to establish a resident-led ‘50+ Steering Group’. The initial aims of the steering group were:

To assess current service and activities •provision for older people in the area;

To overseeing the development and •promotion of such services and activities;

To identifying and addressing the priority •issues affecting local older people.

The steering group comprised leading community figures, several local older residents and some service providers. Service provider

presence was felt to promote a useful exchange; raising awareness of community need, keeping residents abreast of new services, providing a medium for residents to feedback on how services were addressing the needs of local older people.

Initially, much time was spent building relationships within the steering group and promoting teamwork. As a result, the terms of reference enabled steering group members to have a clear sense of direction. A key strength of the group has been the breadth of its partnership working. Partners include the Neighbourhood Care Scheme, Older People’s Council, Brighton & Hove City Council, the NHS, Sheltered Housing, Southern Housing, Anchor Staying Put, the Carers’ Centre, WRVS Heritage Plus Project, the Active for Life team, Albion in the Community and the Falls Prevention team.

Since their formation, the Hangleton and Knoll 50+ steering group have not only achieved its initial objectives, but gone on to develop several new initiatives to the benefit the of local older people.

In its first three years the group achieved a great deal:

Year one

An audit of current community groups and •activities for older people;

An audit of services available for older •people at local chemists;

Representation for residents regarding •proposed developments at Hove Poly Clinic;

Development of a 50+ website;•

Following the identification of a gap in •service provision, exercise classes and games sessions were started by sheltered housing residents.

The Hangleton and Knoll Project’s annual 50+ event at St Richard’s Church and Community Centre in 2010.


Year two

A senior community development worker, •Dave Nicholls, now sadly deceased, joined the HKP with the specific remit of providing community development support to the 50+ steering group. Dave secured further funding from the public health directorate;

Contribution to a falls prevention •programme led by the primary care trust;

Production of ‘50+ Activities’ leaflets, •which were distributed to 8,000 homes as well as at local events and to community buildings;

An audit of local transport provision, •having identified this as a key barrier to the activity and participation of older people;

The establishment of a grant panel to •administer a local small grants programme entitled ‘50+ Health & Wellbeing Grants’.

Year threeDuring year three the steering group, now grown in confidence and recognised locally, settled into their role as an umbrella group, steering all local 50+ work, helping to define local priorities, administering further grants and helping to organise trips for local older people.

Year four to presentThe group has continued to organise a number of outings for local residents, who can not normally get out, using the Dignity and Wonderbus services. In October, they held their third very successful annual steering group event at St. Richard’s church hall in Hangleton. In October of last year the Hangleton and Knoll project worker left and the group had to re-organise themselves to take on much of the work that she did. Supported by a local worker, Ruth Melia, the group have managed to get a very good secretary and treasurer and are now constituted with their own bank account. As with so many ventures of this kind, the group still rely on grant funding to exist and carry out their work. At present they have sufficient funds to see them through the coming year and to finance their annual event but, of course, do not know what will happen beyond 2012.

The Hangleton and Knoll steering group is an example of where a relatively small amount of money can foster horizontal community social cohesion, building a sense of belonging, greater satisfaction, and ultimately improving local services and infrastructure. Local resilience has been much improved during this period. Despite the sad demise of the inspiring community development worker who led the project, the resilience of the steering group was such that the project continues today.

COnCLuSIOnS AnD

RECOMMENDATIONS

The case examples explored here are all relatively small scale in nature. They all involve a partnership across the statutory sector, voluntary sector, and in some cases the business sector too. In that sense they are indicative of the sort of partnership work that is being encouraged by the current Government. Evaluation of these sorts of initiatives is never easy, but several of them have succeeded in demonstrating not just impact, but also outcome.

These initiatives are also good examples of the sort of projects that will inevitably come under funding pressures as public sector finance cuts continue to bite. In reaching decisions about funding priorities, the statutory sector will have to take into consideration not just the short term effect of any ‘service reconfiguration’ but also the potential longer lasting impact of what might seem almost trivial amounts of funding.

Chapter 9

BUILDING RESILIENCE IN BRIGHTON & HOVE There is no single agreed way to build a resilient community. As with building resilience in individuals, there are a number of potential approaches depending upon the particular field of interest (education, economy etc).

INTRODUCTION This final chapter summarises the findings contained in this report and makes some proposals as to how community resilience might be strengthened in Brighton & Hove. It builds on some of the concepts of resilience discussed in Chapters 1 and 2 as well as the key findings illustrated in Chapters 3 to 7.

An overarching principle adopted throughout this report has been to seek to marry existing assets with existing vulnerabilities. This has the advantage of increasing the current set of assets in the city, while at the same time reducing the vulnerabilities. At a time of public sector economic hardship, it is also a cost effective option and in keeping with the Coalition Government’s policies of localism and the ‘Big Society’.

Within the limited published literature, definitions of community resilience vary. That said, different approaches typically share common components. So for example, while the ‘Community, Place, People and Business’ approach1 looks at these four specific

elements, the WARM approach defines three different domains: Self, Support, and Systems and Structures. However, the two approaches are not that different: ‘Self’ is really about ‘People’; ‘Support’ is about ‘Community’ and ‘Systems and Structures’ concerns ‘Place and Business’. The inclusive communities approach2

is a variant of both of these methods and describes five elements: a community’s composition, strengths, opportunities, vulnerabilities and attitudes.

Just as there are common features to how community resilience is defined and scoped, so there are common features within the different approaches taken to building resilience. Resilient communities are best established through the encouragement of connections: mutual cooperation and support, and the building of networks and partnerships between individuals, families, statutory and non-statutory agencies, the business sector and of course communities themselves. These connections should be horizontal (between similar groups) and vertical (between different groups).

As this report has used the WARM approach, the rest of this chapter summarises the key findings that have emerged through this WARM analysis. Based on the overarching principle of matching local assets and vulnerabilities, it takes into consideration the published evidence of what works and suggests some strategies for strengthening resilience in Brighton & Hove.

BUILDING RESILIENCE IN BRIGHTON & HOVE

Life satisfactionSatisfaction with living in Brighton & Hove is high. This is the case for working age adults and yet more so for older people. Many people from LGBT communities move to the city because it is perceived as ‘LGBT friendly’. There is a strong correlation between satisfaction with Brighton & Hove and affluence, with the strongest levels of satisfaction in the more affluent electoral wards.

Chapter 9 I BUILDING RESILIENCE IN BRIGHTON & HOVE I 151

Self domain

152 I Chapter 9 I BUILDING RESILIENCE IN BRIGHTON & HOVE

However, even in some deprived wards there are high levels of life satisfaction. This sense of enjoying life in Brighton is not quite the same as a sense of belonging. For while there are relatively high scores for satisfaction with living here, these are not translated into a sense of belonging, particularly among young adults. Rather than discuss how we might make residents feel happier about living here, a more useful objective might be how to increase their sense of belonging. This is explored later in this chapter.

EducationThere is a good body of evidence on the most effective ways of building resilience in children within schools.3 As discussed in Chapter 4 (children and young people), recent years have seen several national policy initiatives in this direction. Three features have been identified as critical to resilience building programmes for groups of young people: caring relationships, high expectations, and opportunities for participation;4,5

and five themes for the same at the individual level: competency (feeling successful), belonging (feeling valued), usefulness (feeling needed), potency (feeling empowered) and optimism (feeling encouraged and hopeful).6,7

These themes are best addressed through routine teaching practice. Embedding resilience building into the education curriculum helps ensure that it becomes an integral part of education, rather than an ‘add-on’. In the longer term, resilient

children, as they grow will, in turn produce resilient communities.8

Brighton & Hove scores amber overall in the WARM tool analysis, with the assets of a low proportion of residents without any qualifications and a high proportion of residents with highest level qualifications. But there are also several vulnerabilities: many of the highly educated residents are migrants to the city; there are poor results at GCSE level; and relatively low transition by school children into further education. The distribution of educational resilience across the community is strongly correlated with affluence levels.

A focus on establishing stronger resilience in local schools will produce more resilient children, and also help to improve examination results. Further down the line it will embed an ethos of higher academic achievement in more local residents. Some further consideration is required regarding how confident teachers feel about building resilience in children, at the individual and group level. Research into what factors affect students’ learning and resilience has shown that the positive reinforcing role of the individual teacher is the most crucial of all, even more so than the cognitive ability of the student.9 There are opportunities to increase teachers’ capabilities by formalising resilience training with initiatives like the SEAL programme, although before committing to a further extension of this particular programme a local evaluation should be completed.

As well as developing the capacity of teachers to foster resilience, whether through the SEAL programme or other approaches, there is also scope for harnessing the considerable educational resilience that exists in Brighton & Hove. A greater role should be played by local universities working with local secondary schools, with teachers and with pupils, to help raise the academic achievements and aspirations of local children.

Given the relatively poor performance of secondary schools in GCSE achievement over recent years, it is also worth reflecting on whether or not the current method of allocating secondary school places maximises the chances for the greatest number of children. The opportunities for the whole city that stem from the establishment of an academy should be explored by the city council working with the collective body of head teachers.

The highly educated adult population of the city, including older people and the LGBT community, should be encouraged to play a greater role in achieving this educational resilience objective. This will require some innovative thinking on the part of schools and leaders in the statutory sector, for there appear to be few published examples where such an approach has already been implemented. However, as a diverse city we have everything to gain from this vertical integration of different communities, harnessing all the educational resources at our disposal.


Such an approach has the potential not just to build greater educational resilience, but also to foster more of a sense of belonging among groups where this is currently weak, and in the longer term establish greater economic resilience.

HealthIn building resilience in health it is essential to adopt a holistic view of health that encompasses physical and mental health, risk taking behaviour (such as smoking and alcohol consumption) and lifestyle behaviour (such as physical activity, diet and sexual behaviour). The approach should not be confined to children. As in other aspects of resilience, a life course approach fostering a positive start and a continuation of this into adult life and older years is essential in building resilience for health.

Brighton & Hove scores an amber rating overall for the component of health. Within the city there are areas of strong health resilience which are closely correlated with the areas of affluence. As was the case in educational resilience there are no surprises across different parts of the city.

Children and young people in Brighton & Hove demonstrate considerable health assets with good dental health, an improving diet, relatively low and improving levels of childhood obesity and lower levels of school

bullying. However, there are higher levels of tobacco, alcohol and substance misuse and teenage conception has been a concern for many, many years. There is a similar pattern of assets and vulnerabilities among working age adults. The relatively young population is fit with a good diet, but again with risk taking and lifestyle issues related to tobacco, alcohol, and substance misuse, and sexual health. Mental health vulnerabilities are apparent through high suicide numbers. Interestingly, the same picture emerges again for older people living in the city. Healthy life expectancy and disability free life expectancy are both high, and a significantly higher proportion of the older population is independent with a relatively fit lifestyle and a healthy diet when compared to older people living in other parts of the country. There are however, higher levels of alcohol consumption among some of the older population and suicide rates remain stubbornly high.

We shouldn’t be surprised that the same health assets and vulnerabilities are present in young people, working age adults and older people. This reflects the importance of cultural and behaviour patterns and lifestyle choices. As demonstrated in last year’s Report of the Director of Public Health, these patterns stretch back several generations. This consistency of health assets and vulnerabilities across the generations living in Brighton & Hove today is then to be expected.

The approach to building health resilience is not one of addressing different groups in a horizontal fashion, but rather one of vertically integrated programmes. This is also likely to be a lower cost option than providing bespoke initiatives for specific groups. If any targeting is required, it is about geographical targeting at areas of deprivation.

The ‘Health Trainer’ initiative is a good example of an integrated physical and mental wellbeing approach to building health resilience. It is already targeted at reducing inequalities and could, with some additional support, be extended to explicitly cover different generations. Under this initiative, local residents trained in health and wellbeing work as health trainers and are able to advise individual residents on matters relating to diet, exercise, sexual health, smoking, alcohol consumption and mental health. Health trainers are linked into services and can offer referral should further intervention be required.

Measuring the outcome of this sort of work can be problematic, given the small numbers and potential for bias with so many other influences on lifestyle and behaviour. The work of health trainers is however based on the NICE guidance on behaviour change and the programme has been subject to impact monitoring. As a result of this monitoring, the role of health trainers is currently being altered in an effort to ensure that trainers extend the


scope of their work. Given the findings in this report, there is room for a considerable expansion of this programme and an extension of the health trainers’ role from one which deals with individuals’ needs to one that deals with the asset and vulnerabilities of extended families and communities.

There are currently only six health trainers in the city although further recruitment is planned. Given the low cost of health trainers, their local focus and the nature of their work,

it is worth considering a substantial increase in the workforce.

As is the case in education, there needs to be a greater role for the healthy, fit groups across Brighton & Hove, and across all the generations, to help other more vulnerable groups adopt more healthy lifestyles and to improve their healthy life chances. The volunteering strategy, already strong in many respects, offers a mechanism to achieve this.

Material wellbeingThe WARM tool uses deprivation measures, County Court Judgements (CCJ) on debt, household income, and the number of people on income support and incapacity benefit to assess material wellbeing resilience at community level. Brighton & Hove scores an amber rating in this respect, with assets of a relatively low exposure to debt, and benefit claimants who for the most part claim for short periods of time. Vulnerabilities include higher numbers of claimants for income support and incapacity benefit, and residents who are exposed to debt at relatively high levels compared to the average for England.

Across different parts of the city, the picture of material wellbeing is as expected with some exceptions. In Westbourne, although the overall population deprivation rate is not particularly high, some older people experience relatively high levels of deprivation. There are significant pockets of children living in poverty, particularly in East Brighton, and more so in relation to single parents.

Pay rates in Brighton & Hove have remained consistently above national rates but below South East rates for at least the last decade. The proportion of people claiming Jobseeker’s Allowance for short periods has been lower than the national and South East average rates, but these rates are converging. There is convergence too in the rates of long term (more than 12 months) Jobseeker’s Allowance

Safe Space: where distressed people can get help in West Street on Friday and Saturday nights.


claimants which, by contrast in Brighton & Hove, have traditionally been higher than national and South East rates. There are also significant pockets of poorer older people and overall over 50% of older people in Brighton & Hove live in areas which fall within the 40% most deprived of England. Some people in the city, including some elderly people and many carers, miss out on the benefits to which they are entitled; an estimated third of eligible carers are not in receipt of the Carer’s Allowance.

So the picture that emerges in Brighton & Hove is one where, although material wellbeing is generally good, certain groups such as children living with single parents, older people and many carers struggle. When they take on debt, it appears that local residents are apt to take on relatively high levels of debt.

In terms of building material resilience in the city, one measure that should be pursued, and with some haste, is to make sure that residents, many of whom are vulnerable, and who are entitled to benefits, receive those benefits. There are already a range of services which provide benefits advice, but clearly new gateways, such as public libraries (as is being explored), and primary care should be considered. General practice, a setting where vulnerable people are often assessed for other reasons, could be included with little in the way of additional cost. This might also assist

GPs in finding wider solutions to the ‘health’ problems that many vulnerable people experience.

Strong and stable familiesStrong social relationships help to build resilience and promote wellbeing.10 Overall Brighton & Hove scores an amber rating on the WARM analysis with the assets of relatively low proportions of lone parent and carer claimants, but the vulnerability of a relatively high proportion of divorced residents. Relatively large proportions of elderly people in the city live alone and are potentially socially isolated. It should be noted however, that there is no subjective measure in this component, and while low claimant rates may reflect low need, as has been illustrated, they may also reflect low take up and resultant unmet need.

The wards of Withdean, Stanford and Preston Park demonstrate the strongest resilience, while East Brighton, Moulsecoomb and Bevendean, Hollingbury and Stanmer and Westbourne show the greatest vulnerability, with more lone parents, divorced residents and households with dependent children with no adult in employment.

A significant barrier to building strong and stable families is the presence of domestic

violence. In Brighton & Hove, there are relatively high levels of substance misuse, mental health problems and domestic violence. Among the LGBT communities there are high levels of domestic violence; a third of lesbian/gay women and a quarter of gay men reporting having experienced domestic violence or abuse.

The city council tested its new approach to commissioning services by undertaking with partners a small number of pilot commissioning exercises, one of which concerned domestic violence. This should see a much better coordinated approach to addressing this often devastating problem. So far, the pilot has shown that domestic violence episodes are under-reported, and residents have very little confidence in public services. These findings are consistent with findings across the country.

Measures to build resilience in this field include providing support to families to create and engage with social networks and contribute to economic activity; for example targeting unemployed families that have children, with employment initiatives. This can be measured by the uptake of formal childcare by low-income working families.

Another barrier to establishing strong and stable families locally is the presence of substance misuse problems. The misuse of drugs and/or alcohol may adversely affect the

Supports domain


ability of parents to attend to the emotional, physical and developmental needs of their children in both the short and long term. In Brighton & Hove, there is a significant level of substance misuse among residents. The National Drug Treatment Monitoring System (NDTMS) data set (January–March 2009) illustrates the extent of substance misuse problems in Brighton & Hove: 60% of the treatment population were parents; with 61% of those living with their children. Providing support for parents with substance misuse and/or mental health problems and their children will help build resilience in these families.

BelongingSince many people choose to come and study, live and work in Brighton & Hove, and satisfaction rates with living here are high, it might be expected that there would be a strong sense of belonging among residents. In fact, this is not the case and the belonging domain is the only one on the WARM analysis where the city as a whole scores a red rating. Younger adults in particular do not feel involved in the community. There is variation across the city with residents of Portslade, Withdean and Rottingdean scoring higher on belonging while residents in the electoral wards of St. Peter’s and North Laine scoring the lowest of all. Many carers feel lonely and isolated.

A sense of belonging is related to the concepts of social capital and community trust discussed in Chapters 1 and 2 of this report. Research

shows that when there are high levels of involvement in civil society, and where people feel part of local decision-making, there is a greater sense of belonging.10,11 Hence a sense of belonging is strongest in older people who tend to engage more in local organisations.

There are measures that can be taken to build a sense of belonging, and there is already some activity across Brighton & Hove in this

respect, with for example a thriving third sector. The various neighbourhood forums that already exist are a good starting point for the development of local leaders. Such leadership builds trust and strengthens networks.

Some of the local housing work has the potential to foster greater community leadership and resilience and thereby increase the sense of belonging. The Brighton & Hove

American Express: one of the city’s biggest employers. Artist’s impression of the new AMEX building


Supporting local businesses with practical measures and enabling local residents to start up enterprises creates economic resilience. Research suggests that focusing especially on activities and organisations that contribute most to social capital and community capacity helps establish a virtuous cycle of economic and social resilience (Figure 9.1).12

While this is a green rated aspect of resilience, it is not an area without some risk. This is a time of cuts in public sector funding, and locally the public sector employs 30% of the local workforce. There is also a shortage of high quality business accommodation in the city.

Most telling of all perhaps, is that the majority of new jobs created do not actually go to residents who have grown up in Brighton & Hove. There are relatively high numbers of local young people not in education, employment or training (NEET). This vulnerability ties in very strongly with other aspects of resilience and again emphasises the need to improve education opportunities and to create stronger and more stable families.

Public servicesThe commissioning and delivery of good public services are key aspirations of the public sector in Brighton & Hove. Indeed, in its report A Council the City Deserves the city council has stated that it wants to see a rise in levels of satisfaction with the public sector. There is good foundation for this aspiration as research

Seaside Community Homes is a good example of the sort of initiative that can build resilience in this area, as well as improving satisfaction with local public services. It involves a small group of tenants, councillors and independent citizens taking responsibility for 499 vacant homes, with the goal of refurbishing them and supporting new tenants, some of whom are particularly vulnerable. It is after all local communities and residents who have the deepest understanding and greatest motivation to shape their communities for the better.

Initiatives which help communities to embrace diversity by establishing horizontal and vertical links also create a sense of belonging. The need to create opportunities for residents to participate in social activities with one another irrespective of age, socio-economic status, ethnicity, disability, or sexuality is a recurrent theme in this report. The White Night event is a good example of this, although it is for just one day a year. Healthwalks, too, are a good if small example of this. Many social activity initiatives however are targeted at specific groups. If we are to foster a real sense of belonging, it is essential to build both vertical and horizontal ties within communities.

Volunteering is another excellent means of fostering this aspect of resilience. The city has volunteering rates on a par with the average for England. Last year however, the city council adopted a volunteering strategy which allowed staff to spend some of their work time

volunteering, if they were prepared to put the same amount of leisure time into volunteering. This sort of work-based scheme should be rolled out across the city, starting perhaps with other large employers such as the NHS and Amex.

Given the low sense of belonging that seems to reflect the high number of students in the city, it is also worth considering specifically how students living in Brighton & Hove might become more engaged in volunteering and other civic activities within the communities in which they live. There is scope for local universities to engage more with the extensive third sector in order to achieve this.

Local economyThe local economy is the only WARM component where Brighton & Hove is rated green. There is good accessibility to employment with short travel times, high numbers of job vacancies and a high number of small industries. Within the city the central wards with high numbers of vacancies and good transport links do best in this respect. The strong and diverse small business sector means that Brighton & Hove is less vulnerable to the effects of business failures in large employers. Business satisfaction rates with the city as a location are high. There is a good range of organisations, some funded by the local authority, which support business development in the city.



confirms that the quality of public sector services is a key determinant of community resilience.13

The city scores amber overall for the public service aspect of resilience. By virtue of its compact size, most public services are near where people live, however there are relatively low levels of satisfaction across the board with regard to the city council, GP, local hospital and dental services. There is some encouragement. Residents are satisfied with public transport services, they consider that NHS services are improving and many vulnerable residents and older people feel that local services make an effort to respond to their concerns.

As discussed throughout this report, and as is supported by considerable evidence, local authorities can significantly increase the effectiveness of public services by utilising the capacity which sometime lies untapped within communities.14,15,16 The financial pressures faced by a public sector having to do more with less will test the aspiration to improve satisfaction with public services. However, even in these times certain key principles important in building resilience, if used in an explicit way to underpin public services, will see levels of satisfaction increase. These include: treating local communities with trust and respect; recognising and releasing local capabilities; and listening and involving people (residents and front line workers). The Seaside

Figure 9.1: Cycle of economic and social resilience

Source: Westall, Ramsden and Foley (2000), as referenced in Noya and Clarence (2009)

Replacing “imports” with local products - and externally delivered services with locally designed activity

Business and servicesbuying and trading locally

User led, co-produced or locally owned services

Attracting money, wages and investmentinto locality, but increasing local earning and spending

Building social capital – networks, volunteering, community activities, culture

Increasing knowledge, skills and leadership held in community

Supporting local employment and enterprise

Promoting and supporting innovation in business and in public services

Local Multiplier E�ect driving up social capital and economy


Community Homes initiative has already been cited, examples like this can pave the way, even in times of economic hardship, for the council to realise its stated ambition.

Crime and anti-social behaviourCrime and anti-social behaviour has an adverse impact on many aspects of resilience: life satisfaction, the local economy, a sense of belonging and even satisfaction with local services. The Department for Communities and Local Government (DCLG) in 2009 estimated the potential savings in England and Wales associated with an increase in community cohesion and corresponding reductions in crime would save between £193 million and £530 million.

Overall the city scores amber in this component with the assets of a relatively low fear of crime and below average burglary offences. However, the overall crime, anti-social behaviour, violent crime and child and wellbeing crime scores are all relatively high. The picture across electoral wards in the city is in keeping with the deprivation profile. Although the overall crime rate is falling, it has fallen much less than it has across Sussex and nationally. There is some inconsistency between relatively high levels of perceptions of safety in some areas (South Portslade and Patcham) while objective evidence suggests otherwise. In other areas, such as North Portslade and Brunswick and Adelaide, the

converse is true. Young people are more likely than older people to be victims of crime. There is evidence of continued hate crime against members of the LGBT communities, especially in more deprived parts of the city.

There is a perception among some residents that their views are not properly considered by the police. However, this is an area where there is strong partnership working, and numerous crime and anti-social behaviour initiatives in the city, particularly around housing and alcohol consumption. Some early results, for example with regard to anti-social behaviour in children and adults, are encouraging.

The Safe Space initiative funded by NHS Brighton and Hove is a good example of the latter. Residents or visitors who are incapacitated, usually as a result of alcohol consumption, can be treated in a facility open into the early hours in West Street, and thereby avoid intervention by the police, ambulance or A&E services. During the year 2010, 741 people were treated, 75% were aged 18-25 years, 87% were suffering from alcohol intoxication and 55% were from outside of Brighton & Hove. It is estimated that 276 A&E visits were avoided.

While this facility contributes to the resilience of public services, it is not clear what exactly it contributes to health resilience and whether or not any lessons are learned by those who need

and use it. By the same token, it is not clear what, if anything, it contributes to reducing the burden of alcohol on the city. Measures which reduce the supply and sale of alcohol are more likely than safety net measures to contribute more to crime and anti-social behaviour resilience. A greater collective focus on reducing alcohol consumption in the city should then be a major component of efforts to improve resilience in this area.

InfrastructureInfrastructural resilience comprises features such as transport, schools, hospitals as well as community facilities. Overall the city is rated as amber in this component. Residents express high levels of satisfaction with the parks and open spaces in the city (this includes the beaches) while the condition of the city’s housing comprises a vulnerability. With the exception of Moulsecoomb and Bevendean electoral wards, residents living on the outer parts of the city centre tend to have more resilience in terms of infrastructure.

The published literature recognises public libraries as facilities which improve literacy skills, foster community health and wellbeing and in doing so help to build resilience.17 In addition, there is evidence that green spaces also promote resilience. They have been shown to increase community cohesion; 83% more people engage in social activity in green spaces than in other areas.17 They encourage


residents to interact positively, and promote engagement from groups who are more at risk of being marginalised (ethnic minorities, urban youths and disabled people).18 They reduce domestic violence and crime levels,4,9

and thereby help strengthen a sense of belonging and ownership, build community cohesion and contribute to overall community resilience.20,21

The role of infrastructure in building resilience is particularly important at times of relative economic hardship when public services are being cut. What is not so apparent in the research literature however, is a comparison of which public services and infrastructure are more effective in promoting resilience. An element of judgement is therefore required in setting priorities.

Irrespective of the lack of any published framework for prioritisation, it is clear that in terms of infrastructure, housing stands out as the priority for Brighton & Hove. The many problems with housing have been alluded to several times in this report. It affects all ages and many vulnerable groups, such as carers. There are some innovative initiatives to address the city’s housing problems, however it is clear that much more remains to be done.

A number of key messages emerge from this exploration of community resilience in Brighton & Hove. Residents are generally happy living here; they consider it to be a diverse and inclusive city, although sadly many do not feel any sense of belonging.

There are some vulnerabilities which reduce community resilience. These include: poor performance at secondary schools, poor quality housing, less stable families, problems of tobacco, drug and alcohol use, relatively high levels of crime and a lack of satisfaction with public services.

There are also many assets which strengthen community resilience and could be harnessed more to remedy some of the city’s vulnerabilities. These include: a highly educated population, strong further education establishments, a diverse and thriving local economy, strong partnership working, with a thriving third sector and a local population keen to volunteer and capable of designing and delivering solutions to many local problems.

Annual Reports of Directors of Public Health, are sometimes accused of being very good at describing public health problems, but not so good at coming up with solutions. In this report I have sought to focus on problem solving and I have tried to identify where problems can be (and sometimes have been) solved with better community engagement. There are many more people working to build resilience and many more initiatives than I have had space to mention, this report is not meant to be a directory of services, but I apologise if anyone feels their efforts have been ignored.

The challenge to those of us in the statutory and voluntary sector is then clear. It is to work much, much better with the local population, with one another and with new partners; to be innovative and to take some risks in the knowledge that sometimes we will fail and doubtless we will be criticised. But one way or another, to harness the considerable strengths and assets that exist in Brighton & Hove, to the benefit of us all.



References:

1. Experian 2010. Understanding Resilience. Background information – East Yorkshire and Lincolnshire September 2010. Experian Limited 2010. publicsector.experian.co.uk/Products/~/media/Publications/Resilience/Experian_resilience_BBC%20West%20Midlands.ashx (accessed 20 April 2011).

2. Australian Government. Building inclusive and resilient communities. Australian Social Inclusion Board; June 2009.

3. National Education Association. Chapter 4: Resilience in C.A.R.E.: Strategies for closing the achievement gap. Third edition; 2007. www.nea.org/assets/docs/mf_CAREbook0804.pdf (accessed 20 April 2011).

4. Geneva Gay. Culturally Responsive Teaching: Theory, Research, and Practice. New York: Teachers College Press; 2000.

5. Ronald Ferguson. Necessary Policies and Practices to Close the Student Achievement Gaps. Presentation to NEA Symposium on Critical Issues for Educators: Washington, D.C.; 2004.

6. Sagor, R. Building resiliency in students. Educational Leadership 1996; 54(l), 38-41.

7. Wang, M. C., Haertel, G. 0, & Walberg, H. J. Educational resilience: An emergent construct (Clearinghouse No. UD 030 726). Philadelphia, PA: National Education Centre on Education in the Inner Cities;1995.

8. Bonnie Benard, “Turnaround Teachers and Schools” in Belinda Williams(ed), Closing the Achievement Gap: A Vision for Changing Beliefs and Practices, 2nd ed. Alexandria, VA: ASCD; 2003.

9. Hattie J. Teachers make a difference. What is the research evidence? Paper for the Australian Council for Educational Research. University of Auckland; 2003. www.teacherstoolbox.co.uk/T_effect_sizes.html (accessed 19 April 2011).

10. Donovan, N, and Halpern, D. Research based on referenda in Switzerland, in Life Satisfaction: The state of knowledge and implications for government. London: Cabinet Office Strategy Unit; 2002.

11. OECD/Noya A. Clarence E., “Community capacity building: fostering economic and social resilience. Project outline and proposed methodology”. working document.CFE/LEED. OECD; 26-27 November 2009, www.oecd.org/dataoecd/54/10/44681969.pdf?contentId=44681 970.

12. Westall, A., P. Ramsden, and J. Foley. Micro-entrepreneurs: Creating Enterprising Communities. IPPR and EF:London;2000.

13. Friedli, L, and Carlin, M. Resilient Relationships in the North West: What can the public sector contribute? Manchester: NHS Northwest and the Department of Health; 2009.

14. Noya, A. (ed.), The Changing Boundaries of Social Enterprises. OECD: Paris;2009.

15. Noya, A., E. Clarence and G. Craig (eds.) Community Capacity Building: Creating a Better Future Together. OECD: Paris;2009.

16. Noya, A. and E. Clarence (eds.) (2007). The Social Economy: Building Inclusive Economies. OECD: Paris; 2007. 17. Hicken, M. To each according to his needs: public libraries and socially excluded people. Health Information & Libraries Journal. 21 Suppl.2004; 2:45-53. 18. Sullivan, W.C., Kuo, F.E., and DePooter, S.F. The fruit of urban nature: vital neighbourhood spaces. Environment and Behaviour 2004; 36 (5): 678-700.

19. Cohen, D.A., Inagami, S. and Finch, B. The built environment and collective efficacy. Health & Place 2008;14, 198-208.

20. Davies, P., and Deaville, J. Natural heritage: a pathway to health. Countryside Council for Wales: Bangor; 2008.

21. Ravenscroft, N., Markwell, S. Ethnicity and the integration and exclusion of young people through urban park recreation provision. Managing Leisure 2000; 5, 135-150.

22. Bell, S. Hamilton, V., Montarzino, A., Rothnie, H., Travlou, P., and Alves, S. Greenspace and quality of life: a critical literature review. Greenspace. Scotland: Stirling; 2008.

Index of Multiple Deprivation (IMD), Communities and Local Government (CLG)


National Indicator dataset

2007

2007

2009

Adults (25-54) with no or low qualifications rate

Not staying on post 16 rate

NI 163 - Working age population qualified to at least level 2 or higher: no data at ward level

Indicator definitions for the Wellbeing and Resilience Measure (WARM)

The percentage of adults aged 25–54 with no qualifications or with qualifications below NVQ.

Proportion of children aged 17+ not staying on in education, either at school or in further education (FE) (calculated by subtracting the proportion of children still receiving Child Benefit at age 17). (Numerator: Those aged 17 still receiving Child Benefit in 2006 Denominator: Those aged 15 receiving Child Benefit in 2004. The indicator is subtracted from 1 to produce the proportion not staying in education.)

Proportion of population aged 19–64 for males and 19–59 for females qualified to at least level 2 or higher. Proportion of working age (19 years to retirement age) population qualified to at least level 2 or higher. Qualified to level 2 and above: people are counted as being qualified to level 2 and above if they have achieved at least either 5 GCSEs grades A*–C (or equivalent, i.e., O levels, CSE Grade 1s), two A/S levels, or any equivalent or higher qualification in the Qualifications and Credit Framework. Age group: 19–59 inclusive for women and 19–64 inclusive for men.

Self

Indicator definitions for the Wellbeing and Resilience Measure (WARM)

Component Source Date Indicator Definition

Life satisfaction Place Survey 2008 Overall, how satisfied or dissatisfied are you with your local area as a place to live? (Very or quite satisfied)

Education National Indicator dataset

2009 NI 75 - 5 GCSEs A*-C grades including English and maths

Appendix I INDICATOR DEFINITIONS FOR THE WELLBEING AND RESILIENCE MEASURE (WARM) I 163

Component

Education

Source

National Indicator dataset

Child Wellbeing Index (CWI), Communities and Local Government (CLG)

Census 2001

Neighbourhood Statistics

Date

2009

2009

2001

2007

Indicator

NI 165 – Working population qualified to at least level 4 or higher: no data at ward level

Child Wellbeing Index Education Score

% of households with one or more person with a limiting long term illness

Years of Potential Life Lost Indicator

Definition

Proportion of population aged 19–64 for males and 19–59 for females qualified to at least level 4 or higher. Proportion of working age (19 years to retirement age) population qualified to at least level 4 or higher. People are counted as being qualified to level 4 or above if they have achieved qualifications equivalent to NQF levels 4–8. (Level 4–6 qualifications include foundation or first degrees, recognised degree-level professional qualifications, teaching or nursing qualifications, diploma in higher education, HNC/HND or equivalent vocational qualificaation). Qualifications at level 7–8 include higher degrees, and postgraduate level professional qualifications. Age group: 19–59 inclusive for women and 19–64 inclusive for men.

This uses a variety of indicators of education, and then uses maximum likelihood factor analysis to generate weights for combining them. Indicators were:•twoyearrollingaverageofpointsscoreatKeyStages2and3derived

from test score•twoyearrollingaverageofcappedpointsscoreatKey

Stage 4•secondaryschoolabsencerate–basedontwoyearaverage•proportionofchildrennotstayingoninschoolornon-advancedfurther

education or training beyond the age of 16•proportionofthoseagedunder21notenteringhighereducation.

Numerator: Mortality data in five-year age sex bands, for 2001–05.Denominator: Total resident population plus communal establishments minus prison establishment population (resident non-staff) from ONS supplied LSOA population estimates 2005, in five-year age sex bands.Looking at the ‘Value’, a figure of less than 100 represents fewer years of potential life lost in that area and a figure above this shows more years of potential life lost in comparison to the expected figure in that area.Method: Blane and Drever (1998) (with shrinkage applied to age–sex rates and an upper age of 75).

Self

Component

Health

Material Wellbeing

Source


Place Survey



Department for Work and Pensions (DWP)



Communities and Local Government

Date

2009

2008

2007

2007

Aug-09

Aug-09

Nov-10

2010

Indicator

Child Wellbeing Index Health and disability score

% of people who reported good health

Comparative Illness and Disability Ratio

Measure of Adults Suffering from Mood or Anxiety Disorders

Income support

Incapacity Benefits

Claimants for less than 12 Months

Income Index

Definition

Three health indicators were combined with equal weights: proportion of children aged 0–18 admitted to hospital in an emergency; proportion of children aged 0–18 attending hospital as outpatients; and proportion of children aged 0–16 receiving Disabled Living Allowance.

The number of people in receipt of IS Disability Premium, AA, DLA, SDA, IB as an age and sex standardised ratio of the total resident population.

A modelled measure of adults under 60 suffering from mood (affective), neurotic, stress-related and somatoform disorders. Based on data for prescribing, hospital episodes, deaths attributed to suicide and health benefits.

% of Job Seeker’s Allowance (JSA) claimants claiming for less than 12 months

This domain aims to capture the proportion of the population experiencing income deprivation. The indicators that make up this domain include: adults and children in Income Support Households, adults and children living in households in receipt of Income Based Job Seeker’s Allowance, adults and children in Pension Credit (Guarantee) households, households in receipt of Working Tax Credit, or Child Tax Credit, whose income is less than 60 per cent of the median before housing costs, and National Asylum Support Service (NASS) supported asylum seekers in receipt of subsistence only and accommodation support.

Self

164 I Appendix I INDICATOR DEFINITIONS FOR THE WELLBEING AND RESILIENCE MEASURE (WARM)

Component

Material Wellbeing

Source

Nomis

Nomis

Nomis





Date

May-10

May-10

May-10

2009

2010

2005

2005

Indicator

Claimants count

Claimants aged 50+ (average %)

Claimants aged 18-24 (average %)

Child Wellbeing Index material wellbeing score

Income Deprivation Affecting Older People Index (IDAOPI)

Total CCJs

Average value of CCJs

Definition

This is a comprehensive, non-overlapping count of children living in households in receipt of both in-work and out-of-work means-tested benefits. Indicators are the percentage of children aged 0–15 who live in households claiming: Income Support; Income-Based Jobseeker’s Allowance; Pension Credit (Guarantee); Working Tax or Child Tax Credit whose equivalised household income (excluding housing benefits) is below 60 per cent of the median before housing costs; or Child Tax Credit whose equivalised income (excluding housing benefits) is below 60 per cent of the median before housing costs. The indicators are summed and expressed as a rate of the total child population aged 0–15.

Proportion of the population aged 60 and over who are Income Support, Jobseeker’s Allowance or Incapacity Benefit claimants.

Self


Component

Material Wellbeing


Source


Census

Census

Census

Census

Census


Date

2007/ 08

2001

2001

2001

2001

2001

Aug-09

Indicator

NI 166 – Average Weekly Household Total Income Estimate

People aged 16 and over living in households: Not living in a couple: Divorced (%)

Households with no adults in employment: With dependent children (%)

One person: Pensioner (%)

Married couple households: With dependent children (%)

Lone parent households: With dependent children (%)

Lone parent claimants

Definition

Model-based estimates of income for Middle Layer Super Output Areas (MSOAs). The estimates have been produced using a modelling methodology that enables survey data to be combined with Census and administrative data. The survey data used within the modelling process was obtained from the 2004–05 Family Resources Survey (FRS). The choice of the FRS enabled each of the four survey variables on income to be modelled. The estimates and confidence intervals produced are values of the average MSOA income for the following four income types: 1) Average weekly household total income (unequivalised). 2) Average weekly household net income (unequivalised). 3) Average weekly household net income before housing costs (equivalised). 4) Average weekly household net income after housing costs (equivalised).

Working Age Benefit Claimants and is derived from the Work and Pensions Longitudinal Study (WPLS). Benefit claimants categorised by their statistical group (their main reason for interacting with the benefit system). In the case of lone parents it is Income Support claimants with a child under 16 and no partner. This dataset does not double count claimants who receive multiple benefits.

Self

Su

pp

ort

s 166 I Appendix I INDICATOR DEFINITIONS FOR THE WELLBEING AND RESILIENCE MEASURE (WARM)

Component


Belonging

Local economy

Source


Place Survey

Place Survey

Place Survey

Place Survey

Place Survey

Place Survey

Core Accessibility Indicators




Date

Aug-09

Indicator

Carer claimants

% of people who feel that they belong to their neighbourhood (NI 2)

% who have given unpaid help at least once per month over the last 12 months (NI 6)

A member of a group making decisions on local health or education services (%) (NI003)

A member of a decision making group set up to regenerate the local area (%) (NI003)

A member of a decision making group set up to tackle local crime problems (%) (NI003)

A member of a tenants’ group decision making committee (%)(NI003)

Travel time to nearest employment centre by walk/Public Transport

% target population within 20 minutes by composite mode

VAT based local units by employment size band (0-4) (Count)

VAT based local units by employment size band (20+) (Count)

Definition

Working Age Benefit Claimants and is derived from the Work and Pensions Longitudinal Study (WPLS). Benefit claimants categorised by their statistical group (their main reason for interacting with the benefit system). In the case of lone parents it is Carers’ Allowance claimants. This dataset does not double count claimants who receive multiple benefits.

Sup

po

rts

Syst

ems

and

str

uct

ure

s


Component

Local economy

Public services


Source

Nomis

Census

Place Survey





Child wellbeing Index (CWI), Communities and Local Government (CLG)

Place Survey

Date

Nov-10

2001

2008

2009

2009

2009

2009

2009

2008

Indicator

Vacancies – summary analysis (notified vacancies)

Distance travelled to work (less than 2km)

Please indicate how satisfied or dissatisfied you are with each of the following public services in your local area (very satisfied or fairly satisfied) (2008):· Local police · Fire and rescue· GP· Local hospital

Travel time to nearest GP by walk/PT

% of target population weighted by the access to GPs by walk/PT

Number of FE institutions within 30 minutes by walk/PT

Number of primary schools within 15 minutes by walk/PT

Child Wellbeing Index Crime score

How safe or unsafe do you feel when outside in your local area during the day? (safe)

Definition

The number of people aged 16–74, who were usually resident in the area at the time of the 2001 Census, and travelled less than 2km to their place of employment.

Four component indicators are weighted according to maximum likelihood factor analysis for the population aged 0–15. The indicators are: Burglary rate, Theft rate, Criminal damage rate, and Violence rate.

Syst

ems

and

str

uct

ure

s 168 I Appendix I INDICATOR DEFINITIONS FOR THE WELLBEING AND RESILIENCE MEASURE (WARM)

Component


Infrastructure

Source

Place Survey

NPIA

NPIA

NPIA

NPIA



Date

2008

Oct-09

Aug-10

Oct-09

Oct-09

2010

2007

Indicator

How safe or unsafe do you feel when outside in your local area after dark (safe)

All crime offences

Burglary offences

Antisocial behaviour offences

Violent crime offences

Barriers to Housing and Services Score

Difficulty of access to owner occupation

Definition

The indicator is a combination of two indicators: ‘Geographical Barriers’, which measures road distances to: GP premises, primary schools, Post Office, and supermarket/convenience stores; and ‘Wider Barriers’, which includes: difficulty of access to owner-occupation, homelessness and overcrowding.

There are two sub-indicators: ‘Geographical Barriers’, which includes road distances to a) GP premises, b) primary school, c) Post Office and d) supermarket or convenience store; and ‘Wider Barriers’, which includes e) difficulty of access owner-occupation, f) homelessness and g) overcrowding.

This is an indicator score that gives a measure of access to affordable housing based on house prices and income/earnings.

Syst

ems

and

str

uct

ure

s


Component

Infrastructure

Source

Child wellbeing Index (CWI), Communities and Local Government (CLG)



Place Survey

Date

2009

2007

2007

2008

Indicator

Child Wellbeing Index Housing score

Housing In Poor Condition score

Homelessness index: no data at ward level

How satisfied are you with the following services provided or supported by Brighton & Hove City Council ‘parks and open spaces’. (Very or fairly satisfied)

Definition

Four indicators are used to measure access to housing and quality of housing, which are then combined with equal weights. Indicators of access to housing are: Overcrowding (occupancy rating); Shared accommodation: (people aged 0–15 living in shared dwellings as a proportion of all children 0–15 in each LSOA); and Homelessness (concealed families containing dependent children as a proportion of all families with dependent children). Quality of housing is measured by: Lack of central heating (children aged 0–15 years old living in accommodation without central heating as a proportion of all children aged 0–15).

Probability that any house in the LSOA will fail to meet ‘Decent Homes Standard’ as modelled by the Building Research Establishment.

Percentage of households for whom a decision on whether their application for assistance under the homeless provisions of housing legislation has been made.

Added locally

Syst

ems

and

str

uct

ure

sSy

stem

s an

d s

tru

ctu

res

170 I Appendix I INDICATOR DEFINITIONS FOR THE WELLBEING AND RESILIENCE MEASURE (WARM)