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Public Health Wales North Wales Health Profile

Deprivation Key Messages

The influence of social circumstances on health, well-being and length and quality of life has long been recognised and described.

The most up to date deprivation measure, and the one recommended for use locally, is the Welsh Index of Multiple Deprivation (WIMD)-2011 at Lower Super Output Area (LSOA) level.

Denbighshire has the highest percentage of LSOAs in the most deprived 10% in Wales, the Isle of Anglesey the highest percentage in the most deprived 20%, Wrexham the highest percentage in the most deprived 30% and the Isle of Anglesey the highest percentage in the most deprived 50%.

Denbighshire has the highest percentage of people living in the most deprived 10% of LSOAs, Conwy the highest percentage in the most deprived 20%, Wrexham the highest percentage in the most deprived 30% and the Isle of Anglesey the highest percentage living in the most deprived 50%.

Denbighshire has the most number of people living in the most deprived 10% of LSOAs, and Wrexham has the most number of people living in the most deprived 20%, 30% and 50% of LSOAs in Wales.

LSOAs Rhyl West 2, Rhyl West 1 and Queensway 1 are in the top ten most deprived areas in Wales.

Free school meal entitlement is a potentially important indicator of deprivation. The highest levels of free school meal entitlement are in Anglesey for primary schools and Wrexham for secondary schools.

Higher proportions of children attending special schools are entitled to free school meals compared to those attending mainstream schools.

The influence of social circumstances on health, well-being and length and quality of life has long been recognised and describe. The recently published Marmot Review Fair Society, Healthy Lives is of particular importance in this respect 1.

Inequalities in health arise because of inequalities in society – through differences in which individuals are born, grow, live work and age.

Author: Jones C, Atenstaedt R et al

Date: March 2013 Status: Working Draft

Version: Od of 29 Intended Audience: BCU HB and partners


Although inequalities are most commonly described in terms of the socio-economic deprivation in the areas in which people live, classifying individuals by their level of education, occupation or housing conditions will also reveal similar gradients in their health. As Marmot notes:

Social and economic differences in health status reflect, and are caused by, social and economic inequalities in society.

The main mechanism that links the socio-economic environment and poor health is likely to be psychosocial stress. Poor socio-economic circumstances lead to anxiety, insecurity, low self-esteem, social isolation and lack of control over work and home life. They also increase risk-taking behaviour such as smoking, alcohol misuse, drug taking and unsafe sex. The socio-economic environment also determines the level of exposure to physical environment hazards, such as poor housing and road traffic.

1. Measurement of Deprivation

A number of indicators are used to measure and report deprivation. The different indices use a variety of data and, as a consequence, can produce slightly different conclusions. On the whole however, the same communities will be identified as most deprived whichever indicator is used. For completeness, this section will describe the different measures of deprivation and the geographical levels at which the data is available. However, the most up to date deprivation measure, and the one recommended for use locally, is the Welsh Index of Multiple Deprivation (WIMD)-2011 at Lower Super Output Area (LSOA) level.

1.1 Townsend Index

The Townsend Index is a summary score providing an indicator of small area deprivation. It is calculated from four 2001 census-based variables:

proportion of households with no car; proportion of households not owner occupied; proportion of unemployed economically active persons aged 16 to 59

years (females) and 16 to 64 years (males); proportion of households overcrowded.

Although now largely superseded by the WIMD, Townsend is still used for analyses when the unit of measurement is not the LSOA level e.g. GP practice based deprivation.

1.2 Welsh Index of Multiple Deprivation

The Welsh Index of Multiple Deprivation (WIMD) is a geographically based deprivation measure which can be used to show inequalities in health and Author: Jones C, Atenstaedt R et al




suggest areas likely to most need measures to improve health and manage ill-health. As with all area-based measures, it has to be noted that not everyone living in a deprived area is necessarily living in deprived circumstances and, equally, some people living in an area classed as least deprived may experience deprivation.

WIMD is the official measure of relative deprivation for small areas in Wales. It is produced at Lower Super Output Area (LSOA), one of the statistical geographies used to report Census output. LSOAs have an average of 1,500 people within them, and this inevitably means that the geographical size of the areas varies. There are 1,896 LSOAs in Wales (425 in North Wales). The Index was originally developed to ensure that funding, policy and programmes can be effectively focussed on the most disadvantaged communities.

It is important to note that deprivation is a wider concept than poverty, since poverty is usually considered to be a lack of money, whereas deprivation includes a lack of the opportunities and resources we would expect all citizens to have access to. Eight types of deprivation domains are included within the Index:

Employment Income Education Health Community safety Geographical access to services Housing Physical environment

The domains are weighted with income and employment having the highest weight. Each domain is made up of a number of different indicators. The indicators used within the health domain are cancer incidence, all-cause death rate, percentage low birth weights, and long-term limiting illness (from census).

It is also important to note that lack of deprivation is not necessarily the same as affluence. The ranks used within the Index are a relative system of measurement; it describes those areas which are more (or less) deprived than others, but does not measure by how much areas are more (or less) deprived.

The Welsh Index of Multiple Deprivation (WIMD) has been updated for 2011. However, as a number of analyses have used 2008 based data, information on both the 2008 WIMD and 2011 WIMD is included in this report.

1.3 Free school meal entitlementAuthor: Jones C, Atenstaedt R et al




Free school meal entitlement is a potentially important indicator of deprivation, and although the relationships between socio-economic deprivation and educational attainment are complex, this indicator is a useful proxy measure of potential health inequalities.

2 Measurement of Deprivation Results

2.1 Townsend Index

Across Wales, electoral wards have been grouped into fifths (quintiles). On an all Wales basis, 705,118 people are recorded as residing within the most deprived fifth (20%) of wards. 122,181 people are recorded as living within such wards which are located within BCU HB (i.e. approx 17% of the total population living within the most deprived wards in Wales). Table 1 shows that the highest percentage of people living in the most deprived wards in the region are in Gwynedd and the lowest in Flintshire, on the basis of applying Townsend to electoral wards.

Table 1: Percentage of population resident in the most deprived fifth (Townsend index applied to wards), 2001

Number Percentage

Isle of Anglesey 11,622 17Gwynedd 32,900 28Conwy 18,849 17Denbighshire 12,335 13Flintshire 17,931 12Wrexham 28,544 22

Source: NPHS/Census 2001

There is a difference between deprivation measures at ward level compared to LSOA level. The idea of creating deprivation scores at LSOA level is to identify ‘pockets’ of deprivation which may often be hidden in larger geographies, such as wards. Table 2 shows the same results when LSOAs are used. The distribution of deprivation has been divided into five groups (four cut-points) for the analysis. The cut-points for the groups have been defined so that each fifth has an equal number of LSOAs. By this method, the county with the highest percentage of its population living in the most deprived fifth is Conwy and the lowest is Flintshire.

Table 2: Percentage of population resident in the most deprived fifth (Townsend index applied to LSOAs), 2001

Population in most deprived

fifth

Percentage of population in most

deprived fifth

Wales 583,128 20.1Author: Jones C, Atenstaedt R et al




Betsi Cadwaladr UHB 100,361 15.1Isle of Anglesey 9,972 14.9Gwynedd 16,629 14.2Conwy 23,377 21.3Denbighshire 15,140 16.3Flintshire 13,272 8.9Wrexham 21,971 17.1

Source: NPHS / Census 2001

Figure 1 shows the fifths of deprivation into which LSOAs in North Wales fall when the Townsend Index is used. It is apparent that pockets of deprivation are often found in urban centres, for example Rhyl, Bangor, Blaenau Ffestiniog and Wrexham. Rural deprivation is also an important issue in North Wales.





Figure 1: Lower Super Output Areas by fifths of deprivation, Townsend Deprivation Score, North Wales

Crown copyright material is reproduced with the permission of the Controller of HMSO and the Queen’s Printer for Scotland

2.2 Welsh Index of Multiple Deprivation 2008




N.B. In this map, the 1896 LSOAs in Wales have been split into five equal groups based on deprivation scores. The figures in brackets show the number of LSOAs across the whole of Wales in each fifth.


Figure 2 shows the level of deprivation in the health board in comparison to the rest of Wales using WIMD-2008 data.

Figure 2: Lower Super Output Areas by fifths of deprivation, Overall Welsh Index of Multiple Deprivation, North Wales, 2008

In North Wales, 49 out of the 425 LSOAs are in the most deprived fifth in Wales. By this methodology, the county with the highest percentages in the most deprived fifth in Wales is Denbighshire and the lowest is Gwynedd (Table 3). However, it is important to note that not all deprived people live in the most deprived areas. This means that whilst it is true to say that deprivation is more concentrated in some areas, many deprived people will live outside these areas.





Table 3: Percentage of Lower Super Output Areas in most deprived fifth in Wales, 2008

Percentage

Wales 20North Wales 12Isle of Anglesey 11Gwynedd 5Conwy 13Denbighshire 16Flintshire 11Wrexham 14Source: Welsh Government

Table 4 identifies those LSOAs in North Wales which fall into the most deprived 10% in Wales according to WIMD-2008. Rhyl West 2, Queensway 1, Rhyl West 1 and Rhyl South West 2 are all in the top 10 most deprived LSOAs in Wales.

Table 4: North Wales Lower Super Output Areas in most deprived 10% in Wales, 2008Lower Super Output Area Local Authority WIMD 2008 Rank

Rhyl West 2 Denbighshire 1Queensway 1 Wrexham 3Rhyl West 1 Denbighshire 4Rhyl S West 2 Denbighshire 5Wynnstay Wrexham 32Plas Madoc Wrexham 34Glyn 2 Conwy 44Rhyl West 3 Denbighshire 67Peblig (Caernarfon) Gwynedd 82Hermitage 2 Wrexham 83Shotton Higher 2 Flintshire 85Rhyl S West 1 Denbighshire 87Queensway 2 Wrexham 95Tudno 2 Conwy 117Morawelon Anglesey 119Abergele Pensarn Conwy 120Rhiw 3 Conwy 143Holywell Central Flintshire 145Rhyl East 3 Denbighshire 152Greenfield 1 Flintshire 165Mold West 1 Flintshire 166Flint Castle Flintshire 171Marchog 1 Gwynedd 176Marchog 2 Gwynedd 178Cartrefle 2 Wrexham 184Tudur Anglesey 187Source: Welsh Government2.3 Welsh Index of Multiple Deprivation 2011Author: Jones C, Atenstaedt R et al




Figure 3 shows the level of deprivation in North Wales compared to the rest of Wales using WIMD-2011 data; locality boundaries are also shown.

Figure 3: Lower Super Output Areas by fifths of deprivation, Overall Welsh Index of Multiple Deprivation, Betsi Cadwaladr University Health Board with locality boundaries, 2011

Table 5 shows Health Board populations by fifth of deprivation using WIMD 2011 data and 2010 Mid Year Population Estimates for the Office for Author: Jones C, Atenstaedt R et al



© Crown Copyright and database right 2011. Ordance Survey 100044810. Produced by Public Health Wales Observatory; adapted by Claire Jones March 2013.


National Statistics. In BCU HB, 11.9% of the population are in the most deprived fifth compared to 19.2% across Wales.

Table 5: Health Board populations by fifth of deprivation, 2010

Health BoardLeast

DeprivedNext Least Deprived Median

Next Most Deprived

Most Deprived Total

% in most deprived

Abertawe Bro Morgannwg 115,186 74,950 75,125 104,901 134,407 504,569 26.6Aneurin Bevan 106,519 83,041 105,886 137,576 128,398 561,420 22.9Betsi Cadwaladr 137,477 176,292 163,946 119,863 80,883 678,461 11.9Cardiff & Vale 170,471 75,107 55,171 62,218 103,063 466,030 22.1Cwm Taf 31,333 28,052 52,522 79,000 99,101 290,008 34.2Hywel Dda 21,099 108,329 137,908 77,679 29,726 374,741 7.9Powys Teaching 18,334 68,239 25,935 17,563 1,130 131,201 0.9

Total 600,419 614,010 616,493 598,800 576,708 3,006,430 19.2

Produced by Public Health Wales Observatory, using MYE (ONS) and WI MD (Welsh Government)

Summary data for the North Wales Local Authorities is in Tables 6 to 9. According to Table 6, Denbighshire has the highest percentage of LSOAs in the most deprived 10% in Wales, the Isle of Anglesey the highest percentage in the most deprived 20%, Wrexham the highest percentage in the most deprived 30% and the Isle of Anglesey the highest percentage in the most deprived 50%.





Table 6: Percentage of small areas (LSOAs) in each local authority in North Wales which are in the most deprived 10% (ranks 1-190), 20% (ranks 1-380), 30% (ranks 1-570) and 50% (ranks 1-950) of LSOAs in Wales, WIMD 2011

Local authority

Number of LSOAs in local

authority

% LSOAs in most-deprived 10%ranks 1-190




Isle of Anglesey 44 2.3 15.9 20.5 54.5Gwynedd 75 4.0 4.0 6.7 32.0Conwy 71 2.8 14.1 22.5 43.7Denbighshire 58 10.3 15.5 19.0 46.6Flintshire 92 4.3 10.9 17.4 31.5Wrexham 85 5.9 14.1 29.4 43.5North Wales 425 4.9 12.0 19.3 40.5Wales 1,896 10 20 30 50

Produced by Public Health Wales Observatory, using WI MD 2011 (WG)

According to Table 7, Denbighshire has the highest percentage of people living in the most deprived 10% of LSOAs, Conwy the highest percentage in the most deprived 20%, Wrexham the highest percentage in the most deprived 30% and the Isle of Anglesey the highest percentage living in the most deprived 50%.

Table 7: Percentage of people in each local authority in North Wales who live in the most deprived 10%, 20%, 30% and 50% of LSOAs in Wales, WIMD 2011

Local authorityTotal

Population

Percent of people living in most-deprived 10% of LSOAsranks 1-190




Isle of Anglesey 68,592 2.1 15.2 21.1 53.8Gwynedd 119,007 4.1 4.1 7.4 33.5Conwy 110,863 2.6 15.3 24.0 44.3Denbighshire 96,731 9.6 14.1 17.4 46.3Flintshire 149,709 3.9 10.1 17.2 31.8Wrexham 133,559 5.8 14.8 29.8 44.0North Wales 678,461 4.7 11.9 19.5 40.8Wales 3,006,430 9.5 19.2 29.2 49.2

Produced by Public Health Wales Observatory, using WIMD 2011 (WG), MYE 2010 (ONS)

Lastly, Table 8 shows the actual number of people who live in the most deprived LSOAs. Denbighshire has the most number of people living in the most deprived 10% of LSOAs, and Wrexham has the most number of people living in the most deprived 20%, 30% and 50% of LSOAs in Wales.

Table 8: Number of people in each local authority in North Wales who live in the most deprived 10%, 20%, 30% and 50% of LSOAs in Wales, WIMD 2011





Local authorityTotal

Population

Number of people living in most-deprived 10% of LSOAsranks 1-190




Isle of Anglesey 68,592 1,465 10,448 14,497 36,894Gwynedd 119,007 4,932 4,932 8,774 39,902Conwy 110,863 2,855 16,941 26,570 49,107Denbighshire 96,731 9,270 13,662 16,844 44,811Flintshire 149,709 5,876 15,109 25,723 47,570Wrexham 133,559 7,687 19,791 39,864 58,735North Wales 678,461 32,085 80,883 132,272 277,019

Produced by Public Health Wales Observatory, using WIMD 2011 (WG), MYE 2010 (ONS)

Table 9 identifies those LSOAs in North Wales which fall into the most deprived 10% in Wales according to WIMD-2011. LSOAs Rhyl West 2, Rhyl West 1 and Queensway 1 are in the top ten most deprived areas in Wales.

Table 9: Lower Super Output Areas in the most deprived 10% in Wales for WIMD 2011, North Wales

Lower Super Output Area Local Authority WIMD 2011 rankRhyl West 2 Denbighshire 1Rhyl West 1 Denbighshire 7Queensway 1 Wrexham 9Rhyl South West 2 Denbighshire 12Plas Madoc Wrexham 24Wynnstay Wrexham 26Rhyl West 3 Denbighshire 34Glyn (Conwy) 2 Conwy 50Shotton Higher 2 Flintshire 83Queensway 2 Wrexham 88Rhyl South West 1 Denbighshire 96Tudno 2 Conwy 116Peblig (Caernarfon) Gwynedd 119Cartrefle 2 Wrexham 123Marchog 1 Gwynedd 136Marchog 2 Gwynedd 143Morawelon Isle of Anglesey 146Connah's Quay Golftyn 4 Flintshire 153Holywell Central Flintshire 155Denbigh Upper/Henllan 1 Denbighshire 160Mold West 1 Flintshire 184Produced by Public Health Wales Observatory, using WIMD 2011 (WG)

2.4 Comparisons between WIMD-2008 and WIMD-2011

Comparisons between WIMD 2008 and 2011 show the following:

LSOA Rhyl West 2 remains the most deprived LSOA in Wales.





LSOA Rhyl West 1 is the seventh most deprived in Wales in 2011 compared to third most deprived in 2008.

Queensway 1 is the ninth most deprived in Wales in 2011 compared to the second most deprived in 2008.

Rhyl South West 2 is the 12th most deprived in 2011 compared to the fifth most deprived in 2008.

Further Information Public Health Wales Observatory: Measuring Inequalities,

deprivation fifths

2.5 Free School Meal Entitlement

Table 10 suggests that the highest level of entitlement is in the Isle of Anglesey for primary schools and special schools, and in Wrexham for secondary schools. Notably higher proportions of children attending special schools are entitled to free school meals. The table also gives a comparison between counties in North Wales, Wales, England and Scotland. However, it should be noted that the criteria for receiving free school meals may be slightly different across countries, and can change from year to year. For this reason, these figures may not be directly comparable.




http://www.wales.nhs.uk/sitesplus/922/page/58379

http://www.wales.nhs.uk/sitesplus/922/page/58379


Table 10: Percentage of pupils entitled to free school meals, North Wales local authorities, Wales, England and Scotland 2010/11

Local authorityPrimary Schools*

Secondary Schools

Special Schools

Isle of Anglesey 18.8 13.8 47.9Gwynedd 13.0 10.8 38.2Conwy 17.1 14.4 36.7Denbighshire 18.5 14.9 37.1Flintshire 14.2 11.1 33.5Wrexham 16.4 16.3 47.3Wales 18.9 15.8 41.9England 17.3 14.2 33.3Scotland 19.8 14.4 53.4

* Percentages for England include Nursery and Primary Schools Produced by Public Health Wales Observatory, using data from:Welsh Government, Department for Education (England), Scottish Government

3. Deprivation & Health

3.1 Impact of deprivation on health

Figure 4 shows rate ratios for the most deprived compared with the least deprived fifth, for a range of causes of death on Wales. A rate ratio of two indicates that the death rate in the most deprived 20% of areas in Wales is twice that of the least deprived 20% of areas. The widest gap is for alcohol-related deaths amongst men; males living in the most deprived fifth are more than three and a half times more likely to have an alcohol-related death than males in the least deprived fifth.





Figure 4: Mortality by cause of death, rate ratios for the most deprived compared with least deprived fifth, 2007-09Produced by Public Health Wales Observatory, using ADDE/MYE(ONS), WHS/WIMD (WG)

4. Wider Determinants of Health

4.1 Tobacco

There are strong links between smoking and deprivation, with more than one in three people smoking in the most deprived areas of Wales, compared to around one in seven in the least deprived areas 2. These differences are believed to be a major cause of health inequalities.

4.2 Nutrition

People living in the most deprived areas of Wales are less likely to eat five or more portions of fruit and vegetables a day (30%) than those living in the least deprived areas (39%) 2.

4.3 Alcohol

Self-reported measures of drinking above guidelines and binge drinking are as common in the most deprived as in the least deprived communities. Alcohol-attributable mortality rates, however, show substantial inequalities with rates more than twice as high in the most deprived areas compared to the least deprived 3.





4.4 Illicit drugs

Illicit drug use leads to a range of problems in society which can pull communities into a downward spiral of fear and deprivation. These deprived communities are already at greater risk 3.

4.5 Teenage Conceptions

Generally, teenage mothers and their children suffer poor social, economic and health outcomes. Higher rates tend to be found in areas of greatest deprivation, and the risk of becoming a teenage mother for girls whose families are in Social Class V is almost ten times higher compared with girls whose families are in Social Class I 4.

4.6 Work and Unemployment

There is an important cyclical relationship between health and the economy in that not only are healthy populations better able to support economic development, but strong economic conditions also promote better health by giving more people in the population access to well paid jobs. Healthy people not only make fewer demands upon the health and social care systems, they are also more productive. In this sense, resources devoted to securing health improvement are not a cost, but rather an investment in economic and social prosperity. Economic development that is not sustainable can have overall negative health and well-being effects for people, especially for less affluent social groups.

Whilst being in general employment is healthier than unemployment, there is a legacy of ill-health associated with occupation in a number of areas across North Wales. This relates particularly to respiratory conditions associated with work in the Slate and Mining Industries in North West and North East Wales. Conditions most likely to be associated with modern day occupations and working patterns include musculoskeletal disorders, and work related stress, depression and anxiety. Psychosocial stress in the workplace, particularly related to low autonomy at work and ‘high effort – low reward’ work has been implicated as a key determinant of ill-health.

Even after allowing for social class and health status before unemployment, unemployment is closely linked with a number of ill health conditions and premature deaths. The Welsh Health Survey demonstrates that for each of heart disease, cancers, respiratory illness, mental illness, arthritis, back pain, long-term illness, physical and mental component scores, eyesight and hearing problems, and visiting the dentist for a check-up within the last twelve months, health status was worse for unemployed people.





Figures 5, 6 and 7 shows the total number of working age people claiming one or more employment benefits, including Job Seeker’s Allowance, Employment and Support Allowance and Incapacity Benefit 5. Figure 4 also gives locality boundaries. People claiming more than one such benefit are only counted once. Uptake figures could underestimate to true number of people who are eligible for benefits, as some individuals may not realise they are entitled to receive particular payments. Denbighshire (14.5%) has the highest percentage of working-age population claiming employment-related benefits, although it is just below the average for Wales (14.7%). At MSOA level, there is considerable variation; Denbighshire MSOA 004 (Rhyl East, Rhyl West) has the highest percentage, 34.6% compared to 5.3% in Flintshire MSOA 018 (Connah’s Quay Golftyn, Connah’s Quay South, Connah’s Quay Wepre).

Figure 5: Percentage of the working-age population claiming employment-related benefits, Betsi Cadwaladr University Health Board locality areas, November 2009 - August 2010





Figure 6: Percentage of the working-age population claiming employment-related benefits, November 2009 - August 2010




© Crown Copyright License Number 100022432 Produced by Public Health Wales Observatory, adapted by Claire Jones March 2013


9.59.611.612.113.014.014.3

16.820.9

008005004002009007006001003

MSO

A

I sle of Anglesey

I sle of Anglesey % = 14.1

Employment related benefits % 9.19.49.59.710.110.610.611.711.712.012.112.312.312.414.114.2

19.2

015014001004010013011012005016003017007002009008006

MSO

A

Gwynedd

Gwynedd % = 11.1

Employment related benefits %

7.58.210.510.510.611.412.413.414.015.116.017.018.119.3

23.6

003014012006015008011004009013002010001005007

MSO

A

Conwy

Conwy % = 14.1

Employment related benefits % 7.07.17.77.910.010.111.412.312.413.113.1

15.717.718.5

23.734.6

013012014015008016009005010003002001011007006004

MSO

A

Denbighshire

Denbighshire % = 14.5


5.35.86.56.97.07.37.57.88.78.79.011.211.713.013.113.2

16.016.316.520.3

018013012014006010020019015008005017016011001002009007003004

MSO

A

Flintshire

Flintshire % = 11.1

Employment related benefits % 5.75.76.77.79.49.710.410.810.911.413.413.513.514.715.316.718.018.1

27.1

018002001007014019016003011008004006005013009015017012010

MSO

A

Wrexham

Wrexham % = 12.8


9.19.49.59.710.110.610.611.774812.012.112.312.312.414.114.219.2

0.0 5.0 10.0 15.0 20.0 25.0

0.0 5.0 10.0 15.0 20.0 25.0

008005004002009007006001003m

soa

MSOA Local Authority Wales (14.7% )

Isle of Anglesey

Figure 7: Percentage of the working-age population claiming employment-related benefits, November 2009 - August 2010





14.1

11.1

14.1

14.5

11.1 12

.8

10.1

9.6

13

15.1

15.0

19.5

17.1

11.9

12.2

19.1

22.8

18.8

22.9

16.2

9.9

15.1

Isle

of A

ngle

sey

Gwyn

edd

Conw

y

Denb

ighs

hire

Flint

shire

Wre

xham

Powy

s

Cere

digi

on

Pem

brok

eshi

re

Carm

arth

ensh

ire

Swan

sea

Neat

h Po

rt Ta

lbot

Brid

gend

The

Vale

of G

lamor

gan

Card

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Rhon

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Taf

Merth

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dfil

Caer

philly

Blae

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Gwen

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Torfa

en

Monm

outh

shire

Newp

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Percentage of working-age population claiming employment-related benefits, November 2009 - August 2010Produced by Public Health Wales Observatory, using claimants data (ONS) & (DWP)

Wales = 14.7%

Areas ordered geographically from north west to south east

NICE Guidance Management of long-term sickness and incapacity for work Promoting mental wellbeing at work

4.7 Income





Figures 8 and 9 show how the percentage of persons living in households in poverty. The indicator is an experimental modelled estimate of the proportion of households living in poverty, after housing costs has been deducted. This is a relative measure of poverty as it is defined here as having less than 60% of the UK median net equivalised household income.

It must be remembered that these are model based estimates; however, across the health board there was a threefold difference in the proportion of households estimated to be living in poverty from 13.5% (Wrexham MSOA 002) to 41.5% (Wrexham MSOA 010) 5.

Estimates at the local authority level were not available but the median MSOA percentages suggest Gwynedd has higher levels of poverty than the rest and Flintshire has lower levels 5.

Figure 8 suggests higher levels clustering in the south and west of Gwynedd, most of the Conwy and Denbighshire coast from Llandudno to Prestatyn, the easternmost edge of Flintshire and the areas to the north of Wrexham town. More isolated higher levels were estimated for the towns of Denbigh, Bangor, Caernarfon, Holyhead and the north and central area of Anglesey 5. Locality boundaries are also given.

Figure 8: Percentage of persons living in households in poverty, Betsi Cadwaladr University Health Board local areas, 2007/08





Figure 9: Percentage of persons living in households in poverty, 2007/08 Author: Jones C, Atenstaedt R et al



©Crown Copyright & database right 2012. Ordnance Survey 100044810. Produced by Public Health Wales Observatory; adapted by Claire Jones, March 2013.


21.622.522.522.823.423.825.426.9

34.5

004009008002007005001006003

MSO

A

I sle of Anglesey

% of households 17.922.322.624.524.825.826.226.627.427.627.928.228.528.528.530.130.1

004005007003008014013011010012015017016009001006002

MSO

A

Gwynedd

% of households

20.023.123.123.624.424.424.825.626.728.129.229.531.431.7

35.7

003014006012015013008011005010002009001004007

MSO

A

Conwy

% of households 16.520.121.421.622.122.122.223.323.624.525.026.126.426.7

32.639.1

013012010009015003008014016005011007001002004006

MSO

A

Denbighshire

% of households

14.314.615.915.917.218.118.419.219.820.321.722.022.022.723.2

26.927.429.330.031.1

012014018006013019010020005008002016015017001011007003009004

MSO

A

Flintshire

% of households13.514.616.617.017.119.322.123.623.624.824.825.225.525.726.626.627.429.8

41.5

002007014018001016008013011019006003009005015004012017010

MSO

A

Wrexham

% of households

MSOA EASR with 95% confidence interval494

523530539549554564575576581585626656675

736941

Denbighshire EASR = 611003008015001014016012013007009002010005011

006004

Denbighshi re

4.8 EducationAuthor: Jones C, Atenstaedt R et al




Educational attainment is a critical indicator of future education and employment opportunities. These opportunities in turn are critical indicators of income which, as discussed earlier, has a major effect on health 5.

The indicator is based on the area of residence of pupils and represents the absolute achievement of resident school pupils with regards to all approved qualifications taken up to the age of 16 including GCSEs, NVQs, City & Guilds and other vocational qualifications. A higher score indicates better educational achievement 5.

Figures 10 and 11 shows that All of the local authority averages in this Health Board area were very similar to the Welsh average (394), ranging from 375 in the Isle of Anglesey to 416 in Wrexham 5. Figure 9 also gives locality boundaries.

There was considerable variation at the MSOA level from just 270 (Denbighshire MSOA 006) to 593 (Denbighshire 013). The three highest (best) scores occurred in the Ruthin area of Denbighshire (Denbighshire MSOA 013, 014, 015). The lowest scores occurred in MSOAs near Holyhead, Rhyl, Denbigh, Holywell, Flint, Queensferry and to the east of Wrexham 5.

MSOAs with point scores lower than the Welsh average were concentrated in the Isle of Anglesey, a roughly triangular area of Gwynedd and Conwy enclosing Bangor, Porthmadog and Betws-y-Coed, Llandudno and Abergele on the Conwy coast, the whole northern part of Denbighshire down to Denbigh, the entire eastern edge of Flintshire and the central northern parts of Wrexham 5.

Figure 12 shows the variation by LA across Wales.





Figure 10: Key Stage 4 educational attainment mean score, Betsi Cadwaladr University Health Board locality area, 2008-2010




© Crown Copyright License Number 100022432 Produced by Public Health Wales Observatory, adapted by Claire Jones March 2013


Figure 11: Key Stage 4 educational attainment mean score, 2008-10

334362365367380387391407433

003001002009007004006005008

MSO

A

I sle of Anglesey

I sle of Anglesey = 375

Mean points score 358362365367382396400402406415423432454456457473482

002005001006003010007004012015011009014016013008017

MSO

A

Gwynedd

Gwynedd = 412

Mean points score

335340355368377

414423423429440440442450477500

002005001015010011013004006012003014007009008

MSO

A

Conwy

Conwy = 413

Mean points score 270298320327345351354360364376382

438486

554562593

006004011007001002010009005008003012016015014013

MSO

A

Denbighshire

Denbighshire = 396

Mean points score

312332333354361363365374380382394400405406412417433433437454

004009003002001007011005017015008016020019006018014010012013

MSO

A

Flintshire

Flintshire = 387

Mean points score317344355357368376400417428432438439454454462468475480

522

010012005004003006013017009011015014008001019007002016018

MSO

A

Wrexham

Wrexham = 416

Mean points score

358362365367382396400402748415423432454456457473482

0 5 10 15 20 25

0 50 100 150 200 250 300 350 400

003001002009007004006005008m

soa MSOA Local Authority Wales (394)

Isle of Anglesey





Figure 12: 37

5 412

413

396

387

416

430

461

413

420

372

380

380

463

379

383

355 37

3

330 36

9 409

375

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hire

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Key stage 4 educational attainment mean scores by local authority, 2008-10Produced by Public Health Wales Observatory, using PLASC (WG)

Wales = 394


The percentage of year 11 school leavers known not to be in education, employment or training across UAs in BCU HB is lower than the Welsh average. In the region, percentages range from 2.8% in Flintshire to 5.3% in Anglesey.

Figure 13:Author: Jones C, Atenstaedt R et al




5.3

3.6

3.7 4.4

2.8 4.

2

2.9

2.3

4.8

2.9 4.

2

6.6 7.1

4.6

8.8

5.7 7.

6

6.0

8.7

7.0

3.9

7.5

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Percentage of year 11 school leavers known not to be in education, employment or training (NEET), 2010Produced by Public Health Wales Observatory, using data from Careers Wales

Wales = 5.4


95% confidence interval

5. References





1. The Marmot Review 2010. Fair Society Healthy Lives. [Accessed 04.01.12]

2. Welsh Assembly Government 2008. Welsh Health Survey. Cardiff: WAG. [Accessed 04.01.12]

3. Gartner A, Cosh H, Gibbon R, Lester N. 2009. A profile of alcohol and health in Wales. Cardiff: Wales Centre for Health. [Accessed 04.01.12]

4. National Public Health Service, 2006. Deprivation & Health: LHB Summary Reports [Accessed 13.03.13]

5. Public Health Wales, 2012. Wider Determinants of Health. Betsi Cadwaladr University Health Board. Public Health Wales NHS Trust. [Accessed 22.11.12]




http://nww2.nphs.wales.nhs.uk:8080/PubHObservatoryProjDocs.nsf/3653c00e7bb6259d80256f27004900db/06b2bef41d56da06802579e400350ee4/$FILE/WDoH_report_BetsiCadwaladr_v1.pdf

http://nww2.nphs.wales.nhs.uk:8080/PubHObservatoryProjDocs.nsf/3653c00e7bb6259d80256f27004900db/06b2bef41d56da06802579e400350ee4/$FILE/WDoH_report_BetsiCadwaladr_v1.pdf

http://howis.wales.nhs.uk/sitesplus/922/page/36988

http://howis.wales.nhs.uk/sitesplus/922/page/36988

http://www.wales.nhs.uk/sites3/Documents/568/Alcohol%20and%20Health%20in%20Wales_WebFinal_E.pdf

http://www.wales.nhs.uk/sites3/Documents/568/Alcohol%20and%20Health%20in%20Wales_WebFinal_E.pdf

http://wales.gov.uk/topics/statistics/headlines/health2009/hdw200905211/?lang=en

http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review