Joint Strategic Needs
Eden District Statistical Summary
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This Summary Report provides an overview of health and wellbeing in Eden. It forms part of the
Joint Strategic Needs Assessment (JSNA) for Cumbria. Cumbria’s JSNA aims to provide a
comprehensive analysis of the current and future health and wellbeing needs of the county’s
population to inform commissioning and guide the future planning and delivery of health
The JSNA is a statutory duty for upper tier local authorities and the local NHS in recognition that
strategic planning for health and wellbeing is best done in partnership. The Health and Social
Care Bill, published in January 2011, reaffirmed the government’s commitment to the planning
and commissioning of health services at a local level, giving the JSNA a nationally enhanced role.
The Bill requires Health and Wellbeing Boards to produce a JSNA and Joint Health and Wellbeing
Strategy for a local area and to commission with regard to them.
The JSNA draws together a wide range of information about the health and wellbeing of the
people of Cumbria. The evidence base provided in Cumbria’s JSNA will be used as a driver for
local health improvement, enabling local decision makers to set priorities and target resources
to meet the county’s health challenges, tackle health inequalities and fulfil the health and
wellbeing needs of the people of Cumbria, including those of vulnerable and seldom heard
This report is one of six JSNA district statistical summaries and an overall county statistical
summary which focus on health and wellbeing in Cumbria. These statistical summaries, the JSNA
headline report, health and wellbeing Instant Atlas and a range of additional information
sources focusing on health and wellbeing in Cumbria are available to view on the county’s online
JSNA resource: http://www.cumbriaobservatory.org.uk/health/JSNA/2012.asp
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The story of health and wellbeing in Eden is a positive one.
Levels of social and place wellbeing are high. The district has high levels of educational
attainment, low levels of unemployment and a strong sense of neighbourhood belonging.
Yet the district has significant issues around fuel poverty. The proportion of households that are
fuel poor is the highest in Cumbria and over double the national average.
People living in Eden tend to make positive lifestyle choices. Levels of smoking, alcohol related
harm and drug misuse are low, while the numbers who eat healthily and participate in sport are
high. However Eden also has the second highest level of childhood obesity in Cumbria.
The impact of major diseases on the residents of Eden is comparatively low. The district has the
lowest premature mortality rate from cancer and circulatory diseases in the county.
Eden performs strongly in terms of infant health with both the lowest rate of infant mortality
and lowest percentage of babies born with a low birth weight in the county.
While Eden performs strongly across a range of health and wellbeing indicators, high
performance overall conceals significant inequalities in health outcomes within the district. Eden
has the highest life expectancy in Cumbria yet there is also a 14.6 year gap between the wards
with the highest and lowest life expectancies.
Current demand on the adult social care system is low however the ageing nature of Eden’s
population presents significant future health challenges for the district. The demand on adult
health and social care services is projected to rise significantly in the future.
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PEOPLE AND COMMUNITIES
Eden sits in the East of the county. The administrative centre of the district is the market town
of Penrith. Eden contains a number of other historic market towns including Kirkby Stephen,
Appleby-in-Westmorland and Britain’s highest market town Alston which can be reached by the
scenic Hartside pass. Eden has a rich and varied natural landscape, which includes sections of
the Lake District National Park including Ullswater, the countryside of the Eden Valley and the
moorlands that make up the North Pennines, an Area of Outstanding Natural Beauty.
Eden is the least populated district in Cumbria with a current population 51,800 people. Eden
has a geographical area of 2,142 km2 and by far the lowest population density of all the districts
in Cumbria with only 24 people per km2. Eden is also the most rural district in the county with
71.3% of the population living in rural areas. The district’s rural nature has a significant impact
on some residents’ ability to access essential services including schools, post offices, and GPs.
Eden is the most deprived district in England in terms of geographical barriers to services.
4.8% of Eden’s population are from black minority ethnic groups, just below the county average.
Eden’s population is increasing faster than any other district in Cumbria, having grown by 3.8%
since 2001 compared to 1.3% population growth for Cumbria as a whole. The district’s
population is also ageing with a 20.4% increase in residents aged over 65 years since 2001. This
is the largest increase in this age group for any district in Cumbria. It is predicted that Eden’s
population will continue to age at the fastest rate in Cumbria. Between 2010 and 2035 the
number of Eden residents aged over 65 years is projected to rise by 13,100 people (74%).
The percentage of Eden’s population that are of working age is low at 62.7%, while incomes are
comparatively high. The median average annual household income in the district is £27,344,
£1,340 above the county average. Tourism plays a key role in Eden’s economy. Within the
district the largest sectors of employment are accommodation and food services (17.1%), health
(10%) and retail (9.6%).
Levels of unemployment in Eden are low. As of February 2012 1.5% of working age residents in
the district were claiming Job Seekers Allowance (JSA), the lowest proportion in the county.
Unemployment is higher among young people with 3% of 16-24 year olds claiming JSA less than
half the county average of 6.7%. When considering all forms of out of work benefits, the overall
worklessness rate in Eden rises to 8.2%. This is also the lowest in the county.
Eden is a safe place to live, with crime falling by 6.8% in the past year. The district has the lowest
levels of crime in Cumbria and is the 3rd least deprived district in England in terms of crime.
Despite low levels of crime Eden has the highest rate of drug crime in the county (a result of
holding the Kendal Calling festival) and of burglaries at non dwellings. Levels of domestic
violence are also rising. Crime is most likely to be committed by men aged 18-30 years.
Low levels of crime and a rich natural beauty make Eden a very desirable place to live. The mean
house price in the district is £220,400, significantly above the county average of £167,455. The
high demand for housing distorts the local housing market reducing the affordability for
residents on average earnings.
Eden is a relatively affluent district with the second lowest proportion of households in the
county with an annual income of less than £10,000 at 12.3% and children living in poverty at
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9.2%. Yet there are comparatively deprived areas within the district. In Penrith Pategill ward
17.4% of households have an annual income of less than £10,000 and 17.1% of children live in
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HEALTH AND WELLBEING
This section presents a narrative of health and wellbeing in Eden.
Social and Place Wellbeing
The health of individuals and communities is dependent on a wide range of factors that
contribute to an overall sense of social and place wellbeing. Social determinants including
education, housing, levels of unemployment and a sense of belonging to a community have a
major influence on an individual’s health prospects.
Educational attainment is above the county average with 32.6% of adults in the district holding a
certificate of higher education (level four or above) compared to 30.9% in Cumbria. Within Eden
64.4% of 16 year olds achieve 5 A*-C grades including English and Maths, the joint highest in
Cumbria and significantly above the county average of 56.3%. While high, levels of educational
attainment vary significantly across Eden with 81% of 16 year olds in Ullswater ward achieving 5
A*-C grades including English and Maths compared to just 36% in Penrith South ward.
There are high levels of substandard housing in the district with 27% of private sector housing
stock in Eden classified as dangerous (having category one hazards). The district has the highest
level of fuel poverty in the county, at over double the national rate. 38.3% of households in Eden
experience fuel poverty compared to the county average of 28.1% and the national average of
18.4%. The high level of fuel poverty results from the large number of old and poorly insulated
properties in the district, many which are off mains gas and the high proportion of retired
residents on comparably low incomes. While rising, at 14.7 the rate of excess winter deaths in
Eden remains below the county average of 17.
As of February 2012 the Eden had the second lowest number of job seekers to every unfilled job
vacancy in the county reflecting the low number of JSA claimants in the district. In Eden there
are 3 job seekers to every unfiled vacancy compared to 5.7 in Cumbria and England.
Eden has the strongest sense of community belonging in Cumbria with 77% of residents
reporting that they feel they belong to their immediate neighbourhood. In contrast the
percentage of residents who report being able to influence local decision making is
comparatively low at 38% compared to the county average of 40%.
Lifestyles and Health Improvement
An individual’s health is also influenced by their lifestyle choices and behaviours. These are in
turn affected by the socio-economic factors outlined in the section above. Lifestyle choices such
as smoking, alcohol and drug consumption, a lack of physical activity and poor diet all impact
negatively on an individual’s health serving to widen health inequalities.
Residents of Eden make comparatively positive lifestyle choices. The district has the second
lowest proportion of adult smokers in the county after South Lakeland. It is estimated that 18%
of adults smoke compared to the county average 21.5%. This figure is reflected in the
comparatively low levels of smoking related deaths in the district. Among pregnant women in
Eden 13.5% continue to smoke during their pregnancy, again the second lowest in the county
after South Lakeland.
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The impact of alcohol on the health of the population of Eden is comparatively less significant
than on the county as a whole. The district has the lowest rate of hospital admissions
attributable to alcohol in the county and the joint lowest proportion of residents who report
drunk and rowdy behaviour as a problem at just 14%.
Estimated levels of serious drug misuse in Eden have fallen by over 25% and are the second
lowest in the county after South Lakeland. In Eden 6 people per 1000 are estimated to misuse
crack and opiates compared to 7.5 in Cumbria and 9.4 in England.
The district has the highest proportion of adults participating in physical activity in Cumbria.
Participation is rising with 17.1% of adults in Eden taking part in 20 or more sessions of
moderate intensity sport and recreation in the past four weeks, compared to 14.7% in Cumbria
and 11.7% in England. 60.6% of school pupils participate in three hours or more of high quality
sport and P.E. just above the county average.
The number of adults eating healthily in Eden is rising with 31.7% of adults in the district eating
five or more portions of fruit and vegetables a day. Again this is the second highest proportion in
the county after South Lakeland. However the district has an issue around childhood obesity
with 23% of year six children classified as obese. This is the second highest proportion in the
county and considerably above the national average of 19%.
Health and Wellbeing Status
Life Expectancy and Health Inequality
While the overall story of health and wellbeing in Eden is positive measures of health
deprivation show significant health inequalities within the district. Eden has the highest life
expectancy in Cumbria with the average person expected to live to 81.3 years of age, 73 of them
in good health. While overall life expectancy is high there is a 14.6 year gap between the wards
with the highest and lowest life expectancy in the district. People in Greystoke ward have the
highest life expectancy in Cumbria at 82.8 years compared to 69.2 years in Eamont Ward.
In the most recent Indices of Multiple Deprivation Eden was the least deprived district in
Cumbria in the Health Deprivation and Disability domain. The high average score for the district
conceals significant inequalities in health outcomes. Ullswater ward is the least deprived in
terms of health in the county while Penrith Pategill ward falls in the bottom 20% of wards in
Cumbria in this measure.
The impact of both cancer and circulatory disease on the residents of Eden are comparatively
low. While the premature mortality rate from cancer is increasing it is the lowest in the county
at 94 per 100,000 compared to the rate of 111 for Cumbria and 110 for England. The premature
mortality rate from all circulatory diseases is also the lowest in the county and on the decline at
59 per 100,000.
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In terms of mental health Eden performs similar to, or better than, the county average. The
mortality rate from suicide and injuries undetermined in Eden is on the rise at 8.7 per 100,000
compared to the county average of 9.1. Levels of hospital admissions for neuroses are just
above county levels at 19.1 per 100,000 compared to 18.8 for Cumbria. Levels of hospital
admissions for self harm in the district are the lowest in the county.
Children and Young People
Eden performs strongly in terms of infant health. Both the rate of infant mortality and the
percentage of babies born with a low birth weight are on the decline. There are 2.1 deaths in
Eden per 1000 live births, the lowest rate in Cumbria. Similarly the percentage of babies born
with a low birth weight is the lowest in the county at 5.7%.
The rate of teenage pregnancy in Eden on the rise but is the second lowest in the county behind
South Lakeland. There are 26.4 pregnancies per 1000 women aged 15-17 years significantly
below the county rate at 37.4 and the national rate of 38.1.
The level of disabilities among adults in the district is above the county average and rising.
22.8% of the working age population in Eden are classified as having a disability, compared to
the county average of 20.6%. In contrast the number of young people entitled to disability living
allowance is the joint lowest in the county with South Lakeland at 2.2%, compared to the county
average of 2.6%.
The proportion of working age adults with disabilities in employment has declined and at 48% is
similar to county levels.
The demand upon, and utilisation of, health and social care services helps establish the picture
of health and wellbeing in an area. The demand on the Cumbria Health on Call service for
residents who urgently need access to a GP after hours is higher than the county average at 277
calls per 1000 compared to 250 in Cumbria. In other areas demand on the emergency health
system is below that of the county average, with a lower rate of calls to the ambulance service
and emergency admissions to hospital than the county as a whole.
Demand on social care services are low compared to the rest of the county. In Eden 170 children
are receiving social care services. The district has the second lowest rate of children’s social care
users in the county behind South Lakeland with 17.3 users per every 1000 children aged 0-17
years, compared to the county average of 25.5.
The rate of adult social care users is the lowest in the county at 32 users per 1000 people aged
over 18 years, compared to the county average of 43.6. Demand rises among older adults. Out
of the 1,549 adult social care users in Eden 78.4% are aged over 65 years. The primary client
type of 86.6% of the adult social care users in Eden is classified as physical disabilities compared
to 6.7% with learning disabilities. Those receiving social care within Eden often face multiple
health issues and require a variety of services, with the average adult social care user in the
district using over three different services.
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The number of people requiring adult social care services within Eden is projected to rise
resulting in part from the ageing nature of the population. This will place additional demands on
the system in future, with the number of people with dementia in the district due to rise by 767
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Eden Matrix Trend Comparisons
Domain Measure Eden Cumbria North West England
1. % working age adults with level 4 or greater education 32.6% Deteriorating 30.9% 28.7% 31.1%
2. Fuel poverty 38.3% Deteriorating 28.1% 22.1% 18.4%
Social and Place
3. Excess winter deaths 14.7 Deteriorating 17 17.6 18.1
4. All benefit claimants 8.2 Similar to 13.8 18 14.4
5. % children living in poverty 9.2% Similar to 15.4% 23.1% 21.3%
6. % who feel that they belong to their immediate neighbourhood 77% Similar to 70% no data 59%
7. % people who agree they can influence decisions in their area 38% Improving 39.7% no data 29%
8. Estimated smoking prevalence 17.9 no data 21.5 23.4 21.2
9. % of mothers smoking during pregnancy 13.5 no data 15.3 no data no data
Lifestyles and Health
10. Hospital admissions due to alcohol 1,367 Deteriorating 1896 2295 1743
11. % reporting drunk and rowdy behaviour as a problem 14% Improving 20% no data no data
12. Estimated prevalence of drug misuse (crack and opiates) per 1000 6 Improving 7.5 11.5 9.4
13. % of physically active adults 17.1% Improving 14.7% 11.2% 11.7%
14. % children participating in PE 60.6% no data 59.8% 57.9% 55.1%
15. Healthy eating among adults 31.7% Improving 28.5% 26.2% 28.7%
16. % of year six children obese 23% Deteriorating 20.8% 19.7% 19%
17. Mortality from all cancers <75 94 Deteriorating 111 123 110
18. Mortality from all circulatory diseases <75 59 Improving 72 83 67
Health and Well-being Status
19. Hospital admissions for neuroses 19.1 no data 19 30.1 16.4
20. Admissions for deliberate self-harm 110.3 no data 234.5 263.2 198.3
21. Mortality from suicide and injuries undetermined 8.7 Deteriorating 9.1 9.1 7.9
22. Infant mortality per 1000 births 2.1 Improving 3.4 4.9 4.6
23. % born with low birth weight ( <2.5kg) 5.7% Improving 6.8% 7.2% 7.3%
24. Teenage pregnancy rate (aged 15-17) 26.4 Deteriorating 37.4 43.5 38.1
25.% working age population with a disability 22.8% Deteriorating 20.6% 22.5% 20.5%
26. % working age adults with disabilities in employment 48% Deteriorating 49.3% 44% 49.2%
27. % of 0-16 entitled to disability living allowance 2.2% Similar to 2.6% 2.9% 2.8%
Per pop Actual Key
Hospital emergency admissions per 1000 of the population 100 5,304 Worse than
Calls to CHOC (Cumbria Health on Call) per 1000 of the population 277 14,742 Similar to
Calls to ambulance service per 1000 of the population 98 5,200 Better than
Adult Social Care Service users per 1000 pop aged 18+ 32 1,549
Adults predicted to have Dementia per 1000 of the pop aged 18+ 15 739
Number of cared for known to ASC per 1000 of the pop aged 18+ 34 1,635
Children's Social Care Service users per 1000 pop aged 0-17 17 170
Note: The colours denote Eden’s comparative performance against Cumbria, the North
West Region and England.
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Social and Place Wellbeing
1, the percentage of adults aged 16-64 years educated to NVQ4 or above, Annual Population
Survey (APS), January 2010-December 2010.
2, the percentage of households that need to spend more than 10% of their income on fuel
to maintain a satisfactory heating regime (21 degrees in main living area, 18 degrees in
other rooms), Department for Energy and Climate Change, 2009
3, the percentage of excess winter deaths (additional deaths during December-March)
based on the non winter deaths for the period 11th August 2006-31st July 2009, North West
Public Health Observatory (NWPHO) Health Profiles.
4, the percentage of the working age population (16-64 years) receiving state benefits,
NOMIS, August 2011
5, the percentage of children aged 0-19 years living in families in receipt of out of work
benefits or tax credits where their reported income is less than 60% of median income from
HM Revenue and Customs, 2009.
6, Cumbria Place Survey Tracker, 2009.
7, Cumbria Place Survey Tracker, 2009.
Lifestyles and Health Improvement
8, the percentage of adults aged 18 years and over that smoke based on responses to the
Office for National Statistics (ONS) Integrated Household Survey, NWPHO Health Profiles,
9, number of mothers who smoke at the time of delivery per 100 maternities where
smoking status is recorded, from Cumbria Primary Care Trust maternity databases, Q1, Q2
and Q3 2011/12.
10, Admission episodes for alcohol attributable conditions per 100,000 of the population,
DSR, all ages, Local Alcohol Profiles for England, 2009-2010.
11, Cumbria Place Survey Tracker 2009.
12, crude rate of estimated problem drug users per 1000 of the population aged 15-64, from
estimates commissioned by the Home Office, NWPHO Health Profiles, 2008-2009.
13, the percentage participating in sport and active recreation, at moderate
intensity, for at least 30 minutes on at least 20 days but no more than 28 days in the
last 4 weeks (equivalent to at least 5 times a week over the previous month), Active
People Survey Five, Sport England, 2010-2011
14, the percentage of children attending state schools that belong to a school sports
partnership who participate in at least 3 hours of high quality PE and school sport within and
beyond the curriculum in a typical week of the academic year. From TNS-BMRB PE and Sport
Survey, NWPHO Health Profiles, 2009-2010.
15, estimated prevalence of those aged 16 and above who consume 5 or more portions of
fruit and vegetables per day from responses to the Health Survey for England, NWPHO
Health Profiles 2006-2008.
16, percentage of year 6 (aged 10-11) state school pupils classified as obese, from National
Child Measurement Programme, 2010-2011 School year.
Health and Wellbeing Status
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17, mortality from all cancers, DSR per 100,000 of the population, those aged under 75,
from the NHS Information Centre, 2008-2010.
18, mortality from all circulatory diseases, DSR per 100,000 of the population, those aged
under 75, from the NHS Information Centre, 2008-2010.
19, Emergency hospital admissions for neuroses (codes F40-F48), per 100,000 of the
population aged 15-74 years, indirectly age and sex standardised rates, NHS Information
20, emergency hospital admissions for intentional self harm (codes X60-X84), DSR per
100,000 of the population all ages, from Hospital Episode Statistics, NWPHO 2009-2010.
21, mortality from suicide and injury undetermined (codes X60-X84 and Y10-Y34 excluding
Y33.9), DSR per 100,000 of the population, all ages, from NHS Information Centre 2008-
22, rate of infant mortality under age one per 1000 live births, NHS Information Centre
23, percentage of live and still births where the birth weight was less than 2,500 grams, NHS
Information Centre 2010.
24, conception rate per 1000 of the female population aged 15-17, ONS and Department for
25, percentage of the population aged 16-64 years with a disability from the Annual
Population Survey, June 2010-July 2011.
26, percentage of adults aged 16-64 years with disabilities in employment from the Annual
Population Survey, June 2010-July 2011.
27, percentage of the population aged 0-16 years claiming disability living allowance from
the Annual Population Survey and the ONS 2010 mid year population estimates, February
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