Berkeley Vale Development - Berkeley Vale Population and Health

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					                                                                                                                            Appendix 1

                                              Berkeley Vale Population and Health Profile


Figure 1 shows the age profile of the Berkeley Vale Practice Based Commissioning
(PBC) cluster population compared with Gloucestershire PCT population. The age
profile below is based on the GP responsible population – all persons registered with a
Gloucestershire GP practice irrespective of whether or not they live outside the county
boundary. The GP responsible population for the Berkeley Vale PBC cluster is 37,570
persons compared with 608,028 persons for the county as at January 2009. The
Berkeley Vale PBC cluster makes up 6.2% of the county population. Similarly, the
Berkeley Vale population makes up 32% of the Stroud & Berkeley Vale PBC cluster.

Due to the availability of different data sources the health profile is produced where
data are available for the Berkeley Vale PBC specifically, otherwise for Stroud district
as a whole.

Figure 1                                Age Structure of Berkeley Vale and Gloucestershire PCT
                                        Responsible Population – January 2009
                                                           GP Responsible Population, January 2009
                                                       Berkeley Vale PBC Cluster vs Gloucestershire PCT

                                        Berkeley Vale Cluster
                                10      Gloucestershire PCT

                                9

                                8
  Proportion Per Age band (%)




                                7
                                6

                                5

                                4
                                3
                                2
                                1
                                0
                                     0-4 05-9 10- 15-       20-   25- 30-   35-   40- 45-   50-   55- 60-   65-   70- 75-   80- 85+
                                              14 19         24    29 34     39    44 49     54    59 64     69    74 79     84
                                                                     Age band (years)



Source: Exeter extract, January 2009

Figure 1 indicates that, Berkeley Vale PBC Cluster has a different age structure than
Gloucestershire as a whole with larger proportions of the population in the 40-79 age
group and smaller populations in the younger age groups, particularly between the
ages of 20 and 34.




                                                                                                                                      i
                                                                                                                                                                                                                                                      Appendix 1
Male Life Expectancy at Birth

Life expectancy is an estimate of the number of years a new born baby would survive if
he/she were to experience a particular area's age-specific mortality rate, for that time
period throughout their life.

The national target for life expectancy is that „By 2010 to increase the average life
expectancy at birth in England to 78.6 years for men and to reduce the gap by at least
10% between the fifth of areas with the “worst health and deprivation indicators” and
the population as a whole commencing with local authorities‟.

Figure 2                                    Trends in Male Life Expectancy and England Target for 2010
                                            Gloucestershire Local Authorities 1991-93 to 2005-07

                                                                                                       Trends in Male Life Expectancy and England Target for 2010
                                                                                                          Gloucestershire Local Authorities 1991-93 to 2005-07
                           82



                           80



                           78
 Life Expectancy (years)




                           76



                           74



                           72
                                                                                                                                                                    Cheltenham                              Cotsw old                              FOD
                                                                                                                                                                    Gloucester                              Stroud                                 Tew kesbury
                                                                                                                                                                    South West                              England
                           70
                                1991-1993


                                            1992-1994


                                                        1993-1995


                                                                    1994-1996


                                                                                1995-1997 (baseline)


                                                                                                        1996-1998


                                                                                                                    1997-1999


                                                                                                                                1998-2000


                                                                                                                                            1999-2001


                                                                                                                                                        2000-2002


                                                                                                                                                                        2001-2003


                                                                                                                                                                                    2002-2004


                                                                                                                                                                                                2003-2005


                                                                                                                                                                                                               2004-2006


                                                                                                                                                                                                                           2005-2007


                                                                                                                                                                                                                                       2006-2008


                                                                                                                                                                                                                                                    2007-2009


                                                                                                                                                                                                                                                                2008-2010


                                                                                                                                                                                                                                                                            2009-2011
Source: Compendium of Clinical and Health Indicators, December 2008 release

Life expectancy data for Berkeley Vale PBC Cluster specifically is not available.
However Figure 2 shows that life expectancy at birth for males in Stroud was 78.3
years in 2005-07. The corresponding figure for England in the same period is 77.7
years for males. These figures are based on the assumption that the mortality
experience of the past will be the same in the future.


Female Life Expectancy at Birth

The national target for life expectancy is that „By 2010 to increase the average life
expectancy at birth in England to 82.5 years for women and to reduce the gap by at
least 10% between the fifth of areas with the “worst health and deprivation indicators”
and the population as a whole commencing with local authorities‟.




                                                                                                                                                                                                                                                                                        ii
                                                                                                                                                                                                                                                                                                  Appendix 1
Figure 3:                                                        Trends in Female Life Expectancy and England Target by 2010
                                                                 Gloucestershire Local Authorities 1991-93 to 2005-07
                                                                                                                             Trends in Female Life Expectancy and England Target by 2010
                                                                                                                                 Gloucestershire Local Authorities, 1991-93 to 2005-07
                                               84



                                               83




                                               82
 Life Expectancy (Years)




                                               81




                                               80



                                               79                                                                                                                                                                             Cheltenham                       Cotsw old                          FOD
                                                                                                                                                                                                                              Gloucester                       Stroud                             Tew kesbury
                                                                                                                                                                                                                              South West                       England

                                               78



                                               77
                                                    1991-1993


                                                                1992-1994


                                                                             1993-1995


                                                                                         1994-1996


                                                                                                      1995-1997 (baseline)


                                                                                                                               1996-1998


                                                                                                                                              1997-1999


                                                                                                                                                               1998-2000


                                                                                                                                                                           1999-2001


                                                                                                                                                                                          2000-2002


                                                                                                                                                                                                      2001-2003


                                                                                                                                                                                                                  2002-2004


                                                                                                                                                                                                                                2003-2005


                                                                                                                                                                                                                                            2004-2006


                                                                                                                                                                                                                                                         2005-2007


                                                                                                                                                                                                                                                                          2006-2008


                                                                                                                                                                                                                                                                                      2007-2009


                                                                                                                                                                                                                                                                                                    2008-2010


                                                                                                                                                                                                                                                                                                                 2009-2011
                                                                                                                                                                                   Period

Source: Compendium of Clinical and Health Indicators, December 2008 release

Figure 3 shows the trend in female life expectancy in Local Authorities in
Gloucestershire and England from 1991-93 to 2005-07. Female life expectancy at birth
in Stroud was 82.7 years in 2005-07 compared to England‟s average of 81.8 years in
the same time period. These projections are based on the assumption that the
mortality experience of the past will be the same in the future.

Standardised Mortality Ratio (SMR)

Figure 4:                                                        Mortality from All Causes (SMR with 95% CI) All Persons, All Ages
                                                                 Gloucestershire Districts 2005-07 – Pooled
                                                                            Mortality from All Causes ICD 10 A00-Y99 (SMR w ith 95% CI) All Persons, All Ages
                                                                                                Gloucestershire Districts 2005-2007, Pooled
                                              120



                                              100
         Standardised Mortality Ratio (SMR)




                                              80



                                              60

                                                                90                                   86                                                   95                               100                                 96                                    89                                     93

                                              40



                                              20



                                               0
                                                           Cheltenham                      Cotsw old                                       Forest of Dean                              Gloucester                             Stroud                    Tew kesbury                          Gloucestershire


Source: Compendium of Clinical & Health Indicators, December 2008 release



                                                                                                                                                                                                                                                                                                                             iii
                                                                          Appendix 1
Figure 4 shows that mortality from all causes in Stroud district is statistically
significantly lower, though marginally, than England‟s average.

Population Aged 65 and over Predicted to have Dementia

Table 1 shows people aged 65 and over predicted to have dementia, by age band (65-
69, 70-74, 75-79, 80-84 and 85 and over) and gender, projected to 2025

Table 1:     People Aged 65 and over Predicted to have Dementia by Age Band
             and Gender
                                   Stroud     Gloucestershire   Stroud   Gloucestershire
             Year                  2008           2008          2025         2025
 Males aged 65-69
 predicted to have dementia         45             219           56           279
 Males aged 70-74
 predicted to have dementia         71             366          102           508
 Males aged 75-79
 predicted to have dementia         92             479          163           826
 Males aged 80-84
 predicted to have dementia         122            673          235          1,153
 Males aged 85 and over
 predicted to have dementia         177            965          414          2,206
 Total males aged 65 and
 over predicted to have
 dementia                           508           2,703         969          4,973

 Females aged 65-69                 29             148           39           198
 predicted to have dementia
 Females aged 70-74                 60             307           82           422
 predicted to have dementia
 Females aged 75-79                 143            748          234          1,164
 predicted to have dementia
 Females aged 80-84                 266           1,330         359          1,756
 predicted to have dementia
 Females aged 85 and over           529           2,646         907          4,032
 predicted to have dementia
 Total females aged 65 and         1027           5,179         1621         7,572
 over predicted to have
 dementia

 Total population aged 65          1535           7,881         2590        12,544
 and over predicted to have
 dementia
Source: Projecting Older People Population Information System

The prevalence rates have been applied to ONS population projections of the 65 and
over population to give estimated numbers of people predicted to have dementia by
2025. The most recent relevant source of UK data is Dementia UK: A report into the
prevalence and cost of dementia prepared by the Personal Social Services Research
Unit (PSSRU) at the London School of Economics and the Institute of Psychiatry at
Kings College. To calculate the prevalence rates for the 85+ population, rates from the
research for the 85-89, 90-94 and 95+ age groups have been applied to the total
England population of these age groups. In order to calculate the total numbers in
each age group, the total 85+ population has been divided into these groups to
establish the predicted prevalence of the 85+ population as a whole.



                                                                                       iv
                                                                                                    Appendix 1
Population Profile by Deprivation Quintiles

Table 2:            Population Profile by Deprivation Quintiles, Berkeley Vale PBC
                    Cluster and Gloucestershire – January 2009

 IMD 2007 National                             Berkeley Vale                              Gloucestershire
    Deprivation
      Quintiles                     Female          Male       Persons         Female         Male               Persons
 Quintile 1 (most
 deprived)                                    0           0               0     23253         24258               47511
 Quintile 2
                                         1235        1236            2741       34814         34359               69173
 Quintile 3
                                         1650        1711            3361         65042       63483              128525
 Quintile 4
                                         7378        7345           14723       92852         91386              184238
 Quintile 5 (least
 deprived)                               5991        5900           11891       91481         88670              180151

 TOTAL                               16,254        16,192          32,446      307,442       302,156             609,598
Note: The resident registered population is based on persons resident in the county and registered with
Gloucestershire GP practices. However, it excludes persons resident outside the county boundary .

Table 2 shows the population numbers resident within Berkeley Vale PBC by
Deprivation Quintile, in comparison to Gloucestershire PCT. As can be seen from
this table, 82% of patients in Berkeley Vale PBC cluster live in the most affluent
parts of Gloucestershire (Quintiles 4 & 5).

Figure 5:           Percentage of Population, All Persons, All Ages by National
                    Deprivation Quintiles
                    GP Responsible Population by National Deprivation Quintiles, All Persons, All
                       Ages Berkeley Vale PBC Cluster vs Gloucestershire PCT January 2009
            50
                   Gloucestershire PCT
            45     Berkeley Vale PBC Cluster
            40

            35
  Percent




            30

            25

            20

            15

            10

             5

             0
                 Quintile 1 (most        Quintile 2        Quintile 3        Quintile 4      Quintile 5 (least
                   deprived)              IMD 2007 National Deprivation Quintiles              deprived)

Sources: Exeter extract, January 2009 & Department of Communities & Local Government (DCLG)

Figure 5 shows the percentage of responsible patients in each quintile of deprivation in
Berkeley Vale compared with Gloucestershire as a whole.


                                                                                                                    v
                                                                                     Appendix 1
Population Projections

Table 3 shows the total population projections for Stroud District, projected to 2025. Long
term population projections are an indication of the future trends in population by age and
gender. The projections are derived from assumptions about births, deaths and migration
based on trends over the last five years. The projections do not take into account any
future policy changes.

Table 3:      Total Population Projections for Stroud District
                                                                                                     %
                                                                                                  change
                                                                                                   2008 -
                                   2008           2010        2015         2020        2025         2025

 Total population                     111,700     113,200     117,200      121,500    126,000        +12.8
 Population aged 65 and
 over                                  20,800      21,900      25,800       28,600     31,800        +52.9
 Population aged 85 and
 over                                   3000        3,200        3,900       4,600      5,700        +90.0
 % Population aged 65
 and over as a proportion
 of the total population              18.62%      19.35%      22.01%       23.54%      25.24%
 % Population aged 85
 and over as a proportion
 of the total population                2.69%       2.83%       3.33%       3.798%     4.52%
Source: Projecting Older People Population Information System which utilises figures from
Office for National Statistics (ONS) sub-national population projections by sex and quinary age
groups.

The latest sub-national population projections available for England are based on the
2006 mid year population estimates and project forward the population from 2006 to 2031,
therefore is different from the registered population numbers.

Table 4:      Total Population Projections for Gloucestershire PCT
                                                                                            % change
                               2008        2010        2015         2020        2025       2008 - 2025

 Total population            586,100      594,400    614,800      636,100     657,800           +12.2
 Population aged 65
 and over                    106,800      111,800    129,000      142,800     158,200           +48.1
 Population aged 85
 and over                     15,400       16,500      19,000       22,200      27,100           +76
 % Population aged 65
 and over as a
 proportion of the total
 population                   18.22%      18.81%      20.98%       22.45%      24.05%
 % Population aged 85
 and over as a
 proportion of the total
 population                    2.63%       2.78%         3.09%       3.49%        4.12%
Source: Projecting Older People Population Information System which utilises figures from
Office for National Statistics (ONS) sub-national population projections by sex and quinary age
groups.




                                                                                                vi
                                                                                           Appendix 1


Table 3 shows the proportions of older people aged 85+ in Stroud District are expected to
increase from 2.69% to 4.52% by 2025. In comparison, table 4 shows Gloucestershire
PCT‟s population aged 85+ is expected to increase from 2.63% to 4.12% by 2025. Overall
the population in Stroud District is predicted to increase by 12.8% by 2025 compared to
12.2% in Gloucestershire, whilst the equivalent changes in the 65 and over population are
52.9% compared to 48.1% and in the 85 and over population 90% compared to 76%.

The expected changes in older people aged 65+ and 85+, within Stroud District and
Gloucestershire PCT, are shown in Figures 6 & 7.


Figure 6:             Population Projections to 2025 for Persons 65+
                             Population Projections to 2025 for persons aged 65+
               30
                     Stroud
                     Gloucestershire
               25


               20
 Percent (%)




               15


               10


                5


                0
                      2008              2010           2015           2020          2025


Source: Projecting Older People Population Information System

Figure 7:             Population Projections to 2025 for Persons 85+
                               Population Projections to 2025 for persons 85+
               30
                    Stroud
                    Gloucestershire
               25



               20
 Percent (%)




               15



               10



               5



               0
                     2008              2010          2015           2020           2025


Source: Projecting Older People Population Information System


                                                                                                  vii
                                                                          Appendix 1




Ethnic Groupings

Table 5:       Ethnic Groupings for Stroud District, Gloucestershire and
               England & Wales
                                                      Gloucestershire    England &
              Category                Stroud (%)           (%)           Wales (%)
 White                                   98.67             97.2            90.9
  - of which Irish                       0.66               0.8             1.3
    - Minorities overall                 1.33               2.8             9.1
       - Mixed                           0.54               0.9             1.4
   - Asian or Asian British              0.30               1.0             4.6
      - of which Indian                  0.11               0.7             2.1
      - of which Pakistani               0.03               0.1             1.4
      - of which Bangladeshi             0.11               0.1             0.6
      - of which Other Asian             0.05               0.1             0.5
   - Black or Black British              0.16               0.6             2.3
       - of which Caribbean              0.11               0.4             1.1
       - of which African                0.04               0.1             0.2
       - of which Other Black            0.01               0.1             0.2
  - Chinese/ Other Ethnic group          0.33               0.4             0.8
Source: ONS, Census 2001

Table 5 shows that Stroud District (1.3%) has a lower proportion of Minority Ethnic Groups
than Gloucestershire (2.8%) and England & Wales (9.1%).




                                                                                   viii
                                                                                                                    Appendix 1
Main causes of death

Figure 8:             Main causes of death as a percentage of all deaths
                      Persons aged 65+ 2005-07 (pooled)
                     Main causes of death as a % of all deaths in persons aged 65+
                         Stroud District vs Gloucestershire 2005-2007 (pooled)
           40
                                                                                         Stroud
           35                                                                            Gloucestershire


           30


           25
 Percent




           20


           15


           10


            5


            0
                All Cancers    All Circulatory     Respiratory         Infectious &           Others
                                 Diseases           Disease         Parasitic Diseases

Source: PHMF (ONS)

From Figure 8 above deaths from Circulatory diseases and cancer contribute 60% of all
deaths in Stroud district compared to 61.5% of all deaths in Gloucestershire as a whole in
persons aged 65 and over.


Figure 9:             Main causes of death as a percentage of all deaths
                      Persons less than 75 years 2005-07 (pooled)
                 Main causes of death as a % of all deaths in persons less than 75 years
                         Stroud District vs Gloucestershire 2005-2007 (pooled)
           50
                                                                                                  Stroud
           45                                                                                     Gloucestershire


           40

           35

           30
 Percent




           25

           20

           15

           10

            5

            0
                All Cancers      All Circulatory      Respiratory          Infectious &              Others
                                   Diseases            Disease          Parasitic Diseases



From Figure 9 deaths from all cancers account for more than two-fifths of all deaths in
persons less than 75 years, in Stroud District.

                                                                                                                            ix
                                                                                                                                             Appendix 1


Health and Provision of unpaid care
Table 6 below shows that Stroud District had a lower proportion of people living with a limiting long-term illness in comparison to the county. Based
upon patient‟s perception proportion of people reporting their health status as „Not Good‟ (7.24%) is similar to the county (7.57%).
                                                                         Numbers                                           Percent
                 Health Status
                                                      Stroud          Gloucestershire   England           Stroud       Gloucestershire        England
All People                                               107898               564559     49138831
People with a limiting long-term illness*                 17092                91164      8809194              15.84               16.15            17.93
People of **working age with a limiting long-
term illness                                                6971               37887      4014005              10.83               11.12            13.29
General health: ***Good                                    76607              398248     33787361              71.00               70.54            68.76
General health: Fairly good                                23479              123568     10915594              21.76               21.89            22.21
General health: Not good                                    7812               42743      4435876               7.24                7.57             9.03
All people who provide unpaid care #: 1-19
hours a week                                                   8784            41188       3347531             76.45               73.95            68.64
All people who provide unpaid care: 20-49
hours a week                                                   990              5183        530797              8.62                 9.31           10.88
All people who provide unpaid care: 50 or
more hours a week                                              1716             9329        998732             14.93               16.75            20.48
Source: Office for National Statistics, based on 2001 Census

Table Notes:
*All people usually resident in the area at the time of the 2001 Census who had a limiting long-term illness. A limiting long-term illness covers any
long-term illness, health problem or disability that limits daily activities or work.

**Working age is 16 to 64 inclusive for men and 16 - 59 for women.

***All people usually resident in the area at the time of the 2001 Census, who described their general health in the 12 months before Census day as
'Good'.

# All people usually resident in the area at the time of the 2001 Census, who provided unpaid care. Provision of unpaid care includes looking after,
giving help or support to family members, friends, neighbours or others, because of long-term physical or mental ill-health or disability or problems
relating to old age.




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