JSNA Life Course Summary East Sussex 2023
This document takes a life course approach to looking at key data and information about the population of East Sussex. A life course approach values both current and future generations of residents and offers opportunities to consider the protective factors and risk factors that influence a persons physical and mental health and wellbeing throughout their life. Whilst there are many indicators that can be measured, this document will select a few key ones to paint a picture of the East Sussex population.
East Sussex life course statistics 2023
Over half a million people live in East Sussex with 72% living in urban areas and 28% in rural settings. Over a quarter (26%) are aged 65 years or over, a much older age profile compared to England (18% aged 65 years and over). The older, ageing population has significant implications for the local health and care system now and in the future.
80% of the population report good (35%) or very good (45%) health and 6% of the population report bad (4%) or very bad (1%) health (compares to 82% good/very good and 5% bad/very bad for England), Census 2021.
Interim projections estimate a 3.6% population increase in East Sussex by 2027. The over 65 age group is growing faster than younger age groups, with just over half of the population expected to be aged 18-64 (53%) in 2027, and over a quarter (29%) aged 65 and over.
20% of the population have a disability which impacts on their day-to-day activities a little (12%) or a lot (8%). This compares to 10% limited a little and 7% limited a lot for England, Census 2021.
Gender identity refers to a person’s sense of their own gender, whether male, female or another category such as non-binary. This may or may not be the same as their sex registered at birth. East Sussex has a slightly lower proportion of people identifying with a sex different than their sex registered at birth (0.4) than England (0.5).
A slightly higher proportion of the East Sussex population identify as lesbian, gay or bisexual (3.3%) compared to England (3.2%).
Religion or belief
More people in East Sussex state they have no religion (45%) compared to England (37%). A similar proportion are Christian (46%).
East Sussex is less ethnically diverse when compared to England. In East Sussex, 12% of the population are people from ethnic minorities compared to 26% for England.
1 in 10 (10%) of the total East Sussex population aged 5 or above have unpaid caring responsibilities compared to 9% for England.
“Health inequalities are avoidable, unfair and systematic differences in health between different groups of people.” The King’s Fund (2020)
Health inequalities often exist as a result of inequalities in social, environmental and economical factors (explored further on the next page). They are often measured by comparing the health of those who live in the more deprived areas to those who live in the less deprived areas. NHS England have a national approach to inform action to reduce health inequalities, including a focus on the ‘Core20’ – people who live in the 20% most deprived areas in England. Overall 14% of the East Sussex population are in the Core 20, with higher concentrations in some areas.
Map of deprivation in East Sussex (2019)
(darker areas = more deprived)
© Crown copyright – all rights reserved. 100019601, 2023
Life expectancy (LE)
LE at birth is a common measure of health inequality. In East Sussex LE is higher than the England average (2018-2020), however, depending on where you live, some females in East Sussex can expect to live 10.1 years longer than others, and some males can expect to live 12.7 years longer than others (2016-2020).
How much time people spend in good health over the course of their lives (healthy life expectancy) is also a key measure of health inequality, given how crucial good health is to quality of life and people’s ability to do the things that they value (Kings Fund 2022). Within East Sussex, people in some of the least deprived areas can expect to spend more than 19 years longer in good health compared to those who live in the most deprived areas (2009-2013).
Wider determinants of health
“Health is closely linked to the conditions in which people are born, grow, live, work and age and inequities in power, money and resources – the social determinants of health”
The wider determinants of health, also known as social determinants, are a diverse range of social, environmental and economical factors that impact on an individual’s daily life, and therefore their health. Examples would include the quality of housing, levels of education and access to transport.
Inequalities in social determinants translate into inequalities in health outcomes that can persist throughout the life course. Within East Sussex the most deprived areas tend to have poorer housing, higher unemployment, lower levels of education, lower income and higher crime. Communities in these areas also have higher emergency admissions to hospital, more likely to have unhealthy lifestyles, spend more of their lives in poor health and die younger.
A good start in life
“Positive experiences early in life are closely associated with better performance at school, better social and emotional development, improved work outcomes, higher income and better lifelong health, including longer life expectancy”
Although children and young people in East Sussex report increasingly healthier behaviours, we see some clear differences in outcomes. The mental health of children and young people presents a clear public health concern, with 1 in 20 school pupils reporting regular self-harm (weekly) a rising trend of self-harm admissions. Persistent high levels of pupil absence compared to the region, mean many young people are not fulfilling their potential. Core health challenges remain relating to healthy weight and oral health, partly exacerbated during COVID.
A good start
It is incredibly important that adults are physically healthy and mentally well to maintain healthy, happy and productive lives.
Enabling people to establish and maintain healthy behaviours is crucial in helping to reduce the risk of poor physical and mental health and extend healthy life expectancy.
Smoking, low levels of physical activity, being overweight, drinking alcohol to excess and substance misuse are all factors that can influence health, but can be altered given the right help and support to do so.
Healthy behaviours are influenced by the environment in which we live and work, often referred to the ‘wider determinants of health’. These include secure employment, having enough money to eat well, good standards of housing and education, good transport links and access to green space.
Life expectancy has generally increased over time, so it is important that good health is maintained for as long as possible, to ensure people enjoy a happy and fulfilling retirement. Even though people are generally living longer, they can still live a substantial proportion of their life with a disability, or in poor health.
Healthy ageing is the process of optimising opportunities for physical, social and mental health to enable people to spend more years living in good health [adding life to years], to take an active part in society, and to enjoy an independent and good quality of life.
Ensuring people remain as healthy and as fit as possible as they age can delay the onset of frailty and dependency.
The needs and capabilities of people vary depending on their previous life experiences and exposure to risk and protective factors. Many risk factors are modifiable, presenting an opportunity for intervention and prevention in middle age. Apart from stopping smoking and avoiding alcohol abuse, these include the wider determinants of health as we age: ensuring financial security; availability of accessible housing, preventing falls, and loneliness.
A good end in life
End of Life Care
Nearly every person will require End of Life Care. It is the care given to a person in the last hours, days, months or years of their life.
Palliative care is an important part of end of life care, although there is a crucial difference between the two. Palliative care means the easing of suffering - the improvement of quality of life for patients and their families when someone has a complex or serious disease. Palliative care also has a large role to play when someone is not actively dying.
The true measures of what helps someone die a ‘good death’ are: whether they suffered, whether their death was anticipated, whether they died where they wanted to die, with those they love near them, with their spiritual/psychological needs met. These are things we don’t currently measure nationally, and admittedly might be difficult to measure.
(JSNAA Briefing End of Life, 2021)
There are over 6,600 deaths per year in East Sussex with numbers projected to increase due to a growing and ageing population.
A good end
East Sussex Health and Wellbeing Board Strategy
‘Healthy Lives, Healthy People 2022 - 2027’
The East Sussex Strategy sets out a shared vision and commitment to improve health and wellbeing and reduce inequality among our population. This requires an integrated approach with prevention and early intervention at its heart. The strategy highlights plans for integrated health and care services across the county, and shared work to improve the other factors that influence health such as access to good jobs, transport, housing and green space, and opportunities for lifelong learning, exercise, good nutrition and supportive networks and relationships between people and within communities.
Working towards a fully integrated health and care system by 2026 to ensure people receive high quality, coordinated care, enabling them to live good lives. This includes care and support that intervenes early, works with people’s strengths, and supports their resilience.
A shared, local approach
For most people, health, care and support needs will be met locally in the place they live. This strategy prioritises a collaborative East Sussex approach to ensure local access to: preventative services, digital and non-digital services which have the citizen at their heart, proactive support for those more vulnerable, and clear advice on staying well. Stronger links with public and voluntary services will also help to create better opportunities for everyone in our communities by allowing better access to local services and support.
Priorities for action
- To improve population health and wellbeing and reduce inequality
- To provide personalised, integrated health and care across services for children and young people, mental health, community, urgent care and planned care. Shared priorities have been developed for each of these key areas.
- To support personal and community resilience, through an overarching focus on prevention and early intervention
- To provide outstanding quality of care
- To provide affordable and sustainable cost of care