South Tyneside Joint Strategic Needs Assessment 2012 Data Annex Chapter 3: Child Health and Lifestyle South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 91 South Tyneside Joint Strategic Needs Assessment 2012 Data Annex Chapter 3 Child Health and Lifestyle This Annex brings together indicators of population, health, well-being, the wider determinants of health and usage of care and health services among the population of South Tyneside. Trends are considered over time and the values for local populations are compared to figures for local neighbours, similar populations in other parts of England, the NE and England as a whole. The data set has been put together jointly by South Tyneside Primary Care Trust and South Tyneside Council The Annex is divided into nine chapters: 1. Population 2. Social and Environmental Context 3. Child Health and Lifestyle 4. Life Expectancy, Mortality and Ill Health due to All Causes 5. Heart Disease, Stroke and Related Conditions 6. Cancer 7. Adult Health, Long Term Conditions other than Heart Disease and Cancer and Social Care 8. Adult Lifestyle 9. Public Voice Information in this Chapter on child health and lifestyles is grouped into four broad sections.  Infant, Child and Maternal Health  Children and Young People’s Lifestyles  Uptake of children’s services  Wider determinants of child health Wherever information is available at a geographical level below the Local Authority population as a whole, this is illustrated on maps of South Tyneside showing either wards or lower tier super output areas (a geography used within the 2001 Census). Each ward has an average population of around 10,000 and each lower tier super output area has an average population of around 1,500. The maps of variations in health and lifestyle for small areas are constructed so that poor health or less healthy lifestyle behaviours are shown as darker colours. The data set is designed to support Local Authorities, Clinical Commissioning Groups and Primary Care Trusts when undertaking Joint Strategic Needs Assessment. It will also be of use to a wide range of partner agencies in the public, third and commercial sectors and individuals who either provide or use local health and care services. The format of the data set has been agreed through consultation with health and social care specialists across the North East region and this process was facilitated by the North East Public Health Observatory. It also acknowledges the content suggested by the Association of Public Health Observatories in its report “The JSNA Core Dataset”. If you have any queries about the data in this annex please contact: Public Health Analyst, NHS South of Tyne and Wear, Pemberton House, Colima Avenue, Sunderland SR5 3XB Tel: 0191 529 7000 E-mail: andy.billett@sotw.nhs.uk South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 92 Contents Child Health and Lifestyles in South Tyneside in 2012 95 3. Child Health and Lifestyle 101 3.1. Infant, child and maternal health 101 3.1.1. Infant mortality rate 101 3.1.2. Low birthweight births 103 3.1.3. Teenage conception rates, under 18 and under 16 106 3.1.4. Teenage conception rates, ward rates by level of significance compared to England rate 109 3.1.5. Early identification of communities with high teenage conception rates 110 3.1.6. Proportion of mothers smoking at time of delivery 111 3.1.7. Breastfeeding - initiation 115 3.1.8. Breastfeeding – proportion of mothers continuing to breastfeed at the 6 to 8 week health check 121  3.1.9. Children killed or seriously injured in road traffic accidents 125 3.1.10. Rate of emergency admission to hospital among children under 5 years 127 3.1.11. Rate of emergency admission to hospital among children under 18 years 128 3.1.12. Rate of emergency admission to hospital due to intestinal infection among children and young people under 18 years 129 3.1.13. Rate of emergency admission to hospital due to influenza or pneumonia among children and young people under 16 years 130 3.1.14. Rate of emergency admission to hospital due to accidental injury among children under 5 years 131 3.1.15. Rate of emergency admission to hospital due to accidental injury among children and young people under 16 years 132 3.1.16. Mental health – rate of hospital admission due to self-harm among children and young people under 19 years 133 3.1.17. Oral health – average number of diseased, missing or filled teeth (DMFT) among 5 year olds 134 3.2. Children and young people’s lifestyles 136 3.2.1. Participation of children 5-16 years in PE and sport - SURVEY CEASED – SEPT 2010 136 3.2.2. Monitoring health-related behaviours among young people 138 3.2.3. Percentage of Year 10 boys (14 or 15 years of age) who self-report smoking . 139 3.2.4. Percentage of Year 10 girls (14 or 15 years of age) who self-report smoking 140 3.2.5. Percentage of Year 8 boys (12 or 13 years of age) who self-report smoking 141 3.2.6. Percentage of Year 8 girls (12 or 13 years of age) who self-report smoking 142 3.2.7. Percentage of Year 10 boys (14 or 15 years of age) who self-report having consumed alcohol in the past seven days 143 3.2.8. Percentage of Year 10 girls (14 or 15 years of age) who self-report having consumed alcohol in the past seven days 144 3.2.9. Percentage of Year 8 boys (12 or 13 years of age) who self-report having consumed alcohol in the past seven days 145  3.2.10. Percentage of Year 8 girls (12 or 13 years of age) who self-report having consumed alcohol in the past seven days 146 3.2.11. Percentage of Year 10 boys (14 or 15 years) who consumed 3 or more portions of fruit and vegetables yesterday 147 3.2.12. Percentage of Year 10 girls (14 or 15 years) who consumed 3 or more portions of fruit and vegetables yesterday 148 South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 93 3.2.13. Percentage of Year 8 boys (12 or 13 years) who consumed 3 or more portions of fruit and vegetables yesterday 149 3.2.14. Percentage of Year 8 girls (12 or 13 years) who consumed 3 or more portions of fruit and vegetables yesterday 150 3.2.15. Percentage of Year 10 boys (14 or 15 years of age) who had nothing for breakfast on the day of the survey 151 3.2.16. Percentage of Year 10 girls (14 or 15 years of age) who had nothing for breakfast on the day of the survey 152 3.2.17. Percentage of Year 8 boys (12 or 13 years of age) who had nothing for breakfast on the day of the survey 153 3.2.18. Percentage of Year 8 girls (12 or 13 years of age) who had nothing for breakfast on the day of the survey 154 3.2.19. % of Year 10 boys (14 or 15 yrs) who registered a ‘high’ self-esteem score in response to questions about wellbeing 155 3.2.20. % of Year 10 girls (14 or 15 years) who registered a ‘high’ self-esteem score in response to questions about wellbeing 156 3.2.21. % of Year 8 boys (12 or 13 years) who registered a ‘high’ self-esteem score in response to questions about wellbeing 157 3.2.22. % of Year 8 girls (12 or 13 years) who registered a ‘high’ self-esteem score in response to questions about wellbeing 158 3.2.23. Obesity among primary school age children in reception year 159 3.2.24. Obesity among primary school age children in year 6 164 3.3. Uptake of maternity and children’s services 168 3.3.1. Proportion of pregnant women who see a midwife by 12 weeks of gestation 168 3.3.2. Immunisation rates 169 3.3.2.1. Uptake of Diphtheria, Tetanus, Polio, Pertussis and Haemophilus influenzae B (DTaP/IPV/HiB) Immunisation at 12 Months 169 3.3.2.2. Uptake of Meningitis C (MenC) Immunisation at 12 Months 170 3.3.2.3. Uptake of Pneumococcal Conjugate Vaccination (PCV) at 12 Months 171 3.3.2.4. Uptake of Diphtheria, Tetanus, Polio, Pertussis and Haemophilus influenzae B (DTaP/IPV/HiB) Immunisation at 24 Months 172 3.3.2.5. Uptake of Meningitis C (MenC) Immunisation at 24 Months 173 3.3.2.6. Uptake of Measles, Mumps and Rubella (MMR) 1st Dose at 24 Months 174 3.3.2.7. Uptake of Haemophilus Influenzae B and Meningitis C (Hib/MenC) Immunisation at 24 Months 175 3.3.2.8. Uptake of Pneumococcal Conjugate Vaccination (PCV) at 24 Months 176 3.3.2.9. Uptake of Diphtheria, Tetanus and Polio Primary Immunisation at 5 Years 177 3.3.2.10.Uptake of Diphtheria, Tetanus, Polio and Pertussis (DTPP) Booster Immunisation at 5 Years 178  3.3.2.11.Uptake of Haemophilus Influenzae B Primary Immunisation at 5 Years 179 3.3.2.12.Uptake of Mumps, Measles and Rubella (MMR) Immunisation 1st dose at 5 Years 180 3.3.2.13.Uptake of Mumps, Measles and Rubella (MMR) Immunisation 1st and 2nd dose at 5 Years 181 3.3.2.14.Uptake of Human Papilloma Virus (HPV) Vaccination among Girls 12 or 13 Years 182 3.3.3. Immunisation rates by electoral ward 183 3.3.3.1. Uptake of Diphtheria, Tetanus, Polio, Pertussis and Haemophilus influenzae B (5 in 1) Immunisation at 12 Months – 2007/08 to 2008/09 183  3.3.3.2. Uptake of HIB Meningitis C (MenC) Immunisation at 24 Months – 2007/08 to 2008/09 184 3.3.3.3. Uptake of Measles, Mumps and Rubella (MMR) 1st Dose at 24 Months – 2007/08 to 2008/09 185 South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 94 3.3.3.4. Uptake of Diphtheria, Tetanus, Polio and Pertussis (DTPP or 4 in 1) Booster Immunisation at 5 Years – 2007/08 to 2008/09 186 3.3.3.5. Uptake of Mumps, Measles and Rubella (MMR) Immunisation 1st and 2nd dose at 5 Years – 2007/08 to 2008/09 187 3.3.3.6. Uptake of selected immunisations by South Tyneside ward – 2007/08 to 2008/09 188 3.3.3.7. Percentage uptake of selected immunisations by South Tyneside ward – 2007/08 to 2008/09 189 3.3.4. Uptake of chlamydia screening programme 190 3.3.5. Percentage of looked after children who have received an annual health check192 3.3.6. Percentage of looked after children who have received an annual dental check by a dentist 193 3.3.7. Percentage of looked after children whose immunisations were up to date 194 3.3.8. School meals 195 3.3.8.1. Proportion of children in nursery and primary schools eligible for free school meals 195 3.3.8.2. Proportion of children in secondary schools eligible for free school meals 196 3.3.8.3. Proportion of children in nursery and primary schools eligible for free school meals who take them up 197 3.3.8.4. Proportion of children in secondary schools eligible for free school meals who take them up 198 3.3.8.5. Proportion of all children in primary schools that take up school meals 199 3.3.8.6. Proportion of all children in secondary schools that take up school meals 200 3.3.9. Care leavers in suitable accommodation 201 3.3.10. Care leavers in employment, education or training 202 3.3.11. Young offenders’ access to suitable accommodation 203 3.3.12. Young offenders’ engagement in suitable education, training and employment 204 3.4. Wider determinants of child health 205 3.4.1. Children under 16 in households dependent upon Income Support 205 3.4.2. Educational attainment – proportion of school children at Key Stage 4 achieving 5 or more GCSEs at grades A*-C including English and maths 206 3.4.3. Educational qualifications of looked after children 210 3.4.4. Proportion of working age population by highest qualification 213 3.4.5. Ethnic composition of offenders on the Youth Justice System disposals and rates of youth offending 215 South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 95 Child Health and Lifestyles in South Tyneside in 2012 Improving child health, whether by improving the standard of care and health services, or supporting families and children to adopt healthier lifestyles, is an investment in the future. Children picking up healthy lifestyle habits in their early and teenage years are more likely to take these into adult life. Reducing the proportion of young people who smoke, for example, will help to increase life expectancy over the next forty years, and so begin to close the two year gap in life expectancy which persists between South Tyneside and England. Source: 2012 Child Health Profile, Child and Maternal Health Observatory, Association of Public Health Observatories A good overview of child health is provided by the Child Health Profile for South Tyneside published by the Child and Maternal Health Observatory. The red dots on the spine chart reproduced above highlight those areas where health, health outcomes or lifestyles are South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 96 significantly poorer than the national average. The profile highlights that the proportion of mothers that initiate breastfeeding is very low as is the proportion of children in care that have been immunised. The rate of teenage mothers and the proportion of women that continue to smoke during pregnancy are both very high. However, both uptake of childhood immunisations and participation in sport are significantly higher than the national average. Below are some headlines from among the many indicators of child health and lifestyle in South Tyneside monitored in this volume. Health Status Infant mortality The mortality rate among infants (under one year of age) living in South Tyneside is, currently, lower than the England average rate but the difference is not statistically significant. The rate has fallen over the past five years. The number of infant deaths is, thankfully, small. There is currently an average of six infant deaths each year in South Tyneside among 1,700 births. Because the number of deaths is small, any year to year variation in the rate may be due to random or ‘chance’ variations. There is a confidential enquiry into all perinatal deaths (stillbirths or deaths within the first week of life) carried out by a panel of specialists in the Northern region and this feeds its findings into a national enquiry system. Thus there is learning from episodes of infant mortality at both a local and a national level. A detailed analysis of trends in infant mortality across the North East region can be found in the Annual Report of the Regional Maternity Survey Office 1 , which is part of the North East Public Health Observatory. Low birthweight births In 2010 there were 110 low birthweight births (<2,500g) within the population of South Tyneside. This represents 6.5% of all births. The proportion of low birthweight births is lower than the average proportion across the North East (7.6%) and England (7.3%) but the differences are not statistically significant. Low birth weight is closely associated with poor health outcomes both in infancy and later life 2 . Risk factors include poor nutrition 3 and smoking during pregnancy 4 . Reducing the number of women who smoke during pregnancy and improving diet among pregnant women will contribute towards reducing the number of low birthweight births over time. 1 Regional Maternity Survey Office (2011) “RMSO Annual Report 2010” available to download at http://www.nepho.org.uk/rmso/ (last accessed 1 st March 2011) 2 World Health Organisation (2004) “Low birthweight: country, regional and global estimates”, WHO, Geneva 3 ibid. 4 Smokefree (2008) “NHS Smokefree factsheet: Risks of smoking during pregnancy” available to download at smokefree.nhs.uk (last accessed 1 st March 2011) South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 97 Teenage pregnancy The teenage pregnancy rate in South Tyneside fluctuates considerably from one year to the next but has followed a downward trend since1998. The rate is currently below the North East average but above the England average. It is 40% lower than the South Tyneside rate in 1998. In 2010 there were 110 conceptions in South Tyneside among young women under 18 years of age. Because the number is relatively small (around 4% of the total number of young women 15 to 17 years of age in South Tyneside), it fluctuates from year to year due to random factors. Between 2008 and 2010 rates of teenage conceptions were significantly higher than the average rate across England in Bede, Hebburn North, ‘Simonside and Rekendyke’.and Whiteleas wards. Smoking during pregnancy The proportion of mothers smoking throughout pregnancy has been falling in recent years but remains significantly higher in South Tyneside (24%) when compared to the North East (21%) and England (13%) – the smoking during pregnancy rate in South Tyneside is one of the highest among all North East and ‘Industrial Hinterlands’ PCT populations. Rates are highest in the ‘Biddick and All Saints’, Primrose and ‘Simonside and Rekendyke’ wards. Breastfeeding There has been an upward trend in the proportion of mothers initiating breastfeeding in the first 48 hours after birth in South Tyneside but the gap between breastfeeding rates in South Tyneside and England is not closing – Breastfeeding is beneficial for the health of both baby and mother. The proportion starting to breastfeed soon after birth has risen slowly over the past five years. Over half (55%) of mothers now start breastfeeding within 2 days of delivery. However, there is still a significant gap between the proportion of mums in South Tyneside (55%) and the average proportion of mums across England (74%) who start breastfeeding within 48 hours. National research has shown that young mothers from socially and economically more disadvantaged communities are least likely to start breastfeeding 5 . In South Tyneside, the proportion of mums starting breastfeeding soon after birth is lowest in the wards of Bede, ‘Fellgate and Hedworth’ and ‘Biddick and All Saints’. Maintaining breastfeeding into the first six months of life is also beneficial to the infant’s health. Only 23% of mothers in South Tyneside are still breastfeeding at the six to eight week infant health check compared to an average of 48% across England and the proportion in South Tyneside has fallen over the past three years. 5 NHS Information Centre (2011) “Infant Feeding Survey 2010: Early Results” p5, NHS Information Centre, Leeds, available at http://www.ic.nhs.uk/webfiles/publications/003_Health_Lifestyles/IFS_2010_early_results/Infant_Feeding_Survey_ 2010_headline_report2.pdf (last accessed 6th August 2012) South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 98 Road traffic accidents and accidental injury The number of children killed or seriously injured in road traffic accidents in South Tyneside has fallen since the 1990’s – Between 1994 and 1998 an average of 16 children living in South Tyneside were killed or seriously injured in road traffic accidents each year. Between 2008 and 2010 the annual average was 10. The rates of emergency hospital admissions among 0-4 year olds and 0-15 year olds due to all accidentally injury among children in South Tyneside are below NE average rates but similar to average rates of hospital admission across England. Child lifestyle South Tyneside children keep active but a higher proportion smoke compared to England as a whole and over 40% of 15 year olds drink alcohol - The 2009/10 national PE and Sports Survey showed that 73% of children 5-16 years in South Tyneside did at least three hours of PE or sport each week which higher than the England average of 57%. The last survey of children’s lifestyles in South Tyneside was carried out in 2006. At this time the proportion of Year 10 girls (14 or 15 years of age) that smoked (27%) was significantly higher than the average across England (20%). It was also higher than the proportion of Year 10 boys in South Tyneside that smoked (12%). The proportion of Year 10 boys and girls that had consumed alcohol were not significantly different to England averages, but at 44% and 42% respectively, the figures are concerning. This issue becomes more important when viewed in the light of high local rates of alcohol-related hospital admissions among adults. The proportion of both year 8 and year 10 girls in South Tyneside that registered a high self- esteem score in response to a series of questions about emotional wellbeing were significantly lower than the respective England averages. Childhood obesity Over 20% of 10 and 11 year olds in South Tyneside are obese and the proportion appears to be rising slowly over time - Across England there was a constant rise throughout the 1990’s and 2000’s in the proportion of children who are obese 6 . Since 2005, all children in Reception Year and Year 6 across England have been measured and weighed each year, to more accurately track changes in the proportion of children that are overweight or obese. Between 2007 and 2011 there has been a rising trend in the proportion of children in Year 6 (10 and 11 year olds) in South Tyneside that are obese but the trend among Reception Year children (4 and 5 year olds) has been level. In 2010/11 10% of South Tyneside children in Reception Year and 22% in Year 6 were obese. The proportion that was obese in Year 6 was significantly higher than the England average of 19%. 6 NHS Information Centre (2011) “Health Survey for England 2010: Adult Trend Tables” available at http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/health-survey-for- england/health-survey-for-england 2010-trend-tables [...]... Dec 2012 South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 101 Infant mortality rate (cont.) Source: NHS Information Centre at http://indicators.ic.nhs.uk Source: NHS Information Centre at http://indicators.ic.nhs.uk South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 102 3.1.2 Low birthweight births Gateshead Gateshead S Tyneside S Tyneside. .. a whole Statistics for 2012/ 13 will be published in July 2013 South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 115 Breastfeeding – initiation (cont.) Source: Department of Health South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 116 Breastfeeding – initiation (cont.) Patterns of breastfeeding behaviour in South Tyneside  The proportion... as a whole at 95% level of confidence South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 111 Proportion of mothers smoking at time of delivery South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 112 Proportion of mothers smoking at time of delivery (cont.) Proportion of mothers giving birth in South Tyneside recorded as continuing to smoke... as a whole Statistics for 2011/12 will be published in June 2012 South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 121 Breastfeeding – proportion of mothers continuing to breastfeed at the 6 to 8 week health check (cont.) Source: Department of Health South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 122 Breastfeeding – proportion of mothers... South Tyneside Healthcare 2573 29 All South Tyneside resident maternities (source Vital Signs data collection) 3331 27 Source: NHS South of Tyne and Wear based on data provided by South Tyneside Healthcare NHS Foundation Trust * H = significantly higher than South Tyneside average at 95% confidence, L = significantly lower, - = not significantly different South Tyneside 2012 Joint Strategic Needs Assessment. .. number of maternities, NHS South of Tyne and Wear based on data provided by South Tyneside NHS Foundation Trust; NHS Stop Smoking Specialist Adviser Clinics, South Tyneside NHS Foundation Trust South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 113 Proportion of mothers smoking at time of delivery (cont.) Proportion of mothers giving birth in South Tyneside recorded as continuing... of Tyne and Wear, Business Information based on data provided by South Tyneside Healthcare NHS Foundation Trust 2010/11 data will be available in September 2011 South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 119 Breastfeeding – initiation (cont.) Proportion of mothers initiating and continuing breastfeeding by South Tyneside ward % initiating who don't continue to... at 95% confidence, L = significantly lower, - = not significantly different Source: NHS South of Tyne and Wear, Information Services based on data provided by South Tyneside Healthcare NHS Foundation Trust 2010/11 data will be available in September 2011 South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 120 3.1.8 Breastfeeding – proportion of mothers continuing to breastfeed... at 95% confidence, L = significantly lower, - = not significantly different Source: NHS South of Tyne and Wear, Business Information based on data provided by South Tyneside Healthcare NHS Foundation Trust 2010/11 data will be available in September 2011 South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 124 ... among the South Tyneside population, 2007 to 2008 PCT estimates 168 Dept of Health statistics 164 2007 148 Year 145 2008 Source: PCT estimates, Business Information, NHS South of Tyne and Wear; Dept of Health statistics, Department of Health South Tyneside 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd - 110 - 3.1.6 Proportion of mothers smoking at time of delivery Source of data: Department . South Tyneside Joint Strategic Needs Assessment 2012 Data Annex Chapter 3: Child Health and Lifestyle South Tyneside 2012 Joint Strategic Needs. 2012 Joint Strategic Needs Assessment – Data Annex – Version 2 QAd 91 South Tyneside Joint Strategic Needs Assessment 2012 Data Annex Chapter 3 Child