THE POPULATION OF SOUTH YORKSHIRE AND BASSETLAW South

THE POPULATION OF SOUTH YORKSHIRE AND BASSETLAW South Yorkshire and Bassetlaw has a resident population of 1. 52 million. 353, 000 people (23. 3%) are aged between 0 – 19 years and 125, 200 (8. 3%) aged 75 or over. This is a very similar age profile to the English average of 23. 6% 0 – 19 s and 8. 3% 75 and over. Barnsley 2018 Population Total 245, 500 Aged 0 – 19 yrs 22. 6% Aged ≥ 75 yrs 8. 4% % pop ↑ by 2038 Total 6. 4% Aged 0 - 19 yrs 1. 8% Aged ≥ 75 yrs 71% BME 2. 1% (2011) IMD rank 39 (2015) LSOA in most deprived decile nationally 22% Children in low income families 21. 6% The ONS mid year population projections predict that, compared to 2018, by 2038 the SYB population will: – Increase by 6. 4% (96, 600 people). This is less than the English average of 9. 6%. The increase will be greatest in Sheffield (9. 5%) and least in Doncaster (2. 5%). – Have a slightly lower proportion of 0 – 19 year olds (22. 2% compared to 23. 6%). – Have a 57. 3% increase in the 75 s and overs. This is an extra 71, 700 people compared to 2018. The increase in 75 s and overs varies greatly across SYB, from a 44. 7% increase in Sheffield to 72. 7% increase in Bassetlaw. These predictions do not take into account major new housing developments, such as those planned in Bassetlaw. Sheffield 2018 Population At the time of the 2011 census, 8. 9% of the SYB population were from a black or minority ethnic group, which is lower than the English average of 14. 6%. Sheffield has the greatest BME population in SYB at 16. 3%. There is also a significant Eastern European population and Gypsy and Traveller population. South Yorkshire is a relatively deprived area. Barnsley is ranked the 39 th most deprived local authority district in England out of 326, Doncaster 42 nd, Rotherham 52 nd and Sheffield 60 th most deprived. Bassetlaw is less deprived, ranked 114. 34% of LSOAs in SYB are in the 20% most derived LSOAs in the country. All places in SYB (except Bassetlaw) have a higher % of children living in a low income family compared to the English average (SYB ave 21. 8%, Eng 17%). Index of deprivation LSOA s 2015 (population by quintile) Total 581, 900 Aged 0 – 19 yrs 23. 7% Aged ≥ 75 yrs 7. 7% Population ↑ by 2038 Total 9. 5% Aged 0 - 19 yrs 6. 5% Aged ≥ 75 yrs 44. 7% BME 16. 3% (2011) IMD rank 60 LSOA in most deprived decile nationally 23% Children in low income families 23. 1% (2016) Doncaster 2018 Population Total 308, 700 Aged 0 -19 yrs 23. 3% Aged ≥ 75 yrs 8. 4% % pop ↑ by 2038 Total 2. 5% Aged 0 - 19 yrs -4. 6% Aged ≥ 75 yrs 61. 4% BME 4. 7% (2011) IMD rank 42 (2015) LSOA in most deprived decile nationally 21% Children in low income families 22. 0% Rotherham 2018 Population Total 263, 800 Aged 0 – 19 yrs 23. 7% Aged ≥ 75 yrs % Population ↑ by 2038 Total 4. 7% Aged 0 - 19 yrs -0. 3% Aged ≥ 75 yrs 44. 7% BME 6. 4% (2011) IMD rank 52 (2015) LSOA in most deprived decile nationally 19% Children in low income families 21. 5% Bassetlaw 2018 Population Total 115, 900 Aged 0 – 19 yrs 21. 7% Aged ≥ 75 yrs 9. 5%% % Population ↑ by 2038 Total 4. 7% Aged 0 - 19 yrs -0. 5% Aged ≥ 75 yrs 72. 7% BME 2. 6% (2011) IMD rank 114 (2015) LSOA in most deprived decile nationally 9% Children in low income families 15. 8% 1

HEALTH CHALLENGES AND HEALTH INEQUALITIES IN SOUTH YORKSHIRE AND BASSETLAW Our health is determined by our genetics, our lifestyle, the health care we receive and the impact of wider determinants such as our physical, social and economic environment including, for example, education and employment. Health inequalities are avoidable and unfair differences in health between groups of people or communities. A ‘best start in life’ is key for good health throughout life and to decrease inequalities. Although progress is being made in some areas, SYB still has: • High smoking rates at time of delivery • Low rates of breast feeding • High rates of childhood obesity • High rates of dental carries in children • High under 18 conception rate • High rates of children living in low income families • Insufficient uptake of some immunisations in some communities • Rotherham & Doncaster have higher than national average rates of children in care. As seen across England, children and young people’s mental health is of concern in SYB. At the time of the 2011 census about 1% of children in SYB under 16 and 5% of those ages 16 to 24 were providing care for someone. In line with the national picture, improvements in life expectancy in SYB are stalling and inequalities in health persist between SYB and the English average. All five places in SYB have a significantly lower life expectancy at birth in men and women than the national average (SYB average of 1. 1 years less for both men and women). Greater inequalities in life expectancy at birth exist within South Yorkshire : • For men - a difference of 12. 4 yrs between the most deprived decile in Rotherham (72. 5 yrs) and the least deprived decile in Sheffield (84 yrs). • For women – a difference of 9. 6 yrs between the most deprived decile in Barnsley (78. 1 yrs) and the least deprived in Sheffield (87. 7 yrs). (Data not available for Bassetlaw). The greatest contributors to our gap in life expectancy compared to England are deaths from: • Cancer – all five places have higher under 75 cancer mortality rates • Circulatory disease – all places (except Bassetlaw) have higher under 75 CVD mortality rates • Respiratory disease – Barnsley, Doncaster & Rotherham have higher under 75 respiratory mortality In men external causes also make a substantial contribution. We have too many deaths in early adulthood from suicide, drug related death and violence. These areas are also key drivers of health and social care utilisation. While there has been an overall decrease in the under 75 mortality rates for CVD and cancer over the last 15 years, there has been a less clear decrease in the under 75 mortality rate from respiratory disease and the mortality rate from liver disease (included within digestive diseases) is increasing. Neurological diseases are our third biggest cause of death overall. This includes deaths from Alzheimer’s disease, which is now the commonest individual disease causing death in women and fourth commonest in men in Y&H. In the 2011 Census more people in SYB reported : - Having a long term health problem or disability than the national average (21% SYB, 17. 6% Eng). - Being an unpaid carers – with 3% of the total population providing over 50 hours of care a week. Carers are twice as likely to suffer from poor health compared to the general population. 2

HEALTH CHALLENGES AND HEALTH INEQUALITIES IN SOUTH YORKSHIRE AND BASSETLAW Cont. When we consider the main conditions that lead to disability (rather than death) musculoskeletal disorders and mental ill health come top, followed by neurological disorders and chronic respiratory disease. Healthy life expectancy is lower in all SYB places compared to the national average, meaning that people living in SYB are on average living fewer years in good health. Many people are living with multiple long term conditions. A Scottish study in 2012 found that: • 43% of all people have one or more morbidities, and 23% have more than one long term condition. • The presence of a mental health disorder increases as the number of physical morbidities increases • The absolute number of people with multi-morbidity is higher in those younger than 65 • Onset of multi morbidity occurs 10– 15 years earlier in people living in the most deprived areas compared with the most affluent, with socioeconomic deprivation particularly associated with multi-morbidity that includes mental health disorders. Much of this burden of illness can be prevented or delayed. But SYB still has high levels of the common causes of disability & death, including high rates of smoking, obesity, physical inactivity & hospital admissions due to alcohol. We also have: • Many people with undiagnosed or sub-optimally managed hypertension, dyslipidamia, non-diabetic hyperglycaemia and diabetes. But we are close to the national ambitions for atrial fibrillation. • Worse health related elderly quality of life; high admissions from falls in some places; have made little impact on excess winter deaths; increasing numbers of people living with dementia. While we have higher than national uptake rates for breast, cervical and bowel cancer screening, there are still people that don’t get the benefits. Healthy Life Expectancy at Birth, 2015/17 Source: PHE Fingertips HI Dashboard Male Female England Barnsley Doncaster Rotherham Sheffield Nottinghamshire 63. 4 59. 7 61. 8 59. 3 62. 5 65. 2 63. 8 61 61. 1 57. 4 60. 1 62. 7 As elsewhere in the country we are increasingly aware of the health impacts of social isolation & loneliness. Based on national estimates, 25% of SYB have a mental health condition. Compared to the English average, there is : • Higher QOF recorded prevalence of depression in adults & self reported prevalence of long term mental illness • Higher Incidence of new cases of psychosis • Higher rates of suicide particularly in Rotherham which has seen a recent raise in suicide rate Mortality Yrs Lived with Disability Rank of the Top Risk Factors Yorkshire & Humber, Persons, 2017 Source: Global Burden of Disease Mortality Yrs Lived with Disability Rank of Causes of Death & Yrs Lived with Disability Yorkshire & Humber, Persons, 2017 Source: Global Burden of Disease 3

HEALTH CHALLENGES & HEALTH INEQUALITIES IN SOUTH YORKSHIRE AND BASSETLAW Cont. People with severe mental illness in SYB are 3. 5 to 4 times more likely than the general population to die under the age of 75 – commonly 15 – 20 years earlier than the general population. People with a learning disability also have worse physical & mental health. The national average of death for people with a learning disability is 65 for men & 63 for women – 18 years younger than the general population for women & 14 years younger for men. People with learning disabilities are more likely to die from causes of death that are amenable to health care. Less than 50% of people with a learning disability in SYB are having a health check with their GP each year. Many people in contact with the criminal justice system experience multiple & complex needs –such as poor physical health, substance misuse, mental ill health & housing problems, unemployment, poverty & debt, alongside offending behaviour. Military veteran’s can suffer from a range of mental health difficulties, such as anxiety & depression, as well as problems related to alcohol. Veterans who were deployed when serving, have higher rates of Post Traumatic Stress Disorder, up to 17% for those who deployed in a front-line infantry combat role. A small number of armed Forces personnel have complex and enduring physical, neurological & mental health conditions that are attributable to injury whilst in Service. The wider determinants of health are the social, economic and environmental factors which have the greatest impact on a person’s health. These wider determinants of health across the whole life course (from pre-birth to death) drive much of the gap in healthy life expectancy. Education • • • School readiness is increasing across SYB & is similar to the national average except in Sheffield, which is slightly worse. School readiness is about 10% points fewer in children having free schools meals Fewer children in SYB achieve average attainment 8 score. Children in care about half as likely as their peers to reach this level of attainment About 6% of 16 -17 year olds in SYB are not in education, employment or training (NEET) – similar to the national average Employment • • Fewer people in Barnsley & Sheffield aged 16 – 64 are in employment than the national average. All places , except Bassetlaw, have significantly higher rates of long term unemployment. Unemployment rates are higher in those with long term health conditions - 10 – 12% points higher than the general population in Barnsley, Sheffield & Rotherham but nearly double that in Bassetlaw (21. 3%) & also higher in Doncaster (14. 6%) (Eng ave 11. 5%) High claim rates for Employment Support Allowance (ESA) are seen across SYB Many of those living in poverty are in work. Deprivation & Income • • • There are high levels of deprivation across SYB People living in SY have a median income of nearly £ 3, 000 / yr less than the national average All Places, except Bassetlaw, have higher than national rates of children living in low income families. Built and Natural Environment • • • Areas of poor quality private sector housing (owned & private rental) About 30% of adults in contact with secondary mental health services & 20% of adults with learning disabilities in SYB do not who live in stable and appropriate accommodation Air pollution is estimated to cause between 4. 4% and 4. 9% of all deaths in SYB Places (Global Burden of Disease study). Sheffield and Rotherham contain locations where the annual average concentrations of Nitrogen Dioxide (NO₂) exceed statutory limits Access to transport is limited in some SYB places, especially in rural locations High numbers of fast food takeaways Social Capital and Community Safety • • The numbers of people utilising outdoor space for exercise/health reasons in the last 7 days has been increasing but still only ranges from 14 – 19% across the SYB places Cohesive communities and good social links support mental health and resilience, but the percentage of those who have as much social contact as they would like is 40 – 49% for adult social care users and 28 – 43% for adult carers Violent crime rates have been increasing in all five places in SYB and are higher than the national average in all places except Sheffield (2017/18). Hospital admissions due to violent crime are nearly twice the national average in Barnsley and Doncaster, Sheffield also has significantly higher admission rates than the national average. 4

Overview of Health in South Yorkshire and Bassetlaw Robert Barker Trainee Analyst, South Yorkshire and Bassetlaw ICS

This slide deck summarises key health data for the five places in South Yorkshire and Bassetlaw. The data has mostly been drawn from Public Health England’s Fingertips web portal. If you cut and past the URL in the notes section under each slide, it will take you to a bespoke SYB dashboard within fingertips. You will then be able to click on tabs that enable you to see trends over time, spine charts etc for those indictors. A summary of all the URLs is given on the next page.

Description URL ONS Population projections for local authorities https: //www. ons. gov. uk/peoplepopulationandcommunity/populationandmigration/populationprojections/datasets/localauthoriti esinenglandtable 2 Mortality https: //fingertips. phe. org. uk/indicator-list/view/k 2 y. DC 1 zny. U#page/0/gid/1/pat/30000/par/al-qiih 4 CX 7 z 0/ati/154/are/E 38000006 Demographics https: //fingertips. phe. org. uk/indicator-list/view/h. Ta. Sdzt. XTE#page/0/gid/1/pat/30000/par/al-nooz. UPgrq 0/ati/101/are/E 07000171 Work and Education https: //fingertips. phe. org. uk/indicator-list/view/Bzo 62 w. X 9 Eu#page/0/gid/1/pat/30000/ati/101/are/E 06000015 Wider Determinants of Health https: //fingertips. phe. org. uk/indicator-list/view/MBQEu. J 9 E 0 m#page/0/gid/1/pat/30000/par/alnooz. UPgrq 0/ati/101/are/E 08000019 Life Style https: //fingertips. phe. org. uk/indicator-list/view/Dfl. BBCUYAE#page/0/gid/1/pat/30000/ati/101/are/E 06000015 Drugs and Lifestyle https: //fingertips. phe. org. uk/indicator-list/view/us. HOz. Cb. Ax. E#page/0/gid/1/pat/30000/ati/202/are/E 06000015 Sexual and Reproductive Health https: //fingertips. phe. org. uk/indicator-list/view/Psd. Iscx. Iv. U#page/0/gid/1/pat/30000/par/al-nooz. UPgrq 0/ati/101/are/E 08000019 Best Start in Life https: //fingertips. phe. org. uk/indicator-list/view/7 Zeigts. AEU#page/0/gid/1/pat/30000/par/al-nooz. UPgrq 0/ati/101/are/E 08000019 Mental Health in Young People https: //fingertips. phe. org. uk/indicator-list/view/GHKVltt. Yd 0#page/0/gid/1/pat/30000/ati/202/are/E 06000015 Adult Mental Health https: //fingertips. phe. org. uk/indicator-list/view/lj. FCbqt. Ok. S#page/0/gid/1/pat/30000/par/al-qiih 4 CX 7 z 0/ati/154/are/E 38000006 Long Term Conditions https: //fingertips. phe. org. uk/indicator-list/view/B 4 c. N 2 Uk 1 v 0#page/0/gid/1/pat/30000/par/al-qiih 4 CX 7 z 0/ati/154/are/E 38000006

ONS Population Projections for South Yorkshire and Bassetlaw, 2018 – 2038 SYB Barnsley Bassetlaw Doncaster Rotherham Sheffield England 2018 Total population (000 s) 0 - 19 yrs (000 s) % 0 – 19 yrs ≥ 75 yrs (000 s) % ≥ 75 1, 515. 8 245. 5 115. 9 308. 7 263. 8 581. 9 55, 997. 7 353. 0 55. 5 25. 1 72. 0 62. 4 138. 0 13, 239. 8 23. 3 22. 6 21. 7 23. 3 23. 7 23. 6 125. 2 20. 7 11. 0 25. 9 22. 9 44. 7 4, 645. 1 8. 3 8. 4 9. 5 8. 4 8. 7 7. 7 8. 3 2028 Total population (000 s) 0 - 19 yrs (000 s) % 0 – 19 yrs ≥ 75 yrs (000 s) % ≥ 75 1, 576. 7 261. 1 119. 3 313. 8 271. 1 611. 4 59, 043. 5 365. 0 58. 3 25. 6 71. 6 63. 8 145. 7 13, 889. 4 23. 1 22. 3 21. 5 22. 8 23. 5 23. 8 23. 5 161. 9 28. 0 15. 4 33. 8 30. 2 54. 5 6, 204. 9 10. 3 10. 7 12. 9 10. 8 11. 1 8. 9 10. 5 Difference 2028 to 2018 Total population (000 s) 60. 9 15. 6 3. 4 5. 1 7. 3 29. 5 3, 045. 8 4. 0 6. 4 2. 9 1. 7 2. 8 5. 1 5. 4 12. 0 2. 8 0. 5 -0. 4 1. 4 7. 7 649. 6 3. 4 5. 0 2. 0 -0. 6 2. 2 5. 6 4. 9 ≥ 75 yrs (000 s) 36. 7 7. 3 4. 4 7. 9 7. 3 9. 8 1, 559. 8 % Increase in ≥ 75 yrs 29. 3 35. 3 40. 0 30. 5 31. 9 21. 9 33. 6 % Increase Total pop 0 - 19 yrs (000 s) % Increase 0 – 19 yrs

ONS Population Projections for South Yorkshire and Bassetlaw, 2018 – 2038, cont. SYB Barnsley Bassetlaw Doncaster Rotherham Sheffield England 2038 Total population (000 s) 1, 612. 4 261. 1 121. 4 316. 5 276. 3 637. 1 61, 326. 4 0 - 19 yrs (000 s) 358. 5 57. 3 24. 6 67. 4 62. 2 147. 0 13, 630. 2 22. 2 21. 9 20. 3 21. 3 22. 5 23. 1 22. 2 196. 9 35. 4 19. 0 41. 8 36. 0 64. 7 7, 680. 3 12. 2 13. 6 15. 7 13. 2 13. 0 10. 2 12. 5 % 0 - 19 ≥ 75 yrs (000 s) % ≥ 75 Difference 2038 to 2018 Total population (000 s) 96. 6 15. 6 5. 5 7. 8 12. 5 55. 2 5, 328. 7 % Increase Total pop 6. 4 4. 7 2. 5 4. 7 9. 5 0 - 19 yrs (000 s) 5. 5 1. 8 -0. 5 -4. 6 -0. 2 9. 0 390. 4 % Increase 0 - 19 1. 6 3. 2 -2. 0 -6. 4 -0. 3 6. 5 2. 9 ≥ 75 yrs (000 s) 71. 7 14. 7 8. 0 15. 9 13. 1 20. 0 3, 035. 2 % Increase in ≥ 75 yrs 57. 3 71. 0 72. 7 61. 4 57. 2 44. 7 65. 3

Total Population Projection

Population Demographic Prediction

Predicted Population Percentage Change for SYB, 2018 to 2028

Predicted Population Percentage Change, SYB age >50, 2018 to 2028

What LE and HLE for men and women is What is the gap to England Is that overall gap getting bigger or smaller What diseases make up the gap between England each place for SYB What diseases make up the gap within each place by deprivation

Mortality Data for SYB

Demographics and Deprivation for SYB

Work and Education for SYB

Wider determinants for SYB

Lifestyle for SYB

Drugs and Alcohol Treatment for SYB

Sexual and Reproductive Health for SYB

Best Start in Life for SYB

Mental Health in Children and Young People for SYB

Mental Health in Adults for SYB

Long Term Conditions for SYB

Difference in Life Expectancy at Birth between Most and Least Deprived Deciles within Each Place in SYB, 2011/13 and 2015/17 Source: PHE fingertips Health Inequalities Dashboard Male Female 2011/13 2015/17 Change 2011/13 2015/17 England 9. 0 9. 4 0. 4 Barnsley 8. 1 9. 4 1. 3 Doncaster 9. 6 9. 8 Rotherham 9. 2 Sheffield Bassetlaw Change 6. 9 7. 4 0. 5 6. 5 9. 2 2. 7 0. 2 7. 4 7. 8 0. 4 10. 8 1. 6 7. 0 8. 4 10. 0 9. 3 - 0. 7 7. 2 8. 3 1. 1 5. 1 10. 3 5. 2 8. 0 8. 2 0. 2

Range in Life Expectancy at Birth between the Most and Least Deprived Decile of LSOA in South Yorkshire, 2015 -17 Source: PHE Health Inequality Dashboard Male Barnsley Doncaster Rotherham Sheffield SYB Female Barnsley Doncaster Most deprived decile Yrs 75. 8 71. 6 72. 5 74. 5 78. 1 78. 2 Least deprived decile Yrs 81. 9 82. 1 81. 7 84 87. 2 84. 8 Range Yrs 6. 1 10. 5 9. 2 9. 5 12. 4 9. 1 6. 6 Rotherham Sheffield SYB 81* 79. 1 85. 3 87. 7 -4. 3 8. 6 9. 6 *Lowest LE in Rotherham females was in the 5 th least deprived decile

Healthy Life Expectancy at Birth, 2011/13 and 2015/17 Source: PHE fingertips Health Inequalities Dashboard Years Male Female 2011/13 2015/17 Change 2011/13 2015/17 England 63. 2 63. 4 0. 2 Barnsley 55. 9 59. 7 3. 8 Doncaster 58. 4 61. 8 Rotherham 57. 3 Sheffield Nottinghamshire Change 63. 8 0. 0 56 61 5. 0 3. 4 58. 0 61. 1 3. 1 59. 3 2. 0 59. 3 57. 4 -1. 9 60. 3 62. 5 2. 2 59. 4 60. 1 0. 7 64. 4 65. 2 0. 8 63. 8 62. 7 -1. 1

Causes of Death, Source: Global burden of Disease Breakdown by LA and sex is available at https: //vizhub. healthdata. org/gbd-compare/ 29

Years Lived with Disability Source: Global Burden of Disease Break down by LA and Sex is available at https: //vizhub. healthdata. org/gbd-compare/ 30

Rank of Main Causes of Death, 1997 and 2017, combined sex Source: Global Burden of Disease Breakdown by LA and sex is available at https: //vizhub. healthdata. org/gbd-compare 31

Rank of Main Causes of Death, 1997 and 2017, Female, by Individual Diseases Source: Global Burden of Disease Breakdown by LA is available at https: //vizhub. healthdata. org/gbd-compare 32

Rank of main causes of death, 1997 and 2017, Female, by individual disease Source: Global Burden of Disease Breakdown by LA and sex is available at https: //vizhub. healthdata. org/gbd-compare 33

Rank of the Main Causes of Years Lived with Disability 1997 and 2017 Source: Global Burden of Disease Breakdown by LA and sex is available at https: //vizhub. healthdata. org/gbd-compare 34

Rank of the Main Causes of Years Lived with Disability 1997 and 2017, by Individual Disease, Female Source: Global Burden of Disease 35

Rank of the Main Causes of Years Lived with Disability 1997 and 2017, by Individual Disease, Male Source: Global Burden of Disease 36

Rank of the main risk factors for death 1997 and 2017 Source: Global Burden of Disease Breakdown by LA and sex is available at https: //vizhub. healthdata. org/gbd-compare 37

Rank of the main risk factors for years lived with disability 1997 and 2017 Source: Global Burden of Disease Breakdown by LA and sex is available at https: //vizhub. healthdata. org/gbd-compare 38