Section 6: Wider determinants of health Economy

Transcription

1 Section 6: Wider determinants of health Economy E c o n o m y Page 1

2 Related briefings in the JSA for Health and Wellbeing Briefing (and hyperlink) Entire section Health inequalities Mental health and dementia Health and wellbeing benefits of access to nature Community safety Housing Section Health inequalities Children and young people Burden of ill-health: mental health and neurological disorders Wider determinants of health Wider determinants of health Wider determinants of health Outcome Frameworks Summary The Public Health Outcomes Framework for England, outlines the overarching vision for public health as to improve and protect the nation s health and wellbeing, and improve the health of the poorest fastest. The Adult Social Care Outcomes Framework 2014/15 2 is a set of outcome measures, which have been agreed to be of value both nationally and locally for demonstrating the achievements of adult social care. The following indicators from these frameworks are relevant to this section. Framework Reference Indicator Public Health 1.1 Children in poverty Public Health year olds not in education, employment or training Public Health 1.8 Employment for those with a long-term health condition, including those with a learning difficulty/disability or mental illness Public Health 1.9 Sickness absence rate Public Health 1.15 Statutory homelessness Public Health 1.17 Fuel poverty Public Health 2.23 Self-reported wellbeing Public Health 4.15 Excess winter deaths Adult Social 1.E Proportion of adults with learning disabilities in paid Care Adult Social Care 1.F employment Proportion of adults in contact with secondary mental health services in paid employment Edition Edition Version no. Changes/Comments 2012/13 1 N/A 2013/14 1 E c o n o m y Page 2

3 Executive summary Poverty (relative or absolute) is a major determinant of ill health and being out of work is associated with physical, mental and social effects. Poverty is also linked to inequality. Wiltshire continues to have a high economic activity rate for residents aged (79.9%) compared to other areas particularly amongst the male population which rises to 86.6%. Wiltshire claimant count levels are consistently below those found in the South West and England. The claimant count amongst the young is a concern with 30.8% of all claimants falling into the age group; this is higher than that experienced regionally and across England. The adjusted NEET (young people not in employment, education or training) figure for Wiltshire, based on the period November 2012 to January 2013 was 6.0% and equates to 493 young people based on a total cohort of 12,803. This is higher than the comparable figures for England and the South West but not appreciably so. In 2012/13, 21,067 residents of Wiltshire received help from the Citizens Advice Bureau (CAB) service. They were helped with 57,903 issues and 67% of the enquiries were about debt and benefits. CAB are helping clients manage 14.4m worth of debt ( 2m more than in 2011/12) and clients have had 1,266,400 of debt written off. 3.5 million in income was gained for clients, an average of 4,600 per client and 3,280,000 of this was in benefits. Around 1 in 12 people (8%) said their health had got worse for reasons connected to the economic downturn. People in deprived areas and young or disabled people seem to have been disproportionately affected. 76% of GPs believed the economic downturn has had a negative impact on their patient s health in the last 4 years. A further period of no or low economic growth and continuing changes to benefits and tax credits will impact severely on many population groups, including disabled people, people with mental health problems, and large families on low incomes. The effects will be noticeable on levels of personal debt; mental ill-health; child poverty; fuel poverty and homelessness. E c o n o m y Page 3

4 Why this area is important 3 Poverty (relative or absolute) is a major determinant of ill health. Low pay, inadequate benefits or unemployment are associated with lack of food and fuel, poor housing and limited transport options and social isolation. These in turn lead to: Physical problems (e.g. low-birth-weight babies, respiratory disease) Psychological problems (e.g. stress, depression, anxiety) Behavioural changes (e.g. smoking, low exercise, poor diet). Being out of work is associated with physical, mental and social effects. These are related partly to the length of the time spent unemployed. Although being out of work may cause ill-health, the causal relationship also works the other way around: those who are physically or mentally unwell may be more likely to leave jobs or have difficulty working. Studies of factory closures indicate that ill health and health-care use are also associated with job insecurity and particularly the anticipations of job losses. There are consequences from unemployment on the individual, on families and on society at large: Individual suicide rates among the unemployed increase within a year of job loss. Cardiovascular mortality rises over 2 or 3 year and continues for the next years. Family Spouses of people out of work can also experience poor health. In families where individuals are seeking work, the effects of poverty appear most severe in the short term. In the longer term families may adapt to unemployment Society increased unemployment places a greater burden on society through fewer people making a tax contribution and due to the increased social security and health service needs of those without work. Poverty is also linked to inequality; the Black Report in argued that poverty was one of four possible explanations for the widening of health inequalities seen in Britain in the twentieth century. The implication is that income fundamentally influences health and that this influence lies outside of the health care system. These issues were explored further in reports written for the Government in and by Derek Wanless which focused on prevention and the wider determinants of health in England and the cost effectiveness of action that can be taken to improve the health of the whole population and to reduce health inequalities. What are the needs of the population? Background Wiltshire continues to have a high economic activity rate for residents aged (79.9%) compared to other areas particularly amongst the male population which rises to 86.6%. 7 E c o n o m y Page 4

5 The county has an ageing population coupled with a below average number of people working in the care sector and services. This is a concern because it means an increasingly large number of people are requiring care from a limited group of care givers. 8 Wiltshire has a much higher proportion of people (50.8%) employed as managers, professionals and associate professional than that found regionally (43.0%) and nationally (44.2% Great Britain) 9. Additionally, it also has a higher proportion of working age residents qualified to NVQ 3 and above than found regionally and across Great Britain (36.5%, 34.1% and 34.4% respectively). Overall, the number of residents at all qualification levels at NVQ1 or above exceeds those found across the South West and nationally 10. With a higher than average education and higher skilled occupation profile, the average earnings of residents is also higher than the South West, particularly for males. However, the reverse is the case when earnings by workplace are considered. This is due to out-commuting by the higher skilled residents to better paid jobs in towns and cities. 11 Further analyses of the health of the working age population in Wiltshire and comparisons with other areas in the South West are available in a South West Public Health Observatory report Health of the Working-age Population of the South West 12. They show that on a range of employment and health indicators Wiltshire does not appear to perform statistically significantly differently to the South West as a whole. Unemployment The following section was taken from the Economy section of the JSA for Wiltshire 13 and updated with new information from the Swindon and Wiltshire Local Economic Assessment in Unemployment rates Unemployment levels in the county are low compared to those nationally and throughout the recession the economy has been resilient. The economy of Swindon and Wiltshire is forecast to see employment growth of approximately 9% (30,000) over the period , which is almost double that predicted for the UK as a whole. The main reason for this higher growth rate is the area s strong showing in sectors forecast to see the fastest growth over the decade (Professional Services and Accommodation and Food). There have been a number of successful employment schemes running to support young people to enter work and training such as apprenticeships and work placements. The Employment and Skills Board is particularly monitoring youth unemployment as well as long term unemployment for the over 50s. Youth unemployment however is a particular concern and employment opportunities for those under 25 years old have been limited due to competition from more experienced workers released into the labour market as the economy has restructured. The delivery of employability and informal skills for the young as well as exploring alternative routes to work such as apprenticeships and work placements E c o n o m y Page 5

6 will be a priority to offset the threat of this cohort of the population becoming unemployable for the long term. JobSeekers Allowance claimants Figure 1 shows that the claimant count levels in Wiltshire, England and the South West rose sharply from the summer of 2008 as the economic downturn took hold. Levels have remained high since February 2009 although there have been in-year fluctuations which reflect the impact of seasonal employment. The highest levels were experienced during 2009 and early Claimant counts in all 3 geographies have fallen in Wiltshire claimant count levels are consistently below those found in the South West and England although the trends experienced since the onset of the recession have mirrored them. The local economy is therefore closely tied into the general cycle of trends but it has demonstrated its overall resilience through rates being appreciably lower. Figure 1: JSA claimant count, June 2008-October 2013 The claimant count amongst the young is a concern with 30.8% of all claimants falling into the age bracket, this is higher than that experienced regionally and across England. This is even more acutely felt by young men in Wiltshire who are also more likely to be claiming for over 6 months compared to females (10.2% of total male claimants compared to 8.1% of total female claimants). This pattern is also seen at regional and national level. Youth claimant count levels are also appreciably higher than those experienced by the over 50s who currently are more likely to secure work due to their experience as E c o n o m y Page 6

7 well as being better placed to explore self-employment options. The over 50s who have been claiming over 6 months however are a particularly disadvantaged group in terms of their prospects for securing work and levels are expected to rise if economic conditions worsen. That said, the percentage of claimants who are over 50 and have been claiming benefits for over 6 months is still lower in Wiltshire (8.1%) than found across the South West (9.4%) and England (10.2%). Table1: JobSeekers Allowance, claimant count, age and duration, October 2013 Wiltshire South England West Number % % % Total 4, % 2.0% 3.0% Male 2, % 2.6% 3.9% Female 1, % 1.4% 2.2% Youth claimant count aged as % total claimant count 1, % 27.5% 26.1% Youth claimant count claiming for over 6 months aged as % % 8.3% 8.8% total claimant count Claimant count aged 50+ claiming for over 6 months % 9.4% 10.2% Source: NOMIS, November 2013 Out of work benefits 16 While the claimant count measures those who are claiming Jobseekers Allowance, it is important not to overlook those who wish to work, but who are claiming other out of work benefits as well. The challenge for the government and its partners is to work with this larger group who are considerably more distant from the labour market. These out of work benefits include people who are claiming the following working age benefits: Jobseeker s Allowance Employment Support Allowance & Incapacity Benefit/Severe Disablement Allowance Income Support The worklessness rate is the percentage of the working age population who are workless (i.e. claiming one of the above benefits). In total there are 21,130 people on work-related benefits in Wiltshire, equivalent to 7.2% of the working age population; considerably below the national proportion of 11.3%. E c o n o m y Page 7

8 Table 2: Numbers and percentages on different out of work benefits Job seeker ESA and incapacity benefits Lone parent Others on income related benefits All out of work benefits Wiltshire Number 5,920 Rate 2.0% Number 12,010 Rate 4.1% Number 2,410 Rate 0.8% Number 7,180 Rate 2.5% Number 21,130 Rate 7.2% Source: ONS WACG Feb 2013 Note: individual benefit numbers do not sum to the total of all out of work benefits because people may receive more than one benefit. Worklessness can have particularly strong impacts on poverty and deprivation when no-one of working age in a household is in work. In Wiltshire, the proportion of workless households has risen from 12.5% in 2008 to 16.1% in 2012, a slightly lower proportion than nationally (17.5%). NEETs The adjusted NEET (not in employment, education or training) figure for Wiltshire, based on the period November 2012 to January 2013 was 6.0% and equates to 493 young people based on a total cohort of 12,803. This is higher than the comparable figures for England and the South West but not appreciably so. Wiltshire data is available on young people in academic years 12 and 13 (ages 16 and 17). This produces slightly different results from those published by the Department for Education, which uses actual age calculations and a methodology which includes adjustments. However, the Wiltshire data does show that there is a higher NEET percentage amongst 17 year olds than 16 year olds (3.4% compared to 2.1% according to November 2013 data). This data also shows that 8.3% of 16 year olds and 19.7% of 17 year olds are classified as other which includes unknown destination). Young people are particularly disadvantaged by 17 : Recruitment methods - with employers favouring informal methods. Young people tend to lack the necessary connections to access opportunities. An emphasis on experience recruiters place significant emphasis on experience when recruiting, but young people are increasingly less experienced. Compared with 15 years ago the proportion of young people who combine learning and work has declined significantly. E c o n o m y Page 8

9 Labour market trends young people tend to be employed in two occupations retail and elementary occupations 1 both of which are in decline and have been hard hit by recession. A rise in small businesses there has been a rise in small businesses which are more likely to recruit informally and expect prior experience. A range of initiatives under the Employment and Skills Board for Wiltshire are in operation or are being developed to extend employment opportunities for the unemployed. They include advice on self-employment and apprenticeships, tackling issues associated with long term unemployment and re-skilling support so that the local workforce is fit for purpose in the emerging global economic climate. Earnings The economic factsheet on average earnings and gross disposable household income 18 provides details on costs relating to both labour supply and labour demand and also data on economic living standards in an area. Gross Domestic Household Income (GDHI) data provide information on the amount of money that households have to spend or save once expenditure on taxes, pension contributions, mortgage interest payments and other outgoings have been taken account of. The expectation is that GDHI will fall and unemployed residents and those that both live and work in the county have and will continue to experience pressure on their household incomes in the short to medium term and there remain an appreciable number of individuals and families experiencing income deprivation across all areas. In-work poverty is becoming a real issue in Wiltshire 19. The change in wages since 2008 shows that contrary to national growth, Wiltshire has seen a decline in earnings and the local pattern of change differs in key respects from its comparators. Gross weekly pay for men has fallen by in Wiltshire compared with a rise of across England. Overall, total pay has declined by 7.50 per week in Wiltshire. In England it has risen by 16 per week. The trend for falling wages undoubtedly reflects the impact of recession and the excess of labour relative to demand, but may also signal a structural weakness in the economy where significant parts of the economy are using low skills to produce low value added goods, which then support large numbers of relatively low paid jobs a low skills equilibrium. This is at odds with the Wiltshire and Swindon Local Economic Partnership s (LEP) aspiration to become a high value added economy with the skills to match; and suggests that the LEP may need to explore the opportunities to develop high performance working practices in the local economy. 1 Elementary occupations consist of simple and routine tasks which mainly require the use of handheld tools and often some physical effort. E c o n o m y Page 9

10 Social Impact Personal debt For further information on personal debt and an analysis of Wiltshire Citizens Advice data please see Health and Poverty 20. In 2012/13, 21,067 residents of Wiltshire received help from the Citizens Advice Bureau (CAB) service. They were helped with 57,903 issues and 67% of the enquiries were about debt and benefits. CAB are helping clients manage 14.4m worth of debt ( 2m more than in 2011/12) and clients have had 1,266,400 of debt written off. 3.5 million in income was gained for clients, an average of 4,600 per client and 3,280,000 of this was in benefits. CAB clients are often from deprived areas and the majority have an income of less than 1,000 per month. Around a third are recorded as disabled or with long term health problems and a similar percentage have dependent children. The client mix is likely to have remained similar over time 21. Disabled clients are less likely to be employed and so more often require help with benefits. In particular, the recent changes in disability-related benefits are causing problems to these vulnerable groups particularly the introduction of employment and support allowance (ESA) to replace incapacity benefit. Citizens Advice have found disability to be the single biggest cause of employment discrimination amongst clients bigger than race or gender 22. Amongst clients seeking help with employment problems, disabled clients are more frequently advised about discrimination than other clients. Mental health and debt Mental health problems and debt often have a direct link, whether the cause is redundancy, bereavement, relationship breakdown, abuse or everyday concerns. Although both issues may be rarely discussed, there is now good evidence to show that when debts mount up, so does stress and anxiety. Recent surveys have shown that people with mental health problems are nearly three times more likely to report debt compared with individuals without similar conditions. Practical help and advice can contribute to alleviating debt and related mental health problems. Wiltshire Public Health commissioned Wiltshire Citizens Advice (WCA) to provide welfare benefits and financial management advice to service users of the Community Mental Health Teams based at Red Gables in Trowbridge, Green Lane in Devizes, Fountain Way in Salisbury and Bewley House in Chippenham. The service covers two elements: Referrals direct from professionals at Red Gables, Green Lane, Bewley House and Fountain Way to a debt and benefits caseworker for advice. Collecting qualitative data from service users on their experiences of the service received from welfare benefits providers or financial organisations, E c o n o m y Page 10

11 such as banks and creditors. This will form part of the CAB campaign to improve services provided to people with mental health problems. The caseworkers started in summer 2013 and since the start of the project 87 clients have been referred to the service. Of these 24 were referred for debt and benefit advice, 26 for support in claiming benefits and a further 27 needed budgeting and money management. The Community Mental Health Teams have responded positively to the service and some have reported that this is a much needed service. Thirty three clients have been helped to claim benefits or to appeal benefit decisions and the majority of the clients who have spoken to a caseworker would have had a benefit check to ensure they were receiving all the money they are entitled to. The caseworkers have helped clients to claim Employment Support Allowance, Disability Living Allowance, Personal Independence Payments, Working Tax Credits, Housing Benefit and Carer s Allowance. In addition, clients have been advised on how to deal with overpayments of benefits, including how to challenge the decision. Thirty three clients have engaged with the debt process. A total of 12, of debt has been written off after the caseworkers have challenged the creditors. To continue the success of the project the following is needed: Continued support from Community Mental Health Teams for service users there is better engagement from clients when the Social worker/cpn and the WCA caseworker work together. The return of the evaluation forms or input from The Community Mental Health Teams on why the forms are not being completed and returned (although feedback from clients, carers and support workers is recorded) A decision on whether the project covers the Primary Mental Health Teams, referrals from Swindon for clients living in the Wiltshire Local Authority area and Home Visits. Emerging needs Wiltshire Citizens Advice anticipates that the demand for many services, particularly benefit, debt and housing will continue to grow in response to: Continuing changes to benefits and tax credits that will impact severely CAB client groups, including disabled people, people with mental health problems, and large families on low incomes. Increasing levels of poverty as these changes take effect, along with other cuts to public services and continuing high levels of unemployment. Continuing high levels of debt problems with a significant increase in fuel poverty anticipated as fuel prices increase. E c o n o m y Page 11

12 Increasing housing problems as changes to Housing Benefit take which may impact on homelessness. The transition to Universal Credit. The Welfare Reform Act means that Wiltshire will have 73m benefit reduction per year by the end of the Parliament m of this is Tax Credit reduction. The people most affected are working families. Currently only 20% of benefit changes have come into effect. The under occupation criteria ( bedroom tax ) is only a small proportion of the changes but getting the most media coverage. Therefore, the concern for the immediate future is how to support low waged families cope with changes in benefits and increasing costs. There is a need for budgeting advice and to assist people to get online and confident to use the internet for applications. To address this, the Digital Inclusion work stream of the Wiltshire Online project 24 is recruiting volunteers from across the county to provide free, basic computer support to people in their local community. There are dozens of digital champions, managed by volunteer coordinators, covering nearly all community areas. The coordinators also go out and speak to local groups about the free digital champion service, highlighting the benefits of being online and offering support and encouragement to anyone who's keen to give it a try. Wiltshire Money 25 is made up of representatives from Wiltshire Council, Many of Wiltshire s Housing Associations, Wiltshire Citizens Advice, Community First and Nationwide Building Society. It is the lead body for financial inclusion activity within the county and provides a strategic framework for local organisations to co-ordinate their work, develop collaborative partnerships and share lessons learnt. Crime Links between the economic situation in the country, levels of unemployment and debt and crime are numerous and complex, however, crime statistics from Wiltshire Police Force provide little, if any evidence of increased crime during the recession period. During the twelve month period up to June , Wiltshire Police Force recorded a total of 33,363 crimes, down from 36,137 in the previous year, moving from eight to seventh lowest nationally. The total crime rate continues to drop within Swindon and Wiltshire, with a 7.68% reduction over twelve months, equating to 2,774 fewer offences. The Force continues to record a low volume of dwelling burglaries, positioned fourth lowest nationally. There was a 3% reduction in Wiltshire, compared to a national drop of 6% up to June Child Poverty Please see the children and young people: health inequalities section of the Health and Wellbeing JSA. E c o n o m y Page 12

13 Fuel poverty Please see the housing section of the Health and Wellbeing JSA. Housing and homelessness Please see the housing section of the Health and Wellbeing JSA. Inequalities Evidence from previous recessions shows that the incidence of unemployment and worklessness is not evenly spread across the population. Some groups of people fare worse than others, although each recession has had different impacts. The 2009 Equality and Human Rights Commission report Monitoring the impact of the recession on various demographic groups 27 examined the effect by age, gender and on ethnic minorities, disabled people, lone parents, lowest qualified and deprived areas. The study found that compared to the population overall, most of the groups reported on already had significantly lower employment rates; higher unemployment rates; and much higher levels of economic inactivity. For young people, the lowest qualified and those living in deprived areas, the fall in the employment rate over 2008/09 was higher than the fall in the overall rate. Military The military presence is one of the defining characteristics of Wiltshire, with over 30,000 military personnel and their dependants estimated to be living in the county. The significant military presence in Wiltshire is changing. The impact of the Army Basing Review 2013, the closure of RAF Lyneham, and the move of Defence Technical Training to the site, will have implications for local communities across the county for the foreseeable future. These changes are expected to result in a significantly different military population in the county, changes in the use of land and a significant increase in the length of time that army personnel and their families live and work in Wiltshire. The economic significance of the military presence in the wider South West region, and the potential economic impacts of a number of expected military changes in the region are explored in the report Military Presence and Economic Significance in the South West Region 28. Further information on the military can be found in the military and veterans health section of the Health and Wellbeing JSA. What do service users / the public think? The What Matters to You Survey 29 was carried out in December 2011 asking Wiltshire residents to comment on a range of topics that affect life where they live. One of the questions asked whether the current economic downturn had affected their health. Around 1 in 12 people (8%) said their health had got worse for reasons connected to the economic downturn. E c o n o m y Page 13

14 Figure 2: Effect of economic downturn on health The economic downturn seems to have disproportionately affected the health of young people with 17% of those aged saying their health had got worse for reasons connected to the economic downturn compared to only 4% of those aged 65 or over and 8% overall. E c o n o m y Page 14

15 The map opposite shows the areas in Wiltshire with the highest proportion of respondents who said their health had got worse for reasons related to the economic downturn. These areas are concentrated in the more populous parts of Wiltshire, particularly in and around Trowbridge, Melksham, Chippenham, Devizes and Salisbury. Results for individual Community Areas were broadly in line with the overall Wiltshire results in most cases, exceptions included: Malmesbury: where fewer people said their health had got worse for reasons connected to the economic downturn. Trowbridge: where more people said their health had got worse for reasons connected to the economic downturn. Not surprisingly the health of people living in deprived areas had been most affected by economic downturn. 12% in the most deprived quintile said their health had got worse for reasons connected to the economic downturn compared to 5% of those in the least deprived quintile. E c o n o m y Page 15

16 People with disabilities have also suffered more than those without disabilities because of the economic downturn, as Table 3 shows. Table 3: Effect of economic downturn on people with disabilities Disability % saying their health had got worse for reasons connected to Odds Ratio the economic downturn Physical disability 14% 2.2 Learning disability 24% 4.2 Visual impairment 10% 1.5 Hearing impairment 7% 1.0 Speech impairment 17% 2.7 Mental health 38% 8.1 No disabilities 7% 1.0 Total 8% N/A Source: What matters to you survey 2011/12 The odds ratios presented in the table above give further support to the suggestion that the economic downturn has disproportionally affected those with a disability. The odds of someone with a physical disability reporting their health had got worse for reasons connected to the economic downturn were twice of those reporting no disability, with the odds even more pronounced for those with learning disabilities (4.2) and mental health disabilities (8.1). What GPs think A national survey of GPs was carried out by the Insight Research Group to look at the impact of the recession on the UK s health 30. The GPs that were surveyed felt that worries over financial security coupled with many people working longer hours have raised our stress levels. This has not only led to an increase in various mental health disorders but has also influenced other aspects of our life and wellbeing from family planning through to levels of exercise. The overall findings from the survey include: 76% of GPs believed the economic downturn has had a negative impact on their patient s health in the last 4 years. 46% of GPs believed there has been an increase in alcohol abuse amongst patients since 2008, which could be attributed to the economic climate of the last four years. 38% believed patient who are smokers were giving up or cutting down to save money. 60% believed patients were cancelling sporting activities to save money. 34% believed there was an increase over the last 4 years of patients putting off starting a family until their financial security improved. E c o n o m y Page 16

17 77% felt there has been an increase in new cases of mental ill-health conditions in the last 4 years linked to the economic climate. Resources Intelligence Network The Economy section of the Wiltshire Intelligence Network: hosts a wealth of economic statistics and information: Wiltshire Economic Assessment 2010/11 Factsheets Wiltshire Strategic Economic Assessment Regional Impact of Public Sector Spending Cuts report The Recession in Wiltshire reports Sub-regional Economic Indicators. Regional and Sub-regional Economic Simulations and Projections Business Surveys Wiltshire Employment and Skills Analysis 2010 Wiltshire Workspace Strategy The Economic Significance of the Military Average House Price Methodology Crime statistics from survey and police recorded crime: Challenges for consideration Debt Increase in personal debt. Continuing changes to benefits and tax credits that will impact severely many population groups, including disabled people, people with mental health problems, and large families on low incomes. Providing practical help and advice in a range of settings to alleviate debt and related mental health problems. Supporting low waged families to cope with changes in benefits and increasing costs. There is a need for budgeting advice and to assist people to get online and confident to use the internet for applications. Mental health Supporting unemployed people who are at higher risk of mental health problems than those in work. E c o n o m y Page 17

18 Child poverty In 2011, out of Wiltshire s 281 lower super output areas, 36 have over 20% and 11 have over 30% of children living in poverty. If not addressed these will form a hard core of child poverty in Wiltshire. Fuel poverty Develop a robust and efficient action plan with the overall aim of eradicating fuel poverty in Wiltshire. Housing and homelessness Focus on building relationships with private landlords to help maintain tenancies and to secure additional tenancies for households who are homeless or threatened with homelessness. To improve the quality and make best use of the existing stock of social housing across Wiltshire. Crime Monitor the effect of the economic downturn on crime statistics. Unemployment Youth unemployment rates and the likelihood of the development of a cohort of the population whose future employment prospects are restricted because they have never participated fully in the labour market. Address levels of NEETs (not in employment, education or training) within Wiltshire. E c o n o m y Page 18

19 Contact information Document prepared by: Tom Frost Public Health Scientist Wiltshire Public Health Telephone: With input from: Debby Skellern, Economic Growth Manager, Wiltshire Council Wali Rahman, Economic Development Officer, Wiltshire Council Toby Eliot, Data manager, SYP, Wiltshire Council Sarah Cardy, Chief Executive Officer, Wiltshire Citizens Advice Laura Colley, Researcher, Knowledge Management, Wiltshire Council Frances Chinemana, Public Health Consultant, Public Health Wiltshire 1 Healthy Lives, Healthy People: Improving outcomes and supporting transparency, Department of Health, January The Adult Social Care Outcomes Framework 2014/15, Department of Health, November The information in this section is adapted from that contained in Mastering Public Health, G. Lewis et al, Securing our future health: taking a long-term view. Final report. Wanless D. London: HM Treasury, Securing Good Health for the Whole Population Final report. Wanless D. London: HM Treasury, Annual population survey, Jul 2012-Jun2013, NOMIS 8 Annual population survey: employment by occupation as a proportion of all people in employment, Jul 2012-Jun2013, NOMIS 9 Annual population survey: employment by occupation as a proportion of all people in employment, Jul 2012-Jun2013, NOMIS 10 Annual population survey: qualifications as a proportion of residents aged Jan 2010-Dec 2012, NOMIS 11 Annual survey of hours and earnings: median earnings by residence and by workplace, 2012, NOMIS 12 Health of the Working-age Population of the South West, Sara Blackmore, South West Public Health Observatory, Joint Strategic Assessment for Wiltshire, 2012/13. Wiltshire Council, Local Economic Assessment 2013, Swindon and Wiltshire LEP, Red Box research and Rubicon Regeneration, Draft October Local Economic Assessment 2013, Swindon and Wiltshire LEP, Red Box research and Rubicon Regeneration, Draft October Local Economic Assessment 2013, Swindon and Wiltshire LEP, Red Box research and Rubicon Regeneration, Draft October Local Economic Assessment 2013, Swindon and Wiltshire LEP, Red Box research and Rubicon Regeneration, Draft October Average earnings and gross disposable household income (economic factsheet), Deborah Skellern, Wiltshire Council, E c o n o m y Page 19

20 cetype=attachment 19 Local Economic Assessment 2013, Swindon and Wiltshire LEP, Red Box research and Rubicon Regeneration, Draft October Health and Poverty (Wiltshire area): What Citizens Advice Bureau client information can tell us about the needs of residents living in Wiltshire, Wiltshire Citizens Advice, Health and Poverty (Wiltshire area): What Citizens Advice Bureau client information can tell us about the needs of residents living in Wiltshire, Wiltshire Citizens Advice, Health and Poverty (Wiltshire area): What Citizens Advice Bureau client information can tell us about the needs of residents living in Wiltshire, Wiltshire Citizens Advice, Centre for Economic and Social Inclusion estimates for Local Government Association Crime statistics, period ending June 2013, Office for National Statistics 27 Monitoring the impact of the recession on various demographic groups, Equality and Human Rights Commission, July url; 28 Military Presence and Economic Significance in the South West Region, Sally Hunter, Wiltshire Council, South West RDA. Wiltshire Council, March url: cetype=attachment The Austerity Britain Report: The impact of the recession on the UK s health, according to GPs, Insight Research Group, August url: E c o n o m y Page 20