A summary of health issues affecting the people of East Hampshire (pt)

The People 46,661 people live in those electoral wards of East Hampshire covered by Portsmouth and South East Hampshire Health Authority, and this will increase to 48,533 (4.0%) by 2004. 5.8% of East Hampshire (pt)’s population is aged under five, and 15.8% aged 65 years or over.

During 1998 there were 485 births to East Hampshire (pt) women. In 1998, the fertility rate was 52.8 per 1,000 women aged 15 to 44 compared with the district rate of 56.0 per 1,000 women aged 15 to 44.

Perinatal Mortality The perinatal mortality rate is the number of stillbirths and deaths in the first week of life per 1,000 total births. Between 1995 and 1998, there was an average of three perinatal deaths each year in East Hampshire (pt). The three year average perinatal mortality rate for these wards was 5.4 per 1,000 which was lower than that of Portsmouth and South East Hampshire (8.5 per 1,000) (Fig 1).

Major causes of deaths There were 491 deaths to people in East Hampshire (pt) in 1998: of these, 75 were to people aged under 65. Cancers (114), coronary heart disease (104), strokes (41), other cardiovascular diseases (37) and accidents (9) were the principal causes of deaths to residents in East Hampshire (pt) (Fig 2).

Lifestyle preferences Lifestyle preferences of the residents of East Hampshire (pt) are healthier than those of the district as a whole. Lower percentages of residents of East Hampshire (pt) took no physical activity, were obese, drank alcohol above sensible limits or smoked compared with residents in the district. (Fig 3)

Access to preventive services Preventive services include cancer screening and immunisation programmes. Data for is unavailable at local authority level but the uptake rate of the cervical screening programme for East Hampshire Primary Care Group ((PCG), of which East Hampshire is part) is 87% compared with the district uptake rate of 85%. In 1998/99 East Hampshire PCG had a high percentage of inadequate smears (9.8%) and also of smears not taken from the transformation zone (18.9%). Between 1995 and 1998, East Hampshire PCG’s breast screening uptake was 77.5%. The average practice childhood immunisation uptake rates in 1998 ranged from 90.9% to 100%; the average practice pre-school booster uptake rates ranged from 84.2% to 100%. There is evidence that the infant immunisation uptake rates across the district (and nationally) have fallen following adverse publicity.

Hospital utilisation The hospital episode rates per 100,000 age specific populations for East Hampshire (pt) residents are compared with those of Portsmouth and South East Hampshire. Residents of this local authority had lower episode rates for total hospital episodes, emergency episodes, episodes for people aged 75 and over, episodes for children under five and mental health episodes. (Fig 4)

Access to selected operations The NHS Executive has chosen a number of operations as indicators of the success of health authorities in securing clinically effective and appropriate services for their population. Effective operations include coronary artery bypass grafts and coronary angioplasties, cataracts and hip and knee replacements. Ineffective operations include dilatation and curettage for menorrhagia, surgical intervention for glue ear (grommets), extraction of asymptomatic wisdom teeth and varicose vein surgery. Operations with effective alternatives include hysterectomies and elective caesarian sections.

Table 1 compares the East Hampshire (pt) elective operation rate per 100,000 age specific population for certain clinically effective operations with the England rate. East Hampshire (pt) residents undergo higher rates of knee replacements and cataract surgery, but lower rates of hip replacements.

Residents of this local authority undergo a lower rate of hysterectomies in women aged 15 to 49 but higher rates of wisdom teeth extraction and grommet surgery. They also undergo higher rates for elective caesarian sections, which has effective alternatives.

Communicable Disease Between 1991 and 1998, East Hampshire (pt) notifications for food poisoning increased from 18 to 101. Part of this increase is due to improved reporting. However, there is still evidence of under-reporting of notifiable diseases. Notifications for meningitis increased over this period. Conversely, notifications for most vaccine preventable diseases declined. (Fig 5)

Suggestions for health and other agencies working in East Hampshire (pt)

• Continue to tackle poverty in urban and rural areas
• Continue to encourage people to stop smoking, eat a healthier diet, take regular exercise and reduce alcohol intake
• Encourage primary care teams and pathology departments to work together to improve smear taking techniques
• Work with the Health Authority to achieve a more equitable allocation of resources to PCGs – taking account of differences in health needs
• Work with hospital clinicians to review elective operation rates for hip replacements, extraction of asymptomatic wisdom teeth, grommet surgery and elective caesarian sections
• Raise patient and practitioner awareness of the effectiveness or otherwise of certain elective operations
• Encourage GPs to notify all cases of notifiable diseases
• Continue to provide clear and consistent messages to all members of the primary care team and to the public about the effectiveness and safety of childhood vaccinations
• Raise public, patient and food business awareness of food poisoning and how it can be avoided
• Raise patients’ and parents’ awareness of the symptoms of meningitis.

Produced by Public Health and Strategy Directorate, Portsmouth and South East Hampshire Health Authority, Finchdean House, Milton Road, Portsmouth, PO3 6DP. August 1999.

Produced by Ann Edmeades, IT Services, Hampshire County Council
for Portsmouth and South East Hampshire Health Authority
© Copyright Portsmouth and South East Hampshire Health Authority 1998
Last Updated 1st September, 1999