A summary of health issues affecting the people of Fareham

The People 106,176 people live in Fareham and this will increase to 110766 (4.3%) by 2004. 5.5% of Fareham’s population is aged under five, and 16.5% aged 65 years or over.

During 1998 there were 1,028 births to Fareham women. In 1998, the fertility rate was 50.9 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 seven perinatal deaths each year in Fareham. The three year average perinatal mortality rate for these wards was 7.1per 1,000 total births which was lower than that of Portsmouth and South East Hampshire (8.5 per 1,000 total births) (Fig 1).

Major causes of deaths There were 1,082 deaths to people in Fareham in 1998: of these, 141 were to people aged under 65. Cancers (275), coronary heart disease (246), strokes (113), other cardiovascular diseases (98) and accidents (14) were the principal causes of deaths to Fareham residents (Fig 2).

Lifestyle preferences Lifestyle preferences of the residents of Fareham are generally healthier than those of the district as a whole. Lower percentages of residents of Fareham took no physical activity, smoked or were obese compared with residents in the district. The same percentage of Fareham residents drank alcohol above sensible limits (21%) as for the district. (Fig 3).

Access to preventive services Preventive services include cancer screening and immunisation programmes. The uptake rate of the cervical screening programme for GP practices in Fareham Primary Care Group is 87% compared with the district uptake rate of 85%. In 1998/99 Fareham PCG had lower percentages of inadequate smears (8.8%) and also of smears not taken from the transformation zone (15.6%) compared with district percentages. Between 1995 and 1998, Fareham PCG’s breast screening uptake was 80.5%. The average practice childhood immunisation uptake rates in 1998 ranged from 93.5% to 99.0%; the average practice pre-school booster uptake rates ranged from 90.3% to 99.6%. 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 Fareham 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 (CABGs and PTCAs), cataracts and hip and knee replacements. Ineffective operations include dilatation and curettage for menorrhagia, surgical interventions for glue ear (grommets), extraction of asymptomatic wisdom teeth and varicose vein surgery. Operations with effective alternatives include hysterectomies and elective caesarian sections.

The Fareham elective operation rate per 100,000 age specific population for certain clinically effective operations is compared with the England rate (Table 1). Fareham residents undergo lower rates of CABGs and PTCAs. However, Fareham residents' CABGs and PTCA rates are the highest of all local authorities in Portsmouth and South East Hampshire. They undergo higher rates of knee replacements and cataract surgery.

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

Communicable Disease Between 1991 and 1998, Fareham notifications for food poisoning increased from 59 to 147. 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 Fareham

• Encourage people to stop smoking, eat a healthier diet, take regular exercise and reduce alcohol intake
• 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 extraction of asymptomatic wisdom teeth, hysterectomies to women aged 15 to 49, hip revisions and elective caesarian sections
• Raise patient and practitioner awareness of the effectiveness or otherwise of certain elective operations
• 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
• Encourage GPs to notify all cases of notifiable diseases
• 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 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