There have been major improvements in the health of Portsmouth and South East Hampshire population over the past 13 years. However, unacceptable variations in health status between the rich and the poor still persist and these are linked to social and economic deprivation. There are marked differences in life expectancy, mortality and illness rates for different groups of people in different areas of the district. This report also shows that there is variation in the prevalence, treatment and outcomes of conditions such as asthma, diabetes and coronary heart disease.

There is considerable variation in lifestyles affecting health. Smoking, alcohol consumption, lack of physical activity and a poor diet were found to be more prevalent in people in the lower socio-economic groups. Higher levels of stress and poor sun awareness were more common in these groups.

Geographic variations exist in the availability and access to health services. Although people in the most disadvantaged groups make greater use of primary care services, the distribution of these services does not appear to match the level of need. Similarly, people in the lower socio-economic groups make less use of screening services for breast and cervical cancer. Access to private health insurance is greater in the most affluent areas of the district.

Hospital admission rates for all specialties, emergency admissions, admissions of children and for people with a mental health problems are higher for people living in the most deprived wards of the district. In spite of this, there is also evidence that people in the most affluent parts of the district have greater access to some elective operations such as coronary revascularisation, hip and knee replacements. There is also variation in access rates for a number of elective operations such as wisdom tooth extraction, hip revisions, cataract surgery, and varicose veins surgery.

Clearly the Health Authority needs to ensure equity of health care provision and access across its boundaries. It should ensure that services serving disadvantaged populations are not of poorer quality or less accessible; that the allocation and application of resources are in relation to need; and that positive efforts are made to achieve greater uptake and use of effective services by making extra efforts to reach those whose health is poorest.

However, the key to reducing inequalities lies in effective collaboration between the Health Authority, local authorities, private and voluntary organisations and community groups to reduce and eradicate the root causes of these inequalities, i.e. poverty, poor education, environmental factors and social exclusion.

Communicable diseases remain an important health issue; food poisoning and menigococcal disease have increased both locally and nationally. At the same time, uptake rates for childhood vaccines are falling both nationally and in Portsmouth and South East Hampshire as a result of adverse publicity. Another area of concern is the growth in antibiotic resistance, although local resistance patterns appear to be lower than those reported nationally .

The impact of environmental hazards on health are assuming greater relevance with a move towards local responsibility for addressing these. Local issues include the quality of sea water, air pollution and land contamination.

Most of these issues are of relevance to the Health Improvement Programme and require increased participation in inter-agency planning for health improvement. Building these partnerships and making them work will be the challenge for the next few years.

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