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Demographics

This Housing LIN Practice Briefing looks at the importance of end of life care delivered at home, describing the context, inequalities in end of life care, examples of good or emerging practice, and recommendations for actions. Funded by Public Health England, it is intended to be a practical guide for those working in mainstream and/or specialist housing, care and support and public health to understand their respective roles, and how they may work together, to help people to have their end of life care wishes met.

This resource can be accessed by clicking here: bit.ly/1QeCTg9

This Housing LIN Practice Briefing looks at active ageing and the different aspects of the built environment that can promote and sustain it, with examples of good and emerging practice and resources for further information. It is intended for those working in social housing, local government, and the care and support sectors to understand their roles in developing and maintaining a built environment that contributes to active ageing.

To access this resource, please click here: bit.ly/21pTXDL

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People living in less energy efficient properties and those experiencing an excess cold hazard tend to be more affluent and with significant savings. They are likely to read customer magazines such as the Bolton Scene and are acceptable of receiving communications from local and national government. This suggests many may be amenable to making improvements themselves.

One of the more deprived Acorn groups ‘5.O Young hardship’ is at risk of living in a less energy efficient property or one with an excess cold hazard. Households in this group are also at risk of fuel poverty. These people may need more support to make improvements.

People living in more energy efficient properties tend to be more deprived and are more likely to live in social housing.

‘4.N Poorer Pensioners’ are likely to live in a more energy efficient property, but are also at risk of fuel poverty, it may be that more energy efficient social housing is having a protective effect on members of this group.

Overall people in fuel poverty tend to be more deprived, but are less likely to be among the very most deprived Acorn groups or types. The very most deprived Acorn types are more likely to be living in social housing which may be protecting them from the fuel poverty they might otherwise experience.

The change from 10% to LIHC definitions of fuel poverty produced the largest reduction in fuel poverty among the most affluent households. People in fuel poverty under LIHC are less likely to be retired and incomes are on average a little lower, but profiles are in general similar.

The housing stock model included the presence of a serious hazard under the Housing Health and Safety Rating System (HHSRS) and two specific hazards: excess cold and falls. The presence of disrepair was also included.

The Acorn groups most at risk of living in a property with multiple issues, including a serious hazard, a falls hazard, or disrepair are ‘4.L Modest means’ and ‘5.O Young hardship’. The group ‘5.O Young hardship’ is also at risk of an excess cold hazard. They tend to be younger people living in small terraced houses with modest incomes. They may need some support to make improvements to properties, or encourage their private landlords to do so.

Overall, people living in properties with an excess cold hazard tend to be more affluent and with significant savings, with which they may be able to make improvements.

The more deprived group ‘4.N Poorer Pensioners’ are also likely to live in a property with an excess cold hazard. The number of households is smaller, but older people are the group most likely to suffer harm from excess cold.

 

The Director of Public Health Annual Report 2014/2015 focuses on the children and young people of Bolton. This report allows us to paint a picture of what we know about Bolton’s Children and Young People and most importantly what the young people themselves are telling us about their health and health behaviours. It sets out is being done locally to improve services including new models of service, and highlights examples of good practice across the borough. 

Headlines

  • Acorn is a segmentation tool that groups households based on where they live, and helps to understand the different types of communities that make up a larger population and their likely needs, behaviours and opinions relating to a wide range of topics.
  • Acorn is based in where people live, but many people spend a substantial amount of time away from home, at work. Workplace Acorn describes the people who work in each local area. Their Acorn type is determined using their home address, and where people work is estimated from 2011 census data. Ward worker populations are very variable, so Workplace Zones can be used to build up new geographies.
  • Bolton’s workforce population is fairly evenly split: just over a quarter of workers belong to each of ‘4 Financially stretched’ and ‘3 Comfortable communities’ while just under a quarter belong to each of ‘5 Urban adversity’ and ‘1 Affluent achievers’.
  • Compared with residents, the Bolton workforce contains relatively higher proportions of the more affluent Acorn categories and lower proportions of the more deprived Acorn categories. This results in a more even distribution of workers across wards and more homogenous makeup of ward workers than seen in the resident population. Although the differences are smaller, the wards with the highest proportion of affluent residents still tended to be those with higher proportions of affluent workers and relatively fewer deprived workers.
  • The wards containing Bolton town centre (Great Lever, Halliwell and Crompton) are among the most deprived in terms of residents, but when the workforce is considered the wards have a profile much more typical of Bolton as a whole.
  • The insights gained from Acorn data are particularly useful when combined with locally collected data. Acorn data could be used to add value particularly by providing detail about people’s lifestyle choices in wider areas of their life. Workplace Acorn could be used to target employers where workers are likely to be made up of particular Acorn types, groups and categories. It could also be used to guide promotion of products and services which are aimed at the worker population rather than the resident population, particularly where there are large differences between the two.

In depth analytical topic report from the Public Health Intelligence Team of the resident Bolton population using ACORN software

  • Acorn is a segmentation tool that groups households based on where they live, and helps to understand the different types of communities that make up a larger population and their likely needs, behaviours and opinions relating to a wide range of topics.
  • The PHIT team has access to two different segmentations. Both give information about the likely demographics of households, the type of housing they live in, and their socioeconomic status. In addition Acorn gives information about their interests, spending habits and use of the internet while Wellbeing Acorn focusses on topics including likely health conditions experienced, adoption of healthy lifestyle behaviours, and extent of engagement with NHS patient forums.
  • Approximately 60% of Bolton’s population is made up of an even split between the most deprived Acorn categories ‘4 Financially stretched’, and ‘5 Urban adversity’. A further 40% are evenly split between the middling category ‘3 Comfortable communities’ and most affluent category ‘1 Affluent achievers’.
  • A third of the Bolton population falls into the Wellbeing Acorn group ‘2 At risk’; these neighbourhoods do not generally have high incidences of illness, however multiple unhealthy behaviours could put their health at risk in the future. Around half of the Bolton population is evenly split between the two more healthy Wellbeing Acorn groups ’4 Healthy’ and ‘3 Caution’. Some differences were seen when compared with 2014 data, whereby the proportion of residents in Great Lever and Rumworth changed to relatively more healthy Wellbeing Acorn Types. Most of these changes took place between 2014-15 with fewer changes 2015-16.
  • The insights gained from Acorn data are particularly useful when combined with locally collected data. Acorn data could be used to add value particularly by providing detail about people’s lifestyle choices in wider areas of their life, and checking whether service users were those people whom the service expects or wishes to particularly target.

In depth analytical topic report from the Public Health Intelligence Team examining the potential customer-base of the proposed wellness software using ACORN software. You can read part 1 of this report (Bolton Integrated Wellness Service – Customers) by clicking here: http://bit.ly/1k4Qhqt

Headlines

  • The Bolton Integrated Wellness Service will combine existing separate services aimed at helping adults live a healthier lifestyle into one joined up offer. A previous paper described developing 3 groups of potential clients.
  • ‘Unhealthy adversity’ is a combination of low wellbeing, smoking, and less healthy food habits. These people tend to be younger and more deprived; they may live in environments that make it more challenging for them to make healthy choices, and advice and support needs to be tailored accordingly. Many report poor health, with a minority experiencing very poor health - these people may need support to adapt the general healthy living advice to make changes while managing their other health issues.
  • ‘Inactive overweight’ is a combination of low levels of physical activity and a BMI over healthy weight. These people tend to be middle aged and older, living across affluent and deprived neighbourhoods. Services and support offered to this group need to be relevant to people across a diverse range of backgrounds. These people are starting to experience ill-health which may have a lifestyle component; this could be a successful lever to encourage them to make behaviour changes.
  • ‘Imbibers’ are those who drink alcohol at increasing risk levels. They are likely to be in middle age, living in affluent parts of Bolton. Communications should be careful not to seem patronising towards these people who are often highly educated and working in roles with high status and/ or levels of responsibility. Since these people are in generally good health they may not be likely to actively seek out opportunities to make behaviour changes; awareness raising where they are already likely to be could be a first step in encouraging behaviour change.
  • All groups will contain a large majority who use the internet daily but also a substantial minority who had never used the internet. Mobile internet is frequently used, so all websites should be mobile friendly.
  • Non internet users tend to be older and less likely to work in managerial or professional jobs. Younger non internet users may be on an especially low income. Non-internet users prefer to be first contacted by phone, text message or post. Acorn type ‘5.Q.58 Singles and young families, some receiving benefits’, likely to be part of ‘Unhealthy adversity’ are much more likely than average to want to be first approached by home visit.
  • Nearly half of all groups use social media. ‘Unhealthy adversity’ are most likely to do so, and to be more active users. Maintaining a Wellness service social media presence is recommended.
  • Medical, health or fitness apps (particularly paid products) are less popular among the behaviour groups, and likely to be downloaded by a small minority only. Mobile friendly websites and signposting to existing apps are likely to be most appropriate.
  • the numbers of people exhibiting less healthy behaviours is large, but we do not know how many of these people want to make a behaviour change, whether they are already trying to, and if so what services or products they are using to help with this. Data indicating the market share achieved by the Wellness service and how it compares to and is differentiated from alternative services and products should be collected as part of its monitoring data.

In depth analytical topic report from the Public Health Intelligence Team on customer profiles of the proposed integrated wellness service. You can read part 2 of this report (Bolton Integrated Wellness Service - Customers Insights from Acorn data) by clicking here: http://bit.ly/1Qs1nQI

Headlines

  • The Bolton Integrated Wellness Service will combine existing separate services aimed at helping adults live a healthier lifestyle into one joined up offer.
  • Bolton Health and Wellbeing Survey 2010 provided information on the following less healthy behaviours that the service will aim to tackle: respondents’ levels of physical activity, alcohol consumption, weight status, food habits, smoking status and wellbeing. It was very common for people to engage in these less healthy behaviours, 84% did 1 or more, and 52% did 2 or more.
  • A factor analysis was performed to see if some behaviours more commonly occurred together. 3 fairly discrete factors emerged.
  • ‘Unhealthy adversity’ was a combination of low wellbeing, smoking, and less healthy food habits. These people tended to be younger, more deprived, and in poor health, with a minority experiencing very poor health. There are an estimated 24,000 of these people in Bolton.
  • ‘Inactive overweight’ was a combination of low levels of physical activity and a BMI over healthy weight. These people tended to be middle aged and older, living across affluent and deprived neighbourhoods, and experiencing poor health. There are an estimated 51,000 of these people in Bolton.
  • ‘Imbibers’ were those who drank alcohol at increasing risk levels. They were likely to be in middle age, living in affluent parts of Bolton and in generally good health. There are an estimated 39,000 of these people in Bolton.
  • These profiles can be used to plan services that meet these different groups of residents’ needs.

This resource supports local joint strategic needs assessments (JSNAs) and the commissioning of interventions to improve the mental wellbeing of local children and young people. The guide explains about mental wellbeing and its determinants. The technical appendix has measures to quantify mental wellbeing and its determinants, information on using the measures and links to examples of evidence based practice.

You can access them by clicking here: http://bit.ly/1OeTP4u

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