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Joint Strategic Needs Assessment
Older People in Birmingham – Key findings from the JSNA
Iris Fermin, Head of Information and Intelligence
Jim McManus, Joint Director of Public Health
www.bhwp.nhs.uk
The JSNA for Older People
• The Joint Strategic Need Assessment (JSNA) for Older People is a compilation of work that has been executed aiming to highlight and understand the complexity of the needs and issues around health and social care of this age group.
• The objective of the JSNA is to enable Public Health and Commissioners to provide the best care through appropriate commissioning strategies, identifying groups that are more at risk, and changes in the population health patterns
• Figures in this presentation are taken from the JSNA report
www.bhwp.nhs.uk
Birmingham’s Age Structure 2007
www.bhwp.nhs.uk
Project Age Structure 2020
www.bhwp.nhs.uk
Demographic Trends
49-74%
50+26%
Birmingham 2007 male popula-tion by age group
44-68%
45+32%
Birmingham 2007 male popula-tion by age group
49-71%
50+29%
Birmingham 2007 female popula-tion by age group
44-65%
45+35%
Birmingham 2007 female popu-lation by age group
Rate of increase of 23% from 45+ to 50+
Rate of increase of 21% from 45+ to 50+
www.bhwp.nhs.uk
Key Points
• The age structure of Birmingham is youthful, • People are living longer despite our life expectancy being lower than
England and the age group 45 and over makes up 33.7% of the population.
• Older people are a complex population segment that requires lots of services. – It is most characterised by long term conditions and the 75 and over age
range is the critical group. Two of the most important issues in terms of health are physical mobility and mental health.
• Physical mobility for older people is put at risk due to falls.• Falls have a social cost for the population and an economical cost
for the authorities. In the last year there have been increases in falls and its resulting consequences in Birmingham.
www.bhwp.nhs.uk
Key Points 2
• Mental health admissions were 16,956 for 2007/08, with drugs related mental health disorder being the highest reason followed by dementia. – Females are most affected except, however, in drugs related mental
disorders. – Longer life expectancy of the female population is a contributory factor
for the high dementia prevalence. – Age-specific rates for mental health show that at 70 and over mental
health problems are acute.• There are several social determinants that have an impact on older
people’s health and their experience in later life: transport, housing, participating in physical activity, eating patterns, alcohol and drugs; among others.
www.bhwp.nhs.uk
Health determinants
45s
Fem
aleM
ale
Time50s
Male
Fem
ale
hypertension
CH
D
CO
PD
Cance
r
85+
www.bhwp.nhs.uk
Social determinants
Drugs & Alcohol &
SmokingHousing
Transport &
Isolation
Healthy life expectancy
Be active
Nutrition
www.bhwp.nhs.uk
Falls
Findings Recommendations
Osteoporosis as secondary diagnosis
Revision of the mechanism for detection
Increase in arthritis and rheumatoid arthritis
Study interventions for improvement risk factors management
Increase in joint replacement
Introduce mechanism to facilitate awareness about fall and its consequences
75+ most vulnerable Prediction modelling and more focus study
Mortality and secondary cost
More than age
www.bhwp.nhs.uk
Mental Health
Findings Recommendations
Increase in dementia, depression and stress
Revision of the mechanism for early detection
Drugs related mental health affect more male and dementia, depression affect more female
Study interventions for improvement drug-mental health related illness
More people living along is admitted due to mental health
Investigate isolation issues: housing, transport, ill-health
Accommodation is one of the most used resource
Prediction modelling and more focus study
www.bhwp.nhs.uk
Personalisation & Social CareFindings Recommendation
Improvement in delay of transfer is needed
Study into causes and decompose of the data for better understanding and alignment of the strategy
Close the gap between services and demand for End of life and palliative care
Define an effective strategy to increase satisfaction and LTCs register
Gap in services such as Transport, Housing and people awareness
Promote living independently
Mismatch of type of specialist housing provision
Revision of demand and supply for housing
www.bhwp.nhs.uk
Females/Males – where’s the gap?
• There is a common view that• There is a gap between males and females on health –
men are actually getting illnesses earlier– Drugs related mental health affects men more. – For those males with mental health problems, from the age of 45
and over there is unmet need and lack of provision. Males over 45 don’t seem to be going into services.
• LTCs more aggressive for male
www.bhwp.nhs.uk
The Gap….
www.bhwp.nhs.uk
Key Priorities for Commissioners• Intervening from the age of 50 onwards as envisaged in Ageing with
Opportunity to prevent and minimise decline in health
• Mental Health – Depression and dementia
• Falls – preventing and intervening earlier
• Personalisation – individual budgets, impact of isolation of independent living, holistic palliative care
• Early Intervention and prevention agendas to prevent worsening of situation and worsening of care need
• Housing and Transport
• Cancers and Long Term Conditions
www.bhwp.nhs.uk
Information and Analysis
• The data need to reflect age-specific issues• Social and health determinants data relation is needed• Data from interventions and services should be made
available • Recording of low level spatial data is needed• Sharing and availability of data should be encouraged