Topics included on this page:
Global Burden of Disease
Ischaemic heart disease
Low back pain
COPD
Stroke
Diabetes
Lung cancer
Alzheimer’s disease
Falls
Depressive disorders
Colorectal cancer
Global Burden of Disease
Health priorities for Somerset are derived from the Global Burden of Disease, which compare loss to population health from all diseases and risk factors. We have looked at an outcome called a DALY – Disability Adjusted Life Year. This enables us to measure the impact of conditions in both shortening life and reducing years of life lived in full health, recognizing that our key goal is to increase the years of life lived in good health and reduce early deaths – not just try to extend life expectancy. The main causes of loss of DALYs for our whole population are shown below.
Ischaemic Heart Disease
Circulatory diseases such as ischaemic heart disease cause more deaths in Somerset than any other condition type, and contributes 7.19% to the Disability Adjusted Life Years lost in the county.
The prevalence of cardiovascular disease increases significantly after the age of 40 years. The NHS Health Checks programme in Somerset is a key priority as it focuses on raising awareness of the risk factors for cardiovascular disease and offering individuals support to reduce their future risk. During 2018/19, 82% of the annual target population were invited to a check and 27% received a check. In 2019/20 the proportion remained at 27%; this service has been significantly disrupted by covid-19 precautions since then.
Somerset’s mortality rates have declined at a slowing pace, but are consistently lower than the England average.
Key indicator – Under 75 mortality rates
More data from OHID Fingertips
Low Back Pain
Low back pain contributes to 4.79% of the Disability Adjusted Life Years lost in Somerset. This is particularly because of the length of time that people can suffer from such pain, with its effects on physical activity, rather than being a major cause of death in its own right. Somerset tends to have a higher proportion of the population with the condition, which reflects the relatively elderly population structure in the county.
Key indicator
More data from OHID fingertips
Chronic Obstructive Pulmonary Disorder (COPD)
Chronic Obstructive Pulmonary Disease (COPD) includes emphysema and chronic bronchitis, and is one of the most common forms of respiratory diseases and usually affects those over the age of 35. Somerset’s emergency hospital admission rate for COPD tends to be significantly lower than the England value, but still contributes 4.56% of all Disability Adjusted Life Years lost in the county.
Respiratory infection is associated with social inequalities in all age groups and particularly in children. In Somerset the population in the lower quintiles of deprivation have a greater frequency of emergency admission to hospital. Emergency admissions for children due to lower respiratory infections are decreasing in Somerset.
Immunisations are available to protect against certain respiratory infections. Uptake is especially important for vulnerable groups such as older people and those with compromised immune systems. In Somerset, ‘flu and pneumococcal vaccination rates tend to be higher than the national average; however there are still many people who could benefit by receiving protection through vaccination.
Key indicator
Compare with neighbours Public health profiles – OHID (phe.org.uk)
Stroke
Stroke is, like ischaemic heart disease, a circulatory disease that contributes significantly to the loss of Disability Adjusted Life Years in Somerset. Rates in Somerset tend to be higher than the England average, and have shown a long-term increase. Both these can largely be attributed to the elderly population structure.
Key indicator
More data from OHID Fingertips
Diabetes
Diabetes is a common life-long health condition. There are 3.8 million people diagnosed with diabetes in the UK and an estimated 850,000 people who have the condition but don’t know it. Diabetes significantly increases the risks of heart attacks, strokes, blindness, kidney failure and amputation and reduces life expectancy by more than fifteen years for someone with Type 1 diabetes and up to ten years for someone with Type 2 diabetes (source: YHPHO).
Risk factors associated with diabetes include lack of physical activity, obesity and smoking. Age is also a key factor in diabetes prevalence. Type 1 diabetes tends to be diagnosed in childhood but the prevalence of Type 2 diabetes increases steadily after the age of 45 years. Type 2 diabetes prevalence is higher in areas experiencing deprivation. People living in the 20% most deprived neighbourhoods in England are 56% more likely to have diabetes than those living in the least deprived areas. It is known that people from Asian and Black ethnic groups are more likely to have diabetes and tend to develop the condition at younger ages (source: Yorkshire and Humber Public Health Observatory, YHPHO). In addition to direct health costs, there is a considerable impact on social care expenditure as diabetes complications are estimated to increase costs four-fold.
Key indicator
More data from OHID Fingertips
Lung Cancer
Cancer of the lung is one of the most prevalent malignancies, and unlike, say, prostate or breast cancer, is commonly found in both sexes. Incidence and mortality rates tend to be lower in Somerset than for England. Although not the only cause, lung cancer is strongly linked to smoking.
More data from OHID Fingertips
Alzheimer’s disease
Alzheimer’s is the most common form of dementia, which describes a set of symptoms which include loss of memory, mood changes and problems with communication and reasoning. It is progressive, and patients may have the condition for years. It may be a direct cause of death, or frequently a contributing factor; both are included in the indicator.
Key indicator
More data from OHID Fingertips
Falls
Falls are the leading cause of mortality due to injury. As people age, they have an increased risk of falling – an estimated 30% of those aged 65 and up to 50% of those aged 80 fall each year. A fall can lead to complications arising from being unable to get up, a loss of confidence and independence, greater social isolation and a reduction in physical activity. Rates in Somerset have been generally similar to the England average.
Key indicator
More data from OHID Fingertips
Depressive disorders
Depression is, along with anxiety, one of the most frequent conditions of mental ill-health.
Early childhood is a time of particular importance, as children’s brains are quite literally shaped by their experiences. Abuse, insecurity and anxiety in the early years can be hugely detrimental to a child’s development. There is good evidence that investment in early years, preventing exposure to violence and abuse and investment in high quality parenting programmes and conduct disorder interventions can be highly effective in protecting children from the lifelong impacts of poor mental health.
Risk factors for poor mental health in adulthood include unemployment, low income, debt, violence, stressful life events, inadequate housing, fuel poverty and other adversity such as serving in combat. Risk factors disproportionately affect the mental health of people from marginalised groups. Targeted intervention for groups at higher risk of mental illness can prevent a widening of inequalities in comparison with the general population. Protective factors include stable housing, strong, positive social networks and support; access to green space; feeling safe and having a good sense of meaning and purpose.
Key indicator
More data from OHID Fingertips
Colorectal Cancer
Colorectal, or bowel, cancer is one of the most common types of cancer diagnosed in the UK. Most people diagnosed with it are over the age of 60. As well as age and family history, the avoidable risk is higher among those with a diet high in red or processed meat and low in fibre, the overweight, the physically inactive, those who smoke, and drink alcohol.
Rates in Somerset are broadly similar to the England average.
Key indicator
More data from OHID Fingertips
Next: Ill health risk factors