People in Cardiff could be described as being healthier than ever before. Levels of general health are high with life expectancy for men and women continuing to rise, and women in Cardiff projected to live longer than those in the majority of the ‘Core Cities’. However, these headlines hide substantial variability across the city with different age groups and communities facing wide ranging health problems.
There is a significant and growing gap in healthy life expectancy between those living in the least and most deprived areas of the city, which now stands at over 20 years. Similarly, mortality rates from a number of diseases are appreciably higher in more deprived wards.
In terms of healthy lifestyles, more than half of the population in Cardiff are overweight, obese or underweight, comparatively few people undertake physical activity, and – despite recent falls – there is a high number of people smoking and drinking to excess. Lifestyle significantly contributes to the likelihood of living with chronic conditions later in life.
Health and well-being in the early years of childhood particularly impacts on long-term outcomes. 1 in 4 five year olds in Cardiff has an unhealthy weight. The impact of harmful experiences on children can also affect the rest of their lives.
Furthermore, Cardiff’s rapid population growth will be characterised by increases in the number of very young people and an ageing population, both leading to substantial pressures on the city’s health and care services.
This Outcome sets out some of the health challenges facing Cardiff today, notably the gap in life expectancy and healthy life expectancy between the richest and poorest parts of the city and the need to encourage healthy lifestyles to tackle a growing obesity problem.
Looking to the future, the gap between the economic outcomes of different communities seems unlikely to reduce, and given the close correlation between economic and health outcomes, the gap in life expectancy and healthy life expectancy of the people who live in the richest and poorest part of the city seems likely to increase.
Efforts will need to be directed at encouraging healthy lifestyles, given the long-term impact on individuals and demand for health services. While the prevalence of smoking is likely to continue to decline and the percentage of babies born with low birth weight is expected to improve, projections suggest levels of obesity will continue to increase, a key factor in terms of health outcomes. Increasing access to healthy food and opportunities for physical activity will therefore be important in improving the future health of the population.
Meeting the health and care needs of a growing population within ongoing financial constraints will be a major long-term challenge for Cardiff. The number of children aged under four is expected to increase, an age group that has a greater need for health and care services. Work is ongoing nationally and internationally to study the impact of so-called ‘adverse childhood experiences’ – stressful experiences occurring during childhood that directly harm a child (such as mental, physical or sexual abuse) or affect the environment in which they live (such as growing up in a house with domestic violence or where there are harmful behaviours). Indications are that these experiences can make individuals more likely to adopt harmful behaviours, perform less well in school, and can lead to mental and physical ill health in later life. Developing joined-up, preventative responses from public services will be important in supporting the most vulnerable children and families.
The city’s older population is projected to grow substantially, placing greater demands on care services with increases in health problems, particularly chronic conditions such as dementia. Older people are also more likely to require longer and more frequent stays in hospital – nearly two thirds of people currently admitted to hospital are over the age of 65. Addressing increasing levels of social isolation, improving mental and physical well-being in older age and providing more support to people in their communities, will enable people to live independently in their own homes for longer and improve the resilience of our communities.