• Lower life expectancy and high mortality rates: Carlisle has lower life expectancy rates and higher rates of mortality from chronic illnesses such as cancer and cardio vascular disease when compared to national averages. • Self-harming behaviours: Rates of recorded drug use related death, selfharm and suicide are exceptionally high, with Cumberland identified as having some of the highest rates of suicide for both women and men in England. • Mental health problems: There is unprecedented demand for services for adults, children, and young people, leading to growing waiting lists for diagnostic and treatment services. • Ageing populations: Carlisle’s ageing population is presenting current and future public health challenges, including increased demand on health and care services, with particular concerns regarding rural areas that lack facilities and access to services. • New health structures: Recent changes to health structures11 are reported to be creating some confusion about ‘which organisations do what, and where.’ • Obesity: Almost a third of adults in the Cumberland area are classified as obese. This is significantly higher than the national average. CHALLENGES There are so many challenges, and they are all interconnected. For example, obesity – is it education, is it access to food, is it the cost of food, is it the prevalence of takeaways, or where people live? Why are people smoking? Is it a response to the trauma and difficulties that are in their lives that lead smoking to be a coping mechanism? For each one of the different health challenges there is real recognition that it is a range of complex individual choices, experience, knowledge, educational needs as well as societal and contextual pressures that are driving all of those things. There are no simple quick wins. Local Authority Researcher LIFE EXPECTANCY Life expectancy is an important indicator of health. It is concerning that Carlisle has a lower life expectancy at birth than England. Life expectancy at birth in Carlisle is 77.3 years for males and 81.5 years for females between 2020 and 2022 (compared to 78.9 and 82.8 years respectively in England).12 There are also significant differences in life expectancy across Carlisle. Between 2016 and 2020 life expectancy at birth for women was highest in Corby and Hayton ward at 86.1 years and was lowest in Harraby North ward at 78.9 years (compared to England at 83.1). For men over the same period, life expectancy at birth was highest in Wetheral ward at 81.9 years and lowest in Morton ward at 73 years (compared to England at 79.4). The differences between life expectancy in the highest versus the lowest wards in Carlisle is 7.2 years for women and 8.9 years for men.13 SERIOUS ILLNESS In 2023, the under-75 mortality rate in Cumberland from all causes was worse than the England average at 412.1 per 100,000 compared to 341.6 in England. Similarly, the under-75 mortality rate from cardio vascular disease was also worse than England averages (82.7 per 100,000 compared to 77.4), as was the under-75 mortality rates from cancer (at 128.0 per 100,000 compared to 120.8).14 It is also of note that Cumberland has higher mortality rates and lower early-stage diagnoses for cancer than national averages with only 48% of cancers diagnosed at stages 1 and 2, compared to 54.4% nationally.15 This is of particular concern as early diagnosis is critical in improving cancer survival rates. More positively, Cumberland outperformed the England average in terms of cancer screening coverage for breast cancer, bowel cancer, and cervical cancer in 2023.16 BEHAVIOURS THAT CONTRIBUTE TO POOR HEALTH It is estimated that 40% of healthcare provision in England is focused on managing preventable illnesses, costing the NHS acute sector nearly £5 billion per year.17 There are several factors that contribute to the likelihood of becoming and remaining ill: • Where people live is a key factor in determining health inequalities, with poorer communities facing greater challenges. • Smoking is the leading cause of avoidable illness and early death. Smoking prevalence in adults (18+, current smokers) in 2023 was higher in Carlisle (13.3%) than the England average (11.6%).18 • In Cumberland from November 2023 to November 2024, approximately 55,200 people (or 23.9%) of the population aged 16 and over did not participate in regular weekly sport and physical activity. According to Sport England there are many reasons why people don’t participate including gender, ethnicity, socio economic factors (such as lack of money, working or care pressures) as well as disability and poor health.19 • In 2023/2024 across Cumberland, the prevalence of obesity in adults (18+ years) is 30.9%. This is an increase of 4.3% compared to the previous year’s data. This is significantly above the England average of 26.5% and means that almost a third of adults in Cumberland are obese.20 There are lots of initiatives for people to be physically active in Carlisle. However, there are still barriers and stubborn health inequalities which prevent people from taking part. The good work being done now to address these barriers and inequalities will take time to be reflected in the current figures. Sport and Health Sector Representative Carlisle: Opportunities & Challenges 2025 56 57
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