West Cumbria Opportunities & Challenges 2025 56 57 PHYSICAL ACTIVITY AND OBESITY23 Estimates suggest that 40% of national healthcare provision in England is being used to manage preventable ill health, costing the NHS acute sector approximately £5 billion per year.24 Some of these costs could be avoided, through engagement in physical activity. Yet, at present across Cumberland, one in four (25.5% or 58,600 people) aged 16+ are estimated to be physically inactive. Of these, 45.2% are inactive due to low socio-economic status; 47.7% have three or more limited impairments; 27% are females; or are black or Asian at 31.4% and 33.1% respectively.25 It is no surprise therefore that national sports organisations such as Sport England and the Football Foundation have identified four priority groups for targeted interventions on physical inactivity. These groups are women and girls, culturally diverse communities, people with disabilities and people living in low socio-economic groups. Obesity remains a significant national issue, contributing to a wide range of diseases including type diabetes, hypertension and heart disease. Historically, Allerdale and Copeland have both demonstrated levels of overweight and obese adults that are higher than national averages.26 In 2023/2024 across Cumberland, percentages of overweight and obese adults still remains high at 71.3%, compared to the Northwest at 66.7%, and the England value of 64.5%. The prevalence of obesity in adults (18+ years), stands at 30.9%, almost a third of adults in Cumberland, and higher than the England average of 26.5%.27 SEXUAL HEALTH New Sexually Transmitted Infections (STI) diagnoses, excluding chlamydia, are significantly lower in Cumberland than the national average, as are diagnostic rates for both syphilis and gonorrhoea. The STI testing rate in Cumberland (excluding chlamydia aged under 25), however, is significantly worse than the England average.28 The number of new Human Immunodeficiency Virus (HIV) diagnoses per 100,000 is also significantly lower in Cumberland than the national average. However, HIV testing coverage in the region is worse than the national average. HIV testing coverage is also significantly lower in gay and bisexual men, with only 59.6% coverage compared to the England figure of 74.1%, and among all men, with only 55.9% coverage compared to the national figure of 65.1%. Antiretroviral therapy in those accessing HIV care in Cumberland has 100% coverage, which is better than the national figure.29 VACCINATION RATES IN CUMBRIA Vaccinations help protect people from serious diseases and keep them healthy. MMR is the combined vaccine that protects against measles, mumps and rubella. The population vaccination coverage rate for MMR for one dose (2 years old) in Cumbria in 2023/2024 was 95.8% – higher than the England rate of 88.9% with no real changes in recent trends. In 2023/2024 the population vaccination coverage for MMR two doses (5 years old) for Cumbria was 97.2% and in England was 91.9%, showing an improving picture in Cumbria. The HPV vaccination protects against cervical cancer and is given to males and females. In 2023/2024 population vaccination coverage in Cumbria for HPV vaccinations for females 12–13 years (one dose) was at 81.6%. For both males 12–13 years (one dose) and females 13-14 (two doses) the Cumbria vaccination coverage is still below the 80% goal. In 2023/2024 in Cumbria shingles vaccination coverage was also below the 50% goal for people aged 71 years.30 27https://fingertips.phe.org.uk/search/obesity 28Sexual Health area profile: Department of Health and Social Care, https://fingertips.phe.org.uk/search/sexual%20health MENTAL HEALTH31 Along with many parts of the country, there is a growing mental health crisis in West Cumbria. Mental health services both for adults and children and young people are facing 'unprecedented demand', leading to growing waiting lists for diagnostic and treatment services.32 VCSE organisations are endeavouring to support the NHS and other public providers to help meet this demand. However, they too are finding themselves overwhelmed by the increasing numbers of people seeking support, often presenting with multiple and complex mental health challenges. For example, the Farmer’s Network which historically was set up to provide business support to farmers, is now dealing with up to six ‘I am worried’ calls per week, including from farmers experiencing thoughts of suicide. These cries for help point to growing mental health challenges for West Cumbrian farmers that are inextricably linked with their business prospects, family relationships, loneliness, long working hours and financial concerns.33 In Cumberland, specialist mental health services are primarily provided by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW). Within this Trust, referrals for specialist mental health services rose by more than 50% over the last three years.34 North Cumbria Referrals to CNTW for Mental Health Services Across England, the number of people recorded by GP’s as having a diagnosis of depression has nearly doubled in ten years. Such growth is also visible in Cumberland where during 2022/2023 over 40,000 people (or 18% of the adult population) was recorded as having depression, over a third higher than the England average. In addition, over 3,000 people in Cumberland have a recorded diagnosis of schizophrenia, bipolar disorder, or another psychotic disorder - a figure that is approximately 10% higher than the England average and one that has risen by 15-20% over a 10year period.35 Prescribing data from NHS North Cumbria,36 suggests that in November 2023, average antidepressant prescribing stood at 160 items per 1,000 patients - around a third higher than the England average of 120 items per 1,000 patients. Prescription of antipsychotic medications is also higher, at around 10% higher in North Cumbria than the national average. The prescribing of drugs to treat mental health problems across England is also acknowledged to be higher in northern and coastal communities and areas of higher socio-economic deprivation. There is, however, considerable variation in prescribing of mental health medications across Cumberland with the highest prescribing practice issuing nearly twice as many items per patient as the lowest.37 29Department of Health & Social Care: https://fingertips.phe.org.uk/search/HIV 30Fingertips Public Health Data: Department of Health and Social Care, 2024, https://fingertips.phe.org.uk/search/vaccinations#page/1/gid/1/pat/15/ati/402/are/E10000006/iid/30303/age/30/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1
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