A detailed understanding of the socio-economic characteristics of the local population is vital to robust needs assessments. This forms the basis against which other data can be analysed, helps to identify inequalities and is a key building block in modelling service requirements. JSNA data should paint a picture of the local area, its characteristics and the diversity within it.
Warwickshire lies to the south and east of the West Midlands conurbation, and has established links with Coventry, Birmingham and Solihull in the West Midlands region, but also with the South East. Despite the focus of population within the main towns of the county, a significant part of Warwickshire is rural in nature. Warwickshire lies at the heart of Britain’s transport network and several key strategic routes pass through the county.
Warwickshire is a two-tier local authority and comprises five District/Borough areas:
- North Warwickshire Borough
- Nuneaton & Bedworth Borough
- Rugby Borough
- Stratford-on-Avon District
- Warwick District
Socio-Determinants of Health
Our health is influenced by a wide range of social, economic and environmental factors. We as individuals cannot always control them and they influence and often constrain the ‘choices’ we make and the lifestyle we lead.
Dahlgren and Whitehead 1991
The social determinants of health have been described as ‘the causes of the causes’. They are the social, economic and environmental conditions that influence the health of individuals and populations. They include the conditions of daily life and the structural influences upon them, themselves shaped by the distribution of money, power and resources at global, national and local levels.
Please click on the relevant link for a brief topic summary of the following socio-determinants of health, further analysis and access to more detailed data in the Local Information System (where available):
Warwickshire as a Place – past current and future
The following section provides a brief overview of past, present and future key macro level issues affecting Warwickshire. New emerging issues and future challenges have been identified along with future implications for commissioning.
- The latest population estimates reveal that Warwickshire is home to an estimated 554,002 people, this is an increase of 2,408 people from the previous year.
- The ONS 2014-based projections suggest Warwickshire is projected to be home to 618,456 people by 2039. This is a 12.1% increase or 66,912 people in the 25 year period, lower than the equivalent national increase of 15.0%.
- Within Warwickshire, Rugby Borough is expected to experience the highest rates of population growth, increasing by 18.5% from 2015 to 2039.
- The population aged between 0-14 years is expected to grow by 6.7% in the 25 year period; however the population aged between 16-64 years is only expected to grow by 0.1%.
- The Warwickshire population aged 65 years or over is expected to increase by over half (54.4%) over 25 years and when we consider the population aged 90 years or over, this is expected to increase substantially by 269%.
- By 2020 there are predicted to be 2,175 adult Warwickshire residents with a moderate or severe learning disability and 35,465 adult residents with a moderate or serious physical disability.
- It is estimated that there are currently 7,615 people in Warwickshire living with dementia. This number will increase by approximately 34% to just over 11,000 in the next ten years. Of these, two thirds of people with dementia live in the community in their own home.
- The percentage of adults (18+) with dementia (2012/13) was 0.63% (England average 0.57%). In Warwickshire this ranges from over 1,800 people in Stratford-on-Avon district to around 700 in North Warwickshire borough. These demographic pressures will bring increased demand for support services
An ageing population has implications for the future provision of services linked to older age groups, especially with the prevalence of dementia projected to increase by 18% in those aged 65 and over, although this impact is hard to predict. It may lead to an increased pressure on Adult Social Care budgets, although it also presents opportunities in terms of new economic and social opportunities, including volunteering.
- To deliver services to a greater number of residents
- To deliver services to an ageing population
- To recognise that there is increasing diversity in the county
- To tailor services to different communities based on their preferences
Housing & Household Composition
- The demand for housing in Warwickshire will continue to grow, with forecasts suggesting a 21.9% growth in households between 2012 and 2037.
- The proportion of homes that are privately rented has increased in recent years from 7% in 2001 to 12.8% in 2011.
- Projections indicate by 2025, 25% of all households will privately rent, with the largest increase among those aged 20 and 391.
- Housing affordability ratios are an economic indicator used to identify whether those on the lowest incomes can afford to buy the lowest priced housing. It is likely to remain an issue in Warwickshire. The ratio of lowest quartile house prices have been over 6 times lowest quartile earnings since 2003 (currently at 6.72) and is unlikely to reduce significantly in the absence of a housing market crash.
- Large variations exist between affordability in the north and south of the County, Stratford-on-Avon District has a ratio of 8.9 compared to Nuneaton and Bedworth Borough which had an equivalent ratio of 5.3.
Housing demand will need to be delivered in the context of a changed planning system and the adoption of the District/Borough Local Core Strategies, reflecting Housing Needs Assessments for the future. Providing services will need to change to reflect the shifting make-up of how people choose to live. Older people will live independently at home for longer, young adults will live with their parents in a family home for longer and the proportion of single person and transient households will continue to grow.
- A shortage of affordable housing in the south of the county
- A need for improved infrastructure to accommodate the increased number of households
- A need for regeneration in the towns in the north of the county
- Demand for housing will continue to grow in the county
- The unemployment rate in Warwickshire has decreased significantly, with current rates at the lowest seen in 10 years.
- Nuneaton & Bedworth Borough consistently has the highest levels of unemployment in the county, and up until 2015 this rate was higher than the England average.
- Figures indicate the median earnings for a full time worker working in Warwickshire are £787 a year lower than the equivalent for England. However, compared to the West Midlands median annual income is £1,306 higher in Warwickshire.
- A 6% fall in employment growth in Warwickshire during 2006-14 was driven by sharp employment falls in professional services and financial & insurance services. Generally, the trend is fairly consistent with regional and national averages.
- Forecasts show that employment will increase by 6%, exceeding national projections, particularly due to expected growth in food & beverage & IT services.
- Forecasts suggest a 24% growth in GVA between 2015 and 2025, representing an injection of approximately +£2.8 billion into the local economy.
- In 2014 some £36,859 was produced per worker in Warwickshire compared to £39,678 nationally, equating to a £2,819 productivity gap against England. Forecasts show that this gap is projected to widen by 2025, with Warwickshire lagging further behind the UK.
Whilst the outlook for Warwickshire’s workforce and economy appears strong; this should be set against the backdrop of the Government’s unprecedented welfare reform programme, uneven economic recovery and uncertainty around the ramifications of leaving the European Union; the impacts of which are still to emerge fully.
As the welfare reform programme enters its second phase, new welfare cuts have been announced in the recent budget. Headline cuts include, scrapping the automatic entitlement to housing benefit for 18-21 year olds, employment and support allowance claimants in the work related activity group will have their claims cut by 30% in line with the Job Seekers rates, and families with more than two children will not receive tax credits or housing benefit for their third or subsequent child. These changing circumstances may result in additional pressures on other public services.
Changes to the way that local government is going to be funded, with a greater emphasis on the retention of locally generated business rates, will require a much greater understanding of the vitality and vibrancy of our local business base. This will be allied with a greater focus from central government on partnership funding agencies such as Local Enterprise Partnerships, meaning different ways of generating and using future resources.
- A lower level of market investor confidence in the north of the county, and a lack of supply to meet market demands in the south of the county in a sustainable way
- A need to ensure that income from the tourism economy is maximised and retained within the local economy
- Below average rates of productivity, and falling relative to national rates
- A need to better support the growth of our small but innovative enterprises
- A third of all Priority Families in Warwickshire reside in Nuneaton & Bedworth Borough (33%). This proportion is three times the proportion seen in Stratford-on-Avon District (11%)
- The Index of Multiple Deprivation 2015 highlights eight areas in Warwickshire that feature in the 10% most deprived communities in the country, six of these are in Nuneaton & Bedworth, one in Warwick and one in North Warwickshire.
- Nuneaton & Bedworth Borough has the largest concentration of children living in low-income families in the County (18.2%), whilst Stratford-on-Avon District has the smallest concentration (8%).
- Full time workers, who reside in Nuneaton & Bedworth Borough, earn less than their counterparts elsewhere in Warwickshire.
- Despite this, inequalities are spatially dispersed across the county and are often hidden by District/Borough level reporting.
Levels of inequality across Warwickshire are growing. Our more prosperous neighbourhoods have been better placed to deal with the impacts of the recession and associated trends, and have displayed higher levels of resilience in the face of downturns in the economy.
The drive towards maintaining independence, the move to more preventative approaches, the duty to promote the integration of care services, and changing inspection guidance and quality assurance, will all challenge the public sector in the way that we fundamentally view social care and support and safeguarding both adults and children in the future. Underpinning this are the demographic changes in the county which will result in greater
demand for social care.
The Dilnott Report recommendations, the implementation of Part One of the Care Act and the principles of integrated commissioning across education, health and social care in children’s and health and social care in adults, will continue to have an impact on the way services are commissioned in the future, including market sustainability.
Also affecting the market is the promotion of a more personalised approach to care and support, including Personal Budgets and Direct Payments. This will affect the way the market is able to respond to individual requirements.
The pace of technological change is already affecting the way services are delivered, with services increasingly being delivered online. In 2010, around 20% of us owned smartphones; at the beginning of 2015, this figure rose to 69%. At the same time, we are seeing improvements in broadband speed and availability, providing even more opportunities to engage with and deliver services to residents in cost effective ways.
While actively encouraging residents to self-serve and adopt these new technologies, we understand that not all customers are receptive to this change. Consideration needs to be given to the most vulnerable members of our communities, as it is likely they will be more intensive users of our services whilst least willing or able to interact with us in the most cost efficient ways.
National Policies and Developments impacting on Warwickshire
As well as the current policy landscape, by 2018, we will be half way through the new Conservative administration. New policies unknown as yet will impact on Warwickshire. At present we are already aware of national policies and initiatives, some of which are mentioned below.
- Continued impact of austerity and spending reviews including reduction to budgets and the introduction of the living wage
- Health & Social Care integration
- Due to an increasing ageing population the demands on adult social care will increase and by 2020 there are predicted to be 2,175 adult Warwickshire residents with a moderate or severe learning disability and 35,465 adult residents with a moderate or serious physical disability
- Carers, particularly young carers, will continue to play a significant role in delivering aspects of social and personal care
- There is predicted to be an increase in the number of Warwickshire residents aged 65 and over with a limiting long term illness, the estimated figure of residents affected by 2020 is 59,564
- Economic growth, including the Local Economic Partnership
- The number of businesses is likely to increase in the county and employment growth is expected to increase by 6%
- West Midlands Combined Authority
- Education, Academies & Trading
- Blue Light Service Collaboration
- Planning & Infrastructure (including housing, roads and High Speed Rail (HS2))
- Public Service Governance
- Digital First (There will be an increasing demand for digital self-help technology across all services that WCC provides, in particular for social care where digital technology has the potential to improve efficiencies and the quality of care services)
- Priority Families (By 2020 more than 2,790 Priority Families will have been identified and attached to the Warwickshire programme. It is expected that half of these families will see sustained and significant progress in relation to the issues that they face and will be successful payment by results claims (an estimated 1,395 families)
- Upcoming local Elections
- Crime recording issues (both Warwickshire and nationally) – Warwickshire adults are more likely to fall victim to a cybercrime than they are to traditional crime such as being the victim of robbery or theft
- Cyber crime (largely under reported)
- Population increase – particularly in the over 70s age group (estimated 19% increase by 2020)
- Predicted increase in the number of school age children (estimated 4% increase by 2020 – 4 to 17 year olds)
- Housing – demand for housing will increase, with privately rented property figures increasing most for those aged 20 to 39 years. An increase is likely to lead to issues with rent levels, security of tenure and quality, particularly for vulnerable groups.
- Housing – in the social rented sector those living in the most deprived areas will see a reduction in income, year on year, which is likely to be a direct result from the impact of welfare reform.
- Community – there will be a growing reliance on the voluntary and community sector to help deliver services – with an increased focus on empowering the community
- Technology – the increase in use of Smart Phones, Tablets and the improvements in Broadband speed and coverage are changing the way people deliver and receive services
- Health – an ageing population puts pressure on health and social care with the prevalence of dementia projected to increase by 18% in those aged 65 and over
- Life expectancy – life expectancy is increasing, and so is the number of dependent adults aged 65+ and to offset this the retirement age is likely to increase
- Other policy developments