In order to fully understand the health and social care needs of children in Warwickshire, it is important to provide some context in terms of their demographic and socio-economic make-up. 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.
What are the big issues?
According to the mid-2015 estimates, there are approximately 125,251 children and young people aged 0 to 19 years living in Warwickshire which equates to 23% of the total population. This proportion is below the equivalent national and regional figures. Across Warwickshire’s districts and boroughs, Warwick District (30,641) has the largest number of children aged 0 to 19 years, closely followed by Nuneaton & Bedworth Borough (30,133).Rugby Borough has the largest proportion of its total population aged 0 to 19 with one in four falling into this particular age group (25%). In contrast, in Stratford-on-Avon, 21% of the total population are aged between 0 and 19.
According to the January School Census 2015, the vast majority of the maintained and academy school population in Warwickshire are of White British ethnic origin (85%), and the largest minority ethnic groups are Asian (5%), Mixed (4%) and Any Other White Background (4%).
The largest demographic issue facing the county is that of a rapidly ageing population. In comparison, the total child/young people population in Warwickshire is projected to increase by a much lower rate according to the 2014 based ONS projections. The population aged between 0-14 years is expected to grow by 6.7% in the 25 year period from the 2014 base; 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%. However, this projected growth is not insignificant and has a range of future policy implications in terms of increased demand for those services provided for children and young people.
Local analysis shows that 11.5% of mothers in Warwickshire were recorded as smokers at the time of delivery (SATOD) for 2014/15, which is comparable to the England rate (11.4%). Evidence has demonstrated that babies born to women who smoke during pregnancy are around 40% more likely to die within the first four weeks of life than babies born to non-smokers. SATOD reflects the link between smoking and health inequalities and is a precursor to initiating smoking in adolescence. Smoking status at the time of delivery (SATOD) data is not available at district/ borough level, however it is available at CCG level. Warwickshire North CCG had the highest prevalence of pregnant women smoking at the time of delivery (14.0%), followed by Coventry and Rugby CCG (12.3%) and finally South Warwickshire CCG (8.7%). Reducing smoking in pregnancy is a key priority within Warwickshire and a priority theme for the ‘Smoke Free Warwickshire Alliance’.
Injuries represent a major cause of premature mortality for children and young people. They are also a source of long-term health issues. In 2013/14, the rate of hospital admissions as a result unintentional and deliberate injuries in children (aged 0-14 years), was higher in Warwickshire (125.3 per 10,000) than for England (112.2 per 10,000). Warwick District has the highest hospital admission rate for unintentional & deliberate injuries (aged 0-14 years) in the County (138.5 per 10,000). This rate is significantly worse than the England average (112.2 per 10,000). By way of comparison North Warwickshire Borough has the smallest rate in the County, at 102.0 per 10,000 resident population.
Younger carers (aged between 0 and 24 years) are identified as of particular concern in Warwickshire because of the potential impact of caring responsibilities on educational outcomes and wider social opportunities. Young carers have significantly lower educational attainment at GCSE level and those aged 16-18 are twice as likely as their peers to be not in employment, education or training (NEET). Also, high levels of unpaid care have been found to have adverse effects on the health of young people.Nuneaton & Bedworth Borough has the highest proportion of young carers providing 20 or more hours of unpaid care a week. Young carers (16-24 years) are twice as likely to report that their health is ‘not good’ compared with their peers who provide no care. This difference increases with time spent caring, with young carers caring for 50 hours or more per week; five times more likely to report their health as ‘not good’ compared to those of the same age providing no care. This implies that high levels of unpaid care have a greater adverse effect on the health of young people.
Hospital admissions for self-harm in children have increased in recent years, with admissions for young women being much higher than admissions for young men. The rate of hospital admissions as a result of self-harm in young people in Warwickshire is significantly higher than both the England (412 per 100,000) and West Midlands rate (412 per 100,000).
The UK is experiencing an epidemic of obesity affecting both adults and children. Studies tracking child obesity into adulthood have found that the probability of overweight and obese children becoming overweight or obese adults increases with age. Health consequences of childhood obesity include: glucose intolerance & type 2 diabetes.Nuneaton & Bedworth Borough has the largest proportion of obese children in the County, both in reception and year six. Conversely, Warwick District has the smallest proportion of obese children in the County, again both in reception and year six. There is concern about the rise of childhood obesity and the implications of such obesity persisting into adulthood. These implications are not just physical, given that childhood obesity can lead to psychological problems such as social isolation, poor self-esteem and bullying.
The health and wellbeing of Warwickshire children is vital in ensuring the future success of the County. The Warwickshire Joint Strategic Needs Assessment (JSNA) identifies the current and future health & wellbeing needs of the local population. The JSNA aims to establish a shared, evidence based consensus on key local priorities across health and social care, and is being used to develop Warwickshire’s Health and Wellbeing Strategy, commissioning plans for the CCGs and transformation plans for the local health economy.
Teenage pregnancy and early motherhood have been associated with poor educational attainment, poor physical and mental health, and deprivation. The UK has the highest teenage birth rate in Western Europe, and an estimated £63 million a year is spent by the NHS on teenage pregnancies. In 1999 the government introduced the Teenage Pregnancy Strategy, which aimed to half the national under-18 conception rate by 2010. Since then, the under-18 conception rate has continued to decline.
Within Warwickshire, Warwick has the lowest conception rate per 1,000 women aged 15 to 17. When looking at the proportion of under-18 conceptions that have led to abortion, Stratford-on-Avon has the highest proportion (65.5%), whist Rugby has the lowest (47.2%).
Whilst, four of the five districts/boroughs saw a decrease in the under-18 conception rate between 2013/14, Nuneaton & Bedworth saw an increase of +13.3. This increase is not only significant at county level, but nationally, as places Nuneaton & Bedworth as the worst (highest) ranking area for under-18 conception rate in England & Wales. However, it should be noted there was a significant downward spike in the rate in 2013, meaning whilst this rate appears to have gone up significantly between 2013/14, overall the rate is continuing to decline from 1998.
A child is considered to live in poverty if they live in a household with an income below 60% of the UK’s median income. Although Warwickshire has low overall levels of child poverty, localised pockets with relatively high levels do exist, particularly in Nuneaton, and to a lesser extent in Rugby and Bedworth. There are also dispersed rural pockets both in the rural south and north.
Proportion of child in Low-Income Families
The proportion of children (all dependent children under the age of 20) living in low-income families is a measure based on the number of children living in families in receipt of Child Tax Credits whose reported income is less than 60 per cent of the median income or in receipt of Income Support or (Income-Based) Jobs Seekers Allowance, divided by the total number of children in the area (determined by Child Benefit data).
Overall, Warwickshire has a lower proportion of children living in low-income families when compared to both regional and national equivalent figures. This figure steadily declined between 2010 and 2013, in line with national, but not regional trends. When looking at district and borough level data, we can see there is split between the north and south of the County, with the north home to a larger proportion of children living in low-income families. 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%). This data highlights the importance of looking at data at a lower spatial level (district/borough). When looking only at the Warwickshire average, compared to national and regional trends, we can miss important information about the local communities within Warwickshire. Also, data at this level can mask inequalities in the County.
Proportion of children living in all out of work benefit claimants households
This measure looks at the proportion of children living in all out of work benefit claimants households (2014 data). The term ‘out-of-work benefit households’, refers to households where at least one parent or guardian is claiming an out-of-work benefit. Out-of-work benefits include Jobseeker’s Allowance, Income Support, Employment and Support Allowance, Incapacity Benefit, Severe Disability Allowance and Pension Credit. Universal Credit is not included.
National, regional and county figures all show a decrease in the proportion of children living in all out of work benefit claimant households between 2010 and 2015. Whilst Warwickshire (9.8%) has a smaller proportion of children living in these types of household, when compared to national (14.0%) and regional (16.8%) figures, the overall figure for Warwickshire masks large differences which can be seen at district and borough level. Moreover, between 2010 and 2015, Warwickshire saw a smaller reduction in the proportion children living in all out of work benefit claimant households (-3.5% points) when compared to the equivalent figures for both the West Midlands (-4.8% points) and England (-5.0% points). The south of the county is home to a much smaller proportion of children living in these households than the north. In Nuneaton & Bedworth borough 15.7% of children aged 18 and under were identified as living in out of work benefit claimant households (2014), conversely, the equivalent figure for Stratford-on-Avon is 6.2%, representing a 9.5% point difference between the two.
Nationally, The Child Poverty Act came into force in 2010 with the aim of eradicating child poverty by the end of 2020. In the summer of 2014, the Government revised its approach to tackling child poverty over the next three years by seeking to focus on: 1) Supporting families into work and increasing earnings, 2) Improving living standards and 3) Educational attainment. The underlying principle of the Strategy is to ‘address poverty now and break the cycle of intergenerational poverty’. Recently the Warwickshire Child Poverty Strategy has been refreshed, though the central aim of the strategy remains to eradicate child poverty by 2020. The strategy recognising that it is as important to tackle underlying causes of child poverty, as well as dealing with the consequences.
Who needs to know?
- All stakeholders
Comprehensive data and analysis on Warwickshire’s current and future population is contained within the Observatory’s latest Quality of Life Report.