Health and wellbeing strategy consultation background

Complete the Health and wellbeing strategy consultation questionnaire

The Health and Wellbeing Strategy consultation questionnaire lists the 12 areas that local evidence tells us we should consider for our focus over the next 10 years. Below you can find more detail on the background to each of these priorities.

Q1 Support good mental wellbeing throughout life

Good mental health and resilience are fundamental to our physical health, our relationships, our education, our training, our work and to achieving our potential. People with mental health issues can face significant disadvantages throughout their lives.

Findings from the 2021 Herefordshire Community Wellbeing Survey indicate that the average wellbeing scores for adults in the county are above the England average. However, an estimated 24,800 adults in Herefordshire have a common mental health disorder. Results from the 2021 Herefordshire Children and Young People Quality of Life Survey revealed 1 in 4 primary aged children have low to medium mental wellbeing scores, rising to nearly half in secondary aged pupils. We also know that the Covid-19 pandemic has resulted in an increase in people experiencing anxiety and depression. We want to continue to support the expansion of projects across the county that support peoples’ mental well-being.

Q2 Support people who misuse drugs and alcohol, or who smoke

People involved in substance misuse are very likely to have significantly worse mental and physical wellbeing compared to those who don’t have this lifestyle. Nationally, during the Covid-19 pandemic we saw a rise in alcohol and cannabis use and there was disruption in access to support services. However since the latter half of 2021 and 2022 there has been a small but steady increase in the numbers of people completing a rehabilitation programme.

Herefordshire has made good progress in reducing smoking rates across the county (2.3% reduction in the last five years). However, smoking remains the leading cause for differences in life expectancy in the county, and there are challenges within certain population groups such as pregnant women where smoking rates are higher than the national and regional average.

Q3 Support and protect those with multiple complex vulnerabilities

There are small groups of people who are subject to multiple risk factors (alcohol and drug use, severe mental illness, homelessness, at risk of violence and abuse) that in combination are likely to have a severely adverse effect on their mental and physical wellbeing. Often these vulnerabilities stem from negative childhood experiences, hence the important work of the Children and Families Team, but the impact of trauma can be experienced at any age and can prevent people from thriving and being able to function. These people need significant levels of coordinated and sustained support in order to live their lives safely, independently and with fulfilment.

Q4  Every child has the best start in life

The early years of a child’s life have a huge impact on their future development and physical and mental wellbeing. Children in Herefordshire generally thrive and rates of child poverty are lower than the national average. However there are some areas of significant concern. The rates of babies who die at birth or shortly after is higher than the national average, rates of childhood vaccinations are below the national average and the dental health of young children remains poor. In keeping with the national programme, we have a dedicated Children and Families Team that works with young children and their families. These services are there to help families cope with the challenges of raising children, help them have positive parenting experiences and thereby helping children to thrive. The Council is currently working closely with Ofsted (a government regular and inspection agency) to implement better practices within our Children and Families services and we anticipate that this will help us improve our care for families that are most in need.

Q5 Improve education outcomes for disadvantaged children and young people

The quality of a child’s education is one of the most important determinants of their future life chances. Generally, children in Herefordshire do well at school, but there are significant differences in achievement between disadvantaged children and their peers. The Covid-19 pandemic has widened these differences and has resulted in more children not being ready for school. We want to see all children and young people have an equal chance to do well in education and develop the kind of life skills that will equip them to live a fulfilled life in society and to be able to contribute positively to it.

Q6 Ensure there is good work for everyone

Rewarding and fulfilling work supports good physical and mental wellbeing. It fairly rewards peoples’ efforts, enables them to earn a decent living wage and provides opportunity for personal development and financial security. In Herefordshire the economy is dominated by self-employment and the agriculture industry. Although the county has one of the lowest unemployment rates in the West Midlands, (3.4%), low wages are a significant issue, with earnings being consistently the lowest in the region. This therefore makes it difficult for people to improve their financial and life circumstances. We know that there are barriers for certain groups of people being able to access good quality jobs that are suitable for their needs and circumstances, for example, those with poor educational attainment, those with mental health issues and those with learning difficulties. We want to improve the opportunities for these people as well as for the population in general.

Q7  Increase access to healthy and sustainable food and physical activity

A healthy balanced diet and remaining physically active are two of the most important ways of staying healthy. Obesity rates have continued to steadily increase and Herefordshire rates are above the national average, with more than two thirds of adults - about 105,600 people, and over a quarter of reception age children, classed as overweight or obese. Being overweight also has adverse consequences for our mental well-being, not just physical. However we know that if people are helped to make better and easier choices with healthy eating and are enabled to be more physically active, they can improve their all-round health and wellbeing.

Q8 Protect the natural environment and reduce our carbon footprint

The global climate crisis is also an unfolding health crisis, as we see the increasing problems of flooding and poorer air quality. It’s also likely that we’ll see an increase in the frequency and severity of heatwaves which will lead to a rise in the number of heat-related deaths. Herefordshire has declared a climate and ecological emergency, committing to work with partners with the aim of the county becoming carbon neutral by 2030. One of the council’s pioneering projects has been in the wetlands, to improve the polluted water in sections of the Rivers Lugg and Wye and to reduce flood risk.

Q9 Improve housing and reduce homelessness

The links between poverty, inadequate or unsuitable housing and ill-health are well-established. Due to the age and nature of Herefordshire’s housing stock, we have significant issues with fuel poverty and cold homes, especially in more isolated rural areas. ,It’s estimated that 30% of winter deaths are caused by cold living conditions and our fuel poverty rates are above the national average, affecting around 14,100 homes. There has also been an increase in homelessness, partly due to the Covid-19 pandemic and the cost of living crisis. However, a specialist project set up during the pandemic helped to accommodate 239 individuals, of whom 148 were moved into long-term housing, or were waiting to be moved into long term accommodation. The project is still operational and our ambition is that it continues to build upon the work already done.

Q10 Reduce loneliness and social isolation across all ages

There is an established link between loneliness and poor health, both mental and physical. Research tells us that loneliness is associated with a greater risk of unhealthy behaviours and increases early death by 30%. In our 2021 Community well-being survey 1 in 10 adult residents said that they felt lonely, approximately 15,800 of the population. This issue has been exacerbated by Covid19, reflecting its effect nationally and affects greater numbers of young people than previously. However in our well-being survey, 88% of residents also said that they feel a strong sense of belonging where they live and are generally happy, which compares favorably with other areas of the country. We therefore have a positive base upon which to build, but we know there is room to improve how we help people to connect better with each other, whether that is through physical local networks or digital connectivity.

Q11  Support people to age well

Herefordshire has an ageing population, with 25% of residents aged 65 and over which equates to about 48,500 people. This number is predicted to increase 11% by 2025 and is expected to continue increasing. In keeping with the characteristics of an elderly population we have increasing rates of dementia and long term conditions. We want people to enjoy good health and independence for as long as possible and to stay healthier in old age, which includes being able to get diagnosed quicker if they have symptoms of dementia or another long-term condition.

Q12  Improve access to local services

Herefordshire is one of England’s most rural counties. Over half our residents live in rural areas - about 93,000 people. There are benefits to living in a rural setting, with 92% of people reporting being satisfied with where they live. However as the Covid-19 pandemic highlighted, when our geographical movement is restricted, it’s important that we have good access to services, whether this be health and community services, or effective broadband connectivity to help people better connect digitally. The ‘Fastershire’ Broadband project is working to develop better broadband connection, but we also want to see expansion of our community services and local networks which provide vital support to people in a variety of ways.

Further information on the population of Herefordshire can be accessed via our Understanding Herefordshire webpages