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Health Atlas 2008

Health Atlas 2008. Contents. 5 Acknowledgements. 17 % population 65+. 29 IMD 2007 LSOA Sub Domain: Geographical Barriers. 6 The use of colours in the bar charts and maps. 18 % population 75+. 30 IMD 2007 LSOA Sub Domain: Wider Barriers. 7 Life expectancy at birth - ranking.

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Health Atlas 2008

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  1. Health Atlas 2008

  2. Contents 5 Acknowledgements 17 % population 65+ 29 IMD 2007 LSOA Sub Domain: Geographical Barriers 6 The use of colours in the bar charts and maps 18 % population 75+ 30 IMD 2007 LSOA Sub Domain: Wider Barriers 7 Life expectancy at birth - ranking 19 % population non white 31 IMD 2007 LSOA Employment Domain 8 Life expectancy at birth - trends 20 Population in communal establishments per 1000 population 32 IMD 2007 LSOA Living Environment Domain 9 Life expectancy at birth - male 21 IMD 2007 ward overall score 33 IMD 2007 LSOA Sub-Domain: The ‘indoors’ living environment 10 Life expectancy at birth - female 22 IMD 2007 LSOA overall score 34 IMD 2007 LSOA Sub-Domain: The ‘outdoors’ living environment 11 Median age of the population 23 IMD 2007 ward Income Domain 35 IMD 2007 LSOA Crime Domain 12 Fertility rate per 1,000 females aged 15-44 24 IMD 2007 LSOA Income Domain 36 % working population unemployed 13 Low weight births - as a percentage of all births 25 IMD 2007 ward Health Deprivation and Disability Domain 37 IMD 2007 LSOA Education, Skills and Training Deprivation Domain 14 Very low weight births - as a percentage of all births 26 IMD 2007 LSOA Health Deprivation and Disability Domain 38 % people aged 16 to 74 with socio-economic status "never worked or long term unemployed" 15 % population < 5 27 IMD 2007 ward Multiple Barriers to Housing and Services Domain 39 IMD 2007 LSOA Sub Domain: Skills 16 % population 5 - 15 28 IMD 2007 LSOA Multiple Barriers to Housing and Services Domain 40 % people aged 16 to 74 with socio-economic status "higher managerial and professional occupations"

  3. Contents (2) 41 IMD 2007 LSOA Sub Domain: Children/young people 53 % households with single pensioners 65 Adult 5 a day fruit and vegetable consumption synthetic estimate 42 % residents aged 16-74 with no qualifications 54 Residents providing unpaid care per 1000 population 66 Child 3 a day fruit and vegetable consumption synthetic estimate 43 % households with children under 5 55 % households with no car or van 67 Binge drinking synthetic estimate 44 IMD 2007 ward Sub Domain: Children/young people 56 % houses marked as council tax band A 68 10 year predicted risk CVD > 20% directly standardised rate per 100000 aged 35-74 45 % households with one or more dependent children 57 % households rated as overcrowded 69 CHD or Stroke register directly standardised rate per 100000 all ages 46 % households with dependent children in which no adult has employment 58 % population reporting limiting long term illness 70 CHD register directly standardised rate per 100000 all ages 47 % households with lone parents and dependent children 59 % population feeling in poor health 71 Cancer register directly standardised rate per 100000 all ages 48 % households with female lone parent who is unemployed 60 % children overweight or obese in year 6 72 Diabetes register directly standardised rate per 100000 all ages 49 Full time students aged 16 to 17 per 1000 population aged 16-17 61 % children overweight or obese in reception 73 COPD or Asthma register directly standardised rate per 100000 all ages 50 Conception rate per 1000 females aged 15-17 62 Synthetic estimates of lifestyle factors sum of ward rankings 74 James Paget Hospital A&E attendances directly standardised rate per 100000 all ages 51 % single person households 63 Smoking synthetic estimate 75 All cause mortality directly standardised rate per 100000 aged < 75 persons 52 % single person non pensioner households 64 Obesity synthetic estimate 76 Circulatory disease mortality directly standardised rate per 100000 aged < 75 persons

  4. Contents (3) 77 Cancer mortality directly standardised rate per 100000 aged < 75 persons 89 Travel times from postcodes to Southwold Hospital 78 All cause mortality directly standardised rate per 100000 aged < 75 female 79 Circulatory disease mortality directly standardised rate per 100000 aged < 75 female 80 Cancer mortality directly standardised rate per 100000 aged < 75 female 81 All cause mortality directly standardised rate per 100000 aged < 75 male 82 Circulatory disease mortality directly standardised rate per 100000 aged < 75 male 83 Cancer mortality directly standardised rate per 100000 aged < 75 male 84 Travel times from postcodes to Northgate Hospital 85 Travel times from postcodes to Lowestoft Hospital 86 Travel times from postcodes to Beccles Hospital 87 Travel times from postcodes to All Hallows Hospital 88 Travel times from postcodes to Patrick Stead Hospital

  5. Acknowledgements Dr Alistair Lipp for promoting the transition from data to information to knowledge Peter Ayre for constructing the ward maps Public Health team for constructing the IMD 2007 maps ERPHO for the travel time maps Staff at Great Yarmouth and Waveney PCT for reviewing the content Contact Tim Winters with any errors, queries or suggestions Public Health Department Great Yarmouth and Waveney PCT 1 Common Lane North Beccles NR34 9BN Email: tim.winters@nhs.net Phone: 01502 719528 Maps are built from Lower Super Output Area (LSOA) boundaries. Source: ONS, Super Output Area Boundaries. Crown copyright 2004. Crown copyright material is reproduced with the permission of the Controller of HMSO

  6. The use of colours in the bar charts and maps (Census 2001) All bar charts show data from the 40 wards within Great Yarmouth and Waveney PCT. Where available we have shown the average value for Great Yarmouth, Waveney, Great Yarmouth and Waveney PCT and also data from other comparators: England, East of England, ONS cluster Coastal and Countryside, Norfolk and Suffolk. The darkest red is used to show where there might be an increased demand for services. The five shades of red are used to colour the same wards on the map and the bar chart. Title (source and year) Same shade of red used to colour the wards in the bar chart and map Comparators

  7. Life expectancy at birth - ranking (NCHOD / ERPHO 1991-2005) Life Expectancy (at birth) is a reasonable single measure which reflects the overall impact of life's adverse circumstances. Most of the other indicators in this atlas will have some impact - direct or otherwise - on life expectancy. The long-term trend for Waveney males shows a fall in the national "league table" of 352 local authorities - indicating that life expectancy in other areas is increasing faster than in Waveney. However, there has been a promising recent upturn in life expectancy which may, if efforts continue, reverse the long term trend. In Great Yarmouth male life expectancy is less than in Waveney and the long term trend is mostly flat indicating that life expectancy is changing at about the same rate as it always has in relation to other areas. Worryingly for females in Waveney life expectancy for females has fallen down the "league table" since 1999. This needs to be addressed. In Great Yarmouth the increasing rank of female life expectancy shows that life expectancy for females has been increasing faster than in other areas.

  8. Life expectancy at birth - trends (NCHOD / ERPHO 1991-2005) For males in Great Yarmouth and Waveney the long term trends are slightly less steep than the England and East of England trends. This indicates that life expectancy is increasing slower in Great Yarmouth and Waveney. For females the situation is similar.

  9. Life expectancy at birth - male (NCHOD / ERPHO 2003-2005) For males life expectancy in 2003-2005 within Great Yarmouth and Waveney wards ranged from 69 years to 87 years. The lower life expectancy is associated with the more deprived urban wards and the higher life expectancy is associated with the less deprived wards.

  10. Life expectancy at birth - female (NCHOD / ERPHO 2003-2005) For females life expectancy in 2003-2005 within Great Yarmouth and Waveney wards ranged from 76 years to 95 years. Interestingly for female life expectancy there does not appear to be as dramatically an association with deprivation as there is with men.

  11. Median age of the population (Census 2001) Great Yarmouth & Waveney's population is older than that of England and the region (East of England). This is accounted for by above average numbers of elderly people and below average numbers of children. Nevertheless, within the wards there is a considerable range of median ages. Southwold and Reydon and Caister South have the oldest populations. Harbour and Southtown and Cobholm have the youngest populations

  12. Fertility rate per 1,000 females aged 15-44 (ONS/NCHOD 2003-2005) Higher fertility rates potentially indicate a greater need for post natal support services. Nelson ward has the highest fertility rate and Southwold and Reydon the lowest.

  13. Low weight births - as a percentage of all births (ONS/NCHOD 2003-2005) Low weight births (under 2.5 kg) are associated with premature birth, but are also commoner in mothers who smoke heavily. They may also be more common in older mothers. Older mothers may be more associated with less deprived areas who leave pregnancy till later in life. Generally low birth weights are commoner in the more deprived wards. The values are probably affected by the small numbers of births in some of the wards where one or two low birth weight babies have a disproportionate effect.

  14. Very low weight births - as a percentage of all births (ONS/NCHOD 2003-2005) Very low weight births (under 1.5 kg) are associated with premature birth, but are also commoner in mothers who smoke heavily. Very low weight births are associated with the more deprived wards.

  15. % population < 5 (Census 2001) Children are more likely to be found in the deprived central wards in Great Yarmouth and Waveney. However, Worlingham and Carlton Colville also have higher proportions reflecting the growth in new housing. The geographic distribution of young children contrasts with that of the over 65 year olds who are more likely to live in the wards with fewer children.

  16. % population 5 - 15 (Census 2001) Although similar to the distribution of the under five population, the school age population is less concentrated in the central wards and Lowestoft.

  17. % population 65+ (Census 2001) About 1 in 5 people in Great Yarmouth and Waveney are over the age of 65 years. More than 1 in 4 people in Caister South and Gorleston are over the age of 65 years and more than 1 in 3 people in Southwold. These values are higher than for England or the East on England or Suffolk, but similar to the rest of Norfolk. This age group is more likely to live in and around Caister and Gorleston in the Great Yarmouth region and Halesworth and Beccles in Waveney.

  18. % population 75+ (Census 2001) About 1 in 10 people in Waveney are over the age of 75 years. 1 in 5 people in Southwold are over the age of 75 years. About 1 in 10 people in Great Yarmouth are over the age of 75 years. 1 in 7 people in Gorleston are over the age of 75 years. These values are higher than that for Suffolk, England and the East of England, but similar to the rest of Norfolk. It presents a challenge for carers, voluntary and statutory services. The geographic distribution is very similar to that for the over 65 year olds.

  19. % population non white (Census 2001) Great Yarmouth & Waveney with the exception of Lothingland has a less diverse population than the rest of the region and considerably less than the population of England. The white population now includes increasing numbers of people from elsewhere in Europe whose first language is not English. The rarity of the non-white population is likely to make it more difficult for statutory services to respond to specific cultural needs. These minority ethnic groups are more likely to live in the deprived central areas and this is likely to reflect a generally poorer economic status.

  20. Population in communal establishments per 1000 population (Census 2001) This slide represents the proportion of people in communal establishments and currently includes those in prison, hospitals, care homes and sheltered housing. It is easy to see the impact of Blundeston prison in Lothingland ward in Waveney.

  21. IMD 2007 ward overall score (DCLG 2007) Looking at the larger ward level area masks some pockets of deprivation. These pockets can be seen in the more detailed Lower Super Output Area (LSOA) maps that follow. Within Great Yarmouth the most deprived wards are Nelson, Central and Northgate. Within Waveney deprivation appears concentrated in Lowestoft in Harbour and Kirkley wards with additional high levels of deprivation in some of the more rural wards. The pattern of ill health more closely mirrors that of overall deprivation. Great Yarmouth is more deprived than Waveney.

  22. IMD 2007 LSOA overall score (DCLG 2007) The IMD 2007 is a measure of multiple deprivation at the small area level and is comparable to IMD 2004. The model of multiple deprivation which underpins the IMD 2007 is based on the idea of distinct dimensions of deprivation which can be recognised and measured separately. These are experienced by individuals living in an area. People may be counted in one or more of the domains, depending on the number of types of deprivation that they experience. The overall IMD is conceptualised as a weighted area level aggregation of these specific dimensions of deprivation. The domains and their weights are Income Deprivation Domain (22.5 %), Employment Deprivation Domain (22.5%), Health Deprivation and Disability Domain (13.5%), Education, Skills and Training Deprivation Domain (13.5%), Barriers to Housing and Services Domain (9.3%), Crime Domain (9.3%) and Living Environment Deprivation Domain (9.3%).

  23. IMD 2007 ward Income Domain (DCLG 2007) The wards with most deprived in terms of income are Nelson and Claydon in Great Yarmouth and Harbour and Kirkley in Waveney

  24. IMD 2007 LSOA Income Domain (DCLG 2007) The purpose of this domain is to capture the proportion of the population experiencing income deprivation in an area. This is constructed from Adults and children in Income Support Households (Source: Department for Work and Pensions (DWP) 2005), Adults and children in Income-Based JSA Households (Source: DWP 2005), Adults and children in Pension Credit (Guarantee) Households (Source: DWP 2005), Adults and children in those Working Tax Credit households where there are children in receipt of Child Tax Credit whose equivalised income (excluding housing benefits) is below 60 per cent of the median before housing costs (Source: HMRC 2005), Adults and children in Child Tax Credit Households (who are not eligible for IS, Income-Based JSA, Pension Credit or Working Tax Credit) whose equivalised income (excluding housing benefits) is below 60 per cent of the median before housing costs (Source: HMRC 2005) and National Asylum Support Service (NASS) supported asylum seekers in England in receipt of subsistence support, accommodation support, or both (Source: NASS 2006). In addition, an Income Deprivation Affecting Children Index and an Income Deprivation Affecting Older People Index were created. These two indices represent the proportion of children aged 0-15 living in income deprived households and the proportion of older people aged 60 and over living in income deprived households respectively.

  25. IMD 2007 ward Health Deprivation and Disability Domain (DCLG 2007) The wards with the poorest health status are Nelson and Central and Northgate in Great Yarmouth and Kirkley and Harbour in Waveney.

  26. IMD 2007 LSOA Health Deprivation and Disability Domain (DCLG 2007) This domain measures rates of poor health, early mortality and disability in an area and covers the entire age range. This domain is constructed from Years of Potential Life Lost (YPLL) (2001 to 2005, Source: ONS), Comparative Illness and Disability Ratio (CIDR) (2005, Source: DWP), Measures of acute morbidity, derived from Hospital Episode Statistics (2004 to 2005, Source: Department of Health) and The proportion of adults under 60 suffering from mood or anxiety disorders based on prescribing (2005, Source: Prescribing Pricing Authority), Hospital Episode Statistics (2004 to 2005, Source: Department of Health) and Incapacity Benefit data (2005, Source: DWP).

  27. IMD 2007 ward Multiple Barriers to Housing and Services Domain (DCLG 2007) In general, it is the urban areas which have the lowest levels of car ownership. However, the areas with least car ownership are also those nearest to essential services and jobs - suggesting a reduced need for car ownership. Service planning needs to take account of people who rely on public transport to access services. Half of households in Harbour ward in Waveney have no car - twice as many as the average for Waveney. The majority of households in Nelson do not have a car. This is also the ward with the highest level of long-term unemployment. Of note is that in this analysis, the most deprived areas - with the greatest health need - are those with the best geographical access to local services.

  28. IMD 2007 LSOA Multiple Barriers to Housing and Services Domain (DCLG 2007) The purpose of this domain is to measure barriers to housing and key local services. The indicators are structured into two sub-domains: ‘geographical barriers’, and ‘wider barriers’ which includes issues relating to access to housing, such as affordability.

  29. IMD 2007 LSOA Sub Domain: Geographical Barriers (DCLG 2007) The geographical barriers sub domain is constructed from Road distance to a GP surgery (Source: National Administrative Codes Service,2005), Road distance to a general stores or supermarket (Source: MapInfo Ltd, 2005), Road distance to a primary school (Source: DCFS, 2004-05) and Road distance to a Post Office or sub post office (Source: Post Office Ltd, 2005).

  30. IMD 2007 LSOA Sub Domain: Wider Barriers (DCLG 2007) The wider barriers sub domain includes issues relating to access to housing such as affordability. Constructed from Household overcrowding (Source: 2001 Census), LA level percentage of households for whom a decision on their application for assistance under the homeless provisions of housing legislation has been made, assigned to the constituent SOAs (Source: Communities and Local Government, 2005) and Difficulty of Access to owner-occupation (Source: modelled estimates produced by Heriot-Watt University, 2005).

  31. IMD 2007 LSOA Employment Domain (DCLG 2007) This domain measures employment deprivation conceptualised as involuntary exclusion of the working age population from the labour market. This domain is constructed from Recipients of Jobseekers Allowance (both contribution-based and income based): men aged 18-64 and women aged 18-59 (Source: DWP 2005), Recipients of Incapacity Benefit: men aged 18-64 and women aged 18-59 (Source: DWP 2005), Recipients of Severe Disablement Allowance: men aged 18-64 and women aged 18-59 (Source: DWP 2005), Participants in the New Deal for the 18-24s who are not in receipt of JSA (Source: DWP 2005), Participants in the New Deal for 25+ who are not in receipt of JSA (Source: DWP 2005) and Participants in the New Deal for Lone Parents (after initial interview) (Source: DWP 2005).

  32. IMD 2007 LSOA Living Environment Domain (DCLG 2007) This domain focuses on deprivation with respect to the characteristics of the living environment. It comprises two sub-domains: the ‘indoors’ living environment which measures the quality of housing, and the ‘outdoors’ living environment which contains two measures about air quality and road traffic accidents.

  33. IMD 2007 LSOA Sub-Domain: The ‘indoors’ living environment (DCLG 2007) This domain is constructed from Social and private housing in poor condition (2003 – 2005 average, Source BRE and Communities and Local Government, modelled EHCS) and Houses without central heating (Source: 2001 Census).

  34. IMD 2007 LSOA Sub-Domain: The ‘outdoors’ living environment (DCLG 2007) This domain is constructed from Air quality (2005, Source: Geography Department at Staffordshire University and NAEI modelled at LSOA level) and Road traffic accidents involving injury to pedestrians and cyclists (2003-2005 average, Source: DfT, STATS19 (Road Accident Data) smoothed to LSOA level).

  35. IMD 2007 LSOA Crime Domain (DCLG 2007) This domain measures the rate of recorded crime for four major crime types, representing the risk of personal and material victimisation at a small area level. This domain is constructed from Burglary (4 recorded crime offence types, Police Force data for April 2004-March 2005, constrained to Crime and Disorder Reduction Partnership (CDRP) level), Theft (5 recorded crime offence types, Police Force data for April 2004-March 2005, constrained to CDRP level), Criminal damage (10 recorded crime offence types, Police Force data for April 2004-March 2005, constrained to CDRP level) and Violence (14 recorded crime offence types including Robbery, Police Force data for April 2004-March 2005, constrained to CDRP level).

  36. % working population unemployed (NOMIS 2007) More than 1 in 20 people in Great Yarmouth are unemployed. 1 in 8 people in Nelson are unemployed - six times higher than that for the East of England. Unemployment in Waveney is concentrated in the urban areas of Lowestoft I in 12 people are unemployed in Harbour and Kirkley wards of Waveney, well over twice the average for Waveney, where Waveney itself has higher levels of unemployment than England and 50% higher than for the East of England. Fleggburgh, Wainford and The Saints have notably high levels of employment (although the jobs are likely to be elsewhere). Areas of high unemployment have low car ownership, low home ownership and high levels of overcrowding. It is also a strong predictor of ill health.

  37. IMD 2007 LSOA Education, Skills and Training Deprivation Domain (DCLG 2007) This domain captures the extent of deprivation in terms of education, skills and training in a local area. The indicators are structured into two sub domains: one relating to education deprivation for children/young people in the area, and one relating to lack of skills and qualifications among a sub-set of the working age adult population.

  38. % people aged 16 to 74 with socio-economic status "never worked or long term unemployed" (Census 2001) 9 in 10 unemployed residents in Nelson ward have either "never worked" or have been "long-term unemployed". The figure is between 7 and 8 in 10 for Great Yarmouth as a whole.

  39. IMD 2007 LSOA Sub Domain: Skills (DCLG 2007) Proportions of working age adults (aged 25-54) in the area with no or low qualifications (Source: 2001 Census)

  40. % people aged 16 to 74 with socio-economic status "higher managerial and professional occupations" (Census 2001) Great Yarmouth has about half as many Managers and Professionals as the East of England. Even Fleggburgh - which has the highest proportion in Great Yarmouth - still has a lower proportion than that of England and the East of England. The Managers and Professionals are more likely to live in the villages. However, Gorleston has a high proportion as well.

  41. IMD 2007 LSOA Sub Domain: Children/young people (DCLG 2007) Average test score of pupils at Key Stage 2 (2 year weighted average, 2004-2005, Source: Department for Children, Schools and Families (DCSF)), Average test score of pupils at Key Stage 3 (2 year weighted average, 2004-2005, Source: DCSF), Best of 8 average capped points score at Key Stage 4 (this includes results of GCSEs, GNVQs and other vocational equivalents) (2 year weighted average, 2004-2005, Source: DCSF), Proportion of young people not staying on in school or non-advanced education above the age of 16, Source: HMRC Child Benefit (CB) data, Secondary school absence rate (2 year average 2004-2005, Source: DCSF) and Proportion of those aged under 21 not entering higher education (5 year average, 2001-2005, Source: Universities and Colleges Admission Service (UCAS), Higher Education Statistics Agency (HESA)).

  42. % residents aged 16-74 with no qualifications (Census 2001) Great Yarmouth has high proportion of adults with no qualifications. Waveney also has an above average proportion of adults with no qualifications. Every ward in Great Yarmouth has more unqualified 16- 74 year olds than the East of England or England. This will have a significant impact on employment prospects.

  43. % households with children under 5 (Census 2001) When compared with all households with children, those households with children under 5 years are more common in the deprived wards around the port of great Yarmouth. This suggests a particular economic vulnerability for these younger children. Children are also more likely to be found in the deprived central wards in Waveney. However, Worlingham and Carlton Colville also have higher proportions. The geographic distribution of young children contrasts with that of the over 65 year olds who are more likely to live in the wards with fewer children.

  44. IMD 2007 ward Sub Domain: Children/young people (DCLG 2007)

  45. % households with one or more dependent children (Census 2001) Great Yarmouth and Waveney both have a below average proportion of households with dependent children compared to East of England and England. Within Great Yarmouth Southtown and Cobholm has the highest proportion of households with dependent children and in Waveney it is Carlton Colville. Southtown and Cobholm is one of the more deprived wards and Carlton Colville is one of the least deprived.

  46. % households with dependent children in which no adult has employment (Census 2001) Compared to East of England Great Yarmouth and Waveney both have a higher proportion of households with dependent children and no adult in employment. Within Great Yarmouth and Waveney Nelson, Southtown and Cobholm, Harbour and Normanston have the highest number of households with dependent children and no adult in employment.

  47. % households with lone parents and dependent children (Census 2001) In Great Yarmouth and Waveney for those households with dependent children, in about 1 in 5 the children are cared for by a lone-parent. This is a little less than the average for England, but worse than that for the East of England and the rest of Norfolk and Suffolk. In Nelson and Harbour wards about 1 in 3 households with dependent children are single parent households.

  48. % households with female lone parent who is unemployed (Census 2001) In Great Yarmouth and Waveney about 90% of lone parent households are female lone parent households. Unemployed female lone parent households indicate a particular economic vulnerability.

  49. Full time students aged 16 to 17 per 1000 population aged 16-17 (Census 2001) This indicator reflects the number of students continuing their education beyond GSCEs. Great Yarmouth and Waveney both have a below average proportion of full time students aged 16-17 compared to the national average. However, the prosperous wards of Bradwell North, Ormesby, Caister North, Gorleston Worlingham, Ditchingham and Southwold have values above the national average.

  50. Conception rate per 1000 females aged 15-17 (DOH 2002-2004) Teenage pregnancy is a significant public health issue in England. Teenage parents are prone to poor antenatal health, lower birth weight babies and higher infant mortality rates. Teenage mothers are less likely to finish their education, less likely to find a good job, and more likely to end up as single parents or bringing up their children in poverty. Children born to teenage mothers run a much greater risk of poor health and have a much higher chance of becoming teenage mothers themselves. However, it is worth remembering that many young people are successful in adapting to the role of parenthood and have happy, healthy children. Great Yarmouth and Waveney both have teenage conception rates higher than the ONS cluster, East of England and England averages. There are 8 wards which have no reported teenage pregnancies at all (either due to no teenage conceptions or due to disclosure issues). The rates are higher in all the more deprived wards.

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