SPECIAL REPORT: The state of health in Calderdale revealed

All directors of public health in England have a duty to publish an annual report covering the state of health within their community.

The report showed how Calderdale was falling behind in oral health and maternal obesity

The ‘Foundations of Life – First 1000 Days’ provides an independent assessment of the state of health in Calderdale by Paul Butcher, Calderdale Council’s Director of Public Health.

“The first 1000 days are critical because they provide the foundations for virtually every aspect of human development – it is almost impossible to underestimate the importance of this period in a child’s life,” said Mr Butcher.

“There is a lot of evidence to show in getting things right in these first two years of life has a massive impact of economic proseprity.

“We have a lot of focus in this country around jobs, training, skills infrastructure developments. As important as those are the first 1000 days if life.

“The good news in the report is we have seen reductions in infant mortality, childhood obesity at reception year, unintentional and deliberate injuries and improvements in rediness for school.

“There is still work to be done on all these but there have been some good improvements. There are some areas still of concern.”

While researching the report Calderdale Council’s Public Health team spoke to local parents and health professionals and analysed local health data.

The report analyses 13 areas which can have an impact on a child’s health in the very earliest stages of development, including teenage conceptions; low birth weight; infant mortality; smoking; breastfeeding; maternal obesity; relationships and poverty.

However, Mr Butcher stressed that the report was a building point to stimulate conversation between families to improve health in Calderdale.

“The report is to stimulate discssusion and debate about looking for improvement. That’s its purpose. It’s to say this is the picture of our health and our children. It’s to stimulate that discussion and try move things forward.

“There is no magic bullets around this. Everybody needs to play their part in it. We know if they do play their part one in four children will live to a hundred.

“So thre is something we are setting in place here is a legacy for the next hundred years around the health, well-being and prosperity of of Calderdale if we get this right.”

The Findings

The report presents some of the most recent local evidence, trends and areas for further action.

It draws on information from robust and reliable health systems, parental and professional views.

The report revealed concerns on the oral health of children and pregnant mums being overweight.

Maternal obesity increases the risk of still birth and perinatal mortality (deaths occurring in first seven days of life).

Maternal obesity data has not been routinely available however this changed in June 2015 via the national maternity and childrens data set.

The first ‘picture’ Calderdale has received from this set is of concern, with 18 per cent of mothers classified as obese.

Maternal obesity can lead to the need for additional healthcare due to complications associated with the pregnancy.

There are also technical issues to consider during pregnancy including difficulties in performing ultrasound examinations, the size of blood pressure cuffs required, issues concerning foetal monitoring, women having reduced awareness of foetal movements, problems encountered with surgical deliveries and equipment, and implications for regional and general anaesthesia.

The mean level of tooth decay in Calderdale for (2011/12) was 1.88 decayed teeth per child - significantly higher than the national average of 0.94.

In the same period, 39.2 per cent of children aged five in Calderdale experienced tooth decay (defined as one or more decayed, missing or filled teeth) – significantly higher than the England average of 27.9 per cent%

In Calderdale 14/15 there were 299 tooth extractions due to decay for children admitted as in patients to hospital, aged 10 and under. For zeor to four years in the last three year period there were 238 extractions a rate significantly higher than the England rate of 322.

However the report show positive steps being taken in Calderdale.

The percentage of babies born to teenage mothers in Calderdale has shown a welcome fall in recent years in line with national trends.

In comparison to other areas in Yorkshire and Humber the Calderdale rate of teenage conceptions is in line with the England average.

The proportion of women smoking at delivery has shown a welcome fall over the past year.

Programmes from stop smoking services and maternity services have clearly had an impact on the overall rates.

However it is clear from the data that there is significant variation across Calderdale and as such further concerted effort to reduce smoking rates in high prevalence areas is required.

In reception-aged children in Calderdale the Council has seen consistently significantly lower levels of overweight and obesity than the national average, though more recently rates have been in line with national rates. Rates are similar across Calderdale, though in Lower Valley are slightly less than the Calderdale average.