The People of Nottinghamshire is a core part of our Joint Strategic Needs Assessment (JSNA). It aims to paint a picture of what it is like to live, work, learn, travel and enjoy ourselves in Nottinghamshire and how important these social factors are to our health and wellbeing: as little as 10% of what makes us healthy is related to access to health care services[1] the rest is influenced by these social factors.

When broad sociological, demographic and health and wellbeing characteristics of Nottinghamshire County’s population are compared to national figures, our population can appear somewhat average. However, more detailed information reveals that our population is diverse and has wide ranging health and wellbeing needs. Some examples of this diversity are given below and the rest of The People of Nottinghamshire explores these in greater detail.

The number of people living in Nottinghamshire has increased by 5% between the Census of 2001 and 2011 to 785,800. It is expected to increase by a further 6% from 2016 (835,000) to 2026 (858,300).

Overall the age structure of Nottinghamshire is slightly older than the national average, with 20% of the population aged 65+ in 2016 compared with 18% in England. Our population is predicted to continue to age and over the next ten years with the number of 75-84 year olds increasing by 44% and 85+ year olds by 39%. Older people are more likely to experience disability and limiting long-term illnesses. The majority of carers who provide 50 or more hours of care per week are aged 65+, often caring for a partner. Those carers themselves are more likely to experience poorer health than those of a similar age who do not provide care.

It is anticipated that increasingly, older people in Nottinghamshire will live alone (increasing by 21% between 2017 and 2026). Older people living alone and without access to a car in the more rural areas of Nottinghamshire, which also have poorer access to public transport (notably Newark and Sherwood and Bassetlaw) are particularly vulnerable. Our aging and increasingly isolated population has implications for future planning and delivery of services in order to meet their health and wellbeing needs. This is considered in detail in the JSNA chapters.

Children and young people make up around 23% of the population. This population is expected to show a moderate increase of 7% between 2016-2026, with the greatest increase in Broxtowe (12%). In Nottinghamshire, in general, outcomes children and young people are similar to the national average, however, there are large disparities within the County with some children and young people facing greater disadvantages than others. Localities where there are higher numbers of families on low incomes are those localities where children and young people are less healthy and do less well at school. Some children and young people may face particular disadvantages and so need more support to fulfil their potential. This includes disabled children and children in local authority care. The needs of these young people are considered in more detail in the JSNA chapters.

Disability affects a large proportion of our population. Approximately one in ten adults in Nottinghamshire aged 18-64 live with moderate/severe physical disabilities and approximately one in five people aged 65+ in Nottinghamshire are unable to manage at least one daily activity[2]. For older people the numbers are expected to increase from 29,000 in 2015 to 43,000 by 2030.

Although black and minority ethnic (BME) populations are relatively low in Nottinghamshire as a whole, 4% compared with 15% nationally, within the districts of Broxtowe, Gedling and Rushcliffe there are larger population groups (7% each district), mainly Asian and Mixed/Multiple Ethnic groups. BME populations in Nottinghamshire have a younger age profile than the general population. In Nottinghamshire a relatively low proportion of residents were born outside the UK, 5% compared with 10% in the region in 2011 but this varies across the County. A higher proportion of non-UK born residents live in Broxtowe (8%) and Rushcliffe (7%).

Deprivation levels in Nottinghamshire are comparable with England. However, within Nottinghamshire there are communities with both some of the highest levels of deprivation in the country and some of the lowest levels of deprivation. The most deprived areas are Mansfield, Ashfield and Bassetlaw and the least deprived area is Rushcliffe. People living within the more deprived areas of Nottinghamshire have higher levels of unemployment, lower levels of qualifications, less healthy lifestyle choices and poorer health and wellbeing outcomes.

Unemployment rates in Nottinghamshire are historically lower than national levels, (1.6% in June 2017 compared with 1.9% nationally) and have fallen over the past four years from 3.1% in June 2013. However, for those aged 18-24 years, unemployment rates have been higher than national levels for the past 4 years and were 3.0% in June 2017, compared with 2.7% in England.

Health and manufacturing are the largest industry sectors of employment in Nottinghamshire with 14% of jobs in each sector. This compares with 8% of jobs in the manufacturing sector nationally. The manufacturing sector is a particularly important employer in the districts of Ashfield (19%), Bassetlaw (16%) and Broxtowe (14%).

Levels of satisfaction with their local area varies across Nottinghamshire. The highest proportion of residents in Rushcliffe (95%), Gedling (88%) and Newark and Sherwood (85%) reported in the 2016 residents’ survey that they felt very/fairly satisfied with the local area as a place to live. The lowest proportions were reported from people living in Bassetlaw (65%) and Mansfield (67%). Generally residents felt safer to go out during the day than the night time, particularly in Mansfield and Ashfield.

Lifestyle approaches vary across Nottinghamshire.

• Smoking levels in Nottinghamshire are similar to the national average at 16%. Mansfield and Ashfield had the highest levels within the County at 21% in 2016.
• Health eating amongst people living in Mansfield and Ashfield was significantly lower than the national average.
• Participation in sport and active recreation in Nottinghamshire was similar to the national average.
• The proportion of adults who were overweight or obese was significantly higher in Nottinghamshire compared with England.
• It is estimated that there are 21,600 people dependent upon alcohol in Nottinghamshire. Hospital admissions related to alcohol have increased for women in Nottinghamshire. Ashfield and Mansfield had significantly higher rates for women & men compared with the national average.
• It is estimated that there are approximately 9,900 people who use drugs frequently.

Demographic, social, lifestyle, environmental and economic factors experienced across the life course impact upon health and wellbeing outcomes. Healthy life expectancy is an extremely important summary measure of mortality (death) and morbidity (illness). Healthy life expectancy is a measure of the average number of years a person would expect to live in good health based on mortality rates and self-reported good health. In Nottinghamshire healthy life expectancy was 62.2 years for females and 61.91 years for males in 2013-2015.

Levels of self-reported poor/very poor health were significantly higher in Nottinghamshire (6%) compared with the region (5.6%). In general disability and poor health are strongly associated with deprivation within Nottinghamshire. Levels of self-reported poor/very poor health and limiting long-term illness were highest in Ashfield, Mansfield and Bassetlaw districts.

Life expectancy has been increasing over the past 20 years nationally and locally for both males and females. Locally within the districts of Nottinghamshire life expectancy varies considerably with more deprived districts having a shorter life expectancy than less deprived districts For example in 2013-2015, life expectancy in Ashfield, Bassetlaw and Mansfield was significantly lower than for the East Midlands. Across Nottinghamshire life expectancy varied by nine years in males and eight years in females.

[1] Landon, J., ‘Infographic: What makes us healthy?’, in The Health Foundation blog, 29 June 2017.

[2] Activities include: going out of doors and walking down the road; getting up and down stairs; getting around the house on the level; getting to the toilet; getting in and out of bed

Sam Banks

Les Kightley

Ian Bates

James Sinclair