JSNA Healthy People - Long-Term Conditions
Data in this summary is correct as at July 2022
Long-Term Conditions – Isle of Wight data summary
This report provides summary of certain long-term conditions. It aims to understand and quantify how many people on the Isle of Wight are affected by the condition and what the outcomes of this condition may be, exploring data such as hospital admission and premature mortality where available. Premature mortality (deaths in people aged under 75 years) is a good high-level indicator of the overall health of a population, being correlated with many other measures of population health. There are significant inequalities between the premature death rates in different areas and population groups, reflecting a wide range of underlying differences. Where available, inequalities in prevalence and outcomes are also discussed. Also where possible, data includes children and young people, however many of these conditions develop later on in life and therefore focuses mainly on adults.
The data in this report can be explored further by smaller geographies in the JSNA Healthy People data report.
Asthma is the most common long term condition. It is a chronic inflammatory condition of the airways, the cause of which is not completely understood. The airways are hyper-responsive and constrict easily in response to a wide range of stimuli. This may result in coughing, wheezing, chest tightness, and shortness of breath. Nationally the prevalence of asthma in the population aged six and above was 6.4% in 2020/21, and across the Isle of Wight the prevalence is higher at 7.8%.
Blood Borne Viruses - HIV
Human Immunodeficiency Virus (HIV) is a virus that attacks the body’s immune system and if not treated can lead to AIDS. Although there is currently no cure for HIV, treatment can now reduce the viral load and means that people undergoing treatment and adopting a healthy lifestyle can live near-normal lives. In England, the national diagnosed prevalence of HIV was 2.31 per 1,000 people aged 15 to 59. On the Isle of Wight, this rate was statistically significantly lower at 0.63. This rate has remained stable for the Isle of Wight since 2011.
Cardiovascular disease (CVD) should be thought of as a family of diseases which have common risk factors, and includes coronary heart disease, stroke, trans-ischaemic attack (TIA), heart failure, and atrial fibrillation (AF). For each of the separate conditions in 2020/21, the Isle of Wight shows a slightly higher, statistically significant, prevalence than England. This may be related to the population structure because the Isle of Wight has a higher proportion of the population aged 65 and over compared with England overall.
There has been a significant reduction in the premature (under 75) mortality rate from CVD over time on the Isle of Wight. Between 2001-03 and 2017-19, the rate per 100,000 of the population decreased from 131.8 to 72.5, compared with a decrease in England from 136.2 to 70.4. Premature mortality from CVD is higher in males than females on the Isle of Wight, which follows England’s trend.
Cancer is a disease caused by normal cells changing so that they grow in an uncontrolled way forming a tumour. If untreated, the tumour can cause problems by spreading into normal tissues nearby, causing pressure on other body structures, and spreading to other parts of the body through the lymphatic system or bloodstream.
On the Isle of Wight, the number of people registered with their GP with cancer has been increasing steadily since 2016/17, rising from 3.5% to 4.7% in 2020/21. This is statistically significantly higher than England’s prevalence, which rose from 2.6% to 3.2% in the same time frame. On the Isle of Wight, 6,839 people had cancer in 2020/21.
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a group of lung diseases (including emphysema and chronic bronchitis) that are gradual in onset and progressive. The national prevalence of COPD was 1.9% in 2020/21, whereas on the Isle of Wight the prevalence is statistically significantly higher, at 2.6%.
Diabetes is a common and serious life-long health condition where the amount of glucose in the blood is too high. Good diabetes management is shown to reduce the risk of complications. When diabetes is not well managed, it is associated with serious vascular complications. This leads to disability and premature death. Nationally, the prevalence of diabetes in people (including types 1 and 2) was 7.1% of the population aged 17 and over in 2020/21. Prevalence on the Isle of Wight was statistically significantly higher at 7.7%, equating to 9,392 people. There has been a long-term increasing rate of diabetes in England and the Isle of Wight since 2009/10. National modelling suggests that on the Isle of Wight in 2020, there were around an additional 3,500 people who had undiagnosed diabetes.
Epilepsy is a common condition which affects the brain and causes recurrent seizures. The national prevalence of epilepsy was 0.8% in 2020/21. This is comparable to the Hampshire, Southampton and Isle of Wight CCG prevalence which is also 0.8%
Chronic Kidney disease
Chronic Kidney Disease (CKD) includes conditions which damage the kidneys and reduce their ability to filter waste from the blood. As the condition gets worse, waste builds up in the blood and causes symptoms such as high blood pressure, low red blood cell count, weak bones, poor nutritional health, and nerve damage. Over the long term, CKD also increases the risk of cardiovascular disease. The prevalence of CKD on the Isle of Wight in 2020/21 was 4.2%, statistically similar to the national figure of 4%. Overall, on the Isle of Wight 4,835 people are registered with CKD.
Liver disease is one of the top causes of death in England and people are dying from it at younger ages. It is the third biggest cause of premature death amongst the working age population. Most liver disease is preventable and much is influenced by alcohol consumption, obesity prevalence, and also the prevalence of Hepatitis B and Hepatitis C infections. It is estimated that one in three have early-stage non-alcohol related fatty liver disease (NAFLD). Applying this to the population of Isle of Wight estimated to be overweight or obese (61.7%) would mean approximately 24,200 people could have early-stage NAFLD.
Musculoskeletal (MSK) conditions are a group of conditions affecting joints, bones, muscles and soft tissue. It is the biggest cause of years lived with disability across the Isle of Wight. Pain is the most prominent symptom in most people with MSK problems. It leads to limitation in function and can result in long-term work disability with economic consequences. In 2021, 22.9% of people on the Isle of Wight reported having a long-term MSK problem. This is statistically higher compared to England at 17.0%. On the Isle of Wight 18.2% of people reporting at least two long-term conditions, at least one of which is MSK-related in 2021. This is statistically significantly higher than the England percentage of 12.1%.
Oral health is an important aspect of general health and wellbeing. Good oral health is important to prevent dental decay, tooth loss, gum disease and mouth cancer. It enables people to eat and enjoy a variety of foods, communicate, and socialise in the community. All these contribute to a healthier lifestyle. Poor oral health can result in pain, sleepless nights and time off school and work. It tends to be more common in deprived, compared with affluent, communities. Dental caries (tooth decay) and periodontal (gum) disease are the most common dental pathologies in the UK.
Access to primary dental care is key to preventing poor oral health, and maintaining and improving good oral health. In 2019/20, 89.6% of Isle of Wight respondents were able to get an NHS dental appointment in the previous two years compared with 93.7% nationally. In 2020/21, this declined to 70.3% on the Isle of Wight and 77% in England. This dramatic decline was due to the ceasing of all routine and non-urgent dental care during the COVID-19 pandemic lockdowns.