This section considers the health and wellbeing of adults in the so-called third age, retirement, older age, as well as the end of life.
Areas where York is doing well
Healthy life expectancy
Healthy life expectancy is a measure of how many years of life a person can expect to be in good health for. It is a useful indicator to understand the health of older adults and how a population will experience older age, as well as the potential need for health and social care support. In York, the healthy life expectancy for both men and women has been similar to or greater than the healthy life expectancy for the nation for at least the last five years.
Quality of life
Quality of life is an assessment of the level of practical limitations to everyday activities experienced by a person. The health related quality of life reported by residents in York who are aged 65 or over is higher than the national average. This is a stable trend, with older residents in York consistently reporting higher health related quality of life for at least the last five years.
Life expectancy at 65
This is an indicator of how many more years a person will live, on average, after they reach the age of 65. In York, as well as nationally, life expectancy at 65 is on the rise. The pattern for men and women is slightly different. Women have a higher life expectancy at 65 than their peers nationally, and this is rising at a similar rate to the national average. Among men in York, life expectancy at 65 is similar to the national average.
Deaths from communicable disease
Illnesses that can spread from person to person are the cause of a relatively small number of deaths in the UK, particularly in comparison to other countries. Significant effort is given over to the monitoring, identification, vaccination and treatment of infectious conditions to maintain this position. Number of deaths from communicable disease is one indicator of how successful these efforts are. York has lower rates of death from communicable disease than both the regional average and the majority of York' statistical neighbours over the last year. Over the last ten years, York has been similar to or lower than the national average.
In the community
When asked in a York survey, the majority of older adults report that they felt safe when out in their local community. This is important because people who feel safe are more likely to go out to exercise and socialise. Additionally, older adults report a high level of satisfaction with the public transport links available in York.
Areas where York needs to improve
Emergency hospital admissions for falls
Falls are the largest cause of emergency admission to hospital in older adults, and a common trigger factor in someone moving to permanent nursing home care. York has a higher rate of people who are admitted to hospital due to a fall than the national and regional averages, but a similar rate to York's statistical neighbour data. Until 2014/15 York was similar to the national average, but whilst the national trend is stable, York has risen sufficiently in the last year to be above the national average. This is predominantly due to a rise in falls among women aged over 80 years. Nationally, people living in more deprived areas are more likely to be admitted to hospital as a result of a fall than their peers.
Nursing care home use
Nursing care homes offer an important and essential service for some elderly people, but a population with a high use of care homes can indicate a reliance on adult social care services and missed opportunities to reduce or delay frailty or illness in older adults. York has a higher proportion of over 65 year olds living permanently in residential nursing care than the national average, and the majority of York's statistical neighbours. Nationally, the data has remained approximately stable. York has broadly followed this trend, but has risen above the national average in the last reporting period and is somewhat higher than York's statistical neighbours.
When older people leave hospital there is an increased risk that they will be readmitted in the days, weeks, and months that follow. Reablement services are intended to support people as they move back home after a hospital stay to prevent avoidable returns to hospital. In York, a lower proportion of people are offered reablement services than the national average and also the majority of York's statistical neighbours.
Accurate diagnosis of dementia is the first step to getting help and support. York has a lower proportion aged 65 or older with a diagnosis of dementia in comparison to the national average and the majority of York's statistical neighbours. This means that there is likely to be a larger proportion of adults in York who have dementia but who do not have a diagnosis. As this is a relatively new indicator clear trend data is not yet available.
Areas of particular inequality in York
Opportunity for high quality social interaction and connection with other people is important for the mental wellbeing of the majority of adults. When asked in a York survey, about a third of older adults say they going out socially only every few months or less often, and a similar proportion say they don't get as much social contact as they would like. This suggests that a significant proportion of older adults in York are socially isolated. National research shows that some groups are at particuar risk of social isolation in older age.
Among adults in York who use adult social care services, less than half report that they have as much social interaction as they would like to. This suggests that social isolation is common among adults who use adult social care services in York.
Healthy life expectancy
Overall, people in York have a good healthy life expectancy; however this varies significantly by ward. There was a 13 year difference in healthy life expectancy between the most deprived and least deprived areas of the city.
People living in the most deprived ward are twice as likely to get lung cancer as those living in the least deprived ward.
Other important health areas
A death is considered 'preventable' if the underlying cause could have been avoided through public health intervention. Preventable death is therefore a good overall indicator for the quality of impact of public health interventions. Nationally, the proportion of deaths that are preventable is reducing, indicating the overall success of public health interventions. Broadly speaking, this is also happening in York at a similar rate to the rest of England, although in recent years the rate of improvement in York has slowed.
Place of death
Choice about place of death is important to the wellbeing of the individual and their family at the end of someone's life. In York, a similar proportion of people were able to die in their own homes to the national average and also the tendency for the region and York's statistical neighbours. Nationally, the proportion of people dying in their own home is increasing, and York is keeping pace with this trend.
Hip fractures are a significant cause of ongoing pain and reduced mobility. York scores similarly to the national and regional averages as well as the majority of York's statistical neighbours for the number of hip fractures experienced by older adults in York.
Deaths from cardiovascular disease
Cardiovascular disease is one of the leading causes of death in older adults in the UK. The number of deaths from cardiovascular disease in people aged over 65 has been falling year on year across England for over a decade; this decrease has also happened in York at a similar rate. Over the last few years the data shows that the proportion of deaths from cardiovascular disease is similar to the national average.
Deaths from respiratory disease
Deaths from respiratory disease in people over 65 have been falling gradually in the UK over the last decade. In York, rates have also fallen gradually and York has had similar or sometimes lower rates of deaths from respiratory disease across this time period, in comparison to the national average.
Deaths from cancer
Deaths from all types of cancer in people aged 65 or over have been falling gradually in the UK over the last decade. In York, rates have also been gradually falling, and York has seen a similar or sometimes lower rate of death from cancer of all types during this time period.
Excess winter deaths
The rate of deaths in the UK increases in winter; these are known as excess winter deaths and mainly occur in older adults. The immediate causes of death are typically circulatory and respiratory conditions; whereas the underlying causes of death are often cold weather and in some instances fuel poverty. These deaths are predominantly preventable. The national ratio of excess winter deaths varies year by year, and York tends to mirror the national trend. Last year York had a better ratio of excess winter deaths than the rest of the region.