This section covers key health indicators relating to adulthood, including working life, for people living in York.
Areas where York is doing well
Employment is generally considered to be positive for health and wellbeing; it provides income and the opportunity for social interaction. In York employment rates are similar to or better than the England average. This means that there are fewer people unemployed in York than elsewhere in the country. However, York has a very low rate of employment among York’s statistical neighbours; this suggests that York has a lower rate of employment than might be expected for the type of population found in York. When asked in a survey, the majority of people felt that they had the skills and qualifications that are suited to the jobs available in York.
Breast cancer screening
Cancer screening programmes are intended to increase the opportunity for early diagnosis and early treatment of common cancer types. York has a higher proportion of women who attend breast screening programmes than the England, regional, and statistical averages. This is a stable trend; York has been significantly higher than the national average for the last five years.
Physically active adults
Regular physical activity can reduce the risk of a person developing obesity, a range of long term health conditions, and can also improve mental wellbeing. A minimum of 150 minutes of physical activity is the target set by the Chief Medical Officer for England. York has a significantly higher proportion of adults who are physically active for at least 150 minutes a week than the regional and national averages, and also higher than many of York’s statistical neighbours. In particular, York has a very large proportion of adults who walk and cycle regularly.
Excess weight is a risk factor for a wide range of long term health conditions and a reduced life expectancy. York has a lower proportion of adults who are overweight or obese than the national or regional average, and a similar score when compared with statistical neighbour averages. Despite this, over half of adults in York are either overweight or obese. This means that excess weight is harmful to the health of the adult population of York.
Smoking is a major cause of preventable early death and ill health. York has a lower proportion of residents who are smokers than the national, regional, and statistical neighbour averages. Across the country, the proportion of adults who smoke is gradually falling and York is generally following this trend.
Areas where York needs to improve
Employment is generally considered to be beneficial for health and wellbeing. Wages in York are lower than the national average; this is true for both men and women. Additionally, York has a lower proportion of people who receive the minimum living wage than the country as a whole (as defined by the living wage foundation).
Alcohol related hospital admissions
Admissions to hospital for alcohol related conditions are an important indicator of the level of harm caused by long term alcohol misuse, such as chronic conditions. However, it is not a particularly good proxy indicator for the acute alcohol related harm that might result in emergency hospital admissions. Taken as a whole, the alcohol hospital admission data shows that York has a higher rate of admissions to hospital as England, regional and statistical neighbour averages. Alcohol related hospital admissions have increased in York in recent years; and in the last three reporting periods rose above the England average.
The flu vaccination is encouraged for older adults, pregnant women, young children, people with some long term health conditions, and some people who work in health and social care. None of the areas in Yorkshire and Humber meet the national target, but York had the lowest flu vaccination uptake among high risk groups in the region. Take up of the flu vaccination among high risk groups rose slightly compared to the previous year.
Bowel cancer screening
Cancer screening programmes are intended to increase the opportunity for early diagnosis and early treatment of common cancer types. Take up of bowel cancer screening in adults in York has increased in the most recent period to match the national average, but remains lower than the regional average and the majority of York's statistical neighbours.
Other important health topics
Employment for women
Nationally, fewer women than men are employed. For some women this represents a positive choice and promotes wellbeing for them and their families. For other women this reflects that work is not a financially viable or practical option after the costs of caring for children or family members has been considered. In York, more women are employed than the national average and the gap between male and female employment is narrower than the England average. However, it is important to recognise that in York the average hourly rate of pay for women is significantly lower than for men and the pay gap increased during the last reporting period.
Health checks are routinely offered to people once they reach 40 to identify early risk factors for common preventable health conditions. Health checks should be offered on a five year cycle. In quarterly reporting periods over the previous two years York offered a very low number of checks due to changes being made to the delivery model. The numbers are improving but York still performs below the national, regional and statistical neighbour averages for the number of health checks offered and received.
Areas of inequalities in York
Health and employment
Although York has generally good levels of employment. Not all residents have this experience. The rate of unemployment is higher in the most deprived wards than the least deprived wards. Additionally, the likelihood of staying unemployed for more than a year is greater in the most deprived wards. The health outcomes for these groups of people are likely to be worse as a result.
Employment is generally considered to be beneficial for wellbeing, however employment is not a guaranteed route into financial security for everyone in York. Over 20% of working people in York earned less than the living wage (as recommended by the living wage foundation). Additionally, a large proportion of working families on low incomes rely on tax credits to supplement their income.
Additionally, low incomes can mean that people have to spend more on essential goods and services, for example because they are on more expensive tariffs and payment plans, or because they are unable to take advantage of offers and deals. In York the 'poverty premium' costs low income households nearly £500 each year.
Health checks for people with learning disability
Adults with learning disabilities are entitled to a health check each year. In York people with learning disabilities are significantly less likely to receive a health check than their peers nationally, or those who live in York's statistical neighbour areas. This means that more people with learning disabilities in York miss the opportunity for earlier diagnosis and treatment for health conditions.
Employment for people with mental health conditions
Some people may face additional barriers to employment; this may be particularly true for people with mental health conditions. In York, the proportion of people who are in contact with secondary mental health services who are in paid employment was lower than the national average in 2016-2017. Previously, York had seen a similar, or higher, level of employment among people in contact with secondary mental health services when compared to national averages; however the level for employment in this group has fallen in York in the last two reporting periods.
Employment for people with learning disabilities
Some people may face additional barriers to employment; this may be particularly true of people with learning disabilities. It is therefore a measure of health inequality to understand what proportion of people with learning disabilities are in paid employment. York has a higher proportion of people with learning disabilities who are in paid employment than other local authorities; although this proportion has reduced over the past three reporting periods. It is also important to consider that that there is still a considerable employment gap in York between people with learning disabilities and those without.