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Cardiff & Vale University Local Health Board (LHB) area is the smallest and most densely populated LHB area in Wales, primarily due to Wales’ capital city: Cardiff.  Cardiff & Vale University LHB covers less than 3 per cent of the land area of Wales, but includes just under 15 per cent of population.  Cardiff is one of the smaller local authorities in Wales in terms of area size but has the highest population density of 2,288 persons per square km.

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Mid Year Population Estimates

Population estimates are produced by the Office for National Statistics (ONS), and take into account births, deaths, and an estimate of migration between the last census and the middle of the current year. [1]

The population of the Cardiff & Vale University Local Health Board (LHB) area is estimated to have been 445 thousand in 2007, or 15 per cent of the Welsh population. 28 per cent of the Cardiff and Vale University LHB population live within the Vale of Glamorgan. Cardiff has the largest population of all local authorities in Wales accounting for almost 11 per cent of the Welsh population.

References

1. National Statistics. Population estimates. A short guide to population estimates.

London:ONS; 2004  Available at:

http://www.statistics.gov.uk/downloads/theme_population/Short_Guide_revision_

Nov_04_final.pdf [accessed 2nd Jun 2009]

Registered Populations

Around 484,700 individuals are registered with Cardiff and Vale University LHB general practices [or equivalent before October 2009]. Further information and commentary is available.

Population Density

Population density provides a measure of the number of people living in an area. It is calculated by dividing the population by the geographical area in square km. Population density is higher in urban areas, and lower in rural areas.

Cardiff & Vale University Local Health Board (LHB) has the highest population density of all Local Health Board areas, with 945 persons per square km, primarily due to Wales’ capital city Cardiff. Within Cardiff & Vale University LHB the local authority area of Cardiff is the most densely populated of all local authorities in Wales, with 2,288 persons per square km, or six times as many people per square km compared to the Vale of Glamorgan.

 

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References

1. Welsh Assembly Government. Local Authority Population Projections for Wales (2006-based): Summary Report. Cardiff: WAG; 2008. 

Available at: http://new.wales.gov.uk/statsdocs/population/popproj08/popprojsum08e.pdf [accessed 19th May 2009]              

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Every NHS organisation has a statutory duty to promote race equality. Not only may ethnicity reflect specific language and cultural needs but also health needs. People from black and minority ethnic (BME) backgrounds are more likely to come from low income families, suffer poorer living conditions and gain lower levels of educational qualifications compared to white populations. [1] In addition, certain BME groups have higher rates of some health conditions. For example, South Asian and Caribbean-descended populations have a substantially higher risk of diabetes; Bangladeshi-descended populations are more likely to avoid alcohol but to smoke. [2]

Figures from the 2001 Census show that in Wales, the BME population is 2.1 per cent, compared to 7.9 per cent in the UK as a whole. BME populations have, in general, a younger age structure compared to white populations reflecting past immigration and fertility patterns. Progressive ageing of BME populations is anticipated in the future but will depend on fertility levels, mortality rates and future net migration. [3]

In the Cardiff and Vale University LHB area the BME population is 6.7 per cent. At the local authority area level, figures vary from 2.2 per cent in the Vale of Glamorgan to 8.4 per cent in Cardiff.  Cardiff had the highest and the Vale of Glamorgan had the third highest proportion of the population from a BME background of Welsh local authorities in the 2001 Census.

The effect of migration since the 2001 Census is more difficult to quantify. There is no single dataset that holds information on all immigrants and there are many different definitions and categories of ‘migrants’. The NPHS is currently working on some analyses of people registering with a General Practitioner in Wales, who have made no such registration previously in the UK and whose place of birth is outside of the UK. These analyses are more akin to incidence than prevalence, albeit with certain limitations, and indicate post 2001 census demographic and temporal trends, many of which may predate the more recent coverage of inward migration.

Data at MSOA level for Newport, Cardiff, Swansea and the Vale of Glamorgan can be found in their local authority specific documents at [http://www.wales.nhs.uk/sites3/page.cfm?orgId=719&pid=22797]. Data for other local authority areas are not included due to the small number of people from a BME background living in these areas.

References

1. National Public Health Service for Wales [online], 2008. Black and Ethnic Minority Population.

Available at: http://www.wales.nhs.uk/sites3/page.cfm?orgid=719&pid=23574 [accessed 20th May 2009]

2. Health and Social Care Information Centre [online], 2005. Health survey for England 2004: the health of minority ethnic groups – headline tables.

Available at: http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/health-survey-for-england/health-survey-for-england-2004-health-of-ethnic-minorities-headline-tables  [accessed 20th May 2009].

3. National Statistics [online], 2004., Focus on Ethnicity and Identity Age/Sex Distribution Non-White groups are younger.

Available at: http://www.statistics.gov.uk/cci/nugget.asp?id=456 [accessed 19th May 2009].  

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General fertility rate (GFR) is a measure of current fertility levels and denotes the number of live births per 1,000 women aged 15-44. Although GFR takes account of the age and sex distribution of the population, it makes no allowance for different sized cohorts of women at childbearing ages.

The Cardiff and Vale University LHB GFR is lower than the Wales rate but closely reflects the Welsh pattern. In 2007, Cardiff and Vale University LHB had the second lowest GFR of the seven Local Health Boards.

General Fertility Rate Live births per 1,000 females (aged 15-44 yrs), 2007                 (694 KB)

Cardiff and Vale University LHB   The Vale of Glamorgan   Cardiff Wales UK

58.0 60.9 57.1 59.4 61.6

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Life expectancy at birth in the UK has reached its highest level on record for both males and females. A newborn baby boy could expect to live 77.2 years and a newborn baby girl 81.5 years if mortality rates remain the same as they were in 2005–07. Females continue to live longer than males; however the gap is narrowing. Over the past 25 years the gap has narrowed from 6.0 years to 4.3 years. [1]

Figures for the population of Cardiff and Vale University LHB show that life expectancy is slightly higher than that of Wales.

References

1. Office for National Statistics (2009). Life Expectancy at birth. Available    http://www.statistics.gov.uk/CCI/nugget.asp?ID=168  [accessed 2nd Jun 2009]

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Geographically based deprivation measures can be used to show inequalities in health and suggest areas likely to most need measures to improve health and manage ill-health. The Welsh Index of Multiple Deprivation 2008, is produced at a small area level called Lower Super Output Area (LSOA), and is derived from a broad range of factors.

Within the LHB there are areas of deprivation, particularly in the southern part of Cardiff City and Barry. 58 out of the 281 LSOAs in the LHB (21 per cent) are among the most deprived fifth in Wales with 114 (40 per cent) in the least deprived fifth. However, within less deprived areas there are often pockets of hidden deprivation.

 

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People with a Physical/Sensory Disability

NHS bodies have duties under the Disability Discrimination Act 2005 to have due regard to the promotion of equality of opportunity, promotion of positive attitudes towards people with disability and encouraging participation of disabled persons in public life. [1] The original 1995 Act definition of disability is ‘a physical or mental impairment which has substantial and long-term adverse effects on [the] ability to carry out normal day to day activities’. [2]

Many people with physical and sensory impairments live completely independently, however disability can sometimes necessitate increased need for informal help and health care and long-term care needs and costs. [2] Although not an inevitable consequence of ageing, increasing age is commonly associated with increasing disability and loss of independence, with functional impairments such as loss of mobility, sight and hearing. [3]

The term physical/sensory disability covers visual, hearing and physical impairments; the Register of Physical/Sensory Disability is compiled from local authority registers of physically or sensory disabled people in Wales aged 18 years or over. These include people registered under Section 29 of the National Assistance Act 1948 who are normally resident in the local authority. Registration is voluntary and not all people with disabilities choose to register. The registers are therefore not a reliable guide to the prevalence of physical and sensory disability in the population. [4] The higher proportions of people registered could be reflective of the demographics of the local area, for example an older resident population. It could also be influenced by differences in local authority procedures and their capacity for registering people as having a physical/sensory disability.

There are 6,416 people in the Cardiff and Vale University LHB area registered on the Register of Physical/Sensory Disability. 75 per cent of people registered live in Cardiff.

References

1. Office of Public Sector Information. Disability Discrimination Act 2005.

Available http://www.opsi.gov.uk/Acts/acts2005/ukpga_20050013_en_1 [accessed 26th May 2009]

2. Disability Discrimination Act 1995. Chapter 50. London :HMSO; 1995.

Available at: http://www.opsi.gov.uk/acts/acts1995/ukpga_19950050_en_1 [accessed 3rd Jun 2009]

3. Welsh Assembly Government 2006. National Service Framework for Older People in Wales. Available http://www.wales.nhs.uk/sites3/documents/439/NSFforOlderPeopleInWalesEnglish.pdf [accessed 4th Jun 2009]

4. Local Government Data Unit http://dissemination.dataunitwales.gov.uk/webview/index.jsp?language=en 

[accessed 28th May 2009]

Carers

Research shows that unpaid carers, that is, family, friends and neighbours provide around 70 per cent of care in the community. [1] Changes in marriage patterns, increases in single person households, lone parent families and mobility among family members are likely to reduce the availability of informal care. This is especially the case when older people become sick, disabled, frail or vulnerable. A decline in the number of informal carers is likely to increase the demand for statutory health and social services. As life expectancy increases there is a risk that carers may continue their caring roles for much longer periods. They may also be caring for people with multiple and increasingly complex needs. [1]

Local authorities record the number of carers (aged 16 and over) who provide or intend to provide a substantial amount of care on a regular basis for another individual aged 18 or over. This definition is taken from the Carers and Disabled Children Act 2000. [3] Once identified, carers may be offered an assessment to determine their need for services and payments in lieu of the provision of services to them. [2]

These figures relate to number of carers identified during a 12 month period. The number may not reflect the true extent of the caring role in the community as some people may not identify themselves to local authority services as a carer. The higher proportions of people identified as a carer could be reflective of the demographics of the local area, for example an older resident population. It could also be influenced by local authority procedures and their capacity to identify individuals as carers. 

There were 463 identified carers in the Cardiff and Vale University LHB area between 1st April 2007 and 31st March 2008. 74 per cent of those identified live in Cardiff.

Carers Number of carers (aged 16 and over) identified during a 12 month period, 2007-08

Cardiff and Vale University LHB   The Vale of Glamorgan   Cardiff Wales

463 122 341 9,262

 

References

1. Welsh Assembly Government 2007. Carers’ Strategy for Wales Action Plan 2007.

Available http://wales.gov.uk/dhss/publications/socialcare/carers/carers_strategy-e.pdf?lang=en

[accessed 26th May 2009]

2. Local Government Data Unit 2009. Available

http://dissemination.dataunitwales.gov.uk/webview/index.jsp?language=en [accessed 2nd June 2009]

3. Office of Public Sector Information 2009. Carers and Disabled Children Act 2000.

Available http://www.opsi.gov.uk/acts/acts2000/ukpga_20000016_en_1 [accessed 2nd June 2009]

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Living arrangements are important because older people living alone may place a greater demand on personal social services compared to older people with other living arrangements.[1] Greater financial independence, improvements in health and attitudes towards living in communal establishments contribute to the increasing proportion of older people living independently.[2] This is particularly important in the context of recent population trends such as the increase in the proportion of older divorced people. Such trends are closely linked with an increasing need for care facilities outside the family.[2]

Figures from the 2001 Census report that in the Cardiff and Vale University LHB area 41.3 per cent of older people live alone compared to 43.0 per cent in Wales as a whole. However, at the local authority area level figures vary from 39.2 per cent in the Vale of Glamorgan to 42.2 per cent in Cardiff.

References

1. National Public Health Service for Wales (2006) Health Needs Assessment 2006: Older People. Cardiff; NPHS.

Available http://www.wales.nhs.uk/sites3/page.cfm?orgId=719&pid=22801

[accessed 14th May 2009]

2. Tomassini, C. (2005) Chapter 2: Family and living arrangements. In: National Statistics, ed. Focus on older people.

 London: National Statistics pp.11-20. Available http://www.statistics.gov.uk/downloads/theme_compendia/foop05/Olderpeople2005.pdf 

[accessed 14th May 2009]

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Whilst death is an inevitability of life, examining deaths occurring before they might reasonably be expected can demonstrate inequalities in health outcomes. Often these deaths occur for largely preventable reasons, [1] for example as the result of tobacco smoking. Higher rates of death are often associated with deprivation. [2]   

Figures for 2007 show the mortality rate in people less than 75 years old in the Cardiff & Vale University LHB area to be very similar to the rate for Wales as a whole and hence in the middle of the range of rates of the seven new Local Health Boards. There is quite a difference between the two local authorities within this LHB with the rate in The Vale of Glamorgan being substantially lower than the Wales rate (sixth lowest) whilst the rate in Cardiff is substantially higher than the Wales rate (seventh highest). Both local authorities showed increases from 2006 to 2007. Single year rates for local authorities may exhibit substantial fluctuations which could be due to nothing more than random variation and the relatively small populations involved. 

Notes: All causes of death are included here, which may include deaths which could not have been preventable. The analysis uses the method of direct age standardisation, based on the widely used European standard population. The rates produced by this method are not only adjusted to take account of varying local population structures but are directly comparable with each other, be that between years or between areas. Survival until age 75 has been used for calculation of premature mortality, [3] and under 75 European age standardised death rates for certain conditions are used for Welsh Health Gain targets.