To present the 2019 director of public health annual report and to seek the support of the board in implementing the recommendations.

The chairperson asked the director of public health to present the annual report, the key points of the presentation are summarised below:

a.         The consultant in public health and the intelligence team were thanked for their support in producing the annual report.

b.         This report focussed on rural Herefordshire and the often hidden levels of ill health and inequality in rural areas.

c.         Herefordshire was one of England’s most sparsely populated counties, with 42% of residents living in areas officially classified as ‘rural village and dispersed’ and 25% living in ‘very sparse’ areas.

d.         The population age distribution showed that there was a higher proportion of 45 to 79 year olds living in rural areas.

e.         The ageing population profiles in coming years would create significant demand on services, with opportunities but also challenges for people living in rural areas.

f.          It was important to reflect on the wider determinants of health and wellbeing, including housing conditions.

g.         The health and wellbeing of Herefordshire’s rural population was, on average, slightly better than those living in urban areas for many indicators, with the exception of the proportion of households in fuel poverty.  However, there were significant pockets of deprivation and poor health outcomes in rural areas.

h.         A comparison with all the local authorities in England illustrated that Herefordshire was particularly deprived in relation to ‘living environment’ and ‘barriers to housing and services’.

i.           Comparison of the types of deprivation showed that ‘indoor living environment’ and ‘access to services’ were higher in rural areas compared to urban areas of Herefordshire, and were amongst the most deprived in England.

j.           An overview was provided of the housing stock in Herefordshire, and significant challenges were noted in terms of thermal efficiency, affordability and social mobility.

k.         In view of the access times for residents to reach GP surgeries, further consideration was needed on the ways in which people would be able to access services in the future.

l.           The strengths of rural communities and the benefits of the natural environment for health and wellbeing were outlined.

m.        Road safety concerns could be a barrier to people walking and keeping active.

n.         Gypsies and Irish Travellers were represented more in rural areas than in urban areas, were more likely to experience the effects of rural inequality, and had poor outcomes in key areas such as health and education.  It was anticipated that the Talk Community programme would help to reach people more at risk of inequality.

o.         It was emphasised that the report did not capture everything that was happening to support the health and wellbeing of people living in rural areas but an overview was provided of some examples, including Herefordshire Council’s new County Plan, the Children and Young People’s Partnership Plan, Talk Community, the NHS Long Term Plan and Primary Care Networks, the Keep Herefordshire Warm scheme, the Fastershire Broadband Project, and the review of the Housing Strategy.

The chairperson welcomed the annual report.  As a general point to report authors, it  ...  view the full minutes text for item 27