Shropshire, UK: A Health Needs Assessment of Adults Aged 19-64

This report presents a health needs assessment for Shropshire, UK, focusing on adults aged 19-64. It begins with a geographical profile of Shropshire, highlighting population characteristics and health status. The assessment identifies cardiovascular disease, obesity, and mental well-being as ke...Read More

Human life journey

CONTENTS
INTRODUCTION .....................................................................................................................................3
STEP – 1: GEOGRAPHICAL PROFILE OF SHROPSHIRE.............................................................................3
Population characteristics..................................................................................................................3
The health status of the population ..................................................................................................4
Local factors affecting the health of the population .......................................................................5
STEP – 2: DETERMINING & JUSTIFYING TARGET POPULATION .............................................................5
Target population .............................................................................................................................5
STEP – 3: IDENTIFYING & JUSTIFYING THREE HEALTH NEEDS AND PRIORITIZING ONE.........................7
Three health needs............................................................................................................................7
Prioritizing one need .........................................................................................................................9
STEP – 4: HEALTH PROMOTION INITIATIVE ..........................................................................................9
CONCLUSION ......................................................................................................................................11
REFERENCES ........................................................................................................................................12

INTRODUCTION
Health need assessment is being regarded as a systematic approach which
unswervingly focusses on specified health needs of a given population. Considering this, the
current research project emphasize on undertaking a health need assessment for a local
geographical area. The area which will be studies in this research report is Shropshire which
is in England, UK. Further, the current project will throw light on geographical profile of this
area and will going toe explore different factors that might impact the health of the
population of Shropshire. Additionally, target population will be identified and three
important needs of that population will be evaluated. The final section of the report will
include health promotion initiative utilizing a community-centred approach to improve the
health of the target population.
STEP – 1: GEOGRAPHICAL PROFILE OF SHROPSHIRE
Shropshire is also being known as Salop, topographical as well as famous nation plus
unitary authority of western England which is the neighbouring country on Wales. Speaking
in relation with the geographical profile of Shropshire, it is a combination of mountain as
well as plain and includes a different flow as well as scenery of river. The whole nation is
being served as a catchment basis. Further, from pre-Camorian to Lias, the city is being
extended of its stratified rocks (Watts, 2019). The region is also popular for yielding coal
metal, clays and building stones and because of this region, the area catches the attention of
many geologists as well. It also have very beautiful forests, rocky uplands as well as meres
which also supports assortments of birds.
Population characteristics
The census population of Shropshire was 317, 5005 in the year 2021 and it generally
comprise equal number of males as well as females. The average age of people in the area is
43 however the median age is more than 44. Further, around 87 percent of the people living
in this area was born in England. An alteration in the population of Shropshire can be seen in
last few years and it is also assumed that the population size will going to augment by around
8 percent by the end of the year 2032. As a result, the whole structure of the population will
going to change. Additionally, the proportion of population aged 65 and more is increasing at
a faster pace (Shropshire Census Demographics United Kingdom, 2021). Nevertheless, when
it is compared with some of the small area, it is relatively deprived. On the other hand, the
rate of under 25 year olds is quite lower when compared with the average. From the total
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resident population of the county, 65 percent are living in the main centres as well as market
towns and 35 percent are living in the countryside plus small settlements. Further, around 97
percent of the population living in Shropshire speaks in English, nonetheless the other top
languages used by the population are Polish, Welsh, Bulgarian, Chinese, Tagalog, German,
French and Slovak. Talking about the religious makeup of the population of that area, there
are around 68 percent Christians and 22 percent have no religion. Some of the percentage of
population follows Hindu, Sikh, Agnostic, Muslims and Buddhist
The health status of the population
Due to the changing demographics and increasing ageing population in Shropshire,
there has been augmentation in isolated as well as vulnerable older people within the societies
of the nation. Many studies being conducted by National study and historic data reflects that
older population in the area is more at risk related to fire concerning deaths. In addition to
this, the health of people in this area is very diverse in comparison with the average of
England (Population, 2022). Around 12 percent of children are living in low income families.
Further, there has been increase in the life expectancy for both men and women throughout
the period 2000 to 2019. The age of men has also been amplified from 81.3 years to 84.2
years. On the other hand for women it has been augmented from 84.5 years to 86.8 years of
age (Public health England, 2018). The life expectancy for males is relatively more when
compared with the average life expectancy of males of England. Moreover, the main public
health problems in Shropshire are cardiovascular, respiratory and musculoskeletal disease.
Likewise, around twenty three thousand people in this area are suffering from type 2 diabetes
and almost thirty one thousand are projected to have pre-diabetes. There are changeable risk
factors of the population involves high blood pressure, obesity, excess alcohol consumption,
high cholesterol levels and physical inactivity. Besides, there has been rise in the amount of
people suffering from dementia in Shropshire and is anticipated to increase in future as well.
Older population who cannot manage to perform one activity on their own is also estimated
to rise by sixty three percent. Furthermore, most of the elderly people in the area is facing
long term health problems and disabilities (THE SHROPSHIRE STATISTICS, 2016). Since,
there has been increase in the elderly population in this area along with their increased health
issues related to dementia, it can be said that there will be more mobility problems and levels
of disability among the population.
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Local factors affecting the health of the population
Since, the population of Shropshire is ageing very fast and are living longer than ever
before, there health needs are becoming very complex. People in this area are living with one
or two long term health conditions and the main reason behind this loneliness, anxiety and
depression. Other than this, there are several other factors as well which affects the health of
the population in the area and these are as follows: Social and environmental factors – There are many social as well as environmental
factors which are impacting the health and wellbeing of the population in Shropshire.
Further, it has been stated by many studies that people are suffering more from social
problems instead of a medical problem (Local Authority Health Profile 2019, 2020).
There has been rise in the elderly population in the area and thus, people who are aged
65 years and more are not able to move and remain active. They even can’t eat well
and maintain a suitable body weight. In addition to this, the young generation both
males and females are consuming alcohol and there is no one who can get support to
stop smoking and drinking. Air pollution, education and personal association of
people are also impacting the health of population.
 Income and inequalities – Talking about UK, it is the seventh most unequal nation
across the Europe. In small settlements and rural areas, people tend to die 16 years
earlier in comparison with the one who are living in affluent areas. Other than this,
inequalities in health also takes place in relation with sexuality, gender and ethnicity
between the underprivileged groups such as traveller societies, Gypsy, homeless
people and asylum seekers in Shropshire (Improving health and wellbeing in
Shropshire and Telford and Wrekin, 2019).
STEP – 2: DETERMINING & JUSTIFYING TARGET POPULATION
Target population
The chosen target population for Shropshire is aged between 19 to 64 years adult.
This target population was being identified due to the fact that this ageing population is rising
in this area and has more chances of reflecting increased risky behaviour. This might have
influence on their health for longer period of time. Speaking in the context of the life stages
of human development, middle life phase is being regarded as the prime of life. Nevertheless,
it has been quite evident that this mid-life phase brings lot of ill health to the population along
with a dip in their well-being, this age group is being considered as the main priority age
group within the local approaches and practices. Further, around thirty three percent of the
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total population of Shropshire are from 19 to 64 years of age (Population, 2022). The life
course approach is being defined as an approach or theory which helps in evaluating the life
of people within structural, cultural and social contexts. It helps in examining the life history
of individual. The life course approach to public health also supports the choice of target
population. As per the government of United Kingdom, the working-age adult life cycle is
being regarded as an important period for intervention, developing resources as well as
reduction of probable issues or risks. Thus, specifically, the main emphasis here is on
reducing the level of stress, loneliness and anxiety in all the phases of life as well as
promoting that lifestyles which are healthy. As per the National Health and services
Shropshire (2019), males and females falling in the age category of 19 to 64 years bears the
highest burden of unpaid care. As per their report released, most of the residents of this area
die due to untimely illness that might have been prevented through public health
interventions. Considering the figures, it can be noticed that around 311 females over 100000
and 268 males over 100000 under the age of 75 died from the causes which are considered as
preventable (Life expectancy by UK health areas: what's it like near you? 2016). On the other
hand, when compared with the figures of England, it is only 263 females per 100000 and 178
males per 100000 under the age of 75 (Baillie and Hawe, 2012). Considering this figure, it
can be said that the health of women can be enhanced by implementing measures related to
early interventions.
Moving further in this direction, inactive lifestyle, consumption of alcohol and
smoking are some of the reasons which leads towards early health disease which makes early
intervention quite vital in improving the working age health of the women and men. Even,
the rate of mortality is very high among these chosen target population (Population, 2022).
Furthermore, the dependency ratio of Shropshire which significantly reflects the number of
dependents on relative total population, is also rising. In this area, there are 67 dependent
people for every 100 independent people in comparison to 59 on the national basis and 61 on
the regional basis (Public Health England. 2018). This dependency ratio of the region is being
utilized by economists as an important measure of pressure on the productive working age
population especially economically in relation with assisting the requirements of care and
upbringing of the reliant population. This high pressure on the working age population can
influence the economic growth of the local region and policies being developed for nurturing
the fruitful as well as strong labour force.
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STEP – 3: IDENTIFYING & JUSTIFYING THREE HEALTH NEEDS
AND PRIORITIZING ONE
Three health needs
Need is being regarded as an important concept in the health of public. It can be
utilized in planning as well as management of services related to health encompassing
allocation of resources, enhancement and equity. Based on the analysis and discussion above,
there are three important health needs being identified within the chosen target population
that is 19 to 65 years of adults and these needs are cardiovascular disease, obesity and mental
well-being. According to Bradshaw, there are four types of needs that is normative, felt,
comparative and expressed need (Bradshaw, 2016). All three needs being determined above
are considered as a normative need because these needs are being recognized and defined by
experts. Furthermore, they are not absolute and there might be varied standards being laid
down by diverse experts. Explanation of these needs are being elaborated in the subsequent
paragraph:
Mental wellbeing need
As discussed above, it has been noticed that inactive life, consumption of alcohol and
smoking might cause premature illness and preventable death in the old aged people which
might make early intervention important for improving the working age health of an adult. It
has been reported that females are admitted to the hospital more both nationally and locally in
respect with alcohol particular situations. In UK for mental wellbeing 1 out of 4 people are
the ones which are affected from the mental health. In the world 13 % of the worldwide
population suffers from the mental health issues. (THE SHROPSHIRE STATISTICS, 2016).
All these figures are very dangerous and alarming. The percentage of mental health patients
in UK is 25% in comparison to the 13% of the world population which suffers from mental
health.
One of the biggest risk factors of consuming alcohol is death and other includes,
disability, mental disorder and ill health. According to Clark (2016), people who consume
more alcohol are often going to suffer from poisoning, head injuries and sexually transmitted
diseases in the short term. Nevertheless, in longer period of time, the population might suffer
from different diseases such as anxiety, depression, stroke and liver disease. According to
Drinkaware (2019), those people who suffer from anxiety or depression are heavily or
problem drinkers. Because of this, these people might have problems related to poor sleep,
compromised immune system, hypertension, loneliness and isolation. These are some of the
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impacts of depression which can be seen in middle age population. All these illness impacts
the mood, behaviour and thinking of people and thus, mental well-being is considered as very
crucial need for the target population. In this regards, different health and social care services
are being initiated by the National Service Framework for older people and they stated that
people over 65 years of age mostly use these services but sometimes, NSF fails in fulfilling
their requirements (Stevens and Gabbay, 2019).
The need of mental health is very important as it includes the emotional,
psychological and social well-being which affects the though process of the individuals. It
has been considered to be very important for every stages of life which is helpful for
adolesence childhood and also adult hood. The physical impacts of this need would help the
population recognize the impacts mental health on the patients. This health condition has
always been the one which has been ignored over the years. In the short term this need will
not be as effective as the it will be during the long term affects. Social impact of this need
will be that it will spread awareness in the individuals regarding the emotional effects it has
on the individuals. For mental health the cost to NHS in UK is estimated at £34 billion each
year.
Cardiovascular disease
Transport issues, housing income and crimes have a negative influence on the health
of elderly people. The negative affect might include several diseases such as stroke, chronic
heart disease, cancers, diabetes, falls and orthopaedic conditions. Further, it has been
suggested by many reports that ethnic monitories older people usually suffer from multiple
kinds of hazards when they enter in their old age. Cardiovascular disease (CVD) is
accountable for around twenty six percent of all death in the United Kingdom. This associates
to about 160000 deaths every year. In other words it can be said that around 435 people are
died each day due t0 cardio vascular disease. In Shropshire, the main cause of CVS are
hypertension and blood pressure. There are around 48,692 people who have been diagnosed
with hypertension in Shropshire. Furthermore, in total comprising exclusions, there are
almost 10150 people whose blood pressure is not <= 150/90 (Public health England, 2017).
In addition to this, the total national death related to chronic heart disease includes 297 men
and 654 women which in total is 951. Most of the people are belonging from the age group
55 to 85 years of age. Thus, it is important to take care of these population effectively. The
more they live, the more will be the burden on National Health Service, On the other hand,
the local death rate due to chronic heart disease is 188 for men and 170 for women which in
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total is 358 (Heart and Circulatory Disease Statistics 2019, 2019). The national average figure
is less than the local figures of death due to CVD. Due to these diseases there are many
physical problems which is being faced by the people. Falls are being regarded as one of the
most cause of emergency admissions for older people and this might influence the longer
term results particularly for those people who are suffering from some medical issues
(Weerts, 2015). Thus, it can be said that promotion of health and education in relation with
disease prevention is considered as one of the most crucial approach to tackle the health
problems. The number of deaths in UK for 2020 from all types of Cardiovascular disease are
525,048. However in the world the number of deaths from this health condition is 17.9
million. Percentage wise also the UK percentage mortality is higher. This needs is essential to
be made as it is considered to be one of the most effecting health condition and has the most
worst health issues in the patients. For both the short and long term this type of health need is
important for cosideration. The social impacts of this need is that it will help the pateints to
recognize the symptoms regarding these disearse which will help them to regonize their
health conditions. For CVD the cost to NHS in UK is estimated at £7.4 billion per year.
Obesity
In Shropshire, the culture of eating junk food is quite prevalent which has been
determined as unhealthy for the target population. Because of this habit there has been
increase in the rate of mortality that is 88.8 percent and is quite more than the average of the
nation. The main challenge of eating junk food on the whole population of Shropshire being
evident from the studies is obesity, heart problems, stroke and physical inactivity.
Particularly, the residents of this area are continuously eating unhealthy food and this has
resulted in augmented amount of cases pertaining to overweight as well as obesity (Local
first: NICE guidance is clear mandate for community approaches to health and wellbeing,
2016). All these things can be prevented by people by take care of their personal wellbeing
through changing their food habits and eating healthy food and balanced diet. It is also
important for them to remain physically active, controlling blood sugar levels, quieting
alcohol and stop smoking. As per the British Heart Foundation, heart disease and strokes are
the biggest burden in UK. It has been reflected by many statistics that around 7.4 million
people are suffering from heart disease in UK due to obesity and overweight wherein 3.5
million are females and 3.2 million are males (Facts and figures, 2021)
This need is also very important because it is also associated with the poorer mental
health outcomes which is reduced to the quality of life. This is the medical condition which in
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UK has caused the most deaths thus, it is also considered to be very important need to be
considered. In UK 28% of the people are suffering from obeseity whereas in the world this
percentage is 13%. It is a very important needs to be considered becuase this is the health
condition which is spreading alot in the world. The impacts of the health care need can be
considered to be very important for the short and long term as it has already started to show
severity in both UK and world wide. It will spread the awareness in the society regarding the
ways in which it impacts the ways in which it is able to address the healthy living practices
which can stop obesity. It is important for both the short and the long term issues to be
effective as this is the most impacting health condition in both the UK and world. For obesity
the cost to NHS in UK is estimated at £6.1 billion per year.
Prioritizing one need
The prioritized health need of 19 to 64 years adult is mental wellbeing need. There
has been overpowering indication to highlight the mental health of this target population.
Firstly, no other illness other than depression, stroke, chronic heart disease, anxiety and
loneliness have the collective incidence of influence on mental well-being of the population.
Mental health of the elderly people is being regarded as the key priority, programme and
plans of National Health Service. Many age homes and care homes have been upgraded by
the government so as to give emergency support and care at the end of life. There has been
increment in the community services and increased access of rehabilitation and reablement
services (NHS England, 2017). In addition to this, people needs to be educated in relation
with promotion of health and disease prevention as this will reduce the cost of NHS with
£1000 pounds. For UK the most compeling need is obesity as it is affecting a lot of the
population and has been found to be the reason of health issues in the population for multiple
diseases. For the world the need which has been the most effective is the CVD which is the
most affecting disease to the world population as it has the most mortaility rates in the
international data. This has been chosen after the consideration of the cost of NHS which is
suffered by UK.
STEP – 4: HEALTH PROMOTION INITIATIVE
For the purpose of supporting and addressing mental health and wellbeing of the adult
population in Shropshire, one community based approach is being chosen and that is access
to community resources. According to Public Health England (2015), this community based
approach helps community members in building community capacities to take action
together, enhances capabilities of individual to offer advice and information and communities
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and local services functioning together in a group for determining the requirement of
implementation and analysis and finally, connect people to the community resources. A
survey being performed by Coulter and Collins (2019), depicts that communities are desiring
to have better communities, support and interventions and area based initiatives and
pertaining to this, these community based approaches being chosen above will going to
address the needs of the community. Furthermore, NICE (2016), has suggested community
centred approaches and is of the viewpoint that they offer a beneficial guide for the
specialists to make decisions in relation with the best suitable approach to be utilized within a
society. Within the approach pathways to participation will be utilized. The major objective
of this approach is to connect members of the community with the non-clinical teams and
individual for addressing their social needs or general mental health issues through offering
opportunities for engagement in the community. Many authors have strongly promoted this
approach because they are being considered very useful and beneficial in offering help as
well as improved results.
Underpinning the discussion further, one of the most significant illustration of
pathways to participating approach is social prescribing which is being referred as a way of
local agencies to refer people to a link worker which then considers their time and efforts
towards wellbeing and health of people. Social prescribing initiative will be executed for
improving the mental health and wellbeing of the target population that is 19 to 64 years adult
in Shropshire. Over the last few years, this approach has been suggested all throughout the
nation and currently by NHS England in preliminary care by general practices. This scheme
will be founded in local general practices as well as health centres as suggested by NHS
England. In this, general practitioners will discuss and send elderly males and females who
are suffering from depression and anxiety to wide variety of local support teams as well as
networks. Seeking support from these teams, elderly males and females will be able to
discourse their requirements completely which will give permission to local team members to
have control on their lives (Yerbury, 2018). In promotion of health, social prescribing
initiative is the tertiary level because it looks for reducing the functional impact of the target
population suffering from mental illness due to different diseases such as depression, stroke,
chronic heart disease, anxiety and loneliness. Furthermore, an amalgamation of health
promotion strategies such as change in the behaviour, education related to health and
empowerment will also be adopted. The social group will also going to offer help and
materials related to education designed as per the patient because it will be more effective
and useful to them.
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Talking in relation with the main stakeholders being involved in the adopted
initiative, they will be local general practitioners who will utilize their practices, clinical
commissioning group for the purpose of finance, local help teams along with networks for
offering help needed by the adults. Nevertheless, it is in fact not easy to deliver community
centred approaches because it involves different challenges. One of the most important
challenge being identified by Cleveland and Cleveland (2018) is leadership. Numerous
literatures in relation with leadership shows that leadership is not as useful as a broadly
applicable model. For the project to achieve success, qualities and abilities of leader is very
necessary. Collaborative leaders can better impact the behaviour of their followers. Thus, it
can be said that the right leader along with suitable style of leadership is necessary for
effective implementation of social prescribing. Consequently, it can be said that collaborative
leadership style will be used in this community centred approach as it will bring important
alteration in the life of target population. According to the viewpoint of Cleveland and
Cleveland (2018), challenges being presented by leadership can effectively discoursed with
suitable qualities and collaborative leadership styles. Thus, it is necessary to take into
consideration that leader who is right, accurate and possess good qualities and which can lead
this community centred initiative for the purpose of supporting and addressing mental health
and wellbeing of the adult population in Shropshire.
CONCLUSION
Thus, from the above analysis it can be concluded that the current research project has
discovered the manner in which prioritized health need of alcohol consumption, smoking and
unhealthy eating habits influenced the elderly population of Shropshire. The need was being
prioritized by making use of local as well as national drivers. In regards with improving the
health of the identified target population, health initiative known as social prescribing was
being adopted which is one of the best community centred approach. Seeking help from this
initiative, education and awareness about the health can be promoted. Further, this will also
going to influence the population’s behaviour as well.
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Cleveland, M. and Cleveland, S., 2018. Building Engaged Communities—A Collaborative
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