Public Health Wales North Wales Health Profile
Key Messages:
 In 2011, the population of Betsi Cadwaladr University Health
Board (BCU HB) was estimated to be 687,800.
 BCU HB has higher proportions of people aged 55 years and over and lower proportions of the population aged between 15 and 34 years, compared to Wales.
 The proportion of the population aged under 18 years in BCU HB is 20.7%; lower than 21% in Wales as a whole.
 The proportion of people aged over 75 years in BCU HB is higher than the average for Wales, 9.3% compared to 8.6%. There is variation across UAs, MSOAs and localities.
 The proportion of the population aged 85 years and over in BCU
HB is just above the average across Wales, 2.7% compared to
2.5%. There is again variation.
 Five of the six counties in BCU HB are in the top 10 most sparsely populated counties in Wales.
 The percentage of the population in BCU HB aged 65 years and over has increased from 18.3% of the population in 2001 to
20.2% of the population in 2010, reflecting the aging of the population. This is a 10.4% growth in this population.
 The 65 year old and over population in BCU HB is predicted to increase by 60% between 2008 and 2033.
 There are large populations of temporary residents and tourists in North Wales which impact on the provision of health services.
 The General Fertility Rate (GFR) for BCU HB is above the average for Wales, 65.4 per 1,000 compared to 63.3 per 1,000.
 The proportion of low birth weight babies in BCU HB is lower than the average across Wales, 5.5% compared to 5.8%. There is considerable variation across MSOAs in BCU HB. MSOA
Denbighshire 006 (Rhyl South West) has the highest proportion of low birth weight babies, 8.2%. MSOA Conwy 003 (Llandrillo yn
Rhos, Penrhyn) has the lowest proportion, 2.9%.
 Teenage conception rates (15 to 17 year olds) across BCU HB are highest in Wrexham (42.8 per 1,000) which is higher than the average for Wales (37.7 per 1,000).
 The abortion rates in Unitary Authorities across BCU HB, with the exception of Gwynedd, are higher than the average for Wales.
 The Black and Ethnic Minority population in BCU HB is lower than the average for Wales, 2.4% compared to 4.4%.
 Overseas migration data are based on National Insurance
Registrations, although this is deemed to be an underestimation of the true figure. Data show that Wrexham has had the highest
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Public Health Wales North Wales Health Profile number of registrations since 2002/03.
 The percentage of people, aged over three years, able to speak
Welsh in BCU HB ranges from 12.9% in Wrexham to 65.4% in
Gwynedd. All UAs in BCU HB have experienced a decline in the proportion of Welsh speakers between the 2001 and 2011
Census.
 There are 88,600 people of working age in BCU HB with a disability.
North Wales is a geographical area of approximately 2,500 square miles.
There are six unitary authorities (UA) within this region – Isle of
Anglesey, Gwynedd, Conwy, Denbighshire, Flintshire and Wrexham, and one Health Board (HB) – Betsi Cadwaladr University Health Board (BCU
HB).
Table 1 shows that in 2011, the approximate population of BCU HB was
687,800. Flintshire in the North East has the largest population of
152,500 and Anglesey in the North West has the smallest population,
69,700.
Table 1: Population numbers, Wales, Betsi Cadwaladr University Health
Board & unitary authorities, 2011
Wales
Numbers
3,063,500
Betsi Cadwaladr University HB
Isle of Anglesey
Gwynedd
Conwy
Denbighshire
Flintshire
Wrexham
687,800
69,700
121,900
115,200
93,700
152,500
134,800
Source: ONS, Census 2011
Table 2 below shows that 705,715 individuals are registered with a GP in the BCU HB area; a further 8,160 BCU residents are registered with a GP in England and 1,607 with GP elsewhere in Wales. 8,064 individuals who are registered in BCU GP practices reside outside the BCU area. The
registered population is higher than the resident population, this could be partly explained by practice inflation, which occurs when people move to a new practice but do not notify their old practice of the move 1 . It may also be due to people accessing services outside their immediate local area. There are around 697,650 individuals registered with a GP in BCU
HB and residing in the region.
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Public Health Wales North Wales Health Profile
Table 2: Registered GP population, Betsi Cadwaladr University Health
Board, December 2012
Locality Numbers
Anglesey
Arfon
Central & South Denbighshire
Central Wrexham
Conwy East
Conwy West
Dwyfor
Meirionnydd
North & West Wrexham
North Denbighshire
North East Flintshire
North West Flintshire
South Flintshire
South Wrexham
England
Other Wales
Total registered population
66,078
69,148
42,174
52,246
54,030
62,940
25,168
31,992
40,339
59,377
61,343
39,124
48,729
53,027
8,160
1,607
715,482
Source: NWIS, 2011
Figure 1 and Table 3 shows that BCU HB has a larger proportion of the population aged 55 years and over compared to Wales and a smaller proportion of the population in the younger age groups, particularly the mid teens to early 30s age groups.
The proportions of each age band, over 55, over 65, over 75 and over 85 are all individually higher than the average for Wales as a whole. This is important as need for healthcare varies according to age, and in particular, the young and elderly, whose populations are not evenly distributed across the country 2 .
Increases in healthcare costs are strongly associated with increasing age and it is widely projected that the healthcare of the very elderly will account for an increasing proportion of health budgets in the future 3 .
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Public Health Wales North Wales Health Profile
Figure 1:
Proportion of population by age and sex
Betsi Cadwaladr University Health Board and Wales, 2010
Produced by Public Health Wales Observatory, using 2010 mid year population estimates, ONS
Betsi Cadwaladr females Betsi Cadwaladr males Wales females Wales males
85+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
05-09
00-04
12 10 8 6 4 2 0 2 4 6 8 10 12
Proportion (%) of population
Table 3: Proportion and number of population by age and sex, Wales and
Betsi Cadwaladr University Health Board, 2010
% total population Total population (thousands)
Betsi Cadwaladr Wales Betsi Cadwaladr Wales
% Males % Females % Males % Females
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
00-04
05-09
10-14
15-19
20-24
25-29
30-34
35-39
40-44
5.9
5.6
6.1
6.6
6.3
5.7
5.2
6.0
6.8
7.2
6.4
6.4
7.4
6.0
4.7
3.5
2.4
1.8
5.4
5.0
5.6
6.0
5.5
5.0
5.0
6.0
7.0
7.2
6.6
6.5
7.3
5.9
5.0
4.0
3.3
3.7
Produced by Public Health Wales Observatory, using MYE (ONS)
7.2
6.4
6.2
6.8
5.4
4.3
3.3
2.2
1.7
6.0
5.6
6.2
6.9
7.5
6.2
5.3
6.0
6.8
7.2
6.5
6.2
6.7
5.5
4.5
3.8
3.1
3.4
5.5
5.1
5.6
6.3
6.7
5.8
5.2
6.0
7.0
Males Females Males Females
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
00-04
05-09
10-14
15-19
20-24
25-29
30-34
35-39
40-44
19.6
18.5
20.4
22.0
21.0
18.8
17.4
20.0
22.6
24.0
21.3
21.1
24.6
19.8
15.6
11.5
7.9
5.9
18.7
17.4
19.6
20.9
18.9
17.5
17.3
20.6
24.2
25.0
22.7
22.5
25.1
20.6
17.3
14.0
11.5
12.7
88.9
82.9
90.6
102.2
110.1
91.6
78.7
87.9
100.2
105.2
94.4
91.0
99.8
79.1
63.0
48.0
32.4
24.8
Produced by Public Health Wales Observatory, using MYE (ONS)
110.4
99.2
95.2
102.9
83.7
69.7
58.6
47.1
51.7
84.7
78.3
85.8
96.4
103.2
89.7
79.4
92.5
107.0
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Public Health Wales North Wales Health Profile
1.1 Proportion of the population aged under 18 years
In BCU HB, 20.7% of the population is under the age of 18 years, compared with 21.0% in Wales as a whole. Figures 2 and 3 show how this varies across BCU HB, with the highest proportion of under 18s in
Flintshire UA (21.4%) and MSOA Wrexham 010 (Cartrefle, Queensway,
Wynnstay) at 29.4%, and the lowest proportion of under 18s residing in
Conwy UA at 20.0% and MSOA Gwynedd 001 at 10.2% (Deiniol, Hirael,
Marchog, Menai-Bangor). Locality boundaries are also given. Figure 4 shows the variation by UA across Wales.
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Public Health Wales North Wales Health Profile
Flintshire
008
016
011
017
014
005
015
013
018
012
002
020
001
019
006
004
007
003
010
009
Conwy
009
007
008
002
011
005
014
013
015
003
012
010
006
004
001
Figure 2: Percentage of population aged under 18 in Betsi Cadwaladr
University Health Board area, 2009
Produced by the Public Health Wales Observatory using data from ONS (MYE)
Gwynedd
Isle of Anglesey
003
006
007
009
001
004
008
005
002
24.5
22.6
21.4
21.1
20.8
18.9
18.8
17.9
17.8
% under 18
Isle of Anglesey
% = 20.6
002
003
006
004
005
008
009
007
011
015
012
016
010
014
013
017
001
21.5
21.3
20.7
20.0
18.7
18.7
18.2
17.8
16.4
10.2
% under 18
23.4
23.3
23.2
22.9
22.7
22.2
22.1
Gwynedd
% = 20.2
23.8
22.8
22.6
22.2
21.3
21.3
20.6
20.0
19.7
19.5
19.0
17.7
17.4
15.5
14.8
% under 18
Conwy %
= 20.0
Denbighshire
006
002
008
011
012
005
015
009
007
001
014
013
004
010
003
016
19.6
19.0
18.8
18.7
17.1
16.8
% under 18
22.6
22.3
22.3
21.4
21.1
21.0
20.9
20.6
20.3
29.3
Denbighshire
% = 20.6
21.2
20.7
20.3
19.7
19.7
19.6
19.4
18.3
% under 18
23.7
23.2
23.1
23.0
22.4
22.3
22.2
22.0
21.9
21.9
21.9
21.8
Flintshire % =
21.4
Wrexham
014
019
016
018
012
002
008
007
011
010
017
003
004
005
006
015
013
001
009
23.3
29.4
23.1
23.0
20.5
20.1
19.5
18.9
17.3
17.1
16.6
% under 18
22.8
22.5
22.2
22.2
21.6
21.2
20.6
20.6
Wrexham %
= 21.2
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Public Health Wales North Wales Health Profile
Figure 3: Percentage of the population aged under 18 years, Betsi
Cadwaladr University Health Board, locality areas, 2009
©Crown Copyright Licence Number 100022432
Produced by Public Health Wales Observatory, adapted by Claire Jones, March 2013
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Public Health Wales North Wales Health Profile
Figure 4:
Percentage of population aged under 18 by local authority, 2009
Produced by Public Health Wales Observatory, using data from ONS (MYE)
Wales = 21.0%
A reas o rdered geo graphically fro m no rth west to so uth east
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Public Health Wales North Wales Health Profile
1.2 Proportion of the population aged 75 years and over
In BCU HB, the proportion of the population aged 75 years and over is
9.3%, which is higher than the proportion in Wales as a whole, at 8.6%.
Again, there are variations across BCU HB. Figures 5 and 6 show that the highest proportion of the 75s and over reside in Conwy UA at 11.9% and
MSOA Conwy 004 (Llandrillo yn Rhos) at 20.4%, and the lowest proportion in Flintshire UA (7.5%) and MSOA Denbighshire 006 (Rhyl
South West) at 5.3%. Locality boundaries are also given. Figure 7 shows the variation by UA across Wales.
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Public Health Wales North Wales Health Profile
Figure 5: Percentage of population aged 75 and over in Betsi Cadwaladr
University Health Board area, 2009
Produced by Public Health Wales Observatory, using data from ONS (MYE)
Gwynedd
Conwy
004
010
003
001
006
002
008
007
012
005
015
013
011
009
014
Isle of Anglesey
005
002
008
004
006
001
007
009
003
12.5
11.4
10.7
9.9
9.1
8.8
8.7
8.7
7.4
% 75 and over
12.0
10.5
10.5
9.9
9.8
9.2
9.1
8.9
8.1
7.9
% 75 and over
Flintshire
016
004
020
006
017
019
011
001
013
009
014
003
002
012
015
008
018
005
010
007
7.9
7.8
7.8
7.7
7.7
9.9
9.9
9.5
8.5
7.4
7.1
7.1
6.9
6.9
6.4
6.3
6.1
6.0
5.8
5.7
% 75 and over
15.8
15.7
15.4
15.3
Isle of Anglesey
% = 9.6
20.4
Conwy
% = 11.9
Flintshire
% = 7.5
011
016
007
009
015
006
017
014
010
013
012
008
002
005
004
003
001
14.3
13.6
12.3
11.6
11.4
11.4
11.1
9.8
9.2
9.1
8.4
8.2
8.2
7.8
7.3
6.7
5.6
% 75 and over
Denbighshire
004
014
003
016
001
002
010
007
005
012
013
009
011
008
015
006
12.9
12.9
12.7
12.4
12.1
11.8
11.2
10.3
9.6
9.6
9.5
9.0
7.8
7.5
7.4
5.3
% 75 and over
Wrexham
009
002
008
007
019
015
018
014
017
001
006
011
016
012
010
005
013
003
004
8.9
8.7
7.8
12.6
11.4
10.7
10.1
9.5
7.4
7.3
7.1
6.9
6.9
6.7
6.5
6.4
6.1
6.0
5.4
% 75 and over
Gwynedd
% = 9.7
Denbighshire
% = 10.2
Wrexham
% = 7.9
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Public Health Wales North Wales Health Profile
Figure 6: Percentage of the population aged 75 years and over, Betsi
Cadwaladr University Health Board, locality areas, 2009
Figure 7:
Percentage of population aged 75 and over by local authority, 2008
Produced by Public Health Wales Observatory, using data from ONS ( MYE)
Wales = 8.6%
Areas ordered geographically from north west to south east
Areas ordered geographically from north west to south east
1.3 Proportion of the population aged 85 years and over
In BCU HB, 2.7% of the population are aged 85 years and over, which is slightly higher than the average of 2.5% across Wales. Figures 8 and 9 show that the highest proportion of 85 year olds and over reside in Conwy
UA, 3.5% and MSOA Conwy 004 (Llandrillo yn Rhos), 6.8%. The lowest proportions live in Flintshire UA 2.1% and MSOA Wrexham 013 (Minera,
Penycae, Penycae & Ruabon South), 1.2%. Locality boundaries are also given.
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Figure 8: Percentage of population aged 85 and over in Betsi Cadwaladr
University Health Board area, 2009
Produced by Public Health Wales Observatory, using data from ONS (MYE)
Isle of Anglesey
0.0
008
005
002
004
007
006
001
009
003
748
3.5
005
002
0.0
001
009
003
MSOA
Wales (2.5%)
Local Authority
2.7
2.5
3.7
3.5
3.2
2.4
2.4
2.3
2.0
1.8
% 85 and over
Conwy
002
007
013
015
012
005
014
011
009
004
001
003
010
006
008 3.7
3.6
3.6
2.7
2.6
6.8
5.4
5.3
4.5
4.3
2.4
2.2
2.1
2.0
2.0
% 85 and over
Flintshire
014
001
008
018
007
012
010
009
019
003
011
002
015
020
016
004
006
013
017
005
2.1
2.1
2.0
2.0
1.8
1.8
1.7
2.5
2.4
2.2
2.8
2.8
2.7
2.6
1.7
1.6
1.6
1.5
1.5
1.3
% 85 and over
4.0
Conwy
% = 3.5
6.0
4.0
Isle of Anglesey
% = 2.7
6.0
Gwynedd
016
012
007
005
002
006
015
009
008
001
004
003
014
011
017
010
013
8.0
3.2
3.0
3.9
3.9
3.7
3.7
2.9
2.6
2.5
2.4
2.2
2.1
2.0
1.9
1.9
1.6
% 85 and over
Denbighshire
012
007
005
009
008
013
011
015
006
004
014
002
016
010
003
001 3.5
3.3
2.7
2.7
2.6
4.0
3.7
2.5
2.4
2.1
1.9
1.3
% 85 and over
Flintshire
% = 2.1
Wrexham
009
002
015
008
019
007
018
012
001
006
011
005
016
017
010
014
004
003
013
3.8
3.2
2.9
2.7
2.5
2.1
2.0
1.9
1.8
1.8
2.3
2.3
2.3
2.2
1.8
1.6
1.6
1.2
% 85 and over
10.0
10.0
4.5
4.4
4.2
5.1
4.0
12.0
12.0
Gwynedd
% = 2.6
Denbighshire
% = 3.3
Wrexham
% = 2.3
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Public Health Wales North Wales Health Profile
Figure 9: Percentage of the population aged 85 years and over, Betsi
Cadwaladr University Health Board, locality areas, 2009
©Crown Copyright Licence Number 100022432 Produced by Public Health Wales Observatory, adapted by Claire Jones, March 2013
©Crown Copyright Licence Number 100022432
Produced by Public Health Wales Observatory, adapted by Claire Jones, March 2013
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Public Health Wales North Wales Health Profile
Population density provides a measure of the concentration of people living in an area. It is calculated by dividing the population by the geographical area in square kilometres.
Population density varies across Wales. The chart below shows that five out of the six North Wales counties – Gwynedd, Anglesey, Conwy,
Denbighshire and Wrexham – are in the top 10 most sparsely populated counties in Wales. This is important as the cost of providing healthcare may be higher in remote rural areas because of diseconomies of scale.
Figure 10: Population density, Wales & unitary authorities, 2011
Source: Office for National Statistics, Census 2011
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Public Health Wales North Wales Health Profile
North Wales has 62 areas which are classed as ‘urban’ (that is, an area with a minimum population of 1,500). 40 of these areas have populations of less than 5,000 people and 14 areas have populations of 10,000 people or more (Table 4).
It should be noted that this data is now 10 years old and we are awaiting analyses of data from the 2011 Census.
Table 4: Main urban areas in North Wales, 2001 census
Wrexham,
Colwyn Bay
Rhyl
Shotton (inc. Hawarden)
Prestatyn
Buckley
Brymbo/Gwersyllt
Abergele
Connah’s Quay
Bangor
Llandudno
Rhosllanerchrugog
Flint
Holyhead
UA Area
Wrexham
Conwy
Denbighshire
Flintshire
Denbighshire
Flintshire
Wrexham
Conwy
Flintshire
Gwynedd
Conwy
Wrexham
Flintshire
Anglesey
Resident population
42,576
30,269
25,390
24,751
18,496
18,268
17,912
17,574
16,526
15,280
14,872
13,246
11,936
11,237
Source: Census 2001
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Public Health Wales North Wales Health Profile
Table 5 shows that here has been a 3.5% increase in the population of
BCU HB between 2001 and 2011, with Wrexham experiencing the largest percentage increase.
Table 5: Population change, Wales, Betsi Cadwaladr University Health
Board & unitary authorities, 2001-2011
2001 population
(number)
2011 population
(number)
Change since
2001 (%)
Wales
Betsi Cadwaladr UHB
Isle of Anglesey
Gwynedd
Conwy
Denbighshire
Flintshire
Wrexham
2,910,200
664,500
67,800
116,800
109,700
93,100
148,600
128,500
3,063,500
687,800
69,700
121,900
115,200
93,700
152,500
134,800
5.3
3.5
2.8
4.4
5
0.6
2.6
4.9
Source: Office for National Statistics
To look at the percentage chance in specific age-bands, we need to look at mid-year population estimates, as this specific data is not yet available from the 2011 Census. The percentage of the population in BCU HB aged
65 years and over has increased from 18.3% of the population in 2001 to
20.2% of the population in 2010, reflecting the aging of the population.
This is a 10.4% growth in this population.
There has been a 6.8% increase in the population aged 75+ in the same period. The population aged 85+ has grown by 12.5%.
This is important as it is widely projected that the healthcare of the very elderly will account for an increasing proportion of health budgets in the future 3 ; this is shown in Figure 11 and Table 6.
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15
10
5
0
25
20
Public Health Wales North Wales Health Profile
Figure 11:
Percentage of the population aged 65+, 75+ and 85+, persons, Betsi
Cadwaladr University Health Board area, 2001-2010
Produced by Public Health Wales Observatory, using MYE (ONS)
30
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
65+
75+
85+
65+ 75+ 85+
Table 6:
Percentage of the population aged 65+, 75+ and 85+, persons, Betsi Cadwaladr
University Health Board area, 2001-2010
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
18.3 18.5 18.6 18.7 18.9 19.0 19.2 19.5 19.8 20.2
8.8
2.4
8.9
2.4
9.0
2.3
9.0
2.3
9.0
2.4
9.1
2.5
9.2
2.6
9.2
2.6
9.3
2.7
9.4
2.7
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70
60
50
40
30
20
10
0
-10
-20
Public Health Wales North Wales Health Profile
Figure 12 shows that the 65 year old and over age group in BCU HB is predicted to increase by 60% between 2008 and 2033. The proportion aged 75 years and over (Figure 13) is projected to increase around 7% and 8% per cent in Flintshire and Wrexham to around 15% and 14% respectively during this period. In Conwy, the proportion is projected to rise from around 12% to 18%. The percentage aged 85 years and over
(Figure 14) is projected to double from around 2% to 3.5% to around
5.5% to 7% by 2033 4 .
It is important to note that population projections provide estimates of the size of the future population, and are based on assumptions about births, deaths and migration. The assumptions are based on past trends.
Projections only indicate what may happen should the recent trends continue. Projections done in this way do not make allowances for the effects of local or central government policies on future population levels, distribution and change 1 .
Figure 13:
2008-based population projections for Betsi Cadwaladr University Health
Board, persons: 2008 to 2033
Produced by the Public Health Wales Observatory, using data from the Welsh Assembly Government
0-15 16-24 25-44 45-64 65+
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10
8
6
18
16
14
Public Health Wales North Wales Health Profile
Figure 14:
Projected population, 2008-2033, % aged 75 and over
Produced by Public Health Wales Observatory, using data from the Welsh Assembly
Government
Isle of Anglesey Gwynedd Conwy
Flintshire Wrexham Wales
20
Denbighshire
* Y-axis is truncated
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5
4
3
2
7
6
Public Health Wales North Wales Health Profile
Figure 15:
Projected population, 2008-2033, % aged 85 and over
Produced by Public Health Wales Observatory, using data from the Welsh Assembly
Government
Isle of Anglesey Gwynedd Conwy
Flintshire Wrexham Wales
8
Denbighshire
* Y-axis is truncated
Further Information
 Public Health Observatory Wales: Population estimates and projection resources
5.1 Temporary Residents
There is a high concentration of caravan sites on the coastal strip of North
Wales, predominantly around Kinmel Bay and Towyn.
There are likely to be substantial numbers of long-term caravan residents in North Wales who access local health services. However, research from
Lincolnshire 5 has found that the Census of Population, the electoral register and Council Tax register all seriously under-record this
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Public Health Wales North Wales Health Profile population. The omissions from the Census of Population are particularly important because Census data (and the mid-year population estimates built upon Census data) plays a central role in public sector funding formulas.
Key findings on demography of the surveyed caravan population in
Lincolnshire found 5 :
 nearly three-quarters are over 55, and more than 40 per cent over
65
 over 60 per cent describe themselves as ‘retired’
 fewer than a quarter have a job – and this low figure includes a number of site
 workers for whom the caravan came with the job
The households surveyed spend a large proportion of the year living in a caravan:
 85 per cent live on site for at least three months of the year
 over 40 per cent live on site at least nine months of the year
 43 per cent don’t return to another home elsewhere for part of the year
 39 per cent consider their caravan or chalet to be their main home
 39 per cent are permanently registered with a GP at the caravan’s address.
These findings could also be applicable to North Wales.
5.2 Tourists
North Wales is a prime tourist destination, predominantly for visitors from the North West of England/ Merseyside (Liverpool and Manchester), who stay in coastal resorts such as Llandudno, Rhyl and Prestatyn.
The large increase in the number of visitors, especially in the summer months, may lead to increased pressure on health care resources.
In 2011, there were almost 3.5 million overnight visits to North Wales.
Overall, there was a 15% increase in overnight visits to North Wales between 2009 and 2011.
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Table 7: Overnight tourism by GB visitors to North Wales, 2009-2011 millions
2009
2010
2011
3.0
3.4
3.4
Source: Great Britain Tourism Survey
These figures do not include day visits, which are covered in the GB Day
Visits Survey (GBDVS). This was undertaken for the first time in its present form in 2011, so comparative or trend data is not yet available.
Day visits are very significant, however, and GBDVS tells us that in 2011, some 26 million day trips from home were made to destinations in North
Wales. Overseas tourists are covered separately in the International
Passenger Survey. Data for 2011 are not yet available, but in comparison with GB, the volume is relatively small, around 300,000 trips annually to
North Wales.
A review conducted by the National Public Health Service (NPHS) for
Wales on the impact of tourism on health found the following 6 :
 There is little research done on the health impacts of tourism in the
UK
 Holidaymakers have different patterns of consulting in primary care than the resident population, consulting more often for respiratory,
Gastrointestinal, minor infections and skin complaints
 Workload for GP’s in popular holiday resorts can increase in summer months.
 Holidaymakers are often ill prepared for their trip, forgetting vital medications and travelling after major illnesses and surgery.
Comprehensive pre-trip counselling by health professionals in the
‘donor’ areas, especially for those with chronic conditions, could reduce burden on health services in the ‘host’ areas.
 Local residents are more likely to present at A&E for illnesses, and tourists are more likely to present at A&E for accidents in one
Australian seaside resort.
 Tourists often have little local knowledge of conditions, putting them at increased risk of accidents, especially in relation to the natural environment.
 Comprehensive data collection on tourist health episodes and good communication and information sharing between Health Services,
Tourist Industry and Local Government can aid planning for the health impacts of tourism.
 Risky behaviour in terms of alcohol use, drug use and sexual behaviour increase when people are on holiday.
 The hedonistic, ‘carnavalised’, transient atmosphere of UK seaside resorts, together with easy access to alcohol can contribute to risk
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Public Health Wales North Wales Health Profile taking in the sexual behaviour of young people. Young people are often drawn into the leisure and entertainment industry geared towards adults which can leave them open to exploitation.
 Transport problems and issues with visibility and confidentiality can prevent young people from accessing sexual health services in the rural areas surrounding seaside resorts. Schools can be successful in directing young people to appropriate services.
 According to the Single Issue Panel report, Primary Care Trusts in
England may not currently be reimbursed under the Out of Area
Treatment scheme, for temporary residents attending A&E, minor injuries units and outpatient clinics. This may be particularly important in areas with high levels of tourism where the allocation of health service resources are not currently reflecting the burden of tourist health encounters on some services.
The general fertility rate (GFR) is defined as the total number of live births born to females who are of childbearing age in a population, i.e. those aged between 15 and 44 years. This rate provides a useful indicator when studying population growth and change.
Across Wales and the UK, the GFR fell between 1998 and 2001/2002.
Figure 15 shows it has been slowly rising since 2001/2002. It has been postulated that this upturn has been largely driven by increasing birth rates among older women. In 2010, the BCU HB GFR was higher than the
Wales rate (65.4 per 1,000 compared to 63.3 per 1,000), but closely reflects the Welsh pattern.
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Figure 15:
General fertility rate per 1,000 females aged 15-44 years, Wales &
Betsi Cadwaladr University Health Board, 1998-2010
Produced by Public Health Wales Observatory using ADBE/MYE (ONS), adapted by
Claire Jones, March 2013
BCU HB Wales
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Further Information
 Public Health Wales Observatory: UA level trend data
Figures 16 and 17 show that the GFR for 2006-8 is highest in Wrexham
UA (64 per 1,000) and MSOA Wrexham 010 (Cartrefle, Queensway,
Wynnstay) at 93 per 1,000 and lowest in Gwynedd UA (58 per 1,000) and
MSOA Gwynedd 001 (Deiniol, Marchog, Hirael, Menai [Bangor]), 21 per
1,000; rates are particularly low in parts of Bangor where there is a large student population. Figure 16 also shows locality boundaries. Figure 18 shows how GFR varies in UAs across Wales.
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Public Health Wales North Wales Health Profile
008
015
013
016
005
017
011
012
018
010
004
003
002
007
009
014
020
006
019
001
007
010
002
009
005
004
015
014
013
001
008
011
003
006
012
Figure 16: General fertility rate per 1,000 in Betsi Cadwaladr University
Health Board area, females aged 15-44, 2006-08
Produced by Public Health Wales Observatory, using data from ONS (ADBE, MYE)
MSOA GFR with 95%
Gwynedd confidence interval 006 77
Isle of Anglesey
009
012
008
004
007
003
71
68
68
68
003
001
006
004
007
009
002
008
005
52
52
GFR
62
62
60
58
74
68
68
Isle of Anglesey
GFR = 63
011
015
002
005
016
010
013
014
017
001 21
54
54
51
49
67
67
64
64
63
60
57
Gwynedd
GFR = 58
GFR
Conwy Denbighshire
51
51
GFR
61
60
58
56
55
53
67
66
63
61
71
69
84
Conwy
GFR = 62
004
006
011
001
007
014
003
010
012
008
015
013
005
009
016
002
47
46
GFR
56
55
55
53
53
52
84
72
84
69
58
68
57
56
Denbighshire
GFR = 61
Flintshire
Wrexham
54
52
52
52
51
51
50
48
45
61
58
58
58
GFR
69
67
67
66
74
73
71
Flintshire
GFR = 60
013
019
014
001
016
008
011
018
007
009
002
010
012
005
015
017
003
004
006
55
51
48
48
61
59
58
62
61
69
68
47
47
GFR
76
73
73
72
70
93
Wrexham
GFR = 64
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Public Health Wales North Wales Health Profile
Figure 17: General fertility rate per 1,000 females aged 15 to 44 years,
Betsi Cadwaladr University Health Board locality areas, 2006-2008
Figure 18:
General fertility rate per 1,000, by local authority, 2006 -08
Produced by Public Health Wales Observatory, using data from ONS (ADBE, MYE)
95% confidence interval
Wales = 59.7
Areas ordered geographically from north west to south east
Birth weight is measured to identify children who are most at risk of dying young or suffering health related problems in childhood. There is a strong correlation between social deprivation and low birth weight. Figure 19 shows that the percentage of low birth weight births is smaller in BCU HB
(5.5%), compared to 5.8% in Wales as a whole. Figures 20 and 21 show that within BCU HB, the highest percentage of low birth weight babies is in Conwy and Denbighshire UAs (6%), and the lowest in Gwynedd UA
(5%). There is considerable variation across MSOAs; the MSOA with the highest proportion of low birth weight babies is Denbighshire 006 (Rhyl
South West) at 8.2% and the MSOA with the lowest is Conwy OO3
(Llandrillo yn Rhos, Penrhyn) at 2.9%. Figure 20 also shows locality boundaries.
Figure 21 illustrates the variation in low birth weight in UAs across Wales.
Figure 22 shows trends in low birth weight for the six UAs in BCU HB between 2001 and 2009.
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Figure 19: Low birth weight in Betsi Cadwaladr University Health Board area, percentage of singleton live births, 1998-2007
Produced by Public Health Wales Observatory, using data from ONS (ADBE, MYE)
MSOA % with 95% confidence interval
Isle of Anglesey
003
005
001
006
008
002
007
004
009
6.8
6.0
5.7
5.6
5.2
5.0
4.8
4.4
4.3
% low birth weight
Conwy
009
004
006
015
014
011
012
008
003
010
007
013
005
001
002
2.9
6.0
5.5
5.3
5.2
5.0
4.7
4.4
7.3
7.2
7.1
7.0
6.7
6.5
6.3
% low birth weight
Isle of Anglesey
%LBW = 5.4
Conwy
%LBW = 6.0
Gwynedd
012
017
014
002
015
013
004
016
006
003
008
001
009
011
007
010
005
4.4
4.2
4.2
3.6
3.6
3.5
3.4
5.3
5.1
5.0
4.9
4.7
4.6
4.5
7.5
6.8
6.0
% low birth weight
Denbighshire
006
004
003
005
011
009
6.3
6.2
5.9
5.8
8.2
7.4
6.7
6.6
008
001
016
010
007
015
002
014
012
013
Wrexham
4.7
4.6
4.2
4.1
5.8
5.6
5.4
5.3
% low birth weight
Gwynedd
%LBW = 5.0
Denbighshire
%LBW = 6.0
Flintshire
001
020
016
005
006
014
003
013
002
008
007
009
015
017
004
011
012
018
010
019
4.7
4.6
4.3
4.2
5.4
5.2
5.1
4.9
4.8
4.7
8.1
5.8
7.4
5.8
5.7
5.6
5.4
4.1
3.8
3.7
% low birth weight
Flintshire
%LBW = 5.3
010
005
012
004
011
014
017
002
003
015
006
013
007
009
008
019
001
016
018
7.5
7.0
6.1
5.8
5.8
5.6
5.5
5.5
5.4
5.4
5.2
4.9
4.9
4.8
3.0
4.7
4.4
4.3
4.1
% low birth weight
Wrexham
%LBW = 5.4
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Figure 20: Low birth weight, all singleton live births, Betsi Cadwaladr
University Health Board, locality areas, 1998-2007
©Crown Copyright Licence Number 100022432
Produced by Public Health Wales Observatory, adapted by Claire Jones, March 2013
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Figure 21:
Low birth weight by local authority, percentatge of singleton live births, 1998-2007
Produced by Public Health Wales Observatory, using data from ONS (ADBE, MYE)
95% confidence interval
Wales = 5.8%
Areas ordered geographically from north west to south east
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Figure 22:
Rate per 1,000 live births, Betsi Cadwaladr University Health Board local authority areas, 2001-05 to 2005-09 and Wales
Produced by Public Health Wales Observatory, using ADBE (ONS)
Local authority Wales
Isle of Anglesey Gwynedd
6
5
7
6
5
4
9
8
3
2
1
0
Conwy
Denbighshire
4
3
6
5
4
3
2
1
0
9
8
7

2002-06 2004-08
95% confidence interval
2005-09
6
5
4
3
2
1
0
9
8
7
Further Information
 Betsi Cadwaladr University Health Board: Executive Director of Public
Health Annual Report 2011. The Early Years – building the blocks for future life.
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Teenage pregnancy is a known cause of health inequality and childhood poverty. Evidence has shown that teenage pregnancy is related to poor maternal and child health outcomes. There is an increased risk of teenage mothers failing to complete their education, suffering from post natal depression and other mental health issues and of living in poverty. There is a 60% increase in the Infant Mortality Rate in comparison to older mothers 7 .
Children of teenage mothers are at risk of poor health, poor housing, low educational attainment and lower rates of economic activity in adult life
(Department of Health, 2010).
NICE Guidance
 Prevention of sexually transmitted infections and under 18 conceptions
8.1 Conceptions, under 16 year olds
There are around 100 conceptions to females aged 13 to 15 years each year in BCU HB. This equates to a conception rate of 7.8 per 1,000 females aged 13 to 15 years. Table 8 shows that the rates for Anglesey and Conwy in 2008-10 (8.2 per 1,000) are above the average for Wales
(7.8 per 1,000). Denbighshire has the lowest conception rate for under 16 year olds.
Table 8: Under 16 conceptions, (numbers and rates) and outcome, three year aggregates, Wales and Betsi Cadwaladr University Health Board unitary authorities, 2007-09 to 2008-10
2007-2009 2008-2010
Number of
Conceptions
Conception rate per
1,000 females
% of conceptions leading to abortion
Number of
Conceptions
Conception rate per
1,000 females
% of conceptions leading to abortion
Wales 1,329 8.0
7.2
7.1
8.4
6.9
6.4
7.5
54.6
48.1
55.3
52.0
57.9
51.9
66.0
1,265
29
51
48
35
59
54
7.8
8.2
7.8
8.2
6.5
7.0
7.8
56.7
62.1
60.8
45.8
60.0
55.9
64.8
Source: Office for National Statistics
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Figure 23 shows trends in teenage conceptions for females aged 13 to 15 years for the six UAs in BCU HB, from 1999 to 2008.
Rate per 1,000 live births, Betsi Cadwaladr University Health Board local authority areas, 2001-05 to 2005-09
Board local authority areas, 1999 to 2008
Produced by Public Health Wales Observatory, using Conceptions data (WG)
Local authority Wales
95% confidence interval
20
Isle of Anglesey Gwynedd
6
15
10
5
5
0
20
Conwy
4
15
10
5
3 0
2002-06
Denbighshire

2004-08 2005-09
20
15
10
5
0
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8.2 Conceptions, under 18 year olds
Table 9 shows that there were 463 of conceptions to women aged 15 to
17 years in BCU HB in 2010; this number is lower than previous years.
Table 9: Number of conceptions, females aged 15 to 17 years, Wales,
Betsi Cadwaladr University Health Board and unitary authorities, 2001-
2010
2001 2002 2003 2004 2005 2006 2007 2008 2009
Numbers
2010
Wales 2,529 2,601 2,609 2,605 2,521 2,598 2,622 2,578 2,293 2,081
BCU HB
Isle of Anglesey
Gwynedd
Conwy
Denbighshire
Flintshire
Wrexham
479
46
88
74
64
109
98
518
44
95
82
73
116
108
526
44
70
104
79
101
128
566
43
79
99
92
107
146
575
41
85
100
82
115
152
581
55
91
110
80
100
145
572
51
106
85
95
124
111
550
58
82
93
95
106
116
524
62
94
85
84
92
107
463
42
74
77
66
105
99
Source: Office for National Statistics (ONS)
In 2010 the conception rate per 1,000 young women aged 15 to 17 years in England was 35.4; the Wales rate was higher at 37.7 per 1,000 females aged 15 to 17 years.
Table 10 shows that in 2010 Wrexham has the highest rate of conceptions among 15 to 17 year olds (42.8 per 1,000). Gwynedd has the lowest rate in BCU HB (33.7 per 1,000). Teenage conception rates (15 to 17 year olds) in Wrexham, Conwy and Flintshire are higher than the average for
Wales.
Table 10: Conception rate per 1,000 females aged 15 to 17 years, Wales and Betsi Cadwaladr University Health Board unitary authorities, 2001-
2010
Rate per 1,000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Wales 45.5
46.0
45.7
45.0
43.6
45.0
44.9
44.3
40.1
37.7
Isle of Anglesey 36.0
34.8
34.0
32.5
31.1
40.9
36.8
41.5
46.8
34.0
Gwynedd
Conwy
Denbighshire
44.1
38.3
37.3
47.0
41.5
40.8
34.6
53.4
42.8
38.0
49.3
50.5
40.5
49.4
44.7
43.3
52.6
42.6
49.3
40.2
49.8
38.1
43.4
48.6
42.6
41.0
43.6
33.7
38.7
35.2
Flintshire
Wrexham
38.7
40.4
35.5
37.5
40.5
34.2
41.2
35.8
32.3
37.8
40.6
44.9
55.8
62.2
62.5
58.8
43.9
46.9
44.2
42.8
Source: Office for National Statistics (ONS)
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Figure 24 shows trends in under 18 conceptions for the six UAs in BCU HB from 2000 to 2009. There has been an increase in some areas, but a decline in others.
Figure 24: local authority areas, 2001-05 to 2005-09
Board local authority areas, 2000 to 2009
Produced by Public Health Wales Observatory, using Conceptions data (ONS) & (WG)
Local authority Wales
Gwynedd
80
6
60
Isle of Anglesey
95% confidence interval
4
60
40
20
3 0
40
5
20
0
80
Conwy
2002-06
Denbighshire

2004-08 2005-09
80
60
40
20
0
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Table 11 shows that abortion rates within BCU HB vary from 14.2 per
1,000 females aged 15-44 years in Gwynedd to 19.0 per 1,000 in
Wrexham. All rates are higher than the average rate for Wales with the exception of Gwynedd. Abortion rates in Conwy, Denbighshire, Flintshire and Wrexham are higher than the average for England and Wales.
Table 11: Legal abortions, numbers and rates per 1,000 females aged
15-44 years, 2011
Number Rate
England & Wales
England
Wales
Anglesey
Gwynedd
Conwy
Denbighshire
Flintshire
Wrexham
189,931
181,438
8,493
167
312
287
265
455
455
17.5
17.6
14.9
15.5
14.2
18.8
17.8
18.5
19.0
Source: Department of Health
In BCU HB, the Black and Minority Ethnic (BME) population is approximately 2.4%. Table 12 shows that, at UA level, BME population figures range from 1.5% in Flintshire to 3.5% in Gwynedd.
Table 12: Percentage of population by ethnicity, Wales, Betsi Cadwaladr
University Health Board and unitary authorities, 2011
Percentage
Wales
White
95.6
Black &
Minority Ethnic
4.4
Mixed
1.0
Betsi Cadwaladr University HB
Isle of Anglesey
Gwynedd
Conwy
Denbighshire
Flintshire
Wrexham
97.5
98.3
96.5
97.7
97.4
98.5
69.9
2.4
1.7
3.5
2.3
2.6
1.5
3.1
0.7
0.6
0.8
0.7
0.8
0.5
0.7
Source: ONS
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Further Information
 Welsh Government 2012. Statistical Bulletin, 2011 Census: First
Results for Ethnicity, National Identity, and Religion for Wales
 Public Health Wales: A report on the health/health promotion needs of the black and minority ethnic communities in North
Wales.
It is very difficult to estimate the migrant population from overseas in
BCU HB, but an indication can be obtained from the number of National
Insurance Number Registrations, shown in Table 13 and Figure 25. This is likely to be an underestimate of the overseas migrant population, however, as some migrants may have registered elsewhere. The data shows that Wrexham has had the highest number of registrations since
2002/3.
Migrant workers are not asylum seekers or refugees. They may or may not have unmet needs but are not included in legislation or services for asylum seekers 1 .
Table 13: National Insurance Number Registrations to adult overseas nationals entering the UK by year of registration and LA, 2002/03-
2011/12
Isle of Anglesey
Gwynedd
Conwy
Denbighshire
Flintshire
Wrexham
0.07
0.22
0.14
0.14
0.14
0.26
0.10
0.30
0.23
0.23
0.14
0.46
Source: Department for Work & Pensions
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0.15
0.49
0.36
0.27
0.27
0.95
0.23
0.74
0.56
0.52
0.74
1.45
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0.17
0.62
0.48
0.44
0.73
1.17
0.16
0.70
0.40
0.25
0.65
1.13
0.13
0.67
0.35
0.26
0.44
0.82
0.10
0.50
0.26
0.15
0.33
0.76
0.10
0.63
0.30
0.20
0.53
1.10
0.09
0.57
0.23
0.18
0.48
0.68
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Public Health Wales North Wales Health Profile
1.60
1.40
1.20
1.00
0.80
0.60
0.40
0.20
0.00
Figure 25: National Insurance Number Registrations to adult overseas nationals entering the UK by year of registration and LA, 2002/03-
2009/10
Source: Department of Work & Pensions
Isle of Anglesey
Denbighshire
Gwynedd
Flintshire
Conwy
Wrexham
Further Information
 National Public Health Service. Guidance on healthcare issues for asylum seekers in Wales: 2009.
Table 14 shows data on the proportion of people over three years of age who can speak welsh by UA area; this data is taken from the 2011 Census
8 .
In BCU HB, Gwynedd has the highest proportion of Welsh speakers,
65.4%, which is considerably higher than the average for Wales, 19.0%.
The proportion of Welsh speakers in Flintshire (13.2%) and Wrexham
(12.9%) is lower than the average for Wales. All UA areas in BCU HB have experienced a decline in the proportion of Welsh speakers between the 2001 and 2011 Census, with the largest decline occurring in Gwynedd
(-3.6%).
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Table 14: Number and proportion of people (aged 3 and over) able to speak Welsh, Wales and Betsi Cadwaladr University Health Board unitary authorities, 2001-2011
2001 2011 Difference
Wales
Number
582,368
%
20.8
Isle of Anglesey 38,893 60.1
Gwynedd 77,846 69.0
Conwy
Denbighshire
31,298
23,760
29.4
26.4
Flintshire
Wrexham
20,599 14.4
18,105 14.6
Number
562,016
38,568
77,000
30,600
22,236
19,343
16,659
%
19.0
57.2
65.4
27.4
24.6
13.2
12.9
Number %
-20,352
-325
-846
-698
-1,524
-1,256
-1,446
-1.7
-2.9
-3.6
-2.0
-1.8
-1.2
-1.7
Source: ONS / Census 2011
Further Information
 Welsh Government 2012. Statistical Bulletin, 2011 Census: First
Results for Ethnicity, National Identity, and Religion for Wales
 Welsh Assembly Government (2010) Local Area Summary
Statistics Heritage: Welsh speaking
According to the 2011 census, almost 440,000 residents of BCU HB state their religion as Christianity, with the second highest group being those who profess no religion. Table 15 shows the distribution by UA.
Table 15: Percentage of people who state their religion as specified,
Betsi Cadwaladr University Health Board unitary authorities, 2011
Christian Buddhist Hindu Jewish
Muslim
(Islam)
Sikh
Other religion
Numbers
No religion
Religion not stated
Isle of Anglesey
45,400 165 45 40 250 43 257 17,797 5,754
Gwynedd 72,503 426 238 55 1,378 39 637 36,163 10,435
Conwy
74,506 347 206 62 583 17 478 30,017 9,012
Denbighshire 60,129 266 167 32 469 8 345 25,132 7,186
Flintshire
101,298 344 158 70 482 29 362 38,726 11,037
Wrexham 85,576 351 504 58 860 87 310 36,927 10,171
Source: ONS / Census 2011
Further Information
 Welsh Government 2012. Statistical Bulletin, 2011 Census: First
Results for Ethnicity, National Identity, and Religion for Wales
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The Integrated Household Survey is the largest social survey produced by the Office for National Statistics. Questions on sexual identity were added to the survey in 2009 and are asked to respondents aged 16 years and over. Results are shown in Table 16, 17 and 18.
In summary, the survey indicates that:
 94% of adults identified themselves as heterosexual/straight;
 1% of the survey population identified themselves as gay or
lesbian;
 0.5% identified themselves as bisexual;
 0.4% identified themselves as ’other’.
Table 16: Sexual Identity by Gender, United Kingdom, April to March
2009/10 and 2010/11
2009/10
Men
2010/11
Women
2009/10 2010/11
Percentages
Total
2009/10 2010/11
Heterosexual / Straight
Gay / Lesbian
Bisexual
Other
Don't know / Refusal
No response
94.0
1.3
0.3
0.5
3.1
0.8
93.6
1.3
0.4
0.4
3.6
0.7
94.5
0.6
0.6
0.5
3.3
0.5
94.3
0.6
0.6
0.3
3.6
0.6
94.2
0.9
0.5
0.5
3.2
0.6
94.0
1.0
0.5
0.4
3.6
0.7
Source: Office for National Statistics
Table 17: Sexual Identity by Gender, Wales, April to March 2009/10 and
2010/11
Percentage
Heterosexual / Straight
Gay / Lesbian
Bisexual
Other
Don't know / Refusal
No response
94.2
0.9
0.3
0.3
2.9
1.4
Source: Office for National Statistics
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Table 17: Sexual Identity by age group, United Kingdom, April to March
2009/10 and 2010/11
16-24 25-34 35-49 50-64
Percentages
65+
Heterosexual / Straight
Gay / Lesbian
Bisexual
Other
Don't know / Refusal
No response 2
91.4
1.1
1.0
0.3
4.9
1.3
93.6
1.4
0.6
0.3
3.4
0.7
94.0
1.4
0.4
0.3
3.2
0.7
95.2
0.7
0.3
0.3
2.9
0.6
94.7
0.3
0.3
0.5
3.9
0.3
Source: Office for National Statistics
According to Stonewall Cymru, information on the health of the lesbian and gay population in Wales is hard to determine. Using research evidence gathered from health surveys conducted in England, it notes that individuals who are lesbian or gay can:
 Consult late with medical practitioners because of the fear of intrusive and judgmental questioning;
 Experience higher levels of emotional and physical vulnerability when admitted into hospital or receiving healthcare;
 Exhibit to a greater proportion than the general population, many of the illnesses and diseases associated with being discriminated against by others;
 Be vulnerable to experiencing higher levels of mental health issues;
 Lack the social structures to promote wellbeing and good health.
In Wales, Stonewall Cymru believes that among the lesbian and gay population there is no reason to suspect these health factors are any different from across the rest of the UK. However the demographic nature of the lesbian and gay community can mean that such considerations are exacerbated by rural isolation, economic inactivity and peer group oppression. Stonewall Cymru has published a report exploring the health needs of lesbian, gay and bisexual people in North and Mid Wales – Inside
Out Project 9 .
This made the following recommendations:
 All health care staff should receive training on sexual orientation issues both in health care and equality of treatment.
 Health care agencies should improve the recognition, acknowledgement and treatment of same-sex sexual orientation issues both in health care and equality of treatment.
 NHS Wales to increase access to specific sexual health services for lesbian, gay and bisexual people.
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 Health care staff to accept the right of a patient to nominate their same-sex partner/family of choice member as their first point of contact or primary carer (often referred to as ‘next of kin’).
 Statutory bodies to provide sustainable funding and support to the participation of lesbian, gay and bisexual community researchers/interacters in creating an access point and dialogue with this ‘hard to reach’ community.
In October 2010, the Equality Act 2010 replaced most of the Disability
Discrimination Act. The new Act defines a person as having a disability if they have a physical or mental impairment which has a substantial and long-term adverse effect on their ability to perform normal day-to-day activities. The Act also considers progressive conditions to be a disability.
People with Human Immunodeficiency Virus (HIV), cancer or multiple sclerosis are protected by the Act from the point of diagnosis, as are people with some visual impairments 10 .
Levels of disability are an indicator of population health at all ages.
Although not an inevitable consequence of ageing, increasing age is commonly associated with increasing disability and loss of independence, with function impairments such as loss of mobility, sight and hearing. A range of health conditions lead to physical disability such as congenital conditions, injury, stroke, diabetes, vascular disease, arthritis and neurological conditions. Sensory impairment, for example hearing and sight problems, can be related to congenital conditions, diabetes, cataracts, glaucoma, and age.
Table 19 shows that the number and percentage of people of working age with disabilities in BCU HB is 21.2%, which is lower than the 24.4% in
Wales. However, there are 88,600 people in BCU HB of working age with a disability.
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Table 19: Number and percentage people of working age (16-64 years) with disabilities, Wales, Besti Cadwaladr University Health Board and unitary authorities, 2012
Number %
Wales 463,300 24.4
Betsi Cadwaladr UHB
Isle of Anglesey
Gwynedd
Conwy
Denbighshire
Flintshire
Wrexham
88,600 21.2
8,900 21.5
14,100 19.3
13,900 21.7
13,800 23.6
19,300 20.3
18,600 21.7
Source: Annual Population Survey, ONS (StatsWales)
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1.
National Public Health Service & Wales Centre for Health 2009. Betsi
Cadwaladr University Health Board: Demography Profile . [Accessed
18.02.13]
2.
Ball R., King D, Eiser D. Assessing relative spending needs of devolved
government: the Case of Healthcare Spending in the UK. University of
Stirling September 2012.
3.
Caley M, Sidhu, K. Estimating the future healthcare costs of an aging population in the UK: expansion of morbidity and the need for preventative care. Journal of Public Health. 2010. Vol. 33, No. 1, pp.
117–122.
4.
Public Health Wales Observatory 2011. Director of Public Health Annual
Report Chart Book: Betsi Cadwaladr University Health Board.
5.
Beatty, C., Fothergill, S., Powell, R., 2012. Centre for Regional
Economic and Social Research, Sheffield Hallam University. Living in
Seaside Caravans . People, Place & Policy Online [Accessed 18.02.13.]
6.
National Public Health Service for Wales, 2005. Health Impacts of
Seasonal Demographic changes in areas with high levels of tourism in the UK – Key findings from the literature.
7.
Department of Health 2010. ‘Teenage pregnancy strategy: Beyond
2010’ . Department of children, schools and families. Department of
Health. London. [Accessed 18.02.13]
8.
Welsh Government, 2012. 2011 Census: First Results on the Welsh
Language . [Accessed 18.02.13]
9.
Stonewall Cymru 2007. Inside Out Project . [Accessed 18.02.13]
10.
Home Office 2010. Equality Act 2010 . [Accessed 18.02.13]
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