Maternity Needs Assessment for East Sussex

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Maternity Needs Assessment for East Sussex

• Presentation for the Health Overview and Scrutiny
  Committee,
• 17th May, 2007

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A. Population estimates and projections

• Population
• Population projections
• General fertility rate

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Table 1. Total population and women of child
bearing age by PCT and district.
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Figure 1. Population Projections
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(No Transcript)
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B. Births
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C. Population profile

• Key points from Table 3
• Hastings and St Leonards PCT has the highest
  proportion of
• unemployment
• people of non-white ethnicity
• people with no qualifications
• lone parent households with dependent children
• and the lowest proportion of owner-occupation and
  access to a car or van
• Source Census 2001

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D. Access

• Key points from Table 4
• Hastings has the largest number of single parent
  families of the five districts
• 50 of single parent families in Hastings have no
  access to a car or van compared with 39 in
  Eastbourne
• Approximately 1,500 single parent households in
  Hastings have no car or van compared with 1,000
  in Eastbourne.

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E. Deprivation.Why deprivation is important in
assessing maternal and infant needs

• Low birth weight is associated with increased
  illness and mortality in the first year of life
  thro childhood
• Smoking, obesity and teenage pregnancy are key
  areas to reduce health inequalities in infant
  mortality
• There are social class trends in stillbirth and
  low birth weight (higher in unskilled occupations
  or sole reg.)
• The Confidential Enquiry into Maternal
  Deaths(2000-2) found women from the poorest
  backgrounds were 20 times more likely to die than
  a woman from a professional group women from
  ethnic minority groups were three times more
  likely to die 30 of the poorest women did not
  book until they were 5 months pregnant.

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E. Deprivation

• Analysis of deprivation by small areas
• Income Deprivation Affecting Children Index
  (IDACI)
• Super-output areas (SOAs) have a population of
  approximately 1,500.
• IDACI is percentage of children in a SOA living
  in families in receipt of benefits or on the
  lowest income.

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Key points from Table 5

• We divided the super output areas into four
  deprivation categories
• In category a less than 25 of children are
  living in the poorest families
• In category d more than 45 of children are
  living in the poorest families
• Ten out of 14 of the most deprived (category d
  small areas were in Hastings. (2 Wealden, 1
  Eastbourne, 1 Rother)
• If categories c and d are combined 19/34 of
  the most deprived small areas are in Hastings. (7
  Eastbourne, 4 Rother, 3 Wealden, 1 Lewes)

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Figure 5 (Source GP Registrations)
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Figure 6 (Source ONS)
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Mapping of hospital catchment areas by
deprivation (IDAC categories)

• Eastbourne with Southern Wealden was used as a
  proxy for the EDGH catchment
• Hastings and Rother was used as a proxy for the
  Conquest catchment
• Four times as many women, of child bearing age,
  live in the most deprived small areas of the
  Conquest catchment versus EDGH
• Five times as many babies (2003-5 births) in the
  most deprived small areas were born in the
  Conquest catchment compared with EDGH.

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F. Maternal risk factors
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G. Infant outcomes
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Low birthweight
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Summary of key findings

• There is greater deprivation of Hastings women of
  childbearing age compared with Eastbourne women
• There is a reduced ability to access services in
  the Hastings population
• There is evidence of increased maternal risk
  factors such as young age, smoking, late booking
  and obesity in women booking at the Conquest
  compared with EDGH
• The local data suggests broadly similar health
  outcomes for the existing obstetric units.