WHAT will the state of Brighton and Hove's health be like in ten years’ time? In his latest annual report, the city’s director of public health, Tom Scanlon, does a little time-travelling to find out. SIOBHAN RYAN reports.
HE may not have a Tardis like a certain TV doctor, but Dr Scanlon has looked into the future and reported back on what he has found in Brighton and Hove in 2024.
He insists it is not a frivolous exercise but an important and thought-provoking report about what the future holds.
From careful number-crunching of statistics and trends, Dr Scanlon has predicted the city will no longer have vending machines in its schools or leisure centres.
In 2024, some schools will have even planted orchards, while interactive technology at skate parks and basketball courts will ensure they continue to be well used.
Cigarette smoking will be at an all-time low but there will be concerns about the rise in use of e-cigarettes and other tobacco and nicotine products such as hookahs, snus and shisha-pens.
Obesity will have fallen among children but it will still be a problem among adults and cases of diabetes will continue to rise.
Being seriously overweight remains the biggest public health challenge despite major inroads in areas such as food labelling.
However, the food industry is using technology and astute methods to target consumers through social media.
Climate change remains on the national and local political agenda with projected temperature rises appearing to materialise.
Harmful alcohol use is also falling, and, according to the report, the introduction of the minimum pricing has started to have an impact.
There have also been changes to the city's population, with the number of people aged 90 and over rising sharply, leading to an increase in demand for long-term health and social care services.
The introduction of an app, called the O-App, is now providing much needed local advice and information for the over 65s via their mobile phones.
At the same time, the teenage population has fallen slightly while the number of five to nine-year-olds is on the rise.
This has meant that although the secondary school system has managed to cope with numbers so far, the pressure is still on for primary schools and this will have a knock-on effect on secondary places as 2030 approaches.
Housing is also a premium, with the growing student population increasing the pressure for places.
By 2024, every other 20-24 year old in the city is now a student.
Finding an affordable home in the city remains a stubborn challenge.
Opiate drug use has fallen but there has been a worrying rise in the number of psychoactive drugs, such as mephedrone or GBL, being used.
The scale of the problem is proving difficult to track because so many are bought online and the people taking them are not actively seeking help.
The city's population is more ethnically diverse with one in five births to residents born in the wider EU.
Bus journeys have doubled over the previous 20 years to 53 million and cycle trips have quadrupled to 13,000.
The future report reveals how the city council, the NHS and voluntary organisations, who already work together today, will have merged by 2024 to create one organisation responsible for providing care.
It also points out how major changes such as the long awaited redevelopment, which should be finished by 2024, of the Royal Sussex County Hospital are having an impact.
The report has used Office of National Statistics data, published research and lifestyle survey projections to come up with a description of life in 2024.
Dr Scanlon said: “Behind all of this is a serious question and a serious message.
“This is not a frivolous exercise or simply a hostage to fortune.
“We've used the best available data and published research to paint a picture of Brighton and Hove in 2024 with the aim of prompting a debate about how we might change it for the better.
“We need to be looking at planning, education, transport, health and social care – a lot of what the public health team in the council do for a living.
“There are a lot of challenges and we need to be having real, open conversations about what needs to be done to deal with them.”
The 2024 predictions for the future focus on several aspects of health and lifestyle in the city.
Students continue to influence the city profile, particularly housing patterns and the night-time economy, and they now form 54% of the 20 to 24-year-old age group.
However, there has also been a large increase in the number of residents in their 50s.
The behaviour of this pre-retirement group, while not manifest in any social disruption, is quite different to their parents and their alcohol use is placing some additional pressures on health services.
While the total number of over 75s has fallen over the last 20 years, the number of over 90s has increased by almost 50% over the last ten years.
By 2024 there are 165 residents in the 100 plus club.
The growth in a diverse range of tobacco and nicotine products such as hookahs, snus, kreteks, shisha-pens and ever popular e-cigarettes has required a revision of the successful approach that ackled cigarette smoking in the late 20th and early 21st centuries.
While e-cigarettes might help some adults to quit cigarettes, in young people they represent a conduit towards, as opposed to away from, tobacco use.
The latest school e-health survey (2023) reports that just 12% of children aged 11 to 15-years-old in Brighton and Hove had tried tobacco, although this increased to 26% when e-cigs were included.
The ambience of tobacco and nicotine consumption - with these activities closely tied to leisure and social connectivity - presents a challenge to national policy and local practice.
The continued fall in cigarette use is however, one of the great public health successes of recent times.
Even so, the effects of previous smoking are still evident in the spectrum of hospital admissions and will be for some time.
Obesity is the biggest public health challenge that we face in 2024. In Brighton and Hove, the signs are mixed.
There has been year on year improvements in healthy weight figures for children and young people and policies on school meals, vending machine access and education around food and cooking which have been particularly strong in the city over the last 20 years, are bearing (healthy) fruit.
In adults, the picture is different as obesity rates are still increasing although the rate of increase is slowing.
National legislation on menu descriptions and food labelling is likely to have an effect over the coming years.
In 2013, the G8 Global Summit on Dementia set a target to find a cure, or disease altering therapy, for sufferers of dementia by 2025.
There has been much progress with several new drug treatments, stimulated by a global picture of ageing, and although a cure remains elusive, the progression of the disease has slowed considerably.
However, with greater numbers of people living to older age, and no cure, the prevalence of dementia has inevitably increased.
Figures from the Brighton and Hove Memory Assessment Service indicate there are 3,211 city residents aged 65 or over with dementia - an increase of 239 (8%) in the last ten years.
The prevalence of dementia reflects the population age structure with one in six of those aged 85 years or over likely to be living with the condition.
MENTAL AND EMOTIONAL WELL-BEING
The last decade has been a decade of mental wellbeing improvement in Brighton and Hove. Suicide rates have continued to fall. In the last few years self-harm rates have at last gone down, linked to a programme of better staff training.
The work of the Happiness Strategy Group has seen some targeted improvement in wellbeing, such as in local Muslim groups.
Other initiatives, like The Shed for older men and the Crisis Support Centre in West Street have been very successful, and are no doubt behind some of this improving picture of mental health and wellbeing.
TRANSPORT, AIR QUALITY AND CLIMATE CHANGE Over the last 20 years, bus journeys in Brighton and Hove have more than doubled from 23 million per annum to 53 million, while cycle trips have more than quadrupled with people cycling to work rising from 3,000 in 1993, to 6,600 in 2011, to 13,000 in 2023.
However, heavy diesel traffic (bus and taxi) in confined spaces - such as North Street - saw pollution from Nitrogen Dioxide rise in the first part of the 2010s.
The adoption of a Low Emission Zone, and more importantly the subsequent and continuing conversion of diesel buses to electric hybrid buses, has seen the picture improve in recent years.
Transport, pollution and several associated Big Solution ideas remain very much on the local political agenda.
Climate change is visible with coastal erosion and several severe summer and winter weather events including floods.
Projected temperature increases appear to be materialising but there remain a number of possible future scenarios and the city, like the rest of the globe, faces a long-term challenge.
HEALTH AND HEALTHCARE
Coronary heart disease mortality rates continue to improve and are better than national equivalents.
Cancer mortality rates continue to be higher than national rates, although the numbers of deaths have levelled out over the last five years.
Large increases in melanoma and oral cancer rates are grabbing national and local headlines.
Diabetes rates are also increasing in the city and represents the natural progression for many people of our biggest public health challenge - obesity.