Lifestyle

5.1 Key Facts

• In 2016/17, over half (53%) of adults in Barnet had excess weight (i.e. were either overweight or obese with a Body Mass Index (BMI) larger than or equal to 25/m2). This proportion was significantly lower than the national average (61.3%), but similar to the London average (55.2%).
• Barnet had the 6th highest proportion of adults out of all the London boroughs who were physically inactive (i.e. take part in less than 30 minutes of moderate physical activity per week), during 2016/17. Almost three in ten Barnet adults (28.6%) were physically inactive, which was significantly higher than both London (22.9%) and England (22.2%).
• The proportion of Barnet adults who abstain from alcohol (15.9%) is significantly lower than the London average (24.3%), but similar to the national (England) average (15.5%).
• The proportion of non-opiate drug users in Barnet who left treatment successfully and did not represent within 6 months was consistently significantly lower than the London average between 2013 and 2016.
• The rate of smoking attributable mortality in Barnet for adults (aged 35+) was consistently significantly lower than both the London and national averages from 2007-9 to 2014-16.
• Over a fifth (21.8%) of Barnet 15 years olds have either used or tried other tobacco products (e.g. shisha, hookah, hubble-bubble or water pipe), which is similar to London (21.0%), but significantly higher than the national average of 15.2%.
• Between 2010 and 2014, the rate of teenage conceptions for girls under 16 years old in Barnet was significantly lower than the national average. However, during 2015-16, the conception rate for this age group in Barnet was similar to both the London and national averages.
• The abortion rate in Barnet was significantly higher than England between 2012 and 2014, but similar to the national average between 2015 and 2017.
• For Barnet, GP prescription of long acting reversible contraceptives (LARCs) excluding injections, was consistently significantly lower than both London and England between 2011 and 2016.
• During 2017, the diagnostic rates for syphilis, gonorrhoea and genital herpes were all significantly higher in Barnet than the national average.
• Between 2013 and 2017, the chlamydia detection rate in 15-24 year olds in Barnet was consistently significantly lower than both London and England.
• Among females accessing sexual health services, the proportion of new attendees accepting an HIV test fell significantly between 2010 and 2017, from 73.2% to 67.4%.

5.2 Strategic Needs

• Although the prevalence of excess weight in Barnet is lower than the national average, over half of Barnet adults are either overweight or obese, so there is an ongoing need for interventions (such as healthy weight and active travel programmes), to promote healthy lifestyles and help reduce the number of borough residents with excess weight.
• In recent years, obesity and excess weight in Barnet Reception Year and Year 6 children has either been significantly lower or similar to London and national averages. Ongoing monitoring of National Child Measurement Programme (NCMP)[1] data will inform decision-making in this area.
• The Chief Medical Officer (CMO) for England recommends that adults take at least 150 minutes of moderate physical activity per week. Based on this standard, the proportion of adults in Barnet who are physically active in Barnet (in 2016/17) is significantly lower than both the London and national averages.
• Whilst the rates of hospital admissions and mortality due to alcohol related conditions in Barnet have been significantly lower than both London and England in recent years, the proportion of adults who abstain from alcohol in the borough is lower than the London average.
• In recent years, a lower proportion of non-opiate users have successfully completed treatment in Barnet, compared to London. Investigation into the reasons underlying this trend may be required.
• The adult smoking prevalence in Barnet did not change significantly between 2012 and 2017. However, over the same period there were significant falls in adult smoking prevalence in both London and England.
• The relatively high proportion of 15 year olds in the borough who have either used or tried tobacco products other than cigarettes may have been reduced by recent borough initiatives on shisha, so further research in this area may be warranted.
• The consistently lower prescription of LARCs by GPs in Barnet, compared to both London and England, in recent years, may need further investigation.
• The consistently low rates of screening and detection of chlamydia in Barnet may require further attention.
• The significant decrease in HIV coverage (the proportion of eligible new attendees to a specialist sexual health service who accept an HIV test), among Barnet females between 2010 to 2017, may require investigation.

5.3 Tobacco and Smoking

Smoking and tobacco use are risk factors for many chronic health conditions, including cardiovascular disease (CVD), cancer, asthma and chronic obstructive pulmonary disease (COPD). Smoking is the main cause of premature mortality and preventable illness in England. During 2015, an estimated 16% of all deaths in England (79,000) were attributable to smoking.[2]

[2] National Institute for Health and Care Excellence (NICE, 2018). NICE guideline [NG92]: Stop smoking interventions and services. Context. Available at: https://www.nice.org.uk/guidance/ng92/chapter/Context

5.3.1 Smoking in Adults

The estimated smoking prevalence for adults (aged 18+), based on the Annual Population Survey, is shown in Figure 5.1. The adult smoking prevalence in Barnet did not change significantly between 2012 and 2017. However, over the same period there were significant falls in adult smoking prevalence in both London and England. During 2012-17, the smoking prevalence in Barnet was not significantly different from either London or England.[3]

Figure 5.1: Adult smoking prevalence (%) in Barnet, London and England, 2012-2017

Source: Public Health England (PHE, 2018). Public Health Dashboard. Tobacco control. Adult smoking prevalence (%). T-bars indicate 95% confidence interval limits.

Figure 5.2 depicts the trend in the percentage of mothers known to be smokers at the time of their delivery from 2010/11 to 2016/17 for Barnet and England. Over this period, a significantly lower proportion of mothers in Barnet were smokers at the time of their delivery compared to the national average.  Except for 2010/11, the percentage of mothers in Barnet smoking at the time of delivery was also significantly lower than the London average, during this period.[4]

Figure 5.2: Trend in smoking status at time of delivery for Barnet and England, 2010/11 to 2016/17

Source: Public Health England (PHE, 2018). Public Health Outcomes Framework. Smoking status at time of delivery.

The trend in smoking attributable mortality rate per 100,000 residents (aged 35+) between 2007-9 and 2014-16 for Barnet, London and England, is shown in Figure 5.3. During this period, the rate of smoking attributable mortality in Barnet for adults aged 35+ was consistently significantly lower than both the London and national averages.[5]

Figure 5.3: Smoking attributable mortality (persons aged 35+) in Barnet, London and England, 2007-09 to 2014-16

Source: Public Health England (PHE, 2018). Public Health Profiles. Smoking attributable mortality.

Although there are many factors involved in the development of Chronic Obstructive Pulmonary Disease (COPD), smoking is an established risk factor.[6] Based on data from the charity, Action on Smoking and Health (ASH), smoking in Barnet costs society an estimated £78.8 million (see Figure 5.4). The total estimated cost of healthcare due to smoking related illness in Barnet is £14.4 million for Barnet in 2018, of which £5.0 million (35%) is due to hospital admissions and £9.4 million (65%) to treating smoking related illness through primary and ambulatory care services. In terms of potential wealth lost, £54.7 million is annually lost to society due to smoking in Barnet.[7]

Figure 5.4: The estimated economic burden of smoking in Barnet, in millions, 2018

Source: Action on Smoking and Health (ASH), Ready Reckoner toolkit, 2018.

[3] Public Health England (PHE, 2018). Public Health Dashboard. Tobacco control. Adult smoking prevalence (%). Available at: https://fingertips.phe.org.uk/public-health-dashboard-ft#page/3/gid/1938133197/pat/6/par/E12000007/ati/102/are/E09000003/iid/92443/age/168/sex/4

[4] Public Health England (PHE, 2018). Public Health Outcomes Framework. Indicator 2.03 - Smoking status at time of delivery - current method Barnet. Available at: https://fingertips.phe.org.uk/profile/public-health-outcomes-framework/data#page/4/gid/1000042/pat/6/par/E12000007/ati/101/are/E09000003/iid/93085/age/1/sex/2

[5] Public Health England (PHE, 2018). Public Health Profiles. Smoking attributable mortality, Barnet. Available at:https://fingertips.phe.org.uk/search/mortality#page/3/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/113/age/202/sex/4

[6] Salvi, S. (2014). Tobacco smoking and environmental risk factors for chronic obstructive pulmonary disease. Clin Chest Med. 2014 Mar;35(1):17-27. Available at:https://www.ncbi.nlm.nih.gov/pubmed/24507834

[7] Action on Smoking and Health (ASH, 2018). ASH Ready Reckoner, 2018. Available at:http://ash.lelan.co.uk/

5.3.2 Smoking in Children

Figure 5.5 shows the proportion of children aged 15 years who described themselves as current smokers on the What About YOUth (WAY) survey of 2014/15. For Barnet, 4.7% of 15-year olds were current smokers, which was the 10th lowest proportion of all the London boroughs and significantly lower than the national average (8.2%).[8]

Whilst the proportion of 15 years olds in Barnet who are occasional smokers (2.0%) is similar to the national average (2.7%), the percentage of regular smokers (2.6%) and those who use e-cigarettes (9.5%) is significantly lower than the England averages (5.5% and 18.4% respectively). However, the proportion of Barnet 15 years olds (21.8%) who had ever used or tried other tobacco products (e.g. shisha, hookah, hubble-bubble or water pipe) was significantly higher than the national average of 15.2%, but similar to the London average of 21.0% (Figure 5.6).[9] Recent public health initiatives on shisha use in the borough may have had an impact on these figures, so further local research may be required.

Figure 5.5: Percentage of children (aged 15) who are current smokers, for Barnet, London local authorities, London and England, 2014/15

Source: Public Health England (PHE, 2018). Local Tobacco Control Profiles.

Figure 5.6: Percentage of children (aged 15) who have ever used or tried other tobacco products (e.g. shisha), for Barnet, London local authorities, London and England, 2014/15

Source: Public Health England (PHE, 2018). Local Tobacco Control Profiles.

[8] Public Health England (PHE, 2018). Local Tobacco Control Profiles. Smoking prevalence at age 15 - current smokers (WAY survey), 2014/15. Available at: https://fingertips.phe.org.uk/profile/tobacco-control/data#page/3/gid/1938132900/pat/6/par/E12000007/ati/102/are/E09000003/iid/91548/age/44/sex/4 

[9] Public Health England (PHE, 2018). Local Tobacco Control Profiles. Use of other tobacco products at age 15 years (WAY survey), 2014/15. Available at: https://fingertips.phe.org.uk/profile/tobacco-control/data#page/3/gid/1938132900/pat/6/par/E12000007/ati/102/are/E09000003/iid/91768/age/44/sex/4

5.3.3 Local Tobacco and Smoking Needs

Local smoking related needs may include gaining a deeper understanding of the experimental use of tobacco related products, such as shisha, by children in the borough, as well as the ongoing protection of traditionally vulnerable people to tobacco use, such as those living  in deprived areas or with mental health issues.

5.4 Obesity

Obesity is a global health issue. In 2016, over 1.9 billion adults (aged 18+) were overweight, of which 650 million were obese. Between 1975 and 2016, the worldwide prevalence of obesity tripled, so that 13% of the adult population were obese (11% of men and 15% of women).[10] In England, 26% of men and 27% of women were obese during 2016, with a further 40% of men and 30% of women classified as overweight, but not obese.[11]

[10] World Health Organization (WHO, 2018). Factsheet: Obesity and overweight. Available at:http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

[11] NHS Digital (2017). Health Survey for England, 2016. Summary: Key Facts. Available at:https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/health-survey-for-england-2016

5.4.1 Excess weight in adults

As can be seen from Figure 5.7, over half (56.4%) of adults in Barnet had excess weight (i.e. were either overweight or obese with a Body Mass Index (BMI) larger than or equal to 25), in 2017/18. This proportion was significantly lower than the national average (62.0%), but similar to the London average (55.9%).[12]

Figure 5.7: Excess weight in adults in Barnet, London, England and London local authorities, 2017/18

Source: Public Health England (PHE, 2019). Local Authority Health Profiles. Percentage of adults (aged 18+) classified as overweight or obese.

The recorded prevalence of obesity (QoF) is an underestimation of the actual prevalence as it represents the number of people recorded on GP registers with a BMI of 30 or over. However, it gives a useful indication of the relative prevalence of obesity within CCGs.

Figure 5.8 shows the recorded (QoF) prevalence for CCGs in London for adults aged 18+. The QoF prevalence of obesity in Barnet (6.12%) is the 8th lowest in London for 2016/17 and significantly lower than both the London (7.85%) and national average (9.65%).[13]

Figure 5.8: Recorded prevalence (QoF) of obesity for adults (aged 18+), London CCGs, 2016/17

Source: NHS Digital (2017). Quality and Outcomes Framework (QOF).

Based on data from Sport England for 2013-15, the percentage of adults (aged 16+) who have healthy weight in Barnet (41.6%) is significantly higher than the national average (34.0%), but similar to the London average (39.6%). However, the proportion of adults who are obese in Barnet (17.6%) is significantly lower than both the London (20.3%) and national (24.4%) averages. The proportions of adults in Barnet who are underweight or overweight are similar to both the London and national averages (Figure 5.9).[14]

Figure 5.9: Prevalence of underweight, healthy weight, over weight and obese adults (aged 16+) in Barnet, London and England, 2013-2015

Source: Sport England (2016). Active People Survey.

Between 2018 and 2035, the number of older people in Barnet (aged 65+) with obesity (i.e. a BMI greater than or equal to 30) is estimated to increase from around 14,500 to almost 22,000. Figure 5.10 depicts this increase, broken down by gender, for the period 2018 to 2035.[15]

Figure 5.10: Trend in numbers of older obese people in Barnet, by gender, 2018 – 2035

Source: Projecting Older People Population Information (POPPI).

At a ward level, Public Health England (PHE) has modelled estimates of adult obesity (aged 16+) for Barnet for 2006-8. According to this data, the three wards with the highest prevalence of adult obesity (BMI of 30+) are: Burnt Oak (23.7%), Colindale (22.1%) and Underhill (21.6%). In contrast, the three Barnet wards with the lowest prevalence of obesity are Garden Suburb (12.8%), Finchley Church End (14.7%) and West Finchley (14.8%) and had significantly lower prevalence that the highest prevalence wards in the borough.[16]

[12] Public Health England (PHE, 2019). Local Authority Health Profiles. Percentage of adults (aged 18+) classified as overweight or obese, 2017/18. Available at: https://fingertips.phe.org.uk/profile/health-profiles/data#page/3/gid/1938132701/pat/6/par/E12000007/ati/102/are/E09000003/iid/93088/age/168/sex/4

[13] NHS Digital (2017). Quality and Outcomes Framework (QOF) - 2016-17. Available at:https://digital.nhs.uk/data-and-information/publications/statistical/quality-and-outcomes-framework-achievement-prevalence-and-exceptions-data/quality-and-outcomes-framework-qof-2016-17#key-facts

[14] Sport England (2016). Active People Survey (APS).http://webarchive.nationalarchives.gov.uk/20170110171143/https://www.noo.org.uk/LA/obesity_prev/adults

[15] Projecting Older People Population Information (POPPI, 2016). Health: Obesity. Available at:http://www.poppi.org.uk/

[16] Public Health England (2017). Local Health Toolkit. Obese adults. Available at:http://www.localhealth.org.uk/#z=515264,202503,26088,17566;v=map13;i=t2.obese_adults;l=en

5.4.1.1 Adult Obesity Needs

Although the prevalence of excess weight in Barnet is lower than the national average over half of Barnet adults are either overweight or obese, so there is an ongoing need for interventions (such as healthy weight and active travel programmes), to promote healthy lifestyles and help reduce the number of borough residents with excess weight.

5.4.2 Obesity in Children

The National Child Measurement Programme (NCMP) measures the height and weight of 4-5 year olds (Reception Year) and 10-11 year olds (Year 6) in primary schools across England. NCMP data is routinely used by local authorities for benchmarking and decision making, as well as representing a key element in the Government’s approach to tackling childhood obesity.[17]

[17] NHS Digital (2017). National Child Measurement Programme. England 2016/17 school year. Appendices. Annex H – How are the statistics used? Users and uses of the report. Available at:https://files.digital.nhs.uk/publication/j/6/nati-chil-meas-prog-eng-2016-2017-app.pdf

5.4.2.1 Reception-Year Children (aged 4-5 years)

Figure 5.11 shows the prevalence of obesity amongst Barnet 4-5 year olds from 2007/08 to 2016/17, compared to London and England. For most of these years, the prevalence of obesity in Reception Year children in Barnet was similar to the national average, although in 2015/16, the prevalence in Barnet (8.2%) was lower than both the London (10.3%) the national (9.3%) averages.  Compared to London, the prevalence of obesity in Reception Year children in Barnet over the same period, has been consistently significantly lower, except for 2012/13, when it was similar.[18]

Figure 5.11: Prevalence of obesity in 4-5 year olds, for Barnet, London and England, from 2007/08 to 2016/17

Source: National Child Management Programme data from NHS Digital: PHE (2018). NCMP and Child Obesity Profile.

The prevalence of excess weight amongst Barnet 4-5 year olds from 2007/08 to 2016/17, compared to London and England is depicted by Figure 5.12. Since 2013/14, the prevalence of excess weight within Barnet Reception Year children has been consistently significantly lower than both London and England averages.[19]

Figure 5.12: Prevalence of excess weight in 4-5 year olds, for Barnet, London and England, from 2007/08 to 2016/17

Source: National Child Management Programme data from NHS Digital: PHE (2018). NCMP and Child Obesity Profile.

[18] Public Health England (PHE, 2018). NCMP and Child Obesity Profile. Reception: Prevalence of obesity, Barnet. Available at: https://fingertips.phe.org.uk/profile/national-child-measurement-programme/data#page/4/gid/8000011/pat/6/par/E12000007/ati/102/are/E09000003/iid/90319/age/200/sex/4

[19] Public Health England (PHE, 2018). NCMP and Child Obesity Profile. Reception: Prevalence of overweight (including obese), Barnet. Available at: https://fingertips.phe.org.uk/profile/national-child-measurement-programme/data#page/4/gid/8000011/pat/6/par/E12000007/ati/102/are/E09000003/iid/20601/age/200/sex/4

5.4.2.2 Year 6 Children (aged 10-11 years)

Figure 5.13 shows the prevalence of obesity in Barnet 10-11 year olds (Year 6) between 2007/8 and 2016/17, compared to regional and national averages. During this period, the prevalence of obesity in Year 6 pupils within the borough was consistently significantly lower than the London average and similar to the national average.[20]

Figure 5.13: Prevalence of obesity in 10-11 year olds, for Barnet, London and England, from 2007/08 to 2016/17

Source: National Child Management Programme data from NHS Digital: PHE (2018). NCMP and Child Obesity Profile.

The prevalence of excess weight (obesity and overweight combined) for Year 6 children in Barnet, compared to London and England, for the period 2007/8 to 2016/17 is shown in Figure 5.14. During this period, the prevalence of excess weight in Barnet Year 6 children was consistently lower than the London average. However, except for 2016/17, when the Barnet prevalence was significantly lower, the prevalence of excess weight in Year 6 children in the borough was similar to the national average, over this period.[21]

Figure 5.14: Prevalence of excess weight in 10-11 year olds, for Barnet, London and England, from 2007/08 to 2016/17

Source: National Child Management Programme data from NHS Digital: PHE (2018). NCMP and Child Obesity Profile.

[20] Public Health England (PHE, 2018). NCMP and Child Obesity Profile. Year 6: Prevalence of obesity, Barnet. Available at: https://fingertips.phe.org.uk/profile/national-child-measurement-programme/data#page/4/gid/8000011/pat/6/par/E12000007/ati/102/are/E09000003/iid/90323/age/201/sex/4

[21] Public Health England (PHE, 2018). NCMP and Child Obesity Profile. Year 6: Prevalence of overweight (including obese), Barnet. Available at: https://fingertips.phe.org.uk/profile/national-child-measurement-programme/data#page/4/gid/8000011/pat/6/par/E12000007/ati/102/are/E09000003/iid/20602/age/201/sex/4

5.5 Physical activity

Worldwide, about a quarter of adults and over 80% of adolescents are not physically active enough, despite physical inactivity being a leading risk factor for death.[22] The Chief Medical Officer (CMO) for England recommends that adults take at least 150 minutes of moderate physical activity per week. Based on this criterion, in 2016/17, the proportion of adults in Barnet (aged 19+) who are physically active (59.8%) in Barnet was significantly lower than both the London (64.6%) and national (66.0%) average (Figure 5.15).[23]

Figure 5.15: Percentage of physically active adults in Barnet, London, England and London local authorities, 2016/17

Source: Public Health Profiles (PHE, 2018). Physical Activity Profile. Percentage of physically active adults.

Similarly, in 2016/17, Barnet had the 6th highest proportion of adults (aged 19+) out of all the London boroughs who were physically inactive (i.e. take part in less than 30 minutes of moderate physical activity per week). Almost three in ten Barnet adults (28.6%) were physically inactive (see Figure 5.16) which was significantly higher than both London (22.9%) and England (22.2%).[24]

Figure 5.16: Percentage of physically inactive adults in Barnet, London, England and London local authorities, 2016/17

Source: Public Health Profiles (PHE, 2018). Physical Activity Profile. Percentage of physically inactive adults.

[22] World Health Organization (WHO, 2018). Physical activity factsheet. Available at:http://www.who.int/news-room/fact-sheets/detail/physical-activity

[23] Public Health England (PHE, 2018). Physical Activity Profile. Percentage of physically active adults - current method,2016/17. Available at: https://fingertips.phe.org.uk/profile/physical-activity/data#page/3/gid/1938132899/pat/6/par/E12000007/ati/101/are/E09000003/iid/93014/age/298/sex/4

[24]Public Health England (PHE, 2018). Physical Activity Profile. Percentage of physically inactive adults - current method, 2016/17. Available at: https://fingertips.phe.org.uk/profile/physical-activity/data#page/3/gid/1938132899/pat/6/par/E12000007/ati/101/are/E09000003/iid/93015/age/298/sex/4

5.5.1 Physical Activity Needs

One of the key objectives of the London Borough of Barnet (LBB) Health and Wellbeing Strategy 2015-2020[25] is to encourage healthy lifestyles by focusing on the reduction of obesity and prevention of long term conditions, through the promotion of physical activity.

To encourage increased participation in physical activity by borough residents, LBB supports several initiatives, such as “Fit and Active Barnet” (FAB). This major programme works in partnership with “Better,” the operator of the five leisure centres within Barnet, through a free FAB card which gives access to a range of benefits.[26]

[25] London Borough of Barnet (2015). Joint-Health-and-Wellbeing-Strategy-2015-2020. Available at:https://www.barnet.gov.uk/citizen-home/public-health/Key-strategic-documents-and-plans/Joint-Health-and-Wellbeing-Strategy-2015-2020.html

[26] London Borough of Barnet and Better (2018). Fit & Active Barnet Hub. Available at:https://www.better.org.uk/fab-hub 

5.6 Alcohol

The harmful consumption of alcohol results in around 3 million deaths worldwide each year, which represents about 5.3% of all deaths.[27] Alcohol consumption is estimated to cost the NHS £3.5 billion per year and the wider society around £21 billion annually, as well as contributing to hospital admissions and deaths from a wide range of conditions. The level of harm from alcohol is related to both the volume and frequency of consumption, so the only way to remain risk free is to abstain from drinking alcohol.[28]

The proportion of Barnet adults who abstain from alcohol (15.9%) is significantly lower than the London average (24.3%), but similar to the national average (15.5%), based on data from the Health Survey of England for 2011-2014. This is the 8th lowest of all the London boroughs in terms of abstinence from alcohol (see Figure 5.17).[29]

Figure 5.17: Percentage of adults who abstain from alcohol in Barnet, London, England and London local authorities, 2016/17

Source: Public Health England (PHE, 2018). Local Alcohol Profiles for England. Adults who abstain from alcohol.

In 2016, the UK Chief Medical Officers released guidelines which advised that to keep the health risks from alcohol consumption low, it was safest for adults to drink no more than 14 units per week.[30]

Based on Health Survey for England data for 2011-14, only 8.1% of Barnet adults reported drinking over 14 units of alcohol per week (see Figure 5.18), which was the lowest of all the 32 London boroughs and significantly lower than both London (21.6%) and England (25.7%).[31]

Figure 5.18: Percentage of adults drinking over 14 units of alcohol per week in Barnet, London, England and London local authorities, 2011-14

Source: Public Health England (PHE, 2018). Local Alcohol Profiles for England. Percentage of adults drinking over 14 units of alcohol a week.

[27] World Health Organization (WHO, 2018) Alcohol factsheet. Available at: http://www.who.int/news-room/fact-sheets/detail/alcohol

[28] Public Health England (PHE, 2018). Local Alcohol Profiles for England. 19.01 Percentage of adults who abstain from drinking alcohol. Indicator Definitions and Supporting Information.https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/6/gid/1938133118/pat/6/par/E12000007/ati/102/are/E09000003/iid/92774/age/168/sex/4 

[29] Public Health England (2018). Local Alcohol Profiles for England. 19.01 - Percentage of adults who abstain from drinking alcohol,2011 – 14. Available at: https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/3/gid/1938133118/pat/6/par/E12000007/ati/102/are/E09000003/iid/92774/age/168/sex/4

[30] HM Government (2016). UK Chief Medical Officers’ Low Risk Drinking Guideline (p.4). Available at:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545937/UK_CMOs__report.pdf

[31] Public Health England (PHE, 2018). Local Alcohol Profiles for England. 19.03 - Percentage of adults drinking over 14 units of alcohol a week, 2011 – 14. Available at: https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/3/gid/1938133118/pat/6/par/E12000007/ati/102/are/E09000003/iid/92778/age/168/sex/4

5.6.1 Binge Drinking

The estimated percentage of the adult population (aged 16+) who binge drink is provided at ward level by the Local Health tool from Public Health England. Within Barnet, the wards with the highest estimated percentage of adults binge drinking for 2006-8, were Garden Suburb (14.7%), High Barnet (14.4%) and East Barnet (14.0%), while lowest binge drinking prevalence was in Colindale (8.4%), Burnt Oak (9.7%) and West Hendon (10.1%).[32]

[32] Public Health England (PHE, 2018). Local Health tool. Available at:http://www.localhealth.org.uk/#z=469451,231715,107424,72332;v=map13;l=en;sid=34;sly=wd16_DR;i=t2.bingedrinking

5.6.2 Alcohol related admissions and mortality

The directly age standardized rate of alcohol-related hospital admissions per 100,000 population (all ages) in Barnet, compared to London and national averages is shown in Figure 5.19. Between 2012/13 and 2016/17, alcohol related admissions in Barnet have been significantly lower than London and England. For 2016/17, the rate of alcohol related admissions for Barnet (485 per 100,000) was the 9th lowest of all the London boroughs and significantly lower than both London (529 per 100,000) and England (636 per 100,000).[34]

Figure 5.19: Number of admission episodes for alcohol-related conditions (narrow), all ages, for Barnet, London and England, 2009/10 to 2016/17

Source: PHE (2018). Local Alcohol Profiles for England. Admission episodes for alcohol-related conditions (narrow).

In 2016, the estimated rate of alcohol-related mortality for Barnet was 31.2 per 100,000, which was the lowest of all the London boroughs and significantly lower than both London (39.8 per 100,000) and England (46.0 per 100,000). Figure 5.20 shows the rates of alcohol-related mortality for Barnet, London and England from 2009 to 2016. Between 2013 and 2016, the rate of alcohol related deaths in Barnet was significantly lower than both London and England.[35]

Figure 5.20: Estimated number of alcohol related (directly standardised rate) deaths, per 100,000 residents (all ages), for Barnet, London and England, 2009 to 2016

Source: PHE (2018). Local Alcohol Profiles for England. Alcohol-related mortality.

[34] Public Health England (PHE, 2018). Local Alcohol Profiles for England. 10.01 - Admission episodes for alcohol-related conditions (Narrow), Barnet. Available at:  https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/3/gid/1938132984/pat/6/par/E12000007/ati/102/are/E09000003/iid/91414/age/1/sex/4

[35] Public Health England (PHE, 2018). Local Alcohol Profiles for England. 4.01 - Alcohol-related mortality, Barnet. Available at: https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/4/gid/1938132984/pat/6/par/E12000007/ati/101/are/E09000003/iid/91382/age/1/sex/4

5.6.3 Alcohol dependence and treatment

The percentage of dependent drinkers in Barnet (1.09%) is similar to both London (1.36%) and England (1.39%), from modelled estimates based on the Adult Psychiatric Morbidity Survey (APMS) for 2014/15.[36]

In 2016, the proportion of people successfully completing treatment for alcohol in Barnet (38.7%) was similar to both London (40.6%) and England (38.7%).[37]

[36] Public Health England (PHE, 2018). Local Alcohol Profiles for England. 20.01 - Percentage of dependent drinkers, 2014/15. Available at: https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/3/gid/1938133118/pat/6/par/E12000007/ati/102/are/E09000003/iid/93193/age/168/sex/4 

[37] Public Health England (PHE, 2018). Local Alcohol Profiles for England. 15.01 - Successful completion of treatment for alcohol, 2016. Available at: https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/3/gid/1938132895/pat/6/par/E12000007/ati/102/are/E09000003/iid/92447/age/234/sex/4

5.7 Drugs and substance misuse

5.7.1 Prevalence of Drug Misuse

Public Health England has provided estimates of the prevalence of opiate and crack use in local areas for 2014/15. Based on this data, there were 1,668 opiate or crack users (OCU) in Barnet in 2014/15, representing a rate of 6.72 per 1,000 population aged 15-64 years old. This prevalence rate for people using either opiates or crack is similar to that of both London (8.87 / 1,000) and England (8.57 / 1,000). In 2014/15, there were an estimated 1,390 opiate users in Barnet, which equates to 5.60 per 1,000 population aged 15-64. As with OCU, the prevalence of opiate use in Barnet is not significantly different from either London (6.89 / 1,000) and England (7.33 / 1,000). In Barnet, there were an estimated 1,030 crack users in 2014/15, which represents a rate of 4.15 per 1,000 population aged 15-64 which is significantly lower than the London rate (6.63 / 1,000), but similar to the national average (5.21 / 1,000). In Barnet, the age group predicted to have the highest rate of opiate or crack use (OCU) in 2014/15 was 15-24 year olds at 7.69 per 1,000. In contrast, the highest prevalence of opiate users in the borough was predicted to be in the 35-64 year old age group at 6.74 per 1,000.[38]

[38] Public Health England (2018). Research and analysis: Opiate and crack cocaine use: prevalence estimates by local area. Estimates of the number of opiate and crack cocaine users in local areas from 2014 to 2015. Available at: https://www.gov.uk/government/publications/opiate-and-crack-cocaine-use-prevalence-estimates-for-local-populations#history

5.7.2 Drug Related Deaths in Barnet

The standardized mortality ratio compares the observed number of deaths among adults in drug treatment from a local authority with the expected number of deaths if that local authority had the same age specific mortality rate as the entire drug treatment population of England. The ratio is therefore an indicator of the effectiveness, safety and protection provided by local authority drug treatment services. In Barnet, between 2014/15 and 2016/17, the mortality ratio for deaths in drug treatment was 0.62, which was significantly better than the national average of 1.00, and the 8th lowest of all the London boroughs.[39]

5.7.3 Drug Related Crime Data

According to the Metropolitan Police, there were 1,630 drug offences in Barnet between July 2016 and July 2018, representing a rate of 0.55, which was considerably lower than the rate for London over the same period (1.13). The rate of drug offences in Barnet fell by 14.37% compared to 6.96% for London, when the 12 months to July 2018 are compared to the previous 12 months (see Figure 5.21).[40]

Figure 5.21: Drug offences in Barnet, July 2016 – July 2018

Source: Metropolitan Police (2018). Crime Data Dashboard. Drug offences.

[40] Metropolitan Police (2018). Crime Data Dashboard. Available at: https://www.met.police.uk/sd/stats-and-data/met/crime-data-dashboard/

5.7.4 Drug Treatment Completion Rates

In 2016, the proportion of opiate users who successfully left treatment and did not represent within 6 months was 8.3% which was similar to both the London (7.2%) and national (6.7%) averages. Between 2011 and 2016, the percentage of opiate users successfully completing treatment in Barnet has been similar to the national (England) average for all years except for 2011 and 2014, when the proportion in Barnet was significantly higher (Figure 5.22).[41]

Figure 5.22: Successful completion of treatment for opiate use (%), persons aged 18-75, for Barnet, London and England, 2011–2016

Source: Public Health England (2018). Public Health Profiles. Successful completion of drug treatment - opiate users.

Concerning the successful completion of treatment for non-opiate users, the proportion of drug users in Barnet who left treatment successfully and did not represent within 6 months was consistently significantly lower than the London average between 2013 and 2016 (see Figure 5.23).[42]

Figure 5.23: Successful completion of treatment for non-opiate use (%), persons aged 18-75, for Barnet, London and England, 2011–2016

Source: Public Health England (2018). Public Health Profiles. Successful completion of drug treatment - non-opiate users.

[41] Public Health England (PHE, 2018). Public Health Profiles. 2.15i - Successful completion of drug treatment - opiate users, Barnet. Available at:https://fingertips.phe.org.uk/search/non%20opiate#page/6/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/90244/age/234/sex/4

[42] Public Health England (2018). Public Health Profiles. 2.15ii - Successful completion of drug treatment - non-opiate users. Available at:https://fingertips.phe.org.uk/search/non%20opiate#page/4/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/90245/age/234/sex/4

5.8 Sexual and Reproductive Health

5.8.1 Teenage Pregnancy

Teenage pregnancy is often associated with poorer outcomes for both mother and baby. Teenage mothers are less likely to complete their education, more likely to bring their child up alone and in poverty and are also at greater risk of poor mental health, compared to older mothers. Infant mortality is 60% higher for babies born to teenage mothers and when these children grow up they are themselves more likely to live in poverty and suffer from behavioural problems.[43]

The rate of teenage conceptions per 1,000 girls aged 13–15 for 2010-2016, is shown in Figure 5.24. Between 2010 and 2014, the rate of teenage conceptions for under 16s in Barnet was significantly lower than the national average. However, during 2015-16, the under 16 conception rate in the borough was similar to both the London and national averages.[44]

Figure 5.24: Rate of teenage conception (under 16s) for Barnet, London and England, 2010 to 2016

Source: Public Health England (2018). Public Health Profiles. Under 16s conception rate / 1,000.

Figure 5.25 shows the rate of teenage (under 18) conceptions in Barnet, from 2010 to 2016, compared to the London and national average. Over this period, the under 18s conception rate in Barnet has remained consistently significantly lower than both London and England. For example, the conception rate for under 18s in Barnet during 2016 was 10.2 per 1,000 compared to 17.1 / 1,000 in London and 18.8 / 1,000 in England. [45]

Figure 5.25: Rate of teenage conception (under 18s), for Barnet, London and England, 2010 to 2016

Source: Public Health England (2018). Public Health Profiles. Under 18s conception rate / 1,000.

[43] Public Health England (PHE, 2018). Sexual and Reproductive Health Profiles. Under 18s conception rate. Indicator Definitions and Supporting Information. Available at:https://fingertips.phe.org.uk/profile/sexualhealth/data#page/6/gid/8000057/pat/6/par/E12000007/ati/102/are/E09000003/iid/20401/age/173/sex/2

[44] Public Health England (2018). Public Health Profiles. Under 16s conception rate / 1,000 (PHOF indicator 2.04), 2016. Available at:https://fingertips.phe.org.uk/search/teenage%20pregnancy#page/3/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/90639/age/169/sex/2

[45] Public Health England (2018). Public Health Profiles. Under 18s conception rate / 1,000 (PHOF indicator 2.04). Available at:https://fingertips.phe.org.uk/search/teenage%20pregnancy#page/3/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/20401/age/173/sex/2

5.8.2 Abortions

The abortion rate is a measure of lack of access to good quality contraceptive services or advice as well as individual problems in the use of contraceptive methods.[46] Figure 5.26 shows the rate of abortions in Barnet, compared to London and national average rates, from 2012–2017. Over this period, the rate of abortions has been consistently significantly lower in Barnet compared to London. When compared to the national average, the abortion rate in Barnet was significantly higher than England between 2012-2014 and similar to the national average between 2015 and 2017.[47]

Figure 5.26: Rate of abortions per 1,000 female population aged 15–44, for Barnet, London and England, 2012–2017

Source: Public Health England (PHE, 2018). Public Health Profiles. Total abortion rate / 1000.

Most of teenage pregnancies are unplanned and about half end in abortion. As well as representing an avoidable experience for the young women involved, abortions are an avoidable expense to the NHS.[48] Figure 5.27 shows the rate of abortions for teenagers aged under 18 in Barnet, London and England for 2012-2017. Except for 2015, when the rates were similar, between 2012 and 2016, the abortion rate for teenagers aged under 18 in Barnet was significantly lower than the London average. However, in 2017, the abortion rate for under 18s in the borough (7.6 per 1,000) was similar to both the London (9.2 per 1,000) and national average (8.4 per 1,000).[49]

Figure 5.27: Rate of abortions in under 18s, for Barnet, London and England, from 2012 to 2017

Source: Public Health England (PHE, 2018). Public Health Profiles. Under 18s abortion rate.

[46] Public Health England (PHE, 2018). Public Health Profiles. Total abortion rate / 1000, Barnet. Indicator Definitions and Supporting Information. Available At:https://fingertips.phe.org.uk/search/abortion%20rate#page/6/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/90754/age/1/sex/2

[47] Public Health England (PHE, 2018). Public Health Profiles. Total abortion rate / 1000, Barnet. Available at:https://fingertips.phe.org.uk/search/abortion%20rate#page/3/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/90754/age/1/sex/2

[48] Public Health England (PHE, 2018). Public Health Profiles. Under 18s abortion rate. Indicator Definitions and Supporting Information. Available at:https://fingertips.phe.org.uk/search/abortion#page/6/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/91456/age/173/sex/2

[49] Public Health England (PHE, 2018). Public Health Profiles. Under 18s abortion rate. Available at:https://fingertips.phe.org.uk/search/abortion#page/4/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/91456/age/173/sex/2

5.8.3 Contraception (provision of advice and services around contraception)

For Barnet, GP prescription of long acting reversible contraceptives (LARCs) excluding injections, was consistently significantly lower than both London and England, between 2011 and 2016. In 2016, the rate of prescription of LARCs in Barnet (10.2 per 1,000 females aged 15-44) was significantly lower than both London (13.9 / 1,000) and England (28.8 / 1,000). The reasons underlying the consistently lower prescription of LARCs by Barnet GPs may need further investigation.[50]

[50] Public Health England (PHE,2018). Public Health Profiles. GP prescribed LARC excluding injections rate / 1,000, 2016. Available at:https://fingertips.phe.org.uk/search/LARC#page/3/gid/1/pat/6/par/E12000007/ati/101/are/E09000003/iid/91819/age/1/sex/2

5.8.4 Sexual Offences

There were 1,315 sexual offences in Barnet between July 2016 and July 2018, according to the Metropolitan Police, representing a rate of 0.66, which was lower than the rate for London over the same period (0.90). The rate of sexual offences in Barnet rose by 8.88% compared to 10.46% for London, when the 12 months to July 2018 are compared to the previous 12 months (see Figure 5.28).[51]

Figure 5.28: Sexual offences in Barnet, July 2016 – July 2018

Source: Metropolitan Police (2018). Crime Data Dashboard. Sexual offences.

[51] Metropolitan Police (2018). Crime Data Dashboard. Available at: https://www.met.police.uk/sd/stats-and-data/met/crime-data-dashboard/

5.8.5 Sexually Transmitted Infections (STI)

As can be seen from Figure 5.29, during 2017, the diagnostic rates for syphilis, gonorrhoea, genital warts and genital herpes for persons of all ages in London were significantly higher in London compared to both Barnet and England. In 2017, the diagnostic rate for genital warts in Barnet (113.8 per 100,000) was similar to the national average (103.9 per 100,000). However, the diagnostic rates for syphilis, gonorrhoea and genital herpes were all significantly higher in Barnet than the national average.[52]

Figure 5.29: Rate of diagnoses for syphilis, gonorrhoea, genital warts and genital herpes (persons, all ages), for Barnet, London and England, 2017

Source: Public Health England (PHE, 2018). Sexual and Reproductive Health Profiles.

Figure 5.30 shows the chlamydia detection rate for 15-24 year olds in Barnet, London and England between 2013 and 2017. The detection rate in Barnet was consistently significantly lower than both London and England, during this period. Between 2014 and 2017, there has been no significant change in the detection rate of chlamydia in Barnet.[53]

Figure 5.30: Rate of chlamydia detection in the 15-24 year old population, for Barnet, London and England, from 2013 to 2017

Source: Public Health England (PHE, 2018). Sexual and Reproductive Health Profiles. Chlamydia detection rate.

The proportion of the resident 15-24 year old population screened for chlamydia in Barnet during 2017, was 17.5% which was significantly lower than both London (24.0%) and England (19.3%). Between 2012 and 2017, the percentage of young people (aged 15-24 year old) screened for chlamydia in Barnet was significantly lower than both London and England.[54] The consistently low rates of screening and detection of chlamydia in Barnet may need further attention.

[52] Public Health England (PHE,2018). Sexual and Reproductive Health Profiles. Available at:https://fingertips.phe.org.uk/profile/sexualhealth/data#page/0/gid/8000035/pat/6/par/E12000007/ati/102/are/E09000003/iid/90729/age/1/sex/4

[53] Public Health England (PHE, 2018). Sexual and Reproductive Health Profiles. Chlamydia detection rate / 100,000 aged 15-24 (PHOF indicator 3.02), 2017. Available at:https://fingertips.phe.org.uk/profile/sexualhealth/data#page/3/gid/8000035/pat/6/par/E12000007/ati/102/are/E09000003/iid/90776/age/156/sex/4

[54] Public Health England (PHE, 2018). Sexual and Reproductive Health Profiles. Chlamydia proportion aged 15-24 screened, 2017. Available at:https://fingertips.phe.org.uk/profile/sexualhealth/data#page/3/gid/8000058/pat/6/par/E12000007/ati/102/are/E09000003/iid/90777/age/156/sex/4

5.8.6 Human Immunodeficiency Virus (HIV)

To date, HIV has caused around 35 million deaths globally and in 2017 alone about 940,000 people around the world died from HIV related conditions. There are currently an estimated 36.9 million people living with HIV, with 1.8 million new cases emerging in 2017. Testing for HIV infection, often through rapid diagnostic tests (RDTs) for the presence or absence of HIV antibodies, is an integral element of treatment, although there is currently no cure for HIV infection.[55]

HIV coverage assesses the proportion of eligible new attendees to a specialist sexual health service who accept an HIV test. Among women accessing sexual health services, the proportion of new attendees accepting an HIV test fell significantly between 2010 to 2017, from 73.2% to 67.4%. In contrast, for men who have sex with men (MSM) the percentage HIV coverage increased significantly from 83.6% to 91.5%, over the same period. Similarly, for men there was a significant increase in HIV coverage, from 76.9% to 85.6% (see Figure 5.31). The HIV coverage for females was significantly lower than both males and MSM between 2010 and 2017. Over the same period, the HIV coverage for males was significantly lower than MSM.[56]

Figure 5.32 shows the HIV testing uptake in Barnet for males, females and MSM, which represents the proportion of eligible new episodes where a test was accepted as a proportion of those where it was offered. In 2017, the HIV uptake for MSM was 96.0%, which was significantly higher than for both males (90.9%) and females (81.0%) in the borough. For males, females and MSM in Barnet the HIV testing uptake during 2017 was significantly higher than both the London and national averages. Between 2010 and 2017, the % HIV testing uptake for MSM in Barnet increased significantly, for males it did not change significantly and for females it decreased significantly.[57]

Figure 5.31: HIV testing coverage, in Barnet, for females, males and men who have sex with men (MSM), all ages, from 2010 to 2017

Source: Public Health England (PHE, 2018). Public Health Profiles. HIV testing coverage.

Figure 5.32: HIV testing uptake, in Barnet, for females, males and men who have sex with men (MSM), all ages, from 2010 to 2017

Source: Public Health England (PHE, 2018). Public Health Profiles. HIV testing uptake.

[55] World Health Organization (WHO, 2018). HIV / AIDS factsheet. Key facts. Available at:http://www.who.int/en/news-room/fact-sheets/detail/hiv-aids

[56] Public Health England (PHE, 2018). Public Health Profiles. HIV coverage.  Available at:https://fingertips.phe.org.uk/search/HIV%20testing%20coverage

[57] Public Health England (PHE, 2018). Public Health Profiles. HIV uptake.  Available at:https://fingertips.phe.org.uk/search/HIV#page/0/gid/1/pat/6/par/E12000007/ati/102/are/E09000003/iid/90778/age/1/sex/1