Joint Strategic Needs Assessment (JSNA) 2014 updates

The Joint Strategic Needs Assessment (JSNA) reports on the health and wellbeing needs of people in Bristol.

JSNA 2014 reports

A range of JSNA 2014 reports have been developed, including:

A new JSNA 2015 summary report is due for release in December 2015.

Bristol Child Health Profile 2014

This is a summary released by Public Health England (see Documents), to show how how Bristol compares to the England average for 32 different Child Health indicators. Compared with our profile in 2013 a number of changes have occurred. Some key points of note include:

  • Immunisations for children in care (Indicator 5) – There is no data reported for this. It is a data reporting error due to a change in the data systems we are using in Bristol. In 2013-2014 the percentage of children who have been in care for 12 months or more who are up to date with their immunisations was 68% (these are provisional figures which will be confirmed at the end of year submission). Improving the health of children in care is a local priority.
  • Sexually transmitted infections - The rate of acute sexually transmitted infection s per 1000 population aged 15-24yr has gone up between 2013 and 2014. This is likely to reflect the success of a local campaign to encourage young people to be tested for chlamydia and means that young people are receiving treatment for infections and sexual health advice.
  • Wider determinants of health - Several indicators in the section 'Wider determinants of health' on including GCSE’s achieved (Indicator 8), 16-18 year olds not in education, employment or training (Indicator 10), first time entrants in the criminal justice system (Indicator 11) and children in poverty (Indicator 12) all remain Red, that is, significantly worse than the England average. For each of these indicators the values for Bristol have improved between 2013 and 2014 and we are closer to the England average than previously, but there remains room for further improvement.
  • Health improvement - All of the indicators in this section are now Amber (not significantly different to the England average) or Green (significantly better than the England average). Teenage pregnancy rates continue to fall.
  • The rate of breastfeeding - The rate of breastfeeding at 6-8 weeks had not been reported due to changes in data collection methods locally during that year (Indicator 26). Our figures for 2012 show that 55.9% of all babies were breastfed at 6-8 weeks.
  • A&E attendances for children aged 0-4 years - Good progress has been made to reduce the number of A&E attendances for children aged 0-4 years (Indicator 27), suggesting that a number of local initiatives have been effective in ensuring appropriate use of A&E services for this age group.
  • Hospital admissions for self-harm in young people aged 10-24y (Indicator 32) -  The hospital admissions for self-harm in young people aged 10-24y are significantly higher than the England average. A local strategy to reduce self-harm and suicide is in place. Direct comparison of the rates of self-harm between 2013 and 2014 should not be made because the indicator has changed this year, having previously reported a rate for children aged 0-17years

If you want further information or help to interpret the information in this Child Health Profile please contact via the JSNA process (

Bristol Health Profile 2014

This is a summary released by Public Health England (see Documents), to show how how Bristol compares to the England average for 32 Health indicators (including ones for the Wider Determinants of Health).  The JSNA 2014 Update due will contain more updated local data on some indicators than used in this Profile (due to the national benchmarking), but it is a very useful overview of Health in Bristol.  Some key points of note include:

Positive trends:

  • Life expectancy - Overall people are living longer, and current life expectancy at birth estimates for Bristol are 78.3 years for men and 83.0 years for women (2010-12).  For women this is very similar to national, but for men is still significantly lower than national average.
  • Early deaths from Cardiovascular Diseases – this rate has been falling year on year over the last decade.  Bristol is very similar to national rates.
  • Teenage pregnancy – Bristol had one of the worst rates in the country for under-18 conceptions and deliveries.  We are now very close to the England average (Bristol 28.5 per 1,000 girls 15-17, 2012), which is a great local success.  Teenage pregnancy is important as babies and mothers have more complications and less good outcomes from pregnancy if the mothers are very young.
  • Breastfeeding – Bristol has one of the best rates in the country for mothers starting feeding their new born babies with breast milk rather than bottle milk (over 80%). Breast milk contains essential factors which give the baby the best start in life. Bristol was the first city in England to be awarded the UNIECF Baby Friendly Initiative award, which recognises exemplary support for mothers to help breastfeeding.
  • GCSE results.  Bristol is marked as significantly worse than national average for children achieving 5 or more GCSEs at A* to C grade including English & Maths (52.4% of Bristol children, national 60.8%, 2013).  However, we have made great progress to get to where we are now, from 46.3% in 2010 (2011 50.4% and 2012 51.7%), so a strong positive trend, with of course need for further improvement.    [Additional note - over 80% Bristol children now passed 5 or more GCSEs at A* to C grade (any subjects); was under 70% in 2009].

Negative trends:

  • Smoking in pregnancy – In previous years Bristol was significantly better than national average, but now 12.3% of pregnant women are recorded as smoking at the time of delivery, similar to national (2012/13).   Locally, it is noted that it is getting harder to engage with pregnant women despite a variety of approaches being made, and new targeted stop smoking services are being considered.
  • Early deaths from Cancer – although there is a small reduction here, the gap between the national average and local rate is not showing any signs of reducing and Bristol remains significantly worse.

 Other indicators to highlight: 

  • Life expectancy gap - There is a persistent inequality in life expectancy, and average life expectancy in Bristol is 8.2 years lower for men and 6.1 years lower for women in the most deprived 10% areas of Bristol than in the least deprived 10% (2010-12).  In particular, the inequality gap for women appears to be worsening, which may be linked to economic gender inequality impacts [Note – this is not the gap between the wards with lowest and highest expectancy].
  • Child poverty – Bristol has more children under 16 (25.3%) living in families in receipt of means tested benefits and/or having a low income than the England average (20.6%, 2011).  However the Bristol figure is falling (27.1%, 2009), and is comparable to other core cities.  Living in relative poverty means that families tend to make lifestyle choices that are less healthy than those made by more affluent families. The Bristol Child Poverty Strategy tries to tackle this challenge in multiple ways.
  • Childhood obesity – Being obese as a child is a strong predictor for being obese as an adult, and adult obesity is linked to diabetes, heart disease, stroke and cancer. One in five children in Bristol (19.8%) is obese by the time they leave primary school, similar to England average. The number of overweight children was previously going up but over the last few years has plateaued; we would now like to see it falling. Tackling obesity is complicated as the causes are societal, cultural, environmental and economic as well as individual choices.
  • Obese adults – almost 1 in 4 (23.8%) of Bristol adults are estimated to be obese, based on the 2012 Active People Survey (a similar rate to national average).
  • Rates of sexually transmitted infections are higher than average (1189 per 100,000 population, 2012).  However, this is likely to reflect the success of local campaigns to encourage young people to be tested for chlamydia and means that young people are receiving treatment for infections and sexual health advice.
  • Incidence of TB – this is now 19.6 per 100,000 population (2010-12) which is significantly worse than national.  This is linked to changes in the Bristol population demographics.
  • Incidence of Diabetes – this is lower than the national average, but should be noted  this is a crude rate based on those recorded on GP registers, and is linked to Bristol’s younger population profile.
  • Drug misuse – this is a 2010/11 estimate of opiate and crack cocaine users, and has not been updated.  It does not necessarily reflect current service priorities.
  • Long-term unemployment – this is significantly worse than national average, at 10.6 per 1,000 population (2013).  A similar picture was reported for 2012, which had been a striking difference from previous figures where Bristol was significantly lower than national up to 2011.

These are headline figures only, and work is in progress in most areas.  If you want further information or help to interpret the information in the Bristol Health Profile please contact via the JSNA process (