Analysis of Coastal health outcomes.

There has been relatively little research focusing on health and health care in coastal communities. The following chapter is an exploratory analysis comparing coastal and non-coastal areas using Quality Outcome Framework (QOF) data. The key findings of this chapter suggest that: • There is a higher burden of disease and health risk factors in coastal areas, including heart disease, diabetes, cancer, mental health and Chronic Obstructive Pulmonary Disease (COPD). • This difference is partly explained by age and deprivation. However, even after adjusting for these factors (and others including ethnicity), there remains a ‘coastal excess’ in the prevalence of disease and risk factors. • There is some evidence of a health service deficit in terms of recorded service standards, cancers indicators and emergency admissions. The cause of this is unclear. • Standardised Mortality Ratios (SMR) for a range of conditions, including preventable mortality, are significantly higher in coastal areas compared with non-coastal. • Life expectancy (LE), healthy life expectancy (HLE) and disability free life expectancy (DFLE) are all, on average, significantly lower in coastal areas for both males and females. • Lower participation in higher education and higher rates of hospital admissions due to health-risking behaviour by children and young people may point to a degree of socio-psychological as well as economic dislocation in coastal communities. • There is a lack of available small area data for detailed analysis of the health of local communities, both on and beyond the coastal fringe