LEARNING AIM C- EXAMINE HOW SOCIAL INEQUALITIES, DEMOGRAPHIC CHANGE, AND
PATTERNS AND TRENDS AFFECT HEALTH AND SOCIAL CARE DELIVERY
P6: Explain how demographic data is used in service provision in a local health and social care
setting.
P7: Explain patterns and trends in health and ill health within different social groups.
M4 Analyse the impact of the use of demographic data in a local health and social care
: setting in enabling the enhancement of service provision for different social groups.
In this assignment I will be explaining how demographic data is used in service in a local health and
social care setting which is the Harley Grove Medical Centre. I will also be explaining the patterns and
trends in health and ill health within different social groups. I will finally be analysing the impact of the
use of demographic data in the Harley Grove Medical Centre in enabling the enhancement of service
provision of different social groups. Demography is the technical term used to describe the study of
changes in the size and structure of the population and other policymakers all study changes in the size
and make-up of the population. Policy makers are someone who makes the plans carried out by a
government or business. At first, governments were concerned with measuring: natural changes in the
population- changes in the birth rates and death rates and changes in migration (emigration and
immigration). Now demographers examine wider changes in the population, such as changes in
educational achievements, employment, spending patterns and the use of leisure time. Service
provision in health and social care terms is the provision of health services as part of the National Health
Service to an individual and includes the assessment, diagnosis or treatment of that individual. It is
important, when planning health and social care provision, to know, for example: the overall size of the
population, the age structure of the population, including how many people over retirement age and
how many school children there are to support, the numbers of people with disabilities and with mental
health problems and any regional or geographical differences in levels of health and ill health. The local
health and social care setting I will be focusing on is Harley Grove Medical Centre.
BIRTH RATES:
Natural changes in the population include changes in the birth rates. Birth rates are defined as the
number of live births per thousand of the population over a given period, normally a year. The birth
rates fell during the 20thcentury from an average of six children per family in 1870 to 1.7 children in
2007.It is not possible to explain the fall in the birth rate with full certainty, but it is reasonable to
account for it by considering changing social circumstances, such as: the availability of reliable
contraception for women from the late 1960s, women pursuing their own careers and choosing to have
smaller families, the wish to have smaller families in order to enjoy a higher standard of living and the
development of the welfare state, which meant that it was not necessary to have a large family to
ensure that parents were cared for in their old age. Census is defined as a compulsory, official and
detailed count of the population in the UK, held every 10 years. It includes demographic information
about households. (Pearsonactivelearn.com, 2020)
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, This table shows the age
distribution of the UK
population. The 2001 census
showed that, for the first time,
there were fewer children under
the age of 16 than people over
the age of 65. Birth rates
subsequently rose between 2001
and 2012 by 23% but if present
trends continue, it is expected that, by 2044, only 17% of the UK population will be under the age of 16
and 25% of the population will be over the age of 65.
The birth rate in England and Wales - measured as a proportion of the total population - hit a new low in
2018, according to the Office for National Statistics. It says the trend could be driven by falling fertility
rates and an ageing population. Fertility rates decreased in all age groups except women aged 40 and
over. 2018 was the third in a row in which the number of live births has come down. In total, 657,076
babies were born in England and Wales in 2018 - down 3.2% on 2017, and nearly 10% on 2012. The birth
rate decreased to 11.1 live births per 1,000 population in 2018, from a high of 20.5 in 1947, the ONS
report shows. The average number of children born to women, known as the total fertility rate, is also
down, to 1.7 - from 1.76 in 2017. This is a good measure of fertility levels and can be affected by changes
in the timing of when women have babies, as well as size of families and population structure. Total
fertility rate is now at its lowest since the 1999 to 2002 period. In England and Wales, ONS stats show
that the stillbirth rate has reached a record low for the second year in 2018 - of 4.1 stillbirths per 1,000
births. A stillbirth is a baby born showing no signs of life after 24 or more weeks of pregnancy. The
government in England has committed to reducing the stillbirth rate to 2.6 per 1,000 by 2025. (BBC
News, 2020)
In developing countries children are needed as a labour force and to provide care for their parents in old
age. In these countries, fertility rates are higher due to the lack of access to contraceptives and generally
lower levels of female education. The social structure, religious beliefs, economic prosperity and
urbanisation within each country are likely to affect birth rates as well as abortion rates, Developed
countries tend to have a lower fertility rate due to lifestyle choices associated with economic affluence
where mortality rates are low, birth control is easily accessible and children often can become an
economic drain caused by housing, education cost and other cost involved in bringing up children.
Higher education and professional careers often mean that women have children late in life. This can
result in a demographic economic paradox. Previous data showed that birth rates in the UK have
increased; this is predominantly due to immigration so there are still serious concerns about long term
replacement. There are two potential means of addressing the problem of providing a young productive
workforce able to generate income to provide the social care for the old and infirm. The first is to find
ways of increasing the birth rate; this is essentially a long term solution but one which should provide
more steady and predictable results. The second is to encourage immigration of a predominantly young
and skilled workforce; this may provide an instant answer to the problem but is likely to be short-term
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,unless the immigrants decide to stay in large numbers. In the long term it is doubtful whether reliance
should be placed on immigration to solve an intrinsic societal problem in developed nations, namely a
falling birth rate.
There are several factors such as lifestyle factors, an increase in sexually transmitted diseases, rise in
obesity and environmental factors involved in urbanisation and urban lifestyle that are affecting fertility
and have led to rise in male and female subfertility. In addition there are socio-economic factors that
have led to women and couples delaying having children. Lack of affordable housing, flexible and part-
time career posts for women and affordable and publicly funded (free) child care have contributed to
the current low fertility/birth rates. Couples/women are delaying starting a family which has led to a
true decline in their fertility levels due to ovarian ageing and related reasons leading to reduced chance
of conception. It is necessary for governments to provide adequate publicly funded reproductive health
and social care in order to achieve required birth rates and have a younger population to contribute to
nations and global progress. It can be argued that women now contribute more to the total workforce
and social welfare agenda (tax and national insurance) than ever before and deserve to get reproductive
benefits from the public purse. (ncbi. gov, 2020) The rise in feminism may be one of the reasons of why
birth rates are declining which may have an impact on population growth. When women take control of
their fertility, they opt for smaller families and longer, more lucrative careers. These personal choices
may explain why strong economic growth co-exists with declining fertility today. Women increasingly
minimise the financial distress caused by children by postponing births to their late thirties and early
forties. This strategy has worked well for them. Since the end of the Great Recession women’s
employment has increased more than that of men, even in jobs dominated by males. (Npg.org, 2020)
Demographic data is used in service provision in the Harley Grove Medical Centre. Knowing the
configuration of the local population can help professionals to target their initiatives. For example, if the
data tells them there are high levels of smokers or people with alcohol abuse issues in the area, they
could tailor a stop smoking or alcohol awareness campaign and know that staff would identify with this.
Information that the medical centre during the registration process on patient demographic data such
as: age, gender, race and ethnicity; becomes a part of the patient’s medical record. This information
helps the care team communicate effectively with patients, as well as understand a patient’s culture,
which may affect their health. By knowing more about the patients that we serve, our medical centre
will be better able to deliver services. Birth rates could be helpful with this because they could use the
data to find out how many people are there are of that certain age group and if there is a health issue
within that specific age group, they can effectively provide services to patients. (Albany.edu,2020)
DEATH RATES:
Death rates, or mortality rates, are the statistical measure of the number of deaths in the population
and they are normally expressed in terms of the number of deaths per thousand of the population.
Throughout most of the 19th and 20th centuries, the mortality rates in the UK were falling, or to see this
from another point of view, the life expectancy in the UK was increasing. A number of explanations may
be given for this including: improved living standards- more people were living in smaller, warmer
houses, improved diets, and introduction of immunisation programmes- in the 1920s, vaccinations were
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, widely available for diphtheria, tetanus, whooping cough and tuberculosis and, in 1955, for polio. The
National Health Service, which was established in 1948, improved medical knowledge, improved social
care for vulnerable people, including frail and elderly, people with disabilities and people with mental
health problems and improved health education programmes. When accounting for population size and
age-structure, age-standardised mortality rates (ASMRs) for females increased by 0.1%, however, for
males ASMRs continued to decrease by 0.3%. In 2018, there were 541,589 deaths registered in England
and Wales, an increase of 1.6% compared with 2017 (533,253); this is the highest annual number of
deaths since 1999. The North East was the region of England with the highest ASMRs and London was
the lowest for both males and females. Deaths due to dementia and Alzheimer disease continued to
increase and remained the leading cause of death, accounting for 12.8% of all deaths registered.
Although 2018 saw the highest number of deaths since 1999, when taking the age and size of the
population into account, death rates have remained more or less stable since 2011
This graph shows how the
deaths registered in England
and Wales increased by 1.6%
in 2018. While there have
been peaks and troughs in the
numbers of deaths registered,
there was a general decline
from 1999 to the late 2000s.
After this period, the number
of deaths for both males and
females started to increase
again. In 2018, the increase in
registered deaths was driven
by the sharper increase of 2.0% in male deaths since 2017 compared with a 1.1% increase in the number
of deaths registered to females. What is also evident in the graph is how the difference in the number of
deaths between males and females has decreased in recent years. In 1999, the number of deaths
registered to males was 263,166 and females were 290,366, a difference of 27,200 deaths. Whereas in
2018, the difference between the number of deaths registered to males and females was fewer at 5,669
deaths registered (male’s 267,960, females 273,629). This is because generally male life expectancy has
been improving at a slightly faster rate than female life expectancy since early 1980. (Ons.gov.uk. 2020)
The latest death statistics for England and Wales, released by The Office for National Statistics (ONS),
showed the number of people dying of dementia is steadily increasing year on year. In contrast, the
number of people dying from heart disease and stroke has been declining. In 2015, dementia overtook
heart disease and stroke as the UK’s biggest cause of death. Due to medical advances, more people than
ever are surviving heart disease, strokes and many cancers. Age is the biggest risk factor for dementia,
so as we are living longer the number of people developing dementia is increasing. Dementia is a life-
limiting condition and more research is needed to find treatments that can slow or stop the diseases
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