Health and wellbeing in Brighton & Hove

The Brighton & Hove Health and Wellbeing Board is required to produce a Joint Strategic Needs Assessment (JSNA).

The JSNA provides a description of the current and future health, social care and wellbeing needs of the local population, and does so by collating a variety of evidence, including information from:

• existing in-depth needs assessments
• health and social care data
• local views and experiences

The JSNA is used to identify local health and wellbeing issues and inform the commissioning and delivery of local services.

This summary gives a snapshot of health and wellbeing in the city. It will be updated regularly in line with Public Health Outcomes Framework updates.

See the full set of JSNA resources.

Produced by: Public Health Intelligence Team, Brighton & Hove City Council

For more information, send an email to publichealthintelligence@brighton-hove.gov.uk. 

A range of evidence has been collated for the JSNA to inform the key issues for the city presented here, including:

• information gained from in-depth needs assessments
• data from public health, NHS and social care outcomes frameworks

Issues highlighted are those where we are significantly worse than England (or comparator local authorities), where large numbers of people are impacted, or where we have significant inequalities.

Building blocks of health

All ages

Housing

Homelessness and rough sleeping

Tobacco control

Road safety

Active travel

Crime and safety

Starting well

Child poverty

Education

Adverse Childhood Events (ACEs)

Living well

Unemployment

Good employment and healthy workplaces

Ageing well

Fuel poverty

Income deprivation

Lifestyles/prevention

All ages

Domestic and sexual violence

Physical activity, healthy weight

Food poverty and good nutrition

Emotional wellbeing

Starting well

Risk-taking behaviours and the clustering of these behaviours

Smoking

Drugs

Alcohol

Sexual health

Emotional wellbeing

Living well

Smoking

Alcohol and drug misuse

Sexual health (STIs and HIV/AIDS)

Suicide prevention and self-harm

Ageing well

Social isolation/loneliness

Services/support

All ages

Mental health

Physical disability and impairment

Learning disabilities

Starting well

Children in care

Emotional well-being and mental ill health support

Immunisation

Living well

Multiple long-term physical and mental health conditions

Cancer (and cancer screening)

Heart disease and stroke

Musculoskeletal conditions

Mental health

Ageing well

Dementia

Multiple long-term conditions

Immunisation

Dying well

Support for dying in place of preference

Population

The resident population of Brighton & Hove in 2022 was 277,965 people.

Our population profile is younger than the South East and England.

15% (41,300) under 16 (19% South East, 19% England).

73% (201,700) 16 to 66 (64% South East, 65% England).

11% (29,300) 67 to 84 (15%, South East, 14% England).

2% (5,600) 85 or older (3% South East, 2% England).

Population estimates and projections

Due to the need for the Office for National Statistics (ONS) to rebase national and local population estimates and projections following the 2021 Census, there are currently no population projections beyond 2022 available.

According to the ONS release calendar, the new population projections based on the 2021 Census have a provisional release date of ‘early’ 2025.

In December 2023, the ONS released:

• rebased national and local population estimates covering the years 2012 to 2020
• updated 2021 national and local population estimates
• 2022 population estimates

This report will be updated shortly to include these estimates; meanwhile, the data is available on the ONS website.

Population groups

Our city consists of different population groups living in a range of geographical communities.

The lesbian, gay, bisexual and trans (LGBT) and BME communities are key characteristics of the city’s population profile.

The most up-to-date from the 2021 census shows the following:

• a quarter of residents are BME

72,272 residents (26%) are from a Black or Minority Ethnic group. South East (21%), England (27%).

• one in ten residents identify with an LGB+ sexual orientation

At least 25,247 residents age 16+ (10.6%) identified as Gay or Lesbian, Bisexual or Other sexual orientation. Three times higher than seen in the South East (3.1%) and England (3.1%), and the highest proportion seen in any upper-tier authority in England.

• one in five residents was born outside of the UK

54,343 residents (20%) were born outside of the UK. Higher than seen in the South East (16%) and England (17%).

• one in a hundred adult residents identifies as Trans

At least 2,341 residents aged 16+ (1.0%) identify with a gender different from their sex registered at birth. Double what is found in the South East (0.5%) and England (0.5%).

• over half of residents have no religion or belief

152,966 residents (55%) have no religion or belief. Significantly higher than seen in the South East (40%) and England (37%). Highest proportion seen in any upper tier authority in England.

Deprivation

131st most deprived local authority in England (of 317) according to the 2019 Index of Multiple Deprivation (IMD).

In 2019, 17% of the population of the city lived in one of the 20% most deprived areas in England, and 13% lived in one of the 20% least deprived areas in England.

Some areas are more affected by deprivation than others. The highest concentration of deprivation is in Whitehawk, Moulsecoomb, and Hollingbury. Along the coast, to the west of the city and in Woodingdean, there are also pockets of deprivation. All these areas are in the 20% most deprived areas in England.

Our health and well-being is influenced by a wide range of social, economic and environmental factors.

Housing and homelessness

13.2% (16,527 households) estimated in 2022 to be in fuel poverty (South East - 9.7% England - 13.1%).

Those on the lowest 25% of earnings need 10.8 times their earnings to afford the lowest 25% of house prices (2024) (South East 9.7, England 7.7).

76 rough sleepers (increase of 46% from 2023) (Street count 2024).

Air pollution

5.0% of adult mortality (30+) is attributable to particulate air pollution (2023) (5.1% South East, 5.2% England).

Road safety

203 people killed or seriously injured per billion vehicle miles (2023). South East (90), England (92).

Community safety

32 per 100,000 people admitted to hospital due to violent crime, including sexual assault (2021/22 to 2023/24). South East (24), England (34).

Community cohesion

Brighton & Hove has a strong community with higher rates of belonging, pulling together, formal volunteering and feeling that people from different backgrounds get on, to England (City Tracker survey results, 2018).

Population

In 2022 it's estimated that Brighton & Hove has a significantly smaller number of children aged under 18 (46,900 people, 17%) compared to the South East (21%) and England (21%) and a significantly higher number of young adults aged 18 to 24 (38,100 people, 14%) compared to the South East (5%) and England (6%)

Our children and young people's wellbeing is influenced by a wide range of social, economic and environmental factors.

Children in care

76 per 10,000 children and young people (0 to 17 years old) in care (31 March 2024). South East (56), England (70).

School readiness

69% achieved a good level of development at the end of reception (2023/2024). South East (69%), England (66%).

Education

The educational progress pupils make between primary and secondary schools is above the England average (2021/2022).

Child poverty (IDACI)

15% of children live in poverty (2019). South East (13%), England (17%).

Youth unemployment

3.8% of 16 to 17-year-olds (200 people) not in education, employment or training (2022/2023). South East (6.9%), England (5.2%).

Disabilities and sensory impairments

More than 4,500 children and young people with a disability are on the local register (2019/2020).

It's estimated that there are up to 600 children and young people with Autism Spectrum Conditions living in the city.

Young people's current and future wellbeing

We do well in many areas: fewer mothers smoke, more breastfeed, and more children are a healthy weight.

However, we have worse rates of smoking, drinking, and drug use and poorer emotional wellbeing, impacting young people’s current and future wellbeing

Maternal and infant health

75% breastfeed after 6 to 8 weeks. 53% England (2022 to 2023).

6% (124 people) smoking at delivery (2023/2024). South East (7%), England (7%).

All childhood immunisations, including MMR at five years, are below the 95% required for population protection (2023/2024).

10 per 1,000 (41 people) under 18 conceptions, 2021. South East (11 per 1,000), Engand (13 per 1,000).

Young people

We have the highest percentage of 15-year-olds who smoke, have tried cannabis and the 3rd highest weekly drinking in England (2014) and high Sexually Transmitted Infection (STI) rates in young people.

Healthy weight

80% of 4 to 5-year-olds are a healthy weight - 2023/24 (South East 78%, England 77%).

70% of 10 to 11-year-olds are a healthy weight - 2023/2024 (South East 66%, England 63%).

However, it's estimated that 11,000 children and young people in the city are overweight or obese.

Emotional wellbeing

443 per 100,000 10-24 year olds admitted to hospital for self-harm (2023/24). South East (308), England (267).

12% of secondary school children in the city say that they often or sometimes self-harm (2023).

129 per 100,000 of 0 to 17 year olds admitted for mental health conditions (2023/24). South East (81), England (80).

Population

In 2022, Brighton & Hove had a significantly higher proportion of adults aged 16 to 65 years old (72%, 199,400 people) compared to both the South East (63%) and England (64%). The difference is most pronounced between the ages of 19 and 24. Brighton & Hove (12%, 34,500 people), South East (6%) and England (7%).

Employment and work

Getting people into, and remaining in, good work is a priority for physical and mental health.

4.9% (8,500 people) are unemployed (year ending December 2024). South East (3.5%), Great Britain (3.8%).

Employment rates are lower for adults with long-term conditions (2022/2023), a learning disability, and those in contact with secondary mental health services (2021/2022).

16% (15,000 households) have no individuals aged 16 or over in employment (2023). South East (11%), Great Britain (14%).

£725 is the median gross weekly full-time employee earnings (2024). South East (£754) and Great Britain (£730).

Healthy life expectancy

Whilst life expectancy has been steady, healthy life expectancy has not in recent years. People are living longer in ill health. This, alongside the rising retirement age, means increasing numbers of people of working age are living in ill health.

Life expectancy at birth

Female - 83.2 years.

Male - 78.8 years.

Healthy life expectancy at birth

Female - 61.5 years.

Male - 60.6 years.

There are large differences in both life expectancy and healthy life expectancy across the city (see section on living well).

Lifestyles

Some lifestyle behaviours can have a negative impact on our health. Smoking, alcohol and drug misuse, and sexual health are significant issues in the city.

However, we have more physically active residents and fewer obese/overweight adults than England.

579 per 100,000 (1,518 people) hospital admission episodes for alcohol-specific conditions in 2023/2024. South East (521 per 100,000), England (612 per 100,000).

15.3% of adults are current smokers (2023). South East (10.6%), England (11.6%).

14.4 adults per 100,000 aged 15 to 64 (3,030 people) were estimated to use opiates and/or crack cocaine in 2019/2020. (South East 6.6 per 1,000, England 9.5 per 1,000).

Among the highest rates of new STI diagnosis and HIV prevalence outside of London (2022).

61% of adults are overweight or obese (2021/2022). South East (63%), England (64%).

79% of adults are physically active and 12% inactive (2023/2024). England (67% and 22% respectively).

62% of adults cycle and/or walk at least once a week for leisure (2023). South East (61%), England (57%).

Emotional health

Brighton & Hove has above-average levels of mental health issues and higher rates of suicide deaths.

13.4% of adults (37,346 people) are on GP practice depression registers, and 1.3% (4,496 people) have severe mental illness (2022/2023).

1.3% of people (all ages) have a diagnosis of schizophrenia, bipolar affective disorder and other psychoses (2023/2024). South East (0.9%), England (1%).

17 per 100,000 (128 people) suicide and undetermined injury deaths in 2021 to 2023. England (11 per 100,000).

Long-term conditions

There are over 50,900 adults (22%) aged 20 plus with two or more long-term physical or mental health conditions in the city, with a strong link with deprivation (54% with one or more conditions).

19,060 (8% of adults) have mental and physical health conditions.

Without scaling up prevention, there will be over 10,500 more adults with two or more conditions by 2030.

Global burden of disease

Locally, conditions with the greatest burden (2021) are:

• cancers
• cardiovascular disease (including heart conditions)
• musculoskeletal conditions
• mental health
• neurological conditions (including dementia)

Cancer screening

Screening rates for breast, cervical and bowel cancer are all lower than in England (2024).

Healthy life expectancy

There are large differences in life expectancy across the city, with people living in the most deprived areas dying younger. We can see that men in the most deprived areas die 9.1 years younger than men in the least deprived areas.

Inequality in life expectancy at birth (2018 to 2020)

Female - 7.7 years.

Male - 9.1 years.

Inequality in healthy life expectancy at birth (2009 to 2013)

Female - 12.5 years.

Male - 14.0 years.

Population

In 2022, Brighton & Hove had a significantly lower proportion of adults aged 65 years or older (14%, 39,500 people) compared to both the South East (20%) and England (19%).

The difference is most pronounced between the ages of 70 and 79. Brighton & Hove (6%, 17,800 people), South East (9%) and England (9%).

After the age of 85, the difference is smaller, with 5,600 adults aged 85 years or older in Brighton & Hove (2.0%) compared to 2.8% in the South East and 2.5% in England.

Life expectancy at 65

Life expectancy and healthy life expectancy at 65 are similar to England (2021 to 2023).

Life expectancy at 65 (2021 to 2023)

Female - 21.1 years.

Male - 18.3 years.

Healthy life expectancy at 65 (2021 to 2023)

Female - 11.3 years.

Male - 9.8 years.

Social isolation

Brighton & Hove has a relatively large proportion of older people living alone and a higher percentage of older people who are income deprived.

Social care

41.7% of adult social care users have as much social contact as they would like (2023/2024). South East (46.4), England (45.6%).

This was 29.4% for adult carers (2023/2024). South East (25.9%), England (30.0%).

Over a third of older people live alone. 13,875 residents aged 66+ (38%) live alone (2021). Significantly higher than the South East (30%) and England (31%).

An estimated one in five residents aged 60 years or over (18.7%, 10,100 people) are living in income deprivation (2022). England (14.2%).

Health

We have similar rates of age-related macular degeneration (preventable sight loss) and hip fractures, but higher rates of diagnosed dementia in older people and falls. Immunisation for flu in those aged 65+ is also lower than in England.

4.2% of 65+ year olds (1,781 people) have a record of dementia (2020). South East (4.0%), England (4.0%).

55 in every 100,000 65+ year olds (22 people) have age-related macular degeneration, preventable sight loss (2023/2024). South East (102 per 100,000), England (105 per 100,000).

Flu immunisation

Flu immunisation uptake at 73.1% in 65+ year olds (2023/2024) does not meet the goal of 75%. South East (79.9%), England (77.8%).

Falls and hip fractures

2,401 per 100,000 (975 people) aged 65+ were admitted as an emergency to the hospital due to a fall (2023/2024). South East (2,029), England (1,984).

596 per 100,000 (245 people) aged 65+ had a hip fracture (2023/2024). South East (536), England (547).

Place of death

The majority of people would prefer to die at home. In nearly a third of all deaths (31.5%), the death occurred at home (2023/2024). South East (27.5%), England (28.4%).

Winter deaths

There were 13% more deaths (30 people) of 85+ year olds in winter in the period August 2021 to July 2022 than would be expected if the rates were the same as non-winter months (England 11%).

Our Joint Strategic Needs Assessment (JSNA) helps us identify the current and future health and wellbeing needs of people living in Brighton & Hove.

Our JSNA webpages have replaced the BH Connected website.