Living and Working Well in the Joint Strategic Needs Assessment (JSNA) focuses on the health and wellbeing of adults during their working years. This life stage is critical, as it encompasses key factors such as employment, housing, lifestyle choices, and access to healthcare—all of which significantly influence physical and mental health, economic stability, and overall quality of life. Supporting adults to live healthy, productive lives not only benefits individuals and families but also strengthens communities and the wider economy.
JSNA Headline Dashboard Observations
Living and Working Well people aged 18 to 64 years account for almost half of the Devon population.
People aged 18 to 64 years make up nearly half of Devon’s population. While the overall population is projected to grow by around 5.4%, this growth is not evenly distributed. Due to demographic trends such as an ageing population and migration patterns, the working-age population may see slower growth, or even decline, in some rural areas. In contrast, urban centres like Exeter are likely to experience increases, driven by economic opportunities and inward migration.
Educational attainment in Devon is broadly in line with national averages, with a significant proportion of the population educated to A level or equivalent. However, some areas across the country are exceeding 70%, highlighting an opportunity for Devon to raise aspirations and improve outcomes. Increasing educational attainment supports economic growth, social mobility, and workforce resilience. Continued efforts are also needed to support young people not in education, employment, or training (NEET).
Devon demonstrates relatively strong employment levels, reflected in a lower claimant count. However, challenges persist around low earnings, gender pay disparities, and housing affordability. These issues are particularly acute in rural and coastal areas, where employment is often seasonal or part-time, especially in sectors like tourism and agriculture, leading to income instability and limited job security. The rising cost of essentials such as food, energy, and transport has further strained household budgets, particularly for those on fixed or low incomes. In areas like Ilfracombe and parts of North and West Devon, the combination of low wages, high living costs, and limited access to services contributes to persistent poverty and deepens health inequalities. Furthermore, housing stock across certain parts of Devon are older and less energy efficient driving costs further particularly for those living in more nested rural deprived areas.
Health outcomes across Devon reflect these inequalities. People living in the most deprived neighbourhoods tend to die between 5 and 7 years earlier than those in more affluent areas. In smaller communities such as Central Ilfracombe and Littleham in Exmouth, this gap can be as wide as 15 years. Moreover, people in deprived areas often spend more of their shorter lives living with disability or poor health.
These outcomes are shaped by wider social and environmental factors. Modifiable behaviours, such as smoking, alcohol use, poor diet, and physical inactivity, are heavily influenced by the conditions in which people live and work. While medical advances have improved detection and treatment, more
focus is needed on prevention and improving the social determinants of health through the different lenses of inequalities such as those with protective characteristics, socio economic deprivation, rural and urban areas and inclusion health groups.
In 2021, the leading causes of poor health and early death in Devon included cancer, heart disease, musculoskeletal disorders, respiratory infections, and neurological conditions like dementia. The most common cancers were lung, colorectal, and breast. Devon’s ageing population and widening health inequalities, exacerbated by the COVID-19 pandemic and cost-of-living pressures, have led to higher rates of chronic disease and reduced healthy life expectancy in disadvantaged communities.
Alongside these trends, health needs are changing for living and working well groups. Rising mental health challenges, stress-related conditions, and musculoskeletal problems are increasingly prevalent. Furthermore, people with disabilities are living longer, often with multiple long-term conditions, requiring more integrated and accessible health and care services. Neurodivergence is also more widely recognised, with growing evidence of unmet needs in education, employment and health and care systems.
Preventive health services show mixed outcomes. Devon generally performs well in cancer screening uptake, particularly for breast and bowel cancer. However, inequalities persist. People living in more deprived areas, rural and remote areas, those with learning disabilities, and some ethnic minority groups are less likely to participate in screening. Barriers such as transport, digital exclusion, low health literacy, and stigma all contribute to lower engagement.
Digital exclusion remains a significant issue in Devon, particularly in rural communities. It is closely linked to poverty and can lead to food insecurity, social isolation, and reduced access to essential services. Areas such as East Anstey (Mid Devon) and Luppitt (East Devon) continue to struggle with poor mobile coverage and limited broadband, which restricts access to healthcare, education, and employment opportunities. Digital exclusion barriers not only limit access and utilisation of digital opportunities, but further flexibility in how these services are offered is needed to ensure they fit better with the working and caring lives of people in Devon. The NHS is undergoing a major digital transformation and digitalisation plan to expand online access through digital tools to make care more convenient and efficient.
Transport and connectivity are also critical to health and wellbeing. Devon’s rural geography and ageing population mean that many communities face infrequent bus services, increased transport costs, long travel distances to essential services, and limited mobility options for older or disabled residents. Places like Ilfracombe, Okehampton, Dartmouth, and several Mid Devon villages experience these challenges, which further entrench health inequalities and reduce access to opportunities.
A strong sense of community safety and belonging is vital to wellbeing in Devon, where most residents feel safe in their local areas, particularly during the day. However, perceptions of safety vary, with concerns about anti-social behaviour, drug misuse, and property crime more common in some urban and coastal communities. In rural areas, social isolation is a growing concern, especially for older adults and those with limited mobility or digital access.
Devon’s ageing population is reshaping health needs and placing increasing pressure on the health and care workforce. Longer life expectancy often comes with more years lived with multiple long-term conditions, frailty, and dementia, requiring complex, coordinated care. At the same time, the workforce itself is ageing, with recruitment and retention challenges across health and social care.
These trends highlight the need for innovative models of care, investment in workforce planning, and digital solutions that support both patients and staff.
Local Insights, Lived Experience and Research: Living and Working Well
Access to Health Services
Insight questions:
- How do residents experience accessing primary care and mental health services?
- What are the perceived gaps in rural and urban settings?
Sources: Parent and Learner Voice Surveys – Learn Devon, Devon Digital Exclusion Dashboard, Devon & Somerset Local Skills Improvement Plan (LSIP), Education Needs Assessment – Devon SEND Local Offer
Insight: Residents report long waits for GP appointments and difficulty accessing mental health support, especially in rural areas. Lived experience emphasizes the need for trauma-informed care and culturally competent services. Research shows that geographic isolation and digital-only models exacerbate health inequalities, particularly for those with limited mobility or digital access.
Digital Inclusion and Connectivity
Insight questions:
- How does digital exclusion affect access to services, education and employment?
- Which communities are most affected by poor connectivity?
Sources: Healthwatch Devon, JSNA – Devon Health and Wellbeing, NHS Devon 10-Year Health Plan Engagement, Care Experienced Young People’s Health Needs Assessment
Insight: Digital exclusion remains a significant issue in rural Devon, with areas like East Anstey and Luppitt facing poor mobile coverage, limited broadband, poor digital skills and confidence. Lived experience highlights how this restricts access to healthcare, education, and job opportunities. Research shows strong links between digital exclusion, poverty, and poor health outcomes, reinforcing the need for targeted infrastructure investment and digital literacy support.
Transport and Access to Services
Insight questions:
- How do transport barriers affect access to employment, education, and healthcare?
- What are the lived experiences of transport poverty in rural and coastal areas?
Sources: Devon Digital Exclusion Dashboard, Devon Communities Together, NHS Devon 10-Year Health Plan Engagement
Insight: Residents in Ilfracombe, Okehampton, and parts of Mid Devon report infrequent bus services and long travel distances to essential services. Lived experience shows that transport poverty limits access to education, employment, and healthcare, especially for older adults and low-income households. Research confirms that transport barriers deepen rural disadvantage and contribute to persistent health inequalities.
Economic Inclusion and Workforce Resilience
Insight questions:
- What are the barriers to stable employment and fair wages in Devon?
- How do seasonal work and housing costs affect workforce stability?
Sources: Poverty in Devon – Transport and Connectivity, Devon Communities Together, Devon Digital Exclusion Dashboard, Devon Housing Commission Report
Insight: Low earnings, gender pay gaps, and seasonal employment are key challenges in rural and coastal areas. Lived experience highlights income instability and limited job security, especially in tourism and agriculture. Research shows that housing affordability and transport costs further strain household budgets, reducing economic resilience and increasing vulnerability to poverty.
Mental Health and Suicide Prevention
Insight questions:
- What are the barriers to accessing mental health support in Devon?
- How do trauma, isolation, and service design affect engagement?
Sources: Healthwatch Devon, Care Experienced Young People’s Health Needs Assessment, NHS Devon 10-Year Health Plan Engagement, Devon Communities Together Breaking Barriers Report
Insight: Lived experience highlights long waits, lack of trauma-informed care, and digital-only models as key barriers to mental health support. Isolation in rural areas and stigma around mental health further reduce engagement. Research shows that early intervention and culturally competent services are essential to improving outcomes and preventing suicide.
Community Safety and Belonging
Insight questions:
- How do residents perceive safety and social connection in their communities?
- What are the impacts of isolation and anti-social behaviour?
Sources: Devon Communities Together, JSNA – Devon Health and Wellbeing, Health and Wellbeing Library – Devon
Insight: Most residents feel safe during the day, but concerns about anti-social behaviour and drug misuse are more common in urban and coastal areas. In rural communities, older adults and digitally excluded residents report growing social isolation. Research shows that community cohesion and inclusive spaces are vital to wellbeing and resilience.
Environmental Sustainability and Health
Insight questions:
- How do environmental factors affect health outcomes in Devon?
- What are the opportunities for climate adaptation and green jobs?
Sources: Devon Strategic Assessment, Public Health Dashboards – Devon, Health and Wellbeing Library – Devon, Devon Local Nature Recovery Strategy
Insight: Air quality, access to green spaces, and exposure to environmental risks vary across Devon. Lived experience shows that poor housing conditions and lack of green infrastructure affect physical and mental health. Research supports investment in climate adaptation and green jobs to promote long-term health and sustainability.
Gaps in insights and local research
The Living and Working Well chapter provides a valuable overview of the health and wellbeing of Devon’s working-age population. However, there are areas where lived experience and local research could be expanded to strengthen understanding and inform service design. These include:
Housing and Health: While housing affordability is highlighted, there is limited insight into how poor housing conditions, overcrowding, and temporary accommodation affect physical and mental health. Lived experience from tenants, housing officers, and support services could help explore the links between housing insecurity, stress, and chronic illness.
Workplace Health and Economic Stability: Employment data is strong, but there is little qualitative insight into working conditions, job satisfaction, and the health impacts of insecure or seasonal work. Engagement with workers in tourism, agriculture, and care sectors could reveal barriers to wellbeing and opportunities for healthier work environments.
Financial Resilience and Debt: The cost of living is discussed, but there is limited local insight into how debt, financial stress, and access to financial support affect wellbeing. Lived experience from advice services, food banks, and community hubs could enrich understanding of financial vulnerability and coping strategies.
Mental Health and Suicide Prevention: Mental health access is flagged, but there is limited insight into how trauma, stigma, and service design affect engagement, especially in rural areas. More lived experience from people with mental health conditions, carers, and frontline practitioners could inform trauma-informed and culturally competent service models.
Preventative Health Behaviours: Modifiable behaviours like smoking, alcohol use, and physical inactivity are mentioned, but there is little insight into local attitudes and barriers to change, Community-based research could explore motivations, stigma, and access to support for healthier lifestyles.
Environmental Health and Green Space: Environmental sustainability is a priority, but there is limited insight into how access to green space, air quality, and climate risks affect health. Engagement with residents in urban and deprived areas could help understand environmental barriers to wellbeing and inform green infrastructure planning.
Community Belonging and Civic Participation: Safety and isolation are discussed, but there is little insight into civic engagement, volunteering, and what fosters a sense of belonging. VCSE partners could help gather lived experience on community cohesion, inclusion, and the role of local initiatives in improving wellbeing.
Living and Working Well Priorities for Devon
- Health Inequalities: Address the determinants of health such as housing, employment, and education to reduce the burden of preventable illness and disability, with more efforts in areas of greatest need. Embed health equity into local policy through a proportionate universalism approach that tackles the four dimensions of inequality and incorporates systemic rural proofing to ensure services and interventions are accessible and effective for dispersed and remote communities.
- Promote Healthy Lifestyles: Focus on reducing modifiable risk factors such as smoking, alcohol use, poor diet, and physical inactivity, which are major contributors to poor mental and physical wellbeing, and premature mortality.
- Improving Mental Health and Preventing Suicide: Invest in early intervention and suicide prevention, ensuring equitable access to mental health services through a proportionate universalism approach that addresses the four dimensions of inequality.
- Skills and Education: Increase the proportion of adults educated to A level or equivalent by expanding access to adult education and vocational training. Promote lifelong learning and support young people not in education, employment, or training (NEET) through targeted outreach and mentoring to build a more resilient and skilled workforce.
- Supporting Economic Inclusion and Workforce Resilience: Address low earnings and gender pay disparities by promoting inclusive employment practices and supporting small businesses in rural and coastal areas. Encourage flexible and healthy working environments to improve job quality and economic stability.
- Financial Resilience and Cost of Living: Support households facing financial pressure by addressing rising cost of living. Expand access to financial advice, affordable housing, and local employment opportunities. Promote local economic development strategies that build resilience and reduce reliance on low-wage, insecure work.
- Strengthening Vaccination and Sexual Health Services: Increase flu vaccination uptake among at-risk adults by enhancing outreach and accessibility. Ensure STI testing effectively reaches high-risk groups and maintain strong public health messaging to support long-term behaviour change and disease prevention.
- Digital Inclusion and Access: Improve digital access and skills to ensure equitable access in education, employment, and healthcare. Focus on improving and expanding broadband infrastructure in rural areas, providing digital literacy training, and support those at risk of digital exclusion, including low-income households and older adults.
- Transport and Connectivity: Enhance transport infrastructure to improve access to jobs, services, and social opportunities. Prioritise affordable and reliable public transport in rural and coastal areas, and invest in active travel options such as walking and cycling to support health and sustainability.
- Community Safety and Belonging: Foster safer, more connected communities by addressing crime and anti-social behaviour, reducing social isolation, and promoting civic participation. Support initiatives that build community cohesion and create inclusive spaces where people feel safe and valued.
- Environmental Sustainability and Health: Promote healthier environments by improving air quality, increasing access to green spaces, and addressing environmental risks. Support climate adaptation and the development of green jobs to ensure the Devon population can thrive in a sustainable future.
- Inclusive Health and Support for People with Disabilities and Long-Term Conditions: Ensure equitable access to health, care, education, and employment for people living with disabilities, long-term conditions, and neurodivergence. Prioritise integrated care models, accessible environments, and tailored prevention strategies to reduce health inequalities and improve quality of life. Invest in workforce training to deliver inclusive, trauma-informed, and neurodiversity-aware services.
For more information, please visit the following:
(NEW) JSNA Headline Report – Devon Health and Wellbeing
Public Health Dashboards – Devon Health and Wellbeing