Living Well: Adults

Through the national NHS and Public Health England publication ‘A Call to Action: Commissioning for Prevention’ a strong emphasis is placed on identifying the risk factors associated with ill-health and premature death and working proactively to address these issues during adulthood.  Rates of smoking have fallen over recent years, but significantly higher rates in more deprived areas still persist.  Over 225,000 people in Devon are estimated to be affected by high blood pressure (Hypertension) with just over half known to GP services.  Around three in five adults in Devon (60.6%) are recorded as overweight or obese, a figure which has increased over recent years.  An estimated 60.9% of adults in Devon achieved at least 150 minutes of moderate physical activity per week in 2013.  The pattern of alcohol use both nationally and locally is changing, with the sharpest falls in use in younger age groups, and regular use more common in those with higher incomes.  However, alcohol-related illness and death remains more common in those on lower incomes or living in more deprived areas.  The pattern of drug use is also changing, and whilst overall drug use is falling in both younger and older age groups, the use of powder cocaine and new psychoactive substances (formerly known as legal highs) have increased significantly over recent years.  Mental health problems in adulthood vary by area, with the mood and anxiety disorder indicator from the 2010 Indices of Deprivation highlighting higher levels of need in parts of Exeter, Exmouth, Teignmouth, Dawlish, Newton Abbot, Totnes, Ilfracombe, Bideford and Barnstaple.  Suicide rates in Devon have remained consistently above national levels in recent years. The pattern of risk factors coupled with an ageing population in Devon contribute to a growing number of people with long-term conditions in the county, which are typically higher in more deprived areas, with higher levels of complications in these age groups contributing to higher hospital admission and mortality rates.  There is also a growing burden of those living with more than one long term condition (known as multi-morbidity) with around one in seven likely to have two or more conditions.  Local and national evidence suggests people living in the most deprived areas are likely to experience multi-morbidity 10 -15 years earlier than those in the least deprived areas.  There is also a strong relationship between mental health conditions and physical conditions with those on GP registers for depression and serious mental illness much more likely to also have physical long-term conditions.

The following section covers issues relevant to different stages of adulthood. There are many different stages in adulthood and some topics will be relevant to all stages and others just to part of adulthood, for example, adjusting from being teenagers to young adults’ means that young adults have needs in some areas that are not relevant in later adulthood. There are around 452,500 people aged between 16 and 64 in Devon, of which around 8,900 are supported in social care (2013-14 RAP return). This section aims to bring as many topics together as possible and if necessary identify the part of adulthood where they are particularly relevant. There is a specific focus on prevention, the risk factors most strongly associated with poor health outcomes, and long-term conditions.