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Vulnerable groups

Summary :: Our people and place :: Vulnerable groups

In every society there are some groups who are more vulnerable than others, brought about by societal factors and the environments in which people live. There are some common challenges across all vulnerable groups including the risk of stigma and discrimination, restricted access to educational opportunities and exclusion from income generation. Within these groups there are varying levels of vulnerability and that just because a person is older, for example, they are not necessarily vulnerable.

This section illustrates the needs of some of the vulnerable groups in Medway. It is not a complete list of all vulnerable groups and should not be seen as excluding the groups that are not mentioned here. The intention here is to show how vulnerability is an important issue to consider in the design and implementation of services and programmes.

Vulnerable people are a wide ranging group and include:[1]


• Adults living with a disability
• Carers
• Older people
• People with mental health needs
• Adults with long-term conditions
• Children in care
• Minority groups
• Homeless people

Gypsies and Travellers

Research[2] has shown that Gypsies and Travellers have significantly poorer health status and more self-reported symptoms of ill-health than other UK resident, English-speaking minorities. Gypsies and Traveller's health beliefs demonstrate a cultural pride in self-reliance — there is more trust in family carers than professionals. To maintain a sense of independence and autonomy, it is of great importance to travellers to choose whether and how they continue to live a travelling lifestyle. Gender roles are strictly defined, meaning that women's access to health services could be restricted.[2]

Cancer, and other illnesses perceived as terminal, are feared and so screening is avoided. Patient-held records would improve care continuity greatly as they could be taken wherever the patient goes. Severe educational disadvantage and poor levels of literacy were highlighted as issues so audio methods of communication may work better. Gypsies and Travellers access fewer services and therapies despite having greater health needs.[2]

GPs are either reluctant to register Gypsies and Travellers or visit their sites, creating a barrier to primary care. Expectations of Gypsies and Travellers and health staff also differ and attitudes or perceived attitudes have prevented Gypsies and Travellers from seeking help.[2]

As at January 2017, Medway had 48 Traveller caravans. A count is conducted twice a year in January and July. This number has fluctuated between 11 and 48 since January 2015. This was the fourth lowest number across Kent and Medway. Thanet (0), Shepway (7) and Dover (45) had the lowest counts of caravans and Maidstone had the highest (561).[3]

The number of people declaring their ethnicity as 'Gypsy or Irish Traveller' at the time of the 2011 Census in Medway was 510 (0.2% of the total population). This suggests that a substantial section of this community are living in accommodation other than caravans which is something also observed at a national level.[4]

Looked after children

Early experiences may have long-term consequences for the health and social development of children and young people. A number have positive experiences in the care system and achieve good emotional and physical health, do well in their education and have good jobs and careers. However, entering care is strongly associated with poverty and deprivation (for example, low income, parental unemployment, relationship breakdown).[5]

Any child can become a looked after child but the likelihood is many times greater in children from low income/benefit dependent families and from parents with mental health, learning disabilities, drug, domestic violence or alcohol issues. About 60% of those looked after in England have been reported to have emotional and mental health problems and a high proportion experience poor health, educational and social outcomes after leaving care.[5]

One third of all children and young people in contact with the criminal justice system have been looked after.[6] However, a substantial majority of young people in care who commit offences had already started to offend before becoming looked after.[5]

As at March 2017 there were 390 looked after children in Medway. This represents 61 per 10,000 children under 18 years old in Medway compared with a national average of 62 per 10,000. The number of looked after children in Medway has decreased by 9.3% from March 2016 to March 2017, compared to the national average which has increased by 3.2%.[7] These children and young people are some of the most challenging and needy in Medway due to their life experiences.

For more information go to Children -> Looked After Children

People with mental health problems

People with mental health conditions (including schizophrenia, bipolar disorder, depression, epilepsy, alcohol and drug use disorders, child and adolescent mental health conditions, and intellectual impairments) have tended to be overlooked in the planning of development programmes. This is despite the high prevalence of mental health conditions, their economic impact on families and communities, and the associated stigmatisation, discrimination, and exclusion that can occur, bringing about vulnerabilities.[8]

People with mental health conditions are often not given the opportunities by communities and governments to reach their potential as contributors to economic prosperity and well-being. This leads to deeper economic and social marginalisation. They are often excluded from participating fully in society, and are not empowered to change factors which oppress them.[8]

Mental ill health represents up to 23% of the total burden of ill health in the UK — the largest single cause of disability[9]. At least one in four people will experience a mental health problem at some time in their life and one in six will be experiencing a common mental health problem at any one time[10]. Approximately one in 10 children aged between 5–16 years has a mental health problem.[11]

As such, mental health affects a large number of people in Medway. It is predicted that 28,012 people aged 18–64 have a common mental disorder[12] and 2,858 people aged over 65 have dementia.[13]

For more information go to:
• Adults -> Adult mental health -> Dementia
• Children -> Emotional health and wellbeing of children and young people

Long-term unemployed

There is strong evidence that work and paid employment are generally beneficial for physical and mental health and well-being. There is a strong positive association between unemployment and increased rates of overall mortality and morbidity from cardiovascular disease, lung cancer and suicide. It can affect mental health and lead to poorer psychological well-being. The impact of unemployment can alter depending on socio-economic status, income and financial anxiety.[14]

As at August 2017, the number of Jobseeker's Allowance (JSA) claimants in Medway was 2,336, a decrease of 369 (14%) compared to 12 months prior. There have been very similar percentage reductions in Kent, the South East region and England. As at August 2017, Medway's claimant rate was the sixth highest out of the 67 local authorities in the South East.[15]

Within Medway, the wards with the highest unemployment rates are Luton & Wayfield (2.7%), Chatham Central (2.4%), and River (2.4%). Wards that have seen the largest proportional decrease in JSA claims over the past twelve months are: Twydall (-36%), Cuxton and Halling (-29%), and Rainham South (-27%). Chatham Central has seen the largest decrease in the number of claims (-55). In contrast, Rainham Central (21%) and Waldersade (9%) saw an increase in JSA claims over the past twelve months.[15]

Longer-term JSA claims in Medway have decreased over the last 12 months. As at August 2017, there were 1,240 claiming over 6 months and 850 claiming over 12 months in Medway, which is at least a 12% reduction since August 2016. Despite this fact, longer-term claimants in Medway stand above the national level, with 36.3% of claims being by claimants who have been out of work for over twelve months – this compares to 33.0% nationally.[15]

Younger claimants – those aged 18-24 – account for 12.2% of all JSA claims. Claims in this age group peaked in August 2012 (2,220 claims), but have dropped by almost 90% since then.[15]

Older people

Compared to England the population of Medway has a smaller proportion of people over the age of 65 years (Medway 15.5% and England 17.9%). Medway also has a larger proportion between the ages of 0 and 14 years (19.2% and 18.0%) and between the ages of 15 and 24 years (12.9% and 12.2%).[16]. The population of Medway is therefore younger than the population of England overall.

Rainham Central, Hempstead and Wigmore, Rainham North, Peninsula, Rochester South and Horsted, and Cuxton and Halling have larger proportions of older people, with at least one fifth of their populations aged 65 years and above.[17]

People aged 85 and over make up only 1.8% of Medway's population (4,953 people according to 2016 estimates)[16]. Hempstead and Wigmore, Watling, Rochester South and Horsted, Rainham Central, and Rainham North have the highest number of people aged 85 and over as a percentage of their total ward population, whilst Gillingham South and River ward have the least.[17] People aged 85 years old and over are particularly vulnerable because they are more likely to be frail and have mental health problems such as dementia.

(For more information go to Summary -> Our people and place -> Demography -> Medway in the future)

Each of these groups, and others not specifically mentioned here are particularly vulnerable to abuse. Abuse can take various forms including: physical, sexual, psychological, financial, neglect, discriminatory and institutional abuse. It may consist of a single act or repeated acts, but it can also be an omission to act, or it may occur when a vulnerable person is persuaded to enter into a financial or sexual transaction to which he or she has not consented, or cannot consent. Abuse can occur in any relationship.[1]


References

[1]   Medway Council. My Say, My Way in Medway - Medway's Strategy for Advocacy Services 2010; Medway Council. http://democracy.medway.gov.uk/mgConvert2PDF.aspx?ID=3771 .
[2]   Parry G, Cleemput P, Peters J, et al. The Health Status of Gypsies and Travellers in England 2004; University of Sheffield.
[3]   Department for Communities and Local Government. Count of Traveller Caravans England 2017;
[4]   ONS. 2011 Census Analysis, What does the 2011 Census tell us about the Characteristics of Gypsy or Irish Travellers in England and Wales? 2014;
[5]   National Institute for Health and Clinical Excellence. Promoting the quality of life of looked-after children and young people - NICE public health guidance 28 2010; National Institute for Health and Clinical Excellence. http://www.c4eo.org.uk/themes/vulnerablechildren/files/promoting_the_quality_of_life_of_looked_after_children_and_young_people.pdf .
[6]   Department of Health. Healthy Children, Safer Communities -- A strategy to promote the health and well-being of children and young people in contact with the youth justice system. 2009; Department of Health, Ministry of Justice, Home Office and Department for Children, Schools and Families. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_109772.pdf .
[7]   Department for Education. Children looked after in England including adoption: 2016 to 2017
[8]   World Health Organisation. Mental Health and Development: Targeting people with mental health conditions as a vulnerable group 2010; World Health Organisation. http://whqlibdoc.who.int/publications/2010/9789241563949_eng.pdf .
[9]   World Health Organization. The Global Burden of Disease: 2004 update 2008;
[10]   McManus S, Meltzer H, Brugha T, et al. Adult psychiatric morbidity in England, 2007: Results of a household survey 2009; The NHS Information Centre for health and social care. http://bit.ly/GAxluS .
[11]   Green H, McGinnity A, Meltzer H, et al. Mental Health of Children and Young People in Great Britain, 2004. 2005; Office for National Statistics. Basingstoke: Palgrave Macmillan.. http://www.ic.nhs.uk/webfiles/publications/mentalhealth04/MentalHealthChildrenYoungPeople310805_PDF.pdf .
[12]   Projecting Adult Needs and Service Information. People aged 18-64 predicted to have a mental health problem, projected to 2035. 2017;
[13]   Projecting Older People Population Information System. People aged 65 and over predicted to have dementia, by age and gender, projected to 2035. 2017;
[14]   Waddell G, Burton K. Is Work Good For Your Health and Well-Being? 2006;
[15]   NOMIS official labour market statistics. Jobseeker's Allowance with rates and proportions.
[16]   Office for National Statistics. Mid-2016 population estimate
[17]   Office for National Statistics. Ward Level Mid-Year Population Estimates (experimental) 2016;