In this section you will learn about the impacts expected from climate change by the 2050s on health and welfare in the region.

Addressing human health and welfare (impacts of climate change on livestock are addressed within the Business and the Economy section, and on wildlife are addressed in the Biodiversity section) the impacts of climate change on the following areas are particularly addressed:

• Public Health;
• Hospitals;
• Care Homes; and
• Vulnerable Communities.

 

Description
The Yorkshire and Humber Region is home to 5.12 million people and features a broad range of environments giving rise to a wide variety of settlements; from densely populated inner cities to sparsely populated moorland. Standards of health and welfare vary markedly across the region.

Existing key health and welfare issues include;

• Large inequalities throughout the region and indeed within sub-regions and urban centres;
• Significant numbers of wards that are amongst the United Kingdom’s most deprived;
• A large proportion of people deemed to be suffering from ‘fuel poverty’ when compared to England overall;
• Lower than average levels of physical activity, healthy eating and housing deemed suitable for habitation;
• Lower than average GDP per capita;
• Higher than average numbers of premature deaths and long-term preventable illness; and
• An aging population that is migrating away from urban centres towards more rural areas.

The region includes a total of 14 Primary Care Trusts (PCTs), 22 NHS Trusts, 32 general hospitals and 33 community hospitals. One of the Trusts is the Yorkshire and Humber Ambulance Service NHS Trust which serves the whole region.

Addressing deprivation, and the health and welfare problems that it raises, is a critical issue in many urban areas throughout the region. The 2004 report ‘Our region, our health’ (Regional Public Health Group - Yorkshire and the Humber, 2004), highlights that 29% of wards in Yorkshire and Humber are in England’s top 20% most deprived. Areas of deprivation are typically those where a wide range of health and wellbeing issues are found, and are likely to be those where the climate change impacts on health will be greatest felt.

Nationally, populations that enjoy environments with the most greenery also have the lowest levels of health inequality related to income deprivation (Hartig 2008).  The most deprived communities are also most likely to experience other aspects of a poor local environment such as greater exposure to lower air quality.

The issue of fuel poverty is growing in prominence as the cost of living and particularly the cost of energy rises. The Yorkshire and Humber region has the second highest number of homes classified as being in fuel poverty of all regions in England (Yorkshire Futures, 2008). This equates to 163,000 houses or 7.7% of homes, of which an estimated 123,000 are ‘vulnerable’ households. A vulnerable household is one that houses older people (aged over 60), younger people (aged under 16) or those people suffering from long-term illness (Yorkshire Futures, 2008). The causes of fuel poverty are varied, but regardless failure to lift homes out of fuel poverty will likely lead to further preventable health problems. Compared to the national average of 8.5%, 13% of homes in the region have no central heating. ‘Our region, our health’ (Johnstone, 2004) indicated that 22% of Council homes are at risk of not achieving the required ‘decency’ standard by 2010. Likewise, over 35% of private homes are categorised as ‘non-decent’ (Johnstone, 2004).

The rates of long-term limiting illness and disability living allowance claims are the third highest in England. Lower than average levels of physical activity have been evident across the region (Yorkshire Futures, 2008), but active recreation in Yorkshire and Humber is rising and coming in line with the national average.

The population, like many regions in England, is growing as well as getting older. It is forecast to reach 5.7 million by 2029 with the proportion of people aged 65 and over expected to rise from 16% in 2005 to 23% by 2030 (Yorkshire Futures/University of Sheffield). With a growing elderly population come a range of issues including increasing likelihood of fuel poverty, and greater pressure on healthcare resources due to the higher cost of providing services to elderly people. Furthermore, an increasingly ageing population is also likely to result in a higher incidence of people with chronic health disorders (Warnes et. al., 2002). Migration within the region is forecast to follow a clear trend, with elderly people retiring to more rural parts of North and East Yorkshire (Warnes et. al., 2002), where health and care services are currently less concentrated.

Mortality rates are noteworthy in Yorkshire and Humber. A 2007 study (Health Blueprint, Yorkshire and Humber NHS, 2007) showed that residents in the region die at a younger age, on average, than anywhere else in England. Trends suggest that, in common with England as a whole, the prevalence of obesity will continue to increase. In 2003, 25% of men and 24% of women in Yorkshire and Humber were obese. The short-term forecast, for 2010, is for 39% of the male population to be obese. This equates to 784,000 people (Health Blueprint, Yorkshire and Humber NHS, 2007).

There is a positive relationship between black and minority ethnic (BME) groups and higher levels of deprivation and health and welfare problems. Ethnic diversity will grow with BME groups forecast to increase from 8.7% in 2005 to 12.2% of the total population of the region by 2030 (Stillwell et al., 2006). BME groups are most concentrated around the urban centres of the region’s towns and cities. Members of South Asian communities form a relatively large proportion of informal carers of elderly and vulnerable people (personal communication during the project workshops), with support provided within extended family networks.

The Government recognises Barnsley, Bradford, Hull, Doncaster, North East Lincolnshire, Rotherham and Wakefield as being amongst the poorest and most disadvantaged areas in England. Exhibiting significant health inequalities these areas have subsequently been designated as ‘Spearhead areas’ by the Department for Health (Health Blueprint, Yorkshire and Humber NHS, 2007). Spearhead areas receive additional funding from the Department for Health to help address health inequalities.

 

Impacts
Climate change is expected to have a wide range of potential impacts on health across the country. Environmental deprivation is much more likely to affect those people already experiencing other forms of deprivation, i.e. those living in the 20% most deprived communities are also likely to suffer the worst air quality and the lowest levels of access to communal green space. Those issues listed below apply to the Yorkshire and Humber region.

• Increasing incidence of respiratory illnesses such as asthma due to air pollution episodes from elevated levels of atmospheric ozone and other air quality pollutants, exacerbated by hotter drier summers. These will be most pronounced in urban areas and during summer months. Although vehicle emission standards are increasing, the number of vehicles is expected to rise significantly.

• Potential increase in the number of skin cancer cases if rising average temperatures, as people spend more time outdoors potentially exposing themselves to harmful ultra-violet radiation.

• Increasing incidence of mental health problems – anxiety, stress and depression - as a result of increased frequency and intensity of flood events. Climate change is expected to lead to greater seasonality in rainfall, with individual rainfall events likely to become heavier.

• Warmer temperatures will support a wider number of insects that transmit diseases.

• Elevated incidence of food poisoning and illness due to vector-borne and water-borne diseases. As temperatures rise, the conditions necessary for bacteria that lead to food poisoning and related illnesses will be more widespread. Similarly, a warmer climate will provide a favourable environment for insects and vermin that carry diseases, some of which may currently be entirely absent from the region. Water-borne diseases may also become more prevalent as higher water temperatures provide more favourable conditions for pathogens.

• Increased mental and physical health problems due to rising average annual temperatures, particularly during heat wave conditions leading to heat stress, heat stroke, exhaustion and dehydration. Keeping cool will become increasingly difficult for many people.

• A reduction in cold-related morbidity and mortality in winter as average temperatures rise. Similarly, milder winter temperatures will lead to fewer frost days and potentially a reduction in the number of people injured due to icy conditions.

• Acute and chronic impacts on mental wellbeing are especially evident during and following flood events, depending upon how an individual is impacted. The growth of cities and the resultant loss of natural drainage may make large urban centres more vulnerable to flooding, exposing the population to elevated risk. This could occur during the winter when seasonal rainfall will rise markedly, but also during the summer as more extreme storms and rainfall events produce larger volumes of water. Impacts upon health and welfare (particularly mental) due to flooding often persist far beyond the flood itself. Loss of property and possessions, prolonged periods of living in temporary accommodation, slow or incomplete insurance payments and fear of future events can lead to stress, anxiety and depression. 

• Hospitals and care homes across the region may find it increasingly difficult to provide their core services as a result of rising summer temperatures and to a lesser extent, air pollution episodes. Buildings will have increasing difficulty in maintaining a comfortable internal temperature during summer and particularly during a heat wave, placing patients under additional stress and possibly exacerbating their conditions.

• Severe weather may impact mobile care services such as home help, meals on wheels and community transport schemes. Restriction of such services, even over short timescales (i.e. hours) could have serious impacts upon those requiring care. This is particularly important for services in rural areas where care providers cover greater distances and the infrastructure is more vulnerable to disruption due to severe weather – storms and extreme rainfall events – and their secondary impacts such as disrupted energy supplies. As increasing numbers of elderly people move into rural areas, the network of home care services will have to be expanded. Ambulance services, in particular response times and access to the population, will also be affected by the out-migration of an increasingly elderly population.

• Mental (stress, anxiety, depression) and physical (injury, water-borne diseases) health problems due to coastal flooding and increased coastal erosion. Rising sea levels may affect the long-term viability of some coastal communities.

• Increased strain on health services in rural areas as higher temperatures and more extreme weather events impact an increasingly elderly population.

• An increase in the number of extreme hot days, consecutive hot days, and air pollution episodes will place a greater burden on informal carers. This could result in a large increase in the numbers of people passing from informal to formal care services and thus placing additional pressure on public health services.

• Deprived areas and vulnerable people/communities in large urban centres will be most severely affected by the climatic changes detailed above.

 

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| North Yorkshire | West Yorkshire | Humber | South Yorkshire |

 

Description
York and Harrogate are the principal settlements within the North Yorkshire sub-region, which in 2006 had a population of 771,000 people (Learning Skills Council, 2006). The population of North Yorkshire is expected to grow by just under 7% by 2020 compared to 2005. The population of people aged 65 and over is also forecast to increase with the greatest growth expected in the districts of Selby, Hambleton and Richmondshire (North Yorkshire County Council). The number of people aged 65 and over in the sub-region will increase by around 50% by 2020 compared to 2001. Conversely, over the same period the population of 20-40 year olds is expected to decrease by around 7%. It is noteworthy that the district of Richmondshire is one of the most sparsely populated in England. North Yorkshire is largely rural with a population density of 71 people per square kilometre, as opposed to the national average of 1,323 people per km2.

Primary Care Trusts:

• North Yorkshire and York.

National Health Service Trusts:

• Scarborough and North East Yorkshire.

National Health Service Foundation Trusts:

• Harrogate and District; and
• York Hospitals.

There are a high proportion of people who are ‘economically active’ in North Yorkshire – 84% compared to 79% in England and Wales. As the regional and national population becomes older, the proportion of ‘economically active’ people will fall. Whilst Yorkshire and Humber is the region in England with the lowest proportion of pupils achieving five GCSE’s (at grades A-C or equivalent), pupils in North Yorkshire perform consistently well against the national averages, at both GCSE and ‘A’ levels (Learning Skills Council, 2006).

Figures for socio-economic deprivation and the number of children living in poverty are both below the national averages. Levels of unemployment are also below the national average (North Yorkshire County Council).

Forecast future temperature increases are greatest in and around the city of York where summer maximum temperatures are projected to rise by an average of 3oC. Summer temperatures of 30oC and above can be expected in York by 2050. Similarly, the number of hot days (i.e. with maximum temperatures above 28oC) is expected to increase across the sub-region, but especially in York.

The winter reduction in rainfall is expected to be around 17% for the Yorkshire and Humber Region overall. In spite of these overall reductions, there will be an increase in the number and intensity of extreme rainfall events, up to a maximum of around 10% in upland areas, which feature prominently in North Yorkshire. Snowfall will reduce markedly across the sub-region (between 49 and 89%).

 

Impacts

• Increasing morbidity and mortality due to heat exposure in York, especially amongst elder residents who will be more sensitive and vulnerable to heat stress, anxiety, depression, severe discomfort, heat stroke, sun burn and dehydration during prolonged high temperature periods. The expected increase in the number of people aged 65 and over living in North Yorkshire (and moving away from urban centres to more rural locations) by 2050 must be taken into account as this will place a significant burden on rural healthcare services. Small towns in rural areas (or those with large rural catchments) such as Pickering, Richmond and Settle, should also make provision for how best to transport, or access, an increasingly elderly population with chronic disorders.

• Increased levels of atmospheric pollutants leading to higher incidence of respiratory complaints and illness, particularly in York. High temperatures will compound the impact of pollutants. An increasingly elderly population may mean that air pollution episodes impact a larger proportion of the population than at present. Areas of deprivation will be especially affected where background levels of limiting long-term illness will be higher, and overall levels of health will be lower (i.e. home to larger numbers of vulnerable people).

• Acute and chronic impacts on mental wellbeing are especially evident during and following flood events, depending upon how an individual is impacted. The growth of cities and the resultant loss of natural drainage methods may make large urban centres more vulnerable to flooding, exposing the population to elevated risk. This could occur during the winter when seasonal rainfall will rise markedly, but also during the summer as storms and rainfall events produce larger volumes of water than they do now. Impacts upon health and welfare (particularly mental) due to flooding often persist far beyond the flood itself. Loss of property and possessions, prolonged periods living in temporary accommodation, slow or incomplete insurance payments and fear of future events can lead to stress, anxiety and depression.  

• Reduced levels of cold-induced mortality and morbidity in the winter due to rising winter temperatures.

• Hospitals and care homes across the sub-region may find it increasingly difficult to provide their core services as a result of rising summer temperatures and to a lesser extent, air pollution episodes. Buildings will have increasing difficulty in maintaining a comfortable internal temperature during summer and particularly during a heat wave, thus placing patients under additional stress and possibly exacerbating their conditions.

• Severe weather may impact mobile care services such as meals on wheels, community transport schemes and home patient visits. Restriction of such services, even over short timescales (i.e. in terms of hours) could have serious impacts upon the individual requiring care. This is particularly important for services in rural areas where care providers cover greater distances and the infrastructure is vulnerable to disruption due to severe weather – storms and extreme rainfall events – and their impacts such as disruptions to energy supplies. As increasing numbers of elderly people move into rural areas, the network of home care services will have to be expanded. Ambulance services, in particular response times and access to the population, will also be affected by the out-migration of an increasingly elderly population.

• The expected significant reductions in winter snowfall could have detrimental impacts upon aquifers and water availability for domestic, agricultural and business use.

 

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Description
Just over two million people live in West Yorkshire (Yorkshire Forward, 2003), which is divided into the five unitary authority districts of Leeds, Wakefield, Kirklees, Calderdale and Bradford. Similarly, five primary care trusts operate within West Yorkshire. All of the unitary authorities can expect population growth and particularly growth in the 65 and over age groups. The population is expected to increase by 10.5% by 2030 (Yorkshire Forward, 2007). The availability of district-specific health and welfare information varies substantially across the region.

Primary Care Trusts:

• Bradford and Airedale Teaching;
• Leeds;
• Wakefield;
• Calderdale; and
• Kirklees.

National Health Service Trusts:

• Leeds Teaching Hospitals;
• Airedale; and
• Mid Yorkshire Hospitals.

National Health Service Foundation Trusts:

• Leeds Partnerships;
• Bradford Teaching Hospitals; and
• Calderdale and Huddersfield.

Care Trusts:

• Bradford District.

Mental Heath Trusts:

• South West Yorkshire.

The population of Leeds is forecast to grow from 714,000 in 2001 to 760,000 by 2030. In Leeds, one in four homes is in receipt of benefit and a total of 65,000 people are unemployed. The number of people aged 65 and above is forecast to increase by over 25% by 2030. Respiratory diseases resulting in death remain at a statistically significant level above the national average for residents of Leeds (Leeds Joint Health Information Group, 2007). Parts of the city are amongst the most deprived areas in England.

Bradford’s population is expected to grow by over 20% by 2030.

Climate model results for West Yorkshire are centred on Leeds. West Yorkshire can expect average summer maximum temperatures to rise by 3oC with the highest actual temperatures expected in Leeds. Maximum temperatures are to be expected in large urban centres due to the ‘urban heat island’ effect. There will be a significant increase in the number of hot days (at or above 28oC). While the total number of hot days in 2050 may seem small it represents a substantial increase over the existing number.

 

Impacts

• Atmospheric ozone concentrations are expected to increase towards 2050 and combined with periods of high temperature could well lead to an increase in respiratory illness as air pollution events become more common, more intense or both. Leeds’ location with the Pennines to the West could serve to exacerbate this as high pressure systems, frequently featuring easterly winds, could trap poor quality air in the urban areas of West Yorkshire. Increasing road transport emissions from increasing numbers of vehicles, as well as substantial growth plans at Leeds-Bradford International Airport, will contribute to air quality problems.

• Despite its affluence in areas, a large number of people in Leeds live in vulnerable households and/or areas of deprivation. These are the areas that resources should most urgently be focussed. Within these areas will usually be poorer quality housing stock, higher incidence of long-term limiting illness, less social and community cohesion, less access to green spaces, and larger numbers of vulnerable people.

• Increased flood risk (due to increased winter rainfall as well as heavier summer rainfall) leading to large-scale impacts on mental and physical welfare. For example, extensive developments are at risk in the centre of Leeds with around 2,000 properties and 1,000 businesses at risk from a 1 in 200 year flood event on the river Aire.

• Heat stress and the impacts upon residents in urban centres have the potential to cause particular problems. Elderly residents and people living in areas of deprivation will be most severely impacted, but so too will offices, schools, factories and public buildings. Focussed efforts should be made to tackle the root causes of deprivation, and to help build community resilience, as well as helping people to adapt through lifestyle changes and education programmes.

• Hospitals and care homes across the sub-region may find it increasingly difficult to provide their core services as a result of rising summer temperatures and to a lesser extent, air pollution episodes. Buildings will have increasing difficulty in maintaining a comfortable internal temperature during summer and particularly during a heat wave, thus placing patients under additional stress and possibly exacerbating their conditions.

• Severe weather may impact mobile care services such as meals on wheels, community transport schemes and home patient visits. Restriction of such services, even over short timescales (i.e. in terms of hours) could have serious impacts upon the individual requiring care. This is particularly important for services in rural areas where care providers cover greater distances and the infrastructure is vulnerable to disruption due to severe weather – storms and extreme rainfall events – and their secondary impacts such as disrupted energy supplies. As increasing numbers of elderly people move into rural areas, the network of home care services will have to be expanded. Ambulance services, in particular response times and access to the population, will also be affected by the out-migration of an increasingly elderly population. The expected increases in vehicle numbers and congestion levels will further impact upon emergency services response times.

• Acute and chronic impacts on mental wellbeing are especially evident during and following flood events, depending upon how an individual is impacted. The growth of cities and the resultant loss of natural drainage methods may make large urban centres more vulnerable to flooding, exposing the population to elevated risk. This could occur during the winter when seasonal rainfall will rise markedly, but also during the summer as storms and rainfall events produce larger volumes of water than they do now. Impacts upon health and welfare (particularly mental) due to flooding often persist far beyond the flood itself. Loss of property and possessions, prolonged periods living in temporary accommodation, slow or incomplete insurance payments and fear of future events can lead to stress, anxiety and depression.

Reduced levels of cold-induced mortality and morbidity in the winter due to rising winter temperatures.

 

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Description
The availability of district-specific health and welfare information for this sub-region  varies. The Humber sub-region comprises nine non-metropolitan districts and includes the city of Hull and large towns of Grimsby and Scunthorpe.  Four Local Authorities make up the Humber sub region – Hull, East Riding, North Lincolnshire and North-East Lincolnshire.

Primary Care Trusts:

• East Riding of Yorkshire;
• North Lincolnshire; and
• Hull.

National Health Service Foundation Trusts:

• Humber Mental Health Teaching; and
• Northern Lincolnshire and Goole Hospitals.

National Health Service Trusts:

• Hull and East Yorkshire Hospitals;
• Humber Mental Health Teaching; and
• North East Lincolnshire.

The 2008 North Lincolnshire Health and Social Care Consultation, in common with other sub-regions, forecast a significant increase in the population of people aged 65-75 years old. People in these age groups are also migrating away from urban areas to settle in more rural surroundings – by 2018 it is estimated that there will be a 70% increase in the number of 65-74 year olds living in rural areas, when compared to 2008 (North Lincolnshire Council and North Lincolnshire NHS, May 2008). The demand for ‘at home’ social care services is forecast to grow by 60% between 2008 and 2025. It is unlikely that this figure has taken potential impacts of climate change into account. Currently 8% of people aged 65 and over receive adult social care services at home.

Hull is forecasting a modest 3% growth in population between 2006 and 2015. However, this figure includes a projected 28% increase in people aged between 65 and 74 and a 19% increase for people aged 75 and above. In excess of 50% of the population of Hull live in neighbourhoods that are among the most deprived 20% in England, with all wards situated either in the most or second most deprived quartile in England. Correspondingly, the district has one of the highest number of adults who smoke and some of the lowest levels of healthy eating in England. Life expectancy is also significantly below the national average (Hull and East Yorkshire NHS Trust).

The East Riding of Yorkshire enjoys lower than average levels of deprivation and child poverty. Deprivation is present, most notably in the towns of Goole and Bridlington, but overall the picture is positive. Life expectancy is near or above average and deaths attributable to cancer, smoking, heart disease and stroke are all below the national average (Hull and East Yorkshire NHS Trust).

 

Impacts

• Vulnerability of an increasingly elderly population, particularly in rural areas. An increasingly ageing population presents challenges on many levels, as have been highlighted throughout this study. Elderly people living in Hull in the future will be exposed to higher maximum temperatures and elevated levels of air pollution, but will be much closer to accessible health care services. It is likely that health services in both urban and rural areas will be exposed to pressures from an increasingly elderly population, before any possible impacts from climate change are taken into account. The increasing numbers of elderly people living in rural areas will likely enjoy elevated levels of physical and mental wellbeing but will not have such good access to healthcare services.

• Vulnerability of people living in deprived areas, of which there are a significant number in Hull. In common with all urban centres, areas of deprivation will be the most severely impacted by the wide-ranging impacts of climate change. Focussed efforts should be made to build community resilience, and tackling the root causes of deprivation, as well as helping people to adapt through lifestyle changes and education. Home insulation grants should be provided and made easily available, improvements should be made to public transport infrastructure, and open spaces should be made as accessible and green (through widespread tree planting) as possible. Black and minority ethnic groups are often concentrated in deprived parts of cities and language and cultural barriers can make communication difficult. Given the scale of the issue and how widely its impacts will be felt, these communities should form another focal point for efforts to improve communication and understanding.

• A large number of people in the sub-region live in areas that are prone to tidal flooding, which is likely to increase significantly as a result of sea-level rise. Coastal erosion will increase mental health impacts; in severe cases as homes and property is blighted.

• Hospitals and care homes across the sub-region may find it increasingly difficult to provide their core services as a result of rising summer temperatures and to a lesser extent, air pollution episodes. Buildings will have increasing difficulty in maintaining a comfortable internal temperature during summer and particularly during a heat wave, thus placing patients under additional stress and possibly exacerbating their conditions.

• Severe weather may impact mobile care services such as meals on wheels, community transport schemes and home patient visits. Restriction of such services, even over short timescales (i.e. in terms of hours) could have serious impacts upon the individual requiring care. This is particularly important for services in rural areas where care providers cover greater distances and the infrastructure is vulnerable to disruption due to severe weather – storms and extreme rainfall events – and their impacts such as disruptions to energy supplies. As increasing numbers of elderly people move into rural areas, the network of home care services will have to be expanded. Ambulance services, in particular response times and access to the population, will also be affected by the out-migration of an increasingly elderly population.

• Acute and chronic impacts on mental wellbeing are especially evident during and following flood events, depending upon how an individual is impacted. The growth of cities and the resultant loss of natural drainage may make large urban centres more vulnerable to flooding, exposing the population to elevated risk. This could occur during the winter when seasonal rainfall will rise markedly, but also during the summer as storms and rainfall events produce larger volumes of water than they do now. Impacts upon health and welfare (particularly mental) due to flooding often persist far beyond the flood itself. Loss of property and possessions, prolonged periods living in temporary accommodation, slow or incomplete insurance payments and fear of future events can lead to stress, anxiety and depression. 

• Increasing levels of people suffering from heat related health problems during the summer months. It is unlikely that the Humber sub-region will be as impacted upon to the extent that the more urbanised sub-regions. More people live in rural surroundings that are not prone to the excessive temperatures generated by large cities. Proximity to the coast will also limit maximum temperatures, although vulnerability to coastal and other flooding may offset this.

 

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Description
Sheffield, Doncaster, Rotherham and Barnsley are the four districts that make up the South Yorkshire sub-region. The availability of health and welfare data varies between these districts providing detailed information in some areas and much more sparse information in others.

Primary Care Trusts:

• Barnsley;
• Doncaster;
• Rotherham; and
• Sheffield.

National Health Service Foundation Trusts:

• Barnsley Hospital;
• Doncaster and Bassetlaw Hospitals;
• Rotherham General Hospitals;
• Sheffield Children’s;
• Sheffield Teaching Hospitals; and
• Sheffield Health and Social Care.

Mental Health Trusts:

• Rotherham, Doncaster and South Humber.

South Yorkshire has been targeted by the European Regional Development Fund (Objective 1 status) which provides funding to help the poorest regions in Europe, promoting development and economic growth.

Sheffield is England’s fourth largest metropolitan authority. It has a large student population with two universities and also has the highest proportion of older residents of any of England’s major cities. The proportion of people aged 65-79 is expected to grow by 20% by 2029 – a shorter term forecast than the focus of this study but nonetheless indicative of the kinds of trends that will be emerging. Over the same period, the number of people aged over 80 will grow by around 40%. At the same time, there will be a relative reduction in the number of people of working age and thus less people to provide care for an increasingly elderly population. 56,000 people in Sheffield provide some form of care service for others. While a range of indicators for the city compare well with the national average (e.g. life expectancy), key issues relate to inequalities within the city itself. There is, for example, a three-fold difference in cases of ‘all-causes morbidity’ between the least and most deprived parts of the city (Sheffield’s Joint Strategic Needs Assessment, Sheffield City Council and Sheffield NHS, 2008).

Rotherham is a former industrial centre for the manufacture of steel and coal mining. 12% of the population live in neighbourhoods that are ranked amongst the top 10% most deprived in England (Rotherham District Council). Significantly higher than average (compared with England and Wales) numbers of people suffer from limiting long-term illness in the city. This is likely to be a legacy of the coal mining that has been such a prominent feature of Rotherham and its surrounding areas throughout recent centuries.

In common with other urban centres across the region, it is here that the greatest temperature increases will be experienced. Average maximum daily temperatures are expected to rise by 3.1oC, reaching 31.0oC in Sheffield. Extreme hot temperatures will also be most pronounced in Sheffield where they may reach as high as 32oC.

As increasingly stringent vehicle emissions reductions targets are introduced the levels of pollutants such as Nitrogen Oxides, particulates and Volatile Organic Compounds (VOCs) in the atmosphere should begin to decline. Air pollution episodes for these pollutants are not expected to increase between now and 2050. However a significant increase in the number of vehicles, and subsequent congestion, is expected over the next few decades which could offset any benefits of improved emissions standards. Rising traffic and congestion levels will have a detrimental effect on health and welfare, particularly in urban centres where areas of deprivation and the primary road network are in close proximity to each other.

High night-time temperatures can be particularly stressful and will be most evident in urban centres where the urban-heat island effect is more pronounced. The urban environment, due to the materials employed in buildings and infrastructure as well as the energy emitted by people living there, does not lose heat at night like rural areas do. This varies from city to city, and is of course dependent upon the weather conditions at any particular time. The ongoing SCORCHIO project (Sustainable Cities: Options for Responding to Climate cHange Impacts and Outcomes) is investigating the vulnerability of cities to the effects of climate change and will provide tools for planners, engineers and designers to adapt and ‘build in’ resilience to their cities (Jones et al., 2007). Sheffield is one of the two ongoing case studies in the project.

 

Impacts

• Heat induced morbidity and mortality rates will increase as residents in Doncaster, Barnsley, Rotherham and especially Sheffield are exposed to higher average and extreme temperatures. As these cities grow, and average temperatures rise, an intensification of the urban heat-island effect will occur unless dramatic changes in urban design are made in the very near future. The forecast growth in the number of elderly people is going to lead to a relative reduction in the number of people providing care services and will once again put a strain on health and welfare services if suitable mitigation measures are not taken. As a large urban centre, extreme temperatures will be higher in Sheffield than the surrounding area. Combined with a relatively large population of elderly people, living to a greater age, problems related to heat stress could be particularly acute within the city. The impact of high temperatures will be more pronounced in areas of deprivation which already experience higher than average levels of limiting long-term illness.

• Air pollution episodes will lead to increased numbers of respiratory system illnesses and hospital admissions. Areas of deprivation within Sheffield and Rotherham where high levels of long-term illness are endemic are likely to be particularly impacted by air pollution episodes. The wards of Herringthorpe, Greasbrough and Rawmarsh West have the largest concentrations of residents with limiting long-term illnesses in Rotherham (Rotherham Borough Council, 2007). Air pollution episodes may also be intensified by the local topography with the Peak District immediately to the West serving to trap pollutants during anticyclonic (high pressure) weather systems.

• Hospitals and care homes across the sub-region may find it increasingly difficult to provide their core services as a result of rising summer temperatures and to a lesser extent, air pollution episodes. Buildings will have increasing difficulty in maintaining a comfortable internal temperature during summer and particularly during a heat wave, thus placing patients under additional stress and possibly exacerbating their conditions.

• Severe weather may impact mobile care services such as meals on wheels, community transport schemes and home patient visits. Restriction of such services, even over short timescales (i.e. in terms of hours) could have serious impacts upon the individual requiring care. This is particularly important for services in rural areas where care providers cover greater distances and the infrastructure is vulnerable to disruption due to severe weather – storms and extreme rainfall events – and their impacts such as disruptions to energy supplies. Although Sheffield’s population is forecast to become older, the fact that these people will be closer to health and welfare services will be advantageous. By staying in Sheffield they will however be exposed to higher maximum temperatures and to air pollution episodes.

• A large proportion of carers in the Sheffield area are from BME groups. Projected climate change impacts will lead to, or exacerbate, the need for increased care in an ageing population, placing a greater burden on the care community. Communication with BME groups should aim to highlight the threats posed by climate change and work towards mitigation and adaptation measures.

• Acute and chronic impacts on mental wellbeing are especially evident during and following flood events, depending upon how an individual is impacted. The growth of cities and the resultant loss of natural drainage methods may make large urban centres more vulnerable to flooding, exposing the population to elevated risk. This could occur during the winter when seasonal rainfall will rise markedly, but also during the summer as storms and rainfall events produce larger volumes of water. Impacts upon (particularly mental) health and welfare due to flooding often persist far beyond the flood itself. Loss of property and possessions, prolonged periods living in temporary accommodation, slow or incomplete insurance payments and fear of future events can lead to stress, anxiety and depression. Incidence of water and vector-borne diseases following flood events may increase, particularly if a flood occurs during the summer.

• Reduced levels of cold-induced mortality and morbidity in the winter due to rising winter temperatures.

 

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