1. Maternity Needs Assessment for East Sussex Presentation for the Health Overview and Scrutiny Committee, 17 th May, 2007

2. A. Population estimates and projections Population Population projections General fertility rate

3. Table 1. Total population and women of child bearing age by PCT and district. PCTTotal population Females 15- 44 %Total East Sussex497,90083,80017% ESDWPCT327,30055,40017% Eastbourne B.C. 92,90017,20019% Wealden D.C.141,00022,80016% Lewes D.C. 93,40015,40016% HRPCT170,60028,30017% Hastings B.C.84,60016,30019% Rother D.C.86,00012,00014%

4. Figure 1. Population Projections

6. B. Births

8. C. Population profile Key points from Table 3 Hastings and St Leonards PCT has the highest proportion of: unemployment people of non-white ethnicity people with no qualifications lone parent households with dependent children and the lowest proportion of owner-occupation and access to a car or van Source Census 2001

9. D. Access Key points from Table 4 Hastings has the largest number of single parent families of the five districts 50% of single parent families in Hastings have no access to a car or van compared with 39% in Eastbourne Approximately 1,500 single parent households in Hastings have no car or van compared with 1,000 in Eastbourne.

10. E. Deprivation. Why deprivation is important in assessing maternal and infant needs Low birth weight is associated with increased illness and mortality in the first year of life & thro’ childhood Smoking, obesity and teenage pregnancy are key areas to reduce health inequalities in infant mortality There are social class trends in stillbirth and low birth weight (higher in unskilled occupations or sole reg.) The Confidential Enquiry into Maternal Deaths( 2000-2) found women from the poorest backgrounds were 20 times more likely to die than a woman from a professional group; women from ethnic minority groups were three times more likely to die; 30% of the poorest women did not book until they were 5 months pregnant.

11. E. Deprivation Analysis of deprivation by small areas Income Deprivation Affecting Children Index (IDACI) Super-output areas (SOAs) have a population of approximately 1,500. IDACI is percentage of children in a SOA living in families in receipt of benefits or on the lowest income.

12. Key points from Table 5 We divided the super output areas into four deprivation categories In category “a” less than 25% of children are living in the poorest families In category “d” more than 45% of children are living in the poorest families Ten out of 14 of the most deprived (category “d” small areas were in Hastings. (2 Wealden, 1 Eastbourne, 1 Rother) If categories “c” and “d” are combined: 19/34 of the most deprived small areas are in Hastings. (7 Eastbourne, 4 Rother, 3 Wealden, 1 Lewes)

13. Figure 5 (Source GP Registrations)

14. Figure 6 (Source ONS)

15. Mapping of hospital catchment areas by deprivation (IDAC categories) Eastbourne with Southern Wealden was used as a proxy for the EDGH catchment Hastings and Rother was used as a proxy for the Conquest catchment Four times as many women, of child bearing age, live in the most deprived small areas of the Conquest catchment versus EDGH Five times as many babies (2003-5 births) in the most deprived small areas were born in the Conquest catchment compared with EDGH.

16. F. Maternal risk factors

17. G. Infant outcomes

18. Low birthweight

19. Summary of key findings There is greater deprivation of Hastings women of childbearing age compared with Eastbourne women There is a reduced ability to access services in the Hastings population There is evidence of increased maternal risk factors such as young age, smoking, late booking and obesity in women booking at the Conquest compared with EDGH The local data suggests broadly similar health outcomes for the existing obstetric units.