Coventry Health and Wellbeing Strategy 2023-2026

Population

• Coventry continues to be a growing, changing and increasingly diverse city.  Data from the JSNA suggests that in 2021 the city’s recorded population was over 345,000, making it the second largest local authority in the West Midlands region and 25th largest in England.  Coventry prides itself on being a diverse city and continues to welcome many new residents from other parts of the world. Recent data indicates that migration is a significant part of this annual population change. 
• In Coventry, the population size has increased by 8.9%, from around 317,000 in 2011 to 345,300 in 2021. This is higher than the overall increase for England (6.6%), where the population grew by nearly 3.5 million to 56,489,800[1].
• Coventry is a young city compared to the rest of England, with a higher proportion of residents between the ages of 25 and 39. This younger population can also be attributed in part to the city’s high concentration of university students, with 20-year-olds being amongst the most prevalent age group, along with 13% of the population between the ages of 18 and 19.   Understanding the sociodemographic profile of an area is important when planning services, as different population groups may have different health and social care needs and are likely to interact with services in different ways.
• In the 2021 census, 45% of Coventry’s population identified as an ethnic minority, up from 33% in 2011, which is higher than both the regional (28%) and national average (26%)
• Of the ethnic minority population, Asian Indian formed the largest group making up 9% of Coventry’s total population compared to 3% in England and 5% in the West Midlands. Within Coventry, Foleshill West, Foleshill East, and Hillfields had the largest percentage of their population identifying as an ethnic minority with 80% or more doing so.
• According to the latest school census in 2022, 55.9% of Coventry’s school children are from a minority group, this is an increase from 39.7% in 2012 (Coventry City Council, 2022c). Amongst the school-aged population our largest minorities are Black African (11.4%), non-British white (10.2%), and Asian Indian (8.9%) children.

Health Inequalities

• The city is relatively deprived, ranking 46th most deprived borough in England, with 14.4% of the city’s neighbourhood amongst the 10% most deprived areas in England.
• Overall health in Coventry is below the national average and there are significant health inequalities that continue to impact the lives of those most deprived in the city.  Life expectancy for both men (78.0 years) and women (82.0 years) is lower than the England average, with people living more of their later years in ill health and a significantly higher prevalence of preventable deaths.  Healthy life expectancy refers to the number of years a person can expect to live in good health.  In Coventry, this is 64.0 years for females and 61.1 for males.  Compared to the national picture, healthy life expectancy for Coventry males is lower than the national (63.1) and regional (61.9) averages whereas for Coventry females it is slightly higher (62.6) and (63.9). The trends show little change in recent years for women, but it has fallen a little for men. Such data is important for us to take action on the cumulative effect of the prevalence of risk factors, the prevalence and severity of disease, and the effectiveness of interventions and treatment.

Mental Health and Wellbeing

• Loneliness affects many people in Coventry. Findings from the Coventry Household Survey, conducted in 2021, show that 16–24-year-olds score highest on loneliness, with the survey showing that the younger you are, the more likely you are to be lonely. The survey also highlighted that women, carers, disabled and unemployed people are more likely to be lonely.
• Responses to questions in the Coventry Household Survey 2022 also indicate a detrimental impact on mental wellbeing. A series of seven questions about respondents’ wellbeing were asked using the Short Warwick and Edinburgh Mental Wellbeing Scale (‘SWEMWBS’). Respondents can score from 1 (very low wellbeing) to 35 (very high wellbeing); the average score has reduced from 26.4 in 2018 to 22.94 in 2021 and 21.75 in 2022. Further to this, we can broadly categorise respondents’ level of mental wellbeing according to their score; in 2021 28% gave a score that suggests ‘possible’ or ‘probable’ depression, up from 10% in 2018, and only 18% gave a high mental wellbeing score, down from 43% in 2018. These are not clinical diagnosis of course, just an indication to the extent of the impact on wellbeing of the pandemic. 
• The proportion of Coventry adults diagnosed with depression according to GP registers, has been on an increasing trend. Mental ill health is of growing concern, in 2013/14 it was 6.5% which increased to 11.9% in 2021/22, amounting to 40,743 residents.
• The 2021 Coventry & Warwickshire Adult Mental Health and Wellbeing Needs Assessment set out a few key findings: 
  • there are high levels of poor wellbeing and mental ill health.
  • there is difficulty in accessing or understanding available services or support. 
  • there will growing demand in the future, either due to better diagnosis and recognition of mental health issues and/or a general increase in poor mental health.
• Feelings of belonging and cohesion may have reduced over the last few years according to the 2022 Household Survey.  56% of adults said they felt a sense of belonging to Coventry, down from 83% in 2018; and 54% felt they belonged to their immediate neighbourhood, down from 77%.  

Equality, Diversity and Inclusion

• The Census 2021 has confirmed Coventry’s status as one of the most diverse cities in the UK, with 45% of people identifying as being from an ethnic minority group.  The different communities making up the city’s population reflect a broad range of backgrounds and needs.  It is therefore imperative to monitor how Council services are being used, using this latest Census data, to ensure that these diverse needs are being appropriately and adequately met by the Council. 
• Coventry City Council acknowledges the importance of the principles of diversity and inclusion underpinning everything we do and recognises the importance of ensuring that our workforce at all levels, including at senior leadership level, is more reflective of the communities we serve and that we deliver services which meet the needs of all of our diverse citizens of Coventry.  A commitment to this work is reflected in our status as an early adopter of the RACE equality code kitemark which is an accountability framework designed to provide organisations across all sectors and sizes, with the opportunity to address race inequality in the boardroom and at senior leadership level.
• Employees with disabilities can face significant challenges in the workplace & as part of the council’s commitments in the Workforce Diversity & Inclusion Strategy (2021-2023), a series of career development programmes have been launched to equip staff who have a disability, identify as neurodiverse or have a long-term physical or mental health condition to develop leadership skills that will enable them to thrive regardless of their role or position.
• Living with excess weight has health implications across the life course, as well as the burden it places on their families, social care and the NHS.  Across the West Midlands, the prevalence of children at a healthy weight (particularly in year 6) is declining and getting worse at 57.1%.  Obesity prevalence is strongly linked to deprivation, with the rate of obesity in children living in the poorest areas more than double that of those living in the least deprived.  Child obesity levels in the city are higher than the England average, with around 22% of Reception children and 41.1% of Year 6 children classed as overweight & obese in 2021/22.  These figures for Year 6 particularly are increasing and getting worse.  A similar trend is also reflected with the adults in the city with 68.4% classed as overweight or obese.  58.6% of adults in the city are physically activity, which is below both the regional and national average.   These trends come at a significant time given the links between excess weight & COVID-19 severity, along with a range of other chronic diseases.

Education and Skills

• Education standards have increased with 94% of primary and 74% of secondary students attending a good/outstanding school.
• The number of pupils achieving a “strong pass” and “standard pass” at the end of Key Stage 4 is below the national average. In 2022, 46.6% of Coventry students earned "strong passes" in English and Maths at grades 9–5, compared to 44.78% 50% of students in England. In 2022, 65.1% of Coventry students received a "standard pass," or grades 9–4 in English and Maths, up from 64.9% in 2021. This is lower than the 69% national average. For 16–18-year-olds (at key stage 5), Coventry’s average point score is in the middle of Grade C, which is slightly below the national average which is towards the top of Grade C.
• Nearly 19% of Coventry neighbourhoods are amongst the 10% most deprived neighbourhoods in England; 10% of the population has no qualifications at all, limiting their ability to gain rewarding employment. To transform life opportunities and increase everybody’s probability of a successful life needs every child to achieve a good level of development by the age of five; social inequalities are already established from the early years of life. 

Housing and Homelessness

• Where we live can have a significant impact on our wellbeing.  Despite improving local housing systems, the city still has high levels of homelessness; highlighting a need to work together with partners to improve the use of existing homes and empty dwellings.  
•  Household overcrowding is more prevalent in Coventry than national and regional averages. Census 2021 counts 10,196 Coventry households as overcrowded, having fewer rooms than a minimum standard for the number of occupants. This amounts to 7.7% of all households, so overcrowding rates in Coventry are higher than West Midlands (5.4%) and England overall (6.4%). However, overcrowding has reduced since 2011 when it was at 9.5% of households.
• The homelessness rate in the city rose higher in 2021/22 than in the previous year. This is projected to further increase in 2022/2023, the cost-of-living crisis is a factor here. The number of households accepted under a main homelessness duty increased from 722 in 2020/21 to 800 in 2021/22. There was a 14% increase in case demand on homelessness prevention and relief services in 2021/2022 compared with 2020/2021, the Council, obtained secured accommodation for 1,167 households, compared with 1,083 in the previous year. 
• Due to the increase and projected further increase in demand for homelessness support in 2022/2023, the Council has invested in additional frontline resources to support more residents facing homelessness issues and has revised and uplifted contracts for delivering additional support with providers, including The Salvation Army, St Basils, and P3 Charity, for households which are not eligible for a statutory homeless duty.

Employment and Economy

• A protective factor for health is having meaningful employment. Reducing avoidable health disparities will involve tackling the unequal distribution of money, wealth, and power by improving opportunities and skills.
• The city’s advanced manufacturing sector is growing, helped by the increase in the city’s highly skilled and highly qualified working-age population.
• Young people who are not in education, employment or training (NEET) are at greater risk of a range of negative outcomes, including poor health, depression or early parenthood. Across the city, NEET rates are decreasing in the city and getting better at 3.9% which is better than the regional and national average.  The percentage of people of working age in employment in Coventry is 69.2% which is amongst the lowest across the West Midlands & below the England average at 75.4%
• The local economy has experienced significant challenges in recent years with the COVID-19 pandemic, inflation, labour shortages, and new regulations and document requirements for UK-EU trade post-Brexit all of which have slowed economic recovery. This had a major impact on the local labour force, with the claimant count rising from 7,525 (3.0%) recorded in January 2020 to 16,490 (6.6%) in December 2020 (the peak during the pandemic). 

Fuel Poverty

• A household is said to be in fuel poverty if their fuel costs are above average, and when having paid for fuel, they are left with an income below the official poverty line.  In figures, released from 2020, Coventry was one of the worst affected authorities in the country, with 20.3% of households in fuel poverty. Some areas of Coventry have fuel poverty rates of over 50%.  Delivering a sustained recovery from the COVID-19 pandemic and global economic challenges is one of the priorities of Coventry’s economic development strategy which will contribute to achieving the One Coventry objective of “Improving Outcomes and Tackling Inequalities in Communities”.
• The impact of the cost-of-living crisis continues to affect households across the city.18.7% (13,670) children live in low-income families and the impact of fuel poverty has had a significant impact on spending behaviours particularly around food choices with price being the most important factor as highlighted in the Coventry Household Survey 2022.  Data from this survey also noted that people living in Foleshill (31%), St Michael (33%) or Wyken (25%) wards are significantly more likely to feel worried about money almost all the time compared to the total average (17%).  In addition, those with a disability are also more likely to worry about money almost all the time compared to those with no disability (23% vs 14%).
• Smoking is the leading preventable cause of illness & premature death.  Despite the continued decline in smoking prevalence across the West Midlands, 16.4% of adults in Coventry still smoke, which is higher than the national average at 15.4%.   
• Lifestyle questions around smoking behaviours is a component of the Coventry Household Survey (2022) and suggests that those aged 35-44 are significantly more likely to say they currently use e-cigarettes (9%) compared to the survey average of 7%.

More information about health and wellbeing in Coventry can be found in our health and wellbeing profile (Joint Strategic Needs Assessment) and our review of population health needs.