Our city’s largest health and wellbeing survey reveals new statistics and stark inequalities

The largest health and wellbeing survey of adults ever carried out across the city has revealed a new set of health, lifestyle and community statistics for residents and stark inequalities across different areas and population groups.

Health Counts – conducted by the University of Brighton with Brighton & Hove City Council’s Public Health Team – is carried out once a decade, with last year’s survey having a weighted sample of 16,729 people, representing 7.2% of the resident population aged 18 years or over.

Residents answered questions on topics such as general health, emotional wellbeing, falls and pains, alcohol and drug use, sexual health and physical activity, as well as factors covering areas that impact health and wellbeing, such as belonging, social contact and housing concerns.

For the first time, the 2024 survey also included questions on gambling-related harm, suicidal thoughts and attempts, harassment and hate crime, alongside access to nature and the natural environment and cost of living.

Local picture of health and wellbeing

Caroline Vass, Interim Director of Public Health for Brighton & Hove City Council, said: “The Health Counts 2024 survey findings give some of the best evidence on the population of the city, their health and wellbeing, and the stark inequalities across the city - whether by area or particular communities. 

"However, the findings are not an easy read, covering sensitive areas, and evidencing health inequalities affecting our communities, while recognising their strengths and resilience.

“While we have seen many economic, societal and lifestyle changes nationally over the last 10 years that may have impacted people’s health and wellbeing and widened inequalities, this data focuses on the local picture that informs inclusive and accessible service provision, community cohesion, promoting better health and wellbeing for all, and reducing unfair differences between those with the best and poorest health outcomes.”

Informing decision-making and strategies

Conducted between March and April 2024 by researchers from the University of Brighton in collaboration with Brighton & Hove Medical School, NHS Sussex, Healthwatch Brighton &Hove, Brighton & Hove Federation and Brighton & Hove City Council Public Health Intelligence team, Health Counts 2024 provides detailed insights by population groups and areas.

The report highlights health and wellbeing inequalities across different population groups and areas in Brighton & Hove. The evidence gathered will inform the city’s Joint Strategic Needs Assessment (JSNA) – statutory reports and briefings developed by local authorities and the NHS Integrated Care Boards to inform decision-making at our city’s Health & Wellbeing Board – and strategies to improve health and reduce inequalities.

Brighton & Hove City Council has prioritised creating a healthy city where everyone can thrive in its current strategic plan (2023-27). This includes providing high-quality, inclusive and accessible services for children, young people and families, and promoting and improving health and wellbeing to reduce health inequalities and to support people to live independent and fulfilling lives.

The city’s Health and Wellbeing Board is bringing together senior leaders and representatives of health and wellbeing-related services and organisations in Brighton & Hove to highlight some of the key findings from the Health Counts 2024 survey and look at how the evidence can support work already happening, and what can be done differently to tackle the stark inequalities evidenced by the research.

Thank you for taking part

Caroline added: “This research demonstrates the power of working collaboratively with academic, research and health and wellbeing organisations to reach communities and involve residents in developing local strategies.

“We are committed, alongside our partners in the NHS and community and voluntary sector, to use this deeper understanding to maintain and improve health and wellbeing for everyone across our city and tackle inequalities.

“We are incredibly grateful to everyone in the city who completed the survey. By sharing information about your health and wellbeing, you can change how local services are provided. 

"We would also like to thank all our partners, community groups and volunteers who were involved in leading this work. By working together to gather evidence, we can create a healthier community for all.”

Key findings on health and wellbeing include:

• 69% perceived themselves to be in good, very good or excellent health
• 24% recorded a low happiness score and 9% have self-harmed in the last 12 months.
• 13% said pain interferes with their normal work extremely or quite a bit.
• 17% currently smoke – either occasionally (7%) or daily (10%)
• 56% don’t drink alcohol or drink at low risk levels, while 16% binge drink weekly and 2% drink daily or almost daily.
• 20% have taken drugs not prescribed to them and not available at a chemist or pharmacy in the last 12 months.
• 19% who gamble experience at least one gambling-related harm.
• 53% did less than 30 minutes of sport or fitness activity that raised their breathing rate in the last week.
• 37% are a healthy weight, 36% are overweight and 25% are obese.

Key findings on factors that impact residents’ health and wellbeing include:

• 85% of adults were taking at least one action due to the cost of living
• 21% are fairly or very worried about their housing condition, such as damp, cold or leaks
• 81% are fairly or very satisfied with their local areas as a place to live, while 8% are fairly or very dissatisfied
• 53% feel that they belong to their immediate neighbourhood fairly or very strongly, while 42% rate their sense of belonging as not very strong or not at all
• 96% feel safe walking alone in their local area during the day, while 65% feel safe walking along in their local area at night, with 8% feeling very unsafe at night

Data collected on demographic characteristics:

Demographic data is similar to the 2021 Census, giving reassurance that the weighted sample is representative of the city population.

However, the findings below indicate that the 2021 Census figures were a considerable underestimate:

• 5% of adults are TNBI (Trans, non-binary or intersex), higher than 1% reported in 2021 Census.
• 28% of adults are LGBQ+ (Lesbian, gay, bisexual, asexual, queer or prefer another term to describe their sexual orientation but are not heterosexual); this is higher than 11% reported in the 2021 Census.

Key findings comparing the most deprived (20% of the city) to the least deprived (20% of the city) include:

• 56% of adults living in the most deprived areas are in good or better health compared to 76% in the least deprived areas.
• 25% living in the most deprived areas smoke, compared to 9% of those living in the least deprived areas.
• 37% in the most deprived drink at increasing, higher risk or possible dependence level (combined) rates compared to 48% living in the least deprived areas.
• 65% living in the most deprived areas of the city did less than 30 minutes of sport and fitness activity in the last week, compared to 48% living in the least deprived areas.

Information on the survey methods is available in the full report, which contains breakdowns by population groups, areas and trends (figures may not sum to 100% due to rounding). Further profiles will be published in future reports.

Collaboration through research

Professor Nigel Sherriff, professor of public health and health promotion at the University of Brighton and project lead, said: "Including questions on gambling-related harm in the 2024 Health Counts survey marks an important step in understanding the full scope of factors affecting our community’s wellbeing. 

"Gambling harm is a complex and often hidden issue that can significantly impact individuals and families, contributing to financial, emotional and social difficulties.

“By gathering this data alongside other health and lifestyle factors, we can better identify where support is needed and work collaboratively to reduce harm and promote healthier, more resilient communities across Brighton & Hove.”

Dr Lester Coleman, head of research at Healthwatch Brighton & Hove, said: “The evidence provided by Health Counts is of extreme value to the council and all partners who are working towards implementing Integrated Care Teams and Neighbourhood Health Teams, which will both respond to local population need. 

"The user-testing that we led (involving diverse communities) contributed to a survey that generated an exceptional number of respondents across the city.

“Healthwatch Brighton & Hove will use the findings from Health Counts to support our engagement work, planning and constructive challenge to health and social care services.”

Stephen Lightfoot, Chair of NHS Sussex and a member of the Brighton & Hove Health & Wellbeing Board, said: “Tackling health inequalities is a shared priority across Sussex health and care services, and a central aim of our Improving Lives Together strategy. 

2Working in partnership with local authorities, NHS and community organisations, we are focused on delivering fair, inclusive, and safe services that meet the needs of our diverse communities. 

"The Health Counts 2024 survey provides critical local insight that will shape how we plan, prioritise and deliver services, ensuring we tackle the root causes of health inequality and support better outcomes for all.”