Hertfordshire and West Essex Integrated Care Strategy

Strategic priority 3: support our residents to maintain healthy lifestyles

We will support people to be physically active, eat healthily, maintain a healthy weight and provide support and advice to prevent tobacco, alcohol and substance misuse.

Where we are now

Good nutrition, healthy weight and regular physical activity are essential for physical and emotional health. Poor diet and nutrition are key contributors to health problems, including tooth decay, excess weight, and frailty, as well as a number of diseases including type 2 diabetes, heart disease and stroke, and cancers.

Physical inactivity is a leading cause of premature mortality. People who have a physically active lifestyle have a 20 to 35% lower risk of cardiovascular disease, coronary heart disease and stroke compared to those who have a sedentary lifestyle. Regular physical activity is also associated with a reduced risk of diabetes, obesity, osteoporosis, and colon/breast cancer and with improved mental health. In older adults’ physical activity is associated with increased cognitive and functional capacity.

Health behaviours including tobacco, alcohol and substance use account for 30% of the influence on health and wellbeing. Smoking and alcohol use are two of the six common risk factors for premature death, and the main causes of ill health such as cancer, heart disease and respiratory disease. Substance misuse is a significant factor in crime including homicide and domestic and intimate partner violence. Around 7% of the population of Great Britain (adults and children) were found to be negatively affected by someone else’s gambling. Almost half (48%) of people who were affected by a spouse or partner’s gambling reported a severe negative impact.

In Hertfordshire and west Essex:

  • Areas with higher levels of deprivation (including Harlow, Broxbourne, Watford, and Stevenage) have the highest rates of childhood obesity. Rates of obesity at year 6 in Harlow are much higher than the national average.
  • The number of adults who are overweight was similar to that of England in 2020/21, and still notably high at 62%, with wide variation between districts.
  • Around 1 in 5 adults across our geography are physically inactive, which means around 20% of the adult population are at increased risk of a range of health conditions and diseases which are preventable through increased physical activity.
  • Smoking prevalence in adults is similar or better than the England average for all districts in Hertfordshire and west Essex; however, there is some variation between the areas with the lowest rates (St Albans at 5.4%) and the highest (Harlow at 18.9%).
  • Whilst east and north Hertfordshire, south and west Hertfordshire and west Essex are all better than the national average for smoking rates in early pregnancy and at delivery, in west Hertfordshire 1 in 10 women and in Hertfordshire as a whole 1 in 15 women are smokers at this vital time.
  • The relationship between drug use and mental health problems among young people is a particular concern. Research shows that mental health problems are experienced by the majority (70%) of drug users in community substance misuse treatment. Death by suicide is also common, with a history of drug misuse being recorded in 34% of all suicides in people experiencing mental health problems between 2008 and 2018-9.
  • Whilst alcohol-related mortality is statistically similar to the national average across most districts, there is variation, with more deprived areas experiencing higher rates or alcohol-related mortality (Harlow highest at 38.8 per 100,000 compared to 27.1 in North Hertfordshire).
  • The rates of admissions for alcohol specific conditions, by district, are all better than England average, yet vary across Hertfordshire and west Essex from 291 per 100,000 in Broxbourne to 522 in Harlow.
  • Poor mental health is a stronger predictor of at-risk gambling than both poor physical health and negative health behaviours, with the notable exception of alcohol.


Outcomes we want to achieve

We want people to be able to say:

  • I can take care of my own health and wellbeing
  • I know how to live a healthy life
  • I feel supported by my community and local services to stay healthy
  • I live in a smoke-free home, and I do not smoke during pregnancy
  • I am physically active
  • I am and my household is free of addiction


What will change

We will:

  • Develop a new physical activity offer for our residents which:
    • Increases opportunities for physical activity for children, young people and adults in parks, schools, and community centres
    • Explores opportunities to give people on low incomes affordable access to exercise classes and leisure centres
    • Provides information to adults about how to integrate more physical activity into their daily lives and increases provision of support, advice, and services, including those who are housebound and frail, to help improve strength and mobility.
  • Offer all people admitted to hospital who smoke access to NHS-funded tobacco treatment services and adapt the NHS-funded tobacco treatment service model for expectant mothers, and their partners, with a new smoke-free pregnancy pathway including focused sessions and treatments. A new universal smoking cessation offer will be made available as part of specialist mental health services for long-term users of specialist mental health, and in learning disability services.
  • Improve pathways and outcomes for people who have a mental health issue and experience drug and alcohol problems and ensure an integrated new universal smoking cessation offer is also available as part of specialist mental health services for long-term users of specialist mental health, and services for people with learning disabilities and autism.
  • Support hospitals with the highest rate of alcohol dependence-related admissions to establish hospital/community-based alcohol care teams to support people living with alcohol dependency and who have significant physical complications and or those with repeated hospital admissions.
  • Support our residents in low-income households to have access to affordable healthy food and facilities to store and cook it.
  • Support our residents most at risk of poor outcomes from being overweight including those with mental health conditions, physical disability or learning disability and autism.
  • Support children and young people to have access to information, advice, and support to maintain a healthy weight and access to leisure activities in their communities. Including access to effective local weight management services, specialist treatment and surgery for those that need it.
  • Ensure people have access to education, information and advice on how to reduce harm from tobacco, gambling, alcohol and other substances and promote awareness of the risks and harm from tobacco, alcohol, gambling and other substances. Those most at risk will have access to targeted support, advice and treatment.