Although a formal committee of Brighton & Hove City Council, the Health & Wellbeing Board has a remit which includes matters relating to NHS Sussex, the Local Safeguarding Board for Children and Adults and Healthwatch.
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Title:
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Health Counts: Publication, Health and Wellbeing Board partnership event and next steps
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Date of Meeting:
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22 July 2025 |
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Report of:
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Caroline Vass, Director of Public Health |
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Contact:
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Kate Gilchrist, Head of Public Health Intelligence and Research or Louise Knight, Senior Public Health Intelligence and Research Specialist
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Email:
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Kate.gilchrist@brighton-hove.gov.uk or Louise.knight@brighton-hove.gov.uk |
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Wards Affected:
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All |
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FOR GENERAL RELEASE
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Executive Summary
The Health Counts survey is a large health and wellbeing survey of over 16,700 adults in the city. It provides give some of the best evidence on the population of the city, their health and wellbeing, and the stark inequalities across the city.
This paper sets out some of the findings from the first publications of results, the themes from the Health and Wellbeing Board partnership event in June 2025 focused on what we might do differently as a system to tackle the inequalities evidenced in Health Counts.
It then sets out the next steps for using Health Counts evidence in the city to tackle inequalities.
The Board are asked to note the report and support the next steps and partnership approach to these.
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Glossary of Terms TNBI - Trans, non-binary or intersex LGBQ+ - Lesbian, gay, bisexual, asexual, queer or other term to describe sexual orientation but are not heterosexual ICT – Integrated Community Team |
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1. Decisions, recommendations and any options
1.1 That the Board note the publication of the Health Counts summary and full report, the update from the Health Counts Health and Wellbeing Board partnership event and
1.2 That the Board support the next steps.
2. Relevant information
The Health Counts survey
2.1 Health and lifestyle surveys are vital in helping us understand the health and wellbeing of the population of our city and the inequalities that our residents experience. By gathering robust data that can be broken down by different areas in the city and by population groups, we can identify key trends, and highlight emerging public health issues, while also revealing the extent of inequalities in health and wellbeing across different communities.
2.2 The Public Health team has commissioned Health Counts surveys in Brighton & Hove approximately once every decade since 1992 (1992, 2003, 2012 and 2024). The 2024 survey includes new questions, reflecting important Public Health issues in the city, covering gambling-related harm, suicidal thoughts and attempts, harassment and hate crime, alongside access to nature and the natural environment, for the first time.
2.3 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.
2.4 The latest survey was the largest health and wellbeing survey we have undertaken in the city, with a weighted sample of 16,729 people - 7% of the resident population aged 18 or over. The research was led by the University of Brighton, in collaboration with the Public Health Intelligence team, Brighton & Sussex Medical School, NHS Sussex, Healthwatch and Brighton & Hove Federation. This was funded by Public Health.
2.5 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 of the city, or for particular communities. Some of the findings are not an easy read, covering sensitive areas, and evidencing health inequities affecting our communities, while recognising their strengths and resilience.
2.6 Emerging findings were presented to the Health and Wellbeing Board in November 2024.
Published results
2.7 A summary and fuller report were published in June 2025. These provide breakdowns by communities of place and identity.
2.8 In terms of trends, there has been a worsening trend for general health; happiness and anxiety, pain, drugs use, community cohesion (belonging, social contact and support) and community safety. There has been an improving trend in smoking. Not all areas have trend data.
2.9 Comparing to other surveys, some with Brighton & Hove data, some only national, there are worse rates for general health, happiness and anxiety, self-harm and suicidal thoughts, vaping, drugs use, healthy weight, visiting the dentist, feeling safe at night, harassment. There are better rates for time spent in nature and taking actions due to the cost of living.
2.10 Some of the findings around inequalities by place (more available within the summary and full report) include:
10.1. 56% of adults in the most deprived 20% of areas in the city are in good or better health compared to 76% in the least deprived areas – and this gap has widened
10.2. 35% of adults in the most deprived 20% of areas in the have a low happiness score compared to 17% in the least deprived areas – and this gap has widened
10.3. 25% of adults in the most deprived 20% of areas in the city smoke compared to 9% in the least deprived areas – though this gap has narrowed
10.4. 65% of adults in the most deprived 20% of areas in the city do less than 30 minutes of sport/fitness activity a week compared to 48% in the least deprived areas
10.5. 27% of adults in the most deprived 20% of areas in the city are worried about their housing conditions compared to 10% in the least deprived areas
10.6. 45% of adults in the most deprived 20% of areas in the city feel they belong compared to 64% in the least deprived areas.
2.11 As well as health and wellbeing, Health Counts gives us important evidence on population groups in the city. Providing better estimates for our TNBI and LGBQ+ adults and information on communities we haven’t had evidence for before (eg neurodivergent adults and adults with experience of the care system as a child or young person) and on the inequalities faced by communities of identity.
2.12 With such a large sample, we can also analyse health and wellbeing data by intersectionality to further understand the impacts of intersectional vulnerabilities on health and wellbeing. These insights will be included in future analysis.
The Health Counts Health and Wellbeing Board partnership event
2.13 The University of Brighton hosted a Health and Wellbeing Board partnership event on the 18th June 2025, to facilitate multi-organisation conversations about what we might do differently as a system to tackle the inequalities evidenced in Health Counts. The event was funded by the University of Brighton and NHS England (South East School of Public Health Workforce, Training & Education).
2.14 For the question “what might we do differently as a system to tackle these inequalities?” the themes are:
vReframe system culture and leadership
vStrengthen collaboration and resource alignment & transform the way we fund services
vUse data as a tool for action and insight
vMake prevention foundational
vEmpower communities and local assets
vFocus on building blocks of health and connectedness
vRefocus on equity and representation
vImprove communication and narrative
2.15 The impactful ideas from each table were:
vRefresh our health and wellbeing strategy to respond to Health Counts and the safe and well at school survey results. To be co-designed with communities and partners.
vFocus on achieving generational change through better services for children and young people.
vTake time to use data, form a plan and then act together. Proactive and early intervention.
vPut in place a framework/model of collaborative working that is used across the system – based on what has been proven to reduce inequalities.
vAdopt a health equity emergency response approach acting early to prevent inequalities cutting through bureaucracy and focusing system efforts on what matters most to communities, guided by the knowledge of those working closest to them.
vShifting to a social determinants approach to engaging disadvantaged communities/groups to seek health outcome benefits and improved access to timely treatment and prevention.
vTo re-commission services based on need and only related to key population outcomes for no less than five years, that is able to adapt/flex.
vPrioritise, shift and redirect resources from expensive services such as acute trusts towards community services especially those who are most disadvantaged.
Next steps
2.16 Statutory partners have both legal and strategic drivers to tackle local health inequalities. Health Counts data provides an important benchmark against which we can measure progress.
2.17 The Health and Wellbeing Board has a Shared Delivery Plan priority for 2025/26 to act on the results of the Health Counts survey.
2.18 Health Counts data will be used to inform the Local Authority’s Corporate Plan objectives for Living and Ageing Well and support the Sussex Integrated Care Strategy.
2.19 Health Counts data will be used to inform planning for the Joint Strategic Needs Assessment (a statutory duty of the Health and Wellbeing Board) and the delivery and refresh of the Joint Health and Wellbeing Strategy.
2.20 Health Counts data has been used to refresh our local Integrated Community Team (ICT) profiles. Data has been mapped to our three ICT neighbourhood partnership boundaries.
2.21 Each of our ICT leadership groups is using the data to inform their localised ICT plans to ensure ICTs reflect and respond to the needs of their local communities.
2.22 The launch of the first report is the first step in presenting what the Health Counts survey tells us about our residents. There will be further profiles by area and by community of identity as well as a unique opportunity to provide robust evidence on intersectionality.
2.23 The Public Health team, in partnership with the University of Sussex, undertake biennial surveys of school pupils, called the Safe and Well at School Survey. The next survey is scheduled to take place in autumn 2025. It is proposed to use the data to inform a children and young people focussed Health and Wellbeing Board partnership event in 2026, similar to the Health Counts event in June 2025.
3. Important considerations and implications
Legal:
3.1 Health and lifestyle surveys assist in understanding the health and wellbeing of the population of our city, including any inequalities that our residents experience. This can inform the execution of public sector equalities duty and the approach to the delivery of duties in respect of health and wellbeing across different public agencies.
Lawyer consulted: Natasha Watson Date: 11/07/25
Finance:
3.2 Although there are no immediate direct financial implications arising from this report any proposals emerging from the Health Counts survey, will need to be considered as part of a costed implementation plan.
Finance Officer consulted: Steve Williams Date: 09/07/25
Equalities:
3.3 The Health Counts survey provides a rich picture of the health and wellbeing of groups with protected characteristics. The survey is a key evidence source to inform action to improve outcomes in all groups and meet the public sector equality duty (including Equality Impact Assessments).
Sustainability:
3.4 No implications.
Health, social care, children’s services and public health:
3.5 Covered within the paper
Supporting documents and information
Appendix1: Health Counts 2024 Summary and full report available at Health Counts