3. Baseline evidence
Data sources
For the purpose of this assessment, data and information has been gathered and compared to the determinants of health characteristics for all East Sussex Census Output Areas alongside England and the UK and as a whole. East Sussex County Council’s East Sussex in Figures (ESiF) website provides a basis for the data explored in this section, profiled by borough areas. Further, the most up to date information has been accumulated from the State of the County (2023) report), in combination with the Joint Strategic Needs Assessment.
Vulnerable population groups
As set out in Chapter 2: Scoping and Methodology, the following vulnerable groups within the population have been identified:
- Rural communities
- Coastal communities
- Women (with a focus on pregnant women) and girls
- Children and young people
- Older people
- Disabled people
- Unemployed or low-income groups
The following Chapter will take into consideration the needs of these groups and highlight the role of transport can play in facilitating and supporting a more socially equitable and inclusive future in which health inequalities are minimised.
Population demographics
Population size
Based on Office for National Statistics (ONS) 2021 Census, the population in East Sussex is approximately 546,000. There has been population increases in every district, with the overall population increasing by 3.6% since 2011 (East Sussex in Figures - population by age and sex 2001-2021- districts). According to Figure 3.4, within East Sussex itself, Wealden is the most populated district with 160,000 residents, while Hastings has the smallest population of 91,000.
Population projections to the year 2035 reflect the number of extra dwellings being planned for the future by local authorities. By 2029, population is projected to reach 601,006 and by 2035, this is further expected to increase up to 628,000. This population increase represents 12% against the 2020 figure (and 15% against the 2021 Census). Wealden is expected to see a population increase at 22% with an additional 43,600 people, while Eastbourne is expected to experience the smallest increase at 4% with an additional 4,100 people. Hastings is expected to see a 5.4% increase with 5,000 more residents, Lewes with 11,200 more residents (11% increase) and Rother is expected to have 12,100 more residents (12.5% increase). In terms of gender split, East Sussex has a slightly higher female to male ratio, with 283,700 females (51.9%) and 262,147 males (48.1%).
This population growth will drive demand for new housing and additional employment opportunities, educational facilities, and health services. Existing transport is likely to require upgrading to accommodate the additional demand, with appropriate future-proofing options explored to ensure connectivity between new and existing housing, employment, education, and healthcare sites.
Only 29% of women nationally say they achieve the recommended levels of at least 30 minutes of moderate activity five times a week, compared with 39% of men nationally ( Department for Transport). In East Sussex 20% of people did less than 30 minutes of physical activity per week (State of the County: Focus on East Sussex (2023)). Physical inactivity has wider implications in terms of costs to the NHS and reducing economic productivity. Transport can have a role in addressing the barriers preventing both men and women from achieving this recommendation.
Race and Ethnicity
People from ethnic minorities are a population-sub-group reported to be particularly at risk of transport poverty (NatCen Social Research for Department for Transport). Transport poverty refers to households and individuals who struggle or are unable to make the journeys that they need. There are several definitions, but they tend to comprise low income, poor availability of public transport and needing a long time to access essential services.
As shown in Figure 3.1, the majority of people in East Sussex (96%) were of white origin according to the 2011 census – 10% more than the figure for England and Wales. A higher percentage of pupils (15%) are from ethnic minority backgrounds, compared to the adult population. Overall, Eastbourne has the highest percentage of students from ethnic minority backgrounds for both primary (31%) and secondary (22%) schools.
The LTP should seek to develop a transport network which is both financially and physically accessible to all people, and one which has sufficient connectivity that takes people to where they need and want to go.
| Area | White | Black or Black British | Asian or Asian British | Other Ethnic Group | Mixed | All |
|---|---|---|---|---|---|---|
| England and Wales | 48,209,395 | 1,864,890 | 4,213,531 | 563,696 | 1,224,400 | 56,075,912 |
| East Sussex | 505,422 | 2,912 | 9,143 | 1,721 | 7,473 | 526,671 |
| Eastbourne | 93,508 | 783 | 2,795 | 535 | 1,791 | 99,412 |
| Hastings | 84,631 | 1,065 | 2,126 | 484 | 1,948 | 90,254 |
| Lewes | 94,159 | 416 | 1,400 | 252 | 1,275 | 97,502 |
| Rother | 87,951 | 305 | 1,103 | 198 | 1,031 | 90,588 |
| Wealden | 145,173 | 343 | 1,719 | 252 | 1,428 | 148,915 |
Age
Age is an interconnected factor with health determinants. As a result of LTP4, those most vulnerable are likely to be disproportionately impacted. Hence, appropriate analysis of age distribution and demographics in East Sussex is essential to understanding the health impacts on different groups.
Individuals over the age of 65 account for approximately 26% of the population of East Sussex, while over 85s account for 3.8%, both disproportionately larger than the average seen in England (18.4% and 2.4% respectively) ( East Sussex in Figures, population and households profile for East Sussex). Figure 3.3 highlights an ageing population as the proportion of 65s has increased since 2001, which is in line with the rest of the South East (+3%) and England (+2.5%) (East Sussex in Figures, population by age and sex 2001-2021 - districts). Since 2011, there has also been a 5% decrease in those aged between 15 and 44. Eastbourne is the only district with an increase in people aged between 25 and 44, with other districts attributing their decline to an aging population, shifting individuals into older age brackets.
| Age | Eastbourne | Hastings | Lewes | Rother | Wealden |
|---|---|---|---|---|---|
| Under 15 | 6% | -9% | -4% | -6% | -2% |
| 15-24 | 8% | -1% | 5% | 11% | 17% |
| 25-44 | 4% | -2% | -8% | -8% | -7% |
| 45-64 | 32% | 25% | 17% | 15% | 21% |
| Over 65 | 13% | 20% | 27% | 24% | 43% |
The over 65s now represent a quarter of the county’s population and are projected to make up nearly a third of all people by 2034. All elderly age groups are expected to increase in size, with the number of very elderly people aged 85 and over expected to increase by 76%, from around 22,200 in 2020 to 39,100 in 2035. This is particularly pronounced in Rother, as older people (aged 65+) are expected to make up 40% of the population in 2034 (up from 32% in 2019) (Joint Strategic Needs Assessment Population Projections in East Sussex).
As people age, they become more prone to developing complex health conditions such as dementia and type 2 diabetes. Conditions such as this can have a significant impact on people’s ability to move around and can increase the risk of falls. This in turn can lead to people living more reclusive lifestyles.
The LTP4 should also ensure that new development is inclusive and accessible to all users, with careful consideration given to the design of public space. Seating, as well as shade and shelter from the elements should be incorporated into these designs so that older people have places to sit, rest and socialise.
Improving access to public transport should also be an important part of LTP4, particularly in rural and coastal areas which may experience disproportionately negative impacts of a limited service, and where aging is occurring at the greatest pace. This will provide older people with better opportunities to access key services and reduce social isolation.
Population distribution
The distribution of people across East Sussex is presented in Figure 3.4 which highlights the rural nature of the region with population densities below 210 people per km2 in the majority of inland areas. Contrastingly, the most densely populated towns are located on the coast: Eastbourne, Hastings, Bexhill-on-Sea, Seaford and Peacehaven. Over 60% of the population concentrated on the coastal fringe in the three main urban areas of Eastbourne/South Wealden, Bexhill and Hastings, alongside Newhaven, Seaford and Peacehaven (LTP4 Evidence Base).
These towns are where most people live and work. However, there are also several other more densely populated towns located away from the coast, these include Lewes, Crowborough, Uckfield and Hailsham. These towns also play an important role in serving the more rural areas nearby. East Sussex also has a high proportion of over 65s residing in rural areas (27.3%), compared to both the South East (24.3%) and England and Wales (23.6%).
Population distribution
The distribution of people across East Sussex is presented in Figure 3.4 which highlights the rural nature of the region with population densities below 210 people per km2 in the majority of inland areas. Contrastingly, the most densely populated towns are located on the coast: Eastbourne, Hastings, Bexhill-on-Sea, Seaford and Peacehaven. Over 60% of the population concentrated on the coastal fringe in the three main urban areas of Eastbourne/South Wealden, Bexhill and Hastings, alongside Newhaven, Seaford and Peacehaven (LTP4 Evidence Base).
These towns are where most people live and work. However, there are also several other more densely populated towns located away from the coast, these include Lewes, Crowborough, Uckfield and Hailsham. These towns also play an important role in serving the more rural areas nearby. East Sussex also has a high proportion of over 65s residing in rural areas (27.3%), compared to both the South East (24.3%) and England and Wales (23.6%).
Figure 3.4 source: Office for National Statistics
Larger percentages of older people living in rural areas (such as Burwash or Mayfield) is likely to mean that their access to essential services and health care facilities is limited, as they are often located in urban centres. This is a key issue that will need to be addressed through LTP4.
Life expectancy
Life expectancy refers to the number of years an individual is forecasted to live at birth. Figure 3.5 displays life expectancy across England, the South East region and the districts in East Sussex. On average, females in East Sussex have a higher life expectancy of 84.1 years, while males have an average life expectancy of 80.1 years. Wealden has the highest female life expectancy of 85 years, higher than all other districts, East Sussex, the South East region and England averages.
Hastings has the lowest life expectancy for both males (78 years) and females (81.8 years) comparative to the rest of England, East Sussex and the South East (East Sussex in Figures, life expectancy at birth by sex, 1991-2020 - districts. This is likely linked to deprivation levels, as Hastings is the only district which has the highest number in the most deprived decile of the population.
Figure 3.6 shows that most districts in East Sussex have a higher death rate than birth rate. Hastings displays a higher birth rate than death rate in 2011 and 2015. Overall, East Sussex has an infant mortality rate of 2.4 deaths per 1,000 live births (East Sussex in Figures).
The State of the County 2023 Report refers to the gap in life expectancy between the most and least deprived areas of East Sussex, with the biggest causes of death associated with these gaps being circulatory diseases, cancers, and respiratory diseases. On average, people from more deprived areas are dying from these causes at a younger age compared to those living in the least deprived areas. The gap in life expectancy amounts to 4.5 years for women and 6.8 years for men.
There is an opportunity for transport to work towards reducing this life expectancy gap through the provision of an accessible and inclusive transport network. Extending the active travel network to the more deprived areas may encourage proactivity and benefit health and fitness. Improved public transport provision across the county may encourage modal shift away from private vehicles. This may also help reduce the life expectancy gap by improving air quality over time.
| Area | Female | Male |
|---|---|---|
| England | 83.1 | 79.4 |
| South East | 84.1 | 80.6 |
| East Sussex | 84.1 | 80.1 |
| Eastbourne | 83.6 | 78.9 |
| Hastings | 81.8 | 78 |
| Lewes | 84.8 | 80.5 |
| Rother | 84.3 | 80.4 |
| Wealden | 85 | 81.6 |
| Year | East Sussex | Eastbourne | Hastings | Lewes | Rother | Wealden |
|---|---|---|---|---|---|---|
| 2011 | -892 | -124 | 172 | -53 | -560 | -327 |
| 2015 | -1,427 | -224 | 33 | -145 | -730 | -361 |
| 2020 | -2,366 | -420 | -46 | -498 | -708 | -694 |
Source for above figures and tables: East Sussex in Figures
Health determinant 1: Lifestyle
Obesity
Figure 3.7 highlights that obesity is most prevalent among reception in Rother (23.5%), higher than the national average. Obesity is most prevalent in year 6 children in Hastings (38.4%), approximately 1% higher than the national average. According to fingertips data for 2022-2023, 68.3% of adults in Eastbourne are classified as overweight or obese compared to 63.8% in England. However, the prevalence of healthy weight for reception children (78.6%) and year 6 children (64.5%) in East Sussex is greater than the average in England (76.5% and 60.8% respectively).
Obesity can impact an individuals’ mobility, meaning people are more reliant on private car use or public transport to reach goods and services including reaching GPs or hospitals for medical check-ups. This therefore results in more vehicles on the county’s roads, leading to increased emissions. Providing an accessible alternative to private vehicles will aid gradual modal shift to active travel or sustainable transport modes.
The Government’s Transport and Health Resource states that, on average, each journey by public transport requires 6-10 minutes of walking. Whilst the health benefits of journeys solely consisting of active travel are more apparent, the use of public transport can also contribute to achieving recommended levels of physical activity by facilitating small yet routine physical activity.
| Area | Reception: Prevalence of overweight (including obesity) | Year 6: Prevalence of overweight (including obesity) | Adults (18+) classified as overweight or obese |
|---|---|---|---|
| England | 22.3% | 37.8% | 63.8% |
| East Sussex | 20.3% | 34.0% | 62.7% |
| Eastbourne | 19.3% | 32.0% | 68.3% |
| Hastings | 20.6% | 38.4% | 61.5% |
| Lewes | 17.8% | 30.3% | 59.0% |
| Rother | 23.5% | 33.6% | 64.6% |
| Wealden | 18.8% | 30.1% | 63.7% |
Source for above figure and table: Fingertips
Health status
Figure 3.8 shows that health status in East Sussex is generally very good (34.4%) or good (42.7%). ‘Good’ health status in East Sussex is highest in Lewes and Wealden (44% respectively) and ‘very good' health status is highest in Eastbourne (36.4%). Of all districts, Rother has the highest proportion of individuals in ‘very bad’ health and Hastings has the highest proportion of individuals in ‘bad’ health.
Long-term poor health status may result in social isolation and as a consequence increase loneliness and poor mental health. This highlights the necessity of transport connectivity which gives people freedom to travel and facilitates friends and family visiting those who are less able to travel themselves.
| Health status | East Sussex | Eastbourne | Hastings | Lewes | Rother | Wealden |
|---|---|---|---|---|---|---|
| Very good | 34.3 | 36.4 | 34.6 | 33.5 | 30.7 | 35.2 |
| Good | 42.7 | 41.8 | 40.1 | 44.1 | 42.8 | 44.0 |
| Fair | 19 | 17.8 | 19.4 | 17.4 | 23.1 | 18.3 |
| Bad | 3.2 | 3.2 | 5.1 | 4.2 | 0.6 | 1.9 |
| Very bad | 0.8 | 0.7 | 0.8 | 0.8 | 0.9 | 0.7 |
Physical activity and wellbeing
Although the components of mental health are complex, it is a vital part of wellbeing. Mental health can impact physical proactivity, thus a lack of transport connectivity can lead to seclusion and reduced physical activity. The LTP should therefore consider initiatives which encourage people to achieve the recommendation for levels of physical activity. Further, the noise impacts resulting from transport construction and interchange can negatively affect mental health.
Compared to the rest of the South East region, East Sussex has a higher proportion of individuals who do not participate in activity as displayed in Figure 3.9. District specific data set out in Figure 3.10, indicates that Hastings has the highest proportion of inactive adults (27.3%), while Lewes has the highest proportion of active adults (71.9%) followed by Wealden.
| Year | England | South East | East Sussex |
|---|---|---|---|
| Nov 2015-16 | 6.5% | 5.5% | 6.0% |
| Nov 2016-17 | 5.9% | 4.3% | 5.8% |
| Nov 2017-18 | 5.9% | 4.6% | 6.4% |
| Nov 2018-19 | 5.4% | 4.3% | 4.1% |
| Nov 2019-20 | 7.1% | 6.0% | 6.4% |
| Nov 2020-21 | 8.2% | 6.5% | 8.2% |
| Nov 2021-22 | 8.9% | 6.9% | 6.4% |
| Area | Inactive | Fairly inactive | Active |
|---|---|---|---|
| East Sussex | 22.9% | 11.4% | 65.7% |
| Eastbourne | 27.3% | 12.1% | 60.6% |
| Hastings | 19.2% | 8.9% | 71.9% |
| Lewes | 24.7% | 8.8% | 66.6% |
| Rother | 18.7% | 11.6% | 69.7% |
| Wealden | 22.0% | 10.6% | 67.3% |
Sources for above tables and figures: Sports England (no participation in activity) and Sports England (activity levels)
Obesity
Figure 3.7 highlights that obesity is most prevalent among reception in Rother (23.5%), higher than the national average. Obesity is most prevalent in year 6 children in Hastings (38.4%), approximately 1% higher than the national average. According to fingertips data for 2022-2023, 68.3% of adults in Eastbourne are classified as overweight or obese compared to 63.8% in England. However, the prevalence of healthy weight for reception children (78.6%) and year 6 children (64.5%) in East Sussex is greater than the average in England (76.5% and 60.8% respectively).
Obesity can impact an individuals’ mobility, meaning people are more reliant on private car use or public transport to reach goods and services including reaching GPs or hospitals for medical check-ups. This therefore results in more vehicles on the county’s roads, leading to increased emissions. Providing an accessible alternative to private vehicles will aid gradual modal shift to active travel or sustainable transport modes.
The Government’s Transport and Health Resource states that, on average, each journey by public transport requires 6-10 minutes of walking. Whilst the health benefits of journeys solely consisting of active travel are more apparent, the use of public transport can also contribute to achieving recommended levels of physical activity by facilitating small yet routine physical activity.
| Area | Reception: Prevalence of overweight (including obesity) | Year 6: Prevalence of overweight (including obesity) | Adults (18+) classified as overweight or obese |
|---|---|---|---|
| England | 22.3% | 37.8% | 63.8% |
| East Sussex | 20.3% | 34.0% | 62.7% |
| Eastbourne | 19.3% | 32.0% | 68.3% |
| Hastings | 20.6% | 38.4% | 61.5% |
| Lewes | 17.8% | 30.3% | 59.0% |
| Rother | 23.5% | 33.6% | 64.6% |
| Wealden | 18.8% | 30.1% | 63.7% |
Source for above figure and table: Fingertips
Health status
Figure 3.8 shows that health status in East Sussex is generally very good (34.4%) or good (42.7%). ‘Good’ health status in East Sussex is highest in Lewes and Wealden (44% respectively) and ‘very good' health status is highest in Eastbourne (36.4%). Of all districts, Rother has the highest proportion of individuals in ‘very bad’ health and Hastings has the highest proportion of individuals in ‘bad’ health.
Long-term poor health status may result in social isolation and as a consequence increase loneliness and poor mental health. This highlights the necessity of transport connectivity which gives people freedom to travel and facilitates friends and family visiting those who are less able to travel themselves.
| Health status | East Sussex | Eastbourne | Hastings | Lewes | Rother | Wealden |
|---|---|---|---|---|---|---|
| Very good | 34.3 | 36.4 | 34.6 | 33.5 | 30.7 | 35.2 |
| Good | 42.7 | 41.8 | 40.1 | 44.1 | 42.8 | 44.0 |
| Fair | 19 | 17.8 | 19.4 | 17.4 | 23.1 | 18.3 |
| Bad | 3.2 | 3.2 | 5.1 | 4.2 | 0.6 | 1.9 |
| Very bad | 0.8 | 0.7 | 0.8 | 0.8 | 0.9 | 0.7 |
Physical activity and wellbeing
Although the components of mental health are complex, it is a vital part of wellbeing. Mental health can impact physical proactivity, thus a lack of transport connectivity can lead to seclusion and reduced physical activity. The LTP should therefore consider initiatives which encourage people to achieve the recommendation for levels of physical activity. Further, the noise impacts resulting from transport construction and interchange can negatively affect mental health.
Compared to the rest of the South East region, East Sussex has a higher proportion of individuals who do not participate in activity as displayed in Figure 3.9. District specific data set out in Figure 3.10, indicates that Hastings has the highest proportion of inactive adults (27.3%), while Lewes has the highest proportion of active adults (71.9%) followed by Wealden.
| Year | England | South East | East Sussex |
|---|---|---|---|
| Nov 2015-16 | 6.5% | 5.5% | 6.0% |
| Nov 2016-17 | 5.9% | 4.3% | 5.8% |
| Nov 2017-18 | 5.9% | 4.6% | 6.4% |
| Nov 2018-19 | 5.4% | 4.3% | 4.1% |
| Nov 2019-20 | 7.1% | 6.0% | 6.4% |
| Nov 2020-21 | 8.2% | 6.5% | 8.2% |
| Nov 2021-22 | 8.9% | 6.9% | 6.4% |
| Area | Inactive | Fairly inactive | Active |
|---|---|---|---|
| East Sussex | 22.9% | 11.4% | 65.7% |
| Eastbourne | 27.3% | 12.1% | 60.6% |
| Hastings | 19.2% | 8.9% | 71.9% |
| Lewes | 24.7% | 8.8% | 66.6% |
| Rother | 18.7% | 11.6% | 69.7% |
| Wealden | 22.0% | 10.6% | 67.3% |
Sources for above tables and figures: Sports England (no participation in activity) and Sports England (activity levels)
Health determinant 2: Access, accessibility, and community severance
Disability
Health impairments can also include disabilities. Disability refers to people who have physical, sensory, intellectual, or mental health impairment(s). Transport can disproportionately impact individual physical health, which may result in some groups in the population finding it difficult to use certain modes of transport or being excluded from using them entirely. The LTP needs to consider the needs of different users and take steps to accommodate these needs as much as possible in order to provide an inclusive transport network.
Disability and impairment projections set out in Figure 3.11 show that in 2020, the number of people with disabilities in East Sussex were around 97,000, with rates per 100 people highest in Hastings. According to East Sussex County Council forecasts, by 2035 this is expected to reach 122,427. Of these figures, the highest proportion is in Wealden (28% for 2035), indicating a large percentage of disabled individuals residing inland. Compared to 2020, the county is expected to have an increase in people with a disability of 25,800.
The number of Blue Badges issued to disabled people in East Sussex is expected to increase as a result of the county’s aging population and also that hidden disabilities are now eligible. This may require consideration to the increased availability of on-street and off-street parking which is dedicated to Blue Badge holders in the future.
| Area | 2020 | 2025 | 2030 | 2035 |
|---|---|---|---|---|
| East Sussex | 19.2 | 20 | 20.7 | 21.5 |
| Eastbourne | 20.3 | 20.9 | 21.9 | 22.9 |
| Hastings | 21.3 | 21.9 | 22.7 | 23.6 |
| Lewes | 18.4 | 19.2 | 20 | 20.7 |
| Rother | 20.9 | 21.7 | 22.5 | 23.4 |
| Wealden | 17 | 17.8 | 18.4 | 19.1 |
Access to health
Accessibility data in Figure 3.12 shows that the majority of individuals in East Sussex (96.7%) travel by car to access GPs within a 15-minute radius, indicating a lack of appropriate public transport or walking routes. With average cycle times under 20 minutes to GP surgeries there is potential for a higher uptake of cycling here as well. Eastbourne and Hastings have high proportions of individuals cycling to access GPs (96% and 97.3% respectively).
Figure 3.13 shows that hospitals within a distance of 30 minutes are largely accessed by car. The highest proportion using public transport/walking to access hospital comes from individuals in Hastings (84.6%). From Wealden, the average journey time to hospitals by public transport is 58 minutes. This may be the only form of transport for some hospital users, especially patients without access to a car or where walking and cycling journeys are too long. The LTP should look to improve accessibility of health care sites so that locations are accessible to all.
| Area | Walk | Public transport/walk | Cycle | Car |
|---|---|---|---|---|
| East Sussex | 51.3 | 59.4 | 73.4 | 44.6 |
| Eastbourne | 63.5 | 66.2 | 80.0 | 63.4 |
| Hastings | 82 | 96 | 97.3 | 80.8 |
| Lewes | 96.7 | 100 | 100 | 94.5 |
| Rother | 51.3 | 59.4 | 73.4 | 44.6 |
| Wealden | 63.5 | 66.2 | 80 | 63.4 |
Deprivation
The Index of Multiple Deprivation (IMD) is a measure of relative deprivation for small areas (Lower Super Output Areas (LSOAs)) and combines several factors including employment, education, crime, income, barriers to housing and services, living environment and health. These factors are combined and weighted to give an overall score and ranking for each LSOA in England. These rankings demonstrate relative deprivation, as opposed to level of affluence.
Deprivation across England is dispersed, within 61% of local authority districts containing at least one of the country’s most deprived neighbourhoods22. East Sussex experiences the highest levels of deprivation of all the counties in the South East region. Out of 151 upper tier local authorities, East Sussex ranks as 93 for LSOAs among the most deprived 10% in England. The majority of deprived neighbourhoods in East Sussex are coastal areas in Hastings, Eastbourne and Rother. Hastings has the highest number of all five districts within the most deprived 10% (30.2%).
These LSOAs in Hastings, along with 4 LSOAs in Eastbourne and 2 in Rother fall within the most deprived decile nationally. 12 of Eastbourne’s 61 LSOAs are among the most deprived 20% in England, and 18 LSOAs (in Eastbourne rank among the most deprived 30% nationally. Six of Rother’s 58 LSAOs are among the most deprived 20% of LSOAs in England. Lewes reported no residents in the most deprived decile and only 3% in the second with 58% in the top 4 least deprived deciles. Wealden similarly only has 6% of residents in the 4 most deprived deciles and 52% in the top three least deprived. Distribution of deprivation is mapped in Figure 3.14.
Limited travel choices can mean that some people are unable or constrained in their ability to access the places they need and want to go. This exclusion can be made worse when met with high transport costs and lower incomes (a compounding effect known as Transport Poverty). In turn, this can lead to poorer health outcomes. It is important, then, that the transport network is progressive in meeting people’s needs by providing accessible and affordable journeys to all people.
| Area | Walk | Public transport/walk | Cycle | Car |
|---|---|---|---|---|
| East Sussex | 6.7 | 22.5 | 13.7 | 0 |
| Eastbourne | 32.1 | 57.4 | 84.6 | 13.4 |
| Hastings | 40.3 | 96 | 99.1 | 2.3 |
| Lewes | 83.9 | 100 | 100 | 78.4 |
| Rother | 6.7 | 22.5 | 13.7 | 0 |
| Wealden | 32.1 | 57.4 | 84.6 | 13.4 |
Disability
Health impairments can also include disabilities. Disability refers to people who have physical, sensory, intellectual, or mental health impairment(s). Transport can disproportionately impact individual physical health, which may result in some groups in the population finding it difficult to use certain modes of transport or being excluded from using them entirely. The LTP needs to consider the needs of different users and take steps to accommodate these needs as much as possible in order to provide an inclusive transport network.
Disability and impairment projections set out in Figure 3.11 show that in 2020, the number of people with disabilities in East Sussex were around 97,000, with rates per 100 people highest in Hastings. According to East Sussex County Council forecasts, by 2035 this is expected to reach 122,427. Of these figures, the highest proportion is in Wealden (28% for 2035), indicating a large percentage of disabled individuals residing inland. Compared to 2020, the county is expected to have an increase in people with a disability of 25,800.
The number of Blue Badges issued to disabled people in East Sussex is expected to increase as a result of the county’s aging population and also that hidden disabilities are now eligible. This may require consideration to the increased availability of on-street and off-street parking which is dedicated to Blue Badge holders in the future.
| Area | 2020 | 2025 | 2030 | 2035 |
|---|---|---|---|---|
| East Sussex | 19.2 | 20 | 20.7 | 21.5 |
| Eastbourne | 20.3 | 20.9 | 21.9 | 22.9 |
| Hastings | 21.3 | 21.9 | 22.7 | 23.6 |
| Lewes | 18.4 | 19.2 | 20 | 20.7 |
| Rother | 20.9 | 21.7 | 22.5 | 23.4 |
| Wealden | 17 | 17.8 | 18.4 | 19.1 |
Access to health
Accessibility data in Figure 3.12 shows that the majority of individuals in East Sussex (96.7%) travel by car to access GPs within a 15-minute radius, indicating a lack of appropriate public transport or walking routes. With average cycle times under 20 minutes to GP surgeries there is potential for a higher uptake of cycling here as well. Eastbourne and Hastings have high proportions of individuals cycling to access GPs (96% and 97.3% respectively).
Figure 3.13 shows that hospitals within a distance of 30 minutes are largely accessed by car. The highest proportion using public transport/walking to access hospital comes from individuals in Hastings (84.6%). From Wealden, the average journey time to hospitals by public transport is 58 minutes. This may be the only form of transport for some hospital users, especially patients without access to a car or where walking and cycling journeys are too long. The LTP should look to improve accessibility of health care sites so that locations are accessible to all.
| Area | Walk | Public transport/walk | Cycle | Car |
|---|---|---|---|---|
| East Sussex | 51.3 | 59.4 | 73.4 | 44.6 |
| Eastbourne | 63.5 | 66.2 | 80.0 | 63.4 |
| Hastings | 82 | 96 | 97.3 | 80.8 |
| Lewes | 96.7 | 100 | 100 | 94.5 |
| Rother | 51.3 | 59.4 | 73.4 | 44.6 |
| Wealden | 63.5 | 66.2 | 80 | 63.4 |
Deprivation
The Index of Multiple Deprivation (IMD) is a measure of relative deprivation for small areas (Lower Super Output Areas (LSOAs)) and combines several factors including employment, education, crime, income, barriers to housing and services, living environment and health. These factors are combined and weighted to give an overall score and ranking for each LSOA in England. These rankings demonstrate relative deprivation, as opposed to level of affluence.
Deprivation across England is dispersed, within 61% of local authority districts containing at least one of the country’s most deprived neighbourhoods22. East Sussex experiences the highest levels of deprivation of all the counties in the South East region. Out of 151 upper tier local authorities, East Sussex ranks as 93 for LSOAs among the most deprived 10% in England. The majority of deprived neighbourhoods in East Sussex are coastal areas in Hastings, Eastbourne and Rother. Hastings has the highest number of all five districts within the most deprived 10% (30.2%).
These LSOAs in Hastings, along with 4 LSOAs in Eastbourne and 2 in Rother fall within the most deprived decile nationally. 12 of Eastbourne’s 61 LSOAs are among the most deprived 20% in England, and 18 LSOAs (in Eastbourne rank among the most deprived 30% nationally. Six of Rother’s 58 LSAOs are among the most deprived 20% of LSOAs in England. Lewes reported no residents in the most deprived decile and only 3% in the second with 58% in the top 4 least deprived deciles. Wealden similarly only has 6% of residents in the 4 most deprived deciles and 52% in the top three least deprived. Distribution of deprivation is mapped in Figure 3.14.
Limited travel choices can mean that some people are unable or constrained in their ability to access the places they need and want to go. This exclusion can be made worse when met with high transport costs and lower incomes (a compounding effect known as Transport Poverty). In turn, this can lead to poorer health outcomes. It is important, then, that the transport network is progressive in meeting people’s needs by providing accessible and affordable journeys to all people.
| Area | Walk | Public transport/walk | Cycle | Car |
|---|---|---|---|---|
| East Sussex | 6.7 | 22.5 | 13.7 | 0 |
| Eastbourne | 32.1 | 57.4 | 84.6 | 13.4 |
| Hastings | 40.3 | 96 | 99.1 | 2.3 |
| Lewes | 83.9 | 100 | 100 | 78.4 |
| Rother | 6.7 | 22.5 | 13.7 | 0 |
| Wealden | 32.1 | 57.4 | 84.6 | 13.4 |
Health determinant 3: Economic health
Employment and Workforce Breakdown
As evident in Figure 3.15, of the 241,614 people in employment in East Sussex, the majority drive a car or van to work (49%) or mainly work at or from home (31%), while 8% travel to work on foot (East Sussex in Figures).
Travel to work data highlights there is scope to improve the level of physical activity within East Sussex. Improvements to the public transport network, whether this be expanding connectivity, increasing service frequency or reducing the cost of ticket fares, may encourage workers who currently drive to work in a car or van to use a public transport alternative – and all public transport journeys start and end with a walking or wheeling trip.
| Method of travel | Number of people | Percentage |
|---|---|---|
| Driving a car of a van | 117,929 | 49 |
| Work mainly at or from home | 75,130 | 31 |
| On foot | 19,919 | 8 |
| Passenger in a car or van | 9,125 | 4 |
| Bus, minibus or coach | 5,742 | 2 |
| Train | 5,418 | 2 |
| Cycle | 3,061 | 1 |
| Other | 2,514 | 1 |
| Taxi | 1,450 | 1 |
| Motorcycle, scooter or moped | 1,213 | 1 |
Education
Education refers to the acquisition and distribution of knowledge. Transport plays a significant role in accessing educational institutions, facilities and opportunities. A well-educated, skilled workforce encourages growth of a local economy. Restrictions in accessing education can directly affect economic prosperity but also indirectly impact health outcomes.
Figure 3.16 shows that Hastings has the highest level of individuals with no qualifications (20.2%), while Lewes has the highest level of individuals with a Level 4 qualification and above (34.8%). Compared to the rest of the South East, East Sussex has a higher proportion of individuals with no qualifications (15.4% and 17.3% respectively).
| Area | No qualifications | Highest level of qualification Level 4 and above |
|---|---|---|
| East Sussex | 17.3% | 31.3% |
| Eastbourne | 18.4% | 29.8% |
| Hastings | 20.15% | 28.6% |
| Lewes | 16.1% | 34.8% |
| Rother | 18.9% | 29.9% |
| Wealden | 14.9% | 32.6% |
Employment and Workforce Breakdown
As evident in Figure 3.15, of the 241,614 people in employment in East Sussex, the majority drive a car or van to work (49%) or mainly work at or from home (31%), while 8% travel to work on foot (East Sussex in Figures).
Travel to work data highlights there is scope to improve the level of physical activity within East Sussex. Improvements to the public transport network, whether this be expanding connectivity, increasing service frequency or reducing the cost of ticket fares, may encourage workers who currently drive to work in a car or van to use a public transport alternative – and all public transport journeys start and end with a walking or wheeling trip.
| Method of travel | Number of people | Percentage |
|---|---|---|
| Driving a car of a van | 117,929 | 49 |
| Work mainly at or from home | 75,130 | 31 |
| On foot | 19,919 | 8 |
| Passenger in a car or van | 9,125 | 4 |
| Bus, minibus or coach | 5,742 | 2 |
| Train | 5,418 | 2 |
| Cycle | 3,061 | 1 |
| Other | 2,514 | 1 |
| Taxi | 1,450 | 1 |
| Motorcycle, scooter or moped | 1,213 | 1 |
Education
Education refers to the acquisition and distribution of knowledge. Transport plays a significant role in accessing educational institutions, facilities and opportunities. A well-educated, skilled workforce encourages growth of a local economy. Restrictions in accessing education can directly affect economic prosperity but also indirectly impact health outcomes.
Figure 3.16 shows that Hastings has the highest level of individuals with no qualifications (20.2%), while Lewes has the highest level of individuals with a Level 4 qualification and above (34.8%). Compared to the rest of the South East, East Sussex has a higher proportion of individuals with no qualifications (15.4% and 17.3% respectively).
| Area | No qualifications | Highest level of qualification Level 4 and above |
|---|---|---|
| East Sussex | 17.3% | 31.3% |
| Eastbourne | 18.4% | 29.8% |
| Hastings | 20.15% | 28.6% |
| Lewes | 16.1% | 34.8% |
| Rother | 18.9% | 29.9% |
| Wealden | 14.9% | 32.6% |
Health determinant 4: Safety
Road collisions and safety
Road traffic collisions typically involve vehicles and other road users, often resulting in injury. In the context of health, collisions are an immediate risk to the safety of individuals.
Figure 3.17 shows that the number of fatal collisions was lowest in 2019, while the lowest number of slight and serious collisions was in 2020. However, in 2020 the number of fatal collisions increased from 2019. According to information provided by the East Sussex Road Safety Team, collisions were evenly split between urban and rural areas, with cluster locations being those where a collision involves a car.
Focusing on the rate of people killed or seriously injured (KSIs), the average rate in East Sussex has been greater than the average for England (State of the County Report 2023). Based on the latest three year reporting period unaffected by restrictions or lockdown due to COVID-19 (2017-2019), this was 68.1 per 100,000 population for East Sussex compared to 43.2 per 100,000 in England.
Improving road safety through implementation of measures such as reduced speed limits where appropriate, provision of new and improved pedestrian and cycle crossing points, and restrictions to through (motor) traffic will be considered . Providing high quality walking and cycling networks protected from motor traffic, where these are deliverable, will also create safe and convenient options for people to move around the county using active travel.
| Severity | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | Total |
|---|---|---|---|---|---|---|---|
| Fatal | 21 | 23 | 22 | 21 | 14 | 17 | 118 |
| Serious | 291 | 313 | 299 | 303 | 351 | 245 | 1,802 |
| Slight | 1,156 | 1,038 | 1,002 | 936 | 958 | 728 | 5,818 |
| Total | 1,468 | 1,374 | 1,323 | 1,260 | 1,323 | 990 | 7,738 |
Road condition
The quality of road surfaces can influence the extent to which accidents occur, but also the extent to which individuals choose to engage in physical activity (Transport and Health Resource). Road maintenance of the Strategic Road Network (SRN) in East Sussex is managed by National Highways and the remainder of the local and major roads in the county are maintained by the County Council as the local highway authority.
As shown in Figure 3.18, generally the percentage of roads where maintenance should be considered has decreased, suggesting that road maintenance programmes are working. However, variation by road type indicates that unclassified roads were the least maintained as of 2019-20,. The County Council has increased the capital programme budget for road repairs from £15m to £18.1m per annum to maintain the Council’s 10-year road condition targets of 4%, 4% and 14% (for Principal, Non-Principal and Unclassified Roads) in need of repair.
As described in Figure 3.10, 22.9% of the East Sussex population are inactive, indicating scope for improvement in the quality and condition of the public realm and urban environment such as footways and cycle paths, to encourage an increase in levels of physical activity.
| Year | Principal roads | Non-principal roads | Unclassified roads |
|---|---|---|---|
| 2007 | 14% | 15% | 12% |
| 2008 | 13% | 13% | 9% |
| 2009 | 10% | 10% | 11% |
| 2010 | 10% | 10% | 15% |
| 2011 | 10% | 13% | 19% |
| 2012 | 8% | 10% | 19% |
| 2013 | 7% | 9% | 25% |
| 2014 | 5% | 9% | 22% |
| 2015 | 5% | 6% | 22% |
| 2016 | 5% | 6% | 19% |
| 2017 | 4% | 7% | 14% |
| 2018 | 5% | 7% | 9% |
| 2019 | 5% | 5% | 14% |
Road collisions and safety
Road traffic collisions typically involve vehicles and other road users, often resulting in injury. In the context of health, collisions are an immediate risk to the safety of individuals.
Figure 3.17 shows that the number of fatal collisions was lowest in 2019, while the lowest number of slight and serious collisions was in 2020. However, in 2020 the number of fatal collisions increased from 2019. According to information provided by the East Sussex Road Safety Team, collisions were evenly split between urban and rural areas, with cluster locations being those where a collision involves a car.
Focusing on the rate of people killed or seriously injured (KSIs), the average rate in East Sussex has been greater than the average for England (State of the County Report 2023). Based on the latest three year reporting period unaffected by restrictions or lockdown due to COVID-19 (2017-2019), this was 68.1 per 100,000 population for East Sussex compared to 43.2 per 100,000 in England.
Improving road safety through implementation of measures such as reduced speed limits where appropriate, provision of new and improved pedestrian and cycle crossing points, and restrictions to through (motor) traffic will be considered . Providing high quality walking and cycling networks protected from motor traffic, where these are deliverable, will also create safe and convenient options for people to move around the county using active travel.
| Severity | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | Total |
|---|---|---|---|---|---|---|---|
| Fatal | 21 | 23 | 22 | 21 | 14 | 17 | 118 |
| Serious | 291 | 313 | 299 | 303 | 351 | 245 | 1,802 |
| Slight | 1,156 | 1,038 | 1,002 | 936 | 958 | 728 | 5,818 |
| Total | 1,468 | 1,374 | 1,323 | 1,260 | 1,323 | 990 | 7,738 |
Road condition
The quality of road surfaces can influence the extent to which accidents occur, but also the extent to which individuals choose to engage in physical activity (Transport and Health Resource). Road maintenance of the Strategic Road Network (SRN) in East Sussex is managed by National Highways and the remainder of the local and major roads in the county are maintained by the County Council as the local highway authority.
As shown in Figure 3.18, generally the percentage of roads where maintenance should be considered has decreased, suggesting that road maintenance programmes are working. However, variation by road type indicates that unclassified roads were the least maintained as of 2019-20,. The County Council has increased the capital programme budget for road repairs from £15m to £18.1m per annum to maintain the Council’s 10-year road condition targets of 4%, 4% and 14% (for Principal, Non-Principal and Unclassified Roads) in need of repair.
As described in Figure 3.10, 22.9% of the East Sussex population are inactive, indicating scope for improvement in the quality and condition of the public realm and urban environment such as footways and cycle paths, to encourage an increase in levels of physical activity.
| Year | Principal roads | Non-principal roads | Unclassified roads |
|---|---|---|---|
| 2007 | 14% | 15% | 12% |
| 2008 | 13% | 13% | 9% |
| 2009 | 10% | 10% | 11% |
| 2010 | 10% | 10% | 15% |
| 2011 | 10% | 13% | 19% |
| 2012 | 8% | 10% | 19% |
| 2013 | 7% | 9% | 25% |
| 2014 | 5% | 9% | 22% |
| 2015 | 5% | 6% | 22% |
| 2016 | 5% | 6% | 19% |
| 2017 | 4% | 7% | 14% |
| 2018 | 5% | 7% | 9% |
| 2019 | 5% | 5% | 14% |
Health determinant 5: Crime
Barriers to using public transport and engaging in active travel include a fear of crime and the implications for personal safety.
Figure 3.19 highlights that the majority of residents in East Sussex feel fairly safe outside in their local area after dark. Lewes has the highest percentage of residents feeling fairly unsafe (17.8%) or very unsafe (10.4%). Nationally, women feel less safe than men in all settings after dark, according to ONS survey analysis. Compared with data from the previous year, more people had stopped walking in quiet places such as “parks or open spaces” after dark in the last month because of feeling unsafe; an increase in both men (from 18% to 24%) and women (from 32% to 37%).
As presented in Figure 3.20, crime is prominent in East Sussex boroughs and may be a contributing factor in threatening individual perception of safety. Public order offences are highest in Hastings (10 per 1000 population), compared to the national average of 7.4. According to data provided by the Adult Social Care and Health Department in the State of the County 2023 Report, across 2022-2023, there was a 13.2% increase in public place serious violent crimes. Knife crime also increased by 11.5% compared to the previous year (state of the County 2023).
This could be improved through measures such as improved street lighting and wayfinding to provide people with attractive and busier routes through urban areas. This is particularly important in areas such as Eastbourne and Hastings, where public order offences are highest, and residents are most concerned.
| Area | Very safe | Fairly safe | Neither safe nor unsafe | Fairly unsafe | Very unsafe |
|---|---|---|---|---|---|
| East Sussex | 27 | 44 | 16.7 | 8.4 | 3.9 |
| Eastbourne | 20.7 | 43.8 | 17.8 | 11.7 | 5.9 |
| Hastings | 13.5 | 44.6 | 21 | 13.9 | 7.2 |
| Lewes | 11 | 38.8 | 21.9 | 17.8 | 10.4 |
| Rother | 23.3 | 45.7 | 14.9 | 11.3 | 4.8 |
| Wealden | 24.4 | 45.4 | 15.8 | 9.8 | 4.6 |
| Type of crime | England | East Sussex | Eastbourne | Hastings | Lewes | Rother | Wealden |
|---|---|---|---|---|---|---|---|
| Theft offences | 20.3 | 13.7 | 18.1 | 20.8 | 10.8 | 13 | 9.1 |
| Violence against the person | 28 | 23.3 | 32.3 | 38.2 | 19.3 | 20.9 | 13.3 |
| Criminal damage and arson | 7.4 | 7.2 | 8.7 | 11.5 | 6.2 | 7 | 4.5 |
| Public order offences | 7.4 | 6.5 | 9.1 | 10 | 5.5 | 5.8 | 4 |
| Sexual offences | 2.3 | 2.3 | 3.1 | 3.4 | 2.1 | 2.2 | 1.3 |
| Miscellaneous crimes against society | 1.7 | 1.4 | 1.5 | 2.2 | 1.6 | 1.4 | 0.9 |
| Possession of weapons offences | 0.7 | 0.8 | 1.1 | 1.4 | 0.6 | 0.6 | 0.5 |
Health determinant 6: Congestion and stress
Since 2011, the population of East Sussex has increased at a rate of 3.6% (East Sussex in Figures, population by age and sex 2001-2021). With this anticipated growth comes an increase in the need for transport in order to meet demand. Expanding transport provision increases the risk of congestion, which can burden both physical and mental health.
Mental health
Mental health condition prevalence varies between 0.8% in Lewes CCG and 1.1% in Hastings, Rother and Eastbourne, CCGs, with the largest number of patients registered in Hastings and Rother CCG31 according to 2013/2014 data.
It is estimated there are approximately 55,600 people in East Sussex with a common mental health disorder; 2700 with a personality disorder and 1700 with probable psychosis. Suicide rates across males and females are also higher than the national rate. Increasing congestion levels may induce high stress levels, leading to increased isolation and vulnerability of certain groups. According to the State of the County 2023 Report, there is a higher percentage of adults in East Sussex with high anxiety (26%) and low life satisfaction (5.4%) compared to the national average (22.3% and 4.4% respectively).
Additionally, the percentage of adults who feel lonely often, always or some of the time is higher in certain East Sussex boroughs, compared to the England average (22.26%) as evident in Figure 3.21.
There is an opportunity for transport to mitigate detrimental effects on mental health. By improving connectivity, reducing journey times and reducing harmful transport emissions, the stress of travel is also minimised which improves the quality of the transport experience. Provision of affordable transport, such as introducing concessionary travel passes, may reduce social exclusion experienced by older people and those who face mobility difficulties. Moreover, a lack of affordable and inclusive travel options may exacerbate generational divides in social connectivity as transport facilitates social interaction and networking amongst all groups (NatCen for Department for Transport).
| Area | Percentage of adults who feel lonely often or always or some of the time |
|---|---|
| England | 22.26% |
| Eastbourne | 15.3% |
| Hastings | 22.4% |
| Lewes | 24.0% |
| Rother | 22.8% |
| Wealden | 15.9% |
Health determinant 7: Air quality
Air quality and health
The movements of most forms of highway-based transport have resultant impacts on air quality, and is based on several factors, including the fuel type, weight and age/condition of the vehicle. A large range of pollutants result from highways-based transport and are produced through both the combustion/burning of fuels, but also the general wear and tear to the vehicle, such as from tyres and braking systems. Pollutants enter the respiratory system and cause widespread health impacts across the majority of the body’s major functions.
The impact of poor air quality disproportionately impacts individuals both as they age, from children to older people, and also those with underlying health conditions, or if they are pregnant.
How air pollution affects people throughout their lifetime
During pregnancy
- Low birth weight
Children
- Asthma
- Slower development of lung function
- Development problems
- More wheezing and coughs
- Start of atherosclerosis
Adults
- Asthma
- Coronary heart disease
- Stroke
- Lung cancer
- Chronic obstructive pulmonary disease (as chronic bronchitis)
- Diabetes
Older adults
- Asthma
- Accelerated decline of lung function
- Lung cancer
- Diabetes
- Dementia
- Heart attack, heart failure and strokes
Generally, air quality in East Sussex is good, however there are town centre locations where the objectives of air quality are not met. In turn, this may adversely impact individuals who are sensitive to poor air quality.
There is a growing body of evidence that links maternal exposure to air pollution and adverse pregnancy outcomes. Air pollution particles have been shown to reach the foetal side of the placenta (Nature Communications) and there is consistent evidence that exposure to air pollution such as particulate matter and ozone (O3) during pregnancy increases the risk of low birth weight and preterm birth (JAMA Network and National Library of Medicine).
Air Quality Management Areas (AQMAs) are areas where local air quality is unlikely to meet national air quality standards. Consequently, the appropriate district or borough council must monitor local air quality to understand the actions that can be taken to improve its condition. East Sussex has two main AQMAs in Lewes including Lewes Town Centre, and A259 Newhaven Ring Road for nitrogen dioxide pollutants. As of 2017, the Hastings Borough Council AQMA for particulate matter was revoked (Department for Environment, Food & Rural Affairs).
The LTP has a role in reducing health inequalities which may disproportionately impact vulnerable communities, such as those in the most deprived 10% nationally, pregnant women or those with pre-existing health conditions. Improving public transport links to health care facilities, employment centres and education facilities across the county so that people can attend medical appointments, workplaces, and education without being reliant on access to a car. This will likely have a positive impact on air quality, with fewer cars on the roads. For further information on how the LTP addresses equality, please refer to the ESCC LTP4 Equality Impact Assessment (EqIA) and the ESCC LTP4 Integrated Impact Assessment (IIA).
Carbon emissions
Figure 3.23 shows that including all sectors, carbon dioxide emissions in Wealden are higher than any other district in East Sussex. While this could be attributed to Wealden having the highest population, the inverse cannot be applied to Hastings which has the smallest population. Over time, carbon emissions have decreased however, as of 2020, East Sussex had carbon emissions of 2,224 kt, 31% of which came from Wealden, 20% from Rother, 19% from Lewes, 16% from Eastbourne and 14% from Hastings.
Appropriate transport mitigations, such as decarbonisation, should be in place to counter the worsening effects of climate change in line with the Government’s Decarbonising Transport – A Better, Greener Britain strategy.
| Area | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 |
|---|---|---|---|---|---|---|
| East Sussex | 2,224 | 2,147 | 2,033 | 1,992 | 1,880 | 1,672 |
| Eastbourne | 360 | 336 | 315 | 309 | 288 | 263 |
| Hastings | 302 | 279 | 265 | 256 | 246 | 225 |
| Lewes | 432 | 416 | 397 | 387 | 369 | 326 |
| Rother | 439 | 441 | 418 | 417 | 384 | 341 |
| Wealden | 691 | 675 | 638 | 624 | 594 | 516 |
Open spaces
East Sussex is home to a vast range of natural environmental assets. These assets provide opportunities to support both mental and physical wellbeing through giving individuals open space for recreational and leisure purposes. Designated areas in East Sussex (East Sussex in Figures - East Sussex Designations) include:
- 87,981 hectares of High Weald Area of Outstanding Natural Beauty (AONB);
- 365 Sites of Nature Conservation Importance (SNCI), accumulating 8,680 hectares of land;
- 1,398 hectares of land designated as Local Nature Reserve;
- 12,936 hectares designated as Sites of Special Scientific Interest (SSSI);
- 24, 365 hectares of South Downs National Park, split across Eastbourne, Lewes and Wealden;
- 315 scheduled ancient monuments;
- 2 registered battlefields;
- 33 registered parks and gardens;
- 6,379 listed buildings;
- 139 registered conservation areas; and
- 4 registered marine heritage sites.
There is scope for improve transport provision, extending cross-borough to key designated areas in order to maximise use of these spaces. Further, promoting open spaces will benefit disadvantaged community groups who are likely to suffer from seclusion or poor air quality by encouraging active travel as a means to enhance both physical and mental health.
Air quality and health
The movements of most forms of highway-based transport have resultant impacts on air quality, and is based on several factors, including the fuel type, weight and age/condition of the vehicle. A large range of pollutants result from highways-based transport and are produced through both the combustion/burning of fuels, but also the general wear and tear to the vehicle, such as from tyres and braking systems. Pollutants enter the respiratory system and cause widespread health impacts across the majority of the body’s major functions.
The impact of poor air quality disproportionately impacts individuals both as they age, from children to older people, and also those with underlying health conditions, or if they are pregnant.
How air pollution affects people throughout their lifetime
During pregnancy
- Low birth weight
Children
- Asthma
- Slower development of lung function
- Development problems
- More wheezing and coughs
- Start of atherosclerosis
Adults
- Asthma
- Coronary heart disease
- Stroke
- Lung cancer
- Chronic obstructive pulmonary disease (as chronic bronchitis)
- Diabetes
Older adults
- Asthma
- Accelerated decline of lung function
- Lung cancer
- Diabetes
- Dementia
- Heart attack, heart failure and strokes
Generally, air quality in East Sussex is good, however there are town centre locations where the objectives of air quality are not met. In turn, this may adversely impact individuals who are sensitive to poor air quality.
There is a growing body of evidence that links maternal exposure to air pollution and adverse pregnancy outcomes. Air pollution particles have been shown to reach the foetal side of the placenta (Nature Communications) and there is consistent evidence that exposure to air pollution such as particulate matter and ozone (O3) during pregnancy increases the risk of low birth weight and preterm birth (JAMA Network and National Library of Medicine).
Air Quality Management Areas (AQMAs) are areas where local air quality is unlikely to meet national air quality standards. Consequently, the appropriate district or borough council must monitor local air quality to understand the actions that can be taken to improve its condition. East Sussex has two main AQMAs in Lewes including Lewes Town Centre, and A259 Newhaven Ring Road for nitrogen dioxide pollutants. As of 2017, the Hastings Borough Council AQMA for particulate matter was revoked (Department for Environment, Food & Rural Affairs).
The LTP has a role in reducing health inequalities which may disproportionately impact vulnerable communities, such as those in the most deprived 10% nationally, pregnant women or those with pre-existing health conditions. Improving public transport links to health care facilities, employment centres and education facilities across the county so that people can attend medical appointments, workplaces, and education without being reliant on access to a car. This will likely have a positive impact on air quality, with fewer cars on the roads. For further information on how the LTP addresses equality, please refer to the ESCC LTP4 Equality Impact Assessment (EqIA) and the ESCC LTP4 Integrated Impact Assessment (IIA).
Carbon emissions
Figure 3.23 shows that including all sectors, carbon dioxide emissions in Wealden are higher than any other district in East Sussex. While this could be attributed to Wealden having the highest population, the inverse cannot be applied to Hastings which has the smallest population. Over time, carbon emissions have decreased however, as of 2020, East Sussex had carbon emissions of 2,224 kt, 31% of which came from Wealden, 20% from Rother, 19% from Lewes, 16% from Eastbourne and 14% from Hastings.
Appropriate transport mitigations, such as decarbonisation, should be in place to counter the worsening effects of climate change in line with the Government’s Decarbonising Transport – A Better, Greener Britain strategy.
| Area | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 |
|---|---|---|---|---|---|---|
| East Sussex | 2,224 | 2,147 | 2,033 | 1,992 | 1,880 | 1,672 |
| Eastbourne | 360 | 336 | 315 | 309 | 288 | 263 |
| Hastings | 302 | 279 | 265 | 256 | 246 | 225 |
| Lewes | 432 | 416 | 397 | 387 | 369 | 326 |
| Rother | 439 | 441 | 418 | 417 | 384 | 341 |
| Wealden | 691 | 675 | 638 | 624 | 594 | 516 |
Open spaces
East Sussex is home to a vast range of natural environmental assets. These assets provide opportunities to support both mental and physical wellbeing through giving individuals open space for recreational and leisure purposes. Designated areas in East Sussex (East Sussex in Figures - East Sussex Designations) include:
- 87,981 hectares of High Weald Area of Outstanding Natural Beauty (AONB);
- 365 Sites of Nature Conservation Importance (SNCI), accumulating 8,680 hectares of land;
- 1,398 hectares of land designated as Local Nature Reserve;
- 12,936 hectares designated as Sites of Special Scientific Interest (SSSI);
- 24, 365 hectares of South Downs National Park, split across Eastbourne, Lewes and Wealden;
- 315 scheduled ancient monuments;
- 2 registered battlefields;
- 33 registered parks and gardens;
- 6,379 listed buildings;
- 139 registered conservation areas; and
- 4 registered marine heritage sites.
There is scope for improve transport provision, extending cross-borough to key designated areas in order to maximise use of these spaces. Further, promoting open spaces will benefit disadvantaged community groups who are likely to suffer from seclusion or poor air quality by encouraging active travel as a means to enhance both physical and mental health.
Health determinant 8: Noise
Exposure to noise can cause disturbance and annoyance to individuals in close proximity. While auditory impacts are the most common drawback of extreme noise levels, children and older age groups especially may be vulnerable to cognitive dysfunction and/or serious mental health implications.
In some urban areas in East Sussex, noise pollution is an issue around major highways. Strategic noise maps produced under the Environmental Noise (England) Regulations 2006, identifies hotspots where the highest 1% of noise levels occurs in residential locations – they are known as Important Areas (Ias). Figure 3.24 shows the extent of Ias compared to major routes such as the M20 between London and Dover. Highways in East Sussex with a particular need to consider the noise from vehicles include the A21, A22, and A27, and A259.
Figure 3.25 illustrates a higher than national average (12 per 1,000) for noise complaints in the borough of Hastings (19.6 per 1,000). The long-term impacts of noise can be more widespread and extensive than causing hearing loss. The Government’s Transport and Health Resource outlines emotional functionality, stress, communication, and sleep disturbance as indirectly affected by health. Transport construction, operation and systems in East Sussex must consider the negative implications of poor noise management, as it is estimated that the annual social cost of urban road noise in England is £7 to £10 billion (Department for Environment, Food & Rural Affairs).
| Area | Rate of noise complaints per 1000 |
|---|---|
| England | 12 |
| Eastbourne | 7.4 |
| Hastings | 19.6 |
| Lewes | 6.3 |
| Rother | 4.7 |
| Wealden | 3.7 |
Evidence base summary
The evidence base provides a comprehensive overview of the demographics and health determinants of across East Sussex. The key issues identified in the evidence base have been summarised, and an assessment provided as to what the potential implications may be on health, and how they link to transport. Consideration has then been provided to establish what the LTP needs to deliver in order to address these issues and improve health outcomes in East Sussex.
Demographics
Pathways and demographics
- East Sussex has a higher proportion of over 65s and over 85s than the national average.
- East Sussex also has a high proportion of over 65s residing in rural areas compared to both the South East and England and Wales.
- Eastbourne is the only town in East Sussex which is experiencing growth of under 15s, though Lewes, Rother, Wealden and Eastbourne are all experiencing a growth in the population of people aged 15-24.
- During engagement with young people, the majority travel to school via active modes.
Implications on health and the links to transport
- Increased likelihood of age-related impairments occurring, which may be exacerbated by the transport network which currently favours driving cars, rather than walking, cycling or using public transport in many areas.
- Increased risk of social isolation, particularly in rural or coastal areas (such as Hastings) where public transport connections are poorest, and deprivation is highest.
- Large percentages of older people living in rural areas (such as Burwash or Mayfield) is likely to mean that their access to essential services and health care facilities is limited, as they are often located in urban centres.
- Physical inactivity has implications in terms of costs to the NHS and reducing economic productivity. Transport plays a key role in addressing the barriers preventing both men and women from undertaking more exercise.
What the LTP needs to deliver to address issues
- Improving access to public transport, particularly in rural and coastal areas which may experience disproportionately negative impacts of a limited service.
- Developing active travel networks so that people can walk, cycle and wheel to key services, reducing social isolation and increasing daily exercise. This is particularly important in areas of deprivation, where people are less likely to have access to a car.
- Population growth will drive demand for new housing and additional employment opportunities, educational facilities, and health services. Existing transport is likely to require upgrading to accommodate the additional demand, with appropriate future-proofing options explored to ensure connectivity between new and existing housing, employment, education and healthcare sites.
- Improving access to green and blue spaces, as well as connections to leisure centres and gyms.
Lifestyle (Health determinant 1)
Pathways and demographics
- East Sussex fairs relatively well with regard to prevalence of obesity compared to the national average. It needs to be acknowledged, however, that England has higher levels of obesity than many major European countries.
- Health status in East Sussex is generally ‘very good’ or ‘good’, though Rother has the highest proportion of people in ‘very bad’ health, and Hastings the highest with ‘bad’ health.
- Compared to the rest of the South East region, East Sussex has a higher proportion of individuals who do not participate in activity, and this is worst within Hastings.
- During Phase 1 of engagement, the theme ‘safety, health and air quality’ was ranked as the most important in ESCC with 79% of respondents selecting it as an important theme for the forthcoming LTP.
- During the public consultation, improved active travel infrastructure was a recurring suggestion across all of the themes in the ESCC LTP.
Implications on health and the links to transport
- Increased risk of obesity related illness and impairments occurring across the population, particularly in Rother and Hastings, who currently suffer from worse health status’ than other towns within the county.
- Obesity can sometimes affect mobility, meaning people are more reliant on (or inclined to use) private cars to reach goods and services, including reaching GPs or hospitals for medical check-ups. This can consequently result in more vehicles on the county’s roads, leading to increased emissions.
- Long-term poor health status may result in social isolation and as a consequence increase loneliness and poor mental health.
What the LTP needs to deliver to address issues
- Developing active travel networks so that people build in incidental daily exercise into their daily routes, making it attractive and convenient to walk, cycle and wheel. This was a recurring suggestion throughout public engagement and consultation.
- Improving air quality within East Sussex, primarily in urban areas, to reduce the harmful impacts of pollutants on the health of residents
Access, accessibility, and community severance (Health determinant 2)
Pathways and demographics
- Disability and impairment projections for East Sussex show that the county is expected to have an increase in people with a disability going forwards.
- The vast majority of people travel to health care facilities by car, which may indicate a lack of convenient and attractive public transport and active travel connections, or health care facilities located in inaccessible locations.
- East Sussex is among the most deprived 10% of authorities within England, and areas of Hastings, Eastbourne and Rother fall within the most deprived decile nationally.
- During the phase 1 engagement, the theme ‘accessibility, equity and social inclusion’ was ranked as the second most important in ESCC with 77% of respondents selecting it as an important theme for the forthcoming LTP.
- During Phase 1 of engagement, respondents pinned issues on a map relating to ‘accessibility, equity and social inclusion’, The majority of pins are clustered in the larger towns in the county – Eastbourne, Hastings, Bexhill, Uckfield, Crowborough and Lewes.
Implications on health and the links to transport
- Higher levels of deprivation are linked to worse health outcomes, therefore failing to address one of the root causes - poor access to education and employment centres - will result in worse health outcomes on a continual basis.
- Increased risk of social isolation, particularly in rural or coastal areas (such as Hastings) where public transport connections are poorest, and deprivation is highest
- Large percentages of older people living in rural areas (such as Burwash or Mayfield) is likely to mean that their access to essential services and health care facilities is limited, as they are often located in urban centres.
- Limited travel choices can mean that some people are unable or constrained in their ability to access the places they need and want to go. This exclusion can be made worse when met with high transport costs and lower incomes (a compounding effect known as Transport Poverty). In turn, this can lead to poorer health outcomes.
What the LTP needs to deliver to address issues
- Improving accessibility across the transport network so that people living with impairments are not excluded from using the system, and therefore not inadvertently disconnected from employment, education, or leisure activities.
- Improving public transport links to health care facilities, employment centres and education facilities across the county so that people can attend medical appointments, workplaces, and education without being reliant on access to a car.
- Providing genuine and attractive alternatives to the private car, particularly through improved walking and cycling networks, which will provide low cost and efficient transport. This will disproportionately benefit the most deprived residents in the county who are not likely to be able to afford a private car, or who are currently spending large percentages of their income on one currently.
Economic Health (Health determinant 3)
Pathways and demographics
- The majority of people employed within East Sussex drive a car or van to work (49%) or mainly work at or from home (31%), while 8% travel to work on foot.
- During Phase 1 of engagement, 51% of respondents selected the theme ‘sustainable economic development’ as an important theme in ESCC for the forthcoming LTP.
Implications on health and the links to transport
- Higher levels of driving, and lower levels of public transport usage and walking/cycling will have implications for overall public health. Every public transport trip starts and ends with a walk, and active travel requires physical effort – with fewer people using these modes, the benefit of incidental exercise is being missed.
- Restrictions in accessing education can directly affect economic prosperity but also indirectly impact health outcomes by way of learning about benefits and importance of health.
What the LTP needs to deliver to address issues
- Improving public transport links to health care facilities, employment centres and education facilities across the county so that people can attend medical appointments, workplaces, and education without being reliant on access to a car.
- Expanding connectivity through increasing public transport service frequency and/or reducing the cost of ticket fares to encourage workers who currently drive to work in a car or van to use a public transport alternative.
- Developing active travel networks so that people build in incidental daily exercise into their daily routes, making it attractive and convenient to walk, cycle and wheel.
Road Safety (Health determinant 4)
Pathways and demographics
- The rate of people killed or seriously injured (KSIs) in road collisions is higher than the average for England, suggesting that the county has a road safety issue.
- Collisions are mostly evenly split between urban and rural areas
- Engagement with key stakeholders through meetings with specific user groups or one-to-one meetings showed that road safety was a key area for intervention.
Implications on health and the links to transport
- The actual and perceived danger on the roads is a large deterrent to people choosing to walk and cycle. Dangerous roads, whether perceived or real, will ensure that only a small minority of people feel comfortable or safe to switch from private car/public transport usage to active travel. This can have consequences for overall public health, as walking and cycling are proven to be excellent ways of achieving daily recommended exercise.
What the LTP needs to deliver to address issues
- Improving road safety through implementation of measures such as reduced speed limits where appropriate, provision of new and improved pedestrian crossing points, and restrictions to through (motor) traffic.
- Providing high quality walking and cycling networks, protected from motor traffic, thus creating safe and convenient options for people to move around the county using active travel.
Crime (Health determinant 5)
Pathways and demographics
- Most residents in East Sussex feel fairly safe outside in their local area after dark.
- Lewes has the highest percentage of residents feeling fairly unsafe (17.8%) or very unsafe (10.4%).
- Crime is prominent in East Sussex and may be a contributing factor in threatening individual perception of safety.
- Public order offences are highest in Hastings (10 per 1000 population), compared to the national average of 7.4.
Implications on health and the links to transport
- Fear of crime may be deterring some people from choosing to walk or cycle as they feel like more exposed and dangerous activities than using a car or public transport. This can have a negative impact on health outcomes, as people are being prevented from building exercise into their journeys.
- Fear of crime on public transport may also be deterring some people from using the bus or train, which could force them into using a car. This can have externalities which impact on wider health outcomes, such as increased pollution and stress.
What the LTP needs to deliver to address issues
- Improving the safety of streets and public transport hubs through better spatial planning.
- Retrofitting measures such as improved street lighting and wayfinding to provide people with attractive and busier routes through urban areas. This is particularly important in areas such as Lewes and Hastings, where public order offences are highest, and residents are most concerned.
Congestion and stress (Health determinant 6)
Pathways and demographics
- There are approximately 55,600 people in East Sussex with a common mental health disorder; 2,700 with a personality disorder and 1,700 with probable psychosis. Suicide rates across males and females are also higher than the national rate.
- There is a higher percentage of adults in East Sussex with high anxiety and low life satisfaction compared to the national average.
- The percentage of adults who feel lonely ‘often, always, or some of the time’ is higher in Hastings, Lewes and Rother than the national average.
Implications on health and the links to transport
- Increased congestion within the county may lead to worsened health outcomes, with increased stress levels.
- In turn, long-term stress and poor mental health may prevent people from attending work or education, resulting in social isolation and poor education and economic outcomes.
What the LTP needs to deliver to address issues
- Improving public transport links to health care facilities, employment centres and education facilities across the county so that people can attend medical appointments, workplaces, and education. This is particularly important in Hastings, Lewes and Rother where adult loneliness is highest in the county, and above the national average.
- Developing active travel networks so that people build in incidental daily exercise into their daily routes. Exercise has been proven to benefit mental health and stress.
- Ensuring that new development is well planned, and not car dependent. Car dependency is likely to increase congestion, and consequently impact the mental health of residents.
Air Quality (Health determinant 7)
Pathways and demographics
- Generally, air quality in East Sussex is good, however there are town centre locations where the objectives of air quality are not met. East Sussex has two Air Quality Management Areas where air quality is at its worst – in Lewes town centre and Newhaven Ring Road.
- Including all sectors, carbon dioxide emissions in Wealden are higher than any other district in East Sussex. Rother, Lewes, Hasting and Eastbourne also have high carbon emissions.
- During Phase 1 of engagement, the theme ‘safety, health and air quality’ was ranked as the most important in ESCC with 79% of respondents selecting it as an important theme for the forthcoming LTP. Respondents also pinned issues on a map relating to ‘safety, health and air quality’. The majority of these were clustered in the larger towns. In addition, there are clusters of comments along some of the main routes in the county and focus on the towns of Eastbourne, Bexhill, Hastings, Lewes, Peacehaven, Newhaven and Seaford.
Implications on health and the links to transport
- A large range of pollutants result from highways-based transport and are produced through both the combustion/burning of fuels, but also the general wear and tear to the vehicle, such as from tyres and braking systems. Pollutants enter the respiratory system and cause widespread health impacts across the majority of the body’s major functions
- The impact of poor air quality disproportionately impacts individuals both as they age, from children to older people, and also those with underlying health conditions, or if they are pregnant.
- Poor air quality is often experienced by the most deprived people in society, despite them being one of the lowest contributors to the pollution.
- Carbon emissions affect several life expectancy outcomes relating to respiration and food production.
What the LTP needs to deliver to address issues
- Improving public transport links to health care facilities, employment centres and education facilities across the county so that people can attend medical appointments, workplaces, and education without being reliant on access to a car. This will likely have a positive impact on air quality, with fewer cars on the roads. This is especially important in Lewes due to the poor air quality that the town experiences.
- Providing high quality walking and cycling networks, protected from motor traffic, thus creating safe and convenient options for people to make shorter journeys without the need for car.
- Ensuring that appropriate transport mitigations, such as decarbonisation, should be in place to counter the worsening effects of climate change in line with the Government's Decarbonising Transport - A Better, Greener Britain strategy.
- Ensuring that new development is well planned, and not car dependent. Car dependency is likely to increase congestion, and consequently decrease air quality.
Noise (Health determinant 8)
Pathways and demographics
- There are higher than national average (12 per 1,000) for noise complaints in the borough of Hastings (19.6 per 1,000).
- Areas in East Sussex that suffer from the worst transport related noise pollution are along the A21, A22, and A27, and A259.
Implications on health and the links to transport
- Exposure to noise can cause disturbance and annoyance to individuals in close proximity. While auditory impacts are the most common drawback of extreme noise levels, children and older groups especially may be vulnerable to cognitive dysfunction and/or mental health implications.
- The long-term impacts of noise can be more widespread and extensive than causing hearing loss. The Government’s Transport and Health Resource outlines emotional functionality, stress, communication and sleep disturbance as indirect effects of noise.
What the LTP needs to deliver to address issues
- Ensuring that consideration is given to new highway schemes, and the implications that this may have on noise and public health.