JSNA Briefing Session Wednesday 19 February 2014 Green Room, Archive Centre, County Hall Migrant Workers in Norfolk
Role of JSNA provides a picture of the health and wellbeing of a given area only as good as what people contribute we have to have one informs the work of the Health and Wellbeing Board (Strategy) linked to annual DPH report has themes, profiles, reports and data that can be manipulated on the Norfolk Insight website and drawn from that data and analysis - (www.norfolkinsight.org.uk/jsna)
Issues for consideration Is there other key data or information available that would improve what we know about the needs and situation of migrant workers in Norfolk? Who else needs to understand the current situation how is this best shared? What are the key issues that partners (including the Health and Wellbeing Board) need to be aware of / address?
The official data and its limitations there are no reliable estimates of the number of migrant workers nationally or locally in Norfolk the issue is complex - statistics by different agencies capture part of the picture but each contains relative weaknesses, such as problems measuring the levels of seasonal and undocumented workers official data is available for the numbers of National Insurance Number (NINo) registrations to adult overseas nationals entering the UK NINo is generally required by any overseas national looking to work or claim benefits/tax credits in the UK, including the self-employed or students working part time the stats provide a measure of immigration (inflow) but do not reflect emigration (outflow), or the overall migrant population (stock) all adult overseas nationals allocated a NINo are included regardless of their length of stay in the UK of course, undocumented workers are not recorded in NINo data, so there will be under-recording
Number of NINo registrations to adult overseas nationals entering Norfolk and neighbouring counties, 2004-2012 Source: Office for National Statistics Local Area Migration Indicators - http://www.ons.gov.uk/ons/search/in dex.html?newquery=nino
Number of NINo registrations to adult overseas nationals entering Norfolk local authority areas, 2004-2012 variation between areas - Norwich, KL&WN and Breckland consistently higher levels Norwich is a centre for skilled and unskilled industry sectors rural areas have demands in sectors such as agriculture and related food processing and packaging, attracting higher levels of migrant workers Source: Office for National Statistics Local Area Migration Indicators - http://www.ons.gov.uk/ons/search/index.html?newquery=nino
NINo registrations to adult overseas nationals entering Norfolk by % in broad age group (2012/13) compared with general Norfolk population (mid-2012) illustrates that the majority of NINo registrations for Norfolk are in the 18-24 and 25-34 age groups total NINo registrations for Norfolk 2012/13 is 5,579 (2,891 males; 2,688 females) Source: Office for National Statistics Local Area Migration Indicators - http://www.ons.gov.uk/ons/search/index.html?newquery=nino
% of population born in EU accession countries, Census 2011 useful to get a sense of the level of EU (non-uk) born population of Norfolk - those countries that became members between April 2001 and March 2011 as part of the EU enlargement process Norwich, KL&WN and Breckland have higher proportions these areas also have higher levels of NINo registrations to adult overseas nationals Source: Census 2011 - ONS
Norfolk population born outside the UK, by year of arrival, 1941-2011 number of Norfolk s usual resident population born outside the UK, by their year of arrival in this country over the last 70 years from 1941 to 2011, half have come since 2004 UK opened its borders and labour markets to the EU8 central and eastern European countries in 2004 and to the EU2 countries (with restrictions) in 2007 Source: Census 2011 - ONS
Country of birth (by broad country category) of non-uk born Norfolk residents, Census 2011 EU countries* 30,584 rest of Europe 2,418 North Africa 726 Central and western Africa 1,528 South and eastern Africa 4,880 other Africa not specified 70 Middle East 1,504 Eastern Asia 2,762 Southern Asia 4,776 South-east Asia 3,860 Central Asia 104 North America and the Caribbean 5,562 Central and South America 1,214 Antarctica and Oceania incl. Australasia 1,553 Total 61,541 *EU countries Ireland (3,167); EU member countries in March 2001 (12,108); EU accession countries April 2001 to March 2011 (15,309) EU countries rest of Europe North Africa Central and western Africa South and eastern Africa other Africa not specified Middle East Eastern Asia Southern Asia South-east Asia Central Asia North America and the Caribbean Central and South America Antarctica and Oceania incl Australasia
Norfolk children with first language other than English, October 2013 around 125 languages are spoken as a first language other than English, by Norfolk school children almost 7,650 Norfolk school children have a first language other than English around 4,000 primary school age children around 2,400 secondary school age children Norwich has the greatest numbers in each age group Source: NCC Autumn 2013 School Census, October 2013
Norfolk children with first language other than English, October 2013 - most spoken language in each district (where there are 20 or more speakers) Top 3 languages spoken: Age 0-10 Breckland Great Yarmouth Age 11-16 Broadland Polish Polish Portuguese Lithuanian Latvian Russian Portuguese Lithuanian Polish Malayalam Slovak Russian Portuguese Polish Lithuanian Breckland Portuguese Polish Lithuanian Latvian Norwich Polish Lithuanian Arabic Bengali Portuguese Tagalog/Filipino Malayalam Chinese Hungarian Russian Tamil Spanish Swahili/Kiswahili Albanian/Shqip French Hindi Kurdish Romanian Turkish North Norfolk Polish KL&WN Lithuanian Russian Polish Portuguese Latvian Malayalam Chinese Tamil South Norfolk Polish Tagalog/Filipino Malayalam Chinese Arabic South Norfolk Chinese Polish Great Yarmouth Portuguese Lithuanian Polish KL&WN Lithuanian Russian Portuguese Polish Norwich Lithuanian Bengali Polish Portuguese Arabic Hungarian
DWP working age benefit claimants non-uk nationals these statistics do not provide a measure of non-uk nationals currently claiming benefits based on their current nationality the statistics do provide an estimate of the number of people currently claiming benefit who, when they first registered for a NINo (that is, first entered the labour market), were non-uk nationals as at February 2011, over 5.5million people were claiming DWP working age benefits - of these 371,000 (6.4%) are estimated to have been non- UK nationals when they first registered for a NINo there is significant variation by benefit type; 8.5% of all Jobseekers are estimated to have been non-uk nationals when they first registered for a NINo contrasted with 3.5% for working age disabled benefit claimants across all DWP working age benefits, 25% of those claimants who were non-uk nationals at the time they first registered for a NINo were from within the European Union - of the remainder, Asia and Middle East (34%) and Africa (27%) form the largest proportion of those claimants who were non-uk nationals at the time of first NINo registration
Nationality at NINo registration: DWP working age benefit claimants, February 2011, Great Britain Source: DWP: Work and Pensions Longitudinal Study, and HMRC National Insurance and Pay as you Earn System (NPS)
Non-UK nationals at NINo registration: DWP working age benefit claimants by region, February 2011, Great Britain Region thousands % North East 6.2 1.7 North West 30.8 8.3 Yorkshire and the Humber 24.6 6.6 East Midlands 18.1 4.9 West Midlands 34.8 9.4 East of England 19.2 5.2 London 176.9 47.7 South East 26.6 7.2 South West 12.3 3.3 Wales 6.9 1.9 Scotland 12 3.2 Overseas Residents / Unknown 2.8 0.8 Total Great Britain 371.1 Source: DWP: Work and Pensions Longitudinal Study, and HMRC National Insurance and Pay as you Earn System (NPS)
Migrant workers bring many benefits to the area migrant workers make a significant contribution to the economy of the eastern region according to the East of England Development Agency they contribute 360m (2006/07) to the region s economy annually picking, packing and plucking industries rely heavily on migrant labour, as do the health and social care and construction sectors ethnic, linguistic and cultural diversity offers increasing and broadening skills, expertise and knowledge and creates a diverse workforce and diverse community many businesses in the region would fold without migrant workers Source: Workers on the Move: Migrant workers, housing and growth in the eastern region (2008) Published by Keystone Development Trust
Health and Wellbeing issues migrant workers coming to Norfolk over recent years have come from different cultures and traditions we have looked at the main countries of origin of migrant workers in Norfolk, and looked at some of the key health issues that affect them we need to consider whether there are impacts of this on demands for health care in Norfolk the data is for home country populations, not migrants in the UK the health issues focused on are those where comparable data is available
Prevalence of smoking daily any tobacco by country and gender for those aged 15 years and above, 2010 source: World Health Organisation WHO males from Bulgaria and Latvia have the highest rates while the percentage of smoking among females from Romania, Poland and Bulgaria were high data for England was only available for current smoking of cigarettes 22% males, 21% females, and 21% persons
Total (recorded + unrecorded) adult (15+ years) alcohol units consumption per capita, projected estimates for 2008 source: World Health Organisation WHO the units of alcohol consumption among adults 15+ was higher in Lithuania and Romania people from Latvia and Portugal have equivalent level of alcohol consumption to people in England
Incidence of tuberculosis per 100,000 population per year, 2007 to 2012 2012 2011 2010 2009 2008 2007 Bulgaria 32 35 38 41 44 48 Latvia 53 48 50 52 56 65 Lithuania 66 69 73 76 79 81 Poland 21 24 21 24 22 24 Portugal 26 26 27 30 31 32 Romania 94 101 109 116 124 132 UK 15 15 14 16 15 15 source: World Health Organisation WHO for most tuberculosis incidence, reported rates were higher in all selected countries than in the UK Poland showed the lowest rates than Bulgaria, Latvia, Lithuania, Portugal, and Romania, but still slightly higher than England the over time trends is decreasing in most these countries but remain higher that the UK
Comparison of Infectious Disease rates (per 100,000 persons) in the Accession countries with the UK, 2006 Romania had higher rates of measles than the UK Bulgaria, Poland and Romania all had higher rates of mumps than the UK all countries had higher rates of Rubella than the UK, but Poland and Romania had particularly high rates Bulgaria and Poland had high rates of pertussis (whooping cough) Tetanus rates were low throughout all previously eastern European countries
Immunisation coverage rates (%) in the Accession countries and the UK, 2006 BCG immunisation (for TB) is offered only to infants at high risk in UK; elsewhere it is offered universally to neonates Hepatitis B is part of the routine immunisation schedule all countries except the UK and Hungary Haemophilus influenzae type b immunisation (flu) is not part of the routine immunisation schedule in Bulgaria and Romania for most immunisations, reported coverage rates were higher in the accession countries than in the UK
Newly diagnosed cases of HIV (rates per 1,000,000) in the Accession countries and the UK, 2006 notification rates of newly diagnosed HIV cases were higher in the UK (149) than in all accession countries - Latvia (130); Lithuania (29); Poland (20); Bulgaria (12); and Romania (8) in most accession countries, most HIV cases were nationals of that country there were significant differences in the main routes of HIV transmission between countries Lithuania - approximately two thirds of cases were injecting drug users Slovenia - three quarters of cases were men who had sex with men (MSM) Romania three quarters of cases were heterosexually acquired Romania had the highest rate of mother to child transmission
Use of health services NHS Norfolk commissioned UEA (School of Education and Lifelong Learning) in 2009 to report issues related to accessing views of hard to reach groups in Norfolk (summarising information from a number sources) It found that migrant workers had problems with: Language including written information Different expectations of health care services Some taboos about health issues, resulting in suspicions of workers at times Reliant on own community support to help understand and access services appropriately
Implications locally heresay reporting of increased attendance at Hospital A&E departments from migrant workers especially at QE Hospital in King s Lynn and maternity services no hard evidence of this exists, but as the migrant worker population is younger than the Norfolk resident population, higher use of maternity services is likely likely that this is a group that will be looked at by CCGs as they work to reduce hospital admissions in their areas need to consider how to develop services to meet needs of all members of their local population if migrant workers employment ends, or wages are too low, or need to escape trafficking and forced labour, health and wellbeing may suffer, so potential increased burden on services
Partnership working CREB cross-county partnership on equality, hate crime and community cohesion 8 objectives, consultation showed migrant workers was key issue for partners Support capacity building and joint working on key equality issues in Norfolk
Priorities for Partnership Working with Migrant Workers Defined at a CREB partnership meeting of public and voluntary organisations on 23 rd January 2014: Priority 1: Increase the capacity of frontline information, advice and guidance services Priority 2: English language competence and access to translation / interpretation Priority 3: Integration and community cohesion
Priority 4: To increase equitable access to health and well-being services for migrant communities Priority 5: Housing need, housing quality and associated issues Priority 6: To tackle exploitation and discrimination in employment Priority 7: To ensure key partners in Norfolk (Health and Well-Being Board, Community Safety Partnership, Local Employer Partnership) are aware of these priorities and support their delivery
Issues for discussion Is there other key data or information available that would improve what we know about the needs and situation of migrant workers in Norfolk? Who else needs to understand the current situation how is this best shared? What are the key issues that partners (including the Health and Wellbeing Board) need to be aware of / address?