Whole population

Overview

The JSNA identifies smoking, sexual health, access to pharmacy services, active travel, injury prevention, geographical differences, and long-term conditions as broad population concerns. Recent health needs assessments on geographical areas demonstrate interactions between population ageing, deprivation, risk factors, multimorbidity, and service demand. Coastal and urban communities repeatedly experience poorer outcomes. Prevention could reduce future disease burden, but current trends create significant pressure. Local variation means county-wide strategies require proportionate and geographically responsive intervention.

Smoking remains a major preventable cause of illness and death. Adult prevalence has declined, but smoking remains concentrated among deprived communities and people with mental health conditions. High rates also affect other vulnerable groups identified within the assessment. Use of smoking cessation services is small compared to the number of smokers in the population. Prevention among young people, appropriate vaping messages, extended support, and culturally responsive services remain important. Smoking also interacts with respiratory disease, cardiovascular disease, pregnancy outcomes, and multimorbidity.

Analysis on Sexual health shows rising sexually transmitted infections and unequal testing access. Gonorrhoea diagnoses exceed pre-pandemic levels. Chlamydia testing among young women remains considerably below the stated target. Human Immunodeficiency Virus testing has declined among gay, bisexual, and other men who have sex with men.

Health needs assessments on geographical areas identify strong social gradients across long-term conditions, mental health, risk behaviours, and avoidable mortality. East Kent has increasing obesity, continued smoking among routine and manual workers, and higher drug-related deaths, including deaths involving synthetic opioids.

Coastal and urban communities show poorer health than inland communities. Dartford, Gravesham, and Swanley experience inequalities involving obesity, dental admissions, alcohol, smoking, mental health, housing, and primary care access. Community engagement identifies financial pressure, isolation, low trust, and service-navigation difficulties.

Multimorbidity represents a major source of service pressure. Past analysis in East Kent found that multimorbidity affected 18% of residents but accounted for over half of several healthcare activities. It also accounted for 72% of social care costs. More recent modelling anticipates further growth from population ageing. The JSNA Cohort model shows that smoking cessation and weight management can reduce projected disease burden. However, frailty will continue increasing because of demographic change.

NHS pharmaceutical services are well distributed across Kent, serving all the main population centres. The most recent Pharmaceutical Needs Assessment concludes that there is adequate access to a range of NHS services commissioned from pharmaceutical service providers. Population growth, housing development, and pharmacy closures may reduce pharmacy provision relative to population size. Monitoring remains essential throughout the assessment period (2025-2028). Broad service sufficiency requires continued attention to accessibility, not simply overall site numbers.

Active travel patterns changed during and after the coronavirus pandemic. Walking and cycling for travel declined, while leisure walking increased. Participation reduces as required frequency increases. Canterbury, Dover, and Ashford recorded higher average active travel. Dartford and Gravesham recorded lower participation. These patterns connect transport, physical activity, place, and prevention. However, the evidence does not establish causal relationships between local infrastructure and the recorded differences.

Key issues and themes

  • Smoking causes substantial preventable illness, mortality, and societal cost. High prevalence remains concentrated among vulnerable populations. Tobacco Control Needs Assessment supports targeted cessation and whole-system prevention.
  • Sexually transmitted infection rates are rising, while testing and contraceptive use remain below desired levels. Kent Sexual Health Needs Assessment identifies geographical and population access inequalities.
  • East Kent faces increasing obesity, multimorbidity, frailty, osteoporosis, and drug-related deaths. East Kent Needs Assessment identifies poorer health in coastal, urban, and deprived communities.
  • Dartford, Gravesham, and Swanley show mixed improvement alongside continuing health inequalities. Dartford Gravesham and Swanley Health Needs Assessment highlights housing, financial, isolation, access, and trust concerns.
  • West Kent faces population ageing, increasing frailty, multimorbidity, dementia, obesity, inactivity, and mental health pressures. West Kent Health Needs Assessment also identifies fuel poverty and housing concerns.
  • The provision of pharmacy services is currently adequate to meet identified population needs. Population growth and pharmacy closures may reduce future accessibility. The Pharmaceutical Needs Assessment requires continued monitoring and responsive updates.
  • Travel-related walking and cycling declined, while leisure walking increased. District participation varies. Analysis of Active Travel in Kent describes substantial pandemic-related changes.
  • Unintentional injuries disproportionately affect children, young people, deprived communities, and older adults. Unintentional Injury Needs Assessment identifies home, road, fall, poisoning, and burn risks.

Supporting reports

  • East Kent Needs Assessment (2025) – Report
  • Pharmaceutical Needs Assessment (2025) – Report
  • Dartford Gravesham and Swanley Health Needs Assessment (2025) – Report
  • Kent Sexual Health Needs Assessment (2024) – Report
  • Analysis of Active Travel in Kent (2023) – Report
  • West Kent Health Needs Assessment (2023) – Report
  • Tobacco Control Needs Assessment (2022) – Report
  • Unintentional Injury Needs Assessment for Adults and Children (2014) – Report
  • Assessment of Need for People Affected by Eating Disorders (2014) – Report
  • Kent and Medway Eye Health Needs Assessment (2014) – Report