Mapping the Characteristics of Residents Using Temporary Housing on Lincolnshire’s East Coast and their Exposure to Risk Factors for Type 2 Diabetes

Nelson, David, Inghels, Maxime and Gussy, Mark (2022) Mapping the Characteristics of Residents Using Temporary Housing on Lincolnshire’s East Coast and their Exposure to Risk Factors for Type 2 Diabetes. Project Report. University of Lincoln.

Mapping the Characteristics of Residents Using Temporary Housing on Lincolnshire’s East Coast and their Exposure to Risk Factors for Type 2 Diabetes

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In the UK, approximately 17% of the population reside in coastal areas. Coastal communities are increasingly being identified as areas of growing risk for poor health and social outcomes. A recent report by the Chief Medical Officer highlights the unique health challenges faced by people who reside in coastal areas and Lincolnshire’s coastal communities, particularly the towns of Mablethorpe and Skegness in the district of East Lindsey, are amongst the most deprived in the country.

An important subgroup of Lincolnshire’s coastal communities are residents using ‘temporary’ housing (RUTH). Historically the coastal community has hosted a large number of caravans, chalets and other forms of temporary housing to accommodate large numbers of holiday makers. Over time the quantity and quality of this accommodation has changed and there has been an increase in the number of people choosing to use this housing option as a long-term residence. This has resulted in the emergence of what we might call long term RUTH.

Little is known about RUTH in the UK. Anecdotal evidence suggests that a significant proportion of long-term RUTH do not connect with local health and social care services (including registration with general medical practices) but have high health and care needs; they are older, present with multiple chronic health conditions and high levels of limiting long-term illness and disability. These characteristics increase their risk for developing type 2 diabetes or for poor control and management of existing diabetes. Undetected or uncontrolled type 2 diabetes generates significant cost pressure for health services and causes premature death, healthy life expectancy and long-term disability.

This project was funded by the National Institute for Health Research (NIHR) Clinical Research Network (CRN) East Midlands to conduct scoping work with Lincolnshire’s East Coast RUTH community who are potentially at risk of type 2 diabetes but experience inequity of access to diabetes prevention and management services. The work supports engagement with RUTH through three connected work packages. The first work package, which is the focus of this report involves mapping the numbers, demographics and geographical distribution of RUTH as well as their likely health needs related to diabetes prevention and management.

This first part of the research was to quantify and document the extent of the RUTH population on the East Coast of Lincolnshire and their exposure to type 2 diabetes.

To meet this aim we asked the following question(s):

Research Question 1: What is the geographical distribution of RUTH?

Research Question 2: What are the general characteristics and demographics of RUTH?

Research Question 3: What are the area-based indicators for type 2 diabetes risk where RUTH populations live?

The data came from two main sources (1) The Office for National Statistics (ONS) and the (2) Consumer Data Research Centre (CDRC). Where the ONS data required were not publicly available a request was submitted to the ONS Census Commissioning Tables Team. All datasets provided were anonymised with no identifiable individual level information.

We used data from a range of areas across Lincolnshire County, North Lincolnshire, and North East Lincolnshire (Greater Lincs). This was to allow for comparison across different geographies (coastal and inland), as well as, with a view to increasing our total RUTH sample size. In addition to Lincolnshire, we report on data from King’s Lynn and West Norfolk (West Norfolk District) where there is a substantial RUTH coastal population.

Our analysis and interpretation of the findings focuses on Lincolnshire’s East Coast (Lincs Coastal Strip), specifically within the district of East Lindsey, although where appropriate, we have identified some of the differences and similarities that occur across the entire study area.

All statistical analyses were performed using R software (Ver 3.6.3).

The study was given a favourable ethical opinion on the 27th October 2020 by a Research Ethics Committee (REC) from the University of Lincoln (Ethics Reference 2020_3812).


Where is the geographical distribution of RUTH?

 East Lindsey is home to the highest proportion of RUTH across Lincolnshire County where they represent 1.3% of the population in that district.

 Half of RUTH reside in an urban area which is similar to the general population.

 RUTH tend to be highly concentrated in specific small geographic areas, notably, coastal areas close to Mablethorpe and Skegness although they are also present to a lesser extent in inland locations across Lincolnshire.

 Caravan parks are most prevalent in coastal areas of East Lindsey and a considerable number of new caravan park licences have been issued since 2011.

What are the general characteristics and demographics of RUTH?

 RUTH are much older than the rest of the population.

 The greater proportion of older RUTH could help explain the higher percentage of non-professionally active and higher proportion reporting poor health status or daily activities limited.

 Age differences with the general population varied depending on the area with a higher proportion of older RUTH in inland Lincolnshire.

 A significant proportion (33.6%) of the RUTH community were classed as economically active. However, they were twice as likely to experience unemployment compared to the rest of the population.

 Coastal areas were characteristic of the highest in-migration rates of RUTH.

 RUTH live in accommodation with a smaller number of rooms and bedrooms and are more likely not to have central heating in their home.

What are the area-based indicators for type 2 diabetes risk where RUTH populations live?

 Lincolnshire’s East Coast is comprised of Lower Layer Super Output Areas (LSOAs)with high levels of deprivation of income, education/skills attainment, and employment.

 Communities located along the Lincolnshire’s East Coast have high levels of illness and disability relative to other communities at county and national level.

 The physical and social environment present a combination of risk and protective factors for type 2 diabetes.

 Access to health services is poor on Lincolnshire’s East Coast although this is a similar trend across much of Greater Lincs.

 Collectively these findings suggest that there are elevated area-based risk indicators for type 2 diabetes in the Lincolnshire East Coast region.

This study addresses a research gap among RUTH populations by presenting findings from the first group-based analysis of RUTH using ONS 2011 census data. The findings from this report suggest that RUTH could be at higher risk for diabetes because of their characteristics (i.e., older population, poor reported health status and limited daily activities) and the place they live, mainly Lincolnshire’s East Coast, which presents with elevated area-based risk indicators for diabetes.

Because of a lack of available data sources targeting specifically RUTH populations, our study gives a broad overview of type 2 diabetes risk among RUTH and may lack some precision. Further quantitative and qualitative data collection with RUTH is warranted to gain an in-depth understanding of their likely health related needs that can then be used to develop and implement culturally appropriate health interventions with coastal communities.

Keywords:coastal health, coastal areas, Lincolnshire East Coast, caravan parks, residents using temporary housing, type 2 diabetes, Health Inequalities
Subjects:B Subjects allied to Medicine > B900 Others in Subjects allied to Medicine
L Social studies > L510 Health & Welfare
A Medicine and Dentistry > A990 Medicine and Dentistry not elsewhere classified
B Subjects allied to Medicine > B910 Environmental Health
Divisions:College of Social Science > Lincoln International Institute for Rural Health
ID Code:48059
Deposited On:30 Mar 2022 14:59

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