Stimulus: Cwmderwen wellbeing profile

1. The town

Cwmderwen is a small valley town in south Wales with 12,300 residents. It has two wards (areas):

Bryncelyn, a large estate on the hillside to the north. 6,400 residents, of whom 4,900 are adults (aged 18 or over). Many homes were built in the 1950s. The nearest GP surgery is a bus ride away.

Maesderwen, the streets around the town centre and the leisure centre. 5,900 residents, of whom 4,700 are adults.

The local health board wants to decide where to put a new health promotion campaign. It has gathered the wellbeing indicators below.

2. Wellbeing indicators for the two wards

No.	Indicator	Bryncelyn	Maesderwen
1	Life expectancy at birth, males (years)	74.1	81.3
2	Life expectancy at birth, females (years)	78.6	84.2
3	Children living in poverty (%)	36	12
4	Adults aged 16 to 64 in employment (%)	62	80
5	School leavers with 5 or more GCSEs at grade C or above (%)	41	69
6	Homes in poor condition, for example damp or unsafe heating (%)	18	6
7	Adults who smoke (%)	21	9
8	Adults living with obesity (%)	32	21
9	Adults drinking more than 14 units of alcohol a week (%)	14	20
10	Mothers who smoked during pregnancy (%)	17	5

No.

Indicator

Bryncelyn

Maesderwen

Life expectancy at birth, males (years)

74.1

81.3

Life expectancy at birth, females (years)

78.6

84.2

Children living in poverty (%)

Adults aged 16 to 64 in employment (%)

School leavers with 5 or more GCSEs at grade C or above (%)

Homes in poor condition, for example damp or unsafe heating (%)

Adults who smoke (%)

Adults living with obesity (%)

Adults drinking more than 14 units of alcohol a week (%)

Mothers who smoked during pregnancy (%)

3. The leisure centre survey

The Cwmderwen youth forum ran a paper questionnaire at the leisure centre reception on one Saturday, from 10:00 to 13:00. Anyone walking in could fill it in. They asked: “Do you feel you have a healthy lifestyle? Yes or No.”

Where the person lives	Number who answered	Number who said Yes
Bryncelyn	26	11
Maesderwen	94	71
Total	120	82

Where the person lives

Number who answered

Number who said Yes

Bryncelyn

Maesderwen

Total

120

The town newsletter printed the headline: “Two thirds of Cwmderwen say they live healthy lives!”

4. The pop-up wellbeing check

A community nurse ran free wellbeing checks in the Bryncelyn community centre. Six adults agreed for their anonymous results to be used. Each person had one reading, taken sitting down, on the same morning.

Person	Age	Resting pulse (beats per minute)	Blood pressure (mmHg)	Temperature (°C)	Peak flow (litres per minute)	Expected peak flow for their age, height and sex (litres per minute)
A	34	72	118/76	36.6	480	520
B	58	88	146/94	36.9	400	440
C	45	104	128/82	38.3	450	500
D	27	64	112/70	36.4	330	460
E	71	58	136/84	36.2	350	380
F	40	80	124/80	37.0	420	600

Person

Age

Resting pulse (beats per minute)

Blood pressure (mmHg)

Temperature (°C)

Peak flow (litres per minute)

Expected peak flow for their age, height and sex (litres per minute)

118/76

36.6

480

520

146/94

36.9

400

440

104

128/82

38.3

450

500

112/70

36.4

330

460

136/84

36.2

350

380

124/80

37.0

420

600

Reference ranges for adults (simplified for teaching)

Resting pulse: usually 60 to 100 beats per minute. Very fit people and people on some medicines can be lower.
Blood pressure: written as two numbers, for example 120/80. The first (systolic) is the pressure when the heart beats; the second (diastolic) is the pressure when the heart relaxes. Ideal: between 90/60 and 120/80. Slightly raised: above 120/80 but below 140/90. High: 140/90 or higher. If either number is in a higher band, use the higher band.
Temperature: usually about 36 to 37 °C. 38 °C or above is a high temperature.
Peak flow (how fast a person can breathe out): work it out as a percentage of the expected value. 80% or more is usually fine. Below 80% can be a sign that the airways are narrowed, for example by asthma.

5. Adults who smoke, 2016 to 2026

Year	2016	2018	2020	2022	2024	2026
Bryncelyn (%)	29	28	26	24	23	21
Maesderwen (%)	15	14	12	11	10	9

Year

2016

2018

2020

2022

2024

2026

Bryncelyn (%)

Maesderwen (%)

6. The chart in the town newsletter

The newsletter printed this chart under the headline “Bryncelyn smoking crisis!” Look carefully at the vertical axis.

7. Welsh services and campaigns the health board could use

Help Me Quit: the free NHS stop smoking service in Wales.

Flying Start: a Welsh Government programme for families with children under 4 in some areas, including extra health visiting and part-time childcare.

Healthy Weight: Healthy Wales: the Welsh Government’s long-term strategy to prevent and reduce obesity.