WINSFORD and Middlewich's elderly residents, sufferers of mental illness and those with heart and circulatory disease are set to benefit from priorities identified in a new health report.

The Annual Public Health Report for Cheshire County 1998 looks at the burdens of disease and disability in terms of death, illness or costs and suggests ways in which these can be reduced in the county.

The report considers each priority in terms of action which could be taken nationally, locally and by people changing their own behaviour.

Old age, mental illness and heart disease have been targeted because they account for a substantial percentage of total spending on health and personal social services in the county.

Primary care groups, formed from groups of general practices, will be set up to work behind the scenes with other professionals such as nursing staff and pharmacists and staff from the county council.

These will work on behalf of residents to ensure that the report's objectives are met and to encourage decisions regarding local health services to be made at a more local level.

Heart and circulatory disease causes about 34% of premature deaths in males, 23% in females, and accounts for 12% of health expenditure.

The report acknowledges that heart disease and strokes can often be prevented and that considerable research has resulted in risk factors being identified.

It stresses that the best way to relieve the burden of these diseases is to target those with already established conditions and advise them on how to modify their lifestyles, which includes dietary advice and how to quit smoking.

The report says that aspirin and anti-hypertensive drugs are cost effective treatments and that statin drug therapies directly reduce the risk of mortality from heart disease, through their effect on lowering blood cholesterol levels.

Mental health, the report highlights, is the key component of a healthy, active life, though evidence suggests there has been an increase in poor mental health in children and young people in the past three decades.

The report stresses the need for Cheshire's three specialist units in Macclesfield, Chester and Crewe to share experiences so their strengths can be identified and their weaknesses addressed.

Old age has been highlighted because the proportion of the population who are over 65 has risen dramatically and older people in general require more care.

The report re-enforces the need for carers' support groups, which play a crucial role in reducing the burden which falls on families.

It recommends that the health authority should continue to work with local authorities to ensure that broader determinants of health, such as safe transport and independent mobility for older people, are protected and enhanced.

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