Health, wellbeing and regeneration in coastal resorts

Assessing hidden need: the caravan park population

Caravan parks are popular along the British coastline, and a considerable proportion of people in parts of the UK reside in static caravans for much of the year. Residents in caravan parks can be a group hard to reach, and they may have an ambiguous legal status (caravans are often used as permanent homes irrespective of whether the caravan park has a license for long-term residential use). Residents of caravan parks are less likely to be registered with a GP and less likely to be represented on the Census.

In South East Holderness, on the Yorkshire coast, there are more than 2500 caravans. The PCT had anecdotal evidence that residents in the caravan park communities experienced greater socioeconomic and health problems than the general population in South East Holderness, which is itself a deprived coastal area. A substantial proportion of the caravan park community was understood to be elderly, frail and materially deprived. Many of the caravan park community were understood to have migrated to the area, perhaps to escape financial hardship.

The predecessor organisation for the NHS East Riding of Yorkshire commissioned a survey of the caravan park community. This was done jointly with East Riding of Yorkshire Council. After exploratory discussions with caravan park residents it was decided to administer a postal health and lifestyle questionnaire to GP-registered caravan residents. Basing the sample on the GP-registered population was acknowledged to risk excluding people, but it allowed comparison with a recent survey of the general population. Data was gathered on respiratory problems, falls, smoking, alcohol, body mass index (BMI) and service utilisation and compared to national and regional information. The authors state that to avoid intrusion and to achieve reasonable response rates the survey deliberately omitted questions on mental and sexual health, domestic violence or suicide. These were noted as topics for future consideration.

Residents in caravan park communities reported greater levels of poor health than in England. Compared with the local population survey, caravan respondents over 55 years of age were almost twice as likely to report poor health. Three lifestyle areas were addressed: alcohol consumption, smoking and BMI. Caravan park residents drank alcoholic drinks less often, they drank smaller amounts, and were less likely to exceed safe weekly limits than their regional and national counterparts, but they were also less likely to be non-drinkers. Caravan respondents over 55 years of age were more than twice as likely as their counterparts in the local population to be current smokers and 2.3 times as likely to be obese. The survey found rates of chronic cough and rates of wheezing which exceeded twice the national average. Asthma and other chest problems were also frequently reported.

NHS East Riding of Yorkshire have used the results to inform resource allocation and service delivery. These include:

• continued caravan research linked with health promotion;
  
• health trainers in coastal areas;
  
• a health improvement programme covering anxiety and depression, healthy eating, confidence building, relaxation, eating to a budget, and living a healthy lifestyle;
  
• future plans (e.g. a Health Bus);
  
• development of new health interventions, accelerated by linking up with local economic regeneration resources.

A special East Riding of Yorkshire council overview and scrutiny review has recently focused on coastal health.