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Which UK locations are investing the most in sexual health?

Since the pandemic, public health has become a major concern for local authorities across England, with many increasing their budgets to accommodate this over recent years. One extremely important aspect of public health is sexual health services, which need local authority funding in order to operate. But where has sexual health funding increased and decreased recently in the UK?

Using current UK government data the men’s healthcare experts here at FROM MARS have delved into which areas in England are investing the most in sexual health services, as well as comparing this to historic data to find out which locations are benefiting from increased investment and which are being cut back.

The importance of investing in sexual health services

Providing the appropriate funding for sexual health services is key in maintaining both public and individual health through the promotion of sexual health. This results in a lower rate of unintended pregnancies and STIs through three key areas, STI testing and treatment, contraception and promotion and prevention.

One key example which highlights the importance of investing in sexual health services is the detection and treatment of STIs, as some are often asymptomatic and can lead to further diseases or infertility as well as being transmitted to others.

Sexual health services also focus on contraception, by helping people choose the method that suits them best in the long term and increasing their awareness of how to use it effectively to help reduce unintended pregnancy. Sexual health clinics may also provide emergency contraception and abortion services as well as post-exposure prophylaxis for those who may have come into contact with HIV.

Investing in sexual health services is also important as they provide advice to people on how to protect themselves from STIs, information on contraceptives, and planning a pregnancy.

The UK areas spending the most on sexual health

⦁ Birmingham
2021-2022 sexual health expenditure: £16,462,000

It’s no wonder Birmingham tops our list, the second-largest city in England also has the most densely populated local government district and is home to 1.1 million people. Spending more than any other area on STI testing and contraception, £8,504,000 and £6,688,000 respectively. It ranks second in prevention and advice, only allocating £1,270,000 of its budget.

⦁ Kent
2021-2022 sexual health expenditure: £12,825,000

The fact this county comes second is no surprise as Kent has the highest population outside of Greater London. The garden of England has over £1,000,000 more in its budget for sexual health services than the county in third place. More than half of its £12,825,000 budget is allocated to STI testing and treatment. This county has also allocated the most money for promotion, prevention, and advice at £1,417,000.

⦁ Lancashire
2021-2022 sexual health expenditure: £11,322,000

Coming in third is Lancashire, the historic county with a rich history rooted in the industrial revolution. Lancashire allocated £11,322,000 to sexual health services in the 2021 financial year for its 1,449,300 citizens. This county also prioritises contraception allocating £5,502,000, the majority of its sexual health services budget.

The UK area spending the least on sexual health

⦁ Rutland
2021-2022 sexual health expenditure: £268,000

Being the smallest county in England by both population and land area, it’s no surprise Rutland comes last on our list for sexual health service expenditure with a budget more than 47 times less than Kent at the top of the list. The county allocated £2,000 for promotion prevention and advice, also the lowest budget on the list with the majority of £176,000 being spent on STI testing and treatment.

⦁ Wokingham
2021-2022 sexual health expenditure: £960,000

The borough of Wokingham is next on our list, allocating slightly less than £1,000,000 for its sexual health expenditure. The Berkshire borough was found by Public Health England to be one of the healthiest places to live which could explain the low budget. It allocated £723,000 for STI testing and £230,000 for contraception.

⦁ Bracknell Forest
2021-2022 sexual health expenditure: £985,000

Another area in Berkshire on our list is Bracknell Forest, which lies close to Wokingham. With a population of only 122,500, the borough allocated £985,000 for its total sexual health expenditure the vast majority of £887,000 spent on STI treatment with less than £100,000 dedicated to contraception and prevention and advice.

The UK areas with the biggest funding increases

⦁ Cornwall
40.03% increase

Known as the home of British surfing, the seaside county of Cornwall on the South West coast is the area with the largest funding increase for overall sexual health expenditure. With an average increase of 40.03%, nearly 30% more than second place. This is bolstered by an initial rise of 106% in spending between the 2017 -2018 and 2018 – 2019 financial years.

⦁ Wigan
11.31% increase

Similarly to Cornwall, Wigan saw a substantial budget increase from 2017 to 2018 of 23.44% resulting in an average increase of 11.31%. Wigan also saw one of the biggest increases between 2020-2021 and 2021-22, of 20.28%. This increase in spending could be due to the government shift away from austerity politics, as cuts to local authority funding, which had the greatest impact on post-industrial northern towns and cities, have decreased over recent years.

⦁ Oldham
11.18% increase

Despite its largest increase of 25.43% between 2019-2020 and 2020-2021, the average increase in spending for Oldham is 11.18%, only marginally less than Wigan, taking it to third place in our ranking. The post-industrial town has gradually increased spending on sexual health services year on year, with a slight dip of 5.04% between 2020-2021and 2021-2022, a possible result of the COVID pandemic causing a shortfall in council tax revenue resulting in a tighter budget.

The UK areas with the biggest funding decreases

⦁ Hammersmith & Fulham
16.67% decrease

This London borough saw the greatest decrease in funding falling year on year from 2017-2018 onwards, with the biggest drop in funding being an 18.06% reduction between the 2019-2020 to 2020-2021 financial years possibly as a result of COVID straining public health funding. This could be due to the fact that its biggest source of income, central government funding, has decreased by 40% over the last 10 years meaning overall budgets have decreased.

⦁ Herefordshire
12.21% decrease

This county in the West Midlands has also decreased its budget year-on-year since the 2017-2018 financial year, resulting in an average decrease of 12.21%. Its largest budget reduction took place between the 2018-2019 and 2019-2020 financial years, falling by 14.86%.

⦁ Harrow
11.79% decrease

The second London borough on our list, Harrow’s sexual health services budget has decreased by an average of 11.79% since the 2017-2018 financial year, rising slightly by 1.51% between 2019-2020 and 2020-2021. This average decrease in funding could be due to the council facing the challenges of a growing population and an increased need for social care services in the face of it being one of the lowest funded councils nationally.

The areas with the highest rates of sexual health problems

Most teenage births
Middlesbrough: 17.42 per 1000

Middlesbrough tops the list for teenage births with 17.42 per 1000, emphasising the need for properly funded sexual health services as their £1.3 million budget places them near the bottom of the list for total expenditure. One reason sexual health services are vital is that teenage childbearing can lead to a higher risk of intergenerational poverty, denying the mother and child education and employment opportunities as well as a higher risk of infant mortality and post-natal depression.

Most chlamydia diagnoses
Lambeth: 1,171.5 per 100,000

Sexual health services are also important as treating individuals with STIs will prevent further health complications, and can also help prevent possible epidemics, which could save local authorities money in the long run. Lambeth for example spends the majority of its budget on STI testing, having the highest rate of chlamydia diagnoses, at 1,171.5 per 100,000.

Highest abortion rate
Knowsley: 31.1 per 1000

The county with the highest abortion rate is Knowsley with 31.1 per 1000. This emphasises the need for properly funded sexual health services in the form of promotion, prevention and advice, which most local authorities on our list put the least funding into, Knowsley only providing £436,000.

Methodology

To answer the questions around the topic we gathered local authority data from the 2017 to 2021 financial years, taking a combined total for each year from the sexual health services categories. Using this data we were able to calculate and compare trends in local authority spending.

Data on chlamydia diagnoses abortions and birth rates were taken from The Office for Health Improvement and Disparities.