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 report1 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?


University of Lincoln, College of Social Science Research

Dr David Nelson, Dr Maxime Inghels and Prof. Mark Gussy, Lincoln International Institute for Rural Health