Life Expectancy Ward Analysis Ward Profile: Harborne Tackling Health Inequalities: Life Expectancy
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2
Date
June 2009
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Green
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Introduction Life expectancy is one of the main indicators for health inequalities. It has been set as the overarching work stream for tackling health inequalities in Birmingham by the Health and Wellbeing Partnership (BHWP). This Ward Profile series aims to: •
Provide a detailed ward level picture of local health inequality context.
•
Describe life expectancy trend in each target ward.
•
Investigate leading conditions that cause deaths locally, to provide local focus for each target ward.
•
Suggest future area / factors for extended research.
Authors
Jeanette Davis (Public Health Information Analyst) Chris Stephen (Public Health Information Analyst) Mohan Singh (Public Health Database Administrator/ Analyst) Iris Fermin (Head of Information and Intelligence) Jim McManus (Joint Director of Public Health)
For further information please contact the information team: Tel:
0121 465 2995 / 2999
Email:
phit@bhwp.nhs.uk
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1. Summary •
Electoral ward Harborne is within the boundary of NHS South Birmingham.
•
Harborne accounted for 2.16% of Birmingham’s population in 2006.
•
Children and young people (0-19) are the second most populous group in the ward, making up 19.1% of the total population.
•
The percentage of Black and minority ethnic groups in this ward is 22.0%, which is higher than the National (11.3%) but lower than the Birmingham (32.7%) average.
•
Harborne is the 34th (out of 40) most deprived ward in Birmingham.
•
The latest extraction for 2005/07 shows that: o Life expectancy is 77.6 for men and 81.8 for women, over the years 2005/07. o From 1995/97 to 2005/07 male life expectancy has increased by 4.6%. The deficit for Harborne compared with England has shortened by 81% (0.4 years). o From 1995/97 to 2005/07 female life expectancy has increased by 5.2%. The deficit for Harborne compared with England has shortened by 100% (2 years). o Infant Mortality Rates have dropped by 28.5% since 1999/01; the rate for the most deprived wards has also dropped. o The leading conditions that cause deaths in the ward are Circulatory diseases (31.1%), Cancers (28.6%) and Coronary Heart Diseases (14.9%).
•
Lifestyle factors 2005/07 suggest that, in comparison to Birmingham as a whole, the rates for residents of Harborne are: o 6.6 percentage points lower for adult obesity. o 3.5 percentage points higher for binge drinking adults. o 2.0 percentage points lower for adults who smoke.
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2. Local context: demographics and deprivation This section describes population demographics and deprivation in Harborne, in order to provide a local context for life expectancy inequalities. Comparisons are made with Birmingham and England.
2.1. Age and sex distribution The population of Harborne is estimated to be 21,865. This represents 2.16% of the population of Birmingham. Approximately 49.1% (10,732) are male and 50.9% are female (11,173). These estimations are based on ONS mid-year population estimates for 2006. The population pyramid (Figure 1.1) shows the age and sex distributions. Population By Age Group and Gender 2006 Estimates by Ward Source: Office of National Statistics
80+
171
75-79
395
236
70-74
353
307
Males
377
65-69
424
437
60-64
425
424
55-59
611
50-54
603
Females
589 609
643
45-49 40-44
631
775
35-39
674
892
30-34
780
923
788
1253
25-29
1222 1130
20-24
1253
15-19
584
10-14
548 461
508
495
5-9 0-4
511
621
1500
1000
588 500
0
500
1000
1500
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Harborne 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 19.7% (4,316) of the Harborne population. Persons of retirement age (age 65+) account for 15.2% (3,327).
•
The ward has 2.3 percentage points less 'under 19s' and 4.6 percentage points more over 65s than the city averages.
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2.2. Ethnicity Ethnicity has some influences in terms of what kind of illness an individual could develop through their life. Thus, ethnicity analysis becomes a requirement in order to target the health of vulnerable people. Table 1.1 shows the ethnicity distribution in the Harborne population, compared with Birmingham and England. •
•
•
The % column of table 1.1 represents the percentage of the total population that fit into that ethnic group. The N* column show the quantity of people in thousands that are from each group, for the ward, city and nationally. About a quarter (22%) of the population belongs to non-white ethnicity groups, Pakistanis represent 2.88%, Indians 9.18% and Black Caribbeans 2.57%. The proportion of BME groups (22%) is lower than for Birmingham (32.7%), but higher than for England (11.3%).
Table 1.1
Ethnicity groups for Harborne (2001), Birmingham (2006) and England (2006) Harborne % N* 78.0 16.4 13.6 2.9 3.8 0.8 2.6 0.5 2.0 0.4 100 21.0
Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total
Birmingham % N* 67.3 667.0 20.7 207.9 6.7 67.0 3.2 31.8 2.3 22.9 100 1,106.5
% 88.7 5.5 2.8 1.6 1.4 100
England N* 45,018.1 2,786.6 1,403.0 829.5 725.7 50,762.9
*population by thousand Data source: ONS population estimates by ethnic group mid 2006 for Birmingham / England. 2001 Census data for Ward
2.3. Deprivation According to Index of Multiple Deprivation (IMD) 2007 published by ONS, Harborne is the 34th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 21.231. Figure 1.2 shows SOAs in Harborne by IMD quintile, 2007. Most of the area covered by Harborne is in the least and second most deprived SOAs in Birmingham. Table 1.2 shows the area covered by the ward and population density. Table 1.2
Ward Area Characteristics for Harborne 2
2
Area (KM )
Population Density (persons / km )
Population Density – Working Age 2 16-64 (persons/km )
5.461
4018
2741
1
Ward level IMD score is calculated based on IMD score 2007 for SOAs and population weighting from SOAs to Wards in Birmingham produced by Birmingham Strategic Partnership Information Sharing Group from the Birmingham City Council.
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Figure 1.2 Super Output Areas in Harborne by IMD quintile, 2007
2.4. Lifestyle Table 1.3 provides a summary of lifestyle indicators in Harborne in comparison with Birmingham and England. Data presented here are from the synthetic estimates of healthy lifestyle behaviours produced by the NHS Information Centre. •
• •
Compared with the Birmingham average, Harborne has a higher percentage of people who binge drink (3.5 percentage points higher). However less are obese (6.6 percentage points lower) and smoke (2.0 percentage points lower) 25.8% of adults in Harborne eat healthily; this is higher than the Birmingham (25.1%) but lower than the England (26.3%) average. Table 1.3 shows that further information should be sought on why inequalities exist for binge drinking between Harborne and the Birmingham and England averages.
Table 1.3
Key figures for life style Deprivation in Harborne, Birmingham and England
Adults who smoke Binge drinking adults* Healthy eating adults** Obese adults*** * ** ***
Year 2003/05 2003/05 2003/05 2003/05
Harborne 22.9% 21.3% 25.8% 16.8%
Birmingham 24.9% 17.8% 25.1% 23.4%
England 24.1% 18.0% 26.3% 23.6%
Binge drinking: men were defined as having indulged in binge drinking if they had consumed 8 or more units of alcohol on the heaviest drinking day in the previous seven days; for women the cut-off was 6 or more units of alcohol. Healthy eating: five or more portions of fruit and vegetables on the previous day Obese: BMI > 30
Data source: Physically active adults: Active People Survey, Sport England All other indicators: Synthetic estimates of healthy life styles, NHS Information Centre
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3. Life expectancy trend There is evidence that life expectancy is one of the most important determinants for health inequalities across the population. This section gives an overview of life expectancy at birth in terms of trend and variations in different groups and communities. Figure 2.1 shows the trend in male life expectancy in Harborne from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Male life expectancy has increased in Harborne over this time and the gap to the England average has been narrowed. Male Life Expectancy - 3 year rolling average, Harborne, Birmingham & England 79.0
Life Expectancy (Age)
78.0 77.0 76.0 75.0 74.0 73.0 72.0 71.0
/0 6
/0 7 20 05
20 04
/0 5 20 03
/0 4
/0 2
/0 3
20 02
20 01
20 00
19 99
/0 1
/0 0
/9 9
19 98
19 97
/9 8 19 96
19 95
/9 7
70.0
Calendar Year England M ales
Birmingham M ales
Harborne M ales
Data source: ONS
Figure 2.1 Male life expectancy for Harborne, Birmingham and England, 1995/97 to 2005/07
Figure 2.2 shows the trend in female life expectancy in Harborne from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. By 2007 female life expectancy in Harborne was equal to the national average. It may be useful to identify causes for this, so that strategies for improvement can be placed in other, less successful wards.
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Female Life Expectancy - 3 year rolling average, Harborne, Birmingham & England 84.0
Life Expectancy (Age)
83.0 82.0 81.0 80.0 79.0 78.0 77.0 76.0
/0 6
/0 7 20 05
/0 5
20 04
20 03
/0 4 20 02
/0 2
/0 3 20 01
20 00
19 99
/0 1
/0 0
/9 9
19 98
19 97
/9 8 19 96
19 95
/9 7
75.0
Calendar Year England Females
Birmingham Females
Harborne Females
Data source: ONS
Figure 2.2 Female life expectancy for Harborne, Birmingham and England, 1995/97 – 2005/07
As illustrated above, life expectancy for both males and females has increased from 1995/97 to 2005/07. Life expectancy in Harborne is higher than the city average, whilst on a par with the national average. The gaps for both male/female life expectancy between Harborne and England have shortened. •
Male life expectancy has increased by 4.6% from 74.1 years in 1995/97 to 77.6 years in 2005/07.
•
The gap in male life expectancy between Harborne and England has shortened from 0.5 years to 0.1 years, which means a decrease of 81%.
•
Female life expectancy has increased by 5.2% from 77.7 years in 1995/97 to 81.8 years in 2005/07.
•
The gap in female life expectancy between Harborne and England has now closed and is equal to the national average.
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4. Infant mortality In areas with high infant mortality rates, the life expectancy at birth is highly sensitive to the rate of death in the first few years of life. Infant Mortality Rate (IMR) is calculated as the number of newborns dying under one year of age in every 1,000 live births during the year, excluding still births. Figure 2.3 shows trends of IMR in Harborne, Birmingham, England and the most deprived quintile (i.e. 20%) Super Output Areas (SOAs) in Birmingham (based on Lower Super Output Area level IMD score 2007), from 1999/01 to 2005/07. Harborne Infant Mortality Rate - 3 year rolling average 14.0 12.0
Rate per 1,000
10.0 8.0 6.0 4.0 2.0 0.0 1999 / 01
2000 / 02
2001 / 03
2002 / 04
2003 / 05
2004 / 06
2005 / 07
Trend Year Birmingham M ost Deprived Quintile in Bham
England Harborne
Data source: Birmingham, West Midlands and England: National Centre for Health Outcomes Development Most deprived quintile in Birmingham: PHIT
Figure 2.3 Infant mortality rates per 1,000 births in Harborne, Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 2005/07, the IMR in Harborne is slightly higher than in England but lower than in Birmingham. The IMR for those in the most deprived quintile of Birmingham is higher than the Birmingham average. • •
From 1999/01 to 2005/07, the IMR in Harborne has decreased by 28.5%. Birmingham’s IMR has also decreased. Over this time, the gap in IMR between the most deprived quintile SOAs in Birmingham and Harborne has widened from 4.3 to 4.6 per
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•
1,000 less than those in most deprived SOAs, an increase of 6.91% overall. During the same period, the IMR in England has decreased smoothly from 5.6 to 4.9 per 1,000 (at about 0.1 per 1,000 per year). The gap between Harborne and England has decreased from 1.6 to 0.3 per 1,000 above England (81.6%).
5. Mortality rates on selected diseases Age-specific mortality rate is used to calculate life expectancy at birth. Disease specific standardised mortality rates are investigated, in order to identify leading diseases that contribute to the overall mortality rates in Harborne. Table 3.1 shows directly standardised mortality rates for selected conditions in 2005/07. Percentage of each disease’s rate out of the overall rate is also shown here. Cancers, circulatory diseases and coronary heart disease are the major killers. They make up more than 74.6% of the overall DSR. This percentage is consistent with both city and local PCT levels which vary from 72% to 82%. Table 3.1
Directly Standardised Mortality Rates (DSRs) per 100,000 population for selected conditions, Harborne, 2005/07
All Causes
DSR 644.6
% out of all causes rate* 100.0%
All Cancers
184.4
28.6%
All Circulatory Diseases
200.8
31.1%
Coronary Heart Disease
95.8
14.9%
* Percentage of rate for the specific disease out of rate for all causes Data source: National Centre for Health Outcomes Development
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