Local Area Agreement target monitoring
Health Indicators in Birmingham LAA 2008 - 2011 Update to include data for 2008/2009 January 2010
VERSION CONTROL AND DOCUMENT GOVERNANCE Prepared by
Yang Tian, Andy Baker, Jeanette Davis, Ping Sun and Mohan Singh
Approved by
Iris Fermin
Version
Final draft
Date
07/01/2010
File location (public)
http://www.bhwp.nhs.uk/Apps/Content/html/viewContent.aspx?fid =89
Filename and path to locate this document
Y:\Public Health\PHIT\Public Health Server\2. Data and Reports\2. PHIT Reports & Bulletins\Flash Reports\LAA indicators
Contents 1.
Introduction .................................................................................................... 3 1.1. 1.2.
Definition and current performance of the indicators .................................. 3 Related publications................................................................................... 4
2.
NI 8: Adult participation in sport and recreation.......................................... 5
3.
NI 39: Alcohol related hospital admissions.................................................. 7
4.
NI 56: Childhood obesity ............................................................................... 8
5.
NI 112: Under 18 conception ......................................................................... 9
6.
NI 120 (a): All-age All-cause Mortality (AAACM) for males........................ 11
7.
NI 120 (b): All-age All-cause Mortality (AAACM) for females .................... 12
8.
NI 123: 4-week smoking quitters ................................................................. 13
9.
NI 129: End of life care................................................................................. 14
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1. Introduction This document presents health indicators in the Birmingham Local Area Agreement (LAA) 2008-2011 which are monitored by the Public Health Information Team at Birmingham Health and Wellbeing Partnership. Seven indicators are covered in this LAA target monitoring report: • NI 8: Adult participation in sport • NI 39: Alcohol related hospital admissions • NI56: Childhood obesity • NI112: Under 18 conception • NI120a and NI120b: All-age, All-cause mortality rates for males and females • NI123: 4-week smoking quitters • NI129: End of life care This document presents for each indicator a summary of current performance. Rating is given to each indicator in terms of achieving the 2008/09 target as set in the LAA: • Green: On target • Amber: Slightly off target or data not available yet • Red: Off target
1.1. Definition and current performance of the indicators Table 1 shows the definition of the LAA indicators and a summary of the current performance against the LAA target 2008/09. Details of the performance of each indicator are described in the rest of the report. Table 1
Definition and current performance of the LAA health indicators
LAA Indicator
Definition
2008/09 performance
NI 8: Adult participation in sport
Percentage of adult population who participate in sport and active recreation, at moderate intensity, for at least 30 minutes on 3 or more days a week.
18.1%
NI 39: Alcohol-related hospital admissions
Directly age-standardised rate of alcohol related admissions per 100,000 population.
1,943 per 100,000
Percentage of children in Year 6 with height and weight recorded who are obese.
21.6%
NI 56: Childhood obesity
NI 112: Under 18 conception
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Percentage of children in Year 6 with height and weight recorded. Under-18 conceptions per 1,000 girls aged 1517 years resident in the area for the current calendar year, as compared with the 1998 baseline rate, shown as a percentage of the 1998 rate.
Data not available yet
3
Table 1
Definition and current performance of the LAA health indicators
NI 120a: All-age, All-cause mortality for males
Directly age-standardised mortality rates (per 100,000 population) for males for the current calendar year.
777.5 per 100,000
NI 120b: All-age, All-cause mortality for females
Directly age-standardised mortality rates (per 100,000 population) for females for the current calendar year.
523.7 per 100,000
NI 123: 4-week smoking quitters
Crude rate (per 100,000 population aged 16 or over) of self-reported 4-week smoking quitters.
1,102 per 100,000
NI 129: End of life care
Percentage of deaths at home registered in the respective calendar year over the total number of deaths registered in the respective calendar year.
19.2%
1.2. Related publications The Birmingham Local Area Agreement (LAA) 2008 - 2011 that specifies all the targets for the indicators can be accessed from the link: (http://www.bebirmingham.org.uk/page.php?id=85) A report on mortality target monitoring on the current (i.e. data for 2008) performance of life expectancy and All-age All-cause mortality (NI120) in Birmingham was produced by the PHIT team in December 2009. It can be accessed from the link: (http://www.bhwp.nhs.uk/Files/Content/L/191/Mortality%20Target%20Monitoring%20f inal.pdf) A report on the current performance of childhood obesity (NI 56) in Birmingham was produced by the PHIT team in December 2009. It can be accessed from the link: (http://www.bhwp.nhs.uk/AssetLibrary/PHIT%20Publications/PHIT%20Childhood%20 Obesity%20Flash%20Report%2008_09.pdf)
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2. NI 8: Adult participation in sport and recreation Current performance NI 8 (2008/09): 18.1%
Amber: 0.1 percentage point under the LAA target (18.2%)
Table 2 shows the targets for NI 8 set in the LAA 2008-11. Table 2 LAA targets for NI 8, Birmingham, 2008/09 to 2010/11 2008/09 NI 8 Adult participation in sport and active recreation
18.2%
2009/10 19.2%
2010/11 20.2%
Table 3 shows Birmingham’s performance from 2005/06 to 2008/09. Table 3
NI 8: Adults who participate in sport and recreation at least 3 days a week x 30 minutes moderate, Birmingham and constituencies, 2002/03 to 2008/09
Area
Oct' 05 to Oct' 06
Oct' 07 to Oct' 08
Oct' 08 to Oct' 09
Percent
Percent
Percent
Edgbaston (LA Group)
*
20.3
*
Erdington (LA Group)
*
15.8
*
Hall Green (LA Group)
*
20.1
*
Hodge Hill (LA Group)
*
13.8
*
Ladywood (LA Group)
*
16.0
*
Northfield (LA Group)
*
15.6
*
Perry Barr (LA Group)
*
16.5
*
Selly Oak (LA Group)
*
15.9
*
Sutton Coldfield (LA Group)
*
22.4
*
Yardley (LA Group)
*
15.9
*
17.2
17.2
18.1
Birmingham (LA Group) Data source: Sports England Active People Survey
Table 3 shows that: •
The percentage of Birmingham’s population participating in at least 3 days a week of 30 minutes moderate sport and recreation has increased from 17.2% in 2005/06 to 18.1% in 2008/09.
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•
NI8 in Birmingham in 2008/09 (18.1%) is generally on target with only 0.1 percentage point lower than the LAA target (18.2%).
•
The results also show that in 2007/08 Sutton Coldfield constituency has the highest participation rate (22.4%), followed by Edgbaston (20.3%) and Hall Green (20.1%). Hodge Hill has the lowest rate of participation (13.8%).
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3. NI 39: Alcohol related hospital admissions The LAA 2008-11 does not include NI 39. However, a local alcohol related harm indicator (LI Alcohol related harm) is included and the performance of NI 39 reflects the performance of this local indicator. Table 4 shows the trend of alcohol related hospital admissions rate (per 100,000) in Birmingham from 2002/03 to 2008/09. It shows that: •
The rate of admissions for alcohol related harm has increased every year from 2002/03 to 2008/09.
•
The most recent yearly increases have been smaller but still show a 5% increase from the previous year.
Table 4
NI 39: Age standardised rate (per 100,000) of alcohol related hospital admissions in Birmingham, 2002/03 to 2008/09
Year
% Change from previous year
EASR*
2008/09
1943
5.1%
2007/08
1849
4.6%
2006/07
1768
9.9%
2005/06
1609
12.0%
2004/05
1437
19.2%
2003/04
1206
9.8%
2002/03
1098
*EASR is an age and sex standardised rate to the European Standard Population. Data source: North East Public Health Observatory
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4. NI 56: Childhood obesity Current performance NI 56 (2008/09): 21.6%
Green: LAA target achieved by 0.3 percentage points below the target (21.9%).
Table 5 shows the targets for NI 56 set in the LAA 2008-11. Table 5 LAA targets for NI 56, Birmingham, 2008/09 to 2010/11 2008/09 NI 56 Obesity in primary school age children in Year 6
2009/10
21.9%
2010/11
21.8%
21.7%
Table 6 shows the Birmingham’s performance on NI 56 in the years 2007/08 and 2008/09. It shows that: •
The percentage of obesity in Year 6 children reduced from 22.1% in 2007/08 to 21.6% in 2008/09. This is now 0.3 percentage points below the LAA target.
•
However, the overall trend over the three years is up slightly.
•
The percentage of children measured has overall increased across the PCTs.
Table 6
NI 56: Obesity in primary school age children in Year 6, Birmingham, 2006/07 to 2008/09
Prevalence of Obesity (%) Pupil Participation Rate (%) (given separately for PCTs)
2006/07
2007/08
2008/09
21.5
22.1
21.6
BEN
HOB
SB
BEN
HOB
SB
BEN
HOB
SB
87.9
85.6
93.3
89.3
95.7
89.4
87
92
96
Data source: PCT childhood obesity monitoring programmes. PHIT calculation.
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5. NI 112: Under 18 conception Current performance: NI 112 (2008/09)
Amber: 08/09 data not available yet. Trend for future not clear.
Table 7 shows the targets for NI 56 set in the LAA 2008-11. Table 7 LAA targets for NI 112, Birmingham, 2008/09 to 2010/11 Baseline NI 112 Under 18 conception rate
2008/09
58.3 per 1,000 15-17 year olds (1998)
2009/10
15.9% reduction on baseline (i.e. 49.0 per 1,000)
19.5% reduction on baseline (i.e. 46.9 per 1,000)
The latest data available from the ONS on under 18 conception is for the year 2007. Data for 2008 will be available in February 2010. Table 8 shows the under 18 conception rate in Birmingham in 2007, compared with the rate in 1998 (baseline). It shows that the rate has reduced by 9.3% in 2007, from the 1998 baseline. To achieve the LAA target for 2008/09, a further 6.6 percentage points’ reduction (i.e. 3.9 per 1,000) is needed. Table 8
NI 112: Number and rate of under 18 conception per 1,000 girls of 15-17 years old, Birmingham, 1998 and 2007 1998 Rate
N Under 18 conception
2007
1165
Rate
N
58.3
1998-2007
1121
% change in rate
52.9
-9.3%
Data source: ONS
Figure 1 shows the trend of under 18 conception rate in Birmingham, compared with West Midlands and England & Wales, from 1998 to 2007. Figure 1 NI 112 - Under 18 conception 60.0
Rate per 1000
55.0
50.0
45.0
40.0
35.0 1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Year Birmingham MCD
West Midlands
England and Wales
Data source: ONS
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Figure 1 shows that the rate has reduced in Birmingham during the 10-year period. However, it is not a continuous reduction as in some years the rate went up. Therefore, it is hard to estimate whether the 2008/09 LAA target will be achieved.
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6. NI 120 (a): All-age All-cause Mortality (AAACM) for males Current performance NI 120a (2008): 777.5 per 100,000
Red: Higher than the LAA target by 24.5 deaths per 100,000 population in 2008.
Table 9 shows the targets for NI 120(a) set in the LAA 2008-11. Table 9 LAA targets for NI 120(a), Birmingham, 2008/09 to 2010/11 2008/09 NI 120(a) all-age all cause mortality rate - males
2009/10
753
721.6
2010/11 694
Single year AAACM rate for Birmingham has fallen in 2008. •
For males, AAACM rate has reduced to 777.5 deaths per 100,000 population in 2008 from 1068.7 deaths per 100,000 population in 1995, a fall of 27.2%.
•
The 2008 AAACM rate for Birmingham males is higher than the LAA target (NI120a) for this period by 24.5 deaths per 100,000 population.
Figure 2 shows single year AAACM trend in Birmingham for males against the LAA target (NI 120a). Figure 2
1100.00 1000.00 900.00 800.00 700.00
Years Birmingham Trend
20 11
20 10
20 09
20 08
20 07
20 06
20 05
20 04
20 03
20 02
20 01
20 00
19 99
19 98
19 97
19 96
600.00 19 95
Age standardised rate per 100,000 Population
All age all cause mortality (AAACM) - Males Trend and Trajectory: Birmingham MCD 1995 - 2008
Source: Trend - NCHOD LAA trajectory - Birmingham LAA 08-11
LAA trajectory
The current trend for male AAACM suggests challenge in achieving the LAA target in 2010/11.
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7. NI 120 (b): All-age All-cause Mortality (AAACM) for females Current performance NI 120b (2006-08): 523.7 per 100,000
Amber: Slightly higher (1.7 deaths per 100,000 population) than the LAA target.
Table 10 shows the targets for NI 120(b) set in the LAA 2008-11. Table 10
LAA targets for NI 120(b), Birmingham, 2008/09 to 2010/11 2008/09
NI 120(b) all-age all cause mortality rate - females
2009/10
522 (2006-08)
511 (2007-09)
2010/11 499 (2008-10)
Three-year average AAACM rate for Birmingham has fallen in each period since 1995-97. •
For females, AAACM rate has reduced to 523.7 deaths per 100,000 population in 2006-08 from 655.2 deaths per 100,000 population in 1995-97, a fall of 20.1%.
•
The 2006-08 AAACM rate for Birmingham females is slightly (i.e. 1.7 deaths per 100,000 population) higher than the LAA target for this period.
Figure 3 shows 3-year average AAACM trend in Birmingham for females against the LAA target (NI 120b).
All age all cause mortality (AAACM) - Females Trend and Trajectory: Birmingham MCD 1995/1997 to 2006/08 800.00 700.00 600.00 500.00
to 19 19 97 96 to 19 19 98 97 to 1 19 99 98 9 to 20 19 00 99 to 20 20 01 00 to 20 20 02 01 to 2 20 00 02 3 to 20 20 04 03 to 20 20 05 04 to 20 20 06 05 to 2 20 00 06 7 to 20 20 08 07 to 20 20 09 08 to 2 20 01 09 0 to 20 11
400.00
19 95
Age standardised rate per 100,000 Population
Figure 3
Years Birmingham Trend PSA trajectory LAA target
Source: Trend - NCHOD PSA trajectory - PHIT calculation LAA trajectory - Birmingham LAA 08-11
The AAACM trend for females is broadly on course to deliver the LAA target in 200810.
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8. NI 123: 4-week smoking quitters Current performance NI 123 (2008/09): 1102 per 100,000
Green: LAA target achieved by 87 per 100,000 above the target.
Table 11 shows the targets for NI 123 set in the LAA 2008-11. Table 11
LAA targets for NI 123, Birmingham, 2008/09 to 2010/11 2008/09
NI 123 Stopping smoking
2009/10
1015 per 100,000
2010/11
1015 per 100,000
1015 per 100,000
In the year 2008/09, Birmingham has achieved the LAA target for NI123. The crude rate (per 100,000) of 4-week smoking quitters in Birmingham has reached 1102 per 100,000. This is 87 per 100,000 above the target (1015 per 100,000). Figure 4 shows the trend of 4-week smoking quitters’ rate in Birmingham from 2004/05 to 2008/09. It shows that although the current rate is above the target, it has continuously decreased since 2006/07. Figure 4 NI 123: 4-week smoking quiters, Birmingham, 2004/05 - 2008/09 1600.00
1440.97
1400.00
1313.63 Rate per 100,000
1200.00
1172.36
1136.18
1102.39
1000.00 800.00 600.00 400.00 200.00 0.00 2004/2005
2005/2006
2006/2007
2007/2008
2008/2009
2009/2010
2010/2011
Year Rate per 100,000
Target per 100,000
Data source: North 51 call to quit website, ONS mid year population estimate
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9. NI 129: End of life care Current performance NI 129 (2008/09): 19.2%
Green: LAA target achieved by 0.4 percentage points higher than the target (18.8%).
Table 12 shows the targets for NI 129 set in the LAA 2008-11. Table 12
LAA targets for NI 129, Birmingham, 2008/09 to 2010/11 2008/09
NI 129 End of life care – access to appropriate care enabling people to be able to choose to die at home.
2009/10
18.8%
21.8%
2010/11 24.8%
In 2008/09, Birmingham has achieved the target for NI 129: end of life care (18.8%). The Percentage of all deaths occurring at home in Birmingham was 19.23% in this year. Figure 5 shows Birmingham’s performance on NI 129 in the years 2007/08 and 2008/09. It shows that: •
There has been a slight improvement in the overall percentage of people who fulfil the dying at home criteria from 18.3% in 2007/8 to 19.2% in 2008/09. This is slightly higher than the LAA target for 2008/9 of 18.8%. Birmingham is on track to achieve its 2010/11 target of 24.8%.
•
All three of the PCTs are also showing improvements and are on course to achieve the 2010/11 target.
Figure 5 NI 129: End of Life Care - Percentage of All Deaths Occuring at Home, Birmingham, 2007/08 to 2008/09 27.00% 24.00% 21.00%
18.31%
19.23%
18.00% 15.00% 12.00% 9.00% 6.00% 3.00%
Birmingham MCD
11 20 10 /
20 09 /
10
09 20 08 /
20 07 /
08
0.00%
LAA Target
Data source: ONS death data, PHIT calculation
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