Life Expectancy Ward Analysis Ward Profile: Ladywood Tackling Health Inequalities: Life Expectancy
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Date
June 2009
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Green
File location (public) Filename and path to locate this document
PHIT - Ladywood.doc
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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). Eleven wards (out of 40) in Birmingham were identified as proposed target wards for the life expectancy work stream. Details of the identification of the target wards are published in a separate report: ‘Birmingham Health Profile – Tackling Health Inequalities: Life Expectancy’. 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 into leading conditions that cause deaths locally to provide local focus for each target ward and
•
Suggest future area/ factors for extended research
This report is written by Birmingham Public Health Information Team, Suite 203, CIBA Building, 146, Hagley Road, Birmingham B16 9NX Author s
Jeanette Davis (Public Health Information Analyst) Yang Tian (Public Health Information Team Leader) yang.tian@benpct.nhs.uk
0121 465 2995 Chris Stephen (Public Health Information Analyst) Mohan Singh (Public Health Database Administrator/ Analyst) Iris Fermin (Head of Information and Intelligence) Section Director
PHIT - Ladywood.doc
Jim McManus (Joint Director of Public Health)
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Summary •
Electoral ward Ladywood is in the boundary of Heart of Birmingham Teaching PCT (HOB)
•
Ladywood account for 1.42% of population of Birmingham in 2006
•
One of the largest age groups are children and young people [0 – 19] at (20.02%)
•
Black and Minority Ethnicity (BME) group split (40.1%) is higher that national average (11.3%) overall but lower than Birmingham (32.7%). This group accounted for 0.72% of Birmingham’s total population in 2001
•
Ladywood is the 10th (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects: o Life expectancy is now 71.69 for men, 78.5 for women in the year 2005/07 o Male life expectancy has increased by 2.7%. The gap of male life expectancy between Ladywood and England has widened by 0.70 year (i.e. 7 months) from 95/97 to 05/07 o Female life expectancy has increased by 6.4%. The gap of female life expectancy between Ladywood and England has narrowed by 50% from 95/97 to 05/07 o Overall the ten years since 95/97 has seen a decrease of 81% in IMR levels o Circulatory diseases (34.49%), Cancers (21.31%) and Coronary Heart Diseases (18.04%) are the leading conditions that cause deaths in the ward
•
The latest extraction for 2005/07 additionally reflects: o 7.9 percentage points smoke more o 2.8 percentage points are less obese o 2.1 percentage points binge drink less
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1
Local context: demographics and deprivation
This section describes population demographics and deprivation in Ladywood to provide a local context for life expectancy inequalities. Comparisons are made with Birmingham and England.
1.1 Age and sex distribution The population of Ladywood is estimated to be 18,327. This represents 1.42% of the population of Birmingham. Approximately 50.3% (9,293) are male and 49.7% are female (9,034). These estimations are based on ONS mid-year population 2006. The population pyramid (Figure 1.1) shows the age and sex distributions. Population By Age Group and Gender
80+
80
128
Males
75-79
160
70-74
160
212
60-64
203
320
55-59
252 289
399
50-54
451
45-49
Females
181
169
65-69
330
509
40-44
445 480
618
35-39
811
30-34
607
1107
25-29
797 1425
1389
20-24
1608
1284
15-19
564
767
10-14
323
5-9
314 384
345
0-4
511
2000
1500
1000
500
535
0
500
1000
1500
2000
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Ladywood, 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 20.02% (3,743) of the Ladywood population. Persons of retirement age (age 65+) account for a 7.98% (1,463).
•
There are 2.03 percentage points less fewer than 19s in the ward than in the city. Equally, the ward also has a lower level of over 65s i.e. 2.96 percentage points below the city level
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1.2 Ethnicity Ethnicity has some influences in terms what kind of illness an individual could develop through their life. Thus, ethnicity analysis becomes a requirement in order to target health vulnerable people. Table 1.1 shows the ethnicity distribution in the Ladywood population, compared with Birmingham and England. •
•
• • Table 1.1
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 two fifths (40.1%) of the population are of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 4.6%, Indian 5.4% and Black Caribbean 15.6%. The BME (40.1%) higher than Birmingham (32.7%) and England (11.3%). White ethnicity (59.9%) is lower than national and city levels. Ethnicity groups for Ladywood (2001), Birmingham (2006) and England (2006)
Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total
%
Ladywood N* 59.9 8.9 11.2 1.7 19.3 2.9 6.7 1.0 2.9 .3 100 14.8
%
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
%
England N* 88.7 45,018.1 5.5 2,786.6 2.8 1,403.0 1.6 829.5 1.4 725.7 100 50,762.9
*populations by thousand Data source: ONS population estimates by ethnic group Mid 2006 2001 Census data for Ward
1.3 Deprivation According to Index of Multiple Deprivations (IMD) 2007 published by ONS, Ladywood is the 10th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 45.771. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Ladywood is in the second and third most deprived SOAs in Birmingham. Table 1.2 shows the area covered by the ward and population density. Ward Area 2
2
Area (KM )
Population Density (persons / km )
Population Density – Working Age 2 16-64 (persons/km )
5.474
4370
3009
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 Ladywood by IMD quintile, 2007
1.4 Lifestyle Table 1.3 provides a summary of life style indicators in Ladywood, in comparison with Birmingham and England. Data presented are from synthetic estimates of healthy life style behaviours from the NHS Information Centre •
• •
Table 1.2
In terms of proportion of people who smoke, binge drink and are obese, Ladywood has a higher proportion who smoke (7.9 percentage points more), less people who binge drink 2.1 percentage points less) or who are obese (2.8 percentages points less) than both the City and National averages. Compared with the national average, fewer people living in Ladywood eat healthily (13.5 percentage point lower). Table 1.3 shows that Ladywood has a higher proportion of people who smokes and warrants further investigation into the causes of the additional percentage. Key figures for life style Deprivation in Ladywood, Birmingham and England
Adults who smoke Binge drinking adults* Healthy eating adults** Physically active adults*** Obese adults**** * ** *** ****
Year 2003/5 2003/ 2005 2003/ 2005 2007/8 2003/ 2005
Ladywood 32.8% 15.7% 22.8% NA at Ward Level 20.6%
Birmingham 24.9% 17.8% 25.1%
England 24.1% 18.0% 26.3%
16.9%
21.3%
23.4%
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 Physically active: 30 minutes of moderate intensity sport and active recreation on at least three days a week basis. 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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2
Life expectancy trend
Life expectancy is one of the most important determinants for health inequalities across the population; and there is evidence. 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 trend of male expectancy in Ladywood from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 shows evidence that male life expectancy has increased consistency since 1995/97 but is still lower that the Birmingham rate. This therefore needs to be investigated further for causes and solution. Male Life Expectancy - 3 yr Rolling Average, Ladywood, Birmingham & England 80.0 78.0
Life Expectancy (Age)
76.0 74.0 72.0 70.0 68.0 66.0
/0 6
/0 5
/0 7 20 05
20 04
20 03
/0 4
20 02
/0 2
/0 3 20 01
20 00
/0 1
19 99
/0 0
/9 9
19 98
/9 8
19 97
19 96
19 95
/9 7
64.0
Calendar Year Ladywood M ales
England M ales
Birmingham M ales
Data source: ONS
Figure 2.1
Male Life expectancy, Ladywood, Birmingham and England, 1995/97 – 2005/07
Figure 2.2 shows trend of female expectancy in Ladywood from 1995/96 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.2 show that whilst the female life expectancy rate has increased gradually since 1995/97, 2007 saw a drop. This needs to be investigated and acted upon.
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Female Life Expectancy - 3 Yr Rolling Average, Ladywood, Birmingham & England 84.0 82.0
Life Expectancy (Age)
80.0 78.0 76.0 74.0 72.0 70.0
/0 7 20 05
/0 6 20 04
/0 5 20 03
/0 4 20 02
/0 3 20 01
/0 2 20 00
19 99
/0 1
/0 0 19 98
/9 9 19 97
19 96
19 95
/9 7
/9 8
68.0
Calendar Year Ladywood Females
England Females
Birmingham Females
Data source: ONS
Figure 2.2 Female life expectancy for Ladywood, Birmingham and England 1995/97 – 2005/07
As illustrated in Figure 2.1 and Figure 2.2, life expectancy for both males and females has increased. Female life expectancy has increased faster than male life expectancy. Life expectancy in Ladywood is lower than City and national average. The gap of female life expectancy between Ladywood and England has narrowed, while the gap for males has widened. In conclusion: •
Male life expectancy has increased by 2.7% (1.88 years, from 69.7 years during 95/97 to 71.69 years by 05/07).
•
The gap of male life expectancy between Ladywood and England has widened by 0.70 year (i.e. 7 months) from 3.3 years to 4.0 years, which means an increase of 21%.
•
Female life expectancy has increased by 6.4% (4.7 years, from 73.8 in 95/97 years to 78.5 years by 05/07).
•
The gap of female life expectancy between Ladywood and England has narrowed by 50% (from 4.6 years to 2.3 years).
•
Male 71.7 years, Female 78.5 years; this is a reduction of 4.6%.
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2.1 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 2.6 shows trends of IMR in Ladywood, 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 to 2007. Ladywood Infant M ortality Rate - 3 year Rolling average 20.0 18.0 16.0 Rate per 1,000
14.0 12.0 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
Years Ladywood England
Birmingham M ost Deprived Quintile in Bham
Data source: Birmingham, West Midlands and England: National Centre for Health Outcomes Development Most deprived quintile in Birmingham: PHIT
Figure 2.6 Infant mortality rate per 1,000 birth in Ladywood, Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.6, in 05/07, the IMR is approx. 45.9% higher than England and that in the most deprived quintile is about two folds of England. • •
• •
From 99/01 to 05/07, the IMR has decreased by 59.5% (10.4). Ladywood is now lower than the most deprived quintile group SOAs in Birmingham. During the whole period, IMR in the most deprived quintile group has decreased from 11.5 to 9.8 (15%). The gap between the most deprived quintile and Ladywood as a whole has decreased too by 53% from 6.0 higher to 2.8 lower. During the same period, the IMR in England has decreased smoothly from 5.6 to 4.9 (at about 0.1 per year). The gap between Ladywood and England has decreased from 11.9 to 2.2 (81%).
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3
Local focus
This section investigates into the leading causes of deaths locally
3.1
Mortality rates on selected diseases
Age-specific mortality rate is used to calculate life expectancy at birth. Disease specific standardised mortality rates are investigated into in this part in order to identify leading diseases that contribute to the overall mortality rates in Ladywood. Table 3.1 shows directly standardized mortality rates for selected conditions in 2005-2007. Percentage of each disease’s rate out of the overall rate is also shown here. According to the figures, cancers, circulatory diseases and coronary heart disease are the major kiilers. They make more than 73.14% of the overall DSR. This percentage is consistent with both city and local PCT level which vary from 72% to 82% Table 3.1
Directly Standardized Mortality Rates (DSRs) per 100,000 population for selected conditions in Ladywood 2005-2007 DSR
% out of all causes rate*
All Causes
895.77
All Cancers
191.61
21.39%
All Circulatory Diseases
308.96
34.49%
Coronary Heart Disease
161.59
18.04%
•
Percentage of rate for the specific disease out of rate for all causes
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