Life Expectancy Ward Analysis Ward Profile: Longbridge Tackling Health Inequalities: Life Expectancy
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2
Date
June 2009
Status
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 into leading conditions that cause deaths locally to provide local focus for each target ward and
•
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)
Any further Telephone 0121 465 2995 / 2999 or Information Email : PHIT@benpct.nhs.uk
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Summary •
Electoral ward Longbridge is in the boundary of NHS South Birmingham
•
Longbridge accounted for 2.49% of Birmingham’s population in 2006
•
One of the largest areas of the population are children and young people [0 – 19] at 26.91%
•
Black and Minority Ethnicity (BME) group split (6.8%) is lower than national (11.3%) and Birmingham (32.7%) averages. This group accounted for 0.002% of the total population of Birmingham in 2001.
•
Longbridge is the 21st (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects: o Life expectancy in Longbridge is at 76.1 for men, 80.1 for women in the year 2005/07 o Male life expectancy has increased by 3.2%. The gap between Longbridge and England has widened by 77.8% (0.7 years) from 95/97 to 05/07. o Female life expectancy has reduced by 1.3%. The gap between Longbridge and England has widened by 525% (1.7 years) from 95/97 to 05/07. o Infant Mortality Rates have risen by 12.2 % since 99/01, in comparison the rate for the most deprived wards has dropped o Circulatory diseases (29.03%), Cancers (32.59%) and Coronary Heart Diseases (14.58%) are the leading conditions that cause deaths in the ward.
•
The latest extraction for 2005/07 additionally reflects: o 8.3 percentage points smoke less o 0.9 percentage points binge drink less o 0.1 percentage points are less obese
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1
Local context: demographics and deprivation
This section describes population demographics and deprivation in Longbridge 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 Longbridge is estimated to be 25,157. This represents 2.49% of the population of Birmingham. Approximately 47.8% (12,023) are male and 52.2% are female (13,134). 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 2006 Estimates by Ward Source: Office of National Statistics
361
227
80+ 75-79
321
70-74
323
446
445
65-69
540
721
55-59 50-54
785 834
700 766
45-49
Females
482
555
60-64
Males
428
866 920
907
40-44
938
35-39 30-34
965 896
810
25-29
885
20-24
869
15-19
852
10-14
848
1027 898 862 828 798
811
5-9
888
0-4 1500
1000
882 500
0
500
1000
1500
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Longbridge 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 26.91% (6,769) of the Longbridge population. Persons of retirement age (age 65+) account for 13.94% (3,506).
•
The age structure of the ward indicates that it has 4.86 percentage points more people under 19 than Birmingham and 3.30 percentage points more over 65s.
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1.1 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 Longbridge 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. Under a tenth (6.8%) of the population are non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 0.40%, Indian 0.60% and Black Caribbean 1.9%. The BME (6.8%) is lower than Birmingham (32.7%), and England (11.3%). White ethnicity (93.2%0 is higher than local and national levels. Ethnicity groups for Longbridge (2001), Birmingham (2006) and England (2006)
Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total
%
Longbridge N* 93.2 23.2 1.2 0.3 2.5 0.6 2.7 0.6 0.4 0.1 100 24.8
%
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
*population by thousand Data source: ONS population estimates by ethnic group mid 2006 for Birmingham / England. 2001 Census data for Ward
1.3 Deprivation According to Index of Multiple Deprivations (IMD) 2007 published by ONS, Longbridge is the 21st most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 31.451. Figure 1.2 shows SOAs in Longbridge by IMD quintile, 2007. Most of the area covered by Longbridge 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 )
7.124
3106
2016
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 Longbridge by IMD quintile, 2007
1.4 Lifestyle Table 1.3 provides a summary of life style indicators in Longbridge, in comparison with Birmingham and England. Data presented here are from the synthetic estimates of healthy life style behaviours from the NHS Information Centre. •
• •
Table 1.3
Compared with Birmingham average, Longbridge has a higher percentage of people who binge drink (0.9 percentage points higher). Less are obese (0.1 percentage points) but a higher proportion who smoke (8.9 percentage points higher) Compared with the national average, a smaller percentage of people living in Longbridge eat healthily (9.8 percentage point lower). Table 1.3 shows that smoking amongst adults in Longbridge needs to be investigated; additionally strategies are needed to get the ward to eat healthier. Key figures for life style Deprivation in Longbridge, Birmingham and England
Adults who smoke Binge drinking adults* Healthy eating adults** Obese adults*** * ** ***
Year 2003/5 2003/ 2005 2003/ 2005 2003/ 2005
Longbridge 33.2% 17.9% 15.3% 23.3%
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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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 Longbridge 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 in Longbridge over the ten years since 1995. It is still however lower than national levels; so requires further investigation.
Male Life Expectancy - 3 year rolling average, Longbridge, 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 5
/0 7 20 05
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
70.0
Calendar Year England M ales
Birmingham M ales
Longbridge M ales
Data source: ONS
Figure 2.1 Male life expectancy for Longbridge, Birmingham and England, 1995/97 – 2005/07
Figure 2.2 shows trend of female expectancy in Longbridge from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.2 shows that by 2007 female life expectancy in Longbridge is actually decreasing despite being higher than 1995. More strategies are needed to identify underlying causes of this issue.
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Female Life Expectancy - 3 year rolling average, Longbridge, Birmingham & England 83.0
Life Expectancy (Age)
82.0 81.0 80.0 79.0 78.0 77.0
/0 7 20 05
/0 5
/0 6 20 04
20 03
/0 4 20 02
/0 2
/0 3 20 01
20 00
/0 1 19 99
/0 0
19 98
/9 8
/9 9 19 97
19 95
19 96
/9 7
76.0
Calendar Year England Females
Birmingham Females
Longbridge Females
Data source: ONS
Figure 2.2 Female life expectancy for Longbridge, Birmingham and England, 1995/97 – 2005/07
As illustrated in Figure 2.1 and Figure 2.2, life expectancy for males has increased, whilst for females it has decreased. Life expectancy in Longbridge is lower than City and national average. The gap for both male/female life expectancy between Longbridge and England has increased, with the gap for women being slightly more. In conclusion: •
Male life expectancy has increased by 3.2% (2.38 years, from 73.7 years in 1997 to 76.1 years by 2007).
•
The gap of male life expectancy between Longbridge and England has widened by 0.7 year from 0.9 years to 1.6 years, which means an increase of 77.8%.
•
Female life expectancy has decreased by 1.3% (1.0 years, from 81.1 years in 1997 to 80.1 years by 2007).
•
The gap of female life expectancy between Longbridge and England has widened by 2.1 years from 0.4 years more than England to 1.7 years below
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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 2.3 shows trends of IMR in Longbridge, 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. Longbridge 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 Years Birmingham M ost Deprived Quintile in Bham
England Longbridge
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 Longbridge, Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 05/07, the IMR is less than that of England; whilst that in the most deprived quintile is about two folds of England. • •
•
From 99/01 to 05/07, the IMR has dropped by 12.2%. Along with that of Birmingham’s IMR which has also decreased. The gap between the most deprived quintile SOAs in Birmingham and Longbridge has dropped from 7.2 below to 5.2 below mostly because of improvements for the most deprived quintile IMR 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 Longbridge and England has dropped from 1.5 to 0.3 (80%).
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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 Longbridge. 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, coronary heart disease are the major killers. They make more than 76.2% 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, Longbridge 2005-2007 DSR
% out of all causes rate*
All Causes
694.33
All Cancers
226.29
32.59%
All Circulatory Diseases
201.54
29.03%
Coronary Heart Disease
101.24
14.58%
* 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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