Life Expectancy Ward Analysis Ward Profile: Lozells and East Handsworth Tackling Health Inequalities: Life Expectancy
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Date
June 2009
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Green
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PHIT - Lozells & Handsworth LE.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
Jim McManus (Joint Director of Public Health)
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Summary •
The electoral ward of Lozells and East Handsworth is in the boundary of Heart of Birmingham Teaching PCT (HOB)
•
Lozells and East Handsworth accounted for 2.25% of Birmingham population in 2006
•
The largest age group in the population are children and young people [0 – 19] at 35.3%
•
Black and Minority Ethnicity (BME) group split (82.6%) is higher than national average (11.3%) overall and higher than Birmingham (32.7%). This group accounted for 2.44% of Birmingham’s total population in 2001
•
Lozells and East Handsworth is the 9th (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects: o
Life expectancy in Lozells and East Handsworth is now 73.4 for men, 80.8 for women in the year 2005/07
o Male life expectancy has increased by 5%. The gap of male life expectancy between Lozells and East Handsworth and England has decreased by 29.3% from 1995/97 to 2005/07. o Female life expectancy has increased by 3.3%. The gap of female life expectancy between Lozells and East Handsworth and England has narrowed by 0.50% from 1995/97 to 2005/07 o o
Since 95/97 the ward has seen a 13.6% increase in the IMR, with the gap between England and the ward widening by 59.4% Circulatory diseases (34.35%), Cancers (25.54%) and Coronary Heart Diseases (20.09%) are the leading conditions that cause deaths in the ward
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Local context: demographics and deprivation
This section describes population demographics and deprivation in Lozells and East Handsworth 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 Lozells and East Handsworth is estimated to be 29,369. This represents 2.28% of the population of Birmingham. Approximately 50.6% (14,867) are male and 49.4% are female (14,502). 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+
117
143
Males 75-79
247
70-74
353
65-69
356
60-64
405 436
508
45-49
610
702
40-44
711
830
35-39
843
1130
30-34
993
1306
25-29
1075
1477
1347
1959
1580
15-19
1188
10-14
1320
1127
5-9
1151
1272
0-4 2500
403
368
50-54
Females
349
321
55-59
20-24
284
1169
1551
2000
1585
1500
1000
500
0
500
1000
1500
2000
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Lozells and East Handsworth, 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 35.3% (10,363) of the Lozells and East Handsworth population. Persons of retirement age (age 65+) account for 8.2% (2,405).
•
Compared with the age structure of Birmingham, Lozells and East Handsworth has a larger proportion of children and young people, 13.25 percentage points more and a smaller proportion of persons of older age groups – 2.44 percentage points less.
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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 Lozells and East Handsworth 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 four fifths (82.6%) of the population are of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 24%, Indian 17.9% and Black Caribbean 16%. The BME (82.6%) is higher than Birmingham (32.7%) and England (11.3%). White ethnicity (17.4%) is lower than national and city levels. Ethnicity groups for Lozells and East Handsworth (2001), Birmingham (2006) and England (2006) Lozells & East Handsworth % N* 17.4 4.9 56.1 15.7 19.7 5.5 3.8 1.1 3.0 0.8 100 28.0
Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total
Birmingham %
N* 67.3 20.7 6.7 3.2 2.3 100
667.0 207.9 67.0 31.8 22.9 1,106.5
England % 88.7 5.5 2.8 1.6 1.4 100
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 2001 Census Data for Ward
1.3 Deprivation According to Index of Multiple Deprivations (IMD) 2007 published by ONS, Lozells & East Handsworth is the 9th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 46.221. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Lozells & East Handsworth 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 )
3.829
7728
5024
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 Lozells & East Handsworth by IMD quintile, 2007
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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 Lozells and East Handsworth from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 shows an increase in male life expectancy for the ward; however it is still lower than Birmingham and therefore needs investigating. Male Life Expectancy - 3 yr Rolling Average, Lozells & East Handsworth, Birmingham & England 80.0 78.0
Life Expectancy (Age)
76.0 74.0 72.0 70.0 68.0 66.0
/0 7 20 05
/0 6
/0 5
20 04
20 03
/0 4 20 02
/0 3
/0 2
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 Lozells & East Handsworth M ales
England M ales
Birmingham M ales
Data source: ONS
Figure 2.1 Male life expectancy, Lozells & East Handsworth, Birmingham and England, 1995/97 – 2005/07
Figure 2.2 shows trend of female expectancy in Lozells and East Handsworth from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Female life expectancy has continued to increase over the last ten years and is now equal to Birmingham but not as high as England.
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Female Life Expectancy - 3 Yr Rolling Average, Lozells & East Handsworth, Birmingham & England 83.0
Life Expectancy (Age)
82.0 81.0 80.0 79.0 78.0 77.0
/0 7 20 05
20 04
/0 6
/0 5 20 03
/0 4 20 02
/0 3 20 01
/0 2 20 00
/0 1 19 99
/0 0 19 98
19 97
/9 8 19 96
/9 7 19 95
/9 9
76.0
Calendar Year
Lozells & East Handsworth Females
England Females
Birmingham Females
Data source: ONS
Figure 2.2 Female life expectancy, Lozells & East Handsworth, Birmingham and England, 1995/97 – 2005/07
Male life expectancy has increased faster than female life expectancy. Life expectancy in Lozells and East Handsworth is lower than City and national average for men but for women equal to the city and lower than the national level. The gap of female life expectancy between Birmingham and England has narrowed, while the gap for males has widened. In conclusion: •
Male life expectancy has increased by 5% (3.5 years, from 69.9 years in 95/97 to 73.4 years by 05/07).
•
The gap of male life expectancy between Lozells and East Handsworth and England has decrease by 0.9 year (i.e. 10.8 months) from 3.1 years to 2.2 years, which means a decrease of 29.3%.
•
Female life expectancy has increased by 3.3% (2.6 years, from 78.2 years in 95/97 to 80.8 years during 05/07).
•
The gap of female life expectancy between Lozells and East Handsworth and England has narrowed by 0.50 (i.e. 6 months) from 1.5 years to 1 years
•
Male 73.4 years, Female 80.8 years; a reduction of 4.1%
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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 Lozells and East Handsworth, 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. Loxells & East Handworth - Infant M ortality Rate - 3 yr Rolling Average 16.0 14.0
Rate per 1,000
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 Lozells & East Handsworth 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 2.3 Infant mortality rate per 1,000 births in Lozells & East Handsworth, Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 05/07, the IMR is 2 times higher than England and that in the most deprived quintile is about two folds higher of England. • •
• •
From 99/01 to 05/07, the IMR has increased by 13.3% (1.2). The most deprived quintile SOAs in Birmingham shares a similar trend over the period as Lozells and East Handsworth, but with steeper decrease between 02/04 and 04/06. 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 Lozells and East Handsworth as a whole has decreased by over 100% from 2.7 to (0.2). 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 Lozells and East Handsworth and England has increased from 3.2 to 5.1 (59.4%).
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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 Lozells & East Handsworth. 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 79.92% 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, Lozells and East Handsworth, 2005-2007 DSR
% out of all causes rate*
All Causes
665.00
All Cancers
169.82
25.54%
All Circulatory Diseases
228.41
34.35%
Coronary Heart Disease
133.63
20.09%
* 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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