MortalityTargetMonitoring_Dec2009

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Mortality target monitoring

Life expectancy and All-Age All-Cause Mortality, overall and inequalities Update to include data for 2008 December 2009

VERSION CONTROL AND DOCUMENT GOVERNANCE Prepared by

Yang Tian, Mohan Singh, Jeanette Davis and Irena Begaj

Approved by

Iris Fermin

Version

2

Date

16/12/2009

File location (public)

http://www.bhwp.nhs.uk/Apps/Content/html/viewContent.aspx?fid =39

Filename and path to locate this document

Y:\Public Health\PHIT\Public Health Server\2. Data and Reports\2. PHIT Reports & Bulletins\Flash Reports\Mortality


Contents 1.

Introduction .................................................................................................... 3 1.1. 1.2.

2.

Measures................................................................................................... 3 Related publications................................................................................... 3

Key findings ................................................................................................... 3 2.1. Life expectancy at birth/ All-age All-cause Mortality (AAACM) – overall ..... 3 2.1.1. PSA 2010 life expectancy target ........................................................ 3 2.1.2. Life expectancy measure ................................................................... 4 2.1.3. LAA and Vital Signs AAACM targets .................................................. 7 2.1.4. AAACM measure: single year ............................................................ 7 2.1.5. AAACM measure: 3-year average...................................................... 9 2.2. Life expectancy at birth/ All-age All-cause Mortality (AAACM) – inequalities ................................................................................................................ 11 2.2.1. Life expectancy at birth by deprivation quintile ................................. 11 2.2.2. AAACM by deprivation quintile ......................................................... 11

3.

Appendix: Statistical summaries ................................................................ 13 3.1. Life expectancy at birth ............................................................................ 13 3.1.1. Life expectancy at birth 2006 – 2008 by geographical areas in Birmingham.................................................................................................... 13 3.1.2. Life expectancy trend and trajectory - PCTs..................................... 17 3.2. AAACM: Three years average ................................................................. 20 3.2.1. AAACM 2006 – 2008 by geographical areas in Birmingham ............ 20 3.2.2. Three-year average AAACM trend against PSA and LAA target ...... 24 3.3. AAACM: Single years .............................................................................. 27 3.3.1. AAACM 2008 by geographical areas in Birmingham ........................ 27 3.3.2. Single year AAACM trend against LAA and Vital Signs target .......... 31 3.4. Life expectancy and AAACM by deprivation quintile ................................ 34 3.4.1. Life expectancy by IMD quintile - current year .................................. 34 3.4.2. Life expectancy by IMD quintile – trend............................................ 35 3.4.3. AAACM by IMD quintile - current year.............................................. 36 3.4.4. AAACM by IMD quintile - trend......................................................... 36

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1. Introduction This document presents life expectancy at birth figures and all-age all-cause mortality (AAACM) rates, updated to 2006-08. These figures are used to monitor progress against Department of Health (DH) Public Service Agreement (PSA) targets on overall life expectancy and inequalities in life expectancy, and associated indicators on overall AAACM and inequalities in AAACM in the Local Area Agreement (LAA, NI120a and NI120b) and NHS World Class Commissioning Vital Signs (VS, VSB01a and VSB01b). This document follows the release by the Office for National Statistics (ONS) of the annual death registrations’ data and mid-year population estimates figures for 2008. This document presents for each target and indicator a summary of key findings, and a statistical summary with an illustration of the trend.

1.1. Measures The life expectancy targets and AAACM indicators are closely associated, and together constitute a single package of measures used to track progress in improving overall health and reducing health inequalities. The life expectancy targets are the ultimate measure of success, but AAACM is used as a proxy to measure progress, particularly relevant at local level. For the AAACM indicators, progress for England and the Spearhead Group is assessed against the levels required to deliver the targets for overall life expectancy and inequalities in life expectancy.

1.2. Related publications This document updates the data on the inequalities in life expectancy target reported in April 2009 in the Birmingham Life Expectancy report by the PHIT team (accessible from: http://www.bhwp.nhs.uk/Apps/Content/HTML/ViewContent.aspx?id=80). An update on progress against the associated target relating to inequalities in infant mortality will be published by the PHIT team in January 2010. An update on progress against the associated targets relating to mortality from cancer, circulatory diseases, intentional self-harm and accidents will be published by the PHIT team in January 2010.

2. Key findings 2.1. Life expectancy at birth/ All-age All-cause Mortality (AAACM) – overall 2.1.1.

PSA 2010 life expectancy target

The PSA target for overall life expectancy is to increase the average life expectancy at birth in Birmingham to 77.9 years for men and to 81.9 years for women by 2010, in order to close the gap with England by 10%, using 1995/97 figures as the baseline. This equates to AAACM (i.e. age standardised death rate) in Birmingham decreasing to 594 per 100,000 for men and 475 per 100,000 for women by 2009-2011, based on the DH method of converting life expectancy target to AAACM target.

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The targets of life expectancy in 2009-2011 for Birmingham equate to 78.2 years for men and to 81.8 years for women in Birmingham East and North PCT (BEN); 76.1 years for men and to 80.9 years for women in Heart of Birmingham Teaching PCT (HoB); and 78.4 years for men and to 82.1 years for women in South Birmingham PCT (SB).

• • •

2.1.2.

Life expectancy measure

On the life expectancy at birth measure: •

In 2006-08, life expectancy at birth in Birmingham continued to increase for both males and females, and reached its highest level on record at 75.9 years for males and 81.0 years for females.

This compares with life expectancy at birth in 1995-97 of 73.1 years for males and 78.6 years for females (i.e. there has been an increase of 2.8 years (3.8%) for males and 2.4 years (3.1%) for females since 1995-97).

The PSA target trajectory for males in Birmingham is 76.6 years for 2006-08. Birmingham is 0.7 years under the trajectory.

The PSA target trajectory for females in Birmingham is 81.1 years for 200608. Birmingham is 0.1 years under the trajectory.

Figure 1 and Figure 2 show trend of life expectancy in Birmingham against the PSA target for males and females respectively. Figure 1

Male life expectancy - 3 years rolling average

80.00 Projection

79.00 78.00

76.00

73.00 72.00 71.00

Latest

74.00

70.00 19951997

Target year

75.00 PSA target baseline year

Years of age

77.00

19961998

19971999

1998- 19992000 2001

20002002

20012003

20022004

20032005

20042006

2005- 20062007 2008

20072009

20082010

20092011

Years

Birmingham

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England

PSA trajectory*

Data source: England and Birmingham MLE - ONS England MLE Projection - Government Actuary's Department Trajectories - PHIT

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Figure 2 Female life expectancy - 3 years rolling average 85.00 Projection

84.00 83.00

Years of age

82.00 81.00 80.00 79.00

75.00

Target year

76.00

Latest

77.00

Baseline year

78.00

1995- 1996- 1997- 1998- 1999- 2000- 2001- 2002- 2003- 2004- 2005- 2006- 2007- 2008- 20091997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Years

Birmingham

England

PSA trajectory*

Data source: England and Birmingham MLE - ONS England MLE Projection - Government Actuary's Department Trajectories - PHIT

For BEN PCT: •

In 2006-08, life expectancy at birth is 76.3 years for males and 80.6 years for females.

This compares with life expectancy at birth in 1995-97 of 73.5 years for males and 78.5 years for females (i.e. there has been an increase of 2.8 years (3.8%) for males and 2.1 years (2.7%) for females since 1995-97).

For HoB tPCT: •

In 2006-08, life expectancy at birth is 74.2 years for males and 80.6 years for females.

This compares with life expectancy at birth in 1995-97 of 71.2 years for males and 77.6 years for females (i.e. there has been an increase of 3.0 years (4.2%) for males and 3.0 years (3.9%) for females since 1995-97).

For SB PCT •

In 2006-08, life expectancy at birth is 76.6 years for males and 81.8 years for females.

This compares with life expectancy at birth in 1995-97 of 73.7 years for males and 78.8 years for females (i.e. there has been an increase of 2.9 years (3.9%) for males and 3.0 years (3.8%) for females since 1995-97).

Details of the PCTs’ life expectancy trend against the PSA target can be found in the Appendix (3.1.2.).

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Figure 3 and Figure 4 show maps of life expectancy by ward in Birmingham in 200608 for males and females accordingly. Figure 3

Figure 4

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2.1.3.

LAA and Vital Signs AAACM targets

To achieve the PSA 2010 life expectancy target, targets of AAACM for males and females for the years before the target year (i.e. 2010) have been set in the LAA for Birmingham, and in the World Class Commissioning Vital Signs for the three PCTs in Birmingham. Table 1 shows the LAA and VS targets of AAACM for Birmingham and the PCTs Table 1

AAACM targets for Birmingham and PCTs LAA target (NI120) Birmingham

Vital Signs target (VSB01) BEN

HoB

SB

Male 2008

753

735

841

737

2009

722

702

730

736

2010

694

670

694

694

2011

n/a

638

660

672

2008

522 (2006-08)

522

540

518

2009

511 (2007-09)

510

513

514

2010

499 (2008-10)

499

499

499

2011

n/a

488

485

490

Female

2.1.4.

AAACM measure: single year

Single year AAACM rates for Birmingham have fallen in 2008. •

For males, AAACM rates have 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%.

For females, AAACM rates have reduced to 525.5 deaths per 100,000 population in 2008 from 636.1 deaths per 100,000 population in 1995, a fall of 17.4%.

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.

Comparing with AAACM rates in 2002 (which is the earliest year that Birmingham PCTs’ AAACM rates are available), it has reduced 17.6% for males (from 943.2 per 100,000 population) and 11.0% for females (from 590.7 per 100,000 population).

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Figure 5 shows single year AAACM trend in Birmingham for males against the LAA target (NI 120a). Figure 5

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

For each PCT in Birmingham on the AAACM single year measure: For BEN PCT: •

For males, AAACM rates have reduced to 755.1 deaths per 100,000 population in 2008 from 963.2 deaths per 100,000 population in 2002, a fall of 21.6%.

For females, AAACM rates have reduced to 532.5 deaths per 100,000 population in 2008 from 593.6 deaths per 100,000 population in 2002, a fall of 10.2%.

AAACM rates for both males and females are higher than the Vital Signs targets for 2008 in BEN PCT. Males’ rate is 20 deaths per 100,000 population higher than the target (735 per 100,000), and females’ rate is 10 deaths per 100,000 higher than the target (522 per 100,000).

For HoB tPCT: •

For males, AAACM rates have reduced to 885.7 deaths per 100,000 population in 2008 from 1023.5 deaths per 100,000 population in 2002, a fall of 13.5%.

For females, AAACM rates have reduced to 528.0 deaths per 100,000 population in 2008 from 614.2 deaths per 100,000 population in 2002, a fall of 14.0%.

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AAACM rate for males in HoB tPCT is higher than the Vital Signs 2008 (841 per 100,000 population) by 45 deaths per 100,000 population.

AAACM rate for females in HoB tPCT has achieved the Vital Signs 2008 target (540 per 100,000 population) by 12 deaths per 100,000 population lower than the target.

For SB PCT: •

For males, AAACM rate has reduced to 743.7 deaths per 100,000 population in 2008 from 867.5 deaths per 100,000 population in 2002, a fall of 14.3%.

For females, AAACM rate has reduced to 516.2 deaths per 100,000 population in 2008 from 567.6 deaths per 100,000 population in 2002, a fall of 9.1%.

AAACM rate for males in SB PCT is higher than the Vital Signs 2008 target (737 per 100,000 population) by 7 deaths per 100,000 population.

AAACM rate for females in SB PCT has achieved the Vital Signs 2008 target by two deaths per 100,000 population lower than the target (518 per 100,000 population).

Details of the PCTs’ single year AAACM trend against the VS target can be found in the Appendix (3.3.2.).

2.1.5.

AAACM measure: 3-year average

Three-year average AAACM rates for Birmingham have fallen in each period since 1995-97. •

For males, AAACM rates have reduced to 797.3 deaths per 100,000 population in 2006-08 from 1038.6 deaths per 100,000 population in 1995-97, a fall of 23.2%.

For females, AAACM rates have 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.

Comparing with AAACM rates in 2001-03 (which is the earliest year that Birmingham PCTs’ AAACM rates are available), it has reduced 15.3% (from 941.1) for males and 12.0% (from 595.2) for females.

Figure 6 shows 3-year average AAACM trend in Birmingham for females against the LAA target (NI 120b).

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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 6

Years Birmingham Trend PSA trajectory LAA target

Source: Trend - NCHOD PSA trajectory - PHIT calculation LAA trajectory - Birmingham LAA 08-11

For each PCT in Birmingham on the AAACM 3-year average measure: For BEN PCT: •

For males, AAACM rates have reduced to 774.5 deaths per 100,000 population in 2006-08 from 930.4 deaths per 100,000 population in 2001-03, a fall of 16.8%.

For females, AAACM rates have reduced to 546.8 deaths per 100,000 population in 2006-08 from 601.1 deaths per 100,000 population in 2001-03, a fall of 9.0%.

For HoB tPCT: •

For males, AAACM rates have reduced to 910.00 deaths per 100,000 population in 2006-08 from 1019.7 deaths per 100,000 population in 2001-03, a fall of 10.8%.

For females, AAACM rates have reduced to 523.7 deaths per 100,000 population in 2006-08 from 604.3 deaths per 100,000 population in 2001-03, a fall of 13.3%.

For SB PCT: •

For males, AAACM rates have reduced to 759.5 deaths per 100,000 population in 2006-08 from 905.3 deaths per 100,000 population in 2001-03, a fall of 16.1%.

For females, AAACM rates have reduced to 523.7 deaths per 100,000 population in 2006-08 from 576.1 deaths per 100,000 population in 2001-03, a fall of 9.1%.

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Details of the 3-year average AAACM trend in the Birmingham PCTs against the PSA trajectory can be found in the Appendix (3.2.2.). The life expectancy and AAACM trends for females are broadly on course to deliver the PSA target in 2009-11. However, the current trend for male life expectancy and AAACM suggests challenge in achieving the PSA target in 2009-11.

2.2. Life expectancy at birth/ All-age All-cause Mortality (AAACM) – inequalities 2.2.1.

Life expectancy at birth by deprivation quintile

On the life expectancy at birth measure: •

In 2006-08, the gap between life expectancy in the least (i.e. Q1) and most deprived (i.e. Q5) quintiles in Birmingham is 8.5 years for males and 4.4 years for females.

This compares with the gap in 1995-97 of 7.4 years for males and 5.6 years for females (i.e. the gap in males has widened by 1.1 years and in females has narrowed by 1.2 years).

In 2006-2008, the gap between life expectancy in Birmingham as a whole and the most deprived quintile (i.e. Q5) is 3.9 years for males and 1.7 years for females.

This compares with the gap in 1995-97 of 3.6 years for males and 2.7 years for females (i.e. the gap in males has widened by 0.3 years and in females has narrowed by one year).

Figure 7 and Figure 8 show the trend of the life expectancy gap between the most deprived quintile SOAs in Birmingham and Birmingham as a whole. Details of the trend of inequalities in life expectancy in Birmingham can be found in the Appendix (3.4.1. and 3.4.2.).

2.2.2.

AAACM by deprivation quintile

On the AAACM measure: •

In 2008, the gap between AAACM in the least (i.e. Q1) and the most deprived (i.e. Q5) quintiles in Birmingham is 455 deaths per 100,000 population for males and 160 deaths per 100,000 population for females.

This compares with the gap in 1995 of 506 deaths per 100,000 for males and 291 per 100,000 for females (i.e. the gap in both males and females has narrowed, males by 51 deaths per 100,000 and females by 131 deaths per 100,000).

In 2008, the gap between AAACM rate in Birmingham as a whole and the most deprived quintile (i.e. Q5) is 230 deaths per 100,000 population for males and 57 deaths per 100,000 for females.

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•

This compares with the gap in 1995 of 233 deaths per 100,000 population for males and 157 deaths per 100,000 population for females (i.e. the gap in males has narrowed by 3 deaths per 100,000, and in females has narrowed by 100 deaths per 100,000 population).

Details of the trend of inequalities in AAACM in Birmingham can be found in the Appendix (3.4.3. and 3.4.4.). Figure 7 Male Life Expectancy at Birth for Birmingham and the most deprived IMD quintile 1995/97 - 2006/08 Three-year rolling averages

Life Expectancy in years

78.00 76.00 74.00 72.00 70.00 68.00

Most deprived quintile SOAs

00 8

00 7

/2 06 20

20

05

/2

00 6 20

04

/2

00 5 20

03

/2 02 20

Years

/2

00 4

00 3 /2 20

01

/2 00 20

19

99

/2

00 2

00 1

00 0 98 19

97 19

/2

99 9 /1

/1 96 19

19

95

/1

99 8

99 7

66.00

Data source: ONS death registrations Birmingham Average PHIT calculation

Figure 8 Female Life Expectancy for Birmingham and the most deprived quintile SOAs 1995/97- 2006/08 Three-year rolling averages 82.00

81.00

80.00

Life Expectancy

79.00

78.00

77.00

76.00

75.00

74.00

Years Most deprived quintile SOAs

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Birmingham average

/2 00 8 20 06

/2 00 7 20 05

20 04

/2 00 6

/2 00 5 20 03

/2 00 4 20 02

/2 00 3 20 01

/2 00 2 20 00

/2 00 1 19 99

/2 00 0 19 98

/1 99 9 19 97

/1 99 8 19 96

19 95

/1 99 7

73.00

Data source: ONS death registrations PHIT calculation

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3. Appendix: Statistical summaries 3.1. Life expectancy at birth 3.1.1.

Life expectancy at birth 2006 – 2008 by geographical areas in Birmingham

Table 2 shows the three-year average (2006-2008) of life expectancy at birth by PCT, constituency and ward in Birmingham, with the 95% confidence intervals.

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Table 2 Life expectancy at birth with 95% confidence intervals by geographical areas in Birmingham, 2006-2008

Code Area 00CN Birmingham MCD Primary care organisations NHS Birmingham East & 5PG North 5MX Heart of Birmingham tPCT 5M1 NHS South Birmingham BCC Priority neighbourhoods 25 Priority neighbourhoods 25 PNs and 6 clusters Constituencies Edgbaston Erdington Hall Green Hodge Hill Ladywood Northfield Perry Barr Selly Oak Sutton Coldfield Yardley Wards 00CNGS Acocks Green 00CNGT Aston 00CNGU Bartley Green 00CNGW Billesley 00CNGX Bordesley Green 00CNGY Bournville 00CNGZ Brandwood

LE 75.92

Males LL 75.68

UL 76.15

LE 80.98

Females LL UL 80.75 81.20

76.26 74.22 76.62

75.89 73.74 76.23

76.63 74.70 77.02

80.57 80.57 81.75

80.22 80.10 81.38

80.92 81.04 82.11

78.45 77.30 79.24

78.19 76.96 78.97

78.70 77.64 79.52

73.20 73.01

72.75 72.58

73.66 73.44

79.61 79.39

79.15 78.96

80.06 79.81

76.32 76.12

75.99 75.82

76.65 76.43

76.90 74.14 75.70 73.97 71.90 76.71 75.91 76.22 81.23 76.00

76.11 73.38 74.97 73.24 71.11 75.97 75.18 75.49 80.55 75.30

77.69 74.90 76.43 74.70 72.69 77.44 76.65 76.96 81.91 76.69

82.35 79.41 81.41 79.19 79.63 82.09 81.20 80.86 83.69 79.87

81.60 78.68 80.72 78.49 78.82 81.41 80.48 80.22 83.04 79.19

83.10 80.15 82.11 79.90 80.44 82.77 81.93 81.51 84.35 80.55

79.65 76.78 78.54 76.57 75.51 79.48 78.57 78.61 82.51 77.97

79.09 76.25 78.02 76.05 74.92 78.97 78.05 78.11 82.04 77.48

80.20 77.32 79.05 77.09 76.09 79.99 79.10 79.11 82.98 78.46

74.46 71.58 75.35 75.92 73.61 76.78 74.20

73.16 69.95 73.74 74.49 72.23 75.37 72.60

75.77 73.20 76.96 77.35 75.00 78.18 75.81

78.29 83.62 82.41 79.77 78.55 82.46 81.86

76.96 81.84 81.06 78.42 77.22 81.44 80.48

79.62 85.41 83.77 81.12 79.88 83.48 83.24

76.39 76.92 78.89 77.95 76.03 79.72 78.08

75.45 75.71 77.81 76.96 75.07 78.83 77.00

77.33 78.13 79.97 78.94 77.00 80.60 79.16

LE 78.46

Persons LL UL 78.30 78.63

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Code 00CNHA 00CNHB 00CNHC 00CNHD 00CNHE 00CNHF 00CNHG 00CNHH 00CNHJ 00CNHK 00CNHL 00CNHM 00CNHN 00CNHP 00CNHQ 00CNHR 00CNHS 00CNHT 00CNHU 00CNHW 00CNHX 00CNHY 00CNHZ 00CNJA 00CNJB 00CNJC 00CNJD 00CNJE 00CNJF

Area Edgbaston Erdington Hall Green Handsworth Wood Harborne Hodge Hill Kings Norton Kingstanding Ladywood Longbridge Lozells and East Handsworth Moseley and Kings Heath Nechells Northfield Oscott Perry Barr Quinton Selly Oak Shard End Sheldon Soho South Yardley Sparkbrook Springfield Stechford and Yardley North Stockland Green Sutton Four Oaks Sutton New Hall Sutton Trinity

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LE 76.73 74.74 78.56 76.00 78.24 76.24 75.19 74.28 72.38 76.14 72.46 74.19 70.95 77.06 76.80 78.89 77.24 77.91 73.58 77.85 73.27 75.94 71.87 77.91 76.23 72.96 81.58 81.41 82.12

Males LL 75.22 73.15 77.10 74.54 76.74 74.82 73.68 72.86 70.50 74.73 70.88 72.69 69.56 75.55 75.52 77.42 75.61 76.22 72.07 76.24 71.72 74.54 70.42 76.47 74.92 71.31 80.32 79.87 80.82

UL 78.24 76.32 80.02 77.47 79.75 77.66 76.70 75.70 74.25 77.54 74.05 75.69 72.34 78.57 78.08 80.35 78.87 79.60 75.09 79.46 74.82 77.35 73.32 79.36 77.54 74.62 82.84 82.94 83.42

LE 80.20 79.73 83.81 81.25 82.98 80.06 80.78 78.80 78.53 80.73 80.58 80.70 78.90 83.50 79.90 84.00 83.66 79.28 78.78 83.15 78.90 81.18 79.48 81.55 78.50 80.81 84.39 84.74 83.60

Females LL UL 78.22 82.18 78.28 81.18 82.53 85.08 79.68 82.83 81.47 84.49 78.60 81.53 79.51 82.04 77.30 80.29 76.72 80.35 79.33 82.13 79.06 82.09 79.26 82.13 77.32 80.47 82.16 84.83 78.50 81.29 82.45 85.56 82.20 85.13 77.72 80.84 77.37 80.19 81.67 84.63 77.34 80.47 79.77 82.59 78.08 80.88 80.05 83.05 77.20 79.80 79.12 82.49 82.94 85.85 83.44 86.04 82.46 84.74

LE 78.44 77.22 81.20 78.67 80.71 78.21 78.10 76.62 74.92 78.52 76.36 77.43 74.54 80.29 78.46 81.57 80.49 78.64 76.23 80.59 75.96 78.56 75.55 79.72 77.37 76.70 83.07 83.10 82.75

Persons LL UL 77.19 79.70 76.13 78.31 80.21 82.19 77.59 79.75 79.64 81.79 77.18 79.24 77.11 79.10 75.59 77.66 73.60 76.25 77.52 79.52 75.24 77.47 76.36 78.49 73.46 75.61 79.26 81.31 77.50 79.41 80.49 82.65 79.37 81.60 77.49 79.78 75.19 77.28 79.48 81.70 74.84 77.08 77.55 79.57 74.52 76.58 78.67 80.77 76.44 78.30 75.49 77.90 82.10 84.04 82.09 84.12 81.90 83.60

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Code Area 00CNJG Sutton Vesey 00CNJH Tyburn 00CNJJ Washwood Heath 00CNJK Weoley Data source: ONS annual death data, PHIT calculation

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LE 80.06 74.39 72.65 78.61

Males LL 78.72 72.94 71.02 77.08

UL 81.39 75.84 74.27 80.13

LE 82.30 78.80 79.02 84.59

Females LL UL 80.97 83.63 77.45 80.15 77.49 80.56 83.13 86.06

LE 81.26 76.64 75.70 81.67

Persons LL UL 80.33 82.18 75.64 77.65 74.57 76.84 80.59 82.75

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3.1.2.

Life expectancy trend and trajectory - PCTs

The figures below show the trend of life expectancy in the PCTs against the trend in England and the PSA trajectories.

3.1.2.1. Birmingham East and North Figure 9 Male life expectancy - 3 years rolling average

81.60 Projection

79.66

71.93

Latest

73.87

Target year

75.80 PSA target baseline year

Years of age

77.73

70.00 19951997

19961998

19971999

19982000

19992001

20002002

20012003

20022004

20032005

20042006

20052007

20062008

20072009

20082010

20092011

Years

Birmingham East and North PCT

England

Data source: England and Birmingham MLE - ONS England MLE Projection - Government Actuary's Department Trajectories - PHIT

PSA trajectory*

Figure 10 Female life expectancy - 3 years rolling average

85.00 Projection

84.00 83.00

81.00

78.00 77.00 76.00

Latest

79.00

Target year

80.00 PSA target baseline year

Years of age

82.00

75.00 19951997

19961998

19971999

19982000

19992001

20002002

20012003

20022004

20032005

20042006

20052007

20062008

20072009

20082010

20092011

Years

Birmingham East and North PCT

England

PSA trajectory*

Data source: England and Birmingham MLE - ONS England MLE Projection - Government Actuary's Department Trajectories - PHIT

17


3.1.2.2. Heart of Birmingham Figure 11 Male life expectancy - 3 years rolling average

81.60 Projection

79.66

71.93

Latest

73.87

Target year

75.80 PSA target baseline year

Years of age

77.73

70.00 19951997

19961998

19971999

19982000

19992001

20002002

20012003

20022004

20032005

20042006

20052007

20062008

20072009

20082010

20092011

Years

Heart of Birmingham PCT

England

Data source: England and Birmingham MLE - ONS England MLE Projection - Government Actuary's Department Trajectories - PHIT

PSA trajectory*

Figure 12 Female life expectancy - 3 years rolling average

85.00 Projection

84.00 83.00

81.00

78.00 77.00 76.00

Latest

79.00

Target year

80.00 PSA target baseline year

Years of age

82.00

75.00 19951997

19961998

19971999

19982000

19992001

20002002

20012003

20022004

20032005

20042006

20052007

20062008

20072009

20082010

20092011

Years

Heart of Birmingham PCT

Mortality Target Monitoring final

England

PSA trajectory*

Data source: England and Birmingham FLE - ONS England MLE Projection - Government Actuary's Department Trajectories - PHIT

18


3.1.2.3. South Birmingham Figure 13

Male life expectancy - 3 years rolling average

80.00 Projection

79.00 78.00

76.00

73.00 72.00 71.00

Latest

74.00

Target year

75.00 PSA target baseline year

Years of age

77.00

70.00 19951997

19961998

19971999

19982000

19992001

20002002

20012003

20022004

20032005

20042006

20052007

20062008

20072009

20082010

20092011

Years

South Birmingham PCT

England

Data source: England and Birmingham MLE - ONS England MLE Projection - Government Actuary's Department Trajectories - PHIT

PSA trajectory*

Figure 14 Female life expectancy - 3 years rolling average

85.00 Projection

84.00 83.00

81.00

78.00 77.00 76.00

Latest

79.00

Target year

80.00 PSA target baseline year

Years of age

82.00

75.00 19951997

19961998

19971999

19982000

19992001

20002002

20012003

20022004

20032005

20042006

20052007

20062008

20072009

20082010

20092011

Years

South Birmingham PCT

Mortality Target Monitoring final

England

PSA trajectory*

Data source: England and Birmingham MLE - ONS England MLE Projection - Government Actuary's Department Trajectories - PHIT

19


3.2. AAACM: Three years average 3.2.1.

AAACM 2006 – 2008 by geographical areas in Birmingham

Table 4 shows the three-year average of AAACM (2006 to 2008) by PCT, Birmingham City Council priority neighbourhoods, constituency and ward, with the 95% confidence intervals.

Mortality Target Monitoring final

20


Table 4 AAACM 2006 – 2008 by geographical areas in Birmingham Code Area 00CN Birmingham MCD Primary care organisations NHS Birmingham East & 5PG North 5MX Heart of Birmingham tPCT 5M1 NHS South Birmingham BCC Priority neighbourhoods 25 priority neighbourhoods 25 PNs and 6 clusters Constituencies Edgbaston Erdington Hall Green Hodge Hill Ladywood Northfield Perry Barr Selly Oak Sutton Coldfield Yardley Wards 00CNGS 00CNGT 00CNGU 00CNGW 00CNGX 00CNGY 00CNGZ 00CNHA 00CNHB

Acocks Green Aston Bartley Green Billesley Bordesley Green Bournville Brandwood Edgbaston Erdington

Males DSR 797.28

LL 783.27

UL 811.47

Females DSR 532.70

LL 522.64

UL 542.89

Persons DSR 652.98

LL 644.59

UL 661.45

774.46 910.00 759.50

753.58 876.33 736.85

795.76 944.60 782.66

546.79 551.55 505.12

531.26 528.58 489.03

562.63 575.23 521.56

650.54 716.33 618.93

637.82 696.58 605.45

663.44 736.48 632.61

972.30 985.30

938.63 953.73

1006.83 1017.63

595.20 606.64

572.19 585.05

618.86 628.78

766.97 778.85

747.27 760.38

787.05 797.65

740.45 910.89 812.90 914.79 1072.78 752.31 807.86 792.77 531.54 809.24

697.38 863.43 766.09 866.72 1008.14 711.63 762.04 749.80 500.23 767.00

785.43 960.22 861.76 964.78 1140.34 794.66 855.67 837.50 564.22 853.15

479.02 608.78 512.44 607.05 603.15 493.39 516.07 552.05 414.97 586.53

448.34 574.16 480.31 572.54 560.44 464.50 484.31 521.32 390.57 554.47

511.04 644.76 546.04 642.93 648.14 523.47 549.25 583.94 440.35 619.78

597.96 744.33 649.57 746.88 822.41 606.71 646.89 658.68 468.58 687.19

572.13 715.65 622.10 717.99 785.02 582.53 619.87 633.09 449.15 661.21

624.59 773.81 677.90 776.57 861.09 631.59 674.74 684.98 488.59 713.87

933.22 1046.76 813.97 801.46 966.98 759.03 873.08 805.99 858.35

844.27 924.25 727.98 721.24 862.52 680.99 784.52 704.04 769.08

1028.77 1180.12 907.15 887.89 1080.03 843.32 968.67 918.31 954.85

673.73 474.77 505.64 594.24 652.57 488.62 506.37 532.46 592.61

606.54 402.88 446.35 533.25 578.08 438.13 448.02 459.66 525.89

745.59 555.27 569.98 659.48 733.64 542.63 569.63 612.40 664.56

791.83 730.42 645.16 681.97 794.12 608.24 667.98 654.25 716.45

737.10 662.80 594.11 633.11 732.02 563.56 616.75 593.56 661.35

849.31 802.79 699.22 733.33 859.91 655.25 722.13 719.16 774.62

21


Code 00CNHC 00CNHD 00CNHE 00CNHF 00CNHG 00CNHH 00CNHJ 00CNHK 00CNHL 00CNHM 00CNHN 00CNHP 00CNHQ 00CNHR 00CNHS 00CNHT 00CNHU 00CNHW 00CNHX 00CNHY 00CNHZ 00CNJA 00CNJB 00CNJC 00CNJD 00CNJE 00CNJF 00CNJG

Area Hall Green Handsworth Wood Harborne Hodge Hill Kings Norton Kingstanding Ladywood Longbridge Lozells and East Handsworth Moseley and Kings Heath Nechells Northfield Oscott Perry Barr Quinton Selly Oak Shard End Sheldon Soho South Yardley Sparkbrook Springfield Stechford and Yardley North Stockland Green Sutton Four Oaks Sutton New Hall Sutton Trinity Sutton Vesey

Mortality Target Monitoring final

Males DSR 645.33 812.64 693.06 795.40 851.38 927.38 1040.90 802.50

LL 573.23 719.72 609.40 710.88 763.17 833.99 898.63 717.02

UL 723.78 913.81 784.62 887.00 946.82 1028.17 1198.64 895.14

Females DSR 428.29 514.16 450.85 560.40 556.85 635.79 682.83 541.86

LL 376.22 449.63 391.80 496.69 497.06 566.61 579.66 480.70

UL 484.88 584.66 514.94 629.38 621.11 710.47 798.02 608.05

Persons DSR 527.38 644.39 558.86 661.44 681.55 759.00 880.25 655.00

LL 483.69 589.73 508.91 609.76 630.61 702.60 792.06 603.99

UL 573.73 702.51 611.93 716.13 735.26 818.52 975.33 708.96

1008.16 923.47 1193.03 723.68 795.56 653.21 692.68 741.35 939.94 680.60 1013.32 802.19 1116.81 685.75

886.04 820.22 1062.98 647.83 716.15 571.43 615.58 641.52 850.25 603.67 889.99 715.07 989.79 600.53

1141.42 1035.93 1333.80 805.75 881.16 743.22 776.47 851.59 1036.03 764.11 1148.39 896.85 1254.80 779.31

540.92 540.24 633.99 448.98 583.43 416.86 438.93 659.81 633.92 456.93 639.82 533.24 611.13 508.68

464.34 476.15 552.12 395.67 522.90 360.02 383.51 576.79 568.84 400.43 554.39 469.98 531.67 441.24

626.26 609.81 724.02 506.90 648.31 479.51 499.39 749.91 703.28 518.18 734.32 602.17 698.80 583.21

752.33 711.68 887.59 571.76 674.20 518.05 553.29 696.14 771.30 556.94 810.97 650.05 835.52 590.84

683.22 654.02 815.21 526.34 625.57 469.87 506.69 631.95 717.00 509.84 737.87 597.81 764.25 537.13

826.29 772.85 964.50 619.85 725.37 569.62 602.78 764.51 828.21 606.82 889.17 705.50 911.44 648.34

826.91 977.47 523.54 508.36 503.98 588.40

744.12 873.26 464.47 445.06 444.78 522.81

916.20 1090.45 587.70 577.86 568.64 659.67

666.96 543.82 388.23 371.03 426.27 475.86

601.55 474.71 340.79 324.88 378.86 423.84

736.78 619.33 439.60 421.25 477.46 531.80

741.53 730.53 448.33 435.29 465.40 526.50

689.55 670.30 411.05 396.77 427.83 485.42

796.14 794.46 487.81 476.29 505.20 569.88

22


Males Code Area DSR 00CNJH Tyburn 909.17 00CNJJ Washwood Heath 990.58 00CNJK Weoley 654.34 Data source: ONS annual death data, PHIT calculation

Mortality Target Monitoring final

LL 816.86 874.73 580.04

UL 1008.76 1116.90 735.25

Females DSR 651.06 611.07 424.76

LL 582.90 531.65 370.94

UL 724.40 698.52 483.54

Persons DSR 766.65 792.63 526.32

LL 710.52 723.66 481.37

UL 825.81 866.17 574.10

23


3.2.2.

Three-year average AAACM trend against PSA and LAA target

The figures below shows the three-year average AAACM trend in Birmingham and the PCTs against PSA and LAA target for males and females.

3.2.2.1. Birmingham Figure 15

1200.00 1100.00 1000.00 900.00 800.00 700.00 600.00 500.00 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 2 20 00 01 2 to 20 20 03 02 to 20 20 04 03 to 2 20 00 04 5 to 20 20 06 05 to 20 20 07 06 to 2 20 00 07 8 to 20 20 09 08 to 20 20 10 09 to 20 11

400.00

19 95

Age standardised rate per 100,000 Population

All age all cause mortality (AAACM) - Males Trend and Trajectory: Birmingham MCD 1995/1997 to 2006/08

Years Birmingham Trend PSA trajectory

Source: Trend - NCHOD PSA trajectory - PHIT calculation

3.2.2.2. Birmingham East and North Figure 16

1200.00 1100.00 1000.00 900.00 800.00 700.00 600.00 500.00

to 19 19 97 96 to 1 19 99 97 8 to 1 19 99 98 9 to 2 19 00 99 0 to 20 20 01 00 to 20 20 02 01 to 20 20 03 02 to 2 20 00 03 4 to 2 20 00 04 5 to 2 20 00 05 6 to 20 20 07 06 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

All age all cause mortality (AAACM) - Males Trend and Trajectory: NHS Birmingham East and North 1995/1997 to 2006/08

Years BEN Trend PSA trajectory

Source: Trend - NCHOD PSA trajectory - PHIT calculation

24


Figure 17

800.00

700.00

600.00

500.00

400.00

19 95

to 19 19 97 96 to 1 19 99 97 8 to 1 19 99 98 9 to 2 19 00 99 0 to 2 20 00 00 1 to 2 20 00 01 2 to 2 20 00 02 3 to 20 20 04 03 to 20 20 05 04 to 20 20 06 05 to 20 20 07 06 to 2 20 00 07 8 to 2 20 00 08 9 to 2 20 01 09 0 to 20 11

Age standardised rate per 100,000 Population

All age all cause mortality (AAACM) - Females Trend and Trajectory: NHS Birmingham East and North 1995/1997 to 2006/08

Years BEN Trend

Source: Trend - NCHOD PSA trajectory - PHIT calculation LAA trajectory - Birmingham LAA 08-11

PSA trajectory

3.2.2.3. Heart of Birmingham

All age all cause mortality (AAACM) - Males Trend and Trajectory: Heart of Birmingham Teaching PCT 1995/1997 to 2006/08 1200.00 1100.00 1000.00 900.00 800.00 700.00 600.00 500.00

19 19 97 96 to 1 19 99 97 8 to 19 19 99 98 to 20 19 00 99 to 20 20 01 00 to 2 20 00 01 2 to 20 20 03 02 to 20 20 04 03 to 20 20 05 04 to 2 20 00 05 6 to 20 20 07 06 to 20 20 08 07 to 20 20 09 08 to 2 20 01 09 0 to 20 11

400.00

19 95

to

Age standardised rate per 100,000 Population

Figure 18

Years HoB Trend PSA trajectory

Mortality Target Monitoring final

Source: Trend - NCHOD PSA trajectory - PHIT calculation

25


Figure 19 All age all cause mortality (AAACM) - Females Trend and Trajectory: Heart of Birmingham Teaching PCT 1995/1997 to 2006/08

700.00

600.00

500.00

400.00

19 95

to 19 19 97 96 to 1 19 99 97 8 to 1 19 99 98 9 to 20 19 00 99 to 20 20 01 00 to 20 20 02 01 to 20 20 03 02 to 2 20 00 03 4 to 2 20 00 04 5 to 20 20 06 05 to 20 20 07 06 to 20 20 08 07 to 2 20 00 08 9 to 2 20 01 09 0 to 20 11

Age standardised rate per 100,000 Population

800.00

Years HoB Trend

Source: Trend - NCHOD PSA trajectory - PHIT calculation LAA trajectory - Birmingham LAA 08-11

PSA trajectory

3.2.2.4. South Birmingham Figure 20 All age all cause mortality (AAACM) - Males Trend and Trajectory: NHS South Birmingham 1995/97 to 2006/08 Age standardised rate per 100,000 Population

1200.00 1100.00 1000.00 900.00 800.00 700.00 600.00 500.00

11

to

20

20

10

09 20

09 20

20

08

to

to 07

20

20

06

to

20

08

07

06

20

20 20

05

to

to 04

20

20

03

to

20

05

04 20

to 02

20

20

01

to

20

03

02

01 20

00

to

20

20

20 19

99

to

to

19

98

to 97

19

00

99

98

19

19 to

96 19

19

95

to

19

97

400.00

Years SB Trend PSA trajectory

Mortality Target Monitoring final

Source: Trend - NCHOD PSA trajectory - PHIT calculation

26


All age all cause mortality (AAACM) - Females Trend and Trajectory: NHS South Birmingham 1995/1997 to 2006/08 800.00

700.00

600.00

500.00

400.00

19 95

to 19 19 97 96 to 1 19 99 97 8 to 1 19 99 98 9 to 2 19 00 99 0 to 2 20 00 00 1 to 20 20 02 01 to 20 20 03 02 to 20 20 04 03 to 2 20 00 04 5 to 2 20 00 05 6 to 2 20 00 06 7 to 20 20 08 07 to 20 20 09 08 to 20 20 10 09 to 20 11

Age standardised rate per 100,000 Population

Figure 21

Years SB Trend

PSA trajectory

Source: Trend - NCHOD PSA trajectory - PHIT calculation LAA trajectory - Birmingham LAA 08-11

3.3. AAACM: Single years 3.3.1.

AAACM 2008 by geographical areas in Birmingham

Table 5 shows the single year AAACM in 2008, by PCT, Birmingham City Council priority neighbourhoods, constituency and ward, with the 95% confidence intervals.

Mortality Target Monitoring final

27


Table 5

AAACM 2008 by geographical areas in Birmingham

Code Area 00CN Birmingham MCD Primary care organisations NHS Birmingham East & 5PG North 5MX Heart of Birmingham tPCT 5M1 NHS South Birmingham BCC Priority neighbourhoods 25 priority neighbourhoods 25 PNs and 6 clusters Constituencies Edgbaston Erdington Hall Green Hodge Hill Ladywood Northfield Perry Barr Selly Oak Sutton Coldfield Yardley Wards 00CNGS 00CNGT 00CNGU 00CNGW 00CNGX 00CNGY 00CNGZ 00CNHA 00CNHB

Acocks Green Aston Bartley Green Billesley Bordesley Green Bournville Brandwood Edgbaston Erdington

Males DSR 777.51

LL 753.76

UL 801.81

Females DSR 525.53

LL 508.32

UL 543.14

Persons DSR 640.42

LL 626.11

UL 654.95

755.12 885.70 743.69

719.75 828.95 705.24

791.74 945.22 783.65

532.51 527.95 516.17

506.21 489.47 488.02

559.71 568.54 545.37

634.71 691.84 618.18

613.09 658.57 594.96

656.85 726.32 642.01

965.31 969.71

907.37 915.66

1025.89 1026.03

550.17 562.49

512.17 526.88

590.14 599.76

737.66 745.73

704.28 714.57

772.16 777.85

744.96 866.91 770.84 915.39 1073.45 733.11 804.40 771.18 520.70 816.32

671.27 787.71 692.74 832.63 963.05 664.30 726.62 698.64 468.11 743.21

824.37 951.76 855.15 1003.95 1192.60 806.97 888.06 849.01 577.37 894.50

513.49 558.32 507.64 554.36 546.16 480.19 515.85 566.98 449.24 583.74

458.22 502.08 453.64 497.76 477.18 431.76 461.36 512.41 405.34 529.31

572.89 618.62 565.97 615.13 621.95 532.10 574.63 625.15 496.09 641.72

617.90 696.40 632.23 714.85 785.94 590.45 643.56 656.47 482.20 692.67

572.73 648.95 585.85 666.08 723.54 549.62 597.44 612.19 448.40 647.71

665.46 746.23 681.19 766.07 852.14 633.36 692.16 702.90 517.71 739.73

887.19 913.56 760.31 834.05 1018.18 669.40 814.33 717.93 801.29

739.21 728.01 620.65 696.00 834.90 542.55 670.68 557.36 656.55

1055.38 1129.54 921.47 990.58 1227.88 816.18 978.96 909.34 967.57

676.03 411.64 586.09 669.06 543.63 480.92 555.83 643.02 599.60

562.83 298.47 475.83 554.22 429.76 395.96 449.96 504.06 484.32

803.02 551.40 712.04 797.89 677.20 576.43 677.09 804.29 731.14

777.54 637.19 665.77 728.93 755.22 574.85 666.41 668.91 690.65

684.97 532.21 577.41 641.50 651.79 499.57 579.30 565.30 598.91

878.36 755.91 763.16 824.08 869.83 657.32 762.30 784.96 791.58

28 Mortality Target Monitoring final


Code 00CNHC 00CNHD 00CNHE 00CNHF 00CNHG 00CNHH 00CNHJ 00CNHK 00CNHL 00CNHM 00CNHN 00CNHP 00CNHQ 00CNHR 00CNHS 00CNHT 00CNHU 00CNHW 00CNHX 00CNHY 00CNHZ 00CNJA 00CNJB 00CNJC 00CNJD 00CNJE 00CNJF 00CNJG

Area Hall Green Handsworth Wood Harborne Hodge Hill Kings Norton Kingstanding Ladywood Longbridge Lozells and East Handsworth Moseley and Kings Heath Nechells Northfield Oscott Perry Barr Quinton Selly Oak Shard End Sheldon Soho South Yardley Sparkbrook Springfield Stechford and Yardley North Stockland Green Sutton Four Oaks Sutton New Hall Sutton Trinity Sutton Vesey

Mortality Target Monitoring final

Males DSR 639.80 680.31 813.50 762.36 714.47 830.08 1148.30 806.54

LL 518.20 540.72 658.95 622.69 578.44 677.97 893.69 660.20

UL 780.60 843.48 992.20 923.32 872.46 1005.61 1450.72 974.97

Females DSR 466.40 520.98 405.77 505.81 558.22 567.61 662.82 544.15

LL 376.61 412.17 312.79 402.11 459.06 458.85 486.39 437.03

UL 569.20 647.44 513.51 625.98 670.31 692.41 878.56 667.53

Persons DSR 550.12 596.44 586.81 610.60 627.93 686.40 897.29 654.06

LL 474.83 508.63 498.93 525.87 545.93 594.56 744.30 565.80

UL 633.26 694.27 684.24 704.42 718.07 787.80 1071.58 751.55

1160.32 927.20 1134.71 712.55 736.77 726.31 733.22 831.34 902.80 745.27 1114.32 778.96 999.75 605.18

936.02 750.75 920.13 586.87 610.39 579.65 597.16 648.30 754.67 608.28 894.25 633.25 797.53 472.37

1419.14 1131.97 1381.84 856.52 881.06 898.20 890.12 1047.32 1070.12 902.47 1370.49 947.68 1235.33 762.57

615.13 513.75 548.69 404.83 539.84 393.55 444.93 551.76 679.75 438.50 594.67 575.16 581.48 471.54

475.95 408.99 428.28 318.97 442.49 301.88 347.64 425.74 561.58 342.76 454.55 463.87 451.34 363.74

781.46 634.71 691.23 504.85 650.08 502.70 558.38 699.06 811.88 549.44 763.00 703.59 736.41 600.36

857.48 695.63 829.27 537.00 617.10 532.49 578.40 674.89 774.59 576.50 817.70 662.39 772.14 538.58

731.01 598.66 711.93 462.64 539.61 449.33 495.42 565.54 680.84 493.77 692.61 572.58 655.17 452.46

998.85 803.15 959.99 619.28 701.92 625.98 670.50 797.36 876.38 667.95 958.28 761.88 903.32 635.92

855.70 1003.06 520.23 569.73 450.21 543.45

712.38 825.81 422.73 454.72 358.37 437.82

1018.75 1206.21 632.53 703.93 557.85 666.02

648.33 533.81 392.38 381.51 488.60 541.53

540.86 417.72 313.86 305.06 399.53 440.47

768.61 669.63 482.11 469.79 589.69 655.71

753.82 727.04 448.99 470.79 471.73 540.68

664.29 625.46 387.08 402.11 407.70 468.51

851.26 839.60 517.20 547.08 542.40 619.98

29


Males Code Area DSR 00CNJH Tyburn 889.87 00CNJJ Washwood Heath 1004.01 00CNJK Weoley 697.42 Data source: ONS annual death data, PHIT calculation

Mortality Target Monitoring final

LL 734.07 803.34 567.12

UL 1068.03 1237.23 847.77

Females DSR 540.73 492.04 415.50

LL 437.21 376.41 329.27

UL 659.45 630.58 515.27

Persons DSR 691.97 737.79 545.13

LL 601.24 624.01 468.19

UL 791.81 865.47 630.32

30


3.3.2.

Single year AAACM trend against LAA and Vital Signs target

The figures below shows the single year AAACM trend in Birmingham and the PCTs against LAA and Vital Signs target for males and females.

3.3.2.1. Birmingham Figure 22

700.00

600.00

500.00

400.00

300.00

200.00

100.00

0

1 20 1

20 1

9

8

20 0

20 0

7

6

20 0

20 0

5

4

20 0

20 0

2

3 20 0

20 0

0 20 0

20 0

9

8

19 9

19 9

19 9

1

0.00 7

Age standardised rate per 100,000 population

All age all cause mortallity (AAACM) - Females Trend and Trajectory : Birmingham MCD 1997 to 2008

Years Birmingham trend

Source: Trend - NCHOD LAA trajectory - Birmingham LAA 2008 - 2011

LAA trajectory

3.3.2.2. Birmingham East and North Figure 23 All age all cause mortality (AAACM) - Males Trend and Trajectory: NHS Birmingham East and North 2002 - 2008 Age standardised rate per 100,000 Population

1100.00

1000.00

900.00

800.00

700.00

Years BEN Trend

20 11

20 10

20 09

20 08

20 07

20 06

20 05

20 04

20 03

20 02

600.00

Source: Trend - NCHOD VS trajectory - Vital Signs

VS trajectory

31 Mortality Target Monitoring final


Figure 24

700.00

600.00

500.00

400.00

300.00

200.00

100.00

20 11

20 10

20 09

20 08

20 07

20 06

20 05

20 03

20 04

0.00

20 02

Age standardised rate per 100,000 population

All age all cause mortality (AAACM) - Females Trend and Targets : NHS Birmingham East and North 2002 - 2008

Years

BEN trend Vital Signs Target

3.3.2.3. Heart of Birmingham Figure 25 All age all cause mortality (AAACM) - Males Trend and Trajectory: Heart of Birmingham Teaching PCT 2002 - 2008 Age standardised rate per 100,000 Population

1100.00

1000.00

900.00

800.00

700.00

Years HoB Trend VS trajectory

Mortality Target Monitoring final

20 11

20 10

20 09

20 08

20 07

20 06

20 05

20 04

20 03

20 02

600.00

Source: Trend - NCHOD PSA trajectory - PHIT calculation LAA trajectory - Birmingham LAA 08-11

32


Figure 26

700.00

600.00

500.00

400.00

300.00

200.00

100.00

11 20

10 20

20

20

09

08

07 20

20

20

20

05

04

03 20

20

06

0.00 02

Age standardised rate per 100,000 population

All age all cause mortality (AAACM) - Females Trend and Targets : Heart of Birmingham Teaching PCT 2002 to 2008

Years

Source: Trend - NCHOD VSB01 - PCT Performance teams 08 - 11

HoB trend Vital Signs Target

3.3.2.4. South Birmingham Figure 27 All age all cause mortality (AAACM) - Males Trend and Trajectory: NHS South Birmingham 2002 - 2008

Age standardised rate per 100,000 Population

1100.00

1000.00 900.00

800.00

700.00

11 20

10 20

09 20

08 20

07 20

06 20

05 20

04 20

03 20

20

02

600.00

Years SB Trend VS trajectory

Mortality Target Monitoring final

Source: Trend - NCHOD PSA trajectory - PHIT calculation LAA trajectory - Birmingham LAA 08-11

33


Figure 28 All age all cause mortality (AAACM) - Females Trend and Targets - NHS South Birmingham 2002 - 2008

Age standardised rate per 100,000 population

700.00

600.00

500.00

400.00

300.00

200.00

100.00

11 20

20

10

09 20

08

07

20

20

20

06

05 20

04 20

20

20

02

03

0.00

Years Source: Trend - NCHOD VSB01 - PCT Performance teams 08 - 11

SB trend Vital Signs Target

3.4. Life expectancy and AAACM by deprivation quintile 3.4.1.

Life expectancy by IMD quintile - current year

Figure 29

Life expectancy in years

Life expectancy at birth by deprivation quintile with 95% confidence intervals, Birmingham, 2006-08 86 84 82 80 78 76 74 72 70 68 66 64 Q1

Q2

least deprived

Females

Mortality Target Monitoring final

Q3 IMD quintile

Males

Persons

Q4

Q5

most deprived Data source: ONS death registrations PHIT calculation

34


3.4.2.

Life expectancy by IMD quintile – trend

Figure 30 Male Life Expectancy at Birth for Birmingham by IMD Quintile 1995/97 - 2006/08 Three-year averages 82.00

Life Expectancy in years

80.00 78.00 76.00 74.00 72.00 70.00 68.00 66.00 64.00

Years Affluent

Less Affluent

Average

Less Deprived

00 8 /2

00 7 20 06

/2 20 05

20 04

/2

/2

00 6

00 5

00 4 20 03

20 02

/2

00 3 /2

00 2 20 01

/2 20 00

/2 19 99

19 98

00 1

00 0 /2

99 9 /1 19 97

/1 19 96

19 95

/1

99 7

99 8

62.00

Data source: ONS death registrations PHIT calculation

Deprived

Figure 31 Female Life Expectancy for Birmingham by IMD Quintile 1995/97- 2006/08 Three-year rolling averages 86.00

84.00

Life Expectancy

82.00

80.00

78.00

76.00

74.00

Affluent

Mortality Target Monitoring final

Less Affluent

Average

Less Deprived

Deprived

/2 00 8 20 0

6

/2 00 7 20 0

4 20 0

Years

5

/2 00 6

/2 00 5 3 20 0

20 0

20 0

2

/2 00 4

/2 00 3 1

/2 00 2 0 20 0

19 9

9

/2 00 1

/2 00 0 19 9

8

/1 99 9 7 19 9

6 19 9

19 9

5

/1 99 7

/1 99 8

72.00

Data source: ONS death registrations PHIT calculation

35


3.4.3.

AAACM by IMD quintile - current year

Figure 32

All-age all-casuse mortality (AAACM) by IMD quintile, Birmingham, 2006-2008 1200.00

Rate per 100,000

1000.00 800.00 600.00 400.00 200.00 0.00 Q1

Q2

Q3

Least deprived

Males

3.4.4.

Q4

Q5

IMD quintile

Females

Most deprived Data source: ONS death registrations PHIT calculation

Persons

AAACM by IMD quintile - trend

Figure 33 Male AAACM by IMD Quintile in Birmingham 1995 - 2008 Three year rolling average 1400.00

1200.00

1000.00

DSR

800.00

600.00

400.00

200.00

Years Affluent

Less Affluent

Mortality Target Monitoring final

Average

Less Deprived

Deprived

8 /2 00 20 06

/2 00

7

6 20 05

/2 00 20 04

/2 00

5

4 20 03

/2 00 20 02

/2 00

3

2 20 01

/2 00

1 20 00

/2 00 19 99

/2 00 19 98

19 97

/1 99

0

9

8 /1 99 19 96

19 95

/1 99

7

0.00

D a ta source : ON S de a th re gistra tions PH IT ca lcula tion

36


Figure 34 Female AAACM by IMD Quintile in Birmingham 1995 - 2008 Three year rolling average 900.00 800.00 700.00

DSR

600.00 500.00 400.00 300.00 200.00 100.00

Years Affluent

Less Affluent

Average

Less Deprived

/2 00 8 20 0

20 0

6

5

/2 00 7

/2 00 6 20 0

20 0

4

3

/2 00 5

/2 00 4 20 0

20 0

2

1

/2 00 3

/2 00 2 0 20 0

19 9

19 9

9

8

/2 00 1

/2 00 0

/1 99 9 7 19 9

19 9

19 9

6

5

/1 99 8

/1 99 7

0.00

Data source: ONS death registrations PHIT calculation

Deprived

Figure 35 Male AAACM most deprived quintile SOA and Birmingham average 1995/97- 2006/08 Three year rolling average 1400.00

1200.00

1000.00

DSR

800.00

600.00

400.00

200.00

Years Deprived

Mortality Target Monitoring final

Birmingham average

8

7 20 06

/2 00

/2 00 20 05

20 04

/2 00

6

5 /2 00 20 03

20 02

/2 00

4

3 /2 00 20 01

20 00

/2 00

2

1 /2 00 19 99

/2 00 19 98

/1 99 19 97

0

9

8 /1 99 19 96

19 95

/1 99

7

0.00

D a ta source : ON S de a th re gistra tions P H IT ca lcula tion

37


Figure 36 Female AAACM in the most deprived quintile SOAs and in Birmingham 1995/97- 2006/08 Three year rolling average 900.00 800.00 700.00

DSR

600.00 500.00 400.00 300.00 200.00 100.00

Years Most deprived quintile SOAs

Mortality Target Monitoring final

Birmingham average

/2 00 8 6 20 0

20 0

5

/2 00 7

/2 00 6 4 20 0

20 0

3

/2 00 5

/2 00 4 2 20 0

20 0

1

/2 00 3

/2 00 2 0 20 0

19 9

9

/2 00 1

/2 00 0 8 19 9

19 9

7

/1 99 9

/1 99 8 6 19 9

19 9

5

/1 99 7

0.00

Data source: ONS death registrations PHIT calculation

38


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