Life Expectancy Ward Analysis Ward Profile: Northfield 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 Northfield is in the boundary of NHS South Birmingham
•
Northfield accounted for 2.44% of Birmingham’s population in 2006
•
One of the largest age splits of the population are children and young people [0 – 19] at 24.98%
•
Black and Minority Ethnicity (BME) group split (5.7%) is less than national average (11.3%) overall but lower than Birmingham (32.7%). This group accounted for 0.14% of the total population of Birmingham in 2001.
•
Northfield is the 30th (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects: o Life expectancy in Northfield is at 76.5 for men, 82.5 for women in the year 2005/07 o Male life expectancy has increased by 4.6%. The gap between Northfield and England has reduced by 20% (0.3 years) from 95/97 to 05/07 o Female life expectancy has increased by 2.6%. The gap between Northfield and England has remained stagnant at 0.7 from 95/97 to 05/07 o Infant Mortality Rates have dropped by 27.6% since 99/01, the rate for the most deprived wards has also dropped o Circulatory diseases (31.56%), Cancers (31.34%) and Coronary Heart Diseases (16.98%) are the leading conditions that cause deaths in the ward.
•
The latest extraction for 2005/07 additionally reflects: o 3.7 percentage points smoke more o 1.9 percentage points are less obese o 0.6 percentage points binge drink less
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1
Local context: demographics and deprivation
This section describes population demographics and deprivation in Northfield 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 Northfield is estimated to be 24,602. This represents 2.44% of the population of Birmingham. Approximately 48.5% (11,929) are male and 51.5% are female (12,673). 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
430
252
80+ 358
75-79 70-74
507
506
65-69
Females
580 686
646
60-64
Males
501
447
842
55-59 50-54
772 751
745 870
45-49
839 1013
914
40-44
819
35-39
861
30-34
818
685
794
656
25-29 821
20-24
775
974
15-19 10-14
897 735
782 656
665
5-9 739
0-4 1500
1000
698 500
0
500
1000
1500
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Northfield 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 24.98% (6,146) of the Northfield population. Persons of retirement age (age 65+) account for 16.86% (4,149).
•
The ward has 2.93 percentage points more under 19s than Birmingham and 6.22 percentage points more over 65s.
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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 Northfield 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. Less than a tenth (5.7%) of the population are non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 0.33%, Indian 0.78% and Black Caribbean 1.19%. The BME (5.7%) is less than Birmingham (32.7%), and England (11.3%). White ethnicity (94.3%) is higher than both city and national averages. Ethnicity groups for Northfield (2001), Birmingham (2006) and England (2006)
Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total
%
Northfield N* 94.3 23.0 1.3 0.3 1.8 0.4 1.9 0.5 0.7 0.2 100 24.4
%
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, Northfield is the 30th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 24.451. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Northfield is in the least and second 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 )
5.482
4136
2623
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 Northfield by IMD quintile, 2007
1.4 Lifestyle Table 1.3 provides a summary of life style indicators in Northfield, compared 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, Northfield has a lower percentage of people who binge drink (0.6 percentage points lower) and are obese (1.9 percentage points) but a higher proportion who smoke (3.7 percentage points higher) Compared with the national average, a smaller percentage of people living in Northfield eat healthily (6.3 percentage point lower). Table 1.3 shows that smoking amongst adults in Northfield needs to be investigated further along with developing programmes to get people to eat healthier. Key figures for life style Deprivation in Northfield, Birmingham and England
Adults who smoke Binge drinking adults* Healthy eating adults** Obese adults*** * ** ***
Year 2003/5 2003/ 2005 2003/ 2005 2003/ 2005
Northfield 28.6% 17.2% 18.8% 21.5%
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 Northfield from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 shows evidence that whilst male life expectancy has increased in Northfield over the ten years since 1995, 2007 saw a fall. This therefore requires further investigation as to causes as this is not consistent with city or national trends. Male Life Expectancy - 3 year rolling average, Northfield, 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 7 20 05
/0 5
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
19 97
/9 8 19 96
19 95
/9 7
70.0
Calendar Year England M ales
Birmingham M ales
Northfield M ales
Data source: ONS
Figure 2.1 Male life expectancy for Northfield, Birmingham and England, 1995/97 – 2005/07
Figure 2.2 shows trend of female expectancy in Northfield 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 Northfield is actually decreasing despite being higher that 1995. More strategies are needed to identify underlying causes of this issue.
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Female Life Expectancy - 3 year rolling average, Northfield, Birmingham & England 85.0 84.0 Life Expectancy (Age)
83.0 82.0 81.0 80.0 79.0 78.0 77.0 76.0
/0 6
/0 7 20 05
20 04
/0 5 20 03
/0 4
/0 2
/0 3
20 02
20 01
20 00
/0 1 19 99
/0 0
/9 9
19 98
19 97
/9 8 19 96
19 95
/9 7
75.0
Calendar Year England Females
Birmingham Females
Northfield Females
Data source: ONS
Figure 2.2 Female life expectancy for Northfield, 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. Life expectancy in Northfield is lower than City and national averages for men but higher for women at a city level. The gap for both male life expectancy between Northfield and England has reduced, whilst the gap for Female life expectancy has remained the same. •
Male life expectancy has increased by 4.6% (3.38 years, from 73.1 years in 1997 to 76.5 years by 2007).
•
The gap of male life expectancy between Northfield and England has reduced by 0.3 year from 1.5 years to 1.2 years, which means a reduction of 20%.
•
Female life expectancy has increased by 2.6% (2.1 years, from 80.4 years in 1997 to 82.5 years by 2007).
•
The gap of female life expectancy between Northfield and England has remained stagnant at 0.7
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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 Northfield, 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. Northfield 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 Year Birmingham M ost Deprived Quintile in Bham
England Northfield
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 Northfield Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 05/07, the IMR is a twentieth higher than England; whilst that in the most deprived quintile is about two folds of England. • •
•
From 99/01 to 05/07, the IMR has decreased by 27.58%, on a par with Birmingham’s IMR which has decreased. The gap between the most deprived quintile SOAs in Birmingham and Northfield has widened from 2.9 below to 3.5 (20.7%) despite the improvements made by those wards. 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 Northfield and England has increased from 3.1 to 1.4 (54.8%).
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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 Northfield 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 killers. They make more than 79.9% 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, Northfield, 2005-2007 DSR
% out of all causes rate*
All Causes
615.72
All Cancers
192.97
31.34%
All Circulatory Diseases
194.30
31.56%
Coronary Heart Disease
104.56
16.98%
* 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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