Life Expectancy Ward Analysis Ward Profile: Quinton 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 leading conditions that cause deaths locally, to provide local focus for each target ward.
•
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)
For further information please contact the information team: Tel:
0121 465 2995 / 2999
Email:
phit@bhwp.nhs.uk
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1. Summary •
Electoral ward Quinton is within the boundary of NHS South Birmingham.
•
Quinton accounted for 2.31% of Birmingham’s population in 2006.
•
Children and young people (0-19) are the most populous group in the ward, making up 25.9% of the total population.
•
The percentage of Black and minority Ethnic groups in this ward is 14.4%, which is higher than the National (11.3%) but lower than the Birmingham (32.7%) average.
•
Quinton is the 28th (out of 40) most deprived ward in Birmingham.
•
The latest extraction for 2005/07 shows that: o Life expectancy is 77.3 for men and 83.5 for women over the years 2005/07. o From 1995/97 to 2005/07 male life expectancy has increased by 1.7%. However male life expectancy is now lower than the England average. o From 1995/97 to 2005/07 female life expectancy has increased by 3.5%. The gap between Quinton and England has widened by 70% (0.7 years) in the ward’s favour. o Infant Mortality Rates have risen by 24.4% since 1999/01, whilst the rate for the most deprived wards has dropped. o The leading conditions that cause deaths in the ward are Circulatory diseases (33.2%), Cancers (27.9%) and Coronary Heart Diseases (16.1%).
•
Lifestyle factors 2005/07 suggest that, in comparison to Birmingham as a whole the rates for residents of Quinton are: o 3.5 percentage points lower for binge drinking. o 3.2 percentage points lower for adult obesity. o 2.3 percentage points lower for adults who smoke.
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2. Local context: demographics and deprivation This section describes population demographics and deprivation in Quinton, in order to provide a local context for life expectancy inequalities. Comparisons are made with Birmingham and England.
2.1. Age and sex distribution The population of Quinton is estimated to be 23,318. This represents 2.31% of the population of Birmingham. Approximately 47.9% (11,163) are male and 52.1% are female (12,155). These estimations are based on ONS mid-year population estimates for 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
80+
336
212
75-79
387
361
551 Females
517
65-69 60-64
Males
496
412
70-74
578
614 692
55-59
706 677
596
50-54 651
45-49 40-44
754 858
758
896
893
35-39
734
30-34
870 653
25-29 20-24
869 864
779 743
816
15-19
755
10-14
700
725
5-9 0-4
725 758
806
1000
800
600
400
200
0
200
400
600
800
1000
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Quinton 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 28.9% (6,028) of the Quinton population. Persons of retirement age (age 65+) account for 16.5% (3,848).
•
The ward has 6.8 percentage points more under 19s and 5.9 percentage points more over 65s than the city averages.
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2.2. Ethnicity Ethnicity has some influences in terms of what kind of illness an individual could develop through their life. Thus, ethnicity analysis becomes a requirement in order to target the health of vulnerable people. Table 1.1 shows the ethnicity distribution in the Quinton population, compared with Birmingham and England. •
•
•
The % column of table 1.1 represents the percentage of the total population that fit into that ethnic group. The N* column shows the quantity of people in thousands that are from each group, for the ward, city and nationally. About a seventh (14.4%) of the population belongs to non-white (BME) ethnicity groups; Pakistanis represent 0.87%, Indians 5.26% and Black Caribbeans 3.12%. The proportion of BME groups (14.4%) is higher than for England (11.3%) but lower than for Birmingham (32.7%).
Table 1.1
Ethnicity groups for Quinton (2001), Birmingham (2006) and England (2006) Quinton % N* 85.6 19.7 6.8 1.6 3.8 0.8 3.0 0.7 0.8 0.2 100 23.0
Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total
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
% 88.7 5.5 2.8 1.6 1.4 100
England 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 for Birmingham / England. 2001 Census data for Ward
2.3. Deprivation According to Index of Multiple Deprivation (IMD) 2007 published by ONS, Quinton is the 27th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 28.251. Figure 1.2 shows SOAs by IMD quintile, 2007. The area covered by Quinton is comprised of a range of deprivation levels. Table 1.2 shows the area covered by the ward and the population density. Table 1.2
Ward Area Characteristics for Quinton 2
2
Area (KM )
Population Density (persons / km )
Population Density – Working Age 2 16-64 (persons/km )
5.247
4659
2889
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 Quinton by IMD quintile, 2007
2.4. Lifestyle Table 1.3 provides a summary of lifestyle indicators in Quinton, in comparison with Birmingham and England. Data presented here are from the synthetic estimates of healthy lifestyle behaviours produced by the NHS Information Centre. •
• •
Compared with the Birmingham average, Quinton has a lower percentage of people who binge drink (3.5 percentage points lower) and are obese (3.2 percentage points lower); additionally there are less people who smoke (2.3 percentage points lower). A smaller percentage of people eat healthily in Quinton (22.6%) than both in Birmingham (25.1%) and nationally (26.3%). Table 1.3 shows further information should be sought on why inequalities exist for healthy eating between Quinton and the Birmingham and England averages.
Table 1.3
Key figures for life style Deprivation in Quinton, Birmingham and England
Adults who smoke Binge drinking adults* Healthy eating adults** Obese adults*** * ** ***
Year 2003/05 2003/05 2003/05 2003/05
Quinton 22.6% 14.3% 22.6% 20.2%
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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3. Life expectancy trend There is evidence that life expectancy is one of the most important determinants for health inequalities across the population. 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 the trend in male life expectancy in Quinton from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Male life expectancy has increased in Quinton over this time however Quinton has progressed slower and male life expectancy is now lower than the England average. Male Life Expectancy - 3 year rolling average, Quinton, 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
20 04
/0 5 20 03
/0 4
/0 2
/0 3
20 02
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
Quinton M ales
Data source: ONS
Figure 2.1 Male life expectancy for Quinton, Birmingham and England, 1995/97 – 2005/07
Figure 2.2 shows the trend in female life expectancy in Quinton from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. From 1995/97 to 2005/07 the gap between Quinton and the national average has increased in the ward’s favour.
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Female Life Expectancy - 3 year rolling average, Quinton, Birmingham & England 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
Quinton Females
Data source: ONS
Figure 2.2 Female life expectancy for Quinton, Birmingham and England, 1995/97 – 2005/07
As illustrated above life expectancy for both males and females has increased from 1995/97 to 2005/07. Life expectancy in Quinton is higher than city averages for males and females. However, males are lower than the national average, whilst females are higher. •
Male life expectancy has increased by 1.7% from 76.0 years in 1995/97 to 77.3 years in 2005/07.
•
Male life expectancy in Quinton has switched from 1.4 years above to 0.4 years below the national average.
•
Female life expectancy has increased by 3.5% from 80.7 years in 1995/97 to 83.5 years in 2005/07.
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The gap in female life expectancy between Quinton and England has widened from 1.0 years to 1.7 years in the ward’s favour.
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4. 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 Quinton, 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 1999/01 to 2005/07. Quinton 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 Quinton
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 Quinton, Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 2005/07, the IMR in Quinton is around double that of England and is also higher than for the SOAs in the most deprived quintile in Birmingham. • •
From 1999/01 to 2005/07, the IMR in Quinton has increased by 24.4%. Whilst in comparison Birmingham’s IMR has decreased. During the same period, the IMR in England has decreased smoothly from 5.6 to 4.9 per 1,000 (at about 0.1 per 1,000 per year). The gap between Quinton and England has increased from 3.0 to 5.8 per 1,000 (93.3%) above England.
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5. Mortality rates on selected diseases Age-specific mortality rate is used to calculate life expectancy at birth. Disease specific standardised mortality rates are investigated, in order to identify leading diseases that contribute to the overall mortality rates in Quinton. Table 3.1 shows directly standardised mortality rates for selected conditions in 2005/07. Percentage of each disease’s rate out of the overall rate is also shown here. Cancers, circulatory diseases and coronary heart disease are the major killers. They make up more than 77.2% of the overall DSR. This percentage is consistent with both city and local PCT levels, which vary from 72% to 82%. Table 3.1
Directly Standardised Mortality Rates (DSRs) per 100,000 population for selected conditions, Quinton, 2005/07
All Causes
DSR 570.2
% out of all causes rate* 100.0%
All Cancers
158.8
27.9%
All Circulatory Diseases
189.5
33.2%
Coronary Heart Disease
91. 8
16.1%
* 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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