Life Expectancy Ward Analysis Ward Profile: Soho Tackling Health Inequalities: Life Expectancy
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Date
June 2009
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Green
File location (public) Filename and path to locate this document
PHIT - Soho 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
PHIT - Soho LE.doc
Jim McManus (Joint Director of Public Health)
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Summary •
The Electoral ward of Soho is in the boundary of Heart of Birmingham Teaching PCT (HOB)
•
Soho made up 1.99% of the total population of Birmingham in 2006
•
The largest age group are children and young people [0 – 19] at 30.5%
•
Black and Minority Ethnicity (BME) group split (73.2%) is higher than national average (11.3%) and Birmingham (32.7%). This group accounted for 1.89% of Birmingham’s total population in 2001
•
Soho is the 3rd (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects: o Life expectancy is at 72.8 for men, 79.8 for women in the year 2005/07 • Male life expectancy has increased by 5.9%. The gap of male life expectancy between Soho and England has decreased by 1 year which means an increase of 17% from 95/97 to 05/07 • Female life expectancy has increased by 3.7%. The gap of female life expectancy between Soho and England has narrowed by 26% from 95/97 to 05/07 o Since 95/97 the IMR has decreased by 49% reducing the gap between ward and England by 72% o Circulatory diseases ((40.63%), Cancers (20.43%) and Coronary Heart diseases (20.78%) are the leading conditions that cause deaths in the ward
•
The latest extraction for 2005/07 additionally reflects: o 10.1 percentage points binge drink less o 5.0 percentage points smoke more o Obesity is equal to Birmingham average
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1
Local context: demographics and deprivation
This part describes population demographics and deprivations in Soho 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 Soho is estimated to be 25,799. This represents 1.99% of the population of Birmingham. Approximately 52.1% (13,464) are male and 47.9% are female (12,365). 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+
128
157
Males
75-79
209
70-74
243
250
65-69
337
311
60-64
326
55-59
331
366
50-54
Females
339
434
591
45-49
576
640
40-44
710
882
35-39
888
1320
30-34
959
1281
25-29
981
1590
20-24
1159 1438
15-19
1299 1095
902
10-14
896
5-9
882
979
0-4
922
1076
2000
1500
1123
1000
500
0
500
1000
1500
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Soho 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 30.5% (7,875) of the Soho population. Persons of retirement age (age 65+) account for an 8.35% (2,153).
•
Compared with the age structure of Birmingham, Soho has a larger proportion of children and young people i.e. 8.45 percentage points above city levels, and a smaller proportion of persons of older age groups. [65+] i.e. 2.29 percentage points lower
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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 Soho 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 three quarters (73.2%) of the population is of a non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 15%, Indian 24% and Black Caribbean 17.8%. BME (73.2%) is higher than Birmingham (32.7%) and England (11.3%). White ethnicity (26.2%) is lower than national and local levels. Ethnicity groups for Soho 2001, Birmingham (2006) and England (2006)
Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total
%
Soho N* 26.8 6.4 44.9 10.7 21.5 5.1 4.8 1.1 2.0 0.5 100 23.8
%
Birmingham N* 67.3 667.0 20.7 207.9 6.7 67.0 3.2 31.8 2.3 22.9 100 1,106.5
%
England N* 88.7 45,018.1 5.5 2,786.6 2.8 1,403.0 1.6 829.5 1.4 725.7 100 50,762.9
*population by thousands 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, Soho is the 3rd most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 52.001. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Soho 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 )
4.892
4795
3033
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 Soho by IMD quintile, 2007
1.4 Life style Table 1.2 provides a summary of life style indicators in Soho, in comparison with Birmingham and England. Data presented are from synthetic estimates of healthy life style behaviours from the NHS Information Centre •
•
•
Table 1.2
In terms of proportion of people who smoke, binge drink and are obese, Soho has slightly more smokers (5%), a lot less binge drinkers (10.7%) and approx. the same amount of obese people as City and national figures. Compared with the national average, smaller proportion of people living in Soho eat healthily (5.2%) lower than Birmingham and (6.4%) less than the national proportion. Table 1.2 shows that Soho has a higher proportion of people who smoke; which contributions to the overall life expectancy rates for the ward. Therefore, this should be investigated and strategies developed. Key figures for life style Deprivation in Soho, Birmingham and England
Adults who smoke Binge drinking adults* Healthy eating adults** Physically active adults*** Obese adults**** * ** *** ****
Year 2003/5 2003/ 2005 2003/ 2005 2007/8 2003/ 2005
Soho 29.9% 7.1% 19.9% NA at Ward Level 23.4%
Birmingham 24.9% 17.8% 25.1%
England 24.1% 18.0% 26.3%
16.9%
21.3%
23.4%
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 Physically active: 30 minutes of moderate intensity sport and active recreation on at least three days a week basis. 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 Soho from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 shows evidence of continued improvement in the male life expectancy of Soho, however as the rate is below the city, further research needs to be carried out to improve the rate even further Male Life Expectancy - 3 yr Rolling Average, Soho, Birmingham & England 80.0
Life Expectancy (Age)
78.0 76.0 74.0 72.0 70.0 68.0 66.0
/0 7 20 05
/0 5
/0 6 20 04
20 03
/0 4
/0 2
/0 3
20 02
20 01
20 00
/0 1
/0 0
19 99
19 98
/9 9 19 97
19 96
19 95
/9 7
/9 8
64.0
Calendar Year Soho M ales
England M ales
Birmingham M ales
Data source: ONS
Figure 2.1 Male life expectancy, Soho, Birmingham and England 1995/97 – 2005/07
Figure 2.2 shows trend of female expectancy in Soho from 1995/95 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.2 shows a definite improvement in female life expectancy for Soho, but as with male life expectancy further research needs to be carried to devise strategies for further improvement.
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Female Life Expectancy - 3 yr Rolling Average, Soho, Birmingham & England 83.0
Life Expectancy (Age)
82.0 81.0 80.0 79.0 78.0 77.0 76.0 75.0 74.0
/0 7 20 05
/0 6 20 04
/0 5 20 03
/0 4 20 02
/0 3 20 01
/0 2 20 00
/0 1 19 99
/0 0 19 98
/9 9 19 97
/9 8 19 96
19 95
/9 7
73.0
Calendar Year Soho Females
England Females
Birmingham Females
Data source: ONS
Figure 2.2 Female life expectancy, Soho, 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. Male life expectancy has increased faster than Female life expectancy. Life expectancy in Soho is lower than regional and national average. The gap of female/male life expectancy between Soho and England has narrowed. In conclusion: •
Male life expectancy has increased by 5.9% (4.04 years, from 68.7 years during 95/97 to 72.8 years by 05/07).
•
The gap of male life expectancy between Soho and England has decreased by 1 year from 5.9 years to 4.9 years, which means an increase of 17%.
•
Female life expectancy has increased by 3.7% (2.85 years, from 77 years during 95/97 to 79.8 years by 05/07).
•
The gap of female life expectancy between Soho and England has narrowed by 26% (0.7 year (i.e. 8 months)’s gap, from 2.7 years to 2 years).
•
Male 72.8 years, Female 79.8 years; this is a reduction of 4.73%.
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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 Soho, 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. Soho Infant M ortality Rate - 3 yr Rolling Average 20.0 18.0 16.0 Rate per 1,000
14.0 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 Soho 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 rates per 1,000 births in Soho England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 05/07, the IMR in Soho is about 50% higher than England and that in the most deprived quintile is about two folds of England. • •
•
•
From 99/01 to 05/07, the IMR has decreased by 49%. The trend for most deprived quintile SOAs in Birmingham over the period are not the same as Soho. 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 Soho as a whole has decreased too by 1.5 times from 2.9 in favour of the most deprived quintile to 2.5 in favour of Soho 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 Soho and England has decreased from 8.8 to 2.4 (73%).
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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 Soho 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 the major killers are cancers, circulatory diseases and Coronary heart disease. They make up more than 81.8% 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, Soho, 2005-2007 DSR
% out of all causes rate*
All Causes
760.45
All Cancers
155.36
20.43%
All Circulatory Diseases
308.96
40.63%
Coronary Heart Disease
158.04
20.78%
* 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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