Life Expectancy Ward Analysis Ward Profile: Stechford & Yardley North Tackling Health Inequalities: Life Expectancy
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June 2009
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PHIT - Stechford and Yardley N LE.doc
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Introduction Life expectancy is one of the main indicators for health inequalities. It has been set as the overarching work stream for tackling health inequalities in Birmingham by the Health and Wellbeing Partnership (BHWP). Eleven wards (out of 40) in Birmingham were identified as proposed target wards for the life expectancy work stream. Details of the identification of the target wards are published in a separate report: ‘Birmingham Health Profile – Tackling Health Inequalities: Life Expectancy’. This Ward Profile series aims to : •
Provide a detailed ward level picture of local health inequality context
•
Describe life expectancy trend in each target ward
•
Investigate into leading conditions that cause deaths locally to provide local focus for each target ward and
•
Suggest future area/ factors for extended research
This report is written by Birmingham Public Health Information Team, Suite 203, CIBA Building, 146, Hagley Road, Birmingham B16 9NX Author s
Jeanette Davis (Public Health Information Analyst) Yang Tian (Public Health Information Team Leader) yang.tian@benpct.nhs.uk
0121 465 2995 Chris Stephen (Public Health Information Analyst) Mohan Singh (Public Health Database Administrator/ Analyst) Iris Fermin (Head of Information and Intelligence) Section Director
Jim McManus (Joint Director of Public Health)
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Summary •
Electoral ward Stechford and Yardley North is in the boundary of Birmingham East & North (BEN) PCT
•
Stechford and Yardley North accounted for 1.94% of the population of Birmingham in 2006
•
One of the largest age groups are children and young people [0 – 19] at 28.7%
•
Black and Minority Ethnicity (BME) group split (14.6%) is higher than national average (11.3%) overall but lower than Birmingham (32.7%). This group accounted for 0.49% of Birmingham’s total population in 2001
•
Stechford and Yardley North is the 13th (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects: o Life expectancy is now 74.91 for men, 78.3 for women in the year 2005/07 o Male life expectancy has increased by 4.17%. The gap of male life expectancy between Stechford and Yardley North and England has remained the same. o Female life expectancy has decreased by 0.39%. The gap of female life expectancy between Stechford and Yardley North and England has increased 2.5 times, from 1.1 years to 3.5 years) as England’s female life expectancy has increased. Stechford and Yardley North has seen a large increase in their IMR figures (47%) and with this the gap between England and the ward has widened accordingly (420%) because of the drop in the England rate o Circulatory diseases (30.53%), Cancers (26%) and Coronary Heart disease (12.5%) are the leading conditions that cause deaths in the ward
o
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1
Local context: demographics and deprivation
This section describes population demographics and deprivation in Stechford and Yardley North 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 Stechford and Yardley North is estimated to be 25,054. This represents 1.94% of the population of Birmingham. Approximately 49% (12,280) are male and 51% are female (12,773). 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+
208
75-79
408
321
70-74
446
65-69
449
473
60-64
555
713
50-54
627
700
45-49
Females 553
556
55-59
Males
438
663
833
40-44
820
898
35-39
969
879
949
30-34
676
25-29
752
756
20-24
790
917
15-19
936
1007
10-14
966
957
845
5-9
869
0-4
802
893
1500
1000
840
500
0
500
1000
1500
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Stechford and Yardley North 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 28.7% (7,179) of the Stechford and Yardley North population. Persons of retirement age (age 65+) account for a 15.5% (136,700).
•
If we look at the age split for the above two areas we find that this particular ward has 6.65 percentage points more people from 0 – 19 age group than the city average. Equally, there are 4.86 percentage points more of people above the age of 65.
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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 Stechford and Yardley North 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 show the quantity of people in thousands that are from each group, for the ward, City and nationally. Just over one eighth (14.6%) are of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 4.8%, Indian 1.9% and Black Caribbean 3.6%. The BME (14.6%) lower than Birmingham (32.7%) and higher than England (11.3%). White ethnicity (85.4%) is higher than Birmingham’s average but lower than England.
Table 1.1
Ethnicity groups for Stechford & Yardley North (2001), Birmingham (2006) and England (2006) Stechford & Birmingham England Yardley North Ethnicity groups % % % N* N* N* White 85.4 67.3 88.7 21.2 667.0 45,018.1 Asian or Asian British 7.3 20.7 5.5 1.8 207.9 2,786.6 Black or Black British 4.2 6.7 2.8 1.0 67.0 1,403.0 Mixed 2.6 3.2 1.6 0.7 31.8 829.5 Chinese or other 0.5 2.3 1.4 0.1 22.9 725.7 Total 100 100 100 24.8 1,106.5 50,762.9 *population per 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, Stechford and Yardley North is the 13th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 36.451. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Stechford and Yardley North 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 )
4.77
4667
3068
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 Stechford & Yardley North by IMD quintile 2007
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2
Life expectancy trend
Life expectancy is one of the most important determinants for health inequalities across the population; and there is evidence. This section gives an overview of life expectancy at birth in terms of trend and variations in different groups and communities. Figure 2.1 shows trend of male expectancy in Stechford and Yardley North from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 shows a continuing rise in the male life expectancy for the ward, but it is still below Birmingham and therefore requires investigation. Male Life Expectancy - 3 yr Rolling Average, Stechford & North Yardley, Birmingham & England 79.0 78.0 Life Expectancy (Age)
77.0 76.0 75.0 74.0 73.0 72.0 71.0 70.0 69.0
/0 7 20 05
/0 6 20 04
/0 5
/0 4 20 02
20 03
/0 3
/0 2
20 01
20 00
/0 1 19 99
/0 0
19 98
/9 9 19 97
19 96
19 95
/9 7
/9 8
68.0
Calendar Years Stechford and Yardley North M ales
England M ales
Birmingham M ales
Data source: ONS
Figure 2.1 Male life expectancy, Stechford & Yardley North, Birmingham and England, 1995/97 – 2005/07
Figure 2.2 show trends of female expectancy in Stechford and Yardley North from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.2 clearly shows that female life expectancy in the ward has remained fairly stable and has not improved during these years.
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Female Life Expectancy - 3 yr Rolling Average, Stechford & Yardley North, Birmingham & England 83.0
Life Expectancy (Age)
82.0 81.0 80.0 79.0 78.0 77.0 76.0
/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
75.0
Calendar Year Stechford and Yardley North Females
England Females
Birmingham Females
Data source: ONS
Figure 2.2 Female life expectancy, Stechford & Yardley North, Birmingham & England, 1995/97 – 2005/07
As illustrated in Figure 2.1 and Figure 2.2, life expectancy for males Stechford has increased; whilst for females it has remained fairly static. Male life expectancy has increased faster than female life expectancy. Life expectancy in Stechford and Yardley North is lower than regional and national average. The gap of female life expectancy between Stechford and Yardley North and England has widened, whilst the gap for males has remained stagnant. This needs further investigation. In conclusion •
Male life expectancy has increased by 4.17% (3.03 years, from 71.88 years in 95/97 to 74.91 years by 05/07).
•
The gap of male life expectancy between the ward and England has remained the same.
•
Female life expectancy has decreased by 0.39% (0.31 years, from 78.62 in 95/97 years to 78.3 years by 05/07).
•
The gap of female life expectancy between Stechford and Yardley North and England has increased 2.5 times, from 1.1 years to 3.5 years) as England Female life expectancy has increased.
•
Male 74.91 years, Female 78.3 years; an increase of 1.8%.
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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 Stechford and Yardley North, 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. Stechford & Yardley North Infant Mortality Rate - 3 yr 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
Year Stechford & Yardley North 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 Stechford and Yardley North, Birmingham, England and the most deprived quintile in Birmingham, 19992007
As illustrated in Figure 2.3, in 05/07, the IMR in Stechford and Yardley North is about 65% 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 increased by 47% (2.4). The ward rate initially began to fall but since 03/05 has increased rapidly. During the whole period, IMR in the most deprived quintile SOAs in Birmingham has decreased from 11.5 to 9.8 (15%). The gap between the most deprived quintile and Stechford and Yardley North as a whole has decreased too by 62.5% from 6.4 to 2.4. 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 Stechford and Yardley North and England has increased from 0.5 to 2.6 (420%).
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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 Stechford & Yardley North. Table 3.1 shows directly standardized mortality rates for selected conditions in 2005-2007. Percentage of each disease’s rate out of the overall rate is also shown here. According to the figures, cancers, circulatory diseases and coronary heart disease are the major kiilers. They make more than 69% of the overall DSR. The average for both city and local PCT levels vary from 72% to 82%. 69% is below city averages; but they are still the major killers in the ward.
Table 3.1
Directly Standardized Mortality Rates (DSRs) per 100,000 population for selected conditions , Stechford and Yardley North 2005-2007 DSR
% out of all causes rate*
All Causes
845.85
All Cancers
219.93
26%
All Circulatory Diseases
258.28
30.53%
Coronary Heart Disease
105.75
12.50%
* 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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