Life Expectancy Ward Analysis Ward Profile: Stockland Green Tackling Health Inequalities: Life Expectancy
VERSION CONTROL AND DOCUMENT GOVERNANCE Version
2
Date
May 2009
Status
Green
File location (public) Filename and path to locate this document
All maps produced with permission of Dotted Eyes & Ordance Survey Š Crown copyright 2008 licence number 100019918
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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
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) 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)
Any further information
Telephone : 0121 465 2995 / 2999 Email : PHIT@benpct.nhs.uk
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Summary •
Electoral ward Stockland Green is in the boundary of NHS Birmingham East and North
•
Stockland Green accounted for 2.5% of Birmingham’s population in 2006
•
The age group with the highest percentage of the population are children and young people [0 – 19] at 24.22%
•
Black and Minority Ethnicity (BME) group split (24.9%) is higher than national average (11.3%) overall but lower than Birmingham (32.7%). This group accounted for 0.51% of the total population of Birmingham in 2001.
•
Stockland Green is the 24th (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects that: o Life expectancy is at 73.0 for men, 80.2 for women in the year 2005/07 o Male life expectancy has increased by 1.4%. The gap between Stockland Green and England has widened by 81% (2.1 years) from 95/97 to 05/07. o Female life expectancy has increased by 5.6%. The gap between Stockland Green and England has shortened by 57% (2.1 years) from 95/97 to 05/07. o Infant Mortality Rates have risen by 23.1% since 99/01, in comparison the rate for the most deprived wards has dropped o Circulatory diseases (36.05%), Cancers (25.17%) and Coronary Heart Diseases (17.83%) are the leading conditions that cause deaths in the ward.
•
Relatively, compared against Birmingham; for risk factors such as alcohol, obesity and smoking Hodge Hill presents as follows: o 6.5 percentage points more smoke o 1.8 percentage points are less obese o 0.8 percentage points binge drink less
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1
Local context: demographics and deprivation
This section describes population demographics and deprivation, and comparisons are made with Stockland Green, Birmingham and England to provide a local context for life expectancy inequalities.
1.1 Age and sex distribution The population of Stockland Green is estimated to be 21,726. This represents 2.5% of the population of Birmingham. There are (10,798) 49.7% male and (10,928) 50.3% female. These estimations are based on ONS Mid. Year (2006) Population By Age Group and Gender 2006 Estimates by Ward Source: Office of National Statistics
80+
177
75-79
263
249
70-74
352
336
65-69
347
60-64
401
540
570
593
50-54
Females
418
442
55-59
Males
387
526
727
45-49 40-44
695
840
35-39
898
905
30-34
824 804
762
904
25-29
848
1179
20-24
1083
15-19
758
10-14
803 638
635
574
5-9 0-4
549
667
1500
1000
638 500
0
500
1000
1500
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Stockland Green 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 24.22% (5,262) of the Stockland Green’s population. Persons of retirement age (age 65+) account for 13.45% (2,923).
•
The age structure of the ward reflects that the under 19 age group is 2.17 percentage points higher than Birmingham; equally the 65+ are also higher than the city by 2.81 percentage points
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1.2 Ethnicity Ethnicity has some influences in terms of what diseases an individual could develop through their life. With this in mind, analysis of the ethnicity of the local population becomes a requirement in order to target vulnerable health groups. Table 1.1 shows the ethnicity distribution in the Stockland Green 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. About a quarter (24.8%) of the population in Stockland Green is of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 5.67%, Indian 3.39% and Black Caribbean 0.42%. The proportion of BME (24.8%) is nearly the same proportion as within Birmingham (32.7%), and more than doubles that of the average across England (11.3%). The white ethnicity (72.2%) is higher than local levels but lower than nationally.
Table 1.1
Ethnicity groups for Stockland Green (2001), Birmingham (2006) and England (2006) Stockland Green Birmingham England Ethnicity groups % % % N* N* N* White 75.2 67.3 88.7 15.7 667.0 45,018.1 Asian or Asian British 10.3 20.7 5.5 2.2 207.9 2,786.6 Black or Black British 10.1 6.7 2.8 2.1 67.0 1,403.0 Mixed 3.5 3.2 1.6 0.7 31.8 829.5 Chinese or other 0.9 2.3 1.4 0.1 22.9 725.7 Total 100 100 100 20.8 1,106.5 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, Stockland Green is the 24th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 30.801. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Stockland Green is in the third and fourth most deprived SOAs in Birmingham. (ref: IMD Map on following page.)
Ward Area 2
Area (km )
Population Density 2 (persons / km )
Population Density – Working 2 Age 16-64 (persons/km )
4.641
5342
3373
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 Stockland Green by IMD quintile, 2007
1.4 Lifestyle Table 1.2 provides a summary of life style indicators in Stockland Green, in comparison with Birmingham and England. Data presented here are from the synthetic estimates of healthy life style behaviours from the NHS Information Centre. •
• •
Table 1.2
Compared with Birmingham average, Stockland Green has a lower percentage of people who binge drink (0.8 percentage points lower) and are obese (1.8 percentage points) but a higher proportion who smoke (6.5 percentage points higher) Compared with the national average, a smaller percentage of people living in Stockland Green eat healthily (7.5 percentage point lower). Table 1.2 shows that healthy eating amongst adults in Stockland Green needs to be investigated and strategies developed to get the population to eat healthier. Further investigation is also warranted on the high percentage of adults who smoke Key figures for life style Deprivation in Stockland Green, Birmingham and England Year
Adults who smoke Binge drinking adults* Healthy eating adults** Obese adults*** * ** ***
2003/5 2003/ 2005 2003/ 2005 2003/ 2005
Stockland Green 31.4% 17% 17.6% 21.6%
Birmingham
England
24.9% 17.8% 25.1% 23.4%
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 forecasters for health inequalities across the population; since there is evidence that people most needing them do not have access to services. This section gives an overview of life expectancy at birth in Stockland Green, in terms of trend and variations in different groups and communities. Figure 2.1 shows trend of male expectancy in Stockland Green from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England and shows evidence that whilst male life expectancy has increased in Stockland Green over the ten years since 1995. It is still below national and city levels so therefore requires further investigation.
Male Life Expectancy - 3 year rolling average, Stockland Green, Birmingham & England Data source: ONS
79.0
Life Expectancy (Age)
78.0 77.0 76.0 75.0 74.0 73.0 72.0 71.0 70.0 69.0
/0 6
/0 7 20 05
20 04
/0 5 20 03
/0 4
/0 3
20 02
20 01
/0 2 20 00
/0 1 19 99
/0 0 19 98
/9 8
/9 9 19 97
19 96
19 95
/9 7
68.0
Calendar Year England M ales
Birmingham M ales
Stockland Green M ales
Figure 2.1 Male life expectancy for Stockland Green, Birmingham and England, 1995/97 – 2005/07
Figure 2.2 shows trend of female expectancy in Stockland Green from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England and reveals that by 2007 female life expectancy has increased year on year since 1995. However, it is still below the national and city level so more strategies are needed to identify underlying causes of this issue.
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Female Life Expectancy - 3 year rolling average, Stockland Green, Birmingham & England 83.0 82.0 Life Expectancy (Age)
81.0 80.0 79.0 78.0 77.0 76.0 75.0 74.0
20 07 to
20 05
to
20 06
20 05 20 04
to
20 04 20 03
20 03
to
to
to
20 02
20 01
to
20 02
20 01 20 00
20 00 19 99
to
19 99 19 98
to
to
19 98 19 97
19 96
19 95
to
19 97
73.0
Calendar Year England Females
Birmingham Females
Stockland Green Females
Data source: ONS
Figure 2.2 Female life expectancy for Stockland Green, 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 over the period of time. Life expectancy in Stockland Green is lower than City and national averages. The gap for both male life expectancy between Stockland Green and England has increased, although the gap for women has decreased. In conclusion: • •
• •
Male life expectancy has increased by 1.4% (1.01 years, from 72 years in 2000 to 73 years in 2007). The gap of male life expectancy between Stockland Green and England has widened by 2.1 years from 2.6 years in 1997 to 4.7 years, by 2007 which means an increase of 81%. Female life expectancy has increased by 5.6% (4.28 years, from 76 years in 2000 to 80.2 years by 2007). The gap of female life expectancy between Stockland Green and England has shortened by 2.1 years from 3.7 years in 1997 to 1.6 years in 2007.
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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 Stockland Green, 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. Stockland Green Infant Mortality - 3 year rolling average 16.0 14.0
Rate per 1,000
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
Trend Years Birmingham M ost Deprived Quintile in Bham
England Stockland Green
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 Stockland Green, Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 05/07, the IMR is two thirds larger that of than England and only slightly lower that in the most deprived quintile which is about two folds more than England. • •
•
From 99/01 to 05/07, the IMR has increased by 23.1%. Whilst in comparison Birmingham’s IMR has decreased. The gap between the most deprived quintile SOAs in Birmingham and Stockland Green has decreased from 4.4 per 1,000 below to 1 per 1,000 because of improvements in the most deprived quintile IMR 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 Stockland Green and England has increased from 1.6 per 1,000 to 3.9 per 1,000 (143.75%) by 2007.
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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 Stockland Green Table 3.1 shows directly standardized mortality rates for selected conditions during the period 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 79.65% of the overall DSR, this figures is slightly lower than the overall city percentage (0.45 percentage points) but within the PCT range of 72% to 81.6%. Table 3.1
Directly Standardized Mortality Rates (DSRs) per 100,000 population for selected conditions, Stockland Green 2005-2007 % out of all causes rate*
DSR All Causes
770.20
All Cancers
193.83
25.17%
All Circulatory Diseases
277.63
36.05%
Coronary Heart Disease
141.96
18.43%
* 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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