Life Expectancy Ward Analysis Ward Profile: Tyburn Tackling Health Inequalities: Life Expectancy
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2
Date
June 2009
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Green
File location (public) Filename and path to locate this document
PHIT - Tyburn 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 - Tyburn LE.doc
Jim McManus (Joint Director of Public Health)
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Summary •
Electoral Ward Tyburn is in the boundary of Birmingham East and North (BEN) PCT
•
Tyburn made up 1.9% of the population of Birmingham in 2006
•
One of the largest age groups are children or young people [0 – 19] at 28.7%
•
Black and Minority Ethnicity (BME) group (14.4%) is higher than national average (11.3%) overall but lower than Birmingham (32.7%). This group accounted for 0.44% of Birmingham’s total population in 2001
•
Tyburn is the 11th (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects: o
Life expectancy is now 73.54 for men, 78.54 for women in the year 2005/07
o Male life expectancy has increased by 1.97%. The gap of male life expectancy between Tyburn and England has widened by 64%. o Female life expectancy has increased by 2.9%. The gap of female life expectancy between Tyburn and England has remained the same at 3.3 years. o o
PHIT - Tyburn LE.doc
IMR has increased by 23.2%; alongside this the gap between England and Tyburn has widened by 6% Circulatory diseases (34.25%), Cancer (29.09%), and Coronary Heart diseases (17.86%) are the leading conditions that cause deaths in the ward
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1
Local context: demographics and deprivation
This section describes population demographics and deprivation Tyburn 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 Tyburn is estimated to be 24,364. This represents 1.9% of the population of Birmingham. Approximately 48.3% (11,766) are male and 51.7% are female (12,598). 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+
213
75-79
324
328
70-74
462
65-69
467
60-64
527
55-59
535
50-54
Males
442 518
528 561
600
45-49
Females
554
648
767
40-44
752
843
35-39
973
885
30-34
982 785
25-29
870
744
20-24
818
898
15-19
889
933
874
10-14
842
5-9
847
0-4
892 843
950
1500
1000
822
500
0
500
1000
1500
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Tyburn, 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 28.7% (7,003) of the Tyburn population. Persons of retirement age (age 65+) account for a 15.4% (3,756).
•
In comparison to city averages the ward has 6.65 percentage points more 0 – 19 year olds. Additionally, Tyburn has a higher percentage of 65+ i.e. 4.76 percentage points
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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 Tyburn 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 a eighth (14.4%) of the ward is of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 2.5%, Indian 1.7% and Black Caribbean 4.9%. The BME (14.4%) is lower than Birmingham (32.7%) and slightly higher than England (11.3%). White ethnicity (85.6) is higher than Birmingham but lower than national levels. Ethnicity groups for Tyburn (2001), Birmingham (2006) and England (2006)
Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total
%
Tyburn N* 85.6 19.1 4.5 1.0 5.9 1.3 3.5 0.8 0.4 0.1 100 22.3
%
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 per thousand 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, Tyburn is the 11th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 41.561. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Tyburn 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 )
8.583
2855
1767
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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 Tyburn 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 Tyburn from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 shows a continuing improvement in the male life expectancy of Tyburn; however it is still lower than Birmingham and therefore needs further strategies to continue the improvements.
Male Life Expectancy - 3 yr Rolling Average, Tyburn, Birmingham & England 79.0
Life Expectancy (Age)
78.0 77.0 76.0 75.0 74.0 73.0 72.0 71.0 70.0
/0 7 20 05
/0 6 20 04
/0 4
/0 5 20 03
20 02
/0 2
/0 3 20 01
20 00
19 99
/0 1
/0 0
/9 9
19 98
19 97
/9 8 19 96
19 95
/9 7
69.0
Calendar Year Tyburn M ales
England M ales
Birmingham M ales
Data source: ONS
Figure 2.1 Male Life expectancy, Tyburn, Birmingham and England, 1995/97 – 2005/07
Figure 2.2 shows trend of female expectancy in Tyburn from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.2 shows that whilst overall female life expectancy has improved for Tyburn, in 2007 there was a decrease. Strategies need to be developed to stop this continuing.
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Female Life Expectancy - 3 yr Rolling Average, Tyburn, 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
/9 9
/0 0 19 98
19 97
19 96
19 95
/9 7
/9 8
73.0
Calendar Year Tyburn Females
England Females
Birmingham Females
Data source: ONS
Figure 2.2 Female Life expectancy, Tyburn, Birmingham & 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 slightly less than female life expectancy. Life expectancy in Tyburn is lower than regional and national average. The gap of female/male life expectancy between Tyburn and England has widened. •
Male life expectancy has increased by 1.97% (1.42 years, from 72.12 years during 95/97 to 73.54 years by 05/07).
•
The gap of male life expectancy between Tyburn and England has widened by 1.6 year from 2.5 years to 4.1 years, which means an increase of 64%.
•
Female life expectancy has increased by 2.9% (2.2 years, from 76.34 years during 95/97 to 78.54 years by 05/07).
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The gap of female life expectancy between Tyburn and England has remained the same at 3.3years.
•
Male 73.54 years, Female 78.54 years; this is an increase of 2.43%.
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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 Tyburn, 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. Tyburn Infant M ortality 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 Tyburn
Birmingham
England
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 Tyburn, Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 05/07, the IMR is about double that of England and whilst that in the most deprived quintile are about two folds of England. •
• •
•
From 99/01 to 05/07, the IMR has increased by 6% (0.6). It initially began to drop and remained nearer the England number from 01/03 to 03/05 however, since that time it has risen once more During the whole period, IMR in the most deprived quintile SOA’s in Birmingham has decreased from 11.5 to 9.8 (15%). The gap between the most deprived quintile and Tyburn changed from a position in favour of Tyburn 1.5 better to the gap widening to 0.9 an increase of 160% 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 Tyburn and England has increased from 4.5 to 5.8 (23.2%).
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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 Tyburn. 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 just less than 81.2% 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 by Tyburn, 2005-2007 DSR
% out of all causes rate*
All Causes
814.65
All Cancers
237.01
29.09%
All Circulatory Diseases
279.00
34.25%
Coronary Heart Disease
145.52
17.86%
* 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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