Life Expectancy Ward Analysis Ward Profile: Washwood Heath Tackling Health Inequalities: Life Expectancy
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2
Date
June 2009
Status
Green
File location (public) Filename and path to locate this document
PHIT - Washwood Heath 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 - Washwood Heath LE.doc
Jim McManus (Joint Director of Public Health)
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Summary •
Electoral ward Washwood Heath is in the boundary of Birmingham East and North (BEN) PCT
•
Washwood Heath makes up 2.28% of the population of Birmingham in 2006
•
The largest age group are children and young people [0 – 19] at 39.8%
•
Black and Minority Ethnicity (BME) group split (73.2%) is higher than national average (11.3%) and higher than Birmingham (32.7%). This group accounted for 2.09% of Birmingham’s total population in 2001
•
Washwood Heath is the 1st (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects: o Life expectancy is now 73.28 for men; 78.05 for women in the year 2005/07 o Male life expectancy has increased by 1.48%. The gap of male life expectancy between Washwood Heath and England has widened by 83% o Female life expectancy has increased by 1.48% The gap of female life expectancy between Washwood Heath and England has widened by 35.7% o o
•
On a positive note the IMR has decreased by 29.9%, and the gap between England and the ward has also decreased by 39.6% Circulatory diseases (31.16%), Cancers (24.82%) and Coronary Heart Diseases (17.03%0 are the leading conditions that cause deaths in the ward
The latest extraction for 2005/07 additionally reflects: o 10.6 percentage points binge drink less o 6.1 percentage points smoke more o 0.8 percentage points are more obese
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1 Local context: demographics and deprivation This section describes population demographics and deprivation in Washwood Heath 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 Washwood Heath is estimated to be 29,459. This represents 2.28% of the population of Birmingham. Approximately 50.7% (14,945) are male and 49.3% are female (14,514). 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+
124
75-79
169
264
70-74
256
314
65-69
337
361
60-64
286
55-59 584
45-49
599
40-44
430 595 654
682
35-39
706
1082
30-34
Females
358
398
50-54
Males
366
1009
1311
25-29
1405
20-24
1421
15-19
1418
10-14
1110 1321 1377 1322
1369
5-9
1217
1481
0-4
1463
1775
2000
1665
1500
1000
500
0
500
1000
1500
2000
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Washwood Heath, 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 39.8% (11,710) of the Washwood Heath population. Persons of retirement age (age 65+) account for an 8.22% (2,421).
•
In comparison to Birmingham the ward has a vastly higher percentage of under 19s i.e. 17.75 percentage points above the city average. Conversely, the numbers of over 65s are lower by 2.42 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 Washwood Heath 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. Around three quarters (73.2%) is of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 56%, Indian 1.7% and Black Caribbean 3.99%. The BME (73.2%) is higher than Birmingham (32.7%) and England (11.3%). White ethnicity (26.8%) is lower than national and local levels. Ethnicity groups for Washwood Heath (2001), Birmingham (2006) and England (2006) Washwood Heath % N* 26.8 7.3 64.9 17.6 4.9 1.3 2.4 0.7 0.9 0.2 100 27.1
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
%
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 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, Washwood Heath is the most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 53.371. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Washwood Heath 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 )
4.111
4787
3782
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 Washwood Heath by IMD quintile, 2007
1.4 Life style Table 1.3 provides a summary of life style indicators in Washwood Heath, in comparison with Birmingham and England. Data presented are from the synthetic estimates of healthy life style behaviours from the NHS Information Centre. •
• •
Table 1.3
In terms of proportion of people who smoke, binge drink and are obese, Washwood Heath has more smokers (6.1%), less binge drinkers (11.6%) and around the same amount of obese adults only 1% higher. Compared with the national average, smaller proportion of people living in Washwood Heath who eat healthily (8.6%). Based on the numbers in table 1.3 further investigation needs to be done into the smoking and eating habits of the population of Washwood Heath Key figures for life style Deprivation in Washwood Heath, Birmingham and England Year
Adults who smoke Binge drinking adults* Healthy eating adults** Physically active adults*** Obese adults**** * ** *** ****
2003/5 2003/ 2005 2003/ 2005 2007/8 2003/ 2005
Washwood Heath 31% 7.2% 16.6% NA at Ward level 24.2%
Birmingham
England
24.9% 17.8% 25.1% 16.9% 23.4%
24.1% 18.0% 26.3% 21.3% 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 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 Washwood Heath from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 shows an increase in male life expectancy but strategies still need to be developed to continue the increase.
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, Washwood Heath, Birmingham and England 1995/97 to 2005/07
Figure 2.2 shows trend of female expectancy in Washwood Heath from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.2 for female life expectancy again shows an increase but equally as the numbers are still below the city further strategies need to be developed.
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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 95
19 96
/9 7
/9 8
73.0
Calendar Year Tyburn Females
England Females
Birmingham Females
Data source: ONS
Figure 2.2 Female Life expectancy, Washwood Heath, Birmingham & England 1995/97 to 2005/07
As illustrated in Figure 2.1 and Figure 2.2, life expectancy for both males and females has increased. Life expectancy in Washwood Heath is lower than regional and national average. The gap of female/male life expectancy between Washwood Heath and England has widened but male life expectancy has a larger gap. •
Male life expectancy has increased by 1.48% (1.07 years, from 72.21 during 95/97 years to 73.28 years by 05/07).
•
The gap of male life expectancy between Washwood Heath and England has widened by 2 years from 2.4 years to 4.4 years, which means an increase of 83%.
•
Female life expectancy has increased by 1.48% (1.14 years, from 76.91 years in 95/97 to 78.05 years by 05/07).
•
The gap of female life expectancy between Washwood Heath and England has widened by 35.7% (0.7 years), from 2.8 years to 3.5 years).
•
Male 73.28 years, Female 78.05 years; an increase of 1.48%
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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 Washwood Heath, 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. Washwood Heath Infant M ortality Rate - 3 yr Rolling Average 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
Year Washwood Heath 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 rate per 1,000 birth in Washwood Heath, Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 05/07, the IMR is about 2.2 times than England and whilst that in the most deprived quintile are about two folds of England. • •
• •
From 99/01 to 05/07, the IMR has decreased by 29.9% (4.7). The most deprived quintile SOAs in Birmingham shares a similar trend since 03/05 as Washwood Heath. 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 Washwood Heath as a whole has decreased too by 73% from 4.1 to 1.2. 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 Washwood Heath and England has reduced from 10.1 to 6.1 (39.6%).
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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 Washwood Heath. 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 72.5% 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 for Washwood Heath, 2005-2007 DSR
% out of all causes rate*
All Causes
787.60
All Cancers
195.54
24.82%
All Circulatory Diseases
245.39
31.16%
Coronary Heart Disease
134.15
17.03%
* 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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