Life Expectancy Ward Analysis Ward Profile: Weoley Castle 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
PHIT - Weoley Castle.doc
2
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
Authors
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) Jim McManus (Joint Director of Public Health)
Any further Telephone 0121 465 2995 / 2999 or Information Email : PHIT@benpct.nhs.uk
PHIT - Weoley Castle.doc
3
Summary •
Electoral ward Weoley Castle is in the boundary of NHS South Birmingham
•
Weoley Castle accounted for 2.52% of Birmingham’s population in 2006
•
One of the largest age groups in the population are children and young people [0 – 19] at 28.06%
•
Black and Minority Ethnicity (BME) group split (9.7%) is lower than national average (11.3%) overall and lower than Birmingham (32.7%). This group accounted for 0.003% of the total population of Birmingham in 2001.
•
Weoley Castle is the 22nd (out of 40) most deprived ward in Birmingham
•
The latest extraction for 2005/07 reflects: o Life expectancy in Weoley Castle is at 77.9 for men, 84.1 for women in the year 2005/07 o Male life expectancy has increased by 6.8%. The gap between Weoley Castle and England has closed by 129% (1.9 years) from 95/97 to 05/07. o Female life expectancy has increased by 6.2%. The gap between Weoley Castle and England has shortened by 100% (0.5 years) from 95/97 to 05/07 and is now 2.3 higher than England. o Infant Mortality Rates has risen by 208% since 99/01, in comparison the rate for the most deprived wards has dropped o Circulatory diseases (31.42%), Cancers (32.34%) and Coronary Heart Diseases (16.67%) are the leading conditions that cause deaths in the ward.
•
The latest extraction for 2005/07 additionally reflects: o 3.2 percentage points smoke more o 1.6 percentage points binge drink less o 1.0 percentage points are less obese
PHIT - Weoley Castle.doc
4
1
Local context: demographics and deprivation
This section describes population demographics and deprivation in Weoley Castle 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 Weoley Castle is estimated to be 25,409. This represents 2.52% of the population of Birmingham. Approximately 47.7% (12,123) are male and 52.3% are female (13,286). 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 2006 Estimates by Ward Source: Office of National Statistics
358
260
80+ 360
75-79 70-74
538
469
65-69
619
693
55-59 50-54
Females
541
573
60-64
Males
516
425
688 722
656 788
45-49 40-44
856
35-39
855
851 937 1052
30-34
845
747
872
769
25-29 860
20-24
916
1011
15-19 10-14
1047 891
938
5-9
858
0-4
847
1500
1000
740 798 500
0
500
1000
1500
Data source: ONS 2006 mid year population estimates
Figure 1.1 Population by age group and gender, Weoley Castle 2006
Figure 1.1 illustrates: •
Children under school leaving age (i.e. age 0 - 19) represent 28.06% (7,130) of the Weoley Castle population. Persons of retirement age (age 65+) account for 15.66% (3,980).
•
The ward age structure has a higher percentage of under 19s i.e. 6.01 percentage points than Birmingham; additionally the ward has a higher percentage of those over 65 i.e. 5.02 percentage points more than the city average.
PHIT - Weoley Castle.doc
5
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 Weoley Castle population, compared with Birmingham and England. •
•
• • Table 1.1
The % column 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 tenth (9.7%) of the population is of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 0.48%, Indian 1.21% and Black Caribbean 0.02%. The BME (9.7%) lower than Birmingham (32.7%) and less than that of the average across England (11.3%). White ethnicity (90.3%) is higher than both national and city averages. Ethnicity groups for Weoley Castle (2001), Birmingham (2006) and England (2006)
Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total
%
Weoley Castle N* 90.3 22.6 2.3 0.6 3.0 0.7 2.9 0.7 1.5 0.4 100 25.0
%
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 for Birmingham / England. 2001 Census data for Ward
1.3 Deprivation According to Index of Multiple Deprivations (IMD) 2007 published by ONS, Weoley Castle is the 22nd most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 31.351. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Weoley Castle 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 )
5.464
4641
2932
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.
PHIT - Weoley Castle.doc
6
Figure 1.2 Super Output Areas in Weoley Castle by IMD quintile, 2007
1.4 Lifestyle Table 1.3 provides a summary of life style indicators in Weoley Castle 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 1.3
Compared with Birmingham average, Weoley Castle has a lower percentage of people who binge drink (1.6 percentage points lower) and are obese (1 percentage point) but a higher proportion who smoke (3.2 percentage points higher) Compared with the national average, a smaller percentage of people living in Weoley Castle eat healthily (8.2 percentage point lower). Table 1.3 shows that obesity amongst adults in Weoley Castle needs to be investigated further and comparisons may be drawn the lower rates of adults eating healthily. Further investigation is also warranted on the high percentage of adults who smoke Key figures for life style Deprivation in Weoley Castle, Birmingham and England
Adults who smoke Binge drinking adults* Healthy eating adults** Obese adults*** * ** ***
Year 2003/5 2003/ 2005 2003/ 2005 2003/ 2005
Weoley Castle 28.1% 16.2% 16.9% 22.4%
Birmingham 24.9% 17.8% 25.1% 23.4%
England 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
PHIT - Weoley Castle.doc
7
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 Weoley Castle from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 shows evidence that male life expectancy has increased in Weoley Castle over the ten years since 1995. Male Life Expectancy - 3 year rolling average, Weoley Castle, Birmingham & England 79.0
Life Expectancy (Age)
78.0 77.0 76.0 75.0 74.0 73.0 72.0 71.0
/0 6
/0 5
/0 7 20 05
20 04
20 03
/0 4 20 02
/0 2
/0 3 20 01
20 00
/0 1 19 99
/0 0
/9 9
19 98
19 97
19 96
19 95
/9 7
/9 8
70.0
Calendar Year England M ales
Birmingham M ales
Weoley Castle M ales
Data source: ONS
Figure 2.1 Male life expectancy for Weoley Castle, Birmingham and England, 1995/97 – 2005/07
Figure 2.2 shows trend of female expectancy in Weoley Castle from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.2 shows that by 2007 female life expectancy in Weoley Castle are higher than both city and national level; it may be worthwhile looking at causes for these differences and applying them to the wards that have lower life expectancy.
PHIT - Weoley Castle.doc
8
Female Life Expectancy - 3 year rolling average, Weoley Castle, Birmingham & England 85.0 84.0 Life Expectancy (Age)
83.0 82.0 81.0 80.0 79.0 78.0 77.0 76.0
/0 6
/0 5
/0 7 20 05
20 04
20 03
/0 4 20 02
/0 2
/0 3 20 01
20 00
/0 1
/0 0
19 99
19 98
/9 9 19 97
19 96
19 95
/9 7
/9 8
75.0
Calendar Year England Females
Birmingham Females
Weoley Castle Females
Data source: ONS
Figure 2.2 Female life expectancy for Weoley Castle, 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 Weoley Castle is slightly higher than City and national averages. The gap for both male/female life expectancy between Weoley Castle and England has increased, to the favour of the ward. In conclusion: •
Male life expectancy in Weoley Castle has increased by 6.8% (4.99 years, from 72.9 years in 1997 to 77.9 years by 2007).
•
The gap of male life expectancy between Weoley Castle and England has widened by 1.9 years from 1.7 years below England to 0.2 years above, which means an increase of 129% in favour of the ward.
•
Female life expectancy has increased by 6.2% (4.9 years, from 79.2 years in 1997 to 84.1 years by 2007).
•
The gap of female life expectancy between Weoley Castle and England has widened by 2.8 year from 0.5 years below England to 2.3 years above.
PHIT - Weoley Castle.doc
9
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 Weoley Castle, 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. Weoley Castle Infant Mortality Rate - 3 year 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
Trend Year Birmingham M ost Deprived Quintile in Bham
England Weoley Castle
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 Weoley Castle, Birmingham, England and the most deprived quintile in Birmingham, 1999-2007
As illustrated in Figure 2.3, in 05/07, the IMR is half as much again as that of England; whilst that in the most deprived quintile is about two folds of England. • •
•
From 99/01 to 05/07, the IMR has increased by 208%. Whilst in comparison Birmingham’s IMR has decreased. The gap between the most deprived quintile SOAs in Birmingham and Weoley Castle closed in favour of the ward and now widened to 2.4 per 1,000 births in favour of the most deprived quintile SOAs. 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 Weoley Castle and England has increased from 3.2 below England to 2.5 above (73.63%).
PHIT - Weoley Castle.doc
10
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 Weoley Castle. 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, coronary heart disease are the major killers. They make more than 80.43% 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, Weoley Castle, 2005-2007 DSR
% out of all causes rate*
All Causes
554.75
All Cancers
179.42
32.34%
All Circulatory Diseases
174.29
31.42%
Coronary Heart Disease
92.49
16.67%
* Percentage of rate for the specific disease out of rate for all causes Data source: National Centre for Health Outcomes Development
PHIT - Weoley Castle.doc
11
PHIT - Weoley Castle.doc
12