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Life Expectancy Ward Analysis Ward Profile: Perry Barr Tackling Health Inequalities: Life Expectancy

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2

Date

June 2009

Status

Green

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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

Author s

Jeanette Davis (Public Health Information Analyst) Yang Tian (Public Health Information Team Leader) 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)

For further information contact:

Tel. 0121 465 2999

Perry Barr_LE_Ward_Profile.doc

Email: phit@bhwp.nhs.uk

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Summary •

Electoral ward Perry Barr is in the boundary of Heart of Birmingham Teaching PCT

Perry Barr accounted for 2.32% of Birmingham’s population in 2006

The age split of ward is predominantly children and young people [019] at 27.04%

Black and Minority Ethnicity (BME) group split (29.2) is higher than national average (11.3%) overall but lower than Birmingham (32.7%). This group accounted for 0.63% of the total population of Birmingham in 2001.

Perry Barr is the 31st (out of 40) most deprived ward in Birmingham

The latest statistics shows: o Life expectancy is at 79.5 for men, 83.4 for women in the year 2005/07. Male life expectancy has increased by 7.9%. The gap between Perry Barr and England has now moved in Perry Barr’s favour (1.8 years) from 95/97 to 05/07 o Female life expectancy has increased by 3.1%. The gap between Perry Barr and England has widened by 3% (0.4 years) from 95/97 to 05/07 in the wards favour o IMR has dropped by 30.6%; although the trend for the ward is different to the Lower Quintile group o Circulatory diseases (31.64%), Cancers (31.22%) and Coronary Heart Diseases (17.10%) are the leading conditions that cause deaths in the ward.

Relatively, compared against Birmingham; risk factors such as alcohol, obesity and smoking presents as follows: o 4.2 percentage points less binge drink o 2.1 percentage points smoke less o 1.6 percentage points fewer are obese

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1

Local context: demographics and deprivation

This section describes population demographics, deprivation and further comparisons with Birmingham and England to provide a local context for life expectancy inequalities.

1.1 Age and sex distribution The population of Perry Barr is estimated to be 23,432. This represents 2.32% of the population of Birmingham. There are (11,399) 48.7% male and (12,033) 51.3% female. These estimations are based on ONS Mid. Year (2006). The population pyramid (Figure 1.1) below shows the age and sex distributions.

Population By Age Group and Gender 208

80+ 75-79

227

263

Males 358

Females 350

70-74 65-69

428

60-64

555

55-59

550

45-49

518 621 531

655

40-44

738

819

35-39

862

929

904

30-34

772

25-29

812

865

838

1110

1257

15-19

806

10-14

814

5-9

893 770

755

0-4 1500

489

565

50-54

20-24

432

669

826

1000

802

500

0

500

1000

1500

Data source: ONS 2006 mid year population estimates

Figure 1.1 Population by age group and gender, Perry Barr 2006

Figure 1.1 illustrates: •

Children under school leaving age (i.e. age 0 - 19) represent 27.04% (6,335) of the Perry Barrs’ population. Persons of retirement age (age 65+) account for 13.6% (3,196).

If we look at the two age groups above for the ward; it shows that for under 19s the ward is 4.99 percentage points higher that the city. Equally, for the 65+ age group we see the ward is 2.96 percentage points higher than Birmingham’s average

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1.2 Ethnicity There are some illnesses that have more prevalence for some ethnicity group than other, thus knowing the ethnicity population distribution is required to target those in vulnerable health group. Table 1.1 shows the ethnicity distribution in the Perry Barr population, compared with Birmingham and England. •

• •

Table 1.1

The % column in each of table 1.1 represents the percentage of the total population that fit into that ethnic group. The N* column shows the quantity of people in thousands that are from each group, for the ward, City and nationally. About a third (29.2%) of the population in Perry Barr is of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 5.52%, Indian 7.78% and Black Caribbean 7.71%. The proportion of BME 29.2%) is lower than Birmingham (32.7%), but doubles that of the average across England (11.3%). White ethnicity 71.8% is higher than Birmingham but lower than national levels Ethnicity groups for Perry Barr (2001), Birmingham (2006) and England (2006)

Ethnicity groups White Asian or Asian British Black or Black British Mixed Chinese or other Total

%

Perry Barr N* 71.8 16.3 15.3 3.5 9.3 2.1 2.6 0.6 1.0 0.2 100 22.7

%

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, Perry Barr is the 31st most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 24.041. Figure 1.2 shows SOAs in Perry Barr by IMD quintile, 2007. Most of the area covered by Perry Barr is in the second most deprived SOAs in Birmingham. Table 1.2 shows the population density. Ward Area 2

Area (km )

Population Density 2 (person/km )

Population Density – Working 2 Age (person/km )

7.711

3039

1993

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 Perry Barr by IMD quintile, 2007

1.4 Lifestyle Table 1.2 provides a summary of life style indicators in Perry Barr, 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, Perry Barr has a lower percentage of people who binge drink (4.2 percentage points lower), 1.6 percentage points lower in obesity, and equally a smaller proportion smoke (2.1 percentage points) Compared with the national average, a smaller percentage of people living in Perry Barr eat healthily (3.9 percentage point lower). Table 1.2 shows that whilst obesity amongst adults is lower than the Birmingham average; those who eat healthily is still worse, this therefore needs investigated further and strategies developed to counteract the adverse affects of unhealthy eating Key figures for life style Deprivation in Perry Barr, Birmingham and England

Adults who smoke Binge drinking adults* Healthy eating adults** Obese adults*** * ** ***

Year 2003/5 2003/ 2005 2003/ 2005 2003/ 2005

Perry Barr 22.8% 13.6% 21.2% 20.8%

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

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2

Life expectancy trend

Life expectancy is one of the most important indicators for health inequalities across the population; and there is evidence that people that most need support do not have access to services. This section gives an overview of life expectancy at birth in Perry Barr, in terms of trend and variations in different groups and communities. Figure 2.1 shows trend of male expectancy in Perry Barr from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 shows evidence that whilst male life expectancy has increased in Perry Barr over the ten years since 1995, consistently. This is an indication of changes in patterns of the population or services and further studies to establish these correlations are necessary to maintain this trend.

Male Life Expectancy - 3 year Rolling Average, Perry Barr, Birmingham & England 80.0

Life Expectancy (Age)

78.0 76.0 74.0 72.0 70.0

/0 6

/0 7 20 05

20 04

/0 5 20 03

/0 4

/0 2

/0 3

20 02

20 01

20 00

/0 1 19 99

/9 9

/0 0 19 98

19 97

/9 8 19 96

19 95

/9 7

68.0

Calendar Year England M ales

Birmingham M ales

Perry Barr M ales

Data source: ONS

Figure 2.1 Male life expectancy, Perry Barr Birmingham and England, 1995/97 – 2005/07

Figure 2.2 shows trend of female expectancy in Perry Barr 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 Perry Barr is actually decreasing despite being higher that 1995. More strategies are needed to identify underlying causes of this issue.

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Female Life Expectancy - 3 Year Rolling Average, Perry Barr, Birmingham & England 85.0

Life Expectancy (Age)

84.0 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 19 99

/0 0

/9 9

19 98

19 97

/9 8 19 96

19 95

/9 7

75.0

Calendar Year England Females

Birmingham Females

Perry Barr Females

Data source: ONS

Figure 2.2 Female life expectancy – Perry Barr, Birmingham and England, 1995/97 – 2005/07

As illustrated in Figure 2.1 and Figure 2.2, life expectancy for both males and females in Perry Barr has increased over the period of time reviewed. Life expectancy in Perry Barr is higher than City and national average. The gap for both Male/Female life expectancy between Perry Barr and England has increased, but in both cases in the favour of Perry Barr. In conclusion: •

Male life expectancy has increased by 7.9% (5.83 years, from 73.6 years to 79.5 years).

The gap of male life expectancy between Perry Barr and England has widened by 0.8 year from 1 year to 1.8 years in the ward favour, which means an increase of 80%.

Female life expectancy has increased by 3.1% (2.5 years, from 80.9 years to 83.4 years).

The gap of female life expectancy between Perry Barr and England has widened by 0.4 years from 1.2 years to 1.6 years in the wards favour.

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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 Perry Barr, 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. Perry Barr 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 Years Birmingham

England

M ost Deprived Quintile in Bham

Perry Barr

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 Perry Barr Birmingham, England and the most deprived quintile in Birmingham, 1999-2007

As illustrated in Figure 2.3, in 05/07, the IMR in Perry is less than England and that in the most deprived quintile is about two folds of England. •

From 99/01 to 05/07, the IMR in Perry Barr has decreased by 66%. Birmingham’s IMR has also decreased. However, 2002/04 presents an extreme excess for IMR, this should be important to investigate to avoid repetitions. The gap between the most deprived quintile SOAs in Birmingham and Perry Barr has decreased by 0.4 which is consistent with the trend pattern for the most deprived quintile 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 Perry Barr and England has increased from 1.0 to 1.7 (70%), in favour of the ward.

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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 this part in order to identify leading diseases that contribute to the overall mortality rates in Perry Barr. Table 3.1 shows directly standardized mortality rates for selected conditions in Perry Barr 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 (17.10%) are the major killers. They make more than 79.86% of the overall DSR, which consistent across the city; however the PCT percentages are 72% to 81.6%, therefore this ward is higher bracket for each major cause Table 3.1

Directly Standardized Mortality Rates (DSRs) per 100,000 population for selected conditions, Perry Barr, 2005-2007 % out of all causes rate*

DSR All Causes

536.24

All Cancers

167.41

31.22%

All Circulatory Diseases

169.69

31.64%

Coronary Heart Disease

91.71

17.10%

* 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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Perry Barr_LE_Ward_Profile