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Life Expectancy Ward Analysis Ward Profile: Sparkbrook Tackling Health Inequalities: Life Expectancy

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June 2009

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Green

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PHIT - Sparkbrook 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 - Sparkbrook LE.doc

Jim McManus (Joint Director of Public Health)

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Summary •

Electoral ward Sparkbrook is in the boundary of Heart of Birmingham Teaching PCT (HOB)

Sparkbrook accounted for 2.49% of the population of Birmingham in 2006

One of the largest age groups are children and young people [0 – 19] at 39.2%

Black and Minority Ethnicity (BME) group split (79.8%) is higher than national average (11.3%) overall and Birmingham (32.7%). This group accounted for 2.69% of Birmingham’s total population in 2001.

Sparkbrook is the 6th (out of 40) most deprived ward in Birmingham

The latest extraction for 2005/07 reflects: o

Life expectancy for Sparkbrook is at 71.16 for men, 79.4 for women in the year 2005/07

o Male life expectancy has increased by 0.76%. The gap of male life expectancy between Sparkbrook and England has widened by 62.5% o Female life expectancy has increased by 1.1%. The gap of female life expectancy between Sparkbrook and England has widened by 100% o o

Over the last 10 years IMR has increased by 27.6%; with the gap between England and Sparkbrook rising by 100% Circulatory Diseases (36.75%), Cancer (34.34%) and Coronary Heart disease (20.7%) are the leading conditions that cause deaths in the ward

The latest extraction for 2005/07 additionally reflects: o 12.3 percentage points binge drink less o 3.5 percentage points smoke more o 1.5 percentage points are more obese

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1 Local context: demographics and deprivation This part describes population demographics and deprivation in Sparkbrook 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 Sparkbrook is estimated to be 32,143. This represents 2.49% of the population of Birmingham. Approximately 49.8% (15,999) are male and 50.2% are female (16,144). 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+

159

129

75-79

238

70-74

Males

307 364

332

Females

65-69

367

60-64

430 365

339

55-59

389

50-54

479 685

591

45-49

754

684

40-44

871

35-39

864 1035

1072

30-34

1342

25-29

1141 1451

1516

20-24

1773

1694

15-19

1366

1534

10-14

1488

5-9

1571

1511

0-4

1551 1721

1846

2500

2000

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, Sparkbrook 2006

Figure 1.1 illustrates: •

Children under school leaving age (i.e. age 0 - 19) represent 39.2% (12,588) of the Sparkbrook population. Persons of retirement age (age 65+) account for a 7.8% (2,510).

•

Compared with the age structure of Birmingham, Sparkbrook has a larger proportion of children and young people i.e. 17.15 percentage points more and a smaller proportion of persons of older age groups [65+] i.e. 2.84 percentage points lower.

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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 Sparkbrook 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 four fifths (79.8%) of the population are of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 44%, Indian 6% and Black Caribbean 6.1%. The BME (79.8%) is higher than Birmingham (32.7%) and England (11.3%). White ethnicity (20.2%) is lower than city and national levels. Ethnicity groups for Sparkbrook (2001), Birmingham (2006) and England (2006)

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

%

Sparkbrook N* 20.2 6.3 64.9 20.4 8.0 2.5 4.2 1.3 2.7 1.0 100 31.5

%

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, Sparkbrook is the 6th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 46.791. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Sparkbrook 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 )

3.902

6135

4931

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 Sparkbrook by IMD quintile, 2007

1.4 Life style Table 1.3 provides a summary of life style indicators in Sparkbrook, in comparison with Birmingham and England. Data presented are from the synthetic estimates of healthy life style behaviours from the NHS Information Centre. •

• •

Table 1.2

In terms of proportion of people who smoke, binge drink and are obese, Sparkbrook has slightly more people who smoke (3.5 percentage points) than Birmingham. Less people drink (12.3 percentage points) than Birmingham or nationally. However, the proportions of the population who are obese are slightly higher (1.5 percentage points) Compared with the national average, smaller proportion of people living in Sparkbrook eat healthily (1.2 percentage point lower) As you can see from table 1.3 more people smoke in Sparkbrook and less eat healthily. This is obviously an area that needs to be investigated. Key figures for life style Deprivation in Sparkbrook, Birmingham and England

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

Year 2003/5 2003/ 2005 2003/ 2005 2007/8 2003/ 2005

Sparkbrook 28.4% 5.5% 19.1% NA at ward Level 24.9%

Birmingham 24.9% 17.8% 25.1% 16.9% 23.4%

England 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 Sparkbrook from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.1 show that the male life expectancy for Sparkbrook has only slightly improved since 1995. This therefore needs further investigation

Male Life Expectancy - 3 yr Rolling Average, Sparkbrook, Birmingham & England 80.0

Life Expectancy (Age)

78.0 76.0 74.0 72.0 70.0 68.0 66.0

/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

19 96

19 95

/9 7

/9 8

64.0

Calendar Year Sparkbrook M ales

England M ales

Birmingham M ales

Data source: ONS

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

Figure 2.2 shows trend of female expectancy in Sparkbrook from 1995/97 – 2005/07 on a 3-year basis, in comparison with Birmingham and England. Figure 2.2 show that after initially staying on a par with the city; female life expectancy in Sparkbrook is now lower; although still being higher than 1995. This area needs further investigated to improve matters.

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Female Life Expectancy - 3 yr Rolling Average, Sparkbrook, Birmingham & England 83.0 Life Expectancy (Age)

82.0 81.0 80.0 79.0 78.0 77.0 76.0

7

6 20 05

/0

/0 20 04

/0

5

4 20 03

/0

3 20 02

/0 20 01

/0

2

1 20 00

/0

0 98 19

19 99

/0

9 /9 19 97

/9 19 96

19 95

/9

8

7

75.0

Calendar Year Sparkbrook Females

England Females

Birmingham Females

Data source: ONS

Figure 2.2 Female life expectancy, Sparkbrook, 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. Male life expectancy has increased slightly faster than female life expectancy. Life expectancy in Sparkbrook is lower than regional and national average. The gap of female/male life expectancy between Sparkbrook and England has widened. In conclusion: •

Male life expectancy has increased by 0.76% (0.54 years, from 70.6 years during 95/97 to 71.16 years by 05/07).

The gap of male life expectancy between Sparkbrook and England has widened by 2.5 years from 4 years to 6.5 years, which means an increase of 62.5%.

Female life expectancy in Sparkbrook has increased by 1.1% (0.89 years, from 78.5 years during 95/97 to 79.4 years by 05/07).

The gap of female life expectancy between Sparkbrook and England has widened by 1.2 years from 1.2 years to 2.4 years, which means an increase of 100%.

Male 71.16 years, Female 79.4 years; an increase of 0.9%

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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 Sparkbrook, 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. Sparkbrook Infant M ortality Rate - 3yr 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

Years Sparkbrook 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 rates per 1,000 births in Sparkbrook, Birmingham England and the most deprived quintile in Birmingham, 1999-2007

As illustrated in Figure 2.3, in 05/07, the IMR is about 145% higher than England and whilst that in the most deprived quintile are two folds of England. •

From 99/01 to 05/07, the IMR has increases by 27.6%. The IMR has been erratic over the trend years and follows neither the most deprived quintile pattern or City / national trends IMR in the most deprived quintile SOA in Birmingham has decreased from 11.5 to 9.8 (15%). Unlike the IMR for Sparkbrook which has increased. The gap between the most deprived quintile and Sparkbrook as a whole has increased from being 3.1 under the quintile to now being 1.3 higher. 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 Sparkbrook and England has increased from 3.1 to 6.2 which mean the gap has doubled.

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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 Sparkbrook. 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, the major killers are cancers, circulatory diseases and coronary heart disease. They make more than 81.7% 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, Sparkbrook, 2005-2007 DSR

% out of all causes rate*

All Causes

807.82

All Cancers

196.61

24.34%

All Circulatory Diseases

296.84

36.75%

Coronary Heart Disease

167.24

20.70%

* 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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Sparkbrook_LE_Ward_Profile  

Version 2 Status Green Date June 2009 VERSION CONTROL AND DOCUMENT GOVERNANCE Filename and path to locate this document File location (publi...