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Life Expectancy Ward Analysis Ward Profile: Sutton Four Oaks 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

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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

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) 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)

Any further information

Telephone : 0121 465 2995 / 2999 Email : PHIT@benpct.nhs.uk

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Summary •

Electoral ward Sutton Four Oaks is in the boundary of NHS Birmingham East and North

Sutton Four Oaks accounted for 2.25% of Birmingham’s population in 2006

The age group with the largest percentage are children and young people [0 – 19] at 22.47%

Black and Minority Ethnicity (BME) group split (4.7%) is lower than national average (11.3%) overall and lower than Birmingham (32.7%). This group accounted for 0.10% of the total population of Birmingham in 2001.

Sutton Four Oaks is the 40th (out of 40) most deprived ward in Birmingham and therefore the least deprived

The latest extraction for 2005/07 reflects that: o Life expectancy at 80.5 for men, 84.0 for women in the year 2005/07 o Male life expectancy has increased by 3.9%. The gap between Sutton Four Oaks and England has widened by 3.45% (0.1 years) from 95/97 to 05/07. o Female life expectancy has increased by 2.8%. The gap between Sutton Four Oaks and England has widened by 10% (0.2 years) from 95/97 to 05/07 in the wards favour. o Infant Mortality Rates have risen by 2.4 per 1,000 since 99/01, in comparison to the rate for the most deprived wards which have dropped. o Circulatory diseases (29.99%), Cancers (32.27%) and Coronary Heart Diseases (12.87%) are the leading conditions that cause deaths in the ward.

Relatively, compared against Birmingham; for risk factors such as alcohol, obesity and smoking Hodge Hill presents as follows: o 11.2 percentage points smoke less o 6.8 percentage points are less obese o 4.4 percentage points binge drink less

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1

Local context: demographics and deprivation

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

1.1 Age and sex distribution The population of Sutton Four Oaks is estimated to be 22,772. This represents 2.25% of the population of Birmingham. There are (10,905) 47.9% male and (11,867) 52.1% female. These estimations are based on ONS Mid. Year (2006) Population By Age Group and Gender 2006 Estimates by Ward Source: Office of National Statistics

80+

304

75-79 70-74

578

568

65-69

791

785

811

50-54

663

45-49

Females

678

761

55-59

Males

705

565

60-64

40-44

458

491

764

783

798

900

35-39

936 782

852

30-34

564

560

25-29

453

20-24

528

481

15-19

442

730

10-14

666

691

683

634

5-9

585 533

0-4 1000

596 500

0

500

1000

1500

Data source: ONS 2006 mid year population estimates

Figure 1.1 Population by age group and gender, Sutton Four Oaks 2006

Figure 1.1 illustrates: •

Children under school leaving age (i.e. age 0 - 19) represent 22.47% (5,118) of the Sutton Four Oaks population. Persons of retirement age (age 65+) account for 21.96% (5,000).

The age structure of the ward shows that the under 19 group is 0.42 percentage points above the Birmingham average. Equally, the 65+ age group is significantly higher at 11.32 percentages points than the city. Figure 1.1 also shows that this ward does not attract people in the 20 – 39 age group i.e. of working age.

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1.2 Ethnicity Ethnicity has some influences in terms of what diseases an individual could develop through their life. With this in mind, analysis of the ethnicity of the local population becomes a requirement in order to target vulnerable health groups. Table 1.1 shows the ethnicity distribution in the Sutton Four Oaks 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. Only (4.7%) of the population in Sutton Four Oaks are of non-white ethnicity (i.e. Black and Minority Ethnicity (BME) Group. Within the BME group, Pakistanis represents 0.61%, Indian 2.18% and Black Caribbean 0.56%. The proportion of BME (4.7%) is lower than Birmingham (32.7%) and less than that of the average across England (11.3%). The white ethnicity (95.3%) is higher than national and local levels Ethnicity groups for Sutton Four Oaks (2001), Birmingham (2006) and England (2006)

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

Sutton Four Oaks N* % 20.7 95.3 0.6 2.9 0.1 0.7 0.2 0.8 0.1 0.3 21.7 100

Birmingham N*

% 67.3 20.7 6.7 3.2 2.3 100

England % 88.7 5.5 2.8 1.6 1.4 100

667.0 207.9 67.0 31.8 22.9 1,106.5

N* 45,018.1 2,786.6 1,403.0 829.5 725.7 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, Sutton Four Oaks is the 40th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 9.811. Figure 1.2 shows SOAs by IMD quintile, 2007. Most of the area covered by Sutton Four Oaks is in the least deprived SOAs in Birmingham. (ref: IMD map on following page) Ward Area 2

Area (km )

Population Density 2 (persons/km )

Population Density – Working 2 Age 16-64 (persons/km )

19.562

1336

894

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 Sutton Four Oaks by IMD quintile, 2007

1.4 Lifestyle Table 1.2 provides a summary of life style indicators in Sutton Four Oaks 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, Sutton Four Oaks has a lower percentage of people who binge drink (4.4 percentage points lower) and are obese (6.8 percentage points) additionally there is a lower proportion who smoke (11.2 percentage points higher) Compared with the national average, a higher percentage of people living in Sutton Four Oaks eat healthily (1.9 percentage point lower). Table 1.2 shows that the population of has a healthier life style, which could explain the differences in their higher life expectancy than Birmingham Key figures for life style Deprivation in Sutton Four Oaks, Birmingham and England Year

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

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

Sutton Four Oaks 13.7% 13.4% 27% 16.6%

Birmingham

England

24.9% 17.8% 25.1% 23.4%

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 forecasters for health inequalities across the population; since there is evidence that people most need them do not have access to services. This section gives an overview of life expectancy at birth in Sutton Four Oaks in terms of trend and variations in different groups and communities. Figure 2.1 shows trend of male expectancy in Sutton Four Oaks from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England and shows evidence that whilst male life expectancy has increased in Sutton Four Oaks over the ten years since 1995. Male Life Expectancy - 3 year rolling average, Sutton Four Oaks, Birmingham & England Data source:82.0 ONS

Life Expectancy (Age)

80.0 78.0 76.0 74.0 72.0 70.0

/0 7 20 05

/0 6 20 04

/0 4

/0 5 20 03

20 02

/0 3 20 01

/0 1

/0 2 20 00

19 99

/0 0 19 98

/9 8

/9 9 19 97

19 96

19 95

/9 7

68.0

Calendar Year England M ales

Birmingham M ales

Sutton Four Oaks M ales

Figure 2.1 Male life expectancy Sutton Four Oaks, Birmingham and England, 1995/97 – 2005/07

Figure 2.1 Figure 2.2 shows trend of female expectancy from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England; which presents a steady increasing pattern.

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Female Life Expectancy - 3 year rolling average, Sutton Four Oaks, Birmingham 85.0

Life Expectancy (Age)

84.0 83.0 82.0 81.0 80.0 79.0 78.0 77.0 76.0

/0 7 20 05

/0 5

/0 6 20 04

20 03

/0 4 20 02

/0 2

/0 3 20 01

20 00

/0 1 19 99

/0 0 19 98

/9 9 19 97

/9 8 19 96

19 95

/9 7

75.0

Calendar year England Females

Birmingham Females

Sutton Four Oaks Females

Data source: ONS

Figure 2.2 Female life expectancy for Sutton Four Oaks, 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 Sutton Four Oaks is higher than City and national averages. The gap for both female life expectancy between Sutton Four Oaks and England has increased, still to the wards favour. The gap for male life expectancy whilst still be better than England has decreased by 3.45%. In conclusion: • •

• •

Male life expectancy has increased by 3.9% (3.06 years from 77.5 years in 2000 to 80.5 years by 2007). The gap of male life expectancy between Sutton Four Oaks and England has shortened by 0.1 year from 2.9 years in 1997 to 2.8 years by 2007, which means a decrease of 3.45%. Female life expectancy has increased by 2.8% (2.32 years, from 81.7 years during 1997 to 84 years in 2007). The gap of female life expectancy between Sutton Four Oaks and England has widened by 0.2 year from 2.0 years in 1997 to 2.2 years in 2007 but still in the ward 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 Sutton Four Oaks, 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. Sutton Four Oaks 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 M ost Deprived Quintile in Bham

England Sutton Four Oaks

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 Sutton Four Oaks Birmingham, England and the most deprived quintile in Birmingham, 1999-2007

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

From 99/01 to 05/07, the IMR in Sutton Four Oaks has increased by 65%. Whilst in comparison Birmingham’s and the most deprived quintile SOAs IMR has decreased. 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 Sutton Four Oaks and England has increased from 1.9 per 1,000 below the England average to 1.2 per 1,000 above (66.3%).

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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 Sutton Four Oaks. Table 3.1 shows directly standardized mortality rates for selected conditions during the period 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 killers. They make more than 75.1% of the overall DSR, this figures is 5 percentage points lower than the Birmingham average but consistent with the PCT range which is from 72% to 81.6%. Table 3.1

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

DSR All Causes

488.95

All Cancers

157.76

32.27%

All Circulatory Diseases

146.68

29.99%

Coronary Heart Disease

62.95

12.87%

* 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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Sutton Four Oaks_LE_Ward_Profile