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Health Profile 2009

West Midlands This profile gives a snapshot of health in your region. It is designed to help local government and primary care trusts tackle health inequalities and improve people’s health.

Visit the Health Profiles website to: • View profiles for other areas • Use interactive maps • Access updated information • See more indicator data www.healthprofiles.info

Based on Ordnance Survey material. © Crown Copyright 2010. All rights reserved. DH 100020290.

POPULATION: 5,381,800 Mid-2007 population estimate Source National Statistics website: www.statistics.gov.uk.

West Midlands at a glance • The West Midlands still appears to be one of the least healthy regions. Children’s dental health and road injuries and deaths stand out as the two indicators for which the West Midlands is better than the England average. • In comparison with the previous year, many West Midlands indicators show a slight improvement but as the indicators for England also show a slight improvement the position of the West Midlands relative to England has hardly changed. • A newly included indicator shows that the percentage of those aged over 65 who are not in good health is higher in West Midlands than the England average. A new indicator, excess winter deaths (which predominantly affects older people) also shows West Midlands to be worse than the England average. • The health inequalities between local authorities are still marked. Indicators of worse health tend to be clustered in the metropolitan and urban areas, while most indicators for rural areas are good. • Infant deaths are the highest of any region. In part this may be due to the low initiation of breast feeding and high smoking in pregnancy compared to some other regions. • The West Midlands Health and Well-being strategy and the NHS West Midlands “Investing for health” strategy (http://ifh2.westmidlands.nhs.uk/) have prioritised a set of actions intended to tackle the health inequalities in the region and improve health. © Crown Copyright 2010

Health Profiles are produced annually by the Association of Public Health Observatories and funded by the Department of Health.


Introduction by the Regional Director of Public Health

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This profile of the West Midlands region highlights some of the health challenges that we face in the region. It also highlights the wide variations within the region and if our least healthy areas had similar health to our most healthy areas the health of the region would be excellent. The indicators of poverty and prosperity go some way to explaining the overall health of the region and the variations between local authorities within it. Children in poverty are less likely to enjoy good health. Low educational achievement predisposes to poorer health in adult life and people who live in places with high deprivation scores (IMD2007) tend to be less healthy. This emphasises the importance of the efforts being made in the region to regenerate the built environment, boost the economy and minimise unemployment. At the moment the economic winds are harsh; business and employment have been hard hit and there may be worse to come. It is therefore more important than ever that we seek to minimise the health-damaging effects of economic downturn. Many aspects of health are getting better. The trend for death rates from all causes is reassuringly downward but the gap between our region and England is not narrowing. Heart disease and stroke are important both as causes of death and causes of disability. However, deaths and illness from these causes can be reduced – by not smoking, by being more active physically and by avoiding heavy drinking. Early identification and treatment of raised blood pressure and raised cholesterol can further reduce the incidence of these conditions. Furthermore the immediate management of heart attacks and strokes makes a big difference to the eventual outcome and can reduce the risk of death. There is therefore a lot we can do to close the gap between West Midlands and England. Hip fracture is another important condition which commonly affects older people. Too often it is the trigger which leads to loss of mobility and independence. Keeping physically active, which retains good muscle strength, good coordination and bone strength can play a part in reducing the risk of this injury. Treatment after the injury also makes a big difference to the outcome. Patients who have early operation and early mobilisation have a much better chance of making a full recovery and regaining their independence. The West Midlands Strategic Health Authority in its strategy “Investing for Health” has laid out numerous ways of looking at patients’ paths through the health and social care system in order to ensure that patients with heart disease, stroke, hip fracture and many other conditions receive the best care and to reduce the difference in outcome between different parts of the region. The regional health partnership has also drawn up a “Health and Well-being Strategy” (http://www.wmra.gov. uk/documents/health&wellbeing.pdf) which aims to ensure that all aspects of life in the region, for example housing, transport and employment, increase the citizen’s chances of enjoying good health. There is a great deal to do to improve health in the West Midlands. We have started to take the measures that will improve everyone’s health and the NHS and Local Authorities in the West Midlands need to maximise their efforts in partnership working to ensure that we are successful.

© Crown Copyright 2010

Rashmi Shukla C.B.E. West Midlands Regional Director of Public Health


healthprofiles.info Regional Indicator Maps Map 1 Index of Multiple Deprivation 2007 by Lower Super Output Area in West Midlands Region

Legend Local authority area

National deprivation quintiles Quintile 1 (least deprived) Quintile 2 Quintile 3 Quintile 4 Quintile 5 (most deprived)

Based on Ordnance Survey material © Crown Copyright 2010. All rights reserved. DH Licence number 100020290. 2010.

Map 2  Deaths from Smoking by Local Authority Area in West Midlands Region

Legend Local authority area

Rates per 100,000 population (directly agestandardised) aged over 35 years, 2005–07 by national quintiles 134.4–164.7 (best quintile) 164.8–184.0 184.1–205.8 205.9–239.5

Based on Ordnance Survey material. © Crown Copyright 2010. All rights reserved. OS Licence number 100020290. 2010.

© Crown Copyright 2010

239.6–330.2 (worst quintile)


healthprofiles.info Regional Trends Trend 1  All-age all-cause mortality per 100,000 males and females Age-standardised rate per 100,000 population

for England and West Midlands Region 1100

England (males)

1000

West Midlands (males)

900 800 700

England (females)

600

West Midlands (females)

500 400 300 200 100 0 1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

Year (mid-point of three-year moving averages of annual rates)

Age-standardised rate per 100,000 population

Trend 2 

 Early deaths from heart disease and stroke per 100,000 persons aged under 75 years, for England and West Midlands Region 180

England

160

West Midlands

140 120 100 80 60 40 20 0

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

Year (mid-point of three-year moving averages of annual rates)

 mergency admissions for hip fractures in over 65 year olds per E 100,000 persons for England and West Midlands Region 600

England West Midlands

500

400

300

200

100

0

1999/00

2000/01

2001/02

2002/03

2003/04

Year

2004/05

2005/06

2006/07

© Crown Copyright 2010

Age-standardised rate per 100,000 population

Trend 3 


healthprofiles.info Local Variations: Regional Context This table shows how each local authority within this region compares to the regional average, for the range of indicators used in the local Health Profiles. Indicators and areas are sorted from top to bottom and from left to right so that the better overall results appear at the top left and worse overall results at the bottom right of the table. A green box may still indicate an important public health problem.

Significantly better than regional average Not significantly different from regional average No significance can be calculated, or data unavailable or suppressed due to small numbers * Relates to National Indicator 2009

Drug misuse New cases of tuberculosis Deprivation Children in poverty * People diagnosed with diabetes Incapacity benefits for mental illness * Hospital stays for alcohol related harm * Children’s tooth decay (at age 5) Breast feeding initiation * Life expectancy - male * Teenage pregnancy (under 18) * Early deaths: heart disease & stroke * Road injuries and deaths * Adults who smoke * Deaths from smoking Violent crime * Early deaths: cancer * Smoking in pregnancy Statutory homelessness Infant deaths Over-65s ‘not in good health’ GCSE achieved (5A*-C inc. Eng & Maths) * Hip fracture in over-65s Physically active adults Obese adults Obese children * Binge drinking adults Healthy eating adults Life expectancy - female * Excess winter deaths Physically active children * Carbon emissions *

Significantly worse than regional average

Malvern Hills CD Warwick CD Wychavon CD Bromsgrove CD Solihull MCD County of Herefordshire UA Shropshire UA Stratford-on-Avon CD South Staffordshire CD Stafford CD Wyre Forest CD Lichfield CD Rugby CD East Staffordshire CD Staffordshire Moorlands CD Worcester CD North Warwickshire CD Redditch CD Dudley MCD Newcastle-under-Lyme CD Tamworth CD Telford and Wrekin UA Cannock Chase CD Nuneaton and Bedworth CD Coventry MCD Birmingham MCD Walsall MCD Stoke-on-Trent UA Sandwell MCD Worcestershire CC Warwickshire CC Staffordshire CC

© Crown Copyright 2010

Wolverhampton MCD


healthprofiles.info Local Variations: National Context This table shows how each local authority within this region compares to the England average, for the range of indicators used in the local Health Profiles. Indicators and areas are sorted from top to bottom and from left to right so that the better overall results appear at the top left and worse overall results at the bottom right of the table. A green box may still indicate an important public health problem.

Significantly better than England average Not significantly different from England average No significance can be calculated, or data unavailable or suppressed due to small numbers * Relates to National Indicator 2009

Children’s tooth decay (at age 5) New cases of tuberculosis Drug misuse Children in poverty * Deprivation Hospital stays for alcohol related harm * Incapacity benefits for mental illness * Road injuries and deaths * Adults who smoke * Deaths from smoking Smoking in pregnancy Violent crime * Early deaths: heart disease & stroke * Early deaths: cancer * Binge drinking adults GCSE achieved (5A*-C inc. Eng & Maths) * Hip fracture in over-65s Over-65s ‘not in good health’ Teenage pregnancy (under 18) * Excess winter deaths Obese children * Physically active children * Infant deaths Life expectancy - male * Healthy eating adults People diagnosed with diabetes Life expectancy - female * Physically active adults Statutory homelessness Breast feeding initiation * Obese adults Carbon emissions *

Significantly worse than England average

Warwick CD Bromsgrove CD Wychavon CD Malvern Hills CD Shropshire UA Lichfield CD Stratford-on-Avon CD County of Herefordshire UA Solihull MCD Stafford CD Rugby CD South Staffordshire CD Wyre Forest CD Worcester CD East Staffordshire CD Staffordshire Moorlands CD North Warwickshire CD Redditch CD Newcastle-under-Lyme CD Tamworth CD Cannock Chase CD Nuneaton and Bedworth CD Dudley MCD Telford and Wrekin UA Birmingham MCD Walsall MCD Coventry MCD Stoke-on-Trent UA Sandwell MCD Warwickshire CC Worcestershire CC Staffordshire CC

© Crown Copyright 2010

Wolverhampton MCD


healthprofiles.info Regional Variations: National Context This table shows how each region compares to the England average for the range of indicators used in the local Health Profiles. Areas are sorted by a summary score of red, amber and green indicators so that areas with more indicators which are better than the England average appear at the left and those which are worse appear at the right. A green box may still indicate an important public health problem.

5.9

9.2

6.2

16.6

28.5

33.7

31.8

27.2

27.4

22.4

15.4

16.9

16.9

19.5

33.9

26.0

25.0

23.0

24.8

3

Statutory homelessness

2.8

1.5

1.9

2.4

2.5

4.1

3.2

2.7

3.3

4.2

4

GCSE achieved (5A*-C inc. Eng & Maths) *

48.3

51.7

49.2

50.3

47.0

50.6

44.9

47.4

44.4

46.1

5

Violent crime *

17.6

17.7

15.4

13.1

17.3

23.0

16.1

17.3

18.0

18.0

6

Carbon emissions *

7.2

6.8

7.3

7.3

7.8

6.5

8.1

7.1

7.6

7.1

7

Smoking in pregnancy

14.7

13.7

15.2

14.3

16.2

7.2

22.2

19.6

18.0

15.6

8

Breast feeding initiation *

71.0

75.7

76.0

73.0

71.6

84.4

52.5

60.9

64.9

62.6

9

Physically active children *

90.0

89.5

91.8

91.9

89.7

88.9

90.5

89.8

88.8

90.0

10

Obese children *

9.6

8.3

8.9

9.3

9.1

10.9

10.7

10.0

9.8

10.0

11

Children’s tooth decay (at age 5)

1.5

1.1

1.6

1.1

1.3

1.7

2.0

2.0

1.8

1.0

12

Teenage pregnancy (under 18) *

41.2

33.3

34.3

33.0

40.1

45.8

50.6

45.9

47.3

46.5

13

Adults who smoke *

24.1

21.8

21.5

23.5

24.9

23.3

29.1

26.0

25.5

24.0

14

Binge drinking adults

18.0

16.2

15.3

15.2

17.7

12.7

26.5

23.0

22.0

17.9

15

Healthy eating adults

26.3

30.4

25.9

27.0

25.9

29.7

18.5

23.6

24.7

25.1

16

Physically active adults

10.8

11.4

12.3

11.0

11.4

9.4

10.6

10.8

11.3

9.5

17

Obese adults

23.6

22.0

23.2

24.8

25.6

18.4

25.2

24.5

24.1

26.5

18

Over-65s ‘not in good health’

21.5

16.9

18.4

18.2

22.0

22.3

27.5

25.0

25.0

23.5

19

Incapacity benefits for mental illness *

27.7

19.8

26.8

20.6

24.6

27.0

40.2

40.5

28.4

29.0

20

Hospital stays for alcohol related harm *

21

Drug misuse

9.8

5.6

9.0

5.4

8.4

14.2

9.4

12.3

11.8

10.9

22

People diagnosed with diabetes

4.1

3.7

3.9

3.8

4.3

4.2

4.1

4.3

4.1

4.5

23

New cases of tuberculosis

15.0

8.0

5.4

7.9

12.2

44.6

5.6

10.0

11.9

17.4

England

1472.5 1161.4 1365.3 1234.8 1451.6 1386.4 2045.6 1943.8 1413.1 1479.5

24

Hip fracture in over-65s

25

Excess winter deaths

17.0

17.2

17.9

17.7

16.4

16.4

15.8

16.3

16.2

18.2

26

Life expectancy - male *

77.7

78.9

78.7

78.7

77.6

77.9

76.3

76.0

76.9

76.9

27

Life expectancy - female *

81.8

82.7

82.9

82.6

81.6

82.4

80.4

80.4

81.1

81.4

28

Infant deaths

4.9

4.0

4.2

4.1

5.1

4.8

4.9

5.5

5.8

6.2

29

Deaths from smoking

207.2 268.3 253.3 235.0

215.3

30

Early deaths: heart disease & stroke *

31

Early deaths: cancer *

32

Road injuries and deaths *

479.8

467.5 462.7

467.6 480.1 454.4 552.3 493.9 484.0 499.0

210.2 183.0 178.2 185.0 204.5 67.9

78.8

115.5 108.0 106.0 106.9

79.1

114.4

54.3

66.3 54.5

65.6 49.0

60.4

60.5

92.7

96.4

86.1

85.0

112.0 134.3

83.5

129.5

121.0

118.5

54.6

63.3

49.0

50.7

42.8

© Crown Copyright 2010

Our communities Children’s and young people’s health Adults’ health and lifestyle Disease and poor health Life expectancy and causes of death

North West

19.9

Children in poverty *

Indicator

North East

London

Deprivation

2

Domain

South West

1

*Relates to National Indicator 2009

South East

East Midlands

No significance can be calculated, or data unavailable

East of England

Not significantly different from England average

West Midlands

Significantly better than England average

Yorkshire and The Humber

Significantly worse than England average


healthprofiles.info

Health Summary for West Midlands

The chart below shows how people’s health in this region compares to the rest of England. The regional result for each indicator is shown as a diamond, against the range of results for local authorities in England which is shown as a bar. A green diamond may still indicate an important public health problem.

Indicator 1

Deprivation

2

Children in poverty *

3

Statutory homelessness

4

Disease and poor health

Eng Avg

Eng Worst

75th percentile

England Range

Eng Best

1463634

27.4

19.9

89.2

0.0

264252

24.8

22.4

66.5

6.0

8247

4.2

2.8

8.9

0.0

GCSE achieved (5A*-C inc. Eng & Maths) *

31102

46.1

48.3

26.5

73.3

5

Violent crime *

96360

18.0

17.6

38.4

4.8

6

Carbon emissions *

37923

7.1

7.2

15.7

4.6

7

Smoking in pregnancy

10356

15.6

14.7

37.8

3.7

8

Breast feeding initiation *

41678

62.6

71.0

32.5

92.2

9

Physically active children *

635270

90.0

90.0

77.5

100.0

5272

10.0

9.6

16.2

3.9

11 Children’s tooth decay (at age 5)

n/a

1.0

1.5

3.2

0.0

12 Teenage pregnancy (under 18) *

4982

46.5

41.2

79.1

15.0

13 Adults who smoke *

n/a

24.0

24.1

40.9

13.7

14 Binge drinking adults

n/a

17.9

18.0

28.9

9.7

15 Healthy eating adults

n/a

25.1

26.3

15.8

45.8

16 Physically active adults

n/a

9.5

10.8

4.4

17.1

17 Obese adults

n/a

26.5

23.6

31.2

11.9

197297

23.5

21.5

32.5

13.5

19 Incapacity benefits for mental illness *

95170

29.0

27.7

59.4

8.7

20 Hospital stays for alcohol related harm *

91536 1479.5 1472.5 2615.1

639.9

21 Drug misuse

38235

10.9

9.8

27.5

1.3

239574

4.5

4.1

6.3

2.6

930

17.4

15.0

102.1

0.0

499.0 479.8

699.8

219.0

30.3

4.0

10 Obese children *

18 Over-65s ‘not in good health’

Life expectancy and causes of death

Local No. Local Per Year Value

25th percentile

England best

22 People diagnosed with diabetes 23 New cases of tuberculosis 24 Hip fracture in over-65s

5529

25 Excess winter deaths

3006

18.2

17.0

26 Life expectancy - male *

n/a

76.9

77.7

73.2

83.7

27 Life expectancy - female *

n/a

81.4

81.8

78.1

87.8

424

6.2

4.9

9.6

1.3

215.3 210.2

330.2

134.4

79.1

130.5

39.6

118.5 115.5

164.3

75.7

188.3

18.4

28 Infant deaths 29 Deaths from smoking

8622

30 Early deaths: heart disease & stroke *

5014

31 Early deaths: cancer *

6903

32 Road injuries and deaths *

2622

85.0

49.0

54.3

Note (numbers in bold refer to the above indicators) 1 % of people in this area living in 20% most deprived areas of England 2007 2 % of children living in families receiving means-tested benefits 2007 3 Crude rate per 1,000 households 2007/08 4 % at Key Stage 4 2007/08 5 Recorded violence against the person crimes crude rate per 1,000 population 2007/08 6 Total end user CO2 emissions per capita (tonnes CO2 per resident) 2006 7 % of mothers smoking in pregnancy where status is known 2007/08 8 % of mothers initiating breast feeding where status is known 2007/08 9 % 5–16 year olds who spent at least 2 hours per week on high-quality PE and school sport 2007/08 10 % of school children in reception year 2007/08 11 Average number of teeth per child age 5 which were actively decayed, filled or had been extracted 2005/06 12 Under-18 conception rate per 1,000 females (crude rate) 2005–2007 13 %. Direct estimate from Health Survey for England 2003–2005 14 %. Direct estimate from Health Survey for England 2003–2005 15 %. Direct estimate from Health Survey for England 2003–2005 16 % aged 16+ 2007/08 17 %. Direct estimate from Health Survey for England 2003–2005 18 % who self-assessed general health as ‘not good’ (directly age and sex standardised) 2001 19 Crude rate per 1,000 working age population 2007 20 Directly age and sex standardised rate per 100,000 population 2007/08 21 Crude rate per 1,000 population aged 15–64 2006/07 22 % of people on GP registers with a recorded diagnosis of diabetes 2007/08 23 Crude rate per 100,000 population 2004–2006 24 Directly age-standardised rate for emergency admission 2006/07 25 Ratio of excess winter deaths (observed winter deaths minus expected deaths based on non-winter deaths) to average non-winter deaths 1.08.04–31.07.07 26 At birth, 2005–2007 27 At birth, 2005–2007 28 Rate per 1,000 live births 2005–2007 29 Per 100,000 population age 35+, directly age standardised rate 2005-2007 30 Directly age standardised rate per 100,000 population under 75 2005–2007 31 Directly age standardised rate per 100,000 population under 75 2005–2007 32 Rate per 100,000 population 2005–2007 More information is available in The Indicator Guide: www.healthprofiles.info For information on your area contact your regional PHO: www.apho.org.uk You may use this profile for non-commercial purposes provided the source is acknowledged. ‘Source: APHO and Department of Health. © Crown Copyright 2010.’

designed by: Cox Design, Witney, Oxon

Adults’ health and lifestyle

Children’s and young people’s health

Our communities

Domain

England worst

England average

© Crown Copyright 2010

Significantly worse than England average Not significantly different from England average Significantly better than England average No significance can be calculated *Relates to National Indicator 2009

West Midlands Health Profile 2009  

This profile gives a snapshot of health in your region. It is designed to help local government and primary care trusts tackle health inequa...

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