Key Health Data for the West Midlands 2002
CHAPTER TWO: LIFE EXPECTANCY AND INEQUALITIES
List of Tables
List of Figures
Main Body
1: The Geography of the West Midlands
2: Life Expectancy and Inequalities
3: Drinking Water Quality
4: Chemical incidents in the West Midlands
5: Landfill Sites
6: IPPC
7: Fires in the West Midlands
8: Road Traffic Accidents
9: Drownings
10: Access to a healthy diet
11: National Health Service Priority Areas
12: Communicable Disease
13: Older People
2.1 Introduction
This chapter sets out life expectancy at birth at local authority area. In effect it updates the information on health inequalities following last years Key Health Data and the West Midlands Public Health Observatory (WMPHO) report "Health Inequalities in the West Midlands - Exploring Headline Targets" (WMPHO 2002). It takes into account changes made as a result of the publication of "Tackling Health Inequalities - 2002 Cross-Cutting Review" (HM Treasury/Department of Health 2002) and "Improvement, Expansion And Reform: The Next 3 Years Priorities and Planning Framework 2003 - 2006" (Department of Health 2002).
The former reiterates the targets on life expectancy but expressed in terms of local authority areas rather than PCTs. Therefore we have mapped the life expectancy for local authorities and identified the 20% with the lowest overall life expectancy as being those targeted for improvement (see Figures 2.1 & 2.2). The second document on the Priorities and Planning Framework expressed four targets relating specifically to inequalities.
- Deliver a one percentage point reduction per year in the proportion of women continuing to smoke throughout pregnancy, focussing especially on smokers from disadvantaged groups as a contribution to the national target to reduce by at least 10% the gap in mortality between "routine and manual" groups and the population as a whole by 2010, starting with children under one year.
- Contribute to a national reduction in death rates from coronary heart disease (CHD) of at least 25% in people under 75 by 2005 compared to 1995-1997, targeting the 20% of areas with the highest rates of CHD.
- Contribute to a national reduction in cancer death rates of at least 12% in people under 75 by 2005 compared to 1995-1997, targeting the 20% of areas with the highest rates of cancer.
- Achieve the target of 70% uptake in influenza immunisation in people aged 65 years and over, targeting populations in the 20% of areas with the lowest life expectancy.
The first of these cannot be examined using current data as the new Office for National Statistics (ONS) social classifications are not yet available. The second and third are addressed below, showing a comparison between the target areas with the highest rates of CHD and cancer and the overall regional figures. The data on influenza immunisation uptake is not currently available, but the 20% of local authorities with the lowest life expectancy are highlighted below.
2.2. Life expectancy
Figure 2.1 shows the male life expectancy at birth by local authority. As can be seen the lowest life expectancy is predominantly found in the urban areas, with the 20% worst areas in the West Midlands shown in dark blue. These are Sandwell, Stoke-on-Trent, Wolverhampton, Birmingham, Coventry, Nuneaton & Bedworth and Telford & Wrekin.
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Figure 2.1. Life expectancy at birth by local authority, West Midlands region, males, 1996-2000. |
For women, the worst 20% in the West Midlands are all the same as for men except that Cannock Chase replaces Coventry (see Figure 2.2)
If we take the overall life expectancy for both sexes, we get Sandwell, Stoke-on-Trent, Wolverhampton, Cannock Chase, Birmingham, Nuneaton & Bedworth and Coventry in the worst 20%. This illustrates a problem with this type of target in that Telford & Wrekin is in the worst 20% for both men and women separately, but not for the two combined.
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Figure 2.2. Life expectancy at birth by local authority, West Midlands region, females, 1996-2000 |
2.3. Inequalities
The two charts below show the comparison of the local authorities with the worst CHD mortality in under 75-year olds in 1995-1997 and the regional average. The first chart shows that rates both overall and for the worst 20% are decreasing, but the second chart showing the percentage difference between the two highlights the widening gap between those worst in 1995-1997 and the regional average.
These figures need to be interpreted with care however, because the areas with the highest rates in 1995-1997 are not necessarily the same as those with the highest rates in other years, although there is considerable overlap. This means that we may underestimate the gap especially over a long time period.
Figures 2.5 & 2.6 show the same for cancer in the under 75s. Although a similar pattern emerges, the decrease is much less steep than for CHD and the gap in Figure 6 is not so uniformly increasing. This could be due to random fluctuation or, particularly, due to the problems highlighted above with taking a snapshot to set the worst-off areas.
References
Department of Health. Improvement, Expansion And Reform: The Next 3 Years Priorities and Planning Framework 2003 - 2006. London: Department of Health, 2002.
HM Treasury/Department of Health. Tackling Health Inequalities - 2002 Cross-Cutting Review. London: Department of Health, 2002.
WMPHO Inequalities in Health in the West Midlands - Exploring Headline Targets. Birmingham: West Midlands Public Health Observatory, 2002.
For more information please contact Sarafina
Cotterill on 0121 414 3368
© Department of Public Health and Epidemiology, University
of Birmingham