5.1. Introduction

The Tackling Health Inequalities: Programme for Action was produced in July 2003. It describes how the Government’s ambitious strategy for tackling health inequalities outlined in the Cross Cutting Review will be implemented. It also includes 12 national headline indicators for monitoring health inequalities and reinforces the need for a local basket of inequalities indicators.

The main purpose of the local basket of inequalities indicators is to help support local action to achieve the Government’s national inequalities targets for life expectancy and infant mortality, by highlighting information relevant to addressing the targets and assisting local areas with monitoring progress towards reducing health inequalities. It is envisaged that local areas will choose which indicators to use and monitor over time based on locally agreed priorities. [http://www.lho.org.uk/HIL/Inequalities_In_Health/Basket_Of_Indicators/Basket.htm]

The local basket of inequalities indicators is a set of local measures which can be used to monitor progress towards the achievement of national and local targets, as well as for needs assessment, target setting, monitoring, performance management and equity audit.

The local basket of inequalities indicators contains 70 indicators and has been grouped into 13 chapters:

1. Poverty and deprivation
2. Housing and homelessness
3. Education
4. Crime
5. Pollution and the physical environment
6. Community development
7. Lifestyle including diet, smoking and physical activity
8. Access to local health and other services
9. Accidents and injury
10. Mental health
11. Maternal, infant and child health
12. Older people
13. Tackling the major killers

The focus for this chapter will be on tackling the major killers where a chart will be provided for the major killers’ indicators. Titles of the indicators are written as that in the Local basket of health inequalities indicators document.

Indicators are included if they are routinely published for all local authorities or primary care trusts within England. As PCTs are relatively new organisations, their data availability is limited for them at the moment as many datasets are still reported at old Health Authority level, for this reason data have been published here by LA but will be published by PCT on www.wmpho.org.uk when the data become available.

5.1.1.  Indicator 13.1. Breast Cancer

At this time the data for women aged 65-70 being screened are very limited and could only be provided by Strategic Health Authority for Number of women screened after invite 2002/03

Table 5.1. Proportion of women aged 65-70 who have been successfully screened for breast cancer

5.1.2.  Indicator 13.2. Tuberculosis

Figure 5.1. Tuberculosis notification rate per 100,000 population (Directly Standardised Rates)

The graph shows the rate of tuberculosis in the West Midlands, standardised to the European standard population by age. The tuberculosis notification rate for the West Midlands is 12.8 per 100,000 population.

5.1.3.  Indicator 13.3. Revascularisation

Figure 5.2. Proportion of those treated waiting more than 3 months for revascularisation

The graph shows that in the West Midlands between 25% and 60% of people treated are waiting more than 3 months for revascularisation.

5.1.4.  Indicator 13.4. Angiography

Figure 5.3. Proportion of those treated waiting more than 3 months for angiography

The graph shows that in the West Midlands between 5% and 70% of people treated are waiting more than 3 months for angiography.

5.1.4.  Indicator 13.6. Emergency admissions of children aged under 16

Figure 5.4. Number of emergency admissions of children aged under 16 with lower respiratory infections, per 100,000 resident children

The graph shows the standardised mortality ratio of emergency admissions of children aged under 16 with lower respiratory infections in the West Midlands, standardised to the European standard population by age and sex. The emergency admissions ratio of children aged under 16 with lower respiratory infections for the West Midlands is 98.6 per 100,000 population.

5.1.5.  Indicator 13.7. Emergency admissions to hospital

Figure 5.5. Emergency admissions to hospital for people of all ages per 1000 people

The graph shows the directly standardised rate of emergency admissions for all people of all ages in the West Midlands, standardised to the European standard population by age and sex. The rate for the West Midlands is 76.7 per 1,000 population for males and 71.5 per 1,000 population for females.

5.1.6.  Indicator 13.8. Stroke

Table 5.2. Proportion of people admitted for stroke admitted to a hospital with a specialised stroke service

The table shows the number and proportion of stroke admission in the West Midlands. The specialised stroke units have been identified by a phone call to the hospitals as a definitive list was unable to be obtained at the time.

5.1.7.  Indicator 13.9. Mortality rate from circulatory disease

Figure 5.6. Age standardised mortality rate (direct standardised mortality rate per 100,000 population) from circulatory disease for those aged under 75

The graph shows the standardised mortality rate from circulatory disease for those under 75 years old. The Directly Standardised Rates (DSR) were calculated using ONS annual death extracts for 2001 and standardised to the European Standard Population. In the West Midlands the rate from circulatory disease for those aged under 75 for males is 158.9 per 100,000 population and 71.3 for females.

5.1.8.  Indicator 13.10. Mortality rate from cancer

Figure 5.7. Age standardised mortality rate (directly standardised mortality rate per 100,000 population) from cancer for those aged under 75

The graph shows the standardised mortality rate from cancer for those under 75 years old. The Directly Standardised Rates (DSR) were calculated using ONS annual death extracts for 2001 and standardised to the European Standard Population. In the West Midlands the rate from cancer for those aged under 75 is 439.1 per 100,000 for males and 262.3 for females.

5.1.9.  Indicator 13.11. Mortality rate from lung cancer

Figure 5.8. Age standardised mortality rate from lung cancer for those aged under 75

The graph shows the directly standardised rate for lung cancer for people aged under 75 in the West Midlands, standardised to the European standard population age and sex. The rate for the West Midlands is 38.9 per 1,000 population for males and 17.7 per 1,000 population for females.

5.1.10.  Indicator 13.12. Life expectancy at birth

Figure 5.9. Life expectancy at birth

The graph shows life expectancy at birth for the West Midlands. Life expectancy at birth can be defined as the number of years a baby born in a particular area or population can be expected to live if it experienced the current age-specific mortality rates of that particular area or population throughout its life.

In the West Midlands male life expectancy is 76 and females 82.

5.2. Local Basket of Indicators

The local basket of inequalities indicators is a tool under development. It is envisaged that it will develop over time, new indicators will be added and definitions will be refined when necessary. The indicators are largely taken from indicators currently in use, however, as these indicators were not explicitly designed for measuring inequalities in health, there are obvious gaps that need addressing. Further indicators that are currently not available at local level are stressed as important for development.

	Table 5.3. Employment, poverty and deprivation Theme: Addressing the underlying determinants of health
	Table 5.4. Housing and homelessness Theme: Addressing the underlying determinants of health
	Table 5.5. Education Theme: Addressing the underlying determinants of health
	Table 5.6. Crime Theme: Engaging communities and individuals
	Table 5.7. Pollution and the physical environment Theme: Addressing the underlying determinants of health
	Table 5.8. Community development Theme: Engaging communities and individuals
	Table 5.9. Lifestyle including diet, smoking and physical activity Theme: Addressing the underlying determinants of health
	Table 5.10. Access to local health and other services Theme: Preventing illness and providing effective treatment and care.
	Table 5.11. Accidents and injury Theme: Preventing illness and providing effective treatment and care
	Table 5.12. Mental health Theme: Preventing illness and providing effective treatment and care
	Table 5.13. Maternal, infant and child health Theme: Supporting families, mothers and children
	Table 5.14. Older people Theme: Preventing illness and providing effective treatment and care
	Table 5.15. Tackling the major killers Theme: Preventing illness and providing effective treatment and care

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