7.1 Introduction

The West Midlands Public Health Observatory produces Local Authority (LA) Profiles around key indicators of demography, mortality and morbidity. The data for these can be accessed at http://www.wmpho.org.uk/profiles/?id=LTLA
However, these profiles currently provide only a static picture of health across the region in a single year.  It is important to examine trend data to get a clearer picture of the variation in health experienced across the region.  This chapter builds on the work of the previous years KHD chapter (Key Health Data 2004), where trend data was provided for key indicators for all Primary Care Trusts across the region. This year the same indicators are presented by lower tier LAs.

In order to highlight health inequalities across the region, this chapter presents trend data for those LAs with (Directly Standardised Rates) DSRs which fall into the highest and lowest 10 per cent of all West Midlands LAs in the baseline year of 1995 i.e. the top 3 and bottom 3 LAs for that indicator in 1995. The CD-ROM enclosed with this publication contains 1995-2004 trend data for all LAs across the West Midlands Region.

All the charts (1) show directly standardised mortality rates (DSR) for a specific disease except for All Causes.  Deaths were extracted from the ONS annual death extracts from 1995 to 2004 using the year of death registration and standardised to the European Standard Population.  LA codes were allocated using the ‘gridallNov05 NHS Organisation Code’ table supplied by the Organisation Codes Service division of the NHS Information Authority.  LA populations were derived from the UKACR (United Kingdom Association of Cancer Registries) Populations for the appropriate year. Unfortunately these were only available up to and including 2002. Populations for the remaining years, 2003 and 2004 were downloaded from ONS current dataset.
http://www.statistics.gov.uk/statbase/Product.asp?vlnk=601&More=N

From January 2001 following recommendation from the World Health Organisation (WHO) mortality data cause of death has been coded in accordance with the Tenth Revision of the International Classification of Diseases (ICD-10).  This means that for trend analysis, the number of deaths coded to the equivalent ICD-9 code is multiplied by the comparability ratio calculated using the ONS methodology.  This produces an ‘expected’ number of deaths which would have been coded to that specific cause under ICD-10.  Further information on comparability ratios can be found at http://www.statistics.gov.uk/about/classifications/icd10/comparability_ratios.asp

Please refer to the Figure key below for the graphs presented

Figure Key

7.2 Mortality from all Causes Aged Under 75

	Figure 07.02.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.02.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.3 Mortality from All Causes Aged 75 and over

	Figure 07.03.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.03.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline).

7.4 Mortality from Coronary Heart Disease Aged under 75

	Figure 07.04.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.04.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.5 Mortality from Coronary Heart Disease Aged 75 and over

	Figure 07.05.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.05.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline).

7.6 Mortality from Stroke Aged Under 75

	Figure 07.06.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.06.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.7 Mortality from Stroke Aged 75 and over

	Figure 07.07.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.07.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.8 Mortality from All Circulatory Disease Aged Under 75

	Figure 07.08.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.08.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.9 Mortality from All Circulatory Disease Aged 75 and over

	Figure 07.09.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.09.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.10 Mortality from All Cancers Aged Under 75

	Figure 07.10.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.10.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.11 Mortality from Accidents Aged Under 15

	Figure 07.11.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.11.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.12 Mortality from Accidents Aged Under 15

	Figure 07.12.01LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.12.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.13. Mortality from Accidental Falls Aged 75 and over

	Figure 07.13.01 LAs with DSRs that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.13.02 LAs with DSRs that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

7.14 Infant Mortality

	Figure 07.14.01 LAs with infant mortality rates that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.14.02 PCTs with infant mortality rates that fall into the lowest 10 per cent of all West Midlands PCTs (1995 baseline)

7.15 Live birth rates

	Figure 07.15.1 LAs with live birth rates that fall into the highest 10 per cent of all West Midlands LAs (1995 baseline)
	Figure 07.15.2 LAs with live birth rates that fall into the lowest 10 per cent of all West Midlands LAs (1995 baseline)

Reference

1. Key Health Data 2004/5, Public Health and Epidemiology, University of Birmingham.

2.Office of National Statistics Mid-year Population Estimates 2003 and 2004 [Online] http://www.statistics.gov.uk/statbase/Product.asp?vink=601&More=N accessed on 27th April 2006