Life Expectancy Ward Analysis

Ward Profile: Bartley Green Tackling Health Inequalities: Life Expectancy

VERSION CONTROL AND DOCUMENT GOVERNANCE

Version 2

Date June 2009

Status Green

File location (public)

Filename and path to locate this document

PHIT – Bartley Green 2

All maps produced with permission of Dotted Eyes & Ordnance Survey © 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 leading conditions that cause deaths locally, to provide local focus for each target ward.

• Suggest future area/ factors for extended research.

Authors 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)

Jim McManus (Joint Director of Public Health)

For further information please contact the information team:

Tel: 0121 465 2995

Email: phit@bhwp.nhs.uk

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1. Summary

• Electoral ward Bartley Green is within the boundary of NHS South Birmingham.

• Bartley Green accounted for 2.46% of Birmingham’s population in 2006.

• Children and young people (0-19) are the most populous group in the ward, making up 26.7% of the total population.

• The percentage of Black and minority Ethnic groups in this ward is 9.7%, which is lower than both the National (11.3%) and Birmingham (32.7%) averages.

• Bartley Green is the 14th (out of 40) most deprived ward in Birmingham.

• The latest extraction for 2005/07 shows that:

o Life expectancy is 74.3 for men and 82.3 for women, over the years 2005/07.

o From 1995/97 to 2005/07 male life expectancy has increased by 1.9%. However the deficit for Bartley Green compared with England has doubled (an increase of 1.7 years) from 1995/97 to 2005/07.

o From 1995/97 to 2005/07 female life expectancy has increased by 2.4%. The gap between Bartley Green and England has narrowed by 28.6% (0.2 years) in the wards favour.

o Infant Mortality Rates have risen by 68.3% since 1999/01; the rate for the most deprived wards has dropped.

o The leading conditions that cause deaths in the ward are Circulatory diseases (33.8%), Cancers (29.0%) and Coronary Heart Diseases (18.8%).

• Lifestyle factors 2005/07 suggest that, in comparison to Birmingham as a whole, the rates for residents of Bartley Green are:

o 7.2 percentage points higher for adults who smoke. o 0.8 percentage points lower for binge drinking adults. o 0.2 percentage points lower for adult obesity.

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2. Local context: demographics and deprivation This section describes population demographics and deprivation in Bartley Green, in order to provide a local context for life expectancy inequalities. Comparisons are made with Birmingham and England.

2.1. Age and sex distribution The population of Bartley Green is estimated to be 24,816. This represents 2.46% of the population of Birmingham. Approximately 47.5% (11,784) are male and 52.5% are female (13,032). These estimations are based on ONS mid-year population estimates for 2006. The population pyramid (Figure 1.1) shows the age and sex distributions.

Population By Age Group and Gender

2006 Estimates by Ward

Source: Office of National Statistics

802

726

764

969

995

942

884

921

921

804

781

841

611

456

435

457

387

857

787

861

864

859

782

795

837

817

757

673

740

670

431

385

310

195

1000 500 0 500 1000 1500

0-4

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80+

Males

Females

Data source: ONS 2006 mid year population estimates

Figure 1.1 Population by age group and gender, Bartley Green 2006

Figure 1.1 illustrates:

• Children under school leaving age (i.e. age 0 - 19) represent 26.7% (6,630) of the Bartley Green population. Persons of retirement age (age 65+) account for 14.3% (3,556).

• The ward has 4.7 percentage points more under 19s and 3.7 percentage points more over 65s than the city averages.

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2.2. Ethnicity

Ethnicity has some influences in terms of what kind of illness an individual could develop through their life. Thus, ethnicity analysis becomes a requirement in order to target the health of vulnerable people. Table 1.1 shows the ethnicity distribution in the Bartley Green population, compared with Birmingham and England.

• The % column of table 1.1 represents the percentage of the total population that fit into that ethnic group. The N* column shows the quantity of people in thousands that are from each group, for the ward, city and nationally.

• About a tenth (9.7%) of the population belong to non-white (BME) ethnicity groups, Pakistanis represent 0.65%, Indians 1.18% and Black Caribbeans 3.03%.

• The proportion of BME groups (9.7%) is lower than for Birmingham (32.7%) and England (11.3%).

Table 1.1 Ethnicity groups for Bartley Green (2001), Birmingham (2006) and England (2006)

Bartley Green Birmingham England

Ethnicity groups % N* % N* % N* White 90.3 23.0 67.3 667.0 88.7 45,018.1 Asian or Asian British 2.2 0.5 20.7 207.9 5.5 2,786.6 Black or Black British 3.8 0.9 6.7 67.0 2.8 1,403.0 Mixed 3.0 0.7 3.2 31.8 1.6 829.5 Chinese or other 0.7 0.2 2.3 22.9 1.4 725.7 Total 100 25.4 100 1,106.5 100 50,762.9

*population by thousand Data source: ONS population estimates by ethnic group mid 2006 for Birmingham / England. 2001 Census data for Ward

2.3. Deprivation

According to Index of Multiple Deprivation (IMD) 2007 published by ONS, Bartley Green is the 14th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 35.431.

Figure 1.2 shows SOAs in Bartley Green by IMD quintile, 2007. Most of the area covered by Bartley Green is in the third and fourth most deprived SOAs in Birmingham. Table 1.2 shows the area covered by the ward and population density.

Table 1.2 Ward Area Characteristics for Bartley Green

Area (KM2) Population Density (persons / km

2) Population Density – Working Age

16-64 (persons/km2)

8.835 2373 1454

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 Bartley Green by IMD quintile, 2007

2.4. Lifestyle

Table 1.3 provides a summary of lifestyle indicators in Bartley Green, in comparison with Birmingham and England. Data presented here are from the synthetic estimates of healthy lifestyle behaviours produced by the NHS Information Centre.

• Compared with the Birmingham average, Bartley Green has a lower percentage of people who binge drink (0.8 percentage points lower) and are obese (0.2 percentage points lower) but a higher proportion who smoke (7.2 percentage points higher).

• A smaller percentage of people eat healthily in Bartley Green (16.3%), than both in Birmingham (25.1%) and nationally (26.3%).

• Table 1.3 shows that further information should be sought on why inequalities exist for smoking and healthy eating between Bartley Green and the Birmingham and England averages.

Table 1.3 Key figures for life style Deprivation in Bartley Green, Birmingham and England

Year Bartley Green Birmingham England Adults who smoke 2003/05 32.1% 24.9% 24.1% Binge drinking adults* 2003/05 17% 17.8% 18.0% Healthy eating adults** 2003/05 16.3% 25.1% 26.3% Obese adults*** 2003/05 23.2% 23.4% 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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3. Life expectancy trend

There is evidence that life expectancy is one of the most important determinants for health inequalities across the population. This section gives an overview of life expectancy at birth in terms of trend and variations in different groups and communities.

Figure 2.1 shows the trend in male life expectancy in Bartley Green from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Male life expectancy has increased in Bartley Green over this time, although 2005/07 saw a fall. Overall, the trend for the city is for a slow, continuous increase in life expectancy, hence this fall in 2007 requires further investigation, to ascertain why this ward is not consistent with the trend.

Male Life Expectancy - 3 year rolling average,

Bartley Green, Birmingham & England

70.0

71.0

72.0

73.0

74.0

75.0

76.0

77.0

78.0

79.0

1995

/ 97

1996

/ 98

1997

/ 99

1998

/ 0

0

1999

/ 01

2000

/ 02

2001

/ 03

2002

/ 04

2003

/ 05

2004

/ 06

2005

/ 07

Calendar Year

Lif

e E

xp

ecta

ncy (

Ag

e)

England M ales Birmingham M ales Bartley Green M ales

Data source: ONS

Figure 2.1 Male life expectancy, Bartley Green, Birmingham and England, 1995/97 to 2005/07

Figure 2.2 shows the trend in female life expectancy in Bartley Green from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. By 2007 female life expectancy in Bartley Green is running closely to the same pattern to England and is currently slightly higher than the average.

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Female Life Expectancy - 3 year rolling average,

Bartley Green, Birmingham & England

76.0

77.0

78.0

79.0

80.0

81.0

82.0

83.0

1995

/ 97

1996

/ 98

1997

/ 99

1998

/ 0

0

1999

/ 01

2000

/ 02

2001

/ 03

2002

/ 04

2003

/ 05

2004

/ 06

2005

/ 07

Calendar Year

Lif

e E

xp

ecta

ncy (

Ag

e)

England Females Birmingham Females Bartley Green Females

Data source: ONS

Figure 2.2 Female life expectancy for Bartley Green, Birmingham and England, 1995/97 to 2005/07

As illustrated above, life expectancy for both males and females has increased from 1995/97 to 2005/07. Life expectancy in Bartley Green is lower than city and national averages for males but higher for females.

• Male life expectancy has increased by 1.9% from 72.9 years in 1995/97 to 74.3 years in 2005/07.

• The gap in male life expectancy between Bartley Green and England has doubled from 1.7 years to 3.4 years.

• Female life expectancy has increased by 2.4% from 80.4 years in 1995/97 to 82.3 years in 2005/07.

• The gap in female life expectancy between Bartley Green and England has shortened from 0.7 years to 0.5 years.

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Bartley Green Infant Mortality Rate - 3 year rolling average

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

1999 / 01 2000 / 02 2001 / 03 2002 / 04 2003 / 05 2004 / 06 2005 / 07

Trend years

Rate

per

1,0

00

Birmingham England

M ost Deprived Quintile in Bham Bartley Green

4. 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 Bartley Green, 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 1999/01 to 2005/07.

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 Bartley Green, Birmingham, England and the most deprived quintile in Birmingham, 1999/01-2005/07

As illustrated in Figure 2.3, in 2005/07, the IMR in Bartley is higher than in England but lower than in Birmingham. The IMR for those in the most deprived quintile of Birmingham is higher than the Birmingham average.

• From 1999/01 to 2005/07, the IMR in Bartley Green has increased by 68.3%.

• Over this time, the gap in IMR between the most deprived quintile SOAs in Birmingham and Bartley Green has decreased from 6.9 to 2.0 per 1,000. There have been consistent improvements in the most deprived quintile, while the ward’s rate has increased dramatically in the final year. Further investigation needs to be carried out why the ward has increased, when Birmingham as a whole has reduced the mortality rate for infants.

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• During the same period, the IMR in England has decreased smoothly from 5.6 to 4.9 per 1,000 (at about 0.1 per 1,000 per year). The gap between Bartley Green and England has increased from 0.9 per 1,000 below England to 2.9 per 1,000 above.

5. Mortality rates on selected diseases

Age-specific mortality rate is used to calculate life expectancy at birth. Disease specific standardised mortality rates are investigated, in order to identify leading diseases that contribute to the overall mortality rates in Bartley Green.

Table 3.1 shows directly standardised mortality rates for selected conditions in 2005/07. Percentage of each disease’s rate out of the overall rate is also shown here. Cancers, circulatory diseases and coronary heart disease are the major killers. They make up more than 81.2% of the overall DSR. This percentage is consistent with both city and local PCT levels, which vary from 72% to 82%.

Table 3.1 Directly Standardised Mortality Rates (DSRs) per 100,000 population for selected conditions, Bartley Green, 2005/07

DSR % out of all causes rate*

100.0%

All Causes 688.4

All Cancers 199.4 29.0%

All Circulatory Diseases 232.3 33.8%

Coronary Heart Disease 129.4 18.8%

* Percentage of rate for the specific disease out of rate for all causes

Data source: National Centre for Health Outcomes Development