Life Expectancy Ward Analysis

Ward Profile: Billesley 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 - Billesley 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 / 2999

Email: phit@bhwp.nhs.uk

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1. Summary

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

• Billesley accounted for 2.56% of Birmingham’s population in 2006.

• Children and young people (0-19) are the most populous group in the ward, making up 26.8% of the total population.

• The percentage of Black and minority Ethnic groups in this ward is 11.8%, which is higher than the national average (11.3%) but lower than the Birmingham average (32.7%).

• Billesley is the 18th (out of 40) most deprived ward in Birmingham.

• The latest extraction of 2005/07 shows that:

o Life expectancy is 75.7 for men and 80.2 for women over the years 2005/07.

o From 1995/97 to 2005/07, male life expectancy has increased by 2.8%. The deficit for Billesley compared with England has doubled (1 year to 2 years).

o From 1995/97 to 2005/07, female life expectancy has increased by 2.9%. The deficit for Billesley compared with England has closed by 5.9% (0.1 years).

o Infant Mortality Rates for Billesley have risen by 41.9% since 1999/01. However, the rate for the most deprived wards has dropped.

o The leading conditions that cause deaths in the ward are Circulatory diseases (29.6%), Cancers (28.6%) and Coronary Heart Diseases (14.7%).

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

o 5.2 percentage points higher for adults who smoke. o 1.6 percentage points lower for adult obesity. o 0.9 percentage points lower for binge drinking adults.

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2. Local context: demographics and deprivation This section describes population demographics and deprivation in Billesley, 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 Billesley is estimated to be 25,853. This represents 2.56% of the population of Birmingham. Approximately 48.2% (12,475) are male and 51.2% are female (13,378). 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

740

781

857

1058

844

814

773

987

1036

900

744

707

588

547

590

514

424

752

819

906

1025

886

784

747

907

908

915

742

732

553

533

423

378

303

1500 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, Billesley 2006

Figure 1.1 illustrates:

• Children under school leaving age (i.e. age 0 - 19) represent 26.8% (6,938) of the Billesley population. Persons of retirement age (age 65+) account for 16.8% (4,348).

• The ward has 4.8 percentage points more under 19s and 6.2 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 Billesley 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.

• Just over a tenth (11.8%) of the population belong to non-white (BME) ethnicity groups, Pakistanis represent 2.27%, Indians 3.25% and Black Caribbeans 2.33%.

• The proportion of BME groups (11.8%) is lower than for Birmingham (32.7%), and slightly higher than for England (11.3%).

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

Billesley Birmingham England

Ethnicity groups % N* % N* % N* White 88.2 22.8 67.3 667.0 88.7 45,018.1 Asian or Asian British 6.2 1.6 20.7 207.9 5.5 2,786.6 Black or Black British 2.8 0.7 6.7 67.0 2.8 1,403.0 Mixed 2.6 0.6 3.2 31.8 1.6 829.5 Chinese or other 0.2 0.1 2.3 22.9 1.4 725.7 Total 100 25.8 100 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, Billesley is the 18th most deprived electoral ward (out of 40) in Birmingham with an overall IMD score of 33.381.

Figure 1.2 shows SOAs in Billesley by IMD quintile, 2007. Most of the area covered by Billesley 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 Billesley

Area (KM2) Population Density (persons / km

2) Population Density – Working Age

16-64 (persons/km2)

5.639 4582 3101

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 Billesley by IMD quintile, 2007

2.4. Lifestyle

Table 1.3 provides a summary of lifestyle indicators in Billesley, 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, Billesley has a lower percentage of people who binge drink (0.9 percentage points lower) and are obese (1.6 percentage points lower) but a higher proportion who smoke (5.2 percentage points higher).

• A smaller percentage of people eat healthily in Billesley (16.7%) 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 Billesley and the Birmingham and England averages.

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

Year Billesley Birmingham England

Adults who smoke 2003/05 30.1% 24.9% 24.1% Binge drinking adults* 2003/05 16.9% 17.8% 18.0% Healthy eating adults** 2003/05 16.7% 25.1% 26.3% Obese adults*** 2003/05 21.8% 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 lifestyles, 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 Billesley from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Male life expectancy has increased in Billesley over this time. However, the deficit for Billesley compared with England has increased during this time, so strategies should be developed to close this gap.

Male Life Expectancy - 3 year rolling average,

Billesley, 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 Billesley M ales

Data source: ONS

Figure 2.1 Male life expectancy for Billesley, Birmingham and England, 1995/97 to 2005/07

Figure 2.2 shows the trend in female life expectancy in Billesley from 1995/97 to 2005/07 on a 3-year basis, in comparison with Birmingham and England. Female life expectancy in Billesley continues to rise, however it is still lower than both city and national levels.

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Female Life Expectancy - 3 year rolling average,

Billiesley, 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 Billesley Females

Data source: ONS

Figure 2.2 Female life expectancy for Billesley, 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 Billesley is lower than city and national averages. The gap for male life expectancy between Billesley and England has increased, whilst the gap for female life expectancy has closed slightly.

• Male life expectancy has increased by 2.8%, from 73.6 years in 1995/97 to 75.7 years in 2005/07.

• The gap in male life expectancy between Billesley and England has doubled from 1.0 years to 2.0 years.

• Female life expectancy has increased by 2.9% from 78.0 years in 1995/97 to 80.2 years in 2005/07.

• The gap in female life expectancy between Billesley and England has shortened from 1.7 years to 1.6 years.

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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 Billesley, 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.

Billesley 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 Year

Rate

per

1,0

00

Birmingham England

M ost Deprived Quintile in Bham Billesley

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 Billesley Birmingham, England and the most deprived quintile in Birmingham, 1999-2007

As illustrated in Figure 2.3, in 2005/07, the IMR in Billesley is higher than in England, whilst being similar to Birmingham overall. 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 has increased by 42.0%. However, Birmingham’s IMR has decreased.

• Over this time, the gap in IMR between the most deprived quintile SOAs in Birmingham and Billesley has decreased from 5.9 to 1.8 per 1,000. There have been consistent improvements in the most deprived quintile, while the ward’s rate has increased dramatically over this time.

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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 Billesley and England has increased from 0.0 to 3.1 per 1,000.

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 Billesley.

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 72.9% of the overall DSR. This percentage is lower than the Birmingham average but in line with local PCT levels, which vary from 72% to 82%.

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

DSR % out of all causes rate*

All Causes 700.0

100.0%

All Cancers 200.4 28.7%

All Circulatory Diseases 207.2 29.6%

Coronary Heart Disease 102.9 14.7%

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

Data source: National Centre for Health Outcomes Development