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West Midlands Key Health Data 2011/12. Launch Event Monday 18 March 2013 12.30pm – 3.30pm Michael Tippett Room, Staff House University of Birmingham. Chapter 7 Measuring inequalities in small area life expectancy. Chapter contributions from: West Midlands Cancer Intelligence Unit - PowerPoint PPT Presentation
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Chapter 7 Measuring inequalities in small area life expectancy
West Midlands Key Health Data 2011/12
Launch EventMonday 18 March 2013
12.30pm – 3.30pmMichael Tippett Room, Staff House
University of Birmingham
Chapter contributions from:West Midlands Cancer Intelligence UnitHealth Protection Agency West MidlandsThe Perinatal InstituteNHS WarwickshireWarwickshire County CouncilStaffordshire County Council / NHS Staffordshire and NHS Stoke-on-TrentHeart of England Foundation TrustWest Midlands Commissioning Support Unit
Chapter 7 Measuring inequalities in small area life expectancy
West Midlands Key Health Data 2011/12
Measuring inequalities in small area life expectancy
Daniel Eayres, Jane Fletcher, WMCSU
Paul Kingswell, NHS Warwickshire
Why measure life expectancy?
West Midlands Key Health Data 2011/12 Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
Longstanding and widely used measure of overall health outcome
Quantifies mortality risks in a readily understandable metric
Used in previous PSA target to reduce health inequalities between LAs
Public Health Outcomes Framework – Overarching outcomes
increased healthy life expectancy, i.e. taking account of the health quality as well as the length of life;
reduced differences in life expectancy and healthy life expectancy between communities (through greater improvements in more disadvantaged communities).
Life expectancy in the West Midlands
West Midlands Key Health Data 2011/12 Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
Male life expectancy at birth by region, England 2008-10
75
76
77
78
79
80
81
SOUTH EAST
EAST OF ENGLAND
SOUTH WEST
LONDON EAST MIDLANDS
WEST MIDLANDS
YORKSHIRE AND THE HUMBER
NORTH EAST
NORTH WEST
ENGLAND
Life
exp
ecta
ncy
year
s
Region
Source: Compendium of Population Health Indicators, NHS Information Centre.
Life expectancy in the West Midlands
West Midlands Key Health Data 2011/12
Chapter 7 Measuring inequalities in small area life expectancy
Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
Female life expectancy at birth, England and the West Midlands 1991-93 to 2008-10
76
77
78
79
80
81
82
83
Life
exp
ecta
ncy
year
s
Time Period
ENGLAND WEST MIDLANDS
Source: Compendium of Population Health Indicators, NHS Information Centre.
Life expectancy by local authority
West Midlands Key Health Data 2011/12 Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
Life expectancy at birth by local authority, West Midlands 2008-10
Males Females
Life expectancy by local authority
West Midlands Key Health Data 2011/12
Chapter 7 Measuring inequalities in small area life expectancy
Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
y = -0.1378x + 81.097R² = 0.7528
75
76
77
78
79
80
81
0 5 10 15 20 25 30 35 40
Life
exp
ecta
ncy
(yea
rs)
Index of Multiple Deprivation 2010 (average score)
Source: Compendium of Population Health Indicators, NHS Information Centre; Indices of Deprivation 2010, Department for Communities and Local Government.
Male life expectancy at birth vs. Deprivation by local authority, West Midlands 2008-10
Small area geographies
West Midlands Key Health Data 2011/12
Chapter 7 Measuring inequalities in small area life expectancy
Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
Electoral Wards● Politically relevant● Frequent boundary changes● Large variation in population size
Super Output Areas - Lower (LSOA) and Middle (MSOA)● Not directly associated with admin/constiuency areas● Stable boundaries● Little variation in population size
West Midlands○ Wards n = 719, avg pop = 7,800 (LA avg 3,400 - 26,800)○ MSOAsn = 735, avg pop = 7,600 (LA avg 6,200 - 9,200)○ LSOAs n = 3,487, avg pop = 1,600 (LA avg 1,50-1,700)
Life expectancy by small area geography
West Midlands Key Health Data 2011/12 Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
Life expectancy at birth by small area, West Midlands 2008-10
By ward By MSOA
Life expectancy by small area geography
West Midlands Key Health Data 2011/12 Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
Life expectancy at birth by small area, West Midlands Metropolitan County 2008-10
By ward By MSOA
Life expectancy by small area geography
West Midlands Key Health Data 2011/12
Chapter 7 Measuring inequalities in small area life expectancy
Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
y = -0.1673x + 81.718R² = 0.6386
65
70
75
80
85
90
95
0 10 20 30 40 50 60 70 80
Life
exp
ecta
ncy
(yea
rs)
Index of Multiple Deprivation 2010 (average score)
Source: Health profiles – local health, Network of Public Health Observatories; Indices of Deprivation 2010, Department for Communities and Local Government.
Male life expectancy at birth vs. Deprivation by MSOA, West Midlands 2008-10
Slope Index of Inequality
West Midlands Key Health Data 2011/12 Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
Indicator 0.2i: Slope index of inequality (SII) in life expectancy at birth based on national deprivation deciles of Lower Super Output Areas (LSOAs) within England [National level].
Indicator 0.2ii: Number of upper tier local authorities for which the local SII in life expectancy (as defined in 0.2.iii) has decreased [National level].
Indicator 0.2iii: SII in life expectancy at birth within each English upper tier local authority, based on local deprivation deciles of LSOAs [LA level].
Public Health Outcomes Framework life expectancy inequalities
Slope Index of Inequality
West Midlands Key Health Data 2011/12
Chapter 7 Measuring inequalities in small area life expectancy
Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
70
72
74
76
78
80
82
84
86
88
90
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Life
Expe
ctan
cy at
Birt
h (y
ears
)
Percentage of population, ranked from high to low IMD score
Life Expectancy by Deprivation Deciles, showing the Slope Index of InequalityWarwickshire, Males, 2006-10
Slope Index of Inequality = 8.3 years (95% Confidence Interval: 6.0 to 10.6)
Inequality Slope
Life Expectancy with 95% confidence limits
Source: Health Inequality Indicators, Network of Public Health Observatories.
Male life expectancy at birth by deprivation decile showing the SII, Warwickshire 2006-10
Slope Index of Inequality
West Midlands Key Health Data 2011/12
Chapter 7 Measuring inequalities in small area life expectancy
Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
ONS Area code
LA Name Males Females
SII 95% confidence
limits
SII 95% confidence
limits Lower Upper Lower Upper
E06000019 Herefordshire, County of UA 4.8 1.1 8.4 4.1 1.0 7.2 E06000051 Shropshire UA 6.7 4.2 9.1 4.3 2.8 5.8 E06000021 Stoke-on-Trent UA 8.2 5.7 10.7 4.7 1.0 8.5 E06000020 Telford and Wrekin UA 7.0 4.3 9.6 2.8 -1.3 6.8 E10000028 Staffordshire 8.0 6.9 9.1 6.2 4.0 8.5 E10000031 Warwickshire 8.3 6.0 10.6 7.6 5.2 9.9 E10000034 Worcestershire 7.8 5.6 10.0 5.4 4.0 6.8 E08000025 Birmingham 10.8 9.2 12.5 5.9 4.3 7.5 E08000026 Coventry 11.7 9.8 13.7 7.9 5.1 10.8 E08000027 Dudley 9.9 8.7 11.0 5.7 3.4 8.1 E08000028 Sandwell 9.6 7.5 11.8 6.4 4.3 8.6 E08000029 Solihull 10.8 8.3 13.2 10.3 7.7 12.8 E08000030 Walsall 10.8 8.9 12.6 6.9 3.2 10.5 E08000031 Wolverhampton 9.7 7.4 11.9 5.8 2.8 8.8
Source: Health Inequality Indicators, Network of Public Health Observatories.
SII for life expectancy at birth by upper-tier local authority and gender West Midlands 2006-10
Summary Points
West Midlands Key Health Data 2011/12
Chapter 7 Measuring inequalities in small area life expectancy
Chapter 7 Measuring inequalities in small area life expectancyDaniel Eayres, Jane Fletcher, WMCSU; Paul Kingswell, NHS Warks
LE is a high profile outcome indicator that needs to be monitored by HWBs, including the assessment of within local authority inequality.
Life expectancy in the West Midlands is continuing to improve but has remained persistently below the national average for both men and women.
The range between the highest and lowest local authority districts LEs in the West Midlands is ~5 years for males and ~4 years for females.
Significant variation in LE at the ward, MSOA and LSOA deprivation deciles levels using 5-years of mortality data.
At all area levels there is a strong association between LE and deprivation. The association is stronger and the relationship steeper for males than for females.
Wide inequalities in life expectancy exist within even those local authorities that have high life expectancies overall.
SII values for WM upper-tier LAs range from 4.8 to 11.7 years for males and 2.8 to 10.3 years for females.
Measuring the change in the SII over time in individual LAs will be problematic as the confidence intervals are wide and long time periods are needed.
Chapter 7 Measuring inequalities in small area life expectancy
West Midlands Key Health Data 2011/12
END
Daniel Eayres, Jane Fletcher, WMCSU
Paul Kingswell, NHS Warwickshire