Transcript Document

Tackling Health Inequalities Locally
Dr Paul Edmondson-Jones
Portsmouth City Teaching PCT
Portsmouth City Council
Thursday 25th September 2008
A Map of Portsmouth
Paulsgrove
Paulsgrove
Cosham
Cosham
Farlington
& Farlington
Drayton &
Drayton
Index of Multiple
Deprivation 2007
England Deprivation Quintile
IMD 2007
Hilsea
Hilsea
Most Deprived
Copnor
Copnor
Least Deprived
Of the 123 SOAs in Portsmouth
City, 24 are in the 20% most
deprived in England
Nelson
Nelson
Baffins
Baffins
Fratton
Fratton
Dickens
Charles Dickens
Charles
Thomas
St. Thomas
St.
Jude
St. Jude
St.
Of the 14 electoral wards in
Portsmouth City, 7 have SOAs in
the 20% most deprived in England
Central
Central
Southsea
Southsea
Milton
Milton
&
Eastney &
Eastney
Craneswater
Craneswater
Source: Department for Communities and Local Government
Health Inequalities in Portsmouth
Life expectancy at birth (yrs)
Life Expectancy at Birth
Portsmouth City electoral wards, 2000-2004
Portsmouth City average = 77.8 yrs
82
England average = 78.5
80
78
76
74
72
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70
source: South East Public Health Observatory, may 06
Life Story of Janet and John
Demography
Charles Dickens
Drayton &
Farlington
Age band
Age band
Males
10%
8%
6%
4%
2%
Males
Females
80-84
70-74
70-74
60-64
60-64
50-54
50-54
40-44
40-44
30-34
30-34
20-24
20-24
10-14
10-14
0-4
0-4
0%
2%
4%
6%
8%
10%
10%
8%
6%
Females
80-84
4%
2%
Source: Hants County Council Small Area Population Forecasts
0%
2%
4%
6%
8%
10%
Births to Young Mothers 2000-04
(under
20)
Charles Dickens
Drayton & Farlington
% of births 19.8%
% of births 2.6%
Source: Child Health Surveillance System (ad-hoc)
Births to Young Mothers 2000-04
Paulsgrov e
Cosham
Dray ton & Farlington
Hilsea
Copnor
Nelson
Baf f ins
Fratton
Charles Dickens
Milton
St. Thomas
St. Jude
Central
Southsea
Eastney &
Craneswater
Source: Child Health Surveillance System (ad-hoc)
% of births to
mothers under 20 y rs
15.01
10.01
6.01
3.01
2.58
to
to
to
to
to
19.77
15.00
10.00
6.00
3.00
Infant Mortality
(under 1 year old)
Charles Dickens
Drayton & Farlington
Rate / 1000 live births
4.85
Rate / 1000 live births
0.2
Source: ONS Public Health Mortality File
Childhood Vaccination
Uptake Rate
Primary Vaccinations
Charles Dickens
Drayton & Farlington
93.8%
96.5% (highest)
MMR Vaccinations
Charles Dickens
Drayton & Farlington
90.4%
85.4% (lowest)
Source: Child Health Surveillance System
Children aged 0-15 years dependent on
families with workless benefits, April 2007
Charles Dickens
Drayton & Farlington
numbers
rates
numbers
rates
1570
471
80
36
Source: Departent of Work and Pensions June 2008. Rate per 1,000 children aged 0-15yrs
Dental Caries 2006
by school
Charles Dickens
Somers Park Primary
School
DMFT Score
4.23
(highest)
Drayton & Farlington
Solent Infant School
DMFT Score 0.78
(lowest)
Source: British Association for the Study of Community Dentistry, Epidemiological Surveys of 5 year old children, 2006
Dental Caries trends
IMD 2004
ov erall score
most depriv ed
2006 DMFT Score
By School, Year One
0.00 to 0.99
1.00 to 1.99
least depriv ed
2.00 to 2.99
4.23
Source: British Association for the Study of Community Dentistry, Epidemiological Surveys of 5 year old children, 2006
Childhood Accident Admissions
(0-5 years)
Charles Dickens
at home
in the street
41
2
Source: HealthCare Purchaser System
Drayton & Farlington
at home
in the street
5
0
Looked After Children
% of children
aged <16 years
in low income families
55 to 80
40 to 54
25 to 39
10 to 24
Looked A fter C hildren
Source: Portsmouth Unitary Authority Social Services
Looked After Children
overlaid on
% of children aged <16
years in low-income
families
Teenage Conceptions
2002-2004
Charles Dickens
numbers
Rates
89
99
Drayton & Farlington
numbers
Rates
13
19
Source: ONS Teenage Pregnancy Unit. rates per 1000 females aged 15-17 yrs
Screening Uptake Rates
Charles Dickens
Drayton & Farlington
Breast
60.06
Breast
72.15
Cervical
63.97
Cervical
82.40
Source: PPSA
Lifestyle & Risk factors
Charles Dickens
Drayton & Farlington
% of smokers >18
43%
% of smokers >18
13%
% 4 wk quitters
44%
% 4 wk quitters
63%
NOT eating 5 a day
70%
NOT eating 5 a day
55%
Binge drinking
23%
Binge drinking
16%
Insufficient or no Ex
83%
Insufficient or no eX
57%
Obese adults
27%
Obese adults
Source: various sources
6%
Health Inequalities in Portsmouth
Life expectancy at birth (yrs)
Life Expectancy at Birth
Portsmouth City electoral wards, 2000-2004
Portsmouth City average = 77.8 yrs
82
England average = 78.5
80
78
76
74
72
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70
source: South East Public Health Observatory, may 06
Know Your Gap
I keep six honest serving-men
(They taught me all I knew)
Their names are What and Why and When
And How and Where and Who
Rudyard Kipling
Breakdown of Life Expectancy Gap by disease group and gender
Portsmouth City teaching Primary Care Trust
Males
Females
100%
100%
90%
90%
All circulatory disease, 29%
80%
All circulatory disease, 33%
80%
41%
47%
70%
70%
60%
60%
All cancers, 21%
All cancers, 21%
12%
50%
50%
15%
8%
40%
40%
Respiratory disease, 16%
Respiratory disease, 20%
5%
9%
30%
6%
2%
20%
30%
Digestive, 10%
External causes, 6%
18%
10%
Other, 9%
7%
20%
2%
10%
England Spearhead Group
1%
External causes, 4%
Other, 10%
Deaths under 28 days, 4%
0%
Portsmouth
17%
Deaths under 28 days, 4%
0%
Digestive, 9%
9%
Infectious
and
parasitic
disease, 2%
0%
Portsmouth
England Spearhead Group
Infectious
and
parasitic
disease, 2%
Breakdown of Life Expectancy Gap by age group and gender
Portsmouth City teaching Primary Care Trust
Males
Females
01-09, 1%
100%
90%
80%
2%
11%
2%
0%
1%
90%
30-39, 4%
9%
20-29, 1%
40-49, 10%
2%
5%
10-19, 1%
2%
0%
100%
<1, 6%
7%
0%
<1, 10%
10-19, 0%
30-39, 3%
40-49, 8%
80%
50-59, 14%
22%
70%
70%
50-59, 18%
22%
60%
60%
60-69, 23%
50%
50%
60-69, 27%
35%
40%
40%
33%
30%
30%
70-79, 24%
20%
70-79, 30%
20%
19%
10%
16%
10%
80+, 15%
80+, 8%
0%
4%
Portsmouth
8%
0%
England Spearhead Group
Portsmouth
01-09, 1%
England Spearhead Group
20-29, 1%
Portsmouth City Teaching PCT (5FE) Mosaic Types
51; 3%
52; 7%
53; 1% 12; 1%
13; 10%
14; 1%
18; 6%
48; 1%
47; 11%
21; 6%
44; 1%
23; 3%
43; 1%
42; 1%
41; 6%
24; 10%
39; 1%
25; 3%
37; 13%
12
48
13
51
14
52
18
53
21
23
24
34; 3% 33; 3%
25 31 33 34
31; 8%
37
39
41
42
43
44
47
Take action to help
Male Life Expectancy at Birth
1991/03 – 2009/11
StHA
GOSE
England & Wales
Portsmouth City
Linear (Portsmouth City)
80
79
life expectancy at birth
78
77
76
75
74
73
72
71
target
baseline
70
1991-
1992-
1993-
1994-
1995-
1996-
1997-
1998-
1999-
2000-
2001-
2002-
2003-
2004-
2005-
2006-
2007-
2008-
2009-
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
source: compendium of clinical and health indicators or national statics online
Female Life Expectancy at Birth
1991/03 – 2009/11
England & Wales
GOSE
StHA
Portsmouth City
Linear (Portsmouth City)
84
life expectancy at birth
83
82
81
80
79
78
77
target
baseline
76
1991-
1992-
1993-
1994-
1995-
1996-
1997-
1998-
1999-
2000-
2001-
2002-
2003-
2004-
2005-
2006-
2007-
2008-
2009-
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
source: compendium of clinical and health indicators or national statistics online