Transcript Health Inequalities in the East Midlands

Health Inequalities in the East
Midlands
David Meechan
Director, East Midlands Public
Health Observatory
Outline
• Brief overview of health in East Midlands
• Examples of health inequalities in the
Region, focussing on national targets and
Regional priorities
• Demonstrate link between deprivation and
health inequalities in East Midlands
All Cause SMR by Region
2001 Census – Self Reported
Health
• Limiting long-term illness
E.Midlands 18.4%, England 17.9%
• Permanent sickness or disability
E.Midlands 5.3%, England 5.5%
Death rates from accidents by region
Health inequality in the East
Midlands
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Geographical area
Socioeconomic status
Ethnicity
Age
Gender
Disability
National health inequality target –
life expectancy
Starting with local authorities, by 2010 to
reduce by at least 10 per cent the gap
between the fifth of areas with the lowest
life expectancy at birth and the population
as a whole
Male life expectancy by local authority
Female life expectancy by local authority
Nottinghamshire Male Life Expectancy by ward
Derbyshire Female Life Expectancy by Ward
Socio-Economic Determinants
of Health
“The weight of scientific evidence supports
a socio-economic explanation of health
inequalities. This traces the roots of ill
health to such determinants as income,
education and employment as well as to
the material environment and lifestyle.”
Acheson Inquiry into Inequalities on Health,
1998
Male life expectancy and deprivation, LAs
Index of Multiple Deprivation by Ward
Life expectancy and deprivation at ward level
National health inequality target –
infant mortality
• Starting with children under one year, by
2010 to reduce by at least 10 per cent the
gap in mortality between manual groups
and the population as a whole.
Infant mortality rates by Social Class East Midlands
12
Rate per 1,000 live births
10
8
6
4
2
0
I
II
IIIN
IIIM
IV
V
Low Birth weight babies in Nottingham City
Child Poverty in Nottingham City
National inequality target – teenage
pregnancy
• To reduce the under-18 conception rate by
50% by 2010
• To reduce by at least 60% by 2010 the
conception rate among uder-18s in the
worst 20% of wards,thereby reducing the
level of inequality between these areas
and the average by at least 26%
Teenage pregnancy by local authority
Correlation between East Midlands Local Authority
teenage pregnancy rates and deprivation
80
70
Rate per 1000 women aged 15-17
60
50
40
30
20
10
0
0
1000
2000
3000
4000
5000
Deprivation - Average of ward ranks
6000
7000
8000
Teenage Pregnancy in the East
Midlands
• Four-fold variation between LAs
• 60% of teenage pregnancies occurred in
only 22% of wards
• 4% of wards accounted for 20% of
teenage pregnancies
Inequalities in self reported health –
Census 2001
• People reporting health as “not good”
Bolsover 13.7%
S.N’hants 5.8%
• Limiting long-term illness
Bolsover 26%, Mansfield 24%, E.Lindsey 24%
S.N’hants 13%, Daventry 14%, Harborough 14%
Permanent sickness rate by LA
Erewash Health Survey
Inequalities among people aged 65-74
Representative Deprived
excellent or very good health (men)
24%
14%
not very happy/very unhappy (women)
12%
24%
smoking (women)
14%
23%
symptoms of angina - Grade 2 (men)
7%
14%
problem(s) with condition of house/flat
28%
37%
5%
12%
overall quality of life poor/v.poor
Trends in obesity
Obesity by social class
Smoking trends in East Midlands
Smoking trends by social class
Investment for Health – Action to
reduce inequalities
• Addressing the determinants of health
- most deprived areas suffer worst health
• Supporting healthy lifestyles
- manual groups have unhealthiest lifestyles
• Protecting health
- childhood accidents correlated with deprivation
• Health service provision
- utilisation of services is not in line with need
Further information
• www.empho.org.uk
• Local PCTs (eg local health profiles and
DPH Annual reports)
• Local observatories (eg Lincolnshire
Research Observatory)