Causes of Early Death in Wolverhampton · 2019-01-09 · Infant Mortality Infant Mortality rate (IMR) is defined as number of deaths under the age of one year, per 1000 live births.

Causes of Early Death in Wolverhampton

Table of Contents

S.No Title Page No.

2 Causes of Early death 1

2.1 Infant Mortality 5

2.2 Mortality in persons under 75 from all causes 12

2.3 Mortality in persons under 75 from cancer 15

2.4 Mortality in persons under 75 from cardiovascular diseases 21

2.5 Mortality in persons under 75 from liver diseases 30

2.6 Mortality in persons under 75 from respiratory diseases 35

2.7 Mortality rate from communicable diseases 39

2.8 Mortality rate from causes considered preventable 42

2.9 Excess mortality rate in adults with serious mental illness 46

2.10 Suicide (and injury of undetermined intent) 49

2.11 Deaths attributable to smoking 53

2.12 Excess winter deaths 56

Version Control

Version Status Description of

version Date

Completed Distributed to Date of

distribution

1.1 Draft Chapter 1 and 2 25/04/2016 Health and Wellbeing

Board 27/04/2016

1.2 Draft Chapter 1 and 2 03/08/2016 JSNA Steering Group 04/08/2016

1.3 Draft Chapter 2 22/11/2016 Health and Wellbeing

Board 22/11/2016

Summary of outcomes Section Outcome

Latest data refresh year

Last data refresh year

Wolverhampton figure latest data

Better or worse compared to last data refresh

Better or worse compared to England (latest data)

Causes of early death Infant Mortality 2013/15 2012/14 5.6 (per 1000 live births1)

6.4 (per 1000 live births) 3.9 (per 1000 live births)

Causes of early death Mortality in persons under 75 from all causes 2012/14 2011/13 412.4 (DSR2 per 100,000)

408.5 (DSR per 100,000) 339.5 (DSR per 100,000)

Causes of early death Mortality in persons under 75 from cancer 2012/14 2011/13 158.8 (DSR per 100,000)

152.4 (DSR per 100,000) 141.5 (DSR per 100,000)

Causes of early death Mortality in persons under 75 from lung cancer 2012/14 2011/13 37.2 (DSR per 100,000) 35.5 (DSR per

100,000) 33.8 (DSR per 100,000)

Causes of early death Mortality in persons under 75 from cardiovascular diseases 2012/14 2011/13 97.4 (DSR per 100,000)

97.9 (DSR per 100,000) 75.7 (DSR per 100,000

Causes of early death Mortality in persons under 75 from Coronary Heart Disease 2012/14 2011/13 52.7 (DSR per 100,000)

55.7 (DSR per 100,000) 41.9 (DSR per 100,000)

Causes of early death Mortality in persons under 75 from Stroke 2012/14 2011/13 16.6 (DSR per 100,000) 15.1 (DSR per

100,000) 13.9 (DSR per 100,000)

Causes of early death Mortality in persons under 75 from liver diseases 2012/14 2011/13 28 (DSR per 100,000)

28.9 (DSR per 100,000) 17.8 (DSR per 100,000)

Causes of early death Alcohol related mortality rate 2012/14 2011/13 17.4 (DSR per 100,000) 18 (DSR per

100,000) 11.6 (DSR per 100,000)

Causes of early death Mortality in persons under 75 from respiratory diseases 2012/14 2011/13 45.3 (DSR per 100,000)

47.1 (DSR per 100,000) 32.6 (DSR per 100,000)

Causes of early death Mortality rate from communicable diseases 2012/14 2011/13 28 (DSR per 100,000) 31.9 (DSR per

100,000) 17.8 (DSR per 100,000)

Causes of early death Mortality rate from causes considered preventable 2012/14 2011/13

213.3 (DSR per 100,000)

209.2 (DSR per 100,000) 182.7 (DSR per 100,000)

Causes of early death Excess mortality rate in adults with serious mental illness 2012/14 2011/13 378.2 (ISR3) 329.7 (ISR) 351.8 (ISR)

Causes of early death Suicide (and injury of undetermined intent) 2012/14 2011/13 8.8 (DSR per 100,000) 8.5 (DSR per

100,000) 8.9 (DSR per 100,000)

Causes of early death Deaths attributable to smoking 2012/14 2011/13 307.3 (DSR per 100,000)

306.7 (DSR per 100,000) 274.8 (DSR per 100,000)

Causes of early death Excess winter deaths (all ages) 2011/14 2010/13 16.2 (Ratio) 20.8 (Ratio) 15.6 (Ratio)

Causes of early death Excess Winter deaths (aged 85+) 2011/14 2010/13 19.5 (Ratio) 25.2 (Ratio) 22.3 (Ratio) 1 Live Births implies birth following pregnancy where the fetus shows evidence of life such as breathing 2 DSR: Directly Standardised Rate is a method of standardisation used to account for the differences in populations for example, age and sex and to allow for comparisons between different areas. 3 ISR: Indirectly standardised Ratio is a method of standardisation used to account for differences in populations

Infant Mortality in Wolverhampton

Infant Mortality Infant Mortality rate (IMR) is defined as number of deaths under the age of one year, per 1000 live births. It consists of 2 components: • Neonatal mortality rate: rate of neonatal deaths

(those occurring during the first 28 days of life) per 1000 live births

• Post-neonatal mortality rate: rate of infants death occurring between 28 days and less than one year per 1000 live births

Neonatal mortality is considered to reflect the health and care needs of both mother and new-born.

5.6

Infant Mortality in Wolverhampton is reducing

Wolverhampton 2013/15 (per 1000 live births)

England 2013/15 (per 1000 live births)

3.9 2001/03 2013/15

Number of neonatal deaths in Wolverhampton

2004 2014

Neonatal Deaths

(per 1000 live births)

2.3

12

0

2

4

6

8

10

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Infant Mortality: Time trend

Wolverhampton England

0

5

10

15

20

25

30

35

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Nu

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of

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s Deaths in Infants before 28 days in Wolverhampton 2004-2014

Before 28 days Between 28 days and 1 year

Infant Mortality in Wolverhampton is worse compared to 11 of the 15 CIPFA nearest neighbours.

Infant mortality in Wolverhampton is 10th highest compared to other local authorities and is significantly higher compared to England.

Infant Mortality in Wolverhampton compared to other local authorities

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Infant Mortality in Wolverhampton 2013-15: Compared to other local authorities in England

Infant Mortality

• In 2005-14, infant mortality is worse in 3 wards of Wolverhampton: Bushbury North, St Peters and Heath Town

• In 2005-14, Infant mortality is lowest in Graiseley followed by Tettenhall Wightwick and East Park.

• In 2005-14, rate of still births is worse in 3 wards of Wolverhampton: Wednesfield South, Graiseley and Ettingshall

• In 2005-14, rate of still births is lowest in 4 wards of Wolverhampton: Bushbury North, Fallings Park, Penn and Blakenhall

Risks factors for Infant Mortality in Wolverhampton 2004-2014

7 out of 10 infant deaths in Wolverhampton are in the most deprived areas

57% of infant deaths are in low

birth weight babies

63% of infant deaths are in babies born

prematurely at 34 weeks

1 in 3 mothers smoke at time of delivery

22% mothers are obese

6% mothers are under 18

10% of infant deaths are in babies with

congenital abnormalities

14% mothers are booked late for antenatal care

What does this information tell me? • Infant mortality in Wolverhampton has remained fairly static,

despite a recent downward trend, and is worse than most local authorities in England.

• Infant Mortality is influenced by a range of risk factors including smoking during pregnancy and early access to healthcare

Indicative Commissioning Needs • Improving the risk factors through various commissioned services

including – promoting early booking and attendance for antenatal care – preventing poor lifestyle choices including smoking during pregnancy,

obesity and teenage conceptions – improving outcomes for premature births, low birth weight babies and

babies from deprived areas of the City

Mortality in persons aged under 75 from All causes

Mortality rates in Under 75s from all causes

0

200

400

600

800

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

2010-2012

2011-2013

2012-2014

rate

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All cause age standardised mortality rate for persons aged under 75

Wolverhampton Comparator group West Midlands England & Wales

Premature mortality i.e. deaths occurring before a person reaches the age of 75 is a major public health concern.

Premature mortality from all causes in Wolverhampton is improving

England 2012/14 (DSR per 100,000)

412.4 339.5

Wolverhampton 2012/14 (DSR per 100,000)

3.9

2012/14 2011/13

Wolverhampton (DSR per 100,000)

204


1995/97 2012/14

Mortality rates in Under 75s from all causes

Premature mortality rate from all causes in 2010-14 is worst in most deprived

areas of Wolverhampton

528.1 117.7 2010-2014

• In 2010-2014, premature mortality due to all causes is worse in 3 wards of Wolverhampton: Bushbury South and Low Hill, St Peters and Ettingshall.

• In 2010-14, premature mortality due to

CHD is lowest in 3 wards: Tettenhall Regis, Tettenhall Wightwick and Wednesfield South.

Most Deprived

Least Deprived

0

100

200

300

400

500

600

0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100

rate

pe

r 1

00

,00

0

Deprivation quintile (0-19.9 = most deprived to 80.0-100 = least deprived)

All cause age standardised mortality rate for persons aged under 75 (2010-2014) in Wolverhampton

Quintile Wolverhampton Comparator group England & Wales

DSR per 100,000 DSR per 100,000

Mortality in persons aged under 75 from Cancer

https://thenounproject.com/term/cancer/91287

Mortality rates in Under 75s from Cancer

Premature mortality i.e. deaths occurring before a person reaches the age of 75 is a major public health concern. Cancer is one of the leading causes of premature mortality.

Premature mortality from Cancer in Wolverhampton is improving


England 2012/14 (DSR per

100,000)

158.8 141.5

1995/97 2012/14

44.6


6.4

2012/14 2011/13





0

50

100

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200

250

Engl

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DSR

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Under 75 mortality rate for All Cancers (Persons) in Wolverhampton 2012-2014: Compared to CIPFA nearest

neighbours

Mortality rates in Under 75s from Cancer Premature mortality rate due to all cancers in Wolverhampton in 2012-14 is significantly worse compared to England and West Midlands. Premature mortality rate due to all cancers in Wolverhampton is better compared to 12 of 15 CIPFA nearest neighbours.

0

50

100

150

200

250

2001- 03

2002- 04

2003- 05

2004- 06

2005- 07

2006- 08

2007- 09

2008- 10

2009- 11

2010- 12

2011- 13

2012- 14

DSR

pe

r 1

00

,00

0

Under 75 Mortality rate from all cancers in Wolverhampton 2001-03 to 2012-14 by gender

Male Female

Premature mortality rate from all cancers in Wolverhampton has been consistently higher in males compared to females. However the gap between males and females has reduced from 56.1 per 100,000 to 26.6 per 100,000.

Mortality rates in Under 75s from Cancer

• In 2010-2014, Premature mortality due to all cancers is worse in 4 wards of Wolverhampton: Bushbury South and Low Hill, St Peters, Ettingshall and Bilston North.

• In 2010-14, premature mortality due to all cancers is lowest in Penn followed by Tettenhall Wightwick and Park

Premature mortality rate for all cancers in 2010-14 is worst in most deprived


186 57.1 2010-2014

Most Deprived

Least Deprived

0

50

100

150

200

0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100

rate

pe

r 1

00

,00

0


Cancers age standardised mortality rate for persons aged under 75 (2010-2014) in Wolverhampton


DSR per 100,000 DSR per 100,000

Mortality rates in Under 75s from Lung Cancer Premature mortality from lung cancer is an important public health concern in Wolverhampton

0

10

20

30

40

50

60

70

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

2010-2012

2011-2013

2012-2014

rate

pe

r 1

00

,00

0

Year

Lung Cancer age standardised mortality rate for persons aged under 75


Premature mortality from Lung Cancer in Wolverhampton is improving

England 2012/14 (DSR per 100,000)

37.2 33.8


13.7


1995/97 2012/14

1.7

2012/14 2011/13


https://thenounproject.com/term/lung-cancer/9855



Mortality rates in Under 75s from Lung Cancer

Premature mortality rate for lung cancer in 2010-14 is worst in most deprived


49.3 16.9 2010-2014

• In 2010-2014, premature mortality due to lung cancer is worse in 4 wards of Wolverhampton: Bushbury South and Low Hill, St Peters, Ettingshall and Graiseley.

• In 2010-14, premature mortality due to lung cancer is lowest in wards of south west: Tettenhall Regis, Park, Tettenhall Wightwick and Merry Hill.

Most Deprived

Least Deprived

0

10

20

30

40

50

60

0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100

rate

pe

r 1

00

,00

0


Lung Cancer age standardised mortality rate for persons aged under 75 (2010-14) in Wolverhampton


DSR per 100,000 DSR per 100,000

Mortality in persons aged under 75 from Cardiovascular diseases

https://thenounproject.com/term/heart/196367

Premature mortality i.e. deaths occurring before a person reaches the age of 75 is a major public health concern. Cardiovascular diseases is one of the leading causes of premature mortality.

Mortality rates in Under 75s from Cardiovascular Diseases

0

50

100

150

200

2001- 03

2002- 04

2003- 05

2004- 06

2005- 07

2006- 08

2007- 09

2008- 10

2009- 11

2010- 12

2011- 13

2012- 14

DSR

pe

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,00

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Under 75 mortality rate from cardiovascular diseases (Persons) in Wolverhampton from 2001-2003 to 2012-

2014

Wolverhampton West Midlands England

Premature mortality from Cardiovascular diseases in

Wolverhampton is improving

Wolverhampton 2012/14

(DSR per 100,000)

England 2012/14

(DSR per 100,000)

97.4 75.7

2001/03 2012/14

68.3


0.5

2012/14 2011/13





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Under 75 Mortality rate from all Cardiovascular diseases (Persons) in Wolverhampton 2012-14: Compared to

CIPFA nearest neighbours

Mortality rates in Under 75s from Cardiovascular Diseases

Premature mortality rate due to all cardiovascular diseases in Wolverhampton in 2012-14 is significantly worse compared to England and West Midlands. Premature mortality rate due to all cardiovascular diseases in Wolverhampton is better compared to 9 of 15 CIPFA nearest neighbours.

0

50

100

150

200

250

2001- 03

2002- 04

2003- 05

2004- 06

2005- 07

2006- 08

2007- 09

2008- 10

2009- 11

2010- 12

2011- 13

2012- 14

DSR

pe

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Under 75 mortality rate from cardiovascular diseases in Wolverhampton 2001-03 to 2012-14 by gender

Male Female

Premature mortality rate from cardiovascular diseases in Wolverhampton has been consistently higher in males compared to females. However the gap between males and females has reduced dramatically from 130.8 per 100,000 to 76.2 per 100,000. This has been primarily due to reduction of mortality rate in males.

020406080

100120140160180

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

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CHD age standardised mortality rate for persons aged under 75


Mortality rates in Under 75s from Coronary Heart Disease (CHD)

Premature mortality from CHD in Wolverhampton is improving

England 2012/14 (DSR per 100,000)

52.7 41.9


3

2012/14 2011/13


104.8


1995/97 2012/14




Mortality rates in Under 75s from Coronary Heart Disease (CHD)

Premature mortality rate for CHD in 2010-14 is worst in most deprived areas

of Wolverhampton

72.5 26.9 2010-2014

• In 2010-2014, premature mortality due to CHD is worse in 3 wards of Wolverhampton: St Peters, Heath Town and East Park.

• In 2010-14, premature mortality due to

CHD is lowest in wards of south west: Tettenhall Regis, Tettenhall Wightwick and Penn.

Most Deprived

Least Deprived

0

20

40

60

80

0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100

rate

pe

r 1

00

,00

0


CHD age standardised mortality rate for persons aged under 75 (2010-14) in Wolverhampton


DSR per 100,000 DSR per 100,000

Mortality rates in Under 75s from Stroke

0

10

20

30

40

50

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

2010-2012

2011-2013

2012-2014

rate

pe

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00

,00

0

Year

Stroke age standardised mortality rate for persons aged under 75


Premature mortality from Stroke in Wolverhampton is improving

England 2012/14

(DSR per 100,000)

16.6 13.9

Wolverhampton 2012/14

(DSR per 100,000)

1.5

2012/14 2011/13


31.2


1995/97 2012/14




Mortality rates in Under 75s from Stroke

Premature mortality rate for Stroke in 2010-14 is worst in most deprived areas

of Wolverhampton

22.2 5.5 2010-2014

• In 2010-2014, premature mortality due to Stroke is worse in 3 wards of Wolverhampton: Bushbury South and Low Hill, Ettingshall and Bilston East.

• In 2010-14, premature mortality due to Stroke is lowest in 2 wards: Tettenhall Wightwick and Wednesfield South.

Most Deprived

Least Deprived

0

5

10

15

20

25

0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100

rate

pe

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Stroke age standardised mortality rate for persons aged under 75 (2010-14) in Wolverhampton


DSR per 100,000 DSR per 100,000

Mortality rates in Under 75s from Circulatory Diseases

0

50

100

150

200

250

300

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

2010-2012

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Circulatory disease age standardised mortality rate for persons aged under 75


Premature mortality from circulatory diseases in Wolverhampton is

improving England

2012/14 (DSR per 100,000)

97.7 76.4


0.3

2012/14 2011/13


151.1


1995/97 2012/14




Mortality rates in Under 75s from Circulatory Diseases

Premature mortality rate for Circulatory diseases in 2010-14 is worst in most deprived areas of Wolverhampton

133 39.1 2010-2014

• In 2010-2014, premature mortality due to Circulatory diseases is worse in 4 wards of Wolverhampton: Bushbury South and Low Hill, Heath Town, Ettingshall and Bilston East.

• In 2010-14, premature mortality due to Circulatory diseaaes is lowest in 3 wards: Tettenhall Regis, Tettenhall Wightwick and Penn

Most Deprived

Least Deprived

0

50

100

150

0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100

rate

pe

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00

,00

0


Circulatory disease age standardised mortality rate for persons aged under 75 (2010-14) in Wolverhampton


DSR per 100,000 DSR per 100,000

Mortality in persons aged under 75 from Liver diseases

https://thenounproject.com/term/liver/211039

Mortality rates in Under 75s from Liver diseases

0

5

10

15

20

25

30

35

40

2001- 03

2002- 04

2003- 05

2004- 06

2005- 07

2006- 08

2007- 09

2008- 10

2009- 11

2010- 12

2011- 13

2012- 14

DSR

pe

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00

,00

0

Under 75 mortality rate from liver diseases (Persons) in Wolverhampton from 2001-2003 to 2012-2014


Premature mortality i.e. deaths occurring before a person reaches the age of 75 is a major public health concern. Liver diseases is one of the leading causes of premature mortality.

Wolverhampton 2012/14 (DSR per

100,000)

England 2012/14 (DSR per 100,000)

28 17.8

2001/03 2012/14

0.7


Premature mortality from Liver diseases in Wolverhampton is

getting slightly worse compared to 2001/03

0.9

2012/14 2011/13





Mortality rates in Under 75s from Liver diseases

Premature mortality rate due Toliver disease mortality in Wolverhampton in 2012-14 is significantly worse compared to the England and West Midlands average. Premature mortality rate due to all liver diseases in Wolverhampton is worse compared to 10 of 15 CIPFA nearest neighbours.

05

101520253035404550

2001- 03

2002- 04

2003- 05

2004- 06

2005- 07

2006- 08

2007- 09

2008- 10

2009- 11

2010- 12

2011- 13

2012- 14

DSR

pe

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,00

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Under 75 mortality rate from liver disease in Wolverhampton 2001-03 to 2012-14 by gender

Male Female

Premature mortality rate from liver diseases in Wolverhampton has been consistently higher in males compared to females. However the gap between males and females has reduced from 21.6 per 100,000 to 16.3 per 100,000

Alcohol related Mortality rates

Alcohol related mortality in Wolverhampton is getting worse

England 2012/14 (DSR per 100,000)

17.4 11.6


0.6

2012/14 2011/13


3.4


1995/97 2012/14

0

5

10

15

20

25

30

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

2010-2012

2011-2013

2012-2014

rate

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Alcohol related age standardised mortality rate for persons all ages


https://thenounproject.com/term/no-drinks/311803



Alcohol related Mortality rates

Alcohol related mortality rate in 2010-14 is worst in most deprived areas of

Wolverhampton

24.9 4.5 2010-2014

• In 2010-2014, alcohol related mortality is worse in 3 wards of Wolverhampton: St Peters, Blackenhall and East Park.

• In 2010-14, alcohol related mortality is lowest in 4 wards: Tettenhall Wightwick, Oxley, Bushbury North and Spring Vale

Most Deprived

Least Deprived

0

5

10

15

20

25

30

0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100

rate

pe

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,00

0


Alcohol related age standardised mortality rate for persons all ages (2010-2014) in Wolverhampton


DSR per 100,000 DSR per 100,000

Mortality in persons aged under 75 from Respiratory Diseases

https://thenounproject.com/term/lungs/649

Respiratory disease is one of the top causes of death in England in under 75s and smoking is the major cause of chronic obstructive pulmonary disease (COPD), one of the major respiratory diseases

Mortality rates in Under 75s from Respiratory Diseases

0

10

20

30

40

50

2001 -03

2002 -04

2003 -05

2004 -06

2005 -07

2006 -08

2007 -09

2008 -10

2009 -11

2010 -12

2011 -13

2012 -14

Under 75 Mortality rate from respiratory diseases in Wolverhampton 2001-03 to 2012-14


Premature mortality from respiratory disease in

Wolverhampton has worsened since 2001-03 with peaks and troughs

throughout


100,000)

England 2012/14 (DSR per 100,000)

45.3 32.6

2001/03 2012/14

1.2


1.8

2012/14 2011/13






Premature mortality rate from respiratory diseases in Wolverhampton in 2012-14 is significantly worse compared to the England and West Midlands average. Premature mortality rate from respiratory diseases in Wolverhampton is better compared to 10 of 15 CIPFA nearest neighbours.

0

10

20

30

40

50

60

70

2001- 03

2002- 04

2003- 05

2004- 06

2005- 07

2006- 08

2007- 09

2008- 10

2009- 11

2010- 12

2011- 13

2012- 14

DSR

pe

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00

,00

0

Mortality rate in persons aged under 75 from respiratory diseases in Wolverhampton 2001-03 to 2012-14 by

gender

Male Female

Premature mortality rate from respiratory diseases in Wolverhampton has been consistently higher in males compared to females. However the gap between males and females has reduced from 29 per 100,000 to 19 per 100,000.


Premature mortality from respiratory diseases is worse in

North East, South East and Inner City areas of Wolverhampton

•In 2010-2014, premature mortality from respiratory diseases is worse in 3 wards of Wolverhampton: St Peters, Blackbury South and Low Hill and Ettingshall. •In 2010-14, premature mortality from respiratory diseases is lowest in 5 wards: Tettenhall Wightwick, Tettenhall Regis, Merry Hill, Penn and Wednesfield South.

Mortality rate from communicable diseases

https://thenounproject.com/term/infectious-disease/613

Mortality rate from Communicable diseases

Prevention of the spread of communicable diseases is an important issue for Public Health. There is evidence that rapid identification, treatment and prevention of spread can reduce mortality.

Communicable diseases are infectious diseases transmissible (as from person to person) by direct contact with an affected individual or individual's discharges or by

indirect means (as from a vector). These include deaths recorded as following ICD 10 codes • infectious and parasitic diseases A00-B99 • Influenza J09-J11 • Pneumonia J12-J18

0

20

40

60

80

100

120

140

2001- 03

2002- 04

2003- 05

2004- 06

2005- 07

2006- 08

2007- 09

2008- 10

2009- 11

2010- 12

2011- 13

2012- 14

DSR

pe

r 1

00

,00

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Mortality rate from communicable diseases in Wolverhampton 2001/03 - 2012/14



100,000)

England 2012/14 (DSR per 100,000)

28 17.8 2001/03 2012/14

38.4


Mortality rate from Communicable diseases in Wolverhampton is improving

3.9

2011/13 2012/14




020406080

100120

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Mortality rate from communicable diseases (persons) in Wolverhampton 2012-14: Compared to CIPFA nearest

neighbours

Mortality rate from Communicable diseases

Mortality rate from Communicable diseases in Wolverhampton in 2012-14 is better compared to England, West Midlands as well as most of the CIPFA nearest neighbours except Walsall.

Mortality rate from communicable diseases in Wolverhampton has been consistently higher in males compared to females. However the gap between males and females has reduced from 26.6 per 100,000 to 19.1 per 100,000

Mortality rate from causes considered preventable

https://thenounproject.com/term/public-health-clinic/6435

Mortality rate from causes considered preventable The basic concept of preventable mortality is that deaths are considered preventable if, in the light of the understanding of the determinants of health at the time of death, all or most deaths from the underlying cause (subject to age limits if appropriate) could potentially be avoided by public health interventions in the broadest sense.


100,000)

England 2012/14 (DSR per 100,000)

213.3 182.7 2001/03 2012/14

70.7


Mortality rate from causes considered preventable in Wolverhampton is improving

4.1

2011/13 2012/14

0

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100

150

200

250

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2001 - 03 2002 - 04 2003 - 05 2004 - 06 2005 - 07 2006 - 08 2007 - 09 2008 - 10 2009 - 11 2010 - 12 2011 - 13 2012 - 14

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Mortality rate from causes considered preventable in Wolverhampton 2001-03 to 2012-14





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Mortality from causes considered preventable (persons) in Wolverhampton 2012-14: Compared to CIPFA nearest

neighbours


Mortality rate from all causes considered preventable in Wolverhampton in 2012-14 is significantly worse compared to the England and West Midlands average. Mortality rate from all causes considered preventable in Wolverhampton is better compared to 13 of 15 CIPFA nearest neighbours.

Mortality rate from causes considered preventable in Wolverhampton has been consistently higher in males compared to females. However the gap between males and females has reduced from 189.8 per 100,000 to 128.4 per 100,000

0

20

40

60

80

100

120

140

2001 -03

2002 -04

2003 -05

2004 -06

2005 -07

2006 -08

2007 -09

2008 -10

2009 -11

2010 -12

2011 -13

2012 -14

DSR

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Mortality rates from causes considered preventable in Wolverhampton 2001-03 to 2012-14 by specific preventable

causes

cardiovascular cancer liver disease respiratory disease


2001/03 2012/14

2.3


Mortality rate from liver disease considered preventable

2001/03 2012/14

53.2


Mortality rate from cardiovascular disease considered preventable

2001/03 2012/14

23.4


Mortality rate from cancer considered preventable

2001/03 2012/14

0.1


Mortality rate from respiratory disease considered preventable





Excess Mortality rate in adults with serious mental illness

https://thenounproject.com/term/mental-health/566

Excess mortality rate in adults with serious mental illness

The Disability Rights Commission has reported on serious inequalities experienced, in terms of reduced life expectancy, by those with severe mental illness. There is extensive published evidence that people with severe mental illness, such as schizophrenia, die between 15 and 25 years earlier than the average for the general population.

The ratio is expressed as a percentage of the observed number of deaths in adults in contact with secondary mental health services to the expected number of deaths in that population based on age-specific mortality rates in the general population of England.

Wolverhampton 2013/14 (ISR)

England 2013/14 (ISR)

378.2 351.8 2009/10 2013/14

58.7

Wolverhampton (ISR)

Excess mortality rate in adults with serious mental illness in Wolverhampton is worsening

48.5

2011/13 2012/14




Excess mortality rate in adults with serious mental illness

Excess mortality rate in adults with serious mental illness in Wolverhampton in 2013-14 is worse compared to England and West Midlands. Excess mortality rate in adults with serious mental illness in Wolverhampton is worse compared to 8 of 15 CIPFA nearest neighbours.

Suicides (and injury of undetermined intent)


Suicide is a significant cause of death in young adults, and is seen as an indicator of underlying rates of mental ill-health.


100,000)

England 2012/14 (DSR per 100,000)

8.8 8.9 2001/03 2012/14

2.5


Suicide age standardised mortality rate in Wolverhampton is improving

0.3

2011/13 2012/14

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6

8

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Suicide age standardised rate in Wolverhampton 2001-03 to 2012-14



Suicide rate in Wolverhampton in 2012-14 is better compared to the England and West Midlands average. Suicide rate in Wolverhampton is better compared to 12 of 15 CIPFA nearest neighbours.

Age standardised rate of suicides in Wolverhampton has been consistently higher in males compared to females. Gap between rate of suicides in males and females has increased from 3.3 in 1995/97 to 13.7 in 2004/06 and started reducing thereafter to 6.0 in 2009/10. However it has started increasing again and has reached 12.7 in 2012/14.

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Suicide age standardised rate in Wolverhampton 1995-97 to 2012-14 by gender

Female Male


Suicide age standardised rate in 2010-14 is worst in most deprived areas of

Wolverhampton

11.7 8.3 2010-2014

• In 2010-2014, suicide age standardised mortality rate is worse in 4 wards of Wolverhampton: Bushbury South and Low Hill, Park, Graiseley and Ettingshall

• In 2010-14, suicide age standardised mortality rate is lowest in 3 wards: Tettenhall Wightwick, Oxley and Bushbury North

Most Deprived

Least Deprived

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0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100

rate

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Suicide age standardised mortality rate for persons aged 15+ (2010-2014) in Wolverhampton


DSR per 100,000 DSR per 100,000

Deaths attributable to smoking

https://thenounproject.com/term/no-smoking/130

Deaths attributable to Smoking

Smoking remains the biggest single cause of preventable mortality and morbidity in the world. It still accounts for 1 in 6 of all deaths in England, and there exist huge inequalities in smoking related deaths: areas with the highest death rates from smoking are about three times as high than areas with the lowest death rates attributable to smoking.


100,000)

England 2012/14 (DSR per 100,000)

307.3 274.8

2007/09 2012/14

20.7


Smoking attributable mortality rate in Wolverhampton is

improving

0.6

2011/13 2012/14





Deaths attributable to Smoking

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Smoking Attributable mortality rate (DSR) in Wolverhampton 2012-14: compared to CIPFA nearest

neighbours Smoking Attributable mortality rate in Wolverhampton in 2012-14 is significantly worse compared to the England and West Midlands average. Smoking attributable mortality rate in Wolverhampton is better compared to 13 of 15 CIPFA nearest neighbours.

Smoking attributable mortality rate from heart disease has reduced from 41.5 per 100,000 in 2007/09 to 37.2 per 100,000 in 2012/14. Similar pattern has been observed for smoking attributable mortality rate from stroke which has reduced from 14.7 per 100,000 in 2007/09 to 11.8 in 2012/14

Excess Winter Deaths

https://thenounproject.com/term/winter/124189

Excess Winter Deaths Index (EWD Index) is the excess winter deaths measured as the ratio of extra deaths from all causes that occur in the winter months compared with the expected number of deaths, based on the average of the number of non-winter deaths.


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Rat

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Excess winter deaths (all ages) in Wolverhampton 2001/04 to 2011/14


Wolverhampton 2011/14 (Ratio)

England 2011/14 (Ratio)

16.2 15.6

2001/04 2011/14

0

Wolverhampton (Ratio)

Excess Winter deaths index (all ages) in Wolverhampton is

improving

4.6

2010/13 2011/14






Excess Winter deaths index (all ages) in Wolverhampton in 2012-14 is better compared to the England and West Midlands average. Excess winter deaths index in Wolverhampton is better compared to 12 of 15 CIPFA nearest neighbours.

0

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Jul2004

Aug2002 -

Jul2005

Aug2003 -

Jul2006

Aug2004 -

Jul2007

Aug2005 -

Jul2008

Aug2006 -

Jul2009

Aug2007 -

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Aug2008 -

Jul2011

Aug2009 -

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Aug2010 -

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Aug2011 -

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Excess Winter Deaths Index (all ages) in Wolverhampton 2001/04 to 2011/14 by gender

Male Female

Excess winter deaths index in Wolverhampton has been consistently higher in females compared to males. However the gap between males and females has reduced from 5.6 in 2001/04 to 2.1 in 2011/14.

05

10152025303540

Aug2001 -

Jul2004

Aug2002 -

Jul2005

Aug2003 -

Jul2006

Aug2004 -

Jul2007

Aug2005 -

Jul2008

Aug2006 -

Jul2009

Aug2007 -

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Aug2008 -

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Aug2009 -

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Excess winter deaths index in persons aged 85+ in Wolverhampton 2001/04 to 2011/14


Excess Winter Deaths in persons aged 85+

Wolverhampton 2011/14 (Ratio)

England 2011/14 (Ratio)

19.5 22.3

2001/04 2011/14

2.1


Excess Winter deaths index in persons aged 85+ in

Wolverhampton is fluctuating

5.7

2010/13 2011/14



https://thenounproject.com/term/cemetery/836





Excess Winter Deaths in persons aged 85+

Excess Winter deaths index (all ages) in Wolverhampton in 2012-14 is better compared to the England and West Midlands average. Excess winter deaths index in Wolverhampton is better compared to 12 of 15 CIPFA nearest neighbours.

Excess winter deaths index in Wolverhampton has been consistently higher in females compared to males till 2009/12 and since then the trend has reversed.

What does this information tell us? • Premature mortality from cancer, cardiovascular diseases, communicable

diseases, causes considered preventable, suicide and smoking attributable mortality in Wolverhampton is improving.

• Premature mortality from liver diseases has worsened from 2001/03 to 2005/07; however the trend has reversed and is now improving.

• Premature mortality from respiratory diseases has worsened since 2001/03; however it has seen a slight drop in the last year.

• Excess mortality rate in adults with serious mental illness is worsening.

• Excess winter deaths index in persons aged 85+ is worsening.

• Premature mortality is consistently higher in males compared to females with an exception of suicides and excess winter deaths.

• The gap between males and females for all causes of premature mortality is reducing, with the exception of suicides.

• Premature mortality from causes considered preventable is improving; however premature mortality from liver and respiratory diseases considered preventable is increasing.

Indicative Commissioning needs

• Overall, premature mortality rates for the majority of conditions in Wolverhampton is worse than the England average. Lifestyle risk factors such as smoking, obesity and alcohol misuse are major contributors to the rate of premature mortality. Commissioned services need to focus on promoting healthier lifestyles and preventing the development of long term conditions that lead to premature

mortality. • This can be achieved through training service providers to

Make Every Contact Count5 across health, social care and the voluntary sector

5Making Every Contact Count is using daya to day interactions to support people in making positive lifestyle changes. See -

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/515949/Making_Every_Contact_Count_Consensus_Statement.pdf

Important terms

1. Directly standardised rate (DSR): The DSR for an area is the number of deaths, usually expressed per 100,000, that would occur in that area if it had the same age structure as the standard population and the local age-specific rates of the area applied.

Directly standardised mortality rate is calculated by dividing the number of deaths by the actual local population in a particular age group multiplied by the standard population for that particular age group and summing across the relevant age groups. The rate is usually expressed per 100,000.

2. Indirectly Standardised rate (ISR) or (Standardised Mortality Ratio (SMR)

An SMR is essentially a comparison of the number of the observed deaths in a population with the number of expected deaths if the age-specific death rates were the same as a standard population. It is expressed as a ratio of observed to expected deaths, multiplied by 100.

SMRs equal to 100 imply that the mortality rate is the same as the standard mortality rate. A number higher than 100 implies an excess mortality rate whereas a number below 100 implies below average mortality.

A SMR is calculated as the number of deaths observed within an area divided by the expected number of deaths within that area. This ratio is then multiplied by 100. To arrive at the expected number of deaths, for each age group, the standard age-specific death rate is multiplied by the local population in that age group. The number of expected deaths in each age group are then summed across all ages to arrive at the expected number of deaths for the local population.

References

1. Public Health Outcomes Framework Accessed at http://www.phoutcomes.info/ 2. Public Health Mortality Database 3. Office of National Statistics (ONS) Accessed at https://www.ons.gov.uk/ Picture Credits a. Baby created by Saeed Farrahi, IR from The Noun Project b. Scales created by Aldric Rodriguez Iborra, ES from The Noun Project c. Fetus created by Anbileru Adaleru from The Noun Project d. No Smoking created by AIGA Collection from The Noun Project e. Obesity created by Piger, GB from The Noun Project f. Pregnant created by Gerardo Martin Martinez from The Noun Project g. DNA created by Isabel Foo, CA from The Noun Project h. Nurse created by Bridget Gahagan from the Noun Project i. Front cover picture from www.rediff.com

http://www.phoutcomes.info/

https://www.ons.gov.uk/

References (cont)

Picture Credits

j. Death Benefit created by Timothy Miller, US from the Noun Project

k. Cancer created by Martha Ormiston, US from the Noun Project

l. Heart created by PJ Witsakorn from the Noun Project

m. Liver created by Icon 54 from the Noun Project

n. No drink created by Nikita Kozin, RU from the Noun Project

o. Lungs created by Healthcare Symbols collection from the Noun Project

p. Infectious disease by Health care Symbols Collection from the Noun Project

q. Public Health clinic created by Iconathon US from the Noun Project

References (Contd.)

r. Liver created by Icon 54 from the Noun Project

s. Heart created by PJ Witsakorn from the Noun Project

t. Cancer created by Martha Ormiston, US from the Noun Project

u. Lungs created by Healthcare Symbols collection from the Noun Project

v. Mental Health created by Healthcare Symbols collection from the Noun Project

w. No Smoking created by AIGA Collection from the Noun Project

Causes of Early Death in Wolverhampton · 2019-01-09 · Infant Mortality Infant Mortality rate (IMR) is defined as number of deaths under the age of one year, per 1000 live births.

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