MortalityTargetMonitoring_Dec2009

Mortality target monitoring

Life expectancy and All-Age All-Cause Mortality, overall

and inequalities

Update to include data for 2008

December 2009

VERSION CONTROL AND DOCUMENT GOVERNANCE

Prepared by Yang Tian, Mohan Singh, Jeanette Davis and Irena Begaj

Approved by Iris Fermin

Version 2

Date 16/12/2009

File location (public)

http://www.bhwp.nhs.uk/Apps/Content/html/viewContent.aspx?fid=39

Filename and path to locate this document

Y:\Public Health\PHIT\Public Health Server\2. Data and Reports\2. PHIT Reports & Bulletins\Flash Reports\Mortality

Mortality Target Monitoring final 2

Contents

1. Introduction .................................................................................................... 3

1.1. Measures................................................................................................... 3 1.2. Related publications................................................................................... 3

2. Key findings ................................................................................................... 3

2.1. Life expectancy at birth/ All-age All-cause Mortality (AAACM) – overall ..... 3 2.1.1. PSA 2010 life expectancy target ........................................................ 3 2.1.2. Life expectancy measure ................................................................... 4 2.1.3. LAA and Vital Signs AAACM targets .................................................. 7 2.1.4. AAACM measure: single year ............................................................ 7 2.1.5. AAACM measure: 3-year average...................................................... 9

2.2. Life expectancy at birth/ All-age All-cause Mortality (AAACM) – inequalities ................................................................................................................ 11

2.2.1. Life expectancy at birth by deprivation quintile ................................. 11 2.2.2. AAACM by deprivation quintile ......................................................... 11

3. Appendix: Statistical summaries ................................................................ 13

3.1. Life expectancy at birth ............................................................................ 13 3.1.1. Life expectancy at birth 2006 – 2008 by geographical areas in Birmingham.................................................................................................... 13 3.1.2. Life expectancy trend and trajectory - PCTs..................................... 17

3.2. AAACM: Three years average ................................................................. 20 3.2.1. AAACM 2006 – 2008 by geographical areas in Birmingham ............ 20 3.2.2. Three-year average AAACM trend against PSA and LAA target ...... 24

3.3. AAACM: Single years .............................................................................. 27 3.3.1. AAACM 2008 by geographical areas in Birmingham ........................ 27 3.3.2. Single year AAACM trend against LAA and Vital Signs target .......... 31

3.4. Life expectancy and AAACM by deprivation quintile ................................ 34 3.4.1. Life expectancy by IMD quintile - current year.................................. 34 3.4.2. Life expectancy by IMD quintile – trend............................................ 35 3.4.3. AAACM by IMD quintile - current year.............................................. 36 3.4.4. AAACM by IMD quintile - trend......................................................... 36


1. Introduction This document presents life expectancy at birth figures and all-age all-cause mortality (AAACM) rates, updated to 2006-08. These figures are used to monitor progress against Department of Health (DH) Public Service Agreement (PSA) targets on overall life expectancy and inequalities in life expectancy, and associated indicators on overall AAACM and inequalities in AAACM in the Local Area Agreement (LAA, NI120a and NI120b) and NHS World Class Commissioning Vital Signs (VS, VSB01a and VSB01b). This document follows the release by the Office for National Statistics (ONS) of the annual death registrations’ data and mid-year population estimates figures for 2008. This document presents for each target and indicator a summary of key findings, and a statistical summary with an illustration of the trend.

1.1. Measures The life expectancy targets and AAACM indicators are closely associated, and together constitute a single package of measures used to track progress in improving overall health and reducing health inequalities. The life expectancy targets are the ultimate measure of success, but AAACM is used as a proxy to measure progress, particularly relevant at local level. For the AAACM indicators, progress for England and the Spearhead Group is assessed against the levels required to deliver the targets for overall life expectancy and inequalities in life expectancy.

1.2. Related publications This document updates the data on the inequalities in life expectancy target reported in April 2009 in the Birmingham Life Expectancy report by the PHIT team (accessible from: http://www.bhwp.nhs.uk/Apps/Content/HTML/ViewContent.aspx?id=80). An update on progress against the associated target relating to inequalities in infant mortality will be published by the PHIT team in January 2010. An update on progress against the associated targets relating to mortality from cancer, circulatory diseases, intentional self-harm and accidents will be published by the PHIT team in January 2010.

2. Key findings

2.1. Life expectancy at birth/ All-age All-cause Mortality (AAACM) – overall

2.1.1. PSA 2010 life expectancy target The PSA target for overall life expectancy is to increase the average life expectancy at birth in Birmingham to 77.9 years for men and to 81.9 years for women by 2010, in order to close the gap with England by 10%, using 1995/97 figures as the baseline. This equates to AAACM (i.e. age standardised death rate) in Birmingham decreasing to 594 per 100,000 for men and 475 per 100,000 for women by 2009-2011, based on the DH method of converting life expectancy target to AAACM target.


The targets of life expectancy in 2009-2011 for Birmingham equate to

• 78.2 years for men and to 81.8 years for women in Birmingham East and North PCT (BEN);

• 76.1 years for men and to 80.9 years for women in Heart of Birmingham Teaching PCT (HoB); and

• 78.4 years for men and to 82.1 years for women in South Birmingham PCT (SB).

2.1.2. Life expectancy measure On the life expectancy at birth measure:

• In 2006-08, life expectancy at birth in Birmingham continued to increase for both males and females, and reached its highest level on record at 75.9 years for males and 81.0 years for females.

• This compares with life expectancy at birth in 1995-97 of 73.1 years for males and 78.6 years for females (i.e. there has been an increase of 2.8 years (3.8%) for males and 2.4 years (3.1%) for females since 1995-97).

• The PSA target trajectory for males in Birmingham is 76.6 years for 2006-08. Birmingham is 0.7 years under the trajectory.

• The PSA target trajectory for females in Birmingham is 81.1 years for 2006-08. Birmingham is 0.1 years under the trajectory.

Figure 1 and Figure 2 show trend of life expectancy in Birmingham against the PSA target for males and females respectively. Figure 1

Male life expectancy - 3 years rolling average

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Birmingham England PSA trajectory*

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Data source:

England and Birmingham MLE - ONS

England MLE Projection - Government

Actuary's Department

Trajectories - PHIT


Figure 2

Female life expectancy - 3 years rolling average

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Birmingham England PSA trajectory*

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Data source:


England MLE Projection - Government

Actuary's Department

Trajectories - PHIT

For BEN PCT:

• In 2006-08, life expectancy at birth is 76.3 years for males and 80.6 years for females.


For HoB tPCT:



For SB PCT



Details of the PCTs’ life expectancy trend against the PSA target can be found in the Appendix (3.1.2.).


Figure 3 and Figure 4 show maps of life expectancy by ward in Birmingham in 2006-08 for males and females accordingly. Figure 3

Figure 4


2.1.3. LAA and Vital Signs AAACM targets To achieve the PSA 2010 life expectancy target, targets of AAACM for males and females for the years before the target year (i.e. 2010) have been set in the LAA for Birmingham, and in the World Class Commissioning Vital Signs for the three PCTs in Birmingham. Table 1 shows the LAA and VS targets of AAACM for Birmingham and the PCTs

Table 1 AAACM targets for Birmingham and PCTs

LAA target

(NI120) Vital Signs target (VSB01)

Birmingham BEN HoB SB

Male

2008 753 735 841 737

2009 722 702 730 736

2010 694 670 694 694

2011 n/a 638 660 672

Female

2008 522 (2006-08) 522 540 518

2009 511 (2007-09) 510 513 514

2010 499 (2008-10) 499 499 499

2011 n/a 488 485 490

2.1.4. AAACM measure: single year Single year AAACM rates for Birmingham have fallen in 2008.

• For males, AAACM rates have reduced to 777.5 deaths per 100,000 population in 2008 from 1068.7 deaths per 100,000 population in 1995, a fall of 27.2%.

• For females, AAACM rates have reduced to 525.5 deaths per 100,000 population in 2008 from 636.1 deaths per 100,000 population in 1995, a fall of 17.4%.

• The 2008 AAACM rate for Birmingham males is higher than the LAA target (NI120a) for this period by 24.5 deaths per 100,000 population.

• Comparing with AAACM rates in 2002 (which is the earliest year that Birmingham PCTs’ AAACM rates are available), it has reduced 17.6% for males (from 943.2 per 100,000 population) and 11.0% for females (from 590.7 per 100,000 population).


Figure 5 shows single year AAACM trend in Birmingham for males against the LAA target (NI 120a). Figure 5

All age all cause mortality (AAACM) - Males

Trend and Trajectory: Birmingham MCD

1995 - 2008

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Birmingham Trend

LAA trajectory

Source:

Trend - NCHOD

LAA trajectory - Birmingham LAA 08-11

For each PCT in Birmingham on the AAACM single year measure: For BEN PCT:



• AAACM rates for both males and females are higher than the Vital Signs targets for 2008 in BEN PCT. Males’ rate is 20 deaths per 100,000 population higher than the target (735 per 100,000), and females’ rate is 10 deaths per 100,000 higher than the target (522 per 100,000).

For HoB tPCT:




• AAACM rate for males in HoB tPCT is higher than the Vital Signs 2008 (841 per 100,000 population) by 45 deaths per 100,000 population.

• AAACM rate for females in HoB tPCT has achieved the Vital Signs 2008 target (540 per 100,000 population) by 12 deaths per 100,000 population lower than the target.

For SB PCT:

• For males, AAACM rate has reduced to 743.7 deaths per 100,000 population in 2008 from 867.5 deaths per 100,000 population in 2002, a fall of 14.3%.

• For females, AAACM rate has reduced to 516.2 deaths per 100,000 population in 2008 from 567.6 deaths per 100,000 population in 2002, a fall of 9.1%.

• AAACM rate for males in SB PCT is higher than the Vital Signs 2008 target (737 per 100,000 population) by 7 deaths per 100,000 population.

• AAACM rate for females in SB PCT has achieved the Vital Signs 2008 target by two deaths per 100,000 population lower than the target (518 per 100,000 population).

Details of the PCTs’ single year AAACM trend against the VS target can be found in the Appendix (3.3.2.).

2.1.5. AAACM measure: 3-year average Three-year average AAACM rates for Birmingham have fallen in each period since 1995-97.

• For males, AAACM rates have reduced to 797.3 deaths per 100,000 population in 2006-08 from 1038.6 deaths per 100,000 population in 1995-97, a fall of 23.2%.

• For females, AAACM rates have reduced to 523.7 deaths per 100,000 population in 2006-08 from 655.2 deaths per 100,000 population in 1995-97, a fall of 20.1%.

• The 2006-08 AAACM rate for Birmingham females is slightly (i.e. 1.7 deaths per 100,000 population) higher than the LAA target for this period.

• Comparing with AAACM rates in 2001-03 (which is the earliest year that Birmingham PCTs’ AAACM rates are available), it has reduced 15.3% (from 941.1) for males and 12.0% (from 595.2) for females.

Figure 6 shows 3-year average AAACM trend in Birmingham for females against the LAA target (NI 120b).


Figure 6

All age all cause mortality (AAACM) - Females


1995/1997 to 2006/08

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Birmingham Trend

PSA trajectory

LAA target

Source:

Trend - NCHOD

PSA trajectory - PHIT calculation


Source:

Trend - NCHOD



For each PCT in Birmingham on the AAACM 3-year average measure: For BEN PCT:



For HoB tPCT:



For SB PCT:




Details of the 3-year average AAACM trend in the Birmingham PCTs against the PSA trajectory can be found in the Appendix (3.2.2.). The life expectancy and AAACM trends for females are broadly on course to deliver the PSA target in 2009-11. However, the current trend for male life expectancy and AAACM suggests challenge in achieving the PSA target in 2009-11.

2.2. Life expectancy at birth/ All-age All-cause Mortality (AAACM) – inequalities

2.2.1. Life expectancy at birth by deprivation quintile On the life expectancy at birth measure:

• In 2006-08, the gap between life expectancy in the least (i.e. Q1) and most deprived (i.e. Q5) quintiles in Birmingham is 8.5 years for males and 4.4 years for females.

• This compares with the gap in 1995-97 of 7.4 years for males and 5.6 years for females (i.e. the gap in males has widened by 1.1 years and in females has narrowed by 1.2 years).

• In 2006-2008, the gap between life expectancy in Birmingham as a whole and the most deprived quintile (i.e. Q5) is 3.9 years for males and 1.7 years for females.

• This compares with the gap in 1995-97 of 3.6 years for males and 2.7 years for females (i.e. the gap in males has widened by 0.3 years and in females has narrowed by one year).

Figure 7 and Figure 8 show the trend of the life expectancy gap between the most deprived quintile SOAs in Birmingham and Birmingham as a whole. Details of the trend of inequalities in life expectancy in Birmingham can be found in the Appendix (3.4.1. and 3.4.2.).

2.2.2. AAACM by deprivation quintile On the AAACM measure:

• In 2008, the gap between AAACM in the least (i.e. Q1) and the most deprived (i.e. Q5) quintiles in Birmingham is 455 deaths per 100,000 population for males and 160 deaths per 100,000 population for females.

• This compares with the gap in 1995 of 506 deaths per 100,000 for males and 291 per 100,000 for females (i.e. the gap in both males and females has narrowed, males by 51 deaths per 100,000 and females by 131 deaths per 100,000).

• In 2008, the gap between AAACM rate in Birmingham as a whole and the most deprived quintile (i.e. Q5) is 230 deaths per 100,000 population for males and 57 deaths per 100,000 for females.


• This compares with the gap in 1995 of 233 deaths per 100,000 population for males and 157 deaths per 100,000 population for females (i.e. the gap in males has narrowed by 3 deaths per 100,000, and in females has narrowed by 100 deaths per 100,000 population).

Details of the trend of inequalities in AAACM in Birmingham can be found in the Appendix (3.4.3. and 3.4.4.). Figure 7

Male Life Expectancy at Birth for Birmingham and the most deprived IMD

quintile

1995/97 - 2006/08

Three-year rolling averages

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Most deprived quintile SOAs Birmingham Average

Data source:

ONS death registrations

PHIT calculation Figure 8

Female Life Expectancy for Birmingham and the most deprived quintile SOAs

1995/97- 2006/08


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Data source:


PHIT calculation


3. Appendix: Statistical summaries

3.1. Life expectancy at birth

3.1.1. Life expectancy at birth 2006 – 2008 by geographical areas in Birmingham

Table 2 shows the three-year average (2006-2008) of life expectancy at birth by PCT, constituency and ward in Birmingham, with the 95% confidence intervals.

Table 2 Life expectancy at birth with 95% confidence intervals by geographical areas in Birmingham, 2006-2008

14

Males Females Persons

Code Area LE LL UL LE LL UL LE LL UL

00CN Birmingham MCD 75.92 75.68 76.15 80.98 80.75 81.20 78.46 78.30 78.63

Primary care organisations

5PG NHS Birmingham East & North 76.26 75.89 76.63 80.57 80.22 80.92 78.45 78.19 78.70

5MX Heart of Birmingham tPCT 74.22 73.74 74.70 80.57 80.10 81.04 77.30 76.96 77.64

5M1 NHS South Birmingham 76.62 76.23 77.02 81.75 81.38 82.11 79.24 78.97 79.52 BCC Priority neighbourhoods

25 Priority neighbourhoods 73.20 72.75 73.66 79.61 79.15 80.06 76.32 75.99 76.65

25 PNs and 6 clusters 73.01 72.58 73.44 79.39 78.96 79.81 76.12 75.82 76.43

Constituencies

Edgbaston 76.90 76.11 77.69 82.35 81.60 83.10 79.65 79.09 80.20

Erdington 74.14 73.38 74.90 79.41 78.68 80.15 76.78 76.25 77.32

Hall Green 75.70 74.97 76.43 81.41 80.72 82.11 78.54 78.02 79.05

Hodge Hill 73.97 73.24 74.70 79.19 78.49 79.90 76.57 76.05 77.09

Ladywood 71.90 71.11 72.69 79.63 78.82 80.44 75.51 74.92 76.09

Northfield 76.71 75.97 77.44 82.09 81.41 82.77 79.48 78.97 79.99

Perry Barr 75.91 75.18 76.65 81.20 80.48 81.93 78.57 78.05 79.10

Selly Oak 76.22 75.49 76.96 80.86 80.22 81.51 78.61 78.11 79.11

Sutton Coldfield 81.23 80.55 81.91 83.69 83.04 84.35 82.51 82.04 82.98

Yardley 76.00 75.30 76.69 79.87 79.19 80.55 77.97 77.48 78.46

Wards

00CNGS Acocks Green 74.46 73.16 75.77 78.29 76.96 79.62 76.39 75.45 77.33

00CNGT Aston 71.58 69.95 73.20 83.62 81.84 85.41 76.92 75.71 78.13

00CNGU Bartley Green 75.35 73.74 76.96 82.41 81.06 83.77 78.89 77.81 79.97

00CNGW Billesley 75.92 74.49 77.35 79.77 78.42 81.12 77.95 76.96 78.94

00CNGX Bordesley Green 73.61 72.23 75.00 78.55 77.22 79.88 76.03 75.07 77.00

00CNGY Bournville 76.78 75.37 78.18 82.46 81.44 83.48 79.72 78.83 80.60

00CNGZ Brandwood 74.20 72.60 75.81 81.86 80.48 83.24 78.08 77.00 79.16




00CNHA Edgbaston 76.73 75.22 78.24 80.20 78.22 82.18 78.44 77.19 79.70

00CNHB Erdington 74.74 73.15 76.32 79.73 78.28 81.18 77.22 76.13 78.31

00CNHC Hall Green 78.56 77.10 80.02 83.81 82.53 85.08 81.20 80.21 82.19

00CNHD Handsworth Wood 76.00 74.54 77.47 81.25 79.68 82.83 78.67 77.59 79.75

00CNHE Harborne 78.24 76.74 79.75 82.98 81.47 84.49 80.71 79.64 81.79

00CNHF Hodge Hill 76.24 74.82 77.66 80.06 78.60 81.53 78.21 77.18 79.24

00CNHG Kings Norton 75.19 73.68 76.70 80.78 79.51 82.04 78.10 77.11 79.10

00CNHH Kingstanding 74.28 72.86 75.70 78.80 77.30 80.29 76.62 75.59 77.66

00CNHJ Ladywood 72.38 70.50 74.25 78.53 76.72 80.35 74.92 73.60 76.25

00CNHK Longbridge 76.14 74.73 77.54 80.73 79.33 82.13 78.52 77.52 79.52

00CNHL Lozells and East Handsworth 72.46 70.88 74.05 80.58 79.06 82.09 76.36 75.24 77.47

00CNHM Moseley and Kings Heath 74.19 72.69 75.69 80.70 79.26 82.13 77.43 76.36 78.49

00CNHN Nechells 70.95 69.56 72.34 78.90 77.32 80.47 74.54 73.46 75.61

00CNHP Northfield 77.06 75.55 78.57 83.50 82.16 84.83 80.29 79.26 81.31

00CNHQ Oscott 76.80 75.52 78.08 79.90 78.50 81.29 78.46 77.50 79.41

00CNHR Perry Barr 78.89 77.42 80.35 84.00 82.45 85.56 81.57 80.49 82.65

00CNHS Quinton 77.24 75.61 78.87 83.66 82.20 85.13 80.49 79.37 81.60

00CNHT Selly Oak 77.91 76.22 79.60 79.28 77.72 80.84 78.64 77.49 79.78

00CNHU Shard End 73.58 72.07 75.09 78.78 77.37 80.19 76.23 75.19 77.28

00CNHW Sheldon 77.85 76.24 79.46 83.15 81.67 84.63 80.59 79.48 81.70

00CNHX Soho 73.27 71.72 74.82 78.90 77.34 80.47 75.96 74.84 77.08

00CNHY South Yardley 75.94 74.54 77.35 81.18 79.77 82.59 78.56 77.55 79.57

00CNHZ Sparkbrook 71.87 70.42 73.32 79.48 78.08 80.88 75.55 74.52 76.58

00CNJA Springfield 77.91 76.47 79.36 81.55 80.05 83.05 79.72 78.67 80.77

00CNJB Stechford and Yardley North 76.23 74.92 77.54 78.50 77.20 79.80 77.37 76.44 78.30

00CNJC Stockland Green 72.96 71.31 74.62 80.81 79.12 82.49 76.70 75.49 77.90

00CNJD Sutton Four Oaks 81.58 80.32 82.84 84.39 82.94 85.85 83.07 82.10 84.04

00CNJE Sutton New Hall 81.41 79.87 82.94 84.74 83.44 86.04 83.10 82.09 84.12

00CNJF Sutton Trinity 82.12 80.82 83.42 83.60 82.46 84.74 82.75 81.90 83.60




00CNJG Sutton Vesey 80.06 78.72 81.39 82.30 80.97 83.63 81.26 80.33 82.18

00CNJH Tyburn 74.39 72.94 75.84 78.80 77.45 80.15 76.64 75.64 77.65

00CNJJ Washwood Heath 72.65 71.02 74.27 79.02 77.49 80.56 75.70 74.57 76.84

00CNJK Weoley 78.61 77.08 80.13 84.59 83.13 86.06 81.67 80.59 82.75

Data source: ONS annual death data, PHIT calculation

17

3.1.2. Life expectancy trend and trajectory - PCTs The figures below show the trend of life expectancy in the PCTs against the trend in England and the PSA trajectories.

3.1.2.1. Birmingham East and North Figure 9


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Birmingham East and North PCT England PSA trajectory*

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Data source:


England MLE Projection - Government Actuary's

Department

Trajectories - PHIT

Figure 10


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Birmingham East and North PCT England PSA trajectory*

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Data source:



Department

Trajectories - PHIT


3.1.2.2. Heart of Birmingham Figure 11


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Heart of Birmingham PCT England PSA trajectory*

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Department

Trajectories - PHIT

Figure 12


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2008-

2010

2009-

2011

Years

Ye

ars

of

ag

e

Heart of Birmingham PCT England PSA trajectory*

Projection

PS

A t

arg

et

baselin

e y

ear

Late

st

Targ

et

year

Data source:

England and Birmingham FLE - ONS


Department

Trajectories - PHIT


3.1.2.3. South Birmingham Figure 13


70.00

71.00

72.00

73.00

74.00

75.00

76.00

77.00

78.00

79.00

80.00

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

Years

Ye

ars

of

ag

e

South Birmingham PCT England PSA trajectory*

Projection

PS

A t

arg

et

baselin

e y

ear

Late

st

Targ

et

year

Data source:



Department

Trajectories - PHIT

Figure 14


75.00

76.00

77.00

78.00

79.00

80.00

81.00

82.00

83.00

84.00

85.00

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

Years

Ye

ars

of

ag

e

South Birmingham PCT England PSA trajectory*

Projection

PS

A t

arg

et

baselin

e y

ear

Late

st

Targ

et

year

Data source:



Department

Trajectories - PHIT


3.2. AAACM: Three years average

3.2.1. AAACM 2006 – 2008 by geographical areas in Birmingham Table 4 shows the three-year average of AAACM (2006 to 2008) by PCT, Birmingham City Council priority neighbourhoods, constituency and ward, with the 95% confidence intervals.

Table 4 AAACM 2006 – 2008 by geographical areas in Birmingham

21


Code Area DSR LL UL DSR LL UL DSR LL UL





5M1 NHS South Birmingham 759.50 736.85 782.66 505.12 489.03 521.56 618.93 605.45 632.61

BCC Priority neighbourhoods

25 priority neighbourhoods 972.30 938.63 1006.83 595.20 572.19 618.86 766.97 747.27 787.05

25 PNs and 6 clusters 985.30 953.73 1017.63 606.64 585.05 628.78 778.85 760.38 797.65

Constituencies

Edgbaston 740.45 697.38 785.43 479.02 448.34 511.04 597.96 572.13 624.59

Erdington 910.89 863.43 960.22 608.78 574.16 644.76 744.33 715.65 773.81

Hall Green 812.90 766.09 861.76 512.44 480.31 546.04 649.57 622.10 677.90

Hodge Hill 914.79 866.72 964.78 607.05 572.54 642.93 746.88 717.99 776.57

Ladywood 1072.78 1008.14 1140.34 603.15 560.44 648.14 822.41 785.02 861.09

Northfield 752.31 711.63 794.66 493.39 464.50 523.47 606.71 582.53 631.59

Perry Barr 807.86 762.04 855.67 516.07 484.31 549.25 646.89 619.87 674.74

Selly Oak 792.77 749.80 837.50 552.05 521.32 583.94 658.68 633.09 684.98


Yardley 809.24 767.00 853.15 586.53 554.47 619.78 687.19 661.21 713.87

Wards


00CNGT Aston 1046.76 924.25 1180.12 474.77 402.88 555.27 730.42 662.80 802.79


00CNGW Billesley 801.46 721.24 887.89 594.24 533.25 659.48 681.97 633.11 733.33


00CNGY Bournville 759.03 680.99 843.32 488.62 438.13 542.63 608.24 563.56 655.25

00CNGZ Brandwood 873.08 784.52 968.67 506.37 448.02 569.63 667.98 616.75 722.13

00CNHA Edgbaston 805.99 704.04 918.31 532.46 459.66 612.40 654.25 593.56 719.16

00CNHB Erdington 858.35 769.08 954.85 592.61 525.89 664.56 716.45 661.35 774.62




00CNHC Hall Green 645.33 573.23 723.78 428.29 376.22 484.88 527.38 483.69 573.73


00CNHE Harborne 693.06 609.40 784.62 450.85 391.80 514.94 558.86 508.91 611.93

00CNHF Hodge Hill 795.40 710.88 887.00 560.40 496.69 629.38 661.44 609.76 716.13



00CNHJ Ladywood 1040.90 898.63 1198.64 682.83 579.66 798.02 880.25 792.06 975.33

00CNHK Longbridge 802.50 717.02 895.14 541.86 480.70 608.05 655.00 603.99 708.96



00CNHN Nechells 1193.03 1062.98 1333.80 633.99 552.12 724.02 887.59 815.21 964.50

00CNHP Northfield 723.68 647.83 805.75 448.98 395.67 506.90 571.76 526.34 619.85

00CNHQ Oscott 795.56 716.15 881.16 583.43 522.90 648.31 674.20 625.57 725.37

00CNHR Perry Barr 653.21 571.43 743.22 416.86 360.02 479.51 518.05 469.87 569.62

00CNHS Quinton 692.68 615.58 776.47 438.93 383.51 499.39 553.29 506.69 602.78

00CNHT Selly Oak 741.35 641.52 851.59 659.81 576.79 749.91 696.14 631.95 764.51

00CNHU Shard End 939.94 850.25 1036.03 633.92 568.84 703.28 771.30 717.00 828.21

00CNHW Sheldon 680.60 603.67 764.11 456.93 400.43 518.18 556.94 509.84 606.82

00CNHX Soho 1013.32 889.99 1148.39 639.82 554.39 734.32 810.97 737.87 889.17


00CNHZ Sparkbrook 1116.81 989.79 1254.80 611.13 531.67 698.80 835.52 764.25 911.44











00CNJH Tyburn 909.17 816.86 1008.76 651.06 582.90 724.40 766.65 710.52 825.81


00CNJK Weoley 654.34 580.04 735.25 424.76 370.94 483.54 526.32 481.37 574.10


24

3.2.2. Three-year average AAACM trend against PSA and LAA target The figures below shows the three-year average AAACM trend in Birmingham and the PCTs against PSA and LAA target for males and females.

3.2.2.1. Birmingham Figure 15



1995/1997 to 2006/08

400.00

500.00

600.00

700.00

800.00

900.00

1000.00

1100.00

1200.00

1995

to 1

997

1996

to 1

998

1997

to 1

999

1998

to 2

000

1999

to 2

001

2000

to 2

002

2001

to 2

003

2002

to 2

004

2003

to 2

005

2004

to 2

006

2005

to 2

007

2006

to 2

008

2007

to 2

009

2008

to 2

010

2009

to 2

011

Years

Ag

e s

tan

dard

ise

d r

ate

pe

r 1

00

,00

0

Po

pu

lati

on

Birmingham Trend

PSA trajectory

Source:

Trend - NCHOD




Trend and Trajectory: NHS Birmingham East and North

1995/1997 to 2006/08

400.00

500.00

600.00

700.00

800.00

900.00

1000.00

1100.00

1200.00

1995

to 1

997

1996

to 1

998

1997

to 1

999

1998

to 2

000

1999

to 2

001

2000

to 2

002

2001

to 2

003

2002

to 2

004

2003

to 2

005

2004

to 2

006

2005

to 2

007

2006

to 2

008

2007

to 2

009

2008

to 2

010

2009

to 2

011

Years

Ag

e s

tan

dard

ised

ra

te p

er

100

,00

0

Po

pu

lati

on

BEN Trend

PSA trajectory

Source:

Trend - NCHOD



Figure 17



1995/1997 to 2006/08

400.00

500.00

600.00

700.00

800.00

1995

to 1

997

1996

to 1

998

1997

to 1

999

1998

to 2

000

1999

to 2

001

2000

to 2

002

2001

to 2

003

2002

to 2

004

2003

to 2

005

2004

to 2

006

2005

to 2

007

2006

to 2

008

2007

to 2

009

2008

to 2

010

2009

to 2

011

Years

Ag

e s

tan

dard

ised

ra

te p

er

10

0,0

00

Po

pu

lati

on

BEN Trend PSA trajectory

Source:

Trend - NCHOD





Trend and Trajectory: Heart of Birmingham Teaching PCT

1995/1997 to 2006/08

400.00

500.00

600.00

700.00

800.00

900.00

1000.00

1100.00

1200.00

1995

to 1

997

1996

to 1

998

1997

to 1

999

1998

to 2

000

1999

to 2

001

2000

to 2

002

2001

to 2

003

2002

to 2

004

2003

to 2

005

2004

to 2

006

2005

to 2

007

2006

to 2

008

2007

to 2

009

2008

to 2

010

2009

to 2

011

Years

Ag

e s

tan

dard

ised

rate

per

100,0

00

Po

pu

lati

on

HoB Trend

PSA trajectory

Source:

Trend - NCHOD



Figure 19



1995/1997 to 2006/08

400.00

500.00

600.00

700.00

800.00

1995

to 1

997

1996

to 1

998

1997

to 1

999

1998

to 2

000

1999

to 2

001

2000

to 2

002

2001

to 2

003

2002

to 2

004

2003

to 2

005

2004

to 2

006

2005

to 2

007

2006

to 2

008

2007

to 2

009

2008

to 2

010

2009

to 2

011

Years

Ag

e s

tan

da

rdis

ed

rate

pe

r 1

00

,00

0

Po

pu

lati

on

HoB Trend PSA trajectory

Source:

Trend - NCHOD





Trend and Trajectory: NHS South Birmingham

1995/97 to 2006/08

400.00

500.00

600.00

700.00

800.00

900.00

1000.00

1100.00

1200.00

1995

to 1

997

1996

to 1

998

1997

to 1

999

1998

to 2

000

1999

to 2

001

2000

to 2

002

2001

to 2

003

2002

to 2

004

2003

to 2

005

2004

to 2

006

2005

to 2

007

2006

to 2

008

2007

to 2

009

2008

to 2

010

2009

to 2

011

Years

Ag

e s

tan

dard

ise

d r

ate

pe

r

10

0,0

00

Po

pu

lati

on

SB Trend

PSA trajectory

Source:

Trend - NCHOD



Figure 21



1995/1997 to 2006/08

400.00

500.00

600.00

700.00

800.00

1995

to 1

997

1996

to 1

998

1997

to 1

999

1998

to 2

000

1999

to 2

001

2000

to 2

002

2001

to 2

003

2002

to 2

004

2003

to 2

005

2004

to 2

006

2005

to 2

007

2006

to 2

008

2007

to 2

009

2008

to 2

010

2009

to 2

011

Years

Ag

e s

tan

dard

ised

rate

per

10

0,0

00

Po

pu

lati

on

SB Trend PSA trajectorySource:

Trend - NCHOD



3.3. AAACM: Single years

3.3.1. AAACM 2008 by geographical areas in Birmingham Table 5 shows the single year AAACM in 2008, by PCT, Birmingham City Council priority neighbourhoods, constituency and ward, with the 95% confidence intervals.

Table 5 AAACM 2008 by geographical areas in Birmingham

Mortality Target Monitoring final

28







5M1 NHS South Birmingham 743.69 705.24 783.65 516.17 488.02 545.37 618.18 594.96 642.01

BCC Priority neighbourhoods

25 priority neighbourhoods 965.31 907.37 1025.89 550.17 512.17 590.14 737.66 704.28 772.16

25 PNs and 6 clusters 969.71 915.66 1026.03 562.49 526.88 599.76 745.73 714.57 777.85

Constituencies

Edgbaston 744.96 671.27 824.37 513.49 458.22 572.89 617.90 572.73 665.46

Erdington 866.91 787.71 951.76 558.32 502.08 618.62 696.40 648.95 746.23

Hall Green 770.84 692.74 855.15 507.64 453.64 565.97 632.23 585.85 681.19

Hodge Hill 915.39 832.63 1003.95 554.36 497.76 615.13 714.85 666.08 766.07

Ladywood 1073.45 963.05 1192.60 546.16 477.18 621.95 785.94 723.54 852.14

Northfield 733.11 664.30 806.97 480.19 431.76 532.10 590.45 549.62 633.36

Perry Barr 804.40 726.62 888.06 515.85 461.36 574.63 643.56 597.44 692.16

Selly Oak 771.18 698.64 849.01 566.98 512.41 625.15 656.47 612.19 702.90


Yardley 816.32 743.21 894.50 583.74 529.31 641.72 692.67 647.71 739.73

Wards


00CNGT Aston 913.56 728.01 1129.54 411.64 298.47 551.40 637.19 532.21 755.91


00CNGW Billesley 834.05 696.00 990.58 669.06 554.22 797.89 728.93 641.50 824.08


00CNGY Bournville 669.40 542.55 816.18 480.92 395.96 576.43 574.85 499.57 657.32

00CNGZ Brandwood 814.33 670.68 978.96 555.83 449.96 677.09 666.41 579.30 762.30

00CNHA Edgbaston 717.93 557.36 909.34 643.02 504.06 804.29 668.91 565.30 784.96

00CNHB Erdington 801.29 656.55 967.57 599.60 484.32 731.14 690.65 598.91 791.58




00CNHC Hall Green 639.80 518.20 780.60 466.40 376.61 569.20 550.12 474.83 633.26


00CNHE Harborne 813.50 658.95 992.20 405.77 312.79 513.51 586.81 498.93 684.24

00CNHF Hodge Hill 762.36 622.69 923.32 505.81 402.11 625.98 610.60 525.87 704.42



00CNHJ Ladywood 1148.30 893.69 1450.72 662.82 486.39 878.56 897.29 744.30 1071.58

00CNHK Longbridge 806.54 660.20 974.97 544.15 437.03 667.53 654.06 565.80 751.55



00CNHN Nechells 1134.71 920.13 1381.84 548.69 428.28 691.23 829.27 711.93 959.99

00CNHP Northfield 712.55 586.87 856.52 404.83 318.97 504.85 537.00 462.64 619.28

00CNHQ Oscott 736.77 610.39 881.06 539.84 442.49 650.08 617.10 539.61 701.92

00CNHR Perry Barr 726.31 579.65 898.20 393.55 301.88 502.70 532.49 449.33 625.98

00CNHS Quinton 733.22 597.16 890.12 444.93 347.64 558.38 578.40 495.42 670.50

00CNHT Selly Oak 831.34 648.30 1047.32 551.76 425.74 699.06 674.89 565.54 797.36

00CNHU Shard End 902.80 754.67 1070.12 679.75 561.58 811.88 774.59 680.84 876.38

00CNHW Sheldon 745.27 608.28 902.47 438.50 342.76 549.44 576.50 493.77 667.95

00CNHX Soho 1114.32 894.25 1370.49 594.67 454.55 763.00 817.70 692.61 958.28


00CNHZ Sparkbrook 999.75 797.53 1235.33 581.48 451.34 736.41 772.14 655.17 903.32











00CNJH Tyburn 889.87 734.07 1068.03 540.73 437.21 659.45 691.97 601.24 791.81


00CNJK Weoley 697.42 567.12 847.77 415.50 329.27 515.27 545.13 468.19 630.32


Mortality Target Monitoring final

31

3.3.2. Single year AAACM trend against LAA and Vital Signs target The figures below shows the single year AAACM trend in Birmingham and the PCTs against LAA and Vital Signs target for males and females.

3.3.2.1. Birmingham Figure 22

All age all cause mortallity (AAACM) - Females

Trend and Trajectory : Birmingham MCD

1997 to 2008

0.00

100.00

200.00

300.00

400.00

500.00

600.00

700.00

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

Years

Ag

e s

tan

da

rdis

ed

ra

te p

er

10

0,0

00

po

pu

lati

on

Birmingham trend

LAA trajectory

Source:

Trend - NCHOD

LAA trajectory - Birmingham LAA 2008 - 2011




2002 - 2008

600.00

700.00

800.00

900.00

1000.00

1100.00

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

Years

Ag

e s

tan

dard

ised

ra

te p

er

10

0,0

00

Po

pu

lati

on

BEN Trend

VS trajectory

Source:

Trend - NCHOD

VS trajectory - Vital Signs


Figure 24


Trend and Targets : NHS Birmingham East and North

2002 - 2008

0.00

100.00

200.00

300.00

400.00

500.00

600.00

700.00

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

Years

Ag

e s

tan

da

rdis

ed

ra

te p

er

10

0,0

00

po

pu

lati

on

BEN trend

Vital Signs Target




2002 - 2008

600.00

700.00

800.00

900.00

1000.00

1100.00

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

Years

Ag

e s

tan

dard

ised

rate

per

100,0

00

Po

pu

lati

on

HoB Trend

VS trajectory

Source:

Trend - NCHOD




Figure 26


Trend and Targets : Heart of Birmingham Teaching PCT

2002 to 2008

0.00

100.00

200.00

300.00

400.00

500.00

600.00

700.00

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

Years

Ag

e s

tan

dard

ised

rate

pe

r 10

0,0

00 p

op

ula

tio

n

HoB trend

Vital Signs Target

Source:

Trend - NCHOD

VSB01 - PCT Performance teams 08 - 11




2002 - 2008

600.00

700.00

800.00

900.00

1000.00

1100.00

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

Years

Ag

e s

tan

dard

ise

d r

ate

pe

r

10

0,0

00

Po

pu

lati

on

SB Trend

VS trajectory

Source:

Trend - NCHOD




Figure 28


Trend and Targets - NHS South Birmingham

2002 - 2008

0.00

100.00

200.00

300.00

400.00

500.00

600.00

700.00

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

Years

Ag

e s

tan

dard

ised

rate

per

10

0,0

00

po

pu

lati

on

SB trend

Vital Signs Target

Source:

Trend - NCHOD

VSB01 - PCT Performance teams 08 - 11

3.4. Life expectancy and AAACM by deprivation quintile

3.4.1. Life expectancy by IMD quintile - current year Figure 29

Life expectancy at birth by deprivation quintile with 95%

confidence intervals, Birmingham, 2006-08

64

66

68

70

72

74

76

78

80

82

84

86

Q1 Q2 Q3 Q4 Q5

IMD quintile

Lif

e e

xp

ec

tan

cy

in

ye

ars

Females Males Persons

least deprived most

deprived

Data source:


PHIT calculation


3.4.2. Life expectancy by IMD quintile – trend Figure 30

Male Life Expectancy at Birth for Birmingham by IMD Quintile

1995/97 - 2006/08

Three-year averages

62.00

64.00

66.00

68.00

70.00

72.00

74.00

76.00

78.00

80.00

82.00

1995

/ 19

97

1996

/ 19

98

1997

/ 19

99

1998

/ 20

00

1999

/ 20

01

2000

/ 20

02

2001

/ 20

03

2002

/ 20

04

2003

/ 20

05

2004

/ 20

06

2005

/ 20

07

2006

/ 20

08

Years

Lif

e E

xp

ec

tan

cy

in

ye

ars

Affluent Less Affluent Average Less Deprived Deprived

Data source:



Female Life Expectancy for Birmingham by IMD Quintile

1995/97- 2006/08


72.00

74.00

76.00

78.00

80.00

82.00

84.00

86.00

1995

/ 19

97

1996

/ 19

98

1997

/ 19

99

1998

/ 20

00

1999

/ 20

01

2000

/ 20

02

2001

/ 20

03

2002

/ 20

04

2003

/ 20

05

2004

/ 20

06

2005

/ 20

07

2006

/ 20

08

Years

Lif

e E

xp

ecta

ncy


Data source:


PHIT calculation


3.4.3. AAACM by IMD quintile - current year Figure 32

All-age all-casuse mortality (AAACM) by IMD quintile,

Birmingham, 2006-2008

0.00

200.00

400.00

600.00

800.00

1000.00

1200.00

Q1 Q2 Q3 Q4 Q5

IMD quintile

Rate

per

100,0

00


Least deprived Most deprived

Data source:


PHIT calculation

3.4.4. AAACM by IMD quintile - trend Figure 33

Male AAACM by IMD Quintile in Birmingham

1995 - 2008

Three year rolling average

0.00

200.00

400.00

600.00

800.00

1000.00

1200.00

1400.00

1995

/ 19

97

1996

/ 19

98

1997

/ 19

99

1998

/ 20

00

1999

/ 20

01

2000

/ 20

02

2001

/ 20

03

2002

/ 20

04

2003

/ 20

05

2004

/ 20

06

2005

/ 20

07

2006

/ 20

08

Years

DS

R


Da ta source :

ONS de ath re gistrations

PHIT ca lcula tion


Figure 34

Female AAACM by IMD Quintile in Birmingham

1995 - 2008


0.00

100.00

200.00

300.00

400.00

500.00

600.00

700.00

800.00

900.00

1995

/ 19

97

1996

/ 19

98

1997

/ 19

99

1998

/ 20

00

1999

/ 20

01

2000

/ 20

02

2001

/ 20

03

2002

/ 20

04

2003

/ 20

05

2004

/ 20

06

2005

/ 20

07

2006

/ 20

08

Years

DS

R


Data source:



Male AAACM most deprived quintile SOA and Birmingham average

1995/97- 2006/08


0.00

200.00

400.00

600.00

800.00

1000.00

1200.00

1400.00

1995

/ 19

97

1996

/ 19

98

1997

/ 19

99

1998

/ 20

00

1999

/ 20

01

2000

/ 20

02

2001

/ 20

03

2002

/ 20

04

2003

/ 20

05

2004

/ 20

06

2005

/ 20

07

2006

/ 20

08

Years

DS

R

Deprived Birmingham average

Da ta source:

ONS de a th re gistra tions

PHIT ca lcula tion


Figure 36

Female AAACM in the most deprived quintile SOAs and in Birmingham

1995/97- 2006/08


0.00

100.00

200.00

300.00

400.00

500.00

600.00

700.00

800.00

900.00

1995

/ 19

97

1996

/ 19

98

1997

/ 19

99

1998

/ 20

00

1999

/ 20

01

2000

/ 20

02

2001

/ 20

03

2002

/ 20

04

2003

/ 20

05

2004

/ 20

06

2005

/ 20

07

2006

/ 20

08

Years

DS

R

Most deprived quintile SOAs Birmingham average

Data source:


PHIT calculation

MortalityTargetMonitoring_Dec2009

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