Corporate Performance Management – Social Care & Inclusion
Information & Analysis Team
Title
Health Inequalities
Subject
The difference in health inequalities in Walsall
Creator
E Pearson
Status
Draft – version 1
Date
May 2008
1
Introduction
1.1
This report looks at a few key health data sets to assess the health inequalities of
people living in Walsall. The data covered includes:
 Older people population
 Life expectancy – males / females
 Cancer mortality
 Circulatory disease mortality
 Smoking
 Obesity
 Disability Living Allowance (DLA) claimants
By evaluating the data over a period of time, we can evaluate whether or not health
inequalities have got worse or better in Walsall.
2
Summary – Key Points
The information in the report on health inequalities, picks up the following key points:
 Older people in Walsall have increased in number and this trend is set to
continue by almost 10,000 by 2026. The majority of older people live to the
East of the borough
 Life expectancy in men has improved over time however the gap compared to
regionally and nationally has widened
 Life expectancy in women has also got better and the gap compared to
national levels has narrowed
 Geographically, men and women don’t live as long in the more deprived areas
of the borough compared to those in less deprived areas
 The cancer mortality rate has fallen over time but is still higher than the
regional and national rates
 The circulatory disease mortality rate has reduced over time but the gap
compared to nationally has fluctuated
 The most recent lifestyle survey showed that smoking in Walsall has reduced
and the gap has narrowed. Geographically, smoking rates vary, however it is
thought the recent smoking ban in public areas may have a positive effect on
future rates
 There is a slightly higher proportion of people who are overweight in Walsall
compared to regional figures
 Disability Living Allowance claimants are greater to the West of the borough,
1
particularly in the more deprived areas.
increases with age
Nationally, disability prevalence
Generally speaking in Walsall, health inequalities have reduced. The data in the
report shows how Walsall has over time reduced and key health indicators have
shown how Walsall in comparison to nationally has narrowed the gap.
Key Data
Older People Population:
Past population trends have shown that the older population is increasing in Walsall.
Current 2006 mid-year estimates illustrate the over 65 population in Walsall is 43,000
(16.9% of the total population) compared to 41,022 (16.2%) at the last Census.
2004 based Subnational Population Projections - Older People
16.0
14.0
12.0
Thousands
10.0
8.0
65-69
6.0
70-74
4.0
75-79
80-84
2.0
85+
2028
2026
2024
2022
2020
2018
2016
2014
2012
2010
2008
2006
0.0
2004
3
3.1
Year
Source – 2006 MYE
This pattern is expected to continue as shown in the population predictions above
with older people (aged 65 and over) predicted to increase from 43,100 in 2006 to
53,000 in 2026 – almost 10,000 people.
2
When
the
older
people
population
is
mapped
geographically – at ward level
– it clearly shows a greater
number to the east of the
borough compared to the west.
In particular, Aldridge Central
and South, Streetly, Pheasey
Park Farm and Bloxwich East
wards have a greater number
than wards central to the
borough.
3.2
Life Expectancy:
78
77
76
75
74
73
72
71
70
1991- 1992- 1993- 1994- 1995- 1996- 1997- 1998- 1999- 2000- 2001- 2002- 20031993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
England and Wales
West Midlands
In the 1995/1997 baseline
year, Walsall men had a life
expectancy of 73.5 years
compared with 74.49 years
in England and Wales. The
target is for life expectancy
in Walsall men to reach
77.6 years by 2010.
Walsall
Source: Compendium of Clinical and Health Indicators
Life Expectancy at birth for men in Walsall is lower than the West Midlands and
England and Wales. Overall, taking into account yearly fluctuations, the rate is
increasing, mirroring the national trend. The gap between Walsall and England has
increased by 0.2 of a year from 1995/1997 to 2003/2005.
3
Figure 5: Trends in Life Expectancy in Women
82.00
81.00
80.00
79.00
78.00
77.00
76.00
1991- 1992- 1993- 1994- 1995- 1996- 1997- 1998- 1999- 2000- 2001- 2002- 20031993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
England and Wales
West Midlands
In the 1995/97 baseline
year Walsall women had a
life expectancy of 79.2
years compared with 79.61
years in England and
Wales. The target is for life
expectancy
in
Walsall
women to reach 86.06
years by 2010.
Walsall
Source: Compendium of Clinical and Health Indicators
Life expectancy at birth for women in Walsall is marginally lower than in the West
Midlands and England and Wales. Overall, the rate in women is increasing at a faster
rate than nationally and regionally. Therefore, the inequalities gap between Walsall
and England is decreasing and Walsall is expected to meet the 2010 target if it
continues to increase at the current rate.
Life expectancy in Walsall varies with levels of deprivation. In Walsall it is shorter in
the North and West of the borough, with people tending to live longer in the East.
In men, the longest life expectancy occurs in Aldridge Central & South Paddock,
Pelsall, and Pheasey. The lowest life expectancy in men occurs in Blakenall,
Bloxwich East and St Matthews. The range of life expectancy in men living across
Walsall is estimated to be between 72 and 80 years. The absolute gap in life
expectancy across Walsall wards has fallen from 9.4 years in 1996-2000 to 8.4 years
in 2001-2006. This gap in life expectancy slightly increased between 2000-2005 and
2001-2006 by 0.3 years.
The longest life expectancy in women occurs in Paddock and Pelsall to the East. The
lowest life expectancy is in Blakenall, Bloxwich East and Palfrey. The range of life
expectancy in women living across Walsall is estimated to be between 77 and 85
years. The absolute gap in life expectancy in women across Walsall wards has fallen
from 9.5 years in 1996-2000 to 7.6 years in 2001-2006. This gap in life expectancy
slightly increased between 2000-2005 and 2001-2006 by 0.2 years
3.3
Cancer Mortality:
Cancer accounts for around one third of deaths in under 75 year olds. Reducing the
number of people dying from cancer will have a significant impact on increasing life
expectancy.
In recognition of the inequalities gap, Walsall set the year 2010 target to reduce
cancer mortality in the under 75s by 27.5%. Since 1995-97 the rate has fallen by
13% from 150.3 per 100,000 to 130.8 per 100,000 in 2003-05. This means that 50
fewer Walsall people are dying each year from cancer than in 1995-97. Despite year
on year fluctuations, Walsall tPCT is still on track to meet the 2010 target.
4
Figure 6 and 7: Age Standardised Mortality Rates for Cancers and targets, all
persons, Walsall, West Midlands, England & Wales 1993 – 2004
Ra t e pe r
R a t e pe r
10 0 , 0 0 0
10 0 , 0 0 0
16 0
180
160
14 0
140
12 0
120
10 0
100
80
80
60
60
40
40
20
20
0
0
19 9 5 - 9 7
W al sal l
2003- 05
M i l e st o n e
Ta r ge t
2005
2 0 10
W est M i d l and s
Eng l and
1993 1994 1995 1996 1997 1998
W alsall
1999 2000 2001 2002 2003 2004 2005
W est M id land s
Eng land
Source: Compendium of Clinical and Health Indicators and Birmingham and Black Country StHA
Cancer mortality in the under 75s has fallen slightly faster in the West Midlands as a
whole and in England than in Walsall. This means that the inequalities gap between
Walsall and some other West Midlands districts and the national average has
widened. In 2003-05 the Walsall rate remained 10% higher than the England average
rate (14% higher for men and 4% higher for women). Eliminating the inequalities gap
would save an additional 33 lives per year in Walsall.
3.4
Circulatory Disease mortality:
Death rates from circulatory disease (coronary heart disease, stroke and related
disease) are over 25% higher in the North West than in the South East of England.
In recognition of the inequalities gap, Walsall set a year 2010 target to reduce the
cardiovascular mortality rate in the under 75s by 51%. For more than a decade there
has been a relatively steady decline in this mortality rate. By 2003/2005, a 38%
reduction had been achieved against the 1995/1997 baseline, resulting in 189 fewer
annual deaths. The 2010 mortality rate target will be achieved if this trend continues.
Although a substantial percentage reduction in cardiovascular disease mortality has
been achieved in Walsall, there has only been a small reduction in the inequalities
gap. In 1995/1997 the Walsall rate was 19.5% higher than the national rate. In
2003/2005, the Walsall rate remained 16% higher than the national rate suggesting
that the gap has reduced by 3.5% from the 1995/1997 baseline. If this gap was
eliminated, Walsall would save an additional 40 lives per year.
5
Figures 8 and 9: Age Standardised Mortality Rates for All Circulatory Diseases and
targets, all persons under 75 years, Walsall, West Midlands and England 1993 –
2005
180
Ra t e pe r
10 0 , 0 0 0
18 0
140
16 0
120
14 0
Rate per 100,000
160
12 0
100
10 0
80
80
60
60
40
40
20
20
0
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
19 9 5 - 9 7
2003- 05
M i l e st o n e
2005
Walsall
West Midlands
England
W al sal l
W est M i d l and s
Ta r ge t
2 0 10
Eng l and
Source: Compendium of Clinical and Health Indicators
With regards to angina and heart failure, more women die of these than men (211
women compared to 117 men between 2001/02 to 2005/06). However, when the
age structures of both genders are taken into account, the age specific mortality rates
are higher in men than women for all age groups.
Coronary heart disease (excluding angina) kills about 500 Walsall adults every year
(1 in every 5 deaths), the majority of which are in people aged 65 and over. There
are higher age-standardised mortality rates in the centre of the borough and Bloxwich
East compared to the lowest rates in Streetly and Aldridge Central & South wards.
Between 2001/2002 and 2005/2006, Walsall’s overall rate was 178 deaths per
100,000 population. Walsall tPCT’s Public Health department is in the process of
completing a report which will provide detailed information of the long term conditions
in Walsall.
3.5
Smoking
Smoking is the principal avoidable cause of premature death in the UK. A recent
2005 West Midlands Lifestyle Survey showed smoking in adults in Walsall had
reduced and has narrowed the gap with regional levels (19.5% compared to 20.4%
regionally). The survey also shows that men are more likely to smoke than women
(21.0% compared to 19.9% for women).
Smoking rates across Walsall vary considerably. The 2005 Lifestyle Survey suggests
that the highest rates are in the north and west of the borough including Bentley and
Darlaston North (31.5%), Blakenall (30.7%) and Willenhall South (26.8%) and lower
rates in Aldridge North (9.7%), St Matthew’s (11.0%) and Streetly (11.9%).
It is anticipated that the recent smoking in public places ban will have a knock on
effect on cutting down the number of people who smoke. This ban has also had a
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positive effect on reducing the risk of disease through passive smoking.
3.6
Obesity
Obesity and being overweight increase the risk of diseases such as heart disease,
cancer and diabetes. The prevalence of obesity has trebled since the 1980’s and if
the current trend continues, at least one third of adults, one fifth of boys and one third
of girls will be obese by 2020.
BMI recordings of adults in Walsall show that 32% are overweight; this is slightly
above 30% for the West Midlands region.
3.7
Disability Living Allowance claimants
Figure 10: Disability living allowance Claimants, 2005 by Wards in Walsall
Disability
Living
Allowance claimants in
Walsall are higher than
average in the more
deprived areas including
for example Blakenall and
Birchills Leamore.
Source – Job Centre Plus
Nationally the prevalence of disability increases with age, approximately 75% of men
and women aged 85 and over have a disability. Nationally, 20% of those with a
disability are under 45. Although on average females live longer than males, a
greater proportion of a female’s lifespan is lived in ill health (15% compared to 12%).
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