What do we know?
-
Life expectancy in Lewisham is below that of London and
England, for both males and females. Within South East
London, it is below those in Bexley, Bromley and Southwark,
and not significantly different from those in Greenwich and
Lambeth.
-
Life expectancy in Lewisham is increasing, for both males and
females, as it is in England as a whole. For males the gap
between life expectancy in Lewisham and that in England is
not decreasing, while for females the gap is narrowing.
-
There are considerable variations in life expectancy across
Lewisham, for both males and females.
The following table shows the life expectancy for the three years 2007-9, for
the six boroughs in South East London, London, and England, with their
associated 95% confidence intervals.
Borough
England
London
Lewisham
Lambeth
Southwark
Greenwich
Bromley
Bexley
Male life
expectancy
at birth
78.3
78.6
76.3
76.4
77.8
75.8
79.9
79.4
95%C
I LL
95%CI
UL
78.2
78.6
75.8
75.9
77.3
75.3
79.6
78.9
78.3
78.7
76.8
76.9
78.3
76.3
80.3
79.8
Female life
expectancy
at birth
82.3
83.1
81.3
81.1
82.9
81.9
83.8
83.1
The following charts depict the same data visually.
95%C
I LL
95%CI
UL
82.3
83.0
80.9
80.6
82.4
81.4
83.5
82.7
82.3
83.1
81.7
81.5
83.4
82.3
84.2
83.5
Life expectancy at birth: Males
3 year average with 95% confidence intervals
South East London Borough of residence, 2007-09
85
84
83
82
81
Years 80
79
78
77
76
75
England
London
Lewisham Lambeth SouthwarkGreenwich Bromley
Bexley
Life expectancy at birth: Females
3 year average with 95% confidence intervals
South East London Borough of residence, 2007-09
85
84
83
82
81
Years 80
79
78
77
76
75
England
London
Lewisham Lambeth SouthwarkGreenwich Bromley
Bexley
The variation in life expectancy for males across South East London boroughs
is about four years, while for females it is about three years. Lewisham’s
relative position near the lower end is similar in both males and females.
The following table show the changes in life expectancy from 2000 to 2009,
for Lewisham and England, with their associated 95% confidence intervals,
together with the gap (in years) between Lewisham and England, and the gap
as a percentage of the England value in the same year (“relative gap”).
2000-02
2001-03
2002-04
2003-05
2004-06
2005-07
2006-08
2007-09
Males
Lewisham
74.1
74.5
75.1
75.2
75.7
76.0
76.2
76.3
England
76.0
76.2
76.5
76.9
77.3
77.7
77.9
78.3
Gap
-1.9
-1.7
-1.4
-1.7
-1.6
-1.7
-1.7
-2.0
%Gap
-2.5%
-2.3%
-1.9%
-2.2%
-2.1%
-2.1%
-2.2%
-2.5%
Females
Lewisham
79.1
79.1
79.5
79.7
80.3
80.8
81.0
81.3
England
80.7
80.7
80.9
81.1
81.6
81.8
82.0
82.3
Gap
-1.6
-1.6
-1.4
-1.4
-1.3
-1.0
-1.0
-1.0
Life Expectancy at birth: Males
3 year averages 2000-2 to 2007-9 with 95% confidence intervals
England and Lewisham
83
82
81
80
79
Years 78
77
76
75
74
2000-02
2001-03
2002-04
2003-05
2004-06
2005-07
2006-08
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
73
2007-09
%Gap
2.0%
2.0%
1.8%
1.8%
1.6%
1.3%
1.3%
1.2%
Life Expectancy at birth: Females
3 Year averages 2000-2 to 2007-9 with 95% confidence intervals
England and Lewisham
83
82
81
80
79
Years 78
77
76
75
74
2000-02
2001-03
2002-04
2003-05
2004-06
2005-07
2006-08
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
Lewisham
England
73
2007-09
For males the relative gap between Lewisham and England has fluctuated
from year to year, but at 2007-09 it was as wide as at the start of the period.
For females there has been a steady reduction, implying that life expectancy
of females in Lewisham is increasing more rapidly than in England as a whole.
The following table shows life expectancy by Ward in Lewisham with 95%
confidence intervals, together with Borough, England, and London
comparators for the 5-year period 2004-2008.
Ward
Lewisham
Bellingham
Blackheath
Brockley
Catford South
Crofton Park
Downham
Evelyn
Forest Hill
Grove Park
Ladywell
Lee Green
Lewisham Central
New Cross
Perry Vale
Male Life
Expectancy
at Birth
76
75
78
75
77
79
74
75
76
77
75
77
72
73
75
95%CI
Lower
95%CI
Upper
75
74
76
73
76
77
72
73
75
76
74
75
70
72
74
76
77
80
76
78
81
76
77
78
79
76
79
74
75
77
Female Life
Expectancy
at Birth
80
79
82
81
81
85
82
83
80
81
80
81
77
78
82
95%CI
Lower
95%CI
Upper
80
77
80
79
80
83
80
80
79
80
78
79
75
76
80
81
80
83
82
82
88
83
85
81
83
81
82
79
79
83
Rushey Green
Sydenham
Telegraph Hill
Whitefoot
England
London
74
75
76
77
78
78
72
74
75
75
78
78
76
77
78
79
78
78
80
80
79
82
82
82
The following charts depict the same data visually.
Life Expectancy at birth: Males
5 year averages 2004-8 with 95% confidence intervals
Lewisham Borough, Wards in Lewisham, England and London
90
89
88
87
86
85
84
83
82
81
80
79
78
77
76
75
74
73
72
71
70
B
Le
w
is
e l ha
lin m
g
B
la ha
m
ck
h
ea
B
t
C
at roc h
fo
kl
rd
ey
C
ro So
u
ft
on th
P
D
ow ark
n
h
am
Ev
Fo el
re yn
st
G
ro
H
ve ill
P
La ar
dy k
Le
w
L
w
el
is ee
l
h
G
am re
en
C
en
N
ew tra
l
C
r
P
er os
R
s
r
u
sh y V
ey al
e
G
r
S
yd ee
Te
en n
le
gr ha
ap m
h
W
H
il
hi
te l
fo
E n ot
gl
an
Lo d
nd
on
Years
Life Expectancy at birth: Females
5 year averages 2004-8 with 95% confidence intervals
Lewisham Borough, Wards in Lewisham, England and London
89
88
87
86
85
84
83
82
81
80
79
Years
78
77
76
75
74
73
72
71
B
Le
w
is
h
am
el
lin
gh
B
am
la
ck
h
ea
th
B
ro
C
ck
at
fo
le
y
rd
S
C
ou
ro
th
ft
on
P
a
D
ow rk
n
h
am
Ev
el
Fo
yn
re
st
G
H
ro
ill
ve
P
ar
La
k
dy
w
Le
Le
el
l
w
e
is
G
h
am ree
n
C
en
tr
N
al
ew
C
ro
P
ss
er
ry
R
u
V
sh
al
ey
e
G
re
S
e
yd
n
en
Te
h
le
a
gr
m
ap
h
H
W
ill
hi
te
fo
ot
En
gl
an
d
Lo
nd
on
70
The following charts show the same data, with wards ordered by life
expectancy.
78
79
78
80
82
82
81
81
80
84
82
82
Life Expectancy at birth: Males
5 year averages 2004-8 with 95% confidence intervals
Lewisham Borough, Wards in Lewisham, England and London
90
89
88
87
86
85
84
83
82
81
80
79
78
77
76
75
74
73
72
71
70
C
ro
ft
on
B
la Pa
r
c
C
at kh k
fo
ea
rd
th
G So
ro
u
ve th
Le Pa
rk
e
G
W re
hi en
t
Fo efo
Te re ot
s
le
gr t H
ap ill
h
S
yd H
en ill
B
e l ha
lin m
gh
P
a
er
ry m
V
a
E v le
el
La
y
dy n
w
B
el
R
r
l
u
sh ock
ey le
y
G
r
D
ow ee
n
Le
n
w Ne ha
m
w
is
h
am Cr
os
C
en s
Le
t
w ral
is
h
En am
gl
a
L o nd
nd
on
Years
For males, Forest Hill, Sydenham, Bellingham, Perry Vale, Evelyn, Ladywell,
Brockley, Rushey Green, Downham, New Cross, and Lewisham Central wards
all have life expectancy significantly lower than England and London. New
Cross and Lewisham Central have life expectancy significantly lower than the
Lewisham overall. Crofton Park and Blackheath wards have significantly
higher life expectancy than Lewisham overall. No ward had significantly
higher life expectancy than England and London.
Life Expectancy at birth: Females
5 year averages 2004-8 with 95% confidence intervals
Lewisham Borough, Wards in Lewisham, England and London
89
88
87
86
85
84
83
82
81
80
79
Years
78
77
76
75
74
73
72
71
W
hi
t
Ev
el
yn
ef
o
D
ow ot
n
h
B
am
la
ck
h
ea
P
th
er
ry
V
G
al
ro
e
ve
C
at
P
ar
fo
k
rd
S
ou
Le
th
e
G
re
en
B
ro
ck
S
le
yd
y
en
h
am
Fo
re
st
H
ill
La
dy
R
u
w
sh
el
ey
l
G
r
B
e
el
en
lin
Te
gh
le
a
gr
m
ap
h
H
N
Le
ill
ew
w
is
C
h
am r o
ss
C
en
tr
Le
al
w
is
h
am
En
gl
an
d
Lo
nd
on
C
ro
ft
o
n
P
ar
k
70
For females, Sydenham, Forest Hill, Ladywell, Rushey Green, Bellingham,
Telegraph Hill, New Cross and Lewisham Central wards all have life
expectancy significantly lower than England and London. Telegraph Hill, New
Cross and Lewisham Central have life expectancy significantly lower than
Lewisham overall. Crofton Park has significantly higher life expectancy than
England, London, and Lewisham overall.
The Slope Index of Inequality (SII).
From 2009/2010 a new indicator for health inequalities within a local authority
was introduced, the “Slope Index” of inequality. This is a single score which
represents the gap in years of life expectancy between the least deprived
and most deprived within a borough, based on a statistical analysis of the
relationship between life expectancy and deprivation scores across the whole
of Lewisham. The SII is most easily understood with reference to a graph.
The graph from which 2003-2007 SII for males in Lewisham was devised is
shown below1. Lewisham’s population was divided into deciles, by grouping
LSOAs according to their IMD score. Life expectancy at birth was calculated
for each of the deciles and plotted on the graph in blue, with 95% confidence
limits. Hence the blue dot towards the left of the graph shows that for males
in the most deprived 10% of LSOAs in Lewisham, life expectancy was 70.7
years (95% confidence interval 69.5 to 71.8 years). In contrast, the
equivalent figures for the least deprived 10% of LSOAs for males in the
Lewisham were 79.2 years (78.0 to 80.4 years). Following further statistical
adjustment, in which a linear regression was performed to get the best-fit
straight line for the data, the result can be interpreted as a difference in life
expectancy of 7.6 years (5.1 to 10.1) between the most and least deprived
males within Lewisham.
Using the SII as an indicator of health inequalities within Lewisham, with the
goal of reducing health inequalities, a decrease in the SII will represent
progress. This applies only within Lewisham, and gives no indication of
progress relative to the rest of the country.
1
Association of Public Health Observatories, 5LFLewishamPCTSlopeIndex-LEdeciles[1].pdf . Data in deciles for the
PCT was given for 2003-7 only
The following table shows the most recent (for 2005-2009) SIIs for boroughs
in South East London, with 95% confidence intervals.
Borough
Males
SII
(years)
Lewisham
Bexley
Lambeth
Bromley
Greenwich
Southwark
95%CI
lower
6.2
7.4
5.9
8.0
9.2
9.5
Females
SII
(years)
95%CI
upper
3.5
5.3
3.1
5.1
7.7
5.3
8.9
9.5
8.8
10.9
10.8
13.7
95%CI
lower
3.3
4.5
4.5
6.1
6.6
6.9
95%CI
upper
-1.1
1.8
1.4
3.0
3.6
2.7
7.6
7.1
7.5
9.2
9.7
11.1
The following chart shows the same data, graphically.
Slope Index of Inequality, with 95% confidence intervals
South East London Boroughs
2005-9
16
14
12
10
8
Years
6
4
2
0
-2
Male
Female
Lewisham
Male
Female
Bexley
Male
Female
Lambeth
Male
Female
Bromley
Male
Female
Greenwich
Male
Female
Southwark
For males, Lewisham has the second lowest SII in South East London. For
females Lewisham has the lowest SII in South London. For females in this
period the confidence interval includes zero, which means that it would be
consistent with the data for there to be no gradient of life expectancy by
deprivation. However, it would be a mistake to place too much reliance on
this, as because of the degree of uncertainty as measured by the width of the
confidence intervals, no borough in South East London is statistically
significantly different from any other for either sex.
In term of comparison with London, Lewisham ranks 10th lowest for males,
and 6th lowest for females.
The following table shows Lewisham’s SSIs from 2001-5 (the first year for
which data is available) to 2005-9.
Period
2001-2005
SII
Males
95%CI
lower
95%CI
upper
SII
7.5
4.5
10.5
4.3
Females
95%CI
lower
1.5
95%CI
upper
7.1
2002-2006
2003-2007
2004-2008
2005-2009
7.1
7.6
6.5
6.5
4.2
4.9
3.9
3.9
10.0
10.3
9.1
9.1
3.9
3.5
3.4
3.3
0.9
0.2
-0.6
-1.1
6.9
6.9
7.5
7.6
The following chart shows the same data graphically, together with the
median value for England (the value for which there are as many local
authorities with higher values as with lower values).
Slope Index of Inequality with 95% confidence intervals
2001-5 to 2005-9
Lewisham, with England median value
12
10
8
6
England
Years
4
Slope Index
2
0
-2
Male
Female
2001-2005
Male
Female
2002-2006
Male
Female
2003-2007
Male
Female
2004-2008
Male
Female
2005-2009
For males the SIIs have fluctuated over the period. For females there seems
to have been a steady downward trend, but, as the SII has reduced, the 95%
confidence intervals have widened. No year was significantly different from
any other for either males or females.
Sources for Life Expectancy data
Life expectancy at Borough level came from the Compendium of Public Health
Indicators2. Life expectancy at Ward level came from the London Health
Observatory, and is available from the London Health Programme website3. A
detailed explanation of the Slope index of Inequality, together with the data
itself, can be found at the Association of Public Health Observatories website4.
www.nchod.nhs.uk
http://hna.londonhp.nhs.uk/
4 http://www.apho.org.uk/resource/view.aspx?RID=96930
2
3
What is this telling us?
Life expectancy is an internationally accepted measure of the overall health of
a population. It also featured in the previous Government’s overarching
national target for tackling health inequalities, which was “By 2010 to
reduce health inequalities in health outcomes by 10% as measured
by infant mortality and life expectancy at birth”5.
The life expectancy target was expressed in more detail thus:
“Starting with local authorities, by 2010 to reduce by at least 10%
the gap in life expectancy between the fifth of areas with the worst
health and deprivation indicators (the Spearhead group) and the
population as a whole.”
Lewisham was part of the Spearhead group, and the baseline period from
which reduction was to be measured was 1995-7.
In the baseline period life expectancy for females was 79.69 years in England
and 78.4 years in Lewisham, a gap of 1.29 years, or 1.62% of the England
figure. The target was to reduce this by at least 10%, making a relative gap
of 1.45% of the England figure or lower.
At 81.3 years, life expectancy for females in Lewisham is lower than the
England average of 82.3 years, but is increasing slightly faster than the
national average rate. In 2005-2007 the relative gap was 1.3%, making this
the first period in which Lewisham has achieved the 2010 target. This
achievement has been maintained in subsequent years.
In the baseline period life expectancy for males was 74.61 years in England
and 72.2 years in Lewisham, a gap of 2.41 years, or 3.23% of the England
figure. The target is to reduce this by at least 10%, making a relative gap of
2.90% of the England figure or lower.
At 76.3 years, life expectancy for males in Lewisham is lower than the
England average of 78.3 years, but has increased faster than the national
average. In 2005-2007 the relative gap was 2.12%. Since then it has
widened, but Lewisham has achieved the 2010 target every 3-year period
since 2000-2002.
There is considerable inequality in life expectancy across Lewisham
geographically. For both sexes, Crofton Park has the higher life expectancy,
and Lewisham Central has the lowest, with New Cross the second lowest. For
females Lewisham Central ward has significantly lower life expectancy than
13 other wards; for men its life expectancy is significantly below those for 11
Department of health, Health Inequalities: Progress and Next Steps, 9 June 2008,
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_
085312.pdf
5
other wards. Crofton Park ward has significantly higher life expectancy for
females than 11 other wards, and for males than 8 other wards. This appears
not to be directly associated with deprivation, especially for females. Evelyn
Ward in the North and Downham Ward in the south, both of which have high
levels of deprivation, have life expectancies among the highest in the borough
for females, while that in Catford South, the least deprived ward, is very close
to the borough average.