Key Health Indicators
Access to PCT data containing small numbers
Unfortunately due to the possibility of disclosure
by differencing we are unable under ONS's confidentiality protocol
to place PCT-level data containing small numbers on a publicly accessible
website. Therefore, some PCT data is password protected. If you work
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to request access to the data.
Health Indicators
The twin aims of the Regional Public Health Strategy, Investment for
Health are to improve health and reduce inequalities. Progress towards
these aims can be measured using some key indicators. These include:
circulatory disease, accidents, cancer and suicide.
Mortality rates from these indicators are commonly used as indicators
of the health of a population. They have the advantage that they provide
generally
unambiguous
measures of health status and are collected on a consistent basis.
However, it should be remembered that they give an incomplete view
of health as in many situations ill health does not lead to premature
death.
In recent years in England, average life expectancy has been around
75 years for men and 80 years for women. Broadly in line with this,
deaths before the age of 75 are sometimes referred to as “premature
deaths”. Given the inevitability of death at some stage, premature
death is of particular public health interest in that it generally
has a higher degree of preventability.
Direct age-standardised mortality rates (DASRs) are used here to compare
the mortality experience of different populations: firstly because
they facilitate more meaningful comparisons between populations differing
in terms of age/sex structure and secondly because they facilitate
monitoring of changes over time in the same population.
Additionally there are a number of self-reported questions on health
in the census, these include asking people to rate their general
health, whether they are suffering from a limiting long-term illness
and also recorded the number of people, between the ages
of 16 to 74 years, who reported that they were economically inactive
due to permanent disability or sickness.
This is extremely useful since there is a considerable amount of information
on what people die from and why they are admitted to hospital, but
there is remarkably little information about other measures of ill
health in the general population.
Indicators
General Health and
indicators from the 2001 Census
Limiting Long-term Illness
Permanent Disability or Sickness
Mortality from all causes
Mortality rates are commonly used as indicators of the health of
a population. They have the advantage that they provide generally
unambiguous measures of health status and are collected on a consistent
basis. However, it should be remembered that they give an incomplete
view of health as in many situations ill health does not lead to
premature death.
Life
expectancy
Life expectancy is a summary measure of mortality at every age that
allows comparisons to be made between areas and time without the
need to assume a particular standard population. Life expectancy
in an area can be interpreted as the number of years a baby born
in a particular period could be expected to live, if it experienced
the mortality rates in that time period and area throughout its life.
Mortality
from circulatory diseases
One of the Saving Lives: Our Healthier Nation targets is
to reduce the premature (i.e. under age 75) mortality rate from circulatory
disease (coronary heart disease, stroke and related conditions) from
the 1995–97 average by at least two fifths (40%) by 2010.
Mortality
from coronary heart disease
Premature death from coronary heart disease is included in the list
of national targets: “By 2010 to reduce the death rate from
coronary heart disease (CHD) in people aged under 75 by at least
40% (baseline 1995 – 1997 ) with a 25% reduction by 2005.”
Mortality
from accidents
One of the Saving
Lives: Our Healthier Nation targets is to reduce the mortality
rate from accidents in all ages from the 1995–97 average by at
least a fifth (20%) by 2010.
Hospital
admissions following accidents
A further Saving Lives: Our Healthier Nation target relating
to accidents is to reduce the number of admissions relating to serious
injury in all ages by at least a tenth (10%) by 2010 from the 1995/96
baseline rate. Variations between areas in this indicator may be
influenced by the completeness of hospital records, accuracy of diagnoses,
and quality of coding, as well as the underlying rate of serious
injuries.
Mortality
from cancer
The Saving
Lives: Our Healthier Nation target is to reduce the mortality
rate from all cancers in the under 75s by at least a fifth (20%)
by 2010 from the baseline rate in 1995–97.
Cancer
registrations
Access to cancer incidence, mortality and survival data for the East Midlands is available from the cancer data section of the Trent Cancer Registry website.
Suicide
The Saving
Lives: Our Healthier Nation target is to reduce the mortality
rate from suicide and undetermined injury in all ages at least
a fifth (20%) by 2010 from the baseline 1995–97 rate.
Mortality from suicide and undetermined injury has varied within a narrow range
since the 1995 baseline and there is no discernible trend in the mortality rate.
Because of the relatively low number of deaths, the rates for individual
local authorities are subject to a large amount of year on year random
variation. This can be seen in the wide confidence intervals.
- Suicide, East Midlands local authorities, 2005-2007 (pooled) [See 'Access to PCT level data' text box to access this resource]
- Suicide, East Midlands PCTs, 2005-2007 (pooled) [See 'Access to PCT level data' text box to access this resource]
- Trends
in suicide, East Midlands local authorities and PCTS, 1993-2007 [See 'Access to PCT level data' text box to access this resource]
- Suicide
and injury undetermined, East Midlands local authorities, 2005-07 (pooled) [See 'Access to PCT level data' text box to access this resource]
- Suicide
and undetermined injury, East Midlands PCTs, 2005-2007 (pooled) [See 'Access to PCT level data' text box to access this resource]
- Trends
in suicide and injury undetermined, East Midlands local
authorities and PCTs, 1993-2007 [See 'Access to PCT level data' text box to access this resource]
Perinatal
and infant mortality
Although infant mortality rates have improved over recent years,
the English rate remains above the European average. Infant mortality
rates vary widely across the country, with the highest local authority
rates being double the national rate or 16 times that of the lowest
rate. There are also large variations in infant mortality rates by
social class of father and ethnic origin of mother. Infants born
to fathers in unskilled or semi-skilled occupations have a mortality
rate 1.6 times higher than those in professional or managerial occupations.
The infant mortality rate is defined as the number of deaths of
infants within the first year of life per 1000 live births. Perinatal
mortality includes stillbirths and deaths of infants up to 7 days
old.
Low
birthweight
Babies with a low birthweight (weighing less than 2500 grams at birth)
are at a higher risk of both illness and death in the first year of
life. Low birthweight is associated with multiple pregnancies, maternal
nutrition, socio-economic status, teenage pregnancy and smoking in
pregnancy.
Teenage
pregnancy
Teenage parents tend to have poor antenatal health, lower birth weight
babies and higher infant mortality rates. Their own health and their
children’s is worse than average. Teenage parents tend to remain
poor and are disproportionately likely to suffer relationship breakdown.
Their daughters are more likely to become teenage mothers themselves
(Social Exclusion Unit, 1999).
The UK has one of the highest rates of teenage pregnancy in Western
Europe. The Government has set a goal of reducing teenage conceptions,
with the specific aim of halving the rate of conceptions among under
18s and setting a firmly established downward trend in the conception
rates for under 16s by 2010.
Oral
health in children
Improving oral health is a part of the Government’s wider public health
strategy. There is a long term trend towards better oral health, including
in children - the most recent figures show that five year-olds now
have on average 1.5 decayed, missing or filled teeth and that 61 per
cent have no experience of tooth decay. However, the overall improvement
disguises inequalities between more and less deprived areas and particular
problems faced by some black and minority ethnic groups.
The Government’s targets are that, by 2003: on average, five year-old
children should have no more than one decayed, missing or filled primary
tooth; and seventy per cent of five year-old children should have no
experience of tooth decay.
Further detail is provided in an EMPHO report: Dental
Health in 5 year old children in the East Midlands 2001-2002.
Communicable disease
The Compendium for Clinical and Health Indicators (which can be accessed
directly by NHS organisations at nww.nchod.nhs.uk)
includes local authority level incidence data on measles, whooping
cough, meningococcal disease and tuberculosis. However, numbers of
cases in most local authority areas are small and cannot be reproduced
here for reasons of Government disclosure rules.
However, the EMPHO report: Communicable
Disease in the East Midlands includes information on:
- Tuberculosis
- Sexually transmitted infections
- HIV
- Blood Borne Viruses
- Meningococcal disease
- Gastrointestinal Infections
- Healthcare Associated Infections
- Vaccine preventable diseases.
Mental
Illness
Mental illness covers a group of conditions which make it very difficult
for those affected to cope with everyday life. The most common examples
are depression and anxiety; schizophrenia; bipolar affective disorder
(manic depression) and dementia.
Causes are complex and often unclear. Research indicates major risk
factors include: poverty; poor education; unemployment; social isolation
stemming from discrimination due to physical disabilities; major life
events such as bereavement, redundancy, debt and crime; drug and alcohol
misuse; poor parenting; genetic predisposition and foetal damage.
It is estimated that one in four people experience mental health problems
in any year, with one in six requiring treatment.