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THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Updated January 2015 Key results for Wealden (E07000065) Introduction This tool has been developed by Public Health England's (PHE) Knowledge and Intelligence Teams (London and East Midlands) and provides information on the causes of death that are driving inequalities in life expectancy at local area level. Targeting the causes of death which contribute most to the life expectancy gap should have the biggest impact on reducing inequalities. The tool provides data tables and charts showing the breakdown of the life expectancy gap in 2010-12 for two comparisons: 1. The gap between the Local Authority as a whole and England as a whole. This option is only available if the selected area has a lower life expectancy than England. 2. The gap between the most deprived quintile of the selected Local Authority and the least deprived quintile of the Local Authority. This option is available for all areas. This document presents key results for Wealden. The tool, along with a user guide and technical document, can be downloaded from http://www.lho.org.uk/LHO_Topics/Analytic_Tools/Segment/TheSegmentTool.aspx Interpreting the charts Two types of chart are included below. The scarf charts show, for each broad cause of death, the percentage contribution that it makes to the overall life expectancy gap between the areas selected. This could be between the local authority as a whole and England, or between the most deprived quintile of the local authority and the least deprived quintile of the local authority, depending on which comparison has been selected. If a cause shows a contribution of 0, this means that the cause of death does not make any contribution to the life expectancy gap. The bar charts show, for a more detailed breakdown of causes of death, the years of life expectancy that would be gained or lost in the selected area, if it had the same mortality rates as the comparator area. The tables show the percentage contributions and years of life gained for each cause of death. The number of deaths occurring in the area in 2010-12 are shown, and alongside, the number of excess deaths. Excess deaths are the number of 'extra' deaths that occur in the selected area because it has a higher mortality rate for that cause of death than the comparator area. If these deaths were prevented, then the contribution of that cause of death to the overall life expectancy gap would be eliminated. For some causes of death, there are no excess deaths in the selected area, and therefore no impact is made to the life expectancy gap. If this is the case the table shows a value of "..". 1 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Contextual information for Wealden Information on inequalities in life expectancy between Wealden and England Life expectancy at birth in Wealden, 2010-2012 Male 81.0 Female 84.2 Life expectancy at birth in England, 2010-2012 79.2 83.0 Absolute gap in life expectancy between Wealden and England in years* 1.8 1.2 Slope index of inequality** in Wealden, 2010-2012 Male 4.6 Female 3.3 Life expectancy at birth in the most deprived quintile of Wealden, 2010-2012 78.3 82.2 Life expectancy at birth in the least deprived quintile of Wealden, 2010-2012 82.0 85.4 *A value below 0 indicates a lower life expectancy in the selected area compared to England. Information on inequalities in life expectancy within Wealden ** Range of life expectancy in years within the area from most to least deprived. + Slope index of inequality is not available because numbers are too small for robust calculation Sources: Life expectancy - Office for National Statistics (ONS), life expectancy at birth for local areas in England and Wales Slope index of inequality - Public Health England (PHE), Public Health Outcome Framework data tool 2 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Between area inequalities: Life expectancy gap between Wealden as a whole and England Chart 1: Scarf chart showing the breakdown of the life expectancy gap between Wealden as a whole and England as a whole, by broad cause of death, 2010-2012 **This chart is not available as life expectancy is the same as or higher in Wealden than in England as a whole** 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Male Female Footnote: Circulatory diseases includes coronary heart disease and stroke. Digestive diseases includes alcohol-related conditions such as chronic liver disease and cirrhosis. External causes include deaths from injury, poisoning and suicide. Mental and behavioural includes dementia and Alzheimer’s disease. Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates 3 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Chart 2: Bar chart showing life expectancy years gained or lost if Wealden as a whole had the same mortality rates as England as a whole, by broad cause of death, 2010-2012 Male Female External causes Circulatory 0.05 Mental and behavioural 0.36 External causes -0.07 0.11 Other -0.15 Digestive -0.09 Deaths under 28 days -0.15 Deaths under 28 days -0.14 Digestive -0.19 Cancer -0.16 Circulatory -0.36 Mental and behavioural -0.32 Respiratory -0.39 Respiratory -0.34 Cancer Other -0.49 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 Life years lost/gained 2 2.5 3 3.5 -0.56 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 Life years lost/gained 2 2.5 3 Footnote: Circulatory diseases includes coronary heart disease and stroke. Digestive diseases includes alcohol-related conditions such as chronic liver disease and cirrhosis. External causes include deaths from injury, poisoning and suicide. Mental and behavioural includes dementia and Alzheimer’s disease. Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates 4 3.5 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Table 1: Breakdown of the life expectancy gap between Wealden as a whole and England as a whole, by broad cause of death, 2010-2012 Male Number of Number of Number of deaths in local excess deaths years of life authority in local gained/lost* authority Broad cause of death Circulatory Cancer Respiratory Digestive External causes Mental and behavioural Other Deaths under 28 days Total 761 699 295 93 94 134 184 3 -18 -101 -74 -30 -3 -18 -62 -4 Female Contribution Number of Number of Number of to the gap (%) deaths in local excess deaths years of life authority in local gained/lost* authority -0.36 -0.49 -0.39 -0.19 0.05 -0.07 -0.15 -0.15 2,263 ++ ++ ++ ++ ++ ++ ++ ++ 983 676 345 135 91 208 220 2 ++ 2,659 160 -40 -71 -6 20 -109 -143 -3 0.36 -0.16 -0.34 -0.09 0.11 -0.32 -0.56 -0.14 Contribution to the gap (%) ++ ++ ++ ++ ++ ++ ++ ++ ++ * A positive figure indicates that life expectancy years would be gained if the local authority had the same mortality rate as England as a whole (ie the mortality rate in the local authority for the cause is higher than England as a whole). A negative figure indicates that life expectancy years would be lost if the local authority had the same mortality rate as England as a whole. .. The calculated contribution to the gap is negative ++ The figures have not been calculated as life expectancy is higher than England Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates 5 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Chart 3: Bar chart showing life expectancy years gained or lost if Wealden as a whole had the same mortality rates as England as a whole, by detailed cause of death, 2010-2012 Male Other circulatory Other external Other Other mental and behavioural disorders Infectious and parasitic diseases Other digestive Pneumonia Ill defined conditions Stroke Suicide Dementia & Alzheimer's disease Urinary conditions Diabetes Deaths under 28 days Chronic obstructive airways disease Other respiratory disease Chronic liver disease including cirrhosis Other cancers Lung cancer Coronary Heart Disease Female Other circulatory Suicide Other cancers Pneumonia Other external Other mental and behavioural disorders Other digestive Chronic liver disease including cirrhosis Urinary conditions Diabetes Stroke Infectious and parasitic diseases Other Deaths under 28 days Chronic obstructive airways disease Ill defined conditions Other respiratory disease Lung cancer Coronary Heart Disease Dementia & Alzheimer's disease 0.19 0.11 0.04 0.00 0.00 -0.02 -0.04 -0.04 -0.05 -0.05 -0.07 -0.07 -0.07 -0.15 -0.17 -0.17 -0.17 -0.23 -0.26 -0.49 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 2 2.5 3 3.5 Life years lost/gained 0.72 0.09 0.06 0.03 0.03 -0.01 -0.04 -0.06 -0.07 -0.07 -0.09 -0.11 -0.13 -0.14 -0.16 -0.19 -0.20 -0.22 -0.26 -0.30 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 2 2.5 3 3.5 Life years lost/gained Footnote: See table below for details of cause groupings. Details of causes of death included in the 'other' category can be found in the Technical Document. Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates 6 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Table 2: Table showing life expectancy years gained or lost if Wealden as a whole had the same mortality rates as England as a whole, by detailed cause of death, 2010-2012 Broad cause of death Detailed cause of death Coronary Heart Disease Circulatory Stroke Other circulatory Lung cancer Cancer Other cancers Pneumonia Respiratory Chronic obstructive airways disease Other respiratory disease Chronic liver disease including cirrhosis Digestive Other digestive Suicide External Other external Mental and Dementia & Alzheimer's disease Other mental and behavioural disorders behavioural Infectious and parasitic diseases Urinary conditions Other Ill defined conditions Diabetes Other < 28 days Deaths under 28 days Total Male Number of Number of deaths in local excess deaths authority in local authority 338 156 266 131 568 130 105 61 15 78 29 66 132 3 18 26 14 12 113 3 -81 -8 69 -50 -51 2 -40 -35 -22 -8 1 -3 -17 -1 -6 -17 -15 -14 -11 -4 2,263 Female Number of Number of Number of years of life deaths in local excess deaths gained/lost* authority in local authority -0.49 -0.05 0.19 -0.26 -0.23 -0.04 -0.17 -0.17 -0.17 -0.02 -0.05 0.11 -0.07 0.00 0.00 -0.07 -0.04 -0.07 0.04 -0.15 263 243 474 98 578 200 92 55 16 118 16 75 207 2 10 43 27 12 128 2 -48 -14 219 -47 6 22 -41 -50 -6 0 7 13 -107 -1 -23 -22 -65 -17 -17 -3 Number of years of life gained/lost* -0.26 -0.09 0.72 -0.22 0.06 0.03 -0.16 -0.20 -0.06 -0.04 0.09 0.03 -0.30 -0.01 -0.11 -0.07 -0.19 -0.07 -0.13 -0.14 2,659 * A positive figure indicates that life expectancy years would be gained if the local authority had the same mortality rate as England as a whole (ie the mortality rate in the local authority for the cause is higher than England as a whole). A negative figure indicates that life expectancy years would be lost if the local authority had the same mortality rate as England as a whole. Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates 7 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Chart 4: Bar chart showing life expectancy years gained or lost if Wealden as a whole had the same mortality rates as England as a whole, alcohol specific deaths, 2010-2012 Male Female Alcohol specific Alcohol specific -0.17 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 Life years lost/gained 2 2.5 3 3.5 -0.05 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 Life years lost/gained 2 2.5 3 3.5 Footnote: Alcohol specific includes causes of death that are wholly attributable to alcohol Table 3: Table showing life expectancy years gained or lost if Wealden as a whole had the same mortality rates as England as a whole, alcohol specific deaths and all other causes of death, 2010-2012 Cause of death Alcohol specific All other causes of death Total Male Number of Number of deaths in local excess deaths authority in local authority 15 2,244 -19 -294 Female Number of Number of Number of years of life deaths in local excess deaths gained/lost* authority in local authority -0.17 -1.59 12 2,651 2,259 -5 -181 Number of years of life gained/lost* -0.05 -1.18 2,663 * A positive figure indicates that life expectancy years would be gained if the local authority had the same mortality rate as England as a whole (ie the mortality rate in the local authority for the cause is higher than England as a whole). A negative figure indicates that life expectancy years would be lost if the local authority had the same mortality rate as England as a whole Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates 8 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Within area inequalities: Life expectancy gap between the most deprived quintile and least deprived quintle of Wealden Chart 5: Scarf chart showing the breakdown of the life expectancy gap between Wealden most deprived quintile and Wealden least deprived quinitle, by broad cause of death, 2010-2012 100% Circulatory, 7.5% 90% 80% Circulatory, 23.3% Cancer, 21.7% 70% Cancer, 13.7% Respiratory, 12.3% 60% Respiratory, 5.2% Digestive, 0.0% External causes, 13.6% 50% 40% Digestive, 17.5% Mental and behavioural, 7.5% External causes, 2.1% Mental and behavioural, 7.1% 30% 20% Other, 37.4% Other, 25.3% 10% 0% <28 days, 5.8% <28 days, 0.0% Male Female Footnote: Circulatory diseases includes coronary heart disease and stroke. Digestive diseases includes alcohol-related conditions such as chronic liver disease and cirrhosis. External causes include deaths from injury, poisoning and suicide. Mental and behavioural includes dementia and Alzheimer’s disease. Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates, and DCLG Index of Multiple Deprivation, 2010 9 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Chart 6: Bar chart showing life expectancy years gained or lost if Wealden most deprived quintile had the same mortality rates as Wealden least deprived quintile, by broad cause of death, 2010-2012 Male Female Other 1.40 Cancer 0.82 Other 0.79 Circulatory 0.73 External causes 0.51 Digestive Respiratory 0.46 Cancer 0.55 0.43 Circulatory 0.28 Mental and behavioural 0.22 Mental and behavioural 0.28 Deaths under 28 days 0.18 Respiratory 0.16 Digestive -0.01 Deaths under 28 days External causes -0.34 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 Life years lost/gained 2 2.5 3 0.07 -2.5 3.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 Life years lost/gained 2 2.5 3 3.5 Footnote: Circulatory diseases includes coronary heart disease and stroke. Digestive diseases includes alcohol-related conditions such as chronic liver disease and cirrhosis. External causes include deaths from injury, poisoning and suicide. Mental and behavioural includes dementia and Alzheimer’s disease. Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates, and DCLG Index of Multiple Deprivation, 2010 10 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Table 4: Breakdown of the life expectancy gap between Wealden most deprived quintile and Wealden least deprived quintile, by broad cause of death, 2010-2012 Male Number of Number of Number of deaths in most excess deaths years of life deprived in most gained/lost* quintile deprived quintile Broad cause of death Circulatory Cancer Respiratory Digestive External causes Mental and behavioural Other Deaths under 28 days 175 182 76 21 20 38 58 0 Total 569 14 42 31 5 5 17 36 -2 Female Contribution Number of Number of Number of to the gap (%) deaths in most excess deaths years of life deprived in most gained/lost* quintile deprived quintile 0.28 0.82 0.46 -0.01 0.51 0.28 1.40 -0.34 7.5 21.7 12.3 .. 13.6 7.5 37.4 .. 248 147 87 44 16 62 60 1 100 664 38 -1 19 28 -6 19 18 1 0.73 0.43 0.16 0.55 0.07 0.22 0.79 0.18 Contribution to the gap (%) 23.3 13.7 5.2 17.5 2.1 7.1 25.3 5.8 100 * A positive figure indicates that life expectancy years would be gained if the most deprived quintile of the local authority had the same mortality rate as the least deprived quintile (ie the mortality rate in the most deprived quintile for the cause is higher than that of the least deprived quintile). A negative figure indicates that life expectancy years would be lost if the most deprived quintile in the local authority had the same mortality rate as the least deprived quintile. .. The calculated contribution to the gap is negative ## The figures have not been calculated as life expectancy in the most deprived quintile is higher than life expectancy in the least deprived quintile Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates, and DCLG Index of Multiple Deprivation, 2010 11 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Chart 7: Bar chart showing life expectancy years gained or lost if Wealden most deprived quintile had the same mortality rates as Wealden least deprived quintile, by detailed cause of death, 2010-2012 Male Other Lung cancer Other external Dementia & Alzheimer's disease Chronic obstructive airways disease Other cancers Infectious and parasitic diseases Stroke Other circulatory Ill defined conditions Pneumonia Other respiratory disease Urinary conditions Diabetes Suicide Other digestive Other mental and behavioural disorders Chronic liver disease including cirrhosis Coronary Heart Disease Deaths under 28 days Female Other Other digestive Other circulatory Coronary Heart Disease Lung cancer Pneumonia Other cancers Deaths under 28 days Dementia & Alzheimer's disease Suicide Chronic liver disease including cirrhosis Other mental and behavioural disorders Ill defined conditions Diabetes Chronic obstructive airways disease Infectious and parasitic diseases Stroke Urinary conditions Other respiratory disease Other external 0.84 0.53 0.50 0.29 0.28 0.27 0.26 0.19 0.15 0.14 0.08 0.08 0.08 0.07 0.03 0.00 0.00 -0.01 -0.07 -0.34 0.68 0.47 0.40 0.32 0.25 0.20 0.18 0.18 0.16 0.15 0.08 0.06 0.06 0.05 0.04 0.02 0.00 -0.02 -0.07 -0.10 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 2 2.5 3 3.5 Life years lost/gained -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 2 2.5 3 3.5 Life years lost/gained Footnote: See table below for details of cause groupings. Details of causes of death included in the 'other' category can be found in the Technical Document. Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates, and DCLG Index of Multiple Deprivation, 2010 12 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Table 5: Table showing life expectancy years gained or lost if Wealden most deprived quintile had the same mortality rates as Wealden least deprived quintile, by detailed cause of death, 2010-2012 Broad cause of death Detailed cause of death Coronary Heart Disease Circulatory Stroke Other circulatory Lung cancer Cancer Other cancers Pneumonia Respiratory Chronic obstructive airways disease Other respiratory disease Chronic liver disease including cirrhosis Digestive Other digestive Suicide External Other external Mental and Dementia & Alzheimer's disease Other mental and behavioural disorders behavioural Infectious and parasitic diseases Urinary conditions Other Ill defined conditions Diabetes Other < 28 days Deaths under 28 days Total Male Number of Number of deaths in most excess deaths deprived in most quintile deprived quintile 78 36 61 43 139 30 32 14 3 18 7 13 37 1 9 9 2 6 32 0 6 3 5 23 19 7 16 7 0 5 3 2 17 0 6 5 1 5 19 -2 568 Female Number of Number of Number of years of life deaths in most excess deaths gained/lost* deprived in most quintile deprived quintile -0.07 0.19 0.15 0.53 0.27 0.08 0.28 0.08 -0.01 0.00 0.03 0.50 0.29 0.00 0.26 0.08 0.14 0.07 0.84 -0.34 68 55 125 23 124 54 24 10 4 40 2 14 60 2 4 8 7 5 36 1 17 1 20 7 -8 20 3 -4 2 26 1 -7 17 2 3 -2 -2 4 15 1 Number of years of life gained/lost* 0.32 0.00 0.40 0.25 0.18 0.20 0.04 -0.07 0.08 0.47 0.15 -0.10 0.16 0.06 0.02 -0.02 0.06 0.05 0.68 0.18 665 * A positive figure indicates that life expectancy years would be gained if the most deprived quintile of the local authority had the same mortality rate as the least deprived quintile (ie the mortality rate in the most deprived quintile for the cause is higher than that of the least deprived quintile). A negative figure indicates that life expectancy years would be lost if the most deprived quintile in the local authority had the same mortality rate as the least deprived quintile. Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates, and DCLG Index of Multiple Deprivation, 2010 13 THE SEGMENT TOOL SEGMENTING LIFE EXPECTANCY GAPS BY CAUSE OF DEATH Chart 8: Bar chart showing life expectancy years gained or lost if Wealden most deprived quintile had the same mortality rates as Wealden least deprived quintile, alcohol specific deaths, 2010-2012 Male Female Alcohol specific Alcohol specific 0.00 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 Life years lost/gained 2 2.5 3 3.5 0.20 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 Life years lost/gained 2 2.5 3 3.5 Footnote: Alcohol specific includes causes of death that are wholly attributable to alcohol Table 6: Table showing life expectancy years gained or lost if Wealden most deprived quintile had the same mortality rates as Wealden least deprived quintile, alcohol specific deaths and all other causes of death, 2010-2012 Broad cause of death Alcohol specific All other causes of death Total Male Number of Number of deaths in most excess deaths deprived in most quintile deprived quintile 5 562 1 146 Female Number of Number of Number of years of life deaths in most excess deaths gained/lost* deprived in most quintile deprived quintile 0.00 3.71 6 656 567 5 107 Number of years of life gained/lost* 0.20 3.02 662 * A positive figure indicates that life expectancy years would be gained if the most deprived quintile of the local authority had the same mortality rate as the least deprived quintile (ie the mortality rate in the most deprived quintile for the cause is higher than that of the least deprived quintile). A negative figure indicates that life expectancy years would be lost if the most deprived quintile in the local authority had the same mortality rate as the least deprived quintile. Analysis by Public Health England Knowledge and Intelligence Teams (London and East Midlands) based on ONS death registration data, and mid year population estimates, and DCLG Index of Multiple Deprivation, 2010 14