London. Health Profile 2009

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1 Health Profile 2009 This profile gives a snapshot of health in your region. It is designed to help local government and primary care trusts tackle health inequalities and improve people s health. Health Profiles are produced annually by the Association of Public Health Observatories and funded by the Department of Health. Visit the Health Profiles website to: View profiles for other areas Use interactive maps Access updated information See more indicator data www. Based on Ordnance Survey material.. All rights reserved. DH POPULATION: 7,556,900 Mid-2007 population estimate Source National Statistics website: at a glance The health of people in shows a mixed picture compared to as a whole. For both sexes, life expectancy in is better than that of. Compared to the national average however, more people in live in deprived areas and the health of children is generally worse. s rate of early death from heart disease and stroke has decreased in recent years. That decline has been slower than for overall but s rate of early death from cancer is now better than the average. Although the proportion of adults who are obese in is lower than in all other English regions, ers are less physically active than average. is the region with the highest levels of children living in poverty and children classified as obese. Levels of physical activity and teenage pregnancy are also worse than average. However, compared to other regions, women in are less likely to smoke during pregnancy and are more likely to initiate breastfeeding. Levels of drug misuse, violent crime, and new cases of tuberculosis are higher in than in other regions. The capital is the region with the lowest proportion of binge-drinking adults. Priorities for include improving vascular health, smoking cessation and tobacco control, screening, childhood immunisation and sexual health. For more information, please see the NHS website

2 Introduction by the Regional Director of Public Health The task of improving the health of ers is a complex one. The population of is highly diverse and there are huge inequalities in wealth and opportunity across the capital. These characteristics are reflected in health outcomes which vary by place and by population group. Health within s boroughs There are wide inequalities in levels of deprivation across the capital. Compared to the average for, the proportion of people living in deprived areas is low in 14 of s boroughs but high in 18 boroughs. These variations are reflected in health outcomes within the capital and for some indicators of health boroughs have both some of the best and worst results within. In 16 boroughs, for example, male life expectancy is better than the national average, but in 14 boroughs it is worse. The rate of teenage pregnancy also varies dramatically across the capital, with the highest rates found in parts of south. Inequalities in health in the capital can be particularly seen in the contrasts between some boroughs. In areas such as Richmond and Kingston, for example, the health of people is generally better than the average for, but in boroughs such as Lewisham and Tower Hamlets, it is generally worse. For some health outcomes, however, s boroughs do show a more consistent picture. In no boroughs are the levels of binge drinking adults or women smoking in pregnancy worse than the average for. In contrast, in only four boroughs is the proportion of children classified as obese significantly better than the national average. Our Priorities and actions A major focus of our work is embedded in the overarching Healthcare for strategy. This sets out a 10-year programme to transform standards of health and healthcare in and improve the lives of all ers. For more information on Healthcare for, please see the website The NHS Prevention Strategy identifies five priorities to improve the health of ers: vascular health, tobacco control and smoking cessation, screening, childhood immunisation and sexual health. These priorities reflect key indicators of the poor health of ers compared to the national average and provide the focus for targeted action to reduce the variation in health status across the capital. In addition, a great deal of work is being done to control and prevent tuberculosis in. NHS has been promoting the implementation of the NHS Health Check Programme across to prevent coronary heart disease, stroke, diabetes and kidney disease. In the run up to the 2012 Olympic and Paralympic Games, we are seizing the opportunity to create a lasting health legacy for the capital and are working to get ers more physically active to realise long-term benefits to their health and wellbeing. A major programme of work, Go, was launched in early Strong partnership working across has enabled us to make progress against the 2010 target to reduce the relative gap in life expectancy at birth between the Spearhead areas and as a whole by at least 10% 10 of s 11 Spearheads are on track to meet the target for males, females or both. Professor Lindsey Davis, Interim Regional Director of Public Health

3 Regional Indicator Maps Map 1 Index of Multiple Deprivation 2007 by Lower Super Output Area in Region Legend Local authority area National deprivation quintiles Quintile 1 (least deprived) Quintile 2 Quintile 3 Quintile 4 Quintile 5 (most deprived) Based on Ordnance Survey material. All rights reserved. DH Licence number Map 2 Teenage Pregnancy (under 18 years) by Local Authority Area in Region Legend Local authority area Rate per 1,000 females (crude rate) by national quintiles (best quintile) Based on Ordnance Survey material. Due to small numbers, figures have been combined for the City of LB with Hackney LB.. All rights reserved. DH Licence number (worst quintile)

4 Regional Trends Trend 1 All-age all-cause mortality per 100,000 males and females for and Region Age-standardised rate per 100,000 population (males) (males) (females) (females) Year (mid-point of three-year moving averages of annual rates) Trend 2 Early deaths from heart disease and stroke per 100,000 persons aged under 75 years, for and Region Age-standardised rate per 100,000 population Year (mid-point of three-year moving averages of annual rates) Trend 3 Infant mortality for and Region 10 8 Rate per 1,000 live births Year (mid-point of three-year moving averages of annual rates)

5 Local Variations: Regional Context This table shows how each local authority within this region compares to the regional average, for the range of indicators used in the local Health Profiles. Indicators and areas are sorted from top to bottom and from left to right so that the better overall results appear at the top left and worse overall results at the bottom right of the table. A green box may still indicate an important public health problem. Significantly worse than regional average Significantly better than regional average Not significantly different from regional average No significance can be calculated, or data unavailable or suppressed due to small numbers * Relates to National Indicator 2009 Deprivation Road injuries and deaths * Breast feeding initiation * Drug misuse Hip fracture in over-65s New cases of tuberculosis People diagnosed with diabetes Smoking in pregnancy Teenage pregnancy (under 18) * Incapacity benefits for mental illness * Statutory homelessness Adults who smoke * Children in poverty * Deaths from smoking Life expectancy - female * Life expectancy - male * Obese adults Obese children * Physically active children * Binge drinking adults Infant deaths Violent crime * Children s tooth decay (at age 5) Early deaths: cancer * Early deaths: heart disease & stroke * Healthy eating adults Hospital stays for alcohol related harm * Over-65s not in good health Excess winter deaths GCSE achieved (5A*-C inc. Eng & Maths) * Physically active adults Carbon emissions * Richmond upon Thames LB Kingston upon Thames LB Kensington and Chelsea LB Barnet LB Bromley LB Merton LB Sutton LB Harrow LB Redbridge LB Croydon LB Havering LB Bexley LB City of Westminster LB Ealing LB Enfield LB Hillingdon LB Brent LB Hammersmith and Fulham LB Wandsworth LB Camden LB Hounslow LB Haringey LB Waltham Forest LB Islington LB Newham LB Southwark LB Hackney LB Lambeth LB Lewisham LB Barking and Dagenham LB Greenwich LB Tower Hamlets LB

6 Local Variations: National Context This table shows how each local authority within this region compares to the average, for the range of indicators used in the local Health Profiles. Indicators and areas are sorted from top to bottom and from left to right so that the better overall results appear at the top left and worse overall results at the bottom right of the table. A green box may still indicate an important public health problem. Significantly worse than average Significantly better than average Not significantly different from average No significance can be calculated, or data unavailable or suppressed due to small numbers * Relates to National Indicator 2009 Binge drinking adults Smoking in pregnancy Obese adults Breast feeding initiation * Healthy eating adults Road injuries and deaths * Life expectancy - female * Hip fracture in over-65s Early deaths: cancer * Incapacity benefits for mental illness * Hospital stays for alcohol related harm * GCSE achieved (5A*-C inc. Eng & Maths) * Life expectancy - male * Adults who smoke * Deaths from smoking Infant deaths Excess winter deaths Teenage pregnancy (under 18) * Deprivation Physically active children * Over-65s not in good health People diagnosed with diabetes Drug misuse Early deaths: heart disease & stroke * Children s tooth decay (at age 5) Obese children * Violent crime * Physically active adults Children in poverty * Statutory homelessness New cases of tuberculosis Carbon emissions * Richmond upon Thames LB Kingston upon Thames LB Bromley LB Merton LB Sutton LB Barnet LB Kensington and Chelsea LB Harrow LB Havering LB Bexley LB Redbridge LB Enfield LB Croydon LB City of Westminster LB Brent LB Ealing LB Hillingdon LB Haringey LB Hammersmith and Fulham LB Camden LB Hounslow LB Wandsworth LB Waltham Forest LB Southwark LB Greenwich LB Hackney LB Islington LB Newham LB Barking and Dagenham LB Lambeth LB Lewisham LB Tower Hamlets LB

7 Regional Variations: National Context This table shows how each region compares to the average for the range of indicators used in the local Health Profiles. Areas are sorted by a summary score of red, amber and green indicators so that areas with more indicators which are better than the average appear at the left and those which are worse appear at the right. A green box may still indicate an important public health problem. Significantly worse than average Domain Our communities Children s and young people s health Adults health and lifestyle Disease and poor health Life expectancy and causes of death Significantly better than average Not significantly different from average No significance can be calculated, or data unavailable * Relates to National Indicator 2009 Indicator South East 1 Deprivation Children in poverty * Statutory homelessness GCSE achieved (5A*-C inc. Eng & Maths) * Violent crime * Carbon emissions * Smoking in pregnancy Breast feeding initiation * Physically active children * Obese children * Children s tooth decay (at age 5) Teenage pregnancy (under 18) * Adults who smoke * Binge drinking adults Healthy eating adults Physically active adults Obese adults Over-65s not in good health Incapacity benefits for mental illness * Hospital stays for alcohol related harm * Drug misuse People diagnosed with diabetes New cases of tuberculosis* Hip fracture in over-65s Excess winter deaths Life expectancy - male * Life expectancy - female * Infant deaths Deaths from smoking Early deaths: heart disease & stroke * Early deaths: cancer * Road injuries and deaths * South West East of East Midlands North East North West Yorkshire and The Humber West Midlands

8 Health Summary for The chart below shows how people s health in this region compares to the rest of. The regional result for each indicator is shown as a diamond, against the range of results for local authorities in which is shown as a bar. A green diamond may still indicate an important public health problem. Significantly worse than average Not significantly different from average Significantly better than average No significance can be calculated *Relates to National Indicator 2009 worst 25th percentile average 75th percentile best Domain Indicator Local No. Per Year Local Value Eng Avg Eng Worst Range 1 Deprivation Eng Best Our communities 2 Children in poverty * Statutory homelessness GCSE achieved (5A*-C inc. Eng & Maths) * Violent crime * Carbon emissions * Smoking in pregnancy Children s and young people s health 8 Breast feeding initiation * Physically active children * Obese children * Children s tooth decay (at age 5) n/a Teenage pregnancy (under 18) * Adults health and lifestyle 13 Adults who smoke * n/a Binge drinking adults n/a Healthy eating adults n/a Physically active adults n/a Obese adults n/a Over-65s not in good health Disease and poor health 19 Incapacity benefits for mental illness * Hospital stays for alcohol related harm * Drug misuse People diagnosed with diabetes New cases of tuberculosis Hip fracture in over-65s Excess winter deaths Life expectancy - male * n/a Life expectancy and causes of death 27 Life expectancy - female * n/a Infant deaths Deaths from smoking Early deaths: heart disease & stroke * Early deaths: cancer * Road injuries and deaths * Note (numbers in bold refer to the above indicators) 1 % of people in this area living in 20% most deprived areas of % of children living in families receiving means-tested benefits Crude rate per 1,000 households 2007/08 4 % at Key Stage /08 5 Recorded violence against the person crimes crude rate per 1,000 population 2007/08 6 Total end user CO2 emissions per capita (tonnes CO2 per resident) % of mothers smoking in pregnancy where status is known 2007/08 8 % of mothers initiating breast feeding where status is known 2007/08 9 % 5 16 year olds who spent at least 2 hours per week on high-quality PE and school sport 2007/08 10 % of school children in reception year 2007/08 11 Average number of teeth per child age 5 which were actively decayed, filled or had been extracted 2005/06 12 Under-18 conception rate per 1,000 females (crude rate) %. Direct estimate from Health Survey for %. Direct estimate from Health Survey for %. Direct estimate from Health Survey for % aged /08 17 %. Direct estimate from Health Survey for % who self-assessed general health as not good (directly age and sex standardised) Crude rate per 1,000 working age population Directly age and sex standardised rate per 100,000 population 2007/08 21 Crude rate per 1,000 population aged /07 22 % of people on GP registers with a recorded diagnosis of diabetes 2007/08 23 Crude rate per 100,000 population Directly age-standardised rate for emergency admission 2006/07 25 Ratio of excess winter deaths (observed winter deaths minus expected deaths based on non-winter deaths) to average non-winter deaths At birth, At birth, Rate per 1,000 live births Per 100,000 population age 35+, directly age standardised rate Directly age standardised rate per 100,000 population under Directly age standardised rate per 100,000 population under Rate per 100,000 population More information is available in The Indicator Guide: www. For information on your area contact your regional PHO: You may use this profile for non-commercial purposes provided the source is acknowledged. Source: APHO and Department of Health.. designed by: Cox Design, Witney, Oxon