Produced by: Helen Laird, Senior Public Health Analyst, Joint Public Health Unit

Transcription

1 Inequality Profile Wakefield District Local Deprivation These maps show the boundaries of the 209 Super Output Areas (SOAs) within the Wakefield District, each containing an average of 1,500 people. SOA level data allows local issues to be identified and resources to be targeted at areas with highest need. If you would like any detail about these areas or any help with understanding the data contact the Joint Public Health Unit on the above number. The Indices of Multiple Deprivation (IMD) map shows the most deprived and least deprived areas of the district. The averages in the table on the following page correspond with the areas on the IMD map and highlight the inequality gap between the least deprived and most deprived areas. Comparing the IMD map with the other maps shows that there is a general trend whereby the most deprived areas experience the poorest health outcomes. However, looking at the maps in detail highlights that some areas and issues of not follow the general pattern of inequality. Income Deprivation Affecting Children The proportion of children aged 16 and under living in families with low income is an indicator of children living in poverty. Growing up in poverty can have negative effects on children s physical, mental, social and emotional well-being, which impacts outcomes and opportunities in adult life. As the scores used to work out the Income Deprivation Affecting Children Index form part of the overall Index of Multiple Deprivation the most deprived areas match the areas with the higher proportion of children experiencing income deprivation. The quintile averages show that three times as many children living in the most deprived areas live in families with low income than those in the least deprived areas (26.9% and 8% respectively). Indices of Multiple Deprivation 2007 Castleford Ossett Wakefield Normanton Pontefract Knottingley Hemsworth South Kirkby South Elmsall Indices of Multiple Deprivation 2007 Most Deprived Source: NHS Wakefield District, Information Team, October 2009 Least Deprived

2 Summary of Inequalities The indicator averages in these tables correspond with the areas on the local deprivation map and highlight inequalities between the least deprived areas and the most deprived areas. Children and Young People Indicators Wakefield Average Least Affected by Deprivation Most Affected by Deprivation Income Deprivation Affecting Children Smoking in pregnancy Low Birth Weight Breastfeeding Obesity Yr Reception Obesity Yr GCSE 5+A*-C (incl. English & Maths) Not in Education Employment or Training Alcohol Related Admissions

3 Sexual Health: Teenage Pregnancy Outcomes experienced by teenage parents and their children are poorer than those for mothers of an older age. This includes worse health outcomes for the child (e.g. higher rates of infant mortality), poorer mental well-being (e.g. prolonged post-natal depression) and increased poverty. Deprivation, poor educational achievement and low aspirations contribute to national and local variations in teenage pregnancy levels. The government set a target to halve England's under 18 conception rate by 2010, from a 1998 baseline. Teenage pregnancy rates for 2007 are higher in the Wakefield District (56/1,000 females under 18 years of age) than regional (47.6/1,000) and national averages (41.7/1,000). Between teenage pregnancy fell by 10.7% for England and reduced by 1% in the Wakefield District. The map below shows that certain areas of the Wakefield District have higher rates of under 18 conceptions, which are clustered around the most deprived areas. Sexual Health Services and Under 18 Conception Rate per 1,000 by Ward Ossett < + + Wakefield + < + Normanton Castleford < + + < + + < Hemsworth + Pontefract < + < + South Kirkby South Elmsall Knottingley Under 18 Conception Rate per 1,000 by Ward Highest Pregnancy Rate Lowest Pregnancy Rate Source: NHS Wakefield District, Information Team, October < Pharmacies Offering Contraception Sexual Health Clinics Legend Centres Offering C-Card

4 Smoking in pregnancy Smoking during pregnancy is the single greatest cause of premature mortality, with more than a quarter of unexplained infant deaths being attributable to smoking. Smoking in pregnancy can also cause complications during pregnancy and labour, low birth weight and chest conditions in childhood. Wakefield District is amongst the 10% of areas in England with the highest smoking in pregnancy rates. The averages show that levels of smoking in pregnancy are eight times higher amongst pregnant women living in the most deprived areas than those from the least deprived areas (39.17% and 4.88% respectively). This can be seen when comparing patterns of smoking in pregnancy across the District to the deprivation map as parts of some of the areas most affected by deprivation also have the highest levels of smoking in pregnancy (e.g. parts of Kinsley and Fitzwilliam, South Kirkby, Knottingley, Castleford, Featherstone, Sharlston, Pontefract, Normanton, Portobello, Eastmoor and Lupset). However, there are a couple of areas amongst the second lowest fifth least affected by deprivation that do not follow this pattern as smoking in pregnancy levels are amongst the highest quintile (e.g. part of Stanley and Hollingthorpe). Smoking in Pregnancy Percentage of Pregnant Smokers Castleford Ossett Wakefield Normanton Pontefract Knottingley Hemsworth South Kirkby South Elmsall Smoking in Pregnancy Percentage by LSOA Highest Percentage of Pregnant Smokers LowestPercentage of Pregnant Smokers None / no-data Source: NHS Wakefield District, Information Team, October 2009

5 Low Birth Weight Babies born with a weight less than 2,500 grams are classed as low birth weight and this plays a major role in childhood mortality, morbidity and health consequences in later life. Low birth weight is mainly determined by the mother s health and lifestyle status, including poor nutrition, low body mass index, smoking in pregnancy and poor psycho-social well-being. Deprived populations are more likely to experience these risk factors, which creates inequalities in the proportion of low birth weight babies born to deprived and affluent mothers at a national level (8% and 6.5% respectively). Local data supports this as the proportion of low birth weight babies is nine and a half times higher in the most deprived areas than the least deprived areas (13.25% and 1.37% respectively). Looking at the data in more detail shows clear links between the areas with the worst levels of smoking in pregnancy and worst levels of low birth weight. Could this partly explain the high low birth weight levels in the most deprived areas? Breastfeeding Exclusive breastfeeding is recommended for the first 6 months of life due to the many benefits that it can bring for mother and baby. The nutrients provided in breast milk can protect babies from infections and help to prevent problems in later life (e.g. eczema, asthma, diabetes and obesity). In the short-term breastfeeding can help mothers to return to their pre-pregnancy figure faster and in the long-term protect them against ovarian and breast cancer and weak bones. Looking at the quintile averages for breastfeeding demonstrates that levels of breastfeeding are six times higher in the least deprived areas than the most deprived areas (55.5% and 9% respectively).comparing patterns of breastfeeding across the District to the deprivation map confirms this, as the most deprived areas have the lowest levels of breastfeeding (parts of Kinsley, Hemsworth, South Kirkby, Airedale, Featherstone). The map below shows that the breastfeeding support groups are mostly located in areas where levels of breastfeeding are low. Interestingly, a few of the most deprived areas have higher levels of breastfeeding (e.g. Pontefract central, Belle Vue, Peacock, parts of Eastmoor and Primrose Hill) and a couple of the least deprived areas have breastfeeding levels in the lower proportions. What do you think is influencing the higher levels of breastfeesting in some of the most deprived areas? Is there anything we can learn from these areas? When the data is examined in more detail it shows that the areas with the lowest levels of breastfeeding have higher smoking in pregnancy levels. What does this suggest about pregnancy-related lifestyle messages in the most deprived areas? Breastfeeding Percentage of Children Being Breastfed at 6 Weeks Children Being Breastfed at 6-8 Weeks Percentage by LSOA Lowest Percentage of Breastfeeding Highest Percentage of Breastfeeding None / no-data Source: NHS Wakefield District, Information Team, October 2009 Breastfeeding Support Group

6 Childhood Obesity Childhood obesity has an impact on risk of obesity in adulthood, long-term conditions, poor mental well-being and premature death and is mainly caused by physical inactivity and poor nutrition. In , 92.7% of children in Year Reception and 87% of children in Year 6 in the Wakefield District were measured as part of the National Child Measurement Programme. Body Mass Index was measured for each child (height and weight) and compared to the age and sex-specific Body Mass Index percentiles for the UK. Children were defined as obese if their BMI was greater than or equal to the 95th percentile, which means that 95% of children of the same age and sex have a lower BMI. Children were defined as overweight if their BMI was greater than or equal to the 85th percentile but less than the 95th percentile, which means that 85-95% of children of the same age and sex have a lower BMI At a national level, Year 6 childhood obesity is around double that of Year Reception (18.3% and 9.6% respectively). Although the Wakefield District averages are higher than this they still follow this pattern with 10.5% of Year Reception and 20.4% of Year 6 being measured as obese. For both year groups a further 14.9% of children that were measured fell into the overweight category. Year Reception Obesity Percentage of Children Identified as Obese /08 Castleford Ossett Wakefield Normanton Knottingley Pontefract Hemsworth South Elmsall Year Reception Obesity - Children Identified as Obese During Reception Year Percentage Highest Percentage of Obese Children Source: NHS Wakefield District, Information Team, October 2009 None / no-data

7 Levels of Year Reception and Year 6 obesity are higher in the most deprived areas than the least deprived areas. For Year Reception there were 53 Super Output Areas where none of the children measured were identified as obese (these areas appear in white on the map). However, around a quarter of children measured from the most deprived areas were obese. For Year 6 children, childhood obesity was over six times higher in the most deprived areas than the least deprived areas. Some of the most deprived areas have the highest levels of obesity for both year groups (e.g. Airedale, Fitzwilliam Newstead, parts of South Kirkby and South Elmsall). Other deprived areas have high levels of obesity for one year group and low levels for the other year group (e.g. Fitzwilliam Club Terrace and Industrial estate, Knottingley, Normanton, Minsthorpe, Portobello). Contrasting this, some of the least deprived areas have higher levels of obesity for both year groups (e.g. part of Ossett and Hollingthorpe). Certain areas have high levels for Year Reception obesity and low Year 6 obesity (e.g. South of Newmillerdam Notton, Belle Isle, part of Outwood), whereas others have high levels of Year 6 obesity but low levels of Year Reception obesity (e.g. parts of Ackworth, part of Outwood, Sandal Milnthorpe, Pledwick and Woolgreaves) Overall, the data shows that in some areas obesity is high for both year groups, whereas in other areas it is high for one year group and low for the other Year 6 Obesity Percentage of Children Identified as Obese Year 6 Obesity - Children Identified as Obese Percentage /08 Highest Percentage of Obese Children Source: NHS Wakefield Distrcit, Information Team, October 2009 Lowest Percentage of Obese Children None / no-data

8 GCSE Achievement Population groups who are well-educated experience better health. Educational achievement is related to employment, income and lifestyle behaviours, all of which determine health outcomes in later life. Achievement of five or more A*-C grades at GCSE including English and Maths is a national indicator for educational attainment. (Until recently, the national indicator for GCSE s did not specify that A*-C grades in English and Maths were required). Looking at the quintile averages for GCSE s demonstrates that achievement of five or more A*-C grades is three times higher in the least deprived areas than those in the most deprived areas (76.4% and 25.5% respectively). Comparing patterns of GCSE achievement across the District to the deprivation map confirms this as the most deprived areas have lower levels of GCSE achievement (e.g. Knottingley, Airedale, parts of Kinsley, Pontefract, Lupset, Portobello). Interestingly, a few of the most deprived areas do not follow this pattern as they are amongst the areas with better levels of educational achievement (e.g. part of South Elmsall and Normanton). Similarly, some of the least deprived areas have lower levels of educational achievement (e.g. part of Middlestown and Ossett). What factors are influencing the better educational achievement in some of the most deprived areas and poorer achievement in some of the least deprived areas? GCSEs Percentage of Achievement of 5 or more A*-C Grades Including English and Maths GCSEs Percentage of Achievement of 5 or more A*-C grades Including English and Maths Lowest Percentage of Achievement Source: NHS Wakefield District, Information Team, October 2009 Highest Percentage of Achievement None / no-data

9 Not in Education Employment or Training (NEET) There is a national indicator based on the proportion of 16 to 18 year olds who are not in employment, education or training (NEET). Being NEET between the ages of is related to teenage parenthood, depression, poor physical health and unemployment and low income in later life. Looking at the quintile averages for NEET demonstrates that levels of NEET are sixteen times higher in the most deprived areas than the least deprived areas (23.2% and 1.4% respectively). Comparing patterns of NEET across the District to the deprivation map confirms this as some of the most deprived areas have high levels of NEET (e.g. parts of Castleford, Featherstone, Sharlston and Eastmoor). Interestingly, high levels of NEET are particularly clustered around the North East of the District and lesser so around the most deprived areas in the South East. There are also a couple of the least deprived areas that have higher levels of NEET (e.g. Horbury Junction and part of Outwood). What could be causing the lower levels of NEET in the most deprived areas, especially those with lower educational achievement levels (e.g. parts of the South East of the District)? Could this be due to targeted service provision in these areas or could it be due to something else? Not in Employment Education or Training (NEET) Percentage of year olds who are NEET Percentage of Year Olds who are NEET Highest Percentage Source: NHS Wakefield PCT, Information Team, October 2009 Lowest Percentage None / no-data

10 Alcohol Attributable Admissions for Young People Common problems associated with excessive alcohol consumption amongst young people include intoxication, accidents, emotional and psychological problems, sexual activity, anti-social behaviour and violence. Long-term excessive alcohol consumption can cause health problems in later life. Alcohol-attributable admissions give an indication of the proportion of young people that are admitted to hospital for conditions that are directly related to alcohol consumption (e.g. accidental poisoning) and other problems that are attributed to alcohol use (e.g. assault / self-harm). In 2008, 781 people between 0-18 years of age were admitted with alcohol-attributable problems within the Wakefield District. Admissions to hospital for alcohol-related problems were fifteen times higher for young people from the most deprived areas than young people from the least deprived areas. Childhood Accidents Accidents are one of the biggest causes of childhood deaths in the United Kingdom and many childhood accidents can be prevented. Evidence suggests that children from the most deprived areas are more likely to be killed or admitted to hospital with serious injuries than those in the least deprived areas. Childhood A&E Attendances Proportions according to gender and age - April 2007 and March 2008 Examining the data in more detail shows many similarities in the types of injuries sustained by males and females, however there are some differences. More females under the age of 1 attended due to abrasions/contusions/ lacerations than males in the same age group (27.9% and 17.4% respectively). A higher proportion of females aged had been poisoned than males (11.4% and 3.2% respectively); whereas a higher proportion of males in this age group had dislocations/fractures/amputations than females (22.3% and 12.3% respectively). Across all age groups males tended to have a higher proportion of head injuries than females, although the difference is very small in some age categories. For the full report Childhood Accidents at Accident and Emergency Departments: Local Facts and Figures contact jane.stark@wdpct.nhs.uk

11 Inequality Indicators The indicator averages in these tables correspond with the areas on the local deprivation map and highlight inequalities between the least deprived areas and the most deprived areas. Indicators of Inequality Wakefield Average Least Affected by Deprivation Most Affected by Deprivation Burglary (% of households) Incapacity Benefit (% of working age) Council Tax Benefit (% of households) Cancer Mortality (% under age of 75) CVD Mortality (% under age of 75) Household Burglary Experiencing crime and fear of crime can affect physical health, mental well-being and quality of life. Household burglary rates highlight the areas of the District that are experiencing high levels of burglary which may be relevant to explaining community variations in experiences of health and well-being. The average percentage of households being burgled within the District increased slightly between 2007 and 2008 (from 1.34% to 1.46%). The average percentage of household burglaries is seven times higher in the most deprived areas than the least deprived areas (2.97% and 0.42% respectively). These inequalities can be seen by comparing the map for household burglary to the deprivation map as some of the most deprived areas also have high levels of household burglary (e.g. Featherstone and Lupset). However, other areas that are most deprived are not amongst the quintile most affected by household burglary, but are close to other areas that are (e.g. Kinsley, Ryhill and Hemsworth, parts of South Kirkby and Airedale Ferry Fryston). The maps also show that some of the areas that have high levels of household burglary do not have the highest levels of deprivation (e.g. parts of Pontefract, parts of Outwood and Newton Hill, North Agbrigg and Belle Vue, Kettlethorpe and Crigglestone, the areas around Pinderderfields and College Grove Road). There are also a cluster of least deprived areas in the South West that experience the second highest fifth of burglaries (e.g. Woolley, West Bretton, Midgeley, Netherton, parts of Sandal, Pledwick and Durkar) Burglary - % of households burgled

12 Incapacity Benefit and Council Tax Benefit Incapacity benefits and severe disability allowance are claimed by people who are assessed as being incapable of work. This is a good indicator of how poor health varies in the working population across the District. In the Wakefield District 35.4% of claims are due to mental health and behavioural disorders, which has increased by 27% over the last nine years. A further 22.8% of claimants are due to diseases of the musculoskeletal system and connective tissue which is partly a result of the District s industrial heritage. However, the number of people claiming for this reason has declined by 30% over the last nine years. Council tax benefits are means tested to help people on a limited income to pay their Council tax. It gives an indication of where people on low incomes are living throughout the District. The percentage of households claiming Council Tax benefit within the District increased slightly between 2007 and 2008 (from 24.96% to 27%), which could be partly attributed to the economic downturn. Incapacity Benefit & Severe Disability Allowance - % working age - May 2007-Aug 2008

13 Patterns of Incapacity Benefit and Council Tax Benefit Claims Comparing patterns of incapacity benefit and council tax benefit claims to the deprivation map shows that claims are highest in the most deprived areas. The averages confirm this as incapacity benefit claims are nearly five times higher in the most deprived areas than the least deprived areas (17.8% and 3.63% respectively). Furthermore, Council Tax benefit claims are nearly seven times higher in the most deprived areas than the least deprived areas (50.08% and 7.18% respectively). Looking at the two fifths of areas with the highest claims on both maps shows a clear pattern between the areas with high levels claims for both incapacity benefit and council tax benefit (e.g. parts of Wakefield centre, Castleford, Normanton, Featherstone and South Kirkby). This is expected as claiming Incapacity Benefit forms part of the assessment for Council Tax benefits. However, there are some areas where claims for one benefit are amongst the highest fifth and claims for the other benefit are in the second highest fifth. For example, parts of Kinsley, Hemsworth and South Kirkby are amongst the most affected (highest fifth) for incapacity benefits claims, whereas Council Tax benefits in the same areas are in the second highest fifth. Contrasting this, council tax claims are high in parts of Lupset, Upton and Knottingley, and in these areas incapacity benefit claims are not in the highest fifth. What are the possible reasons for the high proportion of claimants of one benefit and low proportion of claimants for the other benefit in certain areas of the District? Council Tax Benefit Claimants - % of households

14 Cancer Mortality and Cardiovascular Disease Mortality Mortality from cancer and cardiovascular disease (CVD) to people under the age of 75 is an indicator of how we are doing in terms of premature mortality (early deaths) from two of the most common causes of death. The most common forms of cancer are lung, colon, rectum, breast and prostate. Cardiovascular disease (CVD) includes diseases that affect the heart and circulatory system such as coronary heart disease, angina, heart attack and stroke. CVD and some cancers can be prevented through maintaining a healthy lifestyle, which sustaining a healthy weight, good nutrition, physical activity, not smoking and reduced alcohol consumption. Additional risk factors for CVD include high blood pressure, high cholesterol and a family history of heart problems. Some cancers can be cured if detected early enough. People who have been diagnosed with CVD can reduce the risk of future problems by maintaining a healthy lifestyle. Cancer Mortality - % of people under the age of

15 Patterns of Cancer Mortality and CVD Mortality Looking at the quintile averages and comparing patterns of cancer and CVD mortality to the deprivation map shows that premature mortality for both diseases is worse in the most deprived areas. This is more apparent for CVD where the average rates of mortality are seven times higher in the most deprived areas than in the least deprived areas (0.63% and 0.09% respectively). The rates of cancer mortality are four times worse in the most deprived areas than the least deprived areas (0.8% and 0.18% respectively). These differences are shown in the maps, as CVD mortality is particularly clustered in the most deprived areas, whereas the areas with highest cancer mortality rates are more widely distributed across Wakefield and the West. The two maps show that in some areas both cancer mortality and CVD mortality are high (e.g. South Kirkby and parts of Hemsworth). In other areas cancer mortality is high and CVD mortality is low (e.g. parts of Ossett, South of Normanton / Heath / Kirkthorpe, Ackworth Moor Top, Darrington / South of Pontefract). Contrasting this, other parts of the District have high CVD mortality and low cancer mortality (e.g. parts of Castleford). Why do you think that in some small areas mortality for one disease is high and the other is low? CVD Mortality - % of people under the age of