joint strategic needs assessment foundation profile - JSNA

JOINT STRATEGIC NEEDS 

ASSESSMENT FOUNDATION 

PROFILE 

HULL HEALTH PROFILE 

RELEASE 3 

Mandy Porter, Robert Sheikh Iddenden, Tim Greene, Des Cooper, 

Jim Keech, Matt Birchall and Andrew Taylor. 

March 2011. 

Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011.

Interative Hull Atlas: www.hullpublichealth.org/Pages/hull_atlas.htm More information: www.jsnaonline.org and www.hullpublichealth.org 

For more information, please contact: 

Mandy Porter, Robert Sheikh Iddenden (Iddy) or Tim Greene, 

Epidemiologists/Statisticians, 

Public Health Sciences, 

Hull Public Health Directorate, 

NHS Hull, 

The Maltings, 

Silvester Square, 

Silvester Street, 

HULL. 

HU1 3HA 

mandy.porter@hullpct.nhs.uk (01482 344805) 

robert.iddenden@hullpct.nhs.uk (01482 344802) 

tim.greene@hullpct.nhs.uk (01482 344804) 

This report and others are available at www.hullpublichealth.org 

and www.jsnaonline.org. 

Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 2


JOINT STRATEGIC NEEDS ASSESSMENT 

FOUNDATION PROFILE 

Contents 

1 EXECUTIVE SUMMARY .................................................................... 16 

2 SUMMARY ......................................................................................... 18 

3 INTRODUCTION ................................................................................ 25 

3.1 Release of Joint Strategic Needs Assessment Foundation ...................... 25 

3.2 Uses of This Report ...................................................................................... 25 

3.2.1 GP Consortia and Commissioning ............................................................. 26 

3.2.2 World Class Commissioning ...................................................................... 26 

3.2.3 Health Needs Assessment ......................................................................... 27 

3.2.4 Health Equity Audit .................................................................................... 27 

3.2.5 Programme Budgeting and Predictive Modelling for Resource Reallocation 

................................................................................................................... 28 

3.2.5.1 Introduction to Programme Budgeting .................................................. 28 

3.2.5.2 Expenditure .......................................................................................... 28 

3.2.5.3 Quadrant Chart – Expenditure and Outcomes...................................... 31 

3.2.5.4 Diabetes Programme Budgeting and Marginal Analysis Pilot in Hull .... 34 

3.2.5.5 Predictive Modelling in Hull by Price Waterhouse Cooper .................... 39 

3.2.5.6 Prioritisation Model ............................................................................... 40 

3.2.5.7 Scenario Generator .............................................................................. 41 

3.3 About This Document ................................................................................... 42 

3.3.1 Topic Ordering ........................................................................................... 42 

3.3.2 Geographical Areas ................................................................................... 44 

3.3.3 Benchmarking and Comparator Areas ....................................................... 44 

3.3.3.1 Comparator Areas for Hull .................................................................... 44 

3.3.3.2 Health, Social and Economic Outcomes Benchmarking: A Tale of Three 

Cities .................................................................................................... 47 

3.3.3.3 General Practice Groupings ................................................................. 47 

3.3.4 Data Sources ............................................................................................. 49 

3.3.5 Listed Sections of This Release ................................................................. 50 

3.3.6 Influence of NHS Reorganisation ............................................................... 51 

3.3.6.1 General Practices and GP Consortia .................................................... 52 

3.3.6.2 Outcome Measures, Performance Targets and Progress Towards 

Targets ................................................................................................. 52 

3.4 Local Surveys, Definitions and Statistical Methods ................................... 54 

3.5 Abbreviations ................................................................................................ 55 

4 GEOGRAPHICAL AREA .................................................................... 57 

4.1 Hull ................................................................................................................. 57 

4.2 Wards Within Hull .......................................................................................... 59 

4.3 Ward Profiles ................................................................................................. 60 

4.4 Localities and Area Committee Areas ......................................................... 61 



5 DEMOGRAPHY AND DEMOGRAPHICS ........................................... 63 

5.1 Population Structure ..................................................................................... 63 

5.1.1 Difference in GP Registered Population and Resident Population............. 63 

5.1.2 Age and Gender Structure of Resident Population .................................... 71 

5.1.3 Total Resident Population at Ward, Area and Locality Level ..................... 78 

5.1.4 Resident Population Pyramids ................................................................... 78 

5.1.5 Change in Resident Population from 2007 to 2008 .................................... 83 

5.1.6 Population Density ..................................................................................... 90 

5.1.7 Age and Gender Structure of Registered (Patient) Population .................. 91 

5.1.8 Total Registered (Patient) Population at Area and Locality Level .............. 96 

5.1.9 Total Registered (Patient) Population at Practice Level ............................. 97 

5.1.10 Mean Age of Patients at Practice Level ..................................................... 98 

5.2 Fertility ......................................................................................................... 100 

5.3 Annual Number of Births and Deaths ........................................................ 102 

5.4 Projected Populations ................................................................................ 104 

5.5 Ethnicity ....................................................................................................... 106 

6 DEPRIVATION AND ASSOCIATED MEASURES ............................ 111 

6.1 Introduction ................................................................................................. 111 

6.2 Inequity ........................................................................................................ 111 

6.3 Rates of Unemployment ............................................................................. 112 

6.4 Benefit Claimants ........................................................................................ 114 

6.4.1 All Benefit Claimants ................................................................................ 114 

6.4.2 Employment and Support Allowance (Incapacity Benefit) Claimants ....... 117 

6.5 Housing Stock and Environment ............................................................... 121 

6.6 Educational Attainment and Absence in Hull Schools ............................ 121 

6.7 Qualifications............................................................................................... 124 

6.8 Crime ............................................................................................................ 126 

6.9 Index of Deprivation .................................................................................... 131 

6.9.1 Index of Deprivation 2007 ........................................................................ 131 

6.9.1.1 For Geographical Areas of Hull .......................................................... 131 

6.9.1.2 For General Practices ......................................................................... 134 

6.9.2 Index of Deprivation 2004 and Change From 2004 to 2007 .................... 137 

6.10 ACORN Classifications ............................................................................... 138 

6.10.1 ACORN .................................................................................................... 138 

6.10.2 Health ACORN ......................................................................................... 144 

7 MEASURES OF GENERAL HEALTH STATUS ............................... 150 

7.1 General Health ............................................................................................. 150 

7.1.1 General Health in Relation to Deprivation ................................................ 153 

7.2 Long-Standing Illness or Disability ........................................................... 154 

7.2.1 Long-Standing Limiting Illness or Disability in Relation to Deprivation ..... 157 

7.3 Learning Disabilities ................................................................................... 158 

7.3.1 Diagnosed and Modelled Prevalence, ..................................................... 158 

7.3.2 Programme Budgeting ............................................................................. 166 

7.4 Caring and Self-Care ................................................................................... 167 

7.4.1 Population Projections for Those Aged 65+ Years .................................. 167 

7.4.2 Responsible for the Long-Term Care of Others ....................................... 167 



7.4.3 Long-term Care of Others in Relation to Deprivation ............................... 170 

7.5 Use of Healthcare Services ........................................................................ 170 

7.5.1 Dental Health ........................................................................................... 171 

7.5.1.1 National Adult Dental Health Survey .................................................. 171 

7.5.1.2 Clinical Dental Statistics ..................................................................... 172 

7.5.1.3 Registered With a Dentist ................................................................... 173 

7.5.1.4 Years Since Last Dental Visit ............................................................. 174 

7.5.1.5 Programme Budgeting and Outcomes ............................................... 176 

7.5.2 Health Service Attendances Within Last Year ......................................... 177 

7.5.3 Use of Private or Other Health Services .................................................. 178 

7.6 Inpatient Hospital Admissions ................................................................... 179 

7.7 Life Expectancy at Birth ............................................................................. 181 

7.7.1 Life Expectancy at Birth in Hull Compared to England and Comparator 

Areas ....................................................................................................... 181 

7.7.2 Life Expectancy at Birth in Hull Wards ..................................................... 183 

7.7.3 Relationship Between Deprivation and Life Expectancy at Birth .............. 185 

7.7.4 Deprivation and Life Expectancy at Birth – Hull and Comparators........... 188 

7.7.5 Progress Towards Targets ....................................................................... 196 

7.8 Mortality ....................................................................................................... 199 

7.8.1 Causes of Death ...................................................................................... 199 

7.8.2 Causes of Death by Age .......................................................................... 205 

7.8.3 Stillbirths and Infant Mortality Rate .......................................................... 209 

7.8.3.1 Stillbirths ............................................................................................. 209 

7.8.3.2 Infant Mortality Rate ........................................................................... 209 

7.8.3.3 Progress Towards Targets ................................................................. 211 

7.8.4 All Cause Mortality ................................................................................... 212 

7.8.4.1 Under 75 Year All Cause Mortality Ratio ............................................ 212 

7.8.4.2 Under 75 Year All Cause Mortality Ratio in Relation to Deprivation ... 214 

7.8.4.3 Under 75 Year All Cause Mortality Rate in Relation to Deprivation for 

Hull and Comparator Areas ................................................................ 215 

7.8.4.4 All Age All Cause Mortality Rate ......................................................... 218 


7.8.5 Deaths at Home ....................................................................................... 228 

7.8.6 Winter Deaths .......................................................................................... 231 

8 LIFESTYLE RISK FACTORS ........................................................... 233 

8.1 Main Risk Factors ........................................................................................ 233 

8.1.1 Definitions of Risk Factors ....................................................................... 233 

8.1.2 Total Estimated Resident Adults With Main Risk Factors ........................ 233 

8.1.3 Total Estimated Resident Young People With Main Risk Factors ............ 238 

8.2 Risk Factors for Different Black and Minority Ethnic groups.................. 239 

8.2.1 Black and Minority Ethnic Groups ............................................................ 239 

8.2.2 Gypsies and Travellers ............................................................................ 242 

8.3 Perceived Impact of Changing Lifestyle on Health .................................. 244 

8.4 Smoking ....................................................................................................... 245 

8.4.1 Smoking as a Risk Factor ........................................................................ 245 

8.4.2 Prevalence ............................................................................................... 246 



8.4.2.1 Adults ................................................................................................. 246 

8.4.2.2 Young People ..................................................................................... 252 

8.4.2.3 Smoking in Pregnancy ........................................................................ 254 

8.4.3 Mortality ................................................................................................... 255 

8.4.4 Attitudes Towards Smoking ..................................................................... 257 

8.4.5 Smoking in Relation to Deprivation .......................................................... 257 

8.4.6 Smoking in Relation to Employment Status ............................................. 258 

8.4.7 Social Marketing and Factors Influencing Smoking Behaviour ................ 259 

8.4.8 Stop Smoking Service .............................................................................. 260 

8.4.9 Stop Smoking Cessation Service and Predictive Modelling in Relation to 

Life Expectancy ........................................................................................ 267 

8.4.10 Stop Smoking Strategy ............................................................................ 269 


8.5 Overweight and Obesity ............................................................................. 273 

8.5.1 Obesity as a Risk Factor .......................................................................... 273 

8.5.2 Definition of Overweight and Obesity ....................................................... 273 

8.5.3 Prevalence of Overweight and Obesity in Adults ..................................... 274 

8.5.4 Prevalence of Overweight and Obesity in Children .................................. 280 

8.5.4.1 National Child Measurement Programme ........................................... 280 

8.5.4.2 Data Completeness ............................................................................ 281 

8.5.4.3 Hull Reception Year Children Aged 4–5 Years ................................... 281 

8.5.4.4 Hull Year 6 Children Aged 10–11 Years ............................................. 285 

8.5.4.5 Hull Children Measured in Year R and Six Years Later in Year 6 ....... 287 

8.5.5 Attitudes Towards Obesity ....................................................................... 293 

8.5.6 Overweight and Obesity in Relation to Deprivation .................................. 294 

8.5.6.1 Adults ................................................................................................. 294 

8.5.6.2 Children .............................................................................................. 295 

8.5.7 Overweight and Obesity in Relation to Employment Status ..................... 295 

8.5.8 Social Marketing and Factors Influencing Obesity ................................... 296 

8.5.9 Weight Loss Programmes ........................................................................ 297 

8.5.10 Evaluation of Weight Loss Programmes .................................................. 298 

8.5.10.1 Geographical Spread of Adults Using Weight Loss Programmes ....... 298 

8.5.10.2 Success of Weight Loss Programmes in Terms of Improvements in 

Physical and Mental Health ................................................................ 300 

8.5.11 Obesity Strategy ...................................................................................... 303 


8.6 Exercise ....................................................................................................... 306 

8.6.1 Lack of Exercise as a Risk Factor ............................................................ 306 

8.6.2 Prevalence ............................................................................................... 306 

8.6.2.1 Adults ................................................................................................. 306 

8.6.2.2 Young People ..................................................................................... 313 

8.6.3 Reasons For Not Exercising .................................................................... 315 

8.6.4 Attitudes Towards Exercise ..................................................................... 316 

8.6.5 Exercise in Relation to Deprivation .......................................................... 316 

8.6.6 Exercise in Relation to Employment Status ............................................. 317 

8.6.7 Social Marketing and Factors Influencing Exercise .................................. 318 

8.6.8 Exercise Programmes .............................................................................. 319 



8.6.9 Evaluation of Exercise Programmes ........................................................ 319 

8.6.10 Physical Activity Strategy ......................................................................... 324 


8.7 Diet ............................................................................................................... 326 

8.7.1 Collecting Information in Diet ................................................................... 326 

8.7.2 Poor Diet as a Risk Factor ....................................................................... 326 

8.7.3 Healthy Diet ............................................................................................. 326 

8.7.3.1 Adults ................................................................................................. 327 

8.7.3.2 Young People ..................................................................................... 328 

8.7.4 Young People‟s Involvement in Cookery ................................................. 329 

8.7.5 5-A-DAY ................................................................................................... 330 

8.7.5.1 Adults ................................................................................................. 330 

8.7.5.2 Young People ..................................................................................... 335 

8.7.6 Breakfast and Lunch Food Items Eaten by Young People ....................... 336 

8.7.7 Attitudes Towards Diet ............................................................................. 337 

8.7.8 Diet in Relation to Deprivation.................................................................. 338 

8.7.8.1 5-A-DAY ............................................................................................. 338 

8.7.8.2 Type of Fat or Oil Used For Frying Food ............................................ 339 

8.7.9 5-A-DAY in Relation to Employment Status ............................................. 340 

8.7.10 Social Marketing and Factors Influencing Diet ......................................... 340 

8.7.11 Dietary Advice and Improving Cookery Skills........................................... 341 


8.8 Alcohol Consumption ................................................................................. 342 

8.8.1 Alcohol as a Risk Factor .......................................................................... 342 

8.8.2 National Recommendations for Alcohol Consumption and Definitions .... 342 

8.8.2.1 Excessive Weekly Alcohol Consumption ............................................ 342 

8.8.2.2 Binge Drinking .................................................................................... 342 

8.8.3 Knowledge About Recommended Alcohol Units ...................................... 343 

8.8.4 Prevalence ............................................................................................... 344 

8.8.4.1 Adults ................................................................................................. 344 

8.8.4.2 Young People ..................................................................................... 353 

8.8.5 Inpatient Hospital Admissions .................................................................. 359 

8.8.6 Mortality From Alcohol-Related Diseases and Conditions ....................... 361 

8.8.7 Attitudes Towards Alcohol ....................................................................... 362 

8.8.8 Alcohol Consumption in Relation to Deprivation ...................................... 363 

8.8.9 Alcohol Consumption in Relation to Employment Status ......................... 364 

8.8.10 Social Marketing and Factors Influencing Alcohol Consumption.............. 364 

8.8.11 Alcohol Strategy ....................................................................................... 365 


8.9 Drug and Substance Abuse ....................................................................... 367 

8.9.1 Prevalence ............................................................................................... 367 

8.9.1.1 Adults ................................................................................................. 367 

8.9.1.2 Prisoners ............................................................................................ 369 

8.9.1.3 Young People ..................................................................................... 370 

8.9.2 Mortality ................................................................................................... 375 

8.9.3 Young People‟s Attitude Towards Drugs ................................................. 375 

8.10 Prevalence of Multiple Risk Factors .......................................................... 376 



8.10.1 From Adult Health and Lifestyle Survey 2007 .......................................... 376 

8.10.2 From Young People Health and Lifestyle Survey 2008-09 ...................... 380 

8.10.3 From Healthy Heart Study ....................................................................... 386 

9 VACCINATIONS, IMMUNISATION & SCREENING ......................... 388 

9.1 Childhood Immunisations .......................................................................... 388 

9.1.1 Schedule of Immunisations ...................................................................... 388 

9.1.2 Vaccination Uptake Rates for One Year Olds .......................................... 389 

9.1.2.1 Hull Versus Comparator Areas ........................................................... 389 

9.1.2.2 At Ward Level in Hull .......................................................................... 390 

9.1.2.3 At Practice Level in Hull ...................................................................... 393 

9.1.3 Vaccination Uptake Rates for Two Year Olds .......................................... 396 




9.1.4 Vaccination Uptake Rates for Five Year Olds .......................................... 403 




9.1.5 Vaccination Uptake Rates by Ethnicity in Hull.......................................... 410 


9.2 Influenza and Pneumococcal Vaccinations .............................................. 413 

9.2.1 Influenza Vaccination ............................................................................... 413 


9.2.2 Pneumococcal Vaccination ...................................................................... 415 

9.3 Screening ..................................................................................................... 416 

9.3.1 Breast Cancer .......................................................................................... 416 

9.3.1.1 Percentage of Women Screened ........................................................ 416 


9.3.2 Cervical Cancer ....................................................................................... 421 

9.3.2.1 Percentage of Women Screened ........................................................ 421 


9.3.3 Influences on Breast and Cervical Screening Rates ................................ 426 

9.3.3.1 Mean Age of Practice Patients ........................................................... 426 

9.3.3.2 Deprivation ......................................................................................... 427 

9.3.3.3 Comparison of Breast and Cervical Cancer Screening Rates at Practice 

Level ................................................................................................... 429 

9.3.4 Colorectal Cancer .................................................................................... 430 

9.3.4.1 Percentage Screened ......................................................................... 430 


9.3.5 Abdominal Aortic Aneurysm ..................................................................... 433 

10 SPECIFIC DISEASES/AREAS ......................................................... 434 

10.1 Circulatory Disease ..................................................................................... 434 

10.1.1 All Circulatory Disease ............................................................................. 434 

10.1.1.1 Risk Factors ........................................................................................ 434 

10.1.1.2 Diagnosed Prevalence ....................................................................... 434 

10.1.1.3 Inpatient Hospital Admissions ............................................................. 438 



10.1.1.4 Mortality .............................................................................................. 441 



10.1.2 Coronary Heart Disease .......................................................................... 447 

10.1.2.1 Risk Factors ........................................................................................ 447 

10.1.2.2 Diagnosed and Modelled Prevalence ................................................. 447 


10.1.2.4 Mortality .............................................................................................. 455 

10.1.2.5 Health Equity Audit ............................................................................. 458 

10.1.2.6 Diagnosed Prevalence in Relation to Deprivation ............................... 458 

10.1.2.7 Inpatient Admissions and Treatment in Relation to Deprivation ......... 460 

10.1.2.8 Mortality in Relation to Deprivation ..................................................... 461 

10.1.2.9 Mortality Within the Most Deprived National Quintile – Hull and 

Comparators ....................................................................................... 462 

10.1.2.10 Progress Towards Targets ............................................................. 464 

10.1.2.11 Programme Budgeting .................................................................... 465 

10.1.3 Stroke ...................................................................................................... 466 

10.1.3.1 Risk Factors ........................................................................................ 466 



10.1.3.4 Mortality .............................................................................................. 471 



10.1.3.7 Inpatient Admissions in Relation to Deprivation .................................. 477 



Comparators ....................................................................................... 479 

10.1.3.10 Social Marketing ............................................................................. 481 



10.1.4 Heart Failure ............................................................................................ 484 

10.1.4.1 Risk Factors ........................................................................................ 484 


10.1.4.3 Mortality .............................................................................................. 488 

10.1.5 Atrial Fibrillation ....................................................................................... 489 


10.1.5.2 Programme Budgeting ........................................................................ 493 

10.1.6 Hypertension ............................................................................................ 494 



10.1.7 Abdominal Aortic Aneurysm ..................................................................... 500 

10.1.7.1 Risk Factors ........................................................................................ 500 

10.1.7.2 Mortality .............................................................................................. 500 

10.1.7.3 Screening ........................................................................................... 500 

10.2 Cancer .......................................................................................................... 501 

10.2.1 All Cancers............................................................................................... 501 

10.2.1.1 Risk Factors ........................................................................................ 501 



10.2.1.2 Incidence ............................................................................................ 502 

10.2.1.3 Diagnosed Cases Since April 2003 .................................................... 506 


10.2.1.5 Mortality .............................................................................................. 513 

10.2.1.6 Cancer Mortality by Tumour Site ........................................................ 516 

10.2.1.7 Survival Rates in Humber and Yorkshire Coast Cancer Network ....... 521 

10.2.1.8 Screening ........................................................................................... 522 


10.2.1.10 Diagnosed Prevalence in Relation to Deprivation ........................... 524 

10.2.1.11 Inpatient Admissions in Relation to Deprivation .............................. 526 

10.2.1.12 Mortality in Relation to Deprivation ................................................. 527 


Comparators ....................................................................................... 528 

10.2.1.14 Survival in Relation to Deprivation .................................................. 529 


10.2.1.16 Programme Budgeting and Outcomes ............................................ 532 

10.2.2 Lung Cancer ............................................................................................ 534 

10.2.2.1 Risk Factors ........................................................................................ 534 

10.2.2.2 Incidence ............................................................................................ 535 


10.2.2.4 Mortality .............................................................................................. 536 

10.2.2.5 Five Year Survival Rates .................................................................... 540 




Comparators ....................................................................................... 543 


10.2.2.10 Risk Stratification in Relation to Lung Cancer Mortality in Most 

Deprived Wards in Hull ....................................................................... 545 

10.2.3 Colorectal Cancer .................................................................................... 549 

10.2.3.1 Risk Factors ........................................................................................ 549 

10.2.3.2 Incidence ............................................................................................ 549 


10.2.3.4 Mortality .............................................................................................. 550 



10.2.4 Prostate Cancer ....................................................................................... 554 

10.2.4.1 Risk Factors ........................................................................................ 554 

10.2.4.2 Incidence ............................................................................................ 554 


10.2.4.4 Mortality .............................................................................................. 555 


10.2.5 Breast Cancer .......................................................................................... 557 

10.2.5.1 Risk Factors ........................................................................................ 557 

10.2.5.2 Incidence ............................................................................................ 557 


10.2.5.4 Mortality .............................................................................................. 558 







10.3 Diabetes ....................................................................................................... 564 

10.3.1 Risk Factors ............................................................................................. 564 

10.3.2 Diagnosed and Modelled Prevalence ...................................................... 564 


10.3.4 Mortality ................................................................................................... 574 

10.3.5 Quality of Care ......................................................................................... 577 

10.3.6 Health Equity Audit .................................................................................. 578 

10.3.7 Diagnosed Prevalence in Relation to Deprivation .................................... 580 

10.3.8 Inpatient Admissions in Relation to Deprivation ....................................... 582 

10.3.9 Mortality in Relation to Deprivation .......................................................... 583 

10.3.10 Prevalence, Inpatient Admissions and Mortality in Relation to Deprivation 

................................................................................................................. 583 


10.3.12 Programme Budgeting and Outcomes ..................................................... 589 

10.4 Chronic Kidney Disease ............................................................................. 591 


10.5 Respiratory Disease .................................................................................... 599 

10.5.1 All Respiratory Disease ............................................................................ 599 

10.5.1.1 Prevalence .......................................................................................... 599 


10.5.1.3 Mortality .............................................................................................. 603 



10.5.2 Asthma ..................................................................................................... 607 



10.5.3 Chronic Obstructive Pulmonary Disease ................................................. 612 

10.5.3.1 Definition............................................................................................. 612 

10.5.3.2 Risk Factors ........................................................................................ 612 



10.5.3.5 Mortality .............................................................................................. 621 






Comparators ....................................................................................... 629 

10.5.3.11 Social Marketing ............................................................................. 631 



10.6 Epilepsy ....................................................................................................... 633 




10.7 Hypothyroidism ........................................................................................... 640 


10.8 Palliative Care .............................................................................................. 648 

10.8.1 Actual and Modelled Prevalence.............................................................. 648 

10.9 Mental Health ............................................................................................... 656 

10.9.1 Introduction .............................................................................................. 656 

10.9.2 Measures of Social Capital ...................................................................... 657 

10.9.2.1 Feeling Safe in the Community ........................................................... 657 

10.9.2.2 Civic Engagement .............................................................................. 658 

10.9.2.3 Neighbourliness .................................................................................. 659 

10.9.2.4 Social Networks .................................................................................. 661 

10.9.2.5 Social Support .................................................................................... 665 

10.9.3 All Mental Health ...................................................................................... 667 

10.9.3.1 Diagnosed Prevalence of Serious Mental Health and Dementia ........ 667 

10.9.3.2 Frequency of Being Happy or Sad in Young People .......................... 670 

10.9.3.3 Mental Health Index and Health Utility Index Emotional Health Score 671 

10.9.3.4 Prevalence of Stress and Pressure .................................................... 674 

10.9.3.5 Incapacity Benefit and Severe Disablement Allowance for Mental Health 

Reasons ............................................................................................. 675 

10.9.3.6 General Practitioner Consultations for Mental Health ......................... 677 

10.9.3.7 Estimated Prevalence of Mental Health in Young People .................. 679 

10.9.3.8 Prevalence of Mental Health in Prisoners ........................................... 681 



10.9.3.11 Programme Budgeting and Outcomes ............................................ 692 

10.9.4 Dementia ................................................................................................. 694 


10.9.5 Serious Mental Ill Health .......................................................................... 699 


10.9.6 Suicide and Undetermined Injury ............................................................. 704 


10.9.8 Mortality ................................................................................................... 706 

10.9.9 Perceived Impact of Stress on Health ...................................................... 708 

10.9.10 Attitudes Towards Drugs and Substance Misuse ..................................... 708 

10.9.11 Diagnosed Prevalence in Relation to Deprivation .................................... 708 

10.9.12 Mortality in Relation to Deprivation .......................................................... 711 

10.10 Sexual Health ............................................................................................... 712 

10.10.1 Abortions .................................................................................................. 712 

10.10.2 Sexual Transmitted Infections .................................................................. 714 

10.10.2.1 Prevalence ...................................................................................... 714 

10.10.2.2 Chlamydia Testing and Screening .................................................. 716 

10.10.2.3 Genito-Urinary Medicine Access Within 48 Hours .......................... 717 

10.10.3 Teenage Pregnancy Rate ........................................................................ 718 

10.10.3.1 Prevalence ...................................................................................... 718 


10.11 Accidents ..................................................................................................... 723 

10.11.1 Children and Young People ..................................................................... 723 



10.11.1.1 Inpatient Hospital Admissions ......................................................... 723 

10.11.1.2 Mortality .......................................................................................... 724 


10.11.2 Road Traffic Accidents ............................................................................. 725 

10.11.3 Falls ......................................................................................................... 729 

10.12 Children and Young People ....................................................................... 730 

10.12.1 Low Birth Weight ...................................................................................... 730 

10.12.2 Infant Mortality ......................................................................................... 730 

10.12.3 Childhood Incidence of Disease ............................................................... 731 

10.12.3.1 Incidence of Measles in Hull and Comparator Areas ...................... 731 

10.12.3.2 Incidence of Whooping Cough in Hull and Comparator Areas ........ 732 

10.12.4 Childhood Vaccinations ........................................................................... 732 

10.12.5 Breastfeeding ........................................................................................... 733 

10.12.5.1 Prevalence ...................................................................................... 733 

10.12.5.2 Social Marketing and Factors Influencing Breastfeeding ................ 734 


10.12.6 Health Needs Assessments ..................................................................... 736 

10.13 Older People ................................................................................................ 737 

10.13.1 Predictions of Future Need to 2030 for Those Aged 65+ Years ............... 737 

10.13.1.1 Population Changes ....................................................................... 737 

10.13.1.2 Pensioners Claiming State Pension and Other State Benefits ....... 738 

10.13.1.3 Predicted Numbers by Tenure, Numbers Without Central Heating and 

Numbers Without Transport ................................................................ 739 

10.13.1.4 Predicted Numbers of Households by Age of Residents ................ 740 

10.13.1.5 Predicted Numbers Living Alone or in Care Homes ....................... 740 

10.13.1.6 Predicted Numbers in Relation to Caring Needs ............................ 741 

10.13.1.7 Predicted Numbers With Limiting Long Term Illness and Disability 745 

10.13.1.8 Predicted Numbers with Various Health Needs .............................. 746 

10.13.1.9 Predicted Numbers Requiring Various Services ............................. 754 

10.13.2 Fractured Neck of Femurs ....................................................................... 756 

10.13.2.1 Hospital Admissions ....................................................................... 756 


11 REFERENCES ................................................................................. 758 

12 GLOSSARY AND EXPLANATION OF STATISTICAL TERMS, DATA 

SOURCES AND METHODS ............................................................. 770 

12.1 Synthetic or Modelled Estimates ............................................................... 770 

12.2 Confounding and Effect Modification ........................................................ 772 

12.3 Standardisation ........................................................................................... 773 

12.4 Significance Testing ................................................................................... 774 

12.5 Confidence Intervals ................................................................................... 775 

12.6 Moving Average ........................................................................................... 776 

12.7 Small Number of Events ............................................................................. 776 

12.8 Percentiles, Quartiles, Quintiles and Medians .......................................... 777 

12.9 Deaths and Mortality Rates: Occurrence Versus Registration................ 778 

12.10 Life Expectancy at Birth ............................................................................. 780 

12.11 Total Period Fertility or Abortion Rate ...................................................... 781 



12.12 Hospital Episode Statistics ........................................................................ 781 

12.13 Quality and Outcomes Framework ............................................................ 782 

12.14 PBS Diabetes Model .................................................................................... 784 

13 APPENDIX ....................................................................................... 788 

13.1 Data Sources ............................................................................................... 788 

13.2 Local Surveys .............................................................................................. 790 

13.2.1 Health and Lifestyle Surveys ................................................................... 790 

13.2.1.1 Adult Survey Conducted in 2003 ........................................................ 790 

13.2.1.2 Adult Survey Conducted in 2007 ........................................................ 791 

13.2.1.3 Adult Black and Minority Ethnic Survey Conducted in 2007 ............... 791 

13.2.1.4 Adult Prevalence Survey Conducted in 2009 ..................................... 791 

13.2.1.5 Young People Survey Conducted in 2002 .......................................... 792 

13.2.1.6 Young People Survey Conducted in 2008-09 ..................................... 792 

13.2.1.7 Veterans‟ Survey Conducted in 2009 ................................................. 792 

13.2.2 Qualitative and Social Marketing Research ............................................. 794 

13.2.2.1 Attitudes to Health Focus Groups 2007 .............................................. 794 

13.2.2.2 Reflector Groups Following 2007 Health and Lifestyle Survey ........... 795 

13.2.2.3 Reflector Groups Following 2008-09 Young People Health and Lifestyle 

Survey ................................................................................................ 796 

13.2.3 Social Capital Surveys ............................................................................. 798 

13.2.3.1 Survey Conducted in 2004 ................................................................. 798 

13.2.3.2 Survey Conducted in 2009 ................................................................. 798 

13.2.4 Other Surveys .......................................................................................... 799 

13.2.5 Patient and Public Involvement Projects .................................................. 799 

13.2.5.1 Membership ........................................................................................ 799 

13.2.5.2 Listening Exercise “We‟re All Ears” .................................................... 799 

13.3 Partnership Working ................................................................................... 802 

13.3.1 Joint Strategic Needs Assessment .......................................................... 802 

13.3.2 Children and Young People Health Needs Assessments ........................ 802 

13.3.3 Health Impact Assessments..................................................................... 802 

13.3.4 Joint Appointments Between NHS Hull and Hull City Council .................. 802 

13.3.5 Local Strategic Partnership ...................................................................... 803 

13.3.6 Locality Boards ........................................................................................ 803 

13.3.7 Health and Wellbeing Strategic Delivery Partnership ............................... 803 

13.3.8 Communities for Health Programme ........................................................ 804 

13.3.9 Partnership Working on Specific Projects ................................................ 804 

13.4 Definitions and Classifications .................................................................. 805 

13.4.1 Definition of Overweight and Obesity ....................................................... 805 

13.4.1.1 Adults ................................................................................................. 805 

13.4.1.2 Children .............................................................................................. 805 

13.4.2 Definitions Used to Measure Alcohol Consumption ................................. 807 

13.4.3 Definitions Used to Measure Levels of Exercise ...................................... 808 

13.4.4 Defining Risk of a Cardiovascular Event Within Ten Years in the Healthy 

Heart Study .............................................................................................. 810 

13.4.5 Disease Definitions Using International Classification of Diseases .......... 811 

13.4.6 Surgical Operations and Procedure Codes .............................................. 813 



13.5 Statistical Methods and Terms................................................................... 813 

13.6 Underlying Data for Figures ....................................................................... 814 

13.7 Time Period for Information, Date Last Updated and Source for Each 

Table and Figure .......................................................................................... 944 

13.7.1 Tables ...................................................................................................... 947 

13.7.2 Figures ..................................................................................................... 956 

14 INDEX ............................................................................................... 962 





1 EXECUTIVE SUMMARY 

Background: This release incorporates data provided by Hull City Council and other partners 

and forms a foundation for the updated Joint Strategic Needs Assessment (JSNA) which can be 

found at www.jsnaonline.org. 

Population: As at October 2010, there were approximately 265,000 residents of Hull, with 

approximately 290,000 persons registered with General Practices in Hull. 

Deprivation: Based on the Index of Multiple Deprivation 2007 score, Hull is the 11 th most 

deprived local authority in England (out of 354). 

Life expectancy: For 2006-2008, life expectancy at birth for Hull men at birth is 75.0 years, 

which is 2.9 years lower than England, and for Hull women it is 79.5 years, which is 2.5 years 

lower than England. 

Smoking: The prevalence of smoking in Hull is estimated to be 35.1% in Hull compared to a 

national estimate of 22%. In Hull, it is estimated that 9% of boys and 21% girls smoke in year 11 

(aged 15-16 years). 

Obesity For both men and women, the prevalence of overweight and obesity is similar for 

England and Hull (after adjusting to take into account that height and weight are self-reported) at 

around 67% for men and 60% for women. In Hull for 2008/2009, 11% of boys and 10% of girls 

aged four to five years old (school year R) were obese, and in the final year of primary school 

(year 6; aged 10 or 11), 23% boys and 21% of girls who were obese, which was slightly higher 

than the national rate. 

Exercise: Overall, 35% of men and 25% of women fulfil the national exercise guidelines in Hull 

compared to 39% of men and 28% of women for England. For secondary school pupils in Hull, 

48% of boys and 34% of girls report exercise levels that fulfil the children‟s national guidelines. 

Diet: A high percentage of men and women in Hull do not eat the recommended five portions of 

fruit and vegetables daily (78% and 70% respectively). For secondary school pupils, the 

majority of the younger children eat 5-A-DAY, but this falls to 40% for boys and 35% for girls in 

year 11 (aged 15-16 years). However, this is considerably higher than the percentages 

nationally so it is likely that young people in Hull have overestimated the number of portions. 

Alcohol: In 2009, the percentage who drink excessively weekly alcohol units was lower in Hull 

than England for 2008. However, in Hull a higher percentage of men binge drink (33%) 

compared to England (26%), but binge drinking for women (18%) was lower than England 

(22%). A small percentage (4%) of young people has exceeded the weekly units of alcohol 

which apply to adults, with 10% drinking alcohol every week. 

Drug and Substance Misuse: The estimated number of problematic drug users in treatment in 

Hull between April 2008 and March 2009 was 2,052, and the figure for all drug users (including 

problematic drug users) was 2,131. Only a very small number of pupils in years 7 and 8 (aged 



11-13 years) reported ever using drugs, but this increased with age so that by year 11 (aged 15- 

16 years), 22% of girls and 18% of boys reported that they had used or tried drugs. 

Screening: As at 31st March 2009, the percentage of women participating in breast screening is 

lower for Hull (72%) compared to England (76.5%) and the local Strategic Health Authority 

(78%). It is also one of the lowest of 10 comparator areas deemed similar to Hull, but still above 

the target for breast screening of 70%. The percentage of women aged 25 to 64 years attending 

cervical screening within the last five years as at 31 st March 2010 for Hull (79.2%) were slightly 

higher than England (78.9%) and the 10 comparator areas average (78.1%). Similar to most 

other areas, in Hull, the target of 80% was not quite achieved. 

Coronary heart disease: For 2009/2010, the prevalence of diagnosed CHD is higher for Hull 

(3.8%) compared to England (3.4%) from general practice registers. For 2006-2008, the under 

75 standardised mortality ratio (SMR) for CHD is 1.39 and 1.67 for males and females 

respectively (so 39% and 67% higher for Hull than England). 

Stroke: For 2009/2010, stroke and transient ischaemic attack prevalence is lower for Hull (1.5%) 

compared to England (1.7%). For 2006-2008, the under 75 SMR for stroke is 1.38 and 1.68 for 

men and women respectively for Hull (so 38% and 68% higher than England). 

Cancer: For 2006-2008, the under 75 SMR for cancer is 29% higher in Hull compared to 

England. A higher percentage of cancer deaths for men and women are due to lung cancer in 

Hull compared to England. For 2006-2008 under 75 SMR from lung cancer for Hull is 1.79 for 

men and 1.82 for women (so 79% and 82% higher for men and women respectively) 

Diabetes: For 2009/2010, prevalence of diagnosed diabetes for those aged 17+ years is lower 

for Hull (5.2%) compared to England (5.4%) based on general practice registers. For 2006- 

2008, the diabetes mortality rate for Hull males and females is higher than England and similar 

to comparator areas with similar ethnicity rates. 

Chronic obstructive pulmonary disease: For 2009/2010, the prevalence of diagnosed COPD 

is higher for Hull (2.1%) compared to England (1.6%) based on general practice disease 

registers. For 2006-2008, the under 75 SMR is 1.7 for men in Hull (70% higher than England) 

which is greater than comparator areas. For women in Hull, the premature COPD mortality rate 

is almost double that of England and is one of the highest of all comparator areas. 

Mental health: For 2009/2010, the prevalence of diagnosed dementia is lower for persons in 

Hull (0.32%) compared to England (0.45%), as is the prevalence of diagnosed serious mental 

health for Hull (0.76%) compared to England (0.77%) based on general practice disease 

registers. The 2009 Social Capital Survey indicates worse mental health for women, the 

younger ages and those living in the most deprived 20% of areas in Hull. Mental health is the 

commonest disease group given for working-age claimants of Incapacity Benefit and Severe 

Disablement Allowance in Hull (39% of claimants). 

Children and young people: For 2006-2008, Hull has the same stillbirth rate as England (5.2 

per 1,000 births), and a similar infant mortality rate compared to England (5.1 deaths per 1,000 

live births in Hull compared to 4.8 in England). The percentage of low birth-weight babies in 

2008 is slightly higher in Hull than England, but similar to comparator areas. (56%) are similar to 

the average for the Industrial Hinterlands (54%) but lower than the average of the ten 

comparators (64%), the Yorkshire and Humber region (68%) and England (73%). 

Breastfeeding rates at 6 weeks are strongly associated with deprivation and ethnicity. 





2 SUMMARY 

This release incorporates data provided by Hull City Council and other partners and 

forms a foundation for the updated Joint Strategic Needs Assessment (JSNA) which can 

be found at www.jsnaonline.org. It is important to examine levels of health and ill-health 

as well as levels of risk factors and attitudes towards health in different populations for 

monitoring purposes including the monitoring of health-related targets, examining trends 

over time, comparison with other geographical areas, examining patterns of health and 

risk factors within the population of Hull (e.g. comparison of different groups such as 

those defined by deprivation), assessment and evaluation of programmes designed to 

improve health, assessing the existing and future need for health-related services 

following changes in health, ill-health or risk factors so that the Commissioning function 

can be adequately fulfilled. Further documents such as the health equity audits, reports 

from the adult and young people health and lifestyle surveys, social capital surveys, 

child obesity reports and Index of Multiple Deprivation report are available at 

www.hullpublichealth.org. 

Geography: NHS Hull (formerly known as Hull Teaching Primary Care Trust (PCT)) is 

one of 14 PCTs within the Yorkshire and Humber Strategic Health Authority. The 

geographical boundaries for the PCT are coterminous with the local authority. There are 

23 wards in Hull, seven local authority area committee areas (Areas) and three NHS 

Localities within Hull. 

Population: As at October 2010, there were approximately 265,000 residents of Hull, 

with approximately 290,000 persons registered with General Practices in Hull. North 

locality has approximately 63,000 residents, East approximately 95,000 and West 

107,000 residents. 

Deprivation and associated measures: Based on the Index of Multiple Deprivation 

2007 score, Hull is the 11 th most deprived local authority in England (out of 354); 8 of 

Hull‟s 23 wards are in the bottom 2% of wards nationally in terms of deprivation, all of 

Hull‟s wards are within the most deprived 44% nationally. As at May 2009, there were 

14,900 residents claiming Incapacity Benefit and Severe Disablement Allowance in Hull, 

which represents 8.7% of the working age population. 

Life expectancy, general health and main causes of death: For 2006-2008, life 

expectancy at birth for Hull men is 75.0 years, which is 2.9 years lower than England, 

and for Hull women it is 79.5 years, which is 2.5 years lower than England. There were 

considerable differences across the wards. For men, life expectancy estimates differ by 

up to 10 years across the wards, for women, the differences is slightly larger at 10.2 years. 



There is a clear association between deprivation and self-rated health status, from the 

2009 Hull Prevalence Survey, with 31% of those living in the most deprived 20% of 

areas rating their health as „fair‟ or „poor‟ compared to only 17% of those living in the 

least deprived 20% of areas. 

The main causes of death in Hull are cancer and coronary heart disease (CHD), and 

these two causes account for more than half of all deaths under the age of 75 years. 

For 2006-2008, the under 75 standardised mortality ratio for Hull is 131, which means 

the mortality rate, after adjusting for the difference in age and gender structure is more 

than 30% higher in Hull than in England. 

Smoking: The prevalence of smoking in Hull is high. From Hull‟s 2009 Prevalence 

Survey, 38.1% for men and 32.2% for women smoked in Hull (35.1% for men and 

women combined), compared to 24% for men and 20% for women from the Health 

Survey for England 2008. In particular, the difference in prevalence is much larger in 

the younger age groups, with the prevalence of daily and occasional smoking in Hull 

being around 40% higher than that of England. 

The 2008-09 Young People Health and Lifestyle Survey estimated 9% of Hull year 11 

boys (aged 15-16 years) smoked regularly, with 55% never smoking, compared to 21% 

of Hull year 11 girls who smoked regularly and 32% who had never smoked. Rates 

were lower in the younger age groups. 

Overweight and obesity: For both men and women, the prevalence of overweight and 

obesity is similar for England and Hull (after adjusting to take into account that height 

and weight are self-reported) at around 67% for men and 60% for women. The largest 

differences appears to occur for men aged less than 25 years, where the prevalence of 

overweight and obesity combined is 33% for England compared to 44% for Hull. 

In Hull for the most recent school year for which data is available (2008/2009), 27% of 

boys and 24% of girls aged four to five years old (school year R) were overweight or 

obese, including 11% of boys and 10% of girls who were obese. Over time, in girls, 

increasing of overweight and obesity has slowed in recent years and has reduced for the 

most recent school year to 23.7%, but for boys the prevalence has increased over time 

to a high of 29.3% in 2007/08 slightly reducing for the 2008/09 school year. 

For children in the final year of primary school (year 6; aged 10 or 11), 36% of boys and 

35% of girls were overweight or obese, including 23% boys and 21% of girls who were 

obese. There was no significant difference in the prevalence of overweight or obesity in 

children among the seven Areas or three Localities, and there was no evidence of an 

association with deprivation. 

There were 4,348 Hull children who had their heights and weights measured when they 

were aged 4-5 and again when aged 10-11 years old. Children who were overweight or 

obese at 4-5 years were more likely to be overweight or obese at year 10-11 years, 

however, there was considerable variability which makes it difficult to predict exactly 



which children might be overweight or obese at age 10-11 years (based on their 

information at age 4-5 years). 

Exercise: In general, men in Hull and women in Hull have lower percentages who 

exercise to the national recommended levels (30 minutes of moderate or vigorous 

exercise five or more times per week). The exceptions are for men aged 65-74 years 

and for women aged 75+ years where the percentages are slightly higher for Hull than 

England. The age-adjusted percentages (taken from the combined 2009 Hull Social 

Capital and Prevalence surveys) fulfilling the national exercise guidelines are 35% in 

Hull for men compared to 39% for England, and 25% for women in Hull compared to 

28% nationally. 

The 2008-09 Young People Health and Lifestyle Survey estimated that 48% of males 

and 34% of females from school years 7 to 11 (secondary school pupils) in Hull 

engaged in sufficient exercise to fulfil national guidelines for young people (at least one 

hour daily). 

Diet: Seven in ten men and eight in ten women in Hull felt they had a healthy diet, and 

the percentage had increased between 2007 and 2009 although the percentage 

reporting that they did not eat a healthy diet remained virtually the same. In addition, the 

percentage who reported that they did not know what a healthy diet was or whether they 

had a healthy diet has fallen between 2007 and 2009. A high percentage of men and 

women in Hull do not eat the recommended five portions of fruit and vegetables daily 

(78% and 70% respectively). 

The 2008-09 Young People Health and Lifestyle Survey estimated the majority of year 7 

(aged 11-12 years) school children in Hull eat five or more portions of fruit and 

vegetables daily, but the percentage falls with age to 40% for boys and 35% for girls in 

year 11 (aged 15-16 years). However, this is considerably higher than the percentages 

nationally so it is likely that young people in Hull have overestimated the number of 

portions eaten. 

Alcohol: Between 2003 and 2009, the proportion of men aged 18-24 years who drink 

everyday is lower in 2009, with the proportion drinking 4-6 days per week lower in every 

age band for 2009. For women, the proportion drinking everyday was highest in the 

majority of age bands for 2009, whilst the proportion of women drinking 4-6 days per 

week was lowest in the majority of age bands for 2009, with the proportion of women 

never drinking higher in 2009. 

In 2009, the percentage of males who drink excessively during the week (22+ units) was 

lower than that of England for 2008, similarly for women (15+ units). A higher 

percentage of men and women in Hull did not drink alcohol the previous week compared 

to England. However, the prevalence of binge drinking (8+ daily units for men and 6+ 

daily units for women at least weekly) is considerably higher in Hull compared to 

England. A higher percentage of men binge drink (33%) compared to England (26%), 

with the percentage of men in Hull binge drinking but staying within the recommended 

weekly guidelines double the percentage for England. The percentage of women binge 



drinking was lower (18%) compared with England (22%), although the percentage 

drinking within the recommended weekly limits and binge drinking was marginally higher 

(11%) compared to England (9%). 

As part of the 2009 Social Capital Survey, survey respondents who reported that they 

drank alcohol were asked to state what they thought the current recommended daily and 

weekly alcohol unit limits were. Those aged 16-24 had less awareness or knowledge of 

national daily and weekly alcohol unit recommendations and as age increases this 

awareness generally improved. 

The 2008-09 Young People Health and Lifestyle Survey estimated a higher percentage 

of both boys and girls in Hull who had drunk alcohol than boys and girls in England as a 

whole, with the possible exception of boys aged 15 years. Higher percentages of girls 

than boys had ever drunk alcohol in Hull from the age of 13 years onwards, whereas in 

England it was from the age of 14 years. A small percentage (4%) of young people had 

exceeded the weekly units of alcohol which apply to adults, with 10% drinking alcohol 

every week. 

Drug and Substance Misuse: The estimated number of problematic drug users in 

treatment in Hull between April 2008 and March 2009 was 2,052, and the figure for all 

drug users (including problematic drug users) was 2,131. The all age directly 

standardised mortality rate for substance abuse for 2007-2009 was 7.7 deaths for men 

and 2.5 deaths for women per 100,000 residents, with higher rates in West Locality 

because it includes the city centre and relatively cheap accommodation and housing, 

and more supported housing. 

Around 1 in 10 pupils reported they had been offered or encouraged to try drugs in the 

last three months, ranging from 4-5% for year 7 and 8 children (aged 11-13 years) to 

19% for year 11 (aged 15-16 years). The drug that pupils most commonly reported they 

were offered or encouraged to try was cannabis. Only a very small number of pupils in 

years 7 and 8 reported ever using drugs. Among the older year groups, the 

percentages increased with school year, and were higher in girls than boys for each 

year group. By year 11, 22% of girls and 18% of boys reported that they had used or 

tried drugs. 

Prevalence of Multiple Risk Factors: The 2007 Attitudes to Health Survey highlighted 

an association between risk factors in particular a relationship between alcohol and 

smoking, and between lack of exercise, diet and obesity. For all of these risk factors, 

gender, age and deprivation are confounders. The prevalence of the combination of five 

risk factors was examined from Hull‟s adult Health and Lifestyle Survey 2007. The risk 

factors considered were smoking, alcohol, exercise, obesity and 5-A-DAY. In Hull, 2% 

of men had all five of these risk factors, 13% had four, 31% had three, 35% had two, 

16% had one and 4% had none of these five risk factors. Overall 0.6% of women had 

all five risk factors, and women tend to have less multiple risk factors compared to men 

but with a similar pattern across the age groups. 



The prevalence of multiple risk factors (smoking, alcohol, exercise, 5-A-DAY and drugs) 

differed among different year groups for the Young People Health and Lifestyle Survey 

2008-09. There was a gradual decrease in the percentage of boys having none of the 

risk factors from 31% in year 7 (aged 11-12 years) to 13% in year 11 (aged 15-16 

years), and this was mainly due to lack of exercise and eating less than 5-A-DAY. The 

same was true for girls, but the percentage with none of the risk factors was lower 

(ranging from 11% to 23%) and again this was mainly due to lack of exercise and eating 

less than 5-A-DAY. Very few young people had three or more risk factors in 

combination. 

Screening: As at 31st March 2009, the percentage of women participating in breast 

screening is lower for Hull (72%) compared to England (76.5%) and the local Strategic 

Health Authority (78%). It is also one of the lowest of 10 comparator areas deemed 

similar to Hull, but still above the target for breast screening of 70%. 

The percentage of women aged 25 to 64 years attending cervical screening within the 

last five years as at 31 st March 2010 for Hull (79.2%) were slightly higher than England 

(78.9%) and the 10 comparator areas average (78.1%). Similar to most other areas, in 

Hull, the target of 80% has not quite been achieved. 

Coronary heart disease: For 2009/2010, the prevalence of diagnosed CHD is higher 

for Hull (3.8%) compared to England (3.4%) from general practice registers. It is also 

possible that the undiagnosed prevalence of CHD is higher in Hull compared to 

England. For 2006-2008, the under 75 standardised mortality ratio (SMR) for CHD is 

1.39 and 1.67 for males and females respectively (so mortality rates 39% and 67% 

higher for Hull than England). For men and women under 75 years, the mortality rate for 

CHD is higher than the Industrial Hinterlands group (the Office for National Statistics 

comparison group assigned to Hull) and the average of 10 comparators deemed similar 

to Hull. 

There is a clear and very strong trend for the under 75 year directly standardised 

mortality rate for CHD across the five deprivation quintiles for 2007-2009. The premature 

mortality rate from CHD is almost three times higher in the two most deprived quintiles in 

Hull compared to the least deprived quintile in Hull. 

Stroke: For 2009/2010, stroke and transient ischaemic attack prevalence is lower for 

Hull (1.5%) compared to England (1.7%). For 2006-2008, the under 75 standardised 

mortality ratio (SMR) for stroke is 1.38 and 1.68 for men and women respectively for Hull 

(so mortality rates 38% and 68% higher than England). Both men and women have a 

higher under 75 years SMR for stroke compared to the Industrial Hinterlands and the 

average of the 10 comparators with the rates for Hull approximately 13% higher than 

these comparators for men and approximately 40% for women. For women, the under 

75 SMR is higher for all 10 of these comparator PCTs. 

There is a strong association between under 75 directly standardised rates for stroke 

and local deprivation quintile with the mortality rate in the most deprived local quintile 

being 2.7 times higher than that for the least deprived local quintile. 



Cancer: For 2006-2008, under 75 directly standardised incidence rate for cancer (all 

sites) is higher for Hull men (358 per 100,000) compared to England (307 per 100,000), 

with Hull women (339 per 100,000) also higher compared to England (301 per 100,000). 

For 2006-2008, the under 75 standardised mortality ratio (SMR) for cancer is 1.29 for 

Hull (so mortality rate 29% higher than England), which is higher than the Industrial 

Hinterlands group and the average of the 10 comparators. 

A higher percentage of cancer deaths for men and women are due to lung cancer in Hull 

compared to England. For 2006-2008 under 75 SMR from lung cancer for Hull is 1.79 

for men and 1.82 for women (so mortality rate 79% and 82% higher for men and women 

respectively compared to England), and is one of the highest of the 10 comparator 

areas. 

Premature cancer mortality is strongly associated with deprivation. The under 75 lung 

cancer standardised mortality rate for people living in the most deprived quintile areas of 

Hull is 77.4 per 100,0000 persons compared to almost one-third lower (26.2 per 100,000 

persons) in the least deprived quintile areas. 

Diabetes: For 2009/2010, prevalence of diagnosed diabetes for those aged 17+ years is 

lower for Hull (5.2%) compared to England (5.4%) based on general practice registers. 

It is also possible that the undiagnosed prevalence of diabetes is higher in Hull 

compared to England. For 2006-2008, the all-age diabetes mortality rate in Hull is 

higher than England for men, but similar to areas with similar ethnicity rates. For 

women, the mortality rate is only slightly higher than England. 

A comparison of prevalence, inpatient admissions and mortality indicated that for a 

particular prevalence level, there were substantially more hospital admissions (double 

the rate) and more deaths in the most deprived quintiles areas compared to the least 

deprived quintile areas of Hull. 

Chronic obstructive pulmonary disease: For 2009/2010, the prevalence of diagnosed 

COPD is higher for Hull (2.1%) compared to England (1.6%) based on general practice 

disease registers. It is also possible that the undiagnosed prevalence of COPD is higher 

in Hull compared to England. For 2006-2008, the under 75 standardised mortality ratio 

is 1.7 for men in Hull (70% higher than England), which is greater than the average of 10 

comparator areas deemed similar to Hull and the Industrial Hinterlands group average. 

For women in Hull, the premature COPD mortality rate is almost double that of England 

at 1.9 and is one of the highest of all comparators (Industrial Hinterlands group and 10 

comparators). 

Given the prevalence of smoking in Hull, it is not surprising that the premature mortality 

rate for COPD is so high, with an estimated 84% of COPD deaths directly attributable to 

smoking. 



Mental health: For 2009/2010, the prevalence of diagnosed dementia is lower for 

persons in Hull (0.32%) compared to England (0.45%) and the prevalence of diagnosed 

serious mental health for Hull (0.76%) is similar to that of England (0.77%) based on 

general practice disease registers. It is possible that the undiagnosed prevalence of 

dementia and serious mental health is higher in Hull compared to England. 

In Hull during the period 2007-2009, there were 12 deaths to persons aged under 75 

years and 195 deaths to persons aged 75+ years with the primary cause of death coded 

as dementia. Over the three year period, there were over 40 deaths due to mental and 

behaviour disorders due to psychoactive substance abuse, which were mainly in the 

younger age groups. 

The 2009 Social Capital Survey indicates worse mental health for women, the younger 

and those living in the most deprived 20% of areas in Hull. The Black and Minority 

Ethnic Health and Lifestyle Survey 2007 indicated worse mental health for failed asylum 

seekers, almost one-third of whom stated that they were „so unhappy that life is not 

worthwhile‟ compared to 13% of those whose asylum had been granted and less than 

4% for all other groups. 

Mental health is the commonest disease group given for claimants of Incapacity Benefit 

and Severe Disablement Allowance in Hull (39% of claimants). Myton ward has the 

highest claimant rate with mental illness as the reason given for the claim. The claimant 

rate is strongly associated with deprivation. Therefore, it is not surprising that Myton has 

a high claimant rate as it is the third most deprived ward in Hull. However, for Myton the 

type of accommodation may be a factor as well with more cheap accommodation and 

supported housing in this ward. 

Children and young people: For 2006-2008, Hull has the same stillbirth rate 

compared to England (5.2 deaths per 1,000 births). The crude infant mortality rate for 

2006-2008 is 5.1 per 1,000 live births which is slightly higher than England (4.8) and 

similar to that for the Industrial Hinterlands group, but considerably lower than the 

average of the 10 comparator groups and lower than the regional average. The 

percentage of low birth-weight babies in 2008 is slightly higher in Hull than England, but 

similar to comparator areas. 

The breastfeeding initiation rates for 2009/2010 in Hull (56.2%) are similar to the 

average for the Industrial Hinterlands (54.4%) but lower than the average of the ten 

comparators (64.0%), the Yorkshire and Humber region (68.0%) and England (72.7%). 

Breastfeeding rates at 6 weeks were examined in more detail for babies born over a four 

month period (February to May 2009). The rates were strongly influence by deprivation 

and ethnicity. Around one in five babies who lived in the most deprived and second 

most deprived quintile areas of Hull were totally breast-fed at 6 weeks, whereas in the 

least deprived and second least deprived quintile areas this was around one in three or 

higher. Three-quarters of babies were exclusively bottle-fed in the most deprived areas 

compared to around 60% in the least deprived areas. The percentage exclusively 

breast-fed at 6 weeks was highest in the Non-British White group (64%), Black or Black 

British (55%) and Asian or Asian British (52%) and lowest in White British (23%). 



3 INTRODUCTION 

3.1 Release of Joint Strategic Needs Assessment Foundation 

It is the intention to release the foundation profile(s) on an on-going basis, with new 

information added to the document and existing data updated as new information 

becomes available over time. The two tables in the APPENDIX starting on page 944 

gives the time period to which the data refers, when the information was last updated 

and the source for each table and figure within this document. 

This document has been produced for use primarily as an electronic document rather 

than as a hardcopy. Therefore, certain topics may be duplicated, or there will be 

references to other sections of the report. It is hoped that the reader can find the 

information by electronic searching, using the hyperlinks within the document and on the 

contents page, and by using the index. 

3.2 Uses of This Report 

This release incorporates data provided by Hull City Council and other partners and 

forms a foundation for the updated Joint Strategic Needs Assessment (JSNA). It is 

important to examine levels of health and ill-health as well as levels of risk factors and 

attitudes towards health in different populations for monitoring purposes including the 

monitoring of health-related targets, examining trends over time, comparison with other 

geographical areas, examining patterns of health and risk factors within the population 

of Hull (e.g. comparison of different groups such as those defined by deprivation), 

assessment and evaluation of programmes designed to improve health, assessing the 

existing and future need for health-related services following changes in health, ill-health 

or risk factors so that the Commissioning function can be adequately fulfilled. 

It is hoped that readers of this report can assess the levels of health, ill-health or risk 

factor that they are interested in for their particular ward, Area or Locality and relate this 

to national figures. In addition, the information provided in this profile can be used as a 

baseline level of health or ill-health in performing health needs assessments and health 

equity audits. 

The document also includes other information on more qualitative research and social 

marketing (in relation to specific risk factors see section 8 on page 233 and in relation 

to the way the research was conducted see section 13.2.2 on page 794), some 

information existing public health programmes (in relative to specific risk factors see 

section 8 on page 233) and information on joint working between NHS Hull and Hull 

City Council (see section 13.3 on page 802). 



3.2.1 GP Consortia and Commissioning 

In order to inform commissioning, information is needed as to the health needs of the 

local population as well as future changes to the population and need. The information 

needs to be at population level, and measure „need‟ as it is well recognised that there is 

an undiagnosis of disease and medical conditions as some patients do not present with 

their symptoms. Whilst the targets are still under consultation, it is likely that a number 

of key targets will remain (see section 3.3.6.2 on page 52) such as reducing the all age 

all cause mortality rate and premature mortality from cardiovascular disease and cancer. 

In order to reduce these rates long-term, it is also necessary to commission public 

health services such as smoking cessation and weight loss programmes. Therefore, 

obtaining information about the prevalence of health and behavioural risk factors is 

important. Reducing the inequalities gap is also a target, and this requires further 

knowledge about differences in risk factors, treatment rates and mortality rates, etc 

among different groups. 

From the Health White Paper (Department of Heath 2010) and the Public Health White 

Paper (Department of Health 2010), new Health and Wellbeing Boards will be set up to 

support collaboration across the NHS and local authorities in order to meet communities‟ 

needs as effectively as possible. GP consortia and local authorities, including Directors 

of Public Health, will each have an equal an explicit obligation to prepare the Joint 

Strategic Needs Assessment (JSNA), and to do so through the arrangements made by 

the health and wellbeing board (see section 3.3.6.1 on page 52). 

3.2.2 World Class Commissioning 

Considerable work has been undertaken in Hull to inform the World Class 

Commissioning (WCC) strategy. There were a number of goal areas for WCC, and 

within this document, these goal areas are discussed in separate sections: heart 

disease (section 10.1.2 on page 447); stroke (section 10.1.3 on page 466); chronic 

obstructive pulmonary disease (section 10.5.3 on page 612); diabetes (section 10.3 on 

page 564); cancer (section 10.2 on page 501); mental health (section 10.9 on page 

656); and children and young people (section 10.12 on page 730). There is no readily 

available information on primary care and community access to present so this is not 

included. The ninth WCC goal area “getting healthy” which underpins all these areas, 

and there is a separate section on risk factors within this document (section 8 on page 

233). Further areas were added to the WCC Strategy for the second year of WCC 

(2010). Due to the major reorganisation of the NHS in relation to commissioning (see 

section 3.3.6 on page 51), there may be differences in terms of targets, key goal areas, 

etc. However, the main focus will be continuing to improve the health of the people of 

Hull, and as a result, any new strategy will commission services which tend to focus on 

the main causes of mortality and morbidity in Hull which will remain unchanged. 



3.2.3 Health Needs Assessment 

Wright et al (Wright, Williams et al. 1998) states: “Assessment of health needs is the 

systematic method of identifying unmet health and healthcare needs of a population and 

making changes to meet those unmet needs. It involves an epidemiological and 

qualitative approach to determining priorities, which incorporates clinical and cost 

effectiveness and patient‟s perspectives. This approach must balance clinical, ethical 

and economic considerations of needs, that is, what should be done, what can be done 

and what can be afforded.” 

In addition, “Health needs assessment (HNA) should not just be a method of measuring 

ill-health, as this assumes that something can be done to tackle it. Incorporating the 

concept of a capacity to benefit introduces the importance of effectiveness of health 

interventions and attempts to make explicit what benefits are being pursued.” 

Therefore, Wright et al (Wright, Williams et al. 1998) states HNA gives the opportunity 

for: 

Describing the patterns of disease in the local population and the differences from 

district, regional, or national disease patterns; 

Learning more about the needs and priorities of their patients and the local 

population; 

Highlighting the areas of unmet need and providing a clear set of objectives to 

work towards meeting these needs; 

Deciding rationally how to use resources to improve the local population‟s health 

in the most effective and efficient way; 

Influencing policy, interagency collaboration, or research and development 

priorities. 

This report informs the first step for equity audits – describing the patterns of disease in 

the local population. 

3.2.4 Health Equity Audit 

There are various definitions of equity and of health equity audits, but essentially a 

health equity audit identifies how fairly services or other resources are distributed in 

relation to health „need‟ of different groups and areas, and assesses the success of 

programmes which aim to improve any inequity that is found. 

The Government White Paper „Choosing Health‟ (Department of Health 2004) states 

that tackling inequalities in health is a key priority and Primary Care Trusts (PCTs) are 

required to undertake Health Equity Audits regularly to tackle inequalities for specific 

diseases and medical conditions. The new Health White Paper (Department of Heath 

2010) and the Public Health White Paper (Department of Health 2010) also highlight 

reducing inequalities as a key priority. 



This document provides some information on the prevalence of some key diseases and 

their treatment in relation to deprivation, and so could inform the first step of a health 

equity audit. Successive steps of initiating interventions and assessing their success 

are not covered in this report, and would need to be undertaken as additional steps for 

those undertaking health equity audits. 

Hull and East Riding of Yorkshire PCTs have produced joint health equity audits on 

coronary heart disease (2004/05), cancer (2005/06), mental health (2006/07), diabetes 

(2007/08) and chronic obstructive pulmonary disease (2010). A further health equity 

audit is currently underway on stroke, and a short equity audit has been undertaken on 

hypertension during 2011. These health equity audits are referred to within the specific 

disease sections (sections 10.1.2.5, 10.2.1.9, 10.9.3.9, 10.3.6, 10.5.3.6, 10.1.3.5 and 

10.1.6.2 respectively) with the full reports for the completed equity audits available at 


3.2.5 Programme Budgeting and Predictive Modelling for Resource 

Reallocation 

3.2.5.1 Introduction to Programme Budgeting 

Programme Budgeting is a well-established technique for assessing investment in 

health programmes rather than services. It can provide an overall view of how Hull PCT 

expenditure (from Department of Health Programme Budgeting information) and health 

outcomes compare with other PCT‟s in England, and to identify programmes that may 

require further investigation. The two quadrant charts used in this section highlight 

better/worse outcomes for spend across individual programmes relative to the England 

average. Expenditure and outcomes are also considered in relation to the the cluster 

group for Hull (Industrial Hinterlands) and Hull‟s nearest comparator (North East 

Lincolnshire) based on analyses completed by the Office for National Statistics (ONS). 

3.2.5.2 Expenditure 

Hull has a relatively high proportion of expenditure that is not assigned to a specific 

programme code, and this may give a less accurate picture of spend on each 

programme. Figure 1 illustrates the 2008/2009 expenditure for each programme for 

Hull, Industrial Hinterlands, North East Lincolnshire and England (see section 3.3.3 on 

page 44 for more information about these comparator areas). Total expenditure in Hull 

is estimated to be £1,595 per head compared to £1,525 for the Industrial Hinterlands 

average, £1,864 for North East Lincolnshire, £1,605 for the SHA and £1,531 for 

England. In relation to the Industrial Hinterlands group, the largest percentage 

discrepancies occurs social care needs where Hull‟s expenditure is 62% lower (£10.53 

for Hull compared to £28.04 for Industrial Hinterlands average per head), for „other‟ 

areas of spend (which includes healthy individuals) where Hull‟s expenditure is 47% 

higher (£282.13 versus £191.65), for problems of the hearing where Hull‟s expenditure 

is 42% lower (£4.94 versus £8.54), disorders of the blood where Hull‟s expenditure is 

41% lower (£11.91 versus £20.03) and conditions of the neonates where Hull‟s 



expenditure is 37% lower (£10.78 versus £17.13). However, examining Figure 1, Hull‟s 

expenditure does not appear to be too dissimilar to the Industrial Hinterlands average or 

North East Lincolnshire, although North East Lincolnshire is an outlier for cancers and 

tumours, and for social care. The latter is not surprising as North East Lincolnshire Care 

Trust Plus replaced North East Lincolnshire Primary Care Trust in full, as well as 

inheriting responsibility for the management of adult social care from North East 

Lincolnshire Council. The underlying data are given in the APPENDIX on page 816. 



Figure 1: Expenditure by programme budget area, 2008/2009 

Other Areas of Spend/Conditions: 

Social Care Needs 

Healthy Individuals 

Adverse effects and poisoning 

Conditions of Neonates 

Maternity and Reproductive Health 

Problems of Genito Urinary System 

Problems due to Trauma and Injuries 

Problems of Musculo Skeletal System 

Problems of the Skin 

Problems of Gastro Intestinal System 

Dental Problems 

Problems of the Respiratory System 

Problems of Circulation 

Problems of Hearing 

Problems of Vision 

Neurological 

Problems of Learning Disability 

Mental Health Disorders 

Endocrine, Nutritional and Metabolic 

Disorders of Blood 

Cancers and Tumours 

Infectious Diseases 

£0 £50 £100 £150 £200 £250 £300 

Spend per weighted head of population 2008/2009 

England Yorkshire & Humber SHA Hull Industrial Hinterlands NE Lincs 



3.2.5.3 Quadrant Chart – Expenditure and Outcomes 

A quadrant chart categorises each programme into four quadrants in terms of 

expenditure for 2008/09 and outcome relative to England (Figure 2). Each dot within 

the quadrant chart represents a programme budget category. The three largest 

spending programmes nationally (mental health, circulatory diseases and cancer) are 

represented by larger dots. A programme outside the solid ±2 z-scores box indicates 

that the data is significantly different from the comparator average. Approximately 5% of 

outcomes and expenditures will be outside this box (i.e. have z-scores larger than +1.96 

or z-scores smaller than –1.96). If the programme lies to the left or right of the box, the 

programme is statistically significantly different on spend and if it lies outside the top or 

bottom of the box the programme is statistically significantly different on outcome. 

Programmes outside the box at the corners are statistically significantly different from 

the England average for both spend and outcome. Programmes outside the dotted ±1 

z-score box, may warrant further exploration. Approximately 30% of outcomes and 

expenditure will be outside this box. The underlying data are given in the APPENDIX on 

page 816 (expenditure) and page 817 (outcomes). 

Learning disabilities, disorders of the blood, hearing problems, problems of the gastro 

intestinal system, problems of the skin, problems of the muscular skeletal system, 

poisoning, healthy individuals and social care needs have no outcomes defined so 

appear on the figure with zero outcomes (horizontal line). 

In relation to England, with the exception of endocrine and vision, Hull‟s outcomes are 

worse than England‟s average. Hull‟s outcome for neurological (directly age 

standardised premature mortality rate from epilepsy) and cancer and tumours (directly 

age standardised premature mortality rate from cancer) are statistically significantly 

worse than England (z-scores –2.02 and –1.96 respectively). 

In relation to England, expenditure is statistically significantly higher than England‟s 

average for respiratory disease (z-score 3.11; 2 nd highest out of 152 PCTs), problems of 

the gastro intestinal system (z-score 2.37; 2 nd highest), poisoning (z-score 2.20; 3 rd 

highest) and neurological (z-score 2.01; 7 th highest). 

Figure 3 illustrates similar quadrant chart information for Hull but in relation to the 

Industrial Hinterlands average. However, instead of z-scores illustrating the outliers, the 

outcomes and expenditures are ranked from one to sixteen. The underlying data are 

given in the APPENDIX on page 816 (expenditure) and page 817 (outcomes). 

Hull has the lowest spend (16 th ) of all PCTs within the Industrial Hinterlands group for 

endocrine, nutritional and metabolic and disorders of the blood programmes. Hull has 

the second highest spend out of the Industrial Hinterlands for adverse effects and 

poisoning, gastro intestinal system and respiratory disease programmes. Hull also has 

the second worst outcomes for mental health and neurological system. Hull is third for 

maternity for outcomes and above the Industrial Hinterlands average for endocrine, 

nutritional and metabolic, vision, neonates and trauma. 



Figure 2: Quadrant chart, expenditure versus outcome for Hull relative to England 

KEY: 

Inf Infectious disease Dent Dental 

Canc Cancers and tumours Gastro Gastro intestinal system 

Resp Respiratory disease Musc Muscular skeletal system 

End Endocrine, nutritional & metabolic Trauma Trauma & injuries 

GU Genito urinary system Blood Disorders of blood 

LD Learning disabilities Mat Maternity 

Pois Adverse effects & poisoning Neo Neonates 

Hear Hearing Neuro Neurological 

Circ Circulation Hlth Healthy individuals 

MH Mental health Soc Social care needs 



Figure 3: Quadrant chart, expenditure versus outcome for Hull relative to Industrial 

Hinterland PCTs 

Health Outcome Ranking 

0 

4 

End 

Blood 

8 

12 

16 

16 

Lower Spend 

Better Outcome 

Neo 

Vision 

Hear,Musc 

LD,Soc 

Inf Canc 

Lower Spend 

Worse Outcome 

MH 

Ranking of spend and outcome relative to ONS Cluster group 

12 

Circ 

KEY: 

Inf Infectious disease Dent Dental 

Canc Cancers and tumours Gastro Gastro intestinal system 

Resp Respiratory disease Musc Muscular skeletal system 

End Endocrine, nutritional & metabolic Trauma Trauma & injuries 

GU Genito urinary system Blood Disorders of blood 

LD Learning disabilities Mat Maternity 

Pois Adverse effects & poisoning Neo Neonates 

Hear Hearing Neuro Neurological 

Circ Circulation Hlth Healthy individuals 

MH Mental health Soc Social care needs 

Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 33 

GU 

8 

Mat 

Trauma 

Skin 

Spend Ranking 

Hlth 

Dent 

4 

Neuro 

Higher Spend 

Better Outcome 

Gastro,Pois 

Resp 

Higher Spend 

Worse Outcome 

0


3.2.5.4 Diabetes Programme Budgeting and Marginal Analysis Pilot in Hull 

The Yorkshire and Humber Public Health Observatory (YHPHO) led the Programme 

Budgeting and Marginal Analysis (PBMA) pilot project in Hull Teaching Primary Care 

Trust with diabetes (for persons aged over 16 years) chosen as the area of care. 

The aim of the pilot was to test the model of PBMA at the micro level (within the 

diabetes programme budget of Hull PCT) as proposed in a seven stage process 

suggested by Ruta et al (Ruta, Mitton et al. 2005). 

The resource envelope for the PBMA project was assumed to be neutral so that any 

service growth would have to be funded from taking resources from elsewhere in 

diabetes care. In Hull, the programme budget was broken into finance, activity and 

outcomes. 

Financial information for diabetes (category four: endocrine, nutritional and metabolic 

problems of the National Programme Budget) for 2004/2005 and 2005/2006 was 

available at the start of the pilot and halfway through the pilot, figures were produced for 

2006/2007 which were incorporated. The percentage allocated to diabetes in the 

primary care category which involved spend on prescribing, acute care, ambulance 

services and community services was determined through the amount allocated to 

diabetes through attainment of Quality and Outcome Framework (QOF) points. This will 

be an underestimate as it does not take into account the cost of primary care 

infrastructure. Prescribing in primary care made up the majority of the prescribing costs. 

It was acknowledged that the programme budget did not fully reflect the true costs of 

providing diabetes care in Hull. Firstly, it only captured NHS costs and secondly, it was 

acknowledged that patients with diabetes often have a range of co-morbidities caused 

by or exacerbated by their condition which could fall under another programme budget 

category. The budget information included costs for providing care to those under 16 

years, but due to the limited time period, unpicking the care for the under 16s from the 

budget would have taken up valuable time and was not necessary for the marginal 

analysis as the resources connected with any proposed service changes would only 

focus on adult care. 

The pilot looked at the routinely available activity data. Secondary care activity could be 

subdivided into inpatient and outpatient. Inpatient activity was assigned to the 

programme budget using Healthcare Resources Groups (HRG) codes. For outpatient 

activity there is no diagnosis code and so this was assigned to the budget on a 

percentage basis. Similarly community service costs are assigned to different 

programme budgets on the basis of a sample of activity. No accurate activity was 

available for community services in Hull. Similarly activity data was not available for the 

ambulance service or primary care. 

The Diabetes Commissioning Toolkit (Department of Health 2006) was used to capture 

the outcomes data available for Hull. This framework maps outcome measures and 

sources of data (where available) to the diabetes care pathway from primary prevention 



to end of life care. It also includes specific outcome measures for complications such as 

gestational diabetes, mental health, complex needs, etc. The outcomes framework was 

initially populated with information in the public domain. This was supplemented with 

locally available data which had been collected by the Public Health Sciences team as 

part of an equity audit focussed on diabetes care (see section 10.3.6 on page 578 for 

more information). 

An advisory group was selected so that all stakeholders were represented. This 

included the following: Diabetes Network Manager; Dietician; Consultant Diabetologists; 

Diabetes Specialist Nurse; Medical Director; Director with Board responsibility for 

diabetes; Assistant Director Public Health Sciences; Epidemiologists; Associate Director 

Finance, Senior Management Accountant; Assistant Director Planning and Service 

Development; Primary Care Facilitator for diabetes; Performance Manager Primary and 

Community Care, Practice Nurse, GP. 

Locally relevant decisions making criteria were determined based on criteria that had 

been used in other PBMA exercises. The criteria fell under four main headings: 

Policy and Strategy (national objectives; local objectives; impact on inequity) 

Feasibility and Practicality (affordability; ease of implementation; acceptability 

to partner agencies; availability of staff; service user acceptance; able to be 

implemented within agreed time-scales) 

Effectiveness (number of patient beneficiaries; evidence base; magnitude of 

individual benefit; physical; mental; social; life expectancy; degree of risk to 

delivery of benefit) 

Quality of Service (patient/carer experience; access and waiting times; equity 

and health inequality impact; human resources and staff impact; quality of 

physical resources (buildings etc); sustainability of service). 

The advisory group were asked to consider these four criteria, including the subcategories 

and were asked to „spend‟ 100 points between the four main categories. 

This point allocation method was chosen as it was easy to understand, quick to carry out 

and produces a robust result. A patient group was also asked to weight the same 

criteria in a similar way to the advisory group. Their weighting was presented separately 

to the advisory group, as the group were keen to explore the effect on prioritisation 

which the difference in the groups‟ weighting made. 

The advisory group identified options for change. The Hull group felt that they had 

already done considerable work, through the Integrated Service Improvement 

Programme (ISIP) and their work with external organisations, notably the Healthcare 

Commission and the National Support Team for Inequalities to identify priorities for 

service change. From the programme budget the group chose a list of priority areas for 

service change. As a validity check, these were compared with the list of priority areas 

which had been identified from work carried out in the PCT by the Healthcare 

Commission and the National Support Team for inequalities. 



A workshop was arranged to collectively identify options for service change. The 

invitation to this workshop was extended to ensure that it adequately covered all 

stakeholders. The workshop was partly facilitated by a practice development manager 

from the PCT to ensure that the process fitted with the PCT‟s approach to service 

change and to strengthen organisational ownership. 

The ISIP process had already generated some ideas for service change. Some of these 

had been suggested by patients and in addition a patient group had added to this list. 

Prior to the workshop these ideas were mapped to the priority areas and emailed to 

those invited to attend the workshop. Invitees were asked to consider options for 

service change in diabetes care which would improve outcomes in the priority areas or 

which would release resources which could be used for reinvestment. For each service 

change that required additional resource they were asked to come up with an option for 

disinvestment or resource release; access to specialist advice to prevent emergency 

admissions 

A list of 15 options for service change which had the potential to improve outcomes was 

identified. Some of these were resource neutral. A list of two options for service change 

which resulted in resource release was identified. The following options were suggested 

by the advisory group: improve diagnosis rates; control of HbA1c levels under 7.5 and 

cholesterol under 5.0 (analysing practice in relation to prescribing); access, capacity and 

waiting times for structured education; improve patient knowledge / measurement tools 

for patients; patients to agree goals and document them; National Institute for Health 

and Clinical Excellence (NICE) foot guidance; and prescribing. The following options 

were suggested by the patient group: develop lifestyle services for those at risk of 

developing diabetes; improve education for people with or at high risk of developing 

diabetes; emphasise value of diabetes support groups in providing education and 

support; need to access out of hours specialist advice; improvements in podiatry 

services; and blood test strips for Type 2 patients. 

The workshop took each priority area in turn, considered the ideas already put forward 

and discussed potential service change which could be turned into a business case. 

The workshop used a simple effort/impact matrix to quickly identify the ideas which had 

the most potential to make a difference to outcomes in the priority areas and were 

therefore worth working up into a business case. Volunteers undertook to use the 

business case format which had been developed using the criteria to enable the options 

to be considered and weighted by the Advisory Group. 

The following priority areas were included as business cases: 

1. Prevalence, Cholesterol and HbA1c, prescribing and footcare though Practice 

Visit Programme. Use QOF, prevalence and prescribing data to assess 

practice prevalence versus expected, cholesterol and HbA1c control and 

associated prescribing practice. Introduce a practice visit programme with the 

aim of increasing prevalence and improving control of cholesterol and HbA1c 

levels through sharing good practice etc. The programme could also be 

extended to include good practice in diabetic footcare as part of a patient‟s 



annual review. Group keen to ensure that the programme focussed on all 

practices starting with those where the data suggested there was most 

potential health gain. 

2. Prevalence: The group were briefed on an existing initiative for coronary heart 

disease (CHD) patients. As part of the initiative patients would have their 

blood sugar tested and this could identify patients who were at risk of or had 

diabetes. Clear pathway for patients identified in this way was required. 

3. Changing insulin prescribing practice. Insulin is started in the diabetes 

specialist service and the prescribing practice established there is continued 

in primary care. Recent evidence on the cheaper forms of insulin may 

suggest that a change in prescribing practice in the specialist service would 

reduce insulin prescribing costs in primary care potentially releasing that 

resource for reinvestment in the diabetes service. 

4. Education. A review of the existing delivery pathway of patient and staff 

diabetes education with the aim of standardising and quality assuring 

education provision. The review will include examination of related lifestyle 

education programmes provided by the PCT in public health and elsewhere. 

5. Access to footcare. Review current footcare commissioning arrangements 

with the aim of standardising and quality assuring footcare provision. There is 

a link with this idea and the practice visit programme if that programme 

includes a footcare element. 

Only one of the ideas put forward was potentially resource releasing, changing insulin 

prescribing practice. 

The business case process was agreed with the PCT and designed to fit into the PCT‟s 

existing processes. Two forms were used. One form contained a brief description of 

the service change and its impact on the criteria. This form had been designed as part 

of the PBMA pilot. The PCT‟s benefits realisation proforma was used to record costs 

and savings. Cases were developed for four of the priority areas: 

An audit in primary care which addressed prevalence, control of HbA1c and 

cholesterol, prescribing practice and the delivery of footcare education. 

A review of the commissioning arrangements for community dieticians to realign 

their remit from generalists to diabetes focussed enabling a wider roll out of 

existing diabetes education and the development/support of alternative education 

schemes. 

A review of the commissioning arrangements for community podiatrists to realign 

their remit from generalist to specialist and to introduce foot education and 

training on foot screening into primary care for staff and patients 

A minor change to an existing CHD Healthy Hearts project so that it could be 

used to assist in identifying previously undiagnosed people with type II diabetes. 



The original intention had been to circulate the finished business cases to the advisory 

group a week before the meeting where they were to be evaluated. In the event the 

cases were all tabled and did not contain all the information needed to make a complete 

judgement on marginal benefit. Capacity was an issue as the PBMA was fitted in as 

extra to the „day job‟ and one person, the diabetes network manager led the production 

of three of the business cases. The business case for changing prescribing practice 

was not completed. Capacity to complete the business case was an issue here. The 

change in prescribing practice was presented as part of the audit in primary care. 

However in discussion the group recognised that this failed to address prescribing 

practice for newly diagnosed diabetics. Clinicians on the group confirmed that by 

changing prescribing practice in secondary care, there was the potential to release 

resource from the prescribing budget in primary care as prescribing regimes were rarely 

changed by primary care clinicians once set in secondary care. There was discussion in 

the group about whether it would be possible to identify the savings and whether it was 

possible to move the resource released from the prescribing budget to be reinvested in 

primary care. This debate was taken up by the Director responsible for diabetes in the 

PCT and is still ongoing. Although members of the group undertook to estimate 

possible resource release from changing prescribing practice this had not been done by 

the end of the pilot. 

The group scored each business case against the four main criteria, giving each 

business case a score against each criteria from 1-5. Scoring as a group meant that 

any uncertainties about how the business cases met the criteria could be discussed 

together and the discussion benefited from the experience of the different professionals 

around the table. It also had the advantage of being quick to do. Scoring individually 

would have more accurately captured individual opinions and could have been 

aggregated into a single average score. 

As all the business cases under consideration were a change to an existing service, it 

was easy for the group to consider the added (or marginal) benefit of each business 

case compared to the current service provided. This would have been more difficult to 

do if the service change under consideration involved discontinuing a service and setting 

up something different. 

All the business cases presented were tabled as having no additional cost implications. 

This meant that providing each case improved outcomes, they should all be 

implemented. However, the group recognised that there would be a cost, in terms of 

time, to implementing the service changes and so prioritised the cases in order of 

weighted criteria. So the ranks for each business case were calculated. The Education 

business case scored highest (4.17 for the using the patient-weighted benefit scores 

and 4.05 using the professional-weighted benefit scores). The Footcare business case 

scored second highest (4.03 patient-weighted and 3.83 professional-weighted), the 

Audit scored third highest (3.93 patient-weighted and 3.45 professional-weighted) and 

the Healthy Hearts business case the lowest (2.98 patient-weighted and 2.73 

professional-weighted). 



All patients with diabetes would potentially benefit from the audit, education and footcare 

service changes and so the number of beneficiaries for each is likely to be similar even 

though this was not explicitly calculated. The Healthy Hearts project proposal focussed 

on a smaller patient group, those with heart disease who were at risk of developing 

diabetes or who had previously undiagnosed diabetes. Accepting the assumption that 

there was no cost associated with the business cases for education, footcare and 

Healthy Hearts, calculating the cost per beneficiary would have switched the rank order 

of the Healthy Hearts and audit business cases as the Healthy Hearts project impacted 

on fewer patients. 

The final results of the pilot were tested in a number of ways. The group was asked to 

reflect on whether the options for service change generated by the PBMA exercise were 

the changes which they would intuitively have felt would have best improved outcomes 

within the priority areas for change. In addition the results were presented to the Director 

with responsibility for Diabetes and the Diabetes Network and its subgroups. The 

questions asked were whether the options for service change could be implemented, 

whether there were issues which needed to be taken into account which had not been 

and, implicitly, whether there had been sufficient consultation on the options for service 

change and therefore whether there was ownership of the final recommendations for 

service change. 

3.2.5.5 Predictive Modelling in Hull by Price Waterhouse Cooper 

Predictive modelling involving sensitivity analysis to determine the impact on key 

indicators of changes in service provision has been undertaken in conjunction with Price 

Waterhouse Cooper (PWC) in a pilot. A template for data was provided by PWC where 

local data could be entered into the models to produce estimates of future need. The 

modelling included sensitivity analyses, i.e. changing the model inputs to assess the 

effect of different levels of service change. The templates included modelling for 11 

areas: reducing falls; reducing teenage pregnancy rate; increase Chlamydia screening 

rate; reduce infant mortality rate; reducing smoking prevalence; increasing vascular 

screening and use of anti-hypertensives/statins; increasing human papillomavirus 

vaccination uptake; increasing bowel screening uptake; increasing breast screening 

uptake; reducing alcohol misuse; and reducing obesity prevalence. The models outputs 

were secondary care need, cost and mortality. 

A bespoke service was employed with new models created by PWC to maximise the 

usefulness of the predictive modelling for Hull. A programme of vascular screening was 

already underway in practices within Hull, so reducing the prevalence of smoking was 

felt to be one of the most important areas in relation to the existing templates (see Table 

101 for the number of deaths directly attributable to smoking in Hull). The template for 

reducing the prevalence of obesity was also used. PWC produced new models for 

chronic obstructive pulmonary disease and diabetes. Smoking and obesity prevalence 

data for each gender and age group were provided from the local Health and Lifestyle 

Survey 2007 to provide initial baseline prevalence estimates. Different scenarios were 

produced with differing future smoking and obesity prevalence rates for 2009/2010 to 



2031/2032 (relative to the baseline for 2008/2009). Based on previous research, the 

PWC model used relative risks for morbidity and mortality separately for each disease 

associated with smoking (lung cancer, ischaemic heart disease, stroke, chronic 

obstructive pulmonary disease, etc) for current smokers, former smokers and never 

smokers for males and females separately, and for each disease associated with 

obesity (diabetes, colorectal cancer, breast cancer, kidney cancer, endometrial cancer, 

gallbladder cancer, arthritis, coronary heart disease and stroke). For smoking, the 

percentage of deaths attributable to smoking was also examined for different causes of 

death, and assumptions were made about the number of years until the full effect of 

quitting smoking was felt. 

NHS Hull was provided with information which illustrates the period of time in which the 

investment in these areas will impact on health outcomes (morbidity and mortality) and 

also on acute service costs and activity. The information was provided as a hard copy 

so further details are not provided within this Foundation Profile, and provide information 

to assist WCC goal groups in priorisation. 

3.2.5.6 Prioritisation Model 

A local prioritisation model was calculated in order to prioritise additional financial spend 

of approximately £90million for the different disease goal areas. 

The different goal areas (chronic obstructive pulmonary disease (COPD), stroke, mental 

health, cancer, coronary heart disease (CHD), children and young people (C&YP), 

diabetes, urgent care, healthy lifestyles, sexual health, and alcohol and drugs) were 

considered in relation to the additional funding, the financial/outcome quadrant for 

2007/2008 for Hull relative to England and the Industrial Hinterlands, and the morbidity 

and mortality impact scores. The prioritisation of the funding was undertaken on the 

basis of the combined impact scores. 

A score for disease morbidity was calculated by multiplying the prevalence of the 

disease or condition by the relative impact. Morbidity for lifestyle was based on the 

prevalence of the multiple risk factors of smoking, excessive weekly alcohol 

consumption and/or obesity (from Table 160 and Table 161) and assuming that a 

smaller proportion were currently experiencing morbidity associated with their 

behavioural or lifestyle risk factor. A similar method was used for mortality using the 

number of deaths for each disease (Table 80) with the impact denoting years lost so 

deaths in infancy was given a higher impact score as this had a larger relative impact on 

life expectancy and a lower impact score for stroke as the majority of deaths occurred 

among those aged 75+ years. The number of deaths attributable to lifestyle was 

calculated for smoking (based on information presented in Table 101) and alcohol 

(based on cause of death given in Table 80). 

The resulting scores for morbidity and mortality were separately classified as low, 

medium or high as given in Table 1. A rank based on „need‟ was calculated based on 

the classifications of morbidity and mortality combined for each goal area. It was 



recommended that 6% of the total budget was redistributed taking into account this rank 

of „need‟ and the rank of the current spend in relation to other PCTs within the Office for 

National Statistics‟ Industrial Hinterlands classification group. 

Table 1: Prioritisation relative morbidity and mortality impact scores 

Goal area Relative 

morbidity 

impact 

Relative 

mortality 

impact 

Need 

rank 

Current 

spend 

rank 

Recommendation 

COPD Medium Medium 3 3 Maintain spend 

Stroke Medium Medium 3 2 Trim spend 

Mental health High Medium 2 1 Trim spend 

Cancer Medium High 2 1 Trim spend 

CHD High High 1 2 Increase spend 

C&YP Medium Medium 3 3 No change 

Diabetes High Low 4 2 Trim spend 

Urgent care No data No data 3 Cost-saving/efficiency 

Healthy lifestyles High High 2 2 No change 

Sexual health Low Low 6 4 No change 

Alcohol, drugs Low Medium 5 3 Reduce spend 

Predictive modelling techniques were used in a project on investment priorisation 

methodology for World Class Commissioning (WCC) goal areas and initiatives, led by an 

external consultant John Hampson. This led to each WCC goal area group being 

supplied with a set of priorities for their initiatives, which were used in spending 

recommendations for year 2 of the WCC Strategy. 

3.2.5.7 Scenario Generator 

Scenario Generator is a predictive modelling tool that models changes in population 

profiles, disease prevalence and patient pathways. A pilot project has set up the base 

system for Hull, and has examined the impact on other providers of transferring services 

to the proposed Integrated Care Centre. The base system models the patient flows for 

all Hull residents, and uses predicted changes in populations to adjust prevalence and 

illustrates the effect of these changes on both financial activity and patient activity. 

There were plans that this software be rolled out to all WCC core groups to map impacts 

of initiatives on patient flows in each pathway, as well as to look at any build up of 

queues in the system that may need resolving, and will model the financial impacts of 

any changes. 



3.3 About This Document 

The aim of this document is to present information about some key themes that have an 

effect on the health and health care of the people of Hull, and show how the smaller 

geographical areas within the local authority, such as wards, area committee areas 

(Areas) or Localities, compare locally and nationally. 

3.3.1 Topic Ordering 

The document covers the following main topic areas: 

Geography 

Demography and demographics 

o Population structure 

o Births, fertility and deaths 

o Population projections 

o Ethnicity 

Deprivation and related measures 

o Unemployment rates 

o Benefit claimants 

o Housing stock 

o Educational attainment 

o Index of Multiple Deprivation 

o Crime 

o ACORN and Health ACORN classifications 

General health characteristics 

o General health status 

o Use of healthcare services 

o Hospital admissions 

o Life expectancy and mortality 

o Deaths at home 

o Winter deaths 

Risk factors for poor health 

o Estimated total number of residents with main risk factors 

o Risk factors for black and minority ethnic groups 

o Smoking 

o Obesity including diet and exercise 

o Alcohol and drugs 

o Prevalence of multiple risk factors including 10-year cardiovascular risk 

Vaccinations, immunisation and screening 

o Childhood immunisation 

o Influenza and pneumococcal vaccinations 

o Screening 



Main specific disease/topic areas: 

o Circulatory diseases including coronary heart disease and stroke 

o Cancer 

o Diabetes 

o Respiratory diseases including chronic obstructive pulmonary disease 

o Mental health and suicide 

o Sexual health including teenage pregnancies 

o Accidents 

o Children and young people mainly information in first year of life 

o Older people including predictions of future need 

References 

Glossary and explanation of statistical terms 

o Explanation of numerous statistical terms 

o Information on deaths occurrences versus registration 

o Information on hospital episode statistics 

o Information on quality and outcomes framework data 

o Information on PBS diabetes model 

Appendix 

o Data sources 

o Information on local surveys conducted including qualitative research 

o Information on partnership working 

o Definitions and classifications 

o Underlying data for figures 

o Information time period, date last updated and source for all tables/ figures 

Index 

There will be duplication across the areas listed above, but references to other sections 

of the report will be included where this is the case. Furthermore, information on 

differences in health status, risk factors, hospital admissions, life expectancy and 

mortality, etc will be included throughout the report where this information is available. 

There are numerous health targets, and progress towards these targets will be provided 

within the relevant sections, e.g. the life expectancy target will be included within life 

expectancy section of report. However, the outcome measures are likely to change (see 

section 3.3.6.2 on page 52). Some information on service provision and uptake is 

included for the risk factors where available. 



3.3.2 Geographical Areas 

Data are presented at a number of levels: 

Lower layer super output areas (areas used in Census with average 1,500 

residents – less variability in resident population size compared to wards) 

Wards 

Area committee areas (Areas) used by the local authority 

Localities used by the local NHS 

Hull 

Strategic Health Authority 

Comparator areas (see section 3.3.3.1). 

At general practice level (see section 3.3.3.3). 

National (generally England for comparison purposes). 

Not all the data are available at all geographical levels. For example, data may not be 

available at the smallest geographical level where an event is rare, or national data may 

not be available. Before 1 st October 2006, Hull was divided into two Primary Care 

Trusts (PCTs): Eastern Hull PCT and West Hull PCT, but merged into a single PCT (Hull 

Teaching PCT which is now known as NHS Hull). Therefore, some data may be 

presented for Eastern Hull PCT and West Hull PCT where it is not available in 

alternative formats. Prior to 1 st October 2006, Hull was within the North and East 

Yorkshire and Northern Lincolnshire (N&E Y & NL) Strategic Health Authority (SHA) and 

since then included within the Yorkshire and The Humber (Y&H) SHA together with 13 

other PCTs. 

PCT Public Health Profiles have been previously produced by the Public Health 

Development Team 1 . These documents form the basis of this Public Health Profile 

document which has incorporated the new Locality structure, and some information may 

be provided for Hull and East Riding of Yorkshire combined. The three NHS Localities 

are highlighted in the tables and figures where possible using yellow for North Locality, 

green for East Locality and orange for West Locality. However, these are likely to be not 

used in the future following the current reorganisation of the NHS. 

3.3.3 Benchmarking and Comparator Areas 

3.3.3.1 Comparator Areas for Hull 

The Office for National Statistics (Office for National Statistics 2005; Office for National 

Statistics 2007) has classified each PCT as one of 12 groups (Regional Centres; 

1 The Public Health Development Team worked across all four Primary Care Trusts in Hull and East 

Riding of Yorkshire (Eastern Hull, West Hull, East Yorkshire, and Yorkshire Wolds and Coast PCTs) until 

March 2006. The structure of the team changed on the 1 st April 2006, with the team splitting between Hull 

and East Riding of Yorkshire. The epidemiologists of this team became part of the Public Health Science 

Team in the new Hull Public Health Directorate. 



Centres with Industry; Thriving London Periphery; London Suburbs; London Centre; 

London Cosmopolitan; Prospering Smaller Towns; New and Growing Towns; Prospering 

Southern England; Coastal and Countryside; Industrial Hinterlands; Manufacturing 

Towns). Hull, with 15 other PCTs, is classified as being within the Industrial Hinterlands 

group (group 7.11), however, Hull is the most unlike the average for this group, and it is 

deemed as being most similar to North East Lincolnshire, which is actually in another 

ONS Area Classification group. 

The characteristics of Hull make it quite unique and no other geographical area is 

„extremely similar‟ or „very similar‟ to Hull. Certain areas may have some characteristics 

that are similar such as a similar population age structure, etc, but there is no area that 

shares a number of characteristics of Hull in terms of Hull‟s population structure, 

ethnicity, deprivation, tight geographical boundaries, type of industry, type of housing, 

workforce, etc. An analysis of comparable areas has been undertaken by the Hull City 

Council (Hull City Council 2006) and Public Health Sciences team, and rather than rely 

on a single geographical area (which will not be all that similar to Hull anyway) and 

might have an unusual characteristic for the particular factor being compared, it is 

preferable to examine Hull in relation to a range of different geographical areas. For 

example, if comparing lung cancer mortality rates one comparator PCT might be similar 

in other characteristics but have a much lower prevalence of smoking. Table 2 gives a 

list of local authorities/PCTs for which Hull has been classified as being the most similar 

by different organisations. 

Table 2: Comparable areas to Hull 

Local authority/ 

PCT 

ONS Audit 

Commission 

OFSTED Home 

Office 

Institute of 

Public 

Finance 

Wolverhampton Y Y 

Salford Y Y Y Y 

Derby Y Y Y 

Stoke-on-Trent Y Y Y 

Coventry Y Y Y Y 

Plymouth Y Y Y Y 

Sandwell Y Y Y 

Middlesbrough Y Y Y Y Y 

Sunderland Y Y Y 

Leicester Y Y Y Y 

NE Lincolnshire Y 

Knowsley Y 

Major 

City 

The local analysis of comparator areas is summarised in Table 3 which the degree of 

similarity ( most similar (generally within ±5% of Hull); similar (within 10%); not 

similar (difference above 15%); least similar (difference above 20%; blank if neither 

similar nor dissimilar or not applicable) between Hull and the potential comparator areas. 

Most of the information presented in the table is from the 2001 Census, which was the 



basis for which ONS produced their Area Classifications. More detailed information is 

given in the APPENDIX on page 814, where the population, deprivation ranks, and 

percentages of the population or households with a particular characteristic are given. It 

can be seen that there is no area that is similar for the majority of characteristics examined. 

Table 3: Potential comparator areas – characteristics (similarity summary) 

Characteristic Potential comparator area 

Population (2005, 000s) 

Age structure 

Deprivation score (IMD2004) 

Housing type 

Central heating 

Mean household rooms 

Mean occupancy rating~ 

Non White British 2006 

Marital status 

Single parent househlds 

Limiting long-term ill/disability 

Not good health 

Working 

Unemployed 

Students 

Retired 

Sick / disabled not working 

No qualifications 

Degree or higher 

Cars/vans per household 

Land use 

Wolverhampton 

Salford 

Derby 

ONS area classification (IndHint) 

~Household scored as -2, -1, 0, 1 or 2 to measure overcrowding. For example, –2 relates to having at 

least two fewer rooms than required based on an assessment of household members relationships to 

each other, their ages and their genders. 


Stoke-on-Trent+ 

Coventry 

Plymouth 

Sandwell 

Middlesbrough 

Sunderland 

Leicester 

NE Lincolnshire


3.3.3.2 Health, Social and Economic Outcomes Benchmarking: A Tale of Three 

Cities 

A comparative analysis of Hull City against York and Sheffield as benchmarks and 

national performance was conducted early in 2009. A wide range of data, produced in 

partnership with the local authority and voluntary sector colleagues, were analysed, and 

selected indicators used to benchmark health needs status, healthcare performance, 

priority health outcomes and economic, housing and educational factors relating to 

health. The analyses were helped to reach a wide audience by being produced as both 

a standard report and an illustrated presentation using PowerPoint (available on 

request; for contact details see page 2). 

3.3.3.3 General Practice Groupings 

The general practices in Hull differ with regard to their registered population in terms of 

deprivation and age of patients. Whilst general practices can be compared, it is better 

and easier to try to compare like-with-like. As a result, the general practices in Hull have 

been grouped according to the average deprivation score of their patients and the 

average age of their patients 2 . The Index of Multiple Deprivation 2007 has been used to 

measure deprivation (see section 6.9.1 on page 131 for more information). Nationally, 

a deprivation score has been assigned to each of the 163 lower layer super output areas 

(LLSOAs) within Hull. On average, 1,500 residents live in each LLSOA in Hull (although 

with population changes to some areas, such as Kings Park, the number of residents is 

higher). A deprivation score has been determined for each registered patient based on 

their postcode (and their LLSOA). There is an assumption that the average deprivation 

score for the LLSOA is representative for each registered patient and this might not be 

the case (the patients registered at a specific practice may be more deprived than the 

average for their area – see section 6.9.1.2 on page 134 for more information). 

Table 28 gives the mean age of the patients registered with each practice (as at April 

2010). The deprivation scores are given in Table 49 should be used as a guide to the 

level of deprivation within each practice. Figure 4 gives the mean deprivation score and 

mean age of the registered patients for each practice (as at April 2010). Table 4 gives 

the assigned groups for each practice based on the deprivation score and mean age of 

their registered patients. 

2 Theoretically it is possible to group practices using more characteristics than deprivation and age, 

however, as the number of characteristics increase, in practice, it becomes much more difficult to group 

the practices into similar groups. 



Figure 4: Mean deprivation score and mean age of registered patients for each general 

practice as at April 2010 and grouping of practices 

Mean age of patients 

48 

46 

44 

42 

40 

38 

36 

34 

32 

30 

28 

26 

10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 

Mean Index of Multiple Deprivation 2007 score 

Table 4: General practice groupings based on deprivation score and mean age of 

registered patients as at April 2010 

Group Code Practice name List Mean Mean Contract IT Locality 

size IMD age 

A B81035 Dr Sande & Ptrns 6,117 21.8 41.7 GMS SystmOne West 

A B81056 Springhead Med Cn 13,612 17.0 40.0 GMS Vision West 

A B81104 Dr Nayar 7,661 22.8 26.4 GMS SystmOne West 

A B81635 Dr Dave 2,966 19.0 43.5 GMS SystmOne East 

A B81662 Mizzen Rd Surgery 1,794 21.5 44.6 PMS SystmOne North 

A Y01200 The Calvert Practice 1,781 18.2 41.4 PMS SystmOne West 

A Y02747 Kingswood Surgery 1,231 11.7 30.3 PMS SystmOne North 

B B81020 Dr Mitchell & Ptrns 7,369 27.2 40.4 PMS Vision North 

B B81021 Faith Hse Surgery 7,275 27.0 40.3 GMS SystmOne North 

B B81075 Dr Mallik 2,233 23.9 47.7 GMS EMIS PCS West 

B B81085 Dr Richardson & Pts 5,294 26.9 43.3 GMS SystmOne East 

B B81094 Dr AK Datta 1,876 23.5 40.2 GMS EMIS LV North 

B B81095 Dr Cook 4,203 26.8 42.9 GMS EMIS LV North 

B B81097 Dr Yagnik 1,692 24.4 45.3 GMS SystmOne East 

B B81690 Dr Ray 1,710 25.6 39.4 GMS SystmOne North 

C B81001 Dr Ali & Partners 3,352 32.9 38.8 GMS SystmOne East 

C B81008 Dr Parker & Partnrs 15,031 35.2 38.4 PMS SystmOne East 

C B81048 Dr SM Hussain &Pts 9,119 27.1 36.0 PMS SystmOne West 

C B81049 Dr Rawcliffe & Ptnrs 9,345 31.5 38.5 GMS EMIS LV North 

C B81052 Dr Musil & Queenan 5,743 33.2 36.8 GMS SystmOne West 

C B81072 Dr Percival & Prtnrs 7,684 27.7 37.5 GMS SystmOne West 

C B81644 Dr Mahendra 2,245 26.4 36.6 PMS EMIS PCS East 

C Y02786 Priory Surgery 289 30.1 33.1 PMS SystmOne West 



Group Code Practice name List Mean Mean Contract IT Locality 

size IMD age 

D B81011 Wheeler St Healthcr 5,230 36.0 40.6 GMS SystmOne West 

D B81038 Dr Mather & Partnrs 7,709 34.6 42.0 GMS EMIS LV West 

D B81057 Dr MacPhie & Koul 3,301 34.1 41.5 GMS Vision West 

D B81074 Dr Rej 3,626 34.7 40.0 GMS SystmOne East 

D B81081 Dr Tang & Partner 3,515 34.1 40.4 GMS SystmOne East 

D B81645 East Park Practice 2,133 33.3 41.6 PMS SystmOne East 

D B81646 Dr Shaikh 1,886 34.5 40.0 GMS EMIS PCS East 

D B81682 Dr Shaikh & Partnrs 3,743 35.0 39.7 PMS SystmOne East 

E B81053 Diadem Med Pract 10,388 41.3 40.5 GMS SystmOne East 

E B81054 Dr Varma & Partnrs 10,794 40.7 40.2 PMS SystmOne West 

E B81058 Dr Foulds & Partner 8,672 37.9 42.2 GMS SystmOne West 

E B81066 Dr Chowdhury 2,483 37.7 39.7 GMS SystmOne East 

E B81080 Dr Malczewski 2,201 37.9 43.3 GMS SystmOne East 

E B81616 Dr Hendow 2,570 37.1 39.3 GMS EMIS LV North 

F B81002 Dr Kumar-Choudhary 3,833 42.6 34.6 PMS SystmOne North 

F B81112 Dr GhoshRaghunath&Pts 3,491 42.5 34.2 GMS EMIS LV North 

F B81119 Dr Palooran & Ptnrs 4,566 42.4 35.3 GMS EMIS PCS North 

F B81634 Dr Venugopal 3,031 42.6 34.2 GMS EMIS LV North 

F B81674 Dr Joseph 2,238 41.5 36.0 GMS SystmOne East 

F B81675 Dr Tak & Stryjakiewicz 9,417 39.4 35.2 PMS SystmOne West 

F B81685 Dr Poulose 2,400 41.3 34.7 GMS SystmOne North 

F B81688 Dr Gopal 2,022 43.1 34.3 GMS SystmOne North 

F Y02344 Northpoint 1,779 42.6 35.9 PMS SystmOne North 

G B81027 St Andrews Gp Pract 5,974 45.4 40.2 PMS EMIS LV West 

G B81040 Dr Newman & Ptnrs 16,760 45.4 37.9 GMS Vision East 

G B81047 Dr Singh & Partners 7,425 43.8 38.4 PMS SystmOne West 

G B81089 Dr Witvliet 3,593 47.7 36.6 GMS EMIS PCS East 

G B81631 Dr Raut 3,397 44.4 31.8 PMS EMIS LV North 

G B81683 Dr Raghunath & Pts 1,672 47.4 35.8 PMS SystmOne West 

G Y02896 Story St Pract & Walk In 319 47.8 37.8 PMS SystmOne West 

H B81017 Kingston Med Grp 6,724 50.6 39.2 PMS SystmOne West 

H B81018 Dr Awan & Partners 6,549 56.8 35.9 GMS EMIS LV North 

H B81032 Dr AW Hussain & Pts 2,416 51.8 39.1 GMS SystmOne West 

H B81046 Dr Blow & Partners 9,129 52.0 36.8 GMS SystmOne West 

H B81692 Quays Med Centre 1,738 55.1 32.9 PMS SystmOne West 

H Y00955 Riverside Med Centre 2,492 66.1 35.1 PMS SystmOne West 

H Y02748 Haxby Orchard Pk Surg 271 53.5 30.6 PMS SystmOne North 

3.3.4 Data Sources 

Where possible, we have used sources of data that are routinely available nationally, 

either as published material (e.g. the Compendium of Clinical and Health Indicators, the 

Census, Quality and Outcomes Framework (QOF) data, etc) or from websites of 

Government Offices (e.g. Department of Health). Elsewhere we have used raw data at 

patient or episode level (e.g. Public Health Mortality Files) to construct local indicators of 

health. Local information has been provided by others within NHS Hull or colleagues at 

the Hull City Council and other organisations. The prevalence of lifestyle behavioural 

risk factors comes from local surveys such as the local Health and Lifestyle Survey, and 

comparison information from the annual Health Survey for England (Health Survey for 



England 2008) and the General Household Survey (Economic and Social Data Service 

2008). Further more detailed information on the data sources used within this report 

and information about the local surveys conducted are given in the APPENDIX on page 

790. Furthermore, the source of each table and figure is given in section 13.7.1 on 

page 947 (tables) and in section 13.7.2 on page 956 (figures). 

We have provided the most up-to-date data available. Not all the data relate to the 

same time period. Different sets of data are published at different times of the year and 

the most recent data may not yet be published, or if the numbers of events are very low 

for rare diseases, the data for several years are combined to obtain a more reliable 

picture. 

3.3.5 Listed Sections of This Release 

Section 1 is the two-page executive summary. 

Section 2 gives a summary of the findings. 

Section 3 provides an introduction to this document and the background. 

Section 4 gives an overview of the geographical area. 

Section 5 gives an overview of the population including total number of births 

and deaths, population projections, and estimates of ethnicity. 

Section 6 describes patterns of deprivation in the local population. This includes 

information on the employment, benefit claimant rates, housing stock, educational 

attainment and crime as well as describing the Index of Multiple Deprivation. 

Section 7 provides information on general health, including health status, limiting 

long-term illness and disability, learning disabilities, hospital admissions, life 

expectancy and mortality. 

Section 8 provides information about risk factors for poor health, providing local 

information on the prevalence of smoking, alcohol consumption, obesity, diet and 

exercise. The total number of people with different risk factors and the 

prevalence of multiple risk factors are also estimated. This section also includes 

brief information on existing programmes to reduce the prevalence of these risk 

factors and some details on the social marketing work being undertaken. 

Section 9 gives information on vaccinations, immunisations and screening. 

Section 10 gives information on specific diseases or topics including seven of the 

eight original key areas from the World Class Commissioning Strategy (coronary 

heart disease; stroke; chronic obstructive pulmonary disease; diabetes; cancer; 

mental health; and children and young people; with primary and community care 

not included) as well as other disease areas or groups. Disease prevalence or 

incidence, hospital admissions, mortality and quality of care information is 

included. However, this information is not available for all the diseases presented 

within this section (as some information is not available or the numbers of people 

are too small). There are also be a section on older people, which includes 

predictions on future need in relation to older people. 

Section 11 gives a list of references. 



Section 12 is a glossary of terms and contains an explanation of some of the 

statistical terms and methods used within the report. 

Section 13 is the appendix which includes further background information such 

as details of the local surveys conducted, definitions and classifications used. 

Information relating to the qualitative findings are also presented. The appendix 

also gives the data for the underlying tables (page 814), and a table which gives 

information on when each table and figure was last updated, the time period to 

which the table or figure refers and the data source (page 944). 

Section 14 is the index. 

3.3.6 Influence of NHS Reorganisation 

This Release 3 of the Joint Strategic Needs Assessment Foundation Profile 

concentrates on measures of health and well-being and influential factors for Hull 

residents and/or the patients registered with general practices within the Hull (PCT or 

local authority area). In the White Paper “Equity and excellence: liberating the NHS” 

published in July 2010 (Department of Heath 2010), a major reorganisation is planned 

where the PCTs will no longer exist and commissioning powers are given to GP 

consortia. In the local area, as at February 2011, the process of setting up the GP 

consortia is underway. As well as this reorganisation, in the meantime (between now 

and the disbandment of the PCTs in 2013), PCTs must cluster together to share key 

functions and ensure that all statutory work is completed with their depleted staffing 

levels (with staff leaving due to management cost reductions and leaving to find 

employment prior to the PCTs being disbanded). It is likely that Hull PCT will be in a 

cluster with East Riding of Yorkshire and North Lincolnshire, and possibly North East 

Lincolnshire 3 . Nationally, an independent and accountable NHS Commissioning Board 

will be set up. From the Public Health White Paper published in December 2010 

(Department of Health 2010), local authorities will be given the responsibility for 

improving people‟s health and tackling health inequalities, with Directors of Public Health 

in upper-tier local government and unitary local authorities, backed up by a new service 

Public Health England. 

From the Health White Paper (Department of Heath 2010) and the Public Health White 

Paper (Department of Health 2010), new Health and Wellbeing Boards will be set up to 

support collaboration across the NHS and local authorities in order to meet communities‟ 

needs as effectively as possible. GP consortia and local authorities, including Directors 

of Public Health, will each have an equal an explicit obligation to prepare the Joint 

Strategic Needs Assessment, and to do so through the arrangements made by the 

health and wellbeing board. 

3 As North East Lincolnshire has taken on provision of social care it is not known if it needs to cluster with 

other PCTs. 



3.3.6.1 General Practices and GP Consortia 

The formation of the GP consortia is currently underway as at February 2011, and the 

final GP consortium or consortia within the Hull area has not been agreed. It is possible 

that there will be one GP consortium in the Hull area covering the GP practices that are 

currently within Hull. However, this may not be the case, and it is possible that there 

could be more than one consortium in Hull, or one consortium that also covers some 

practices within East Riding of Yorkshire. Therefore, it is not possible, at this time, to 

provide any information in relation to the local GP consortia. 

3.3.6.2 Outcome Measures, Performance Targets and Progress Towards Targets 

In the two years prior to May 1010, substantial work was undertaken in Hull developing 

the World Class Commissioning (WCC) Strategy, and it included a number of targets for 

improving health. Also prior to the change in Government (May 2010), in partnership 

with the local authority, there were also a number of targets from the Local Area 

Agreement (and Local Area Agreement 2) through the Health and Wellbeing Strategic 

Delivery Partnership. In Release 2 of the Joint Strategic Needs Assessment Foundation 

Profile, progress towards these targets was discussed. There were also a number of 

Vital Signs targets. However, with the major reorganisations currently underway, it is 

not clear what outcome measures will be retained and which, if any, indicators will 

become new outcome measures and what the targets will be set at locally. The 

proposals for new public health outcomes are currently (as at February 2011), under 

consultation (Department of Health 2010). 

In the list of potential public health outcomes are a number of indicators or similar 

indicators which existed previously or were local measures including: 

All age all cause mortality 

Under 75 circulatory disease mortality 

Under 75 cancer mortality 

Differences in life expectancy between communities 

Suicide and undetermined injury mortality 

Breastfeeding at 6-8 weeks 

Infant mortality rate 

Incidence of low birth weight of term babies 

Percentage of reception year and year 6 children who are obese 

Child immunisation uptake rates 

Hospital admissions for alcohol-related harm 

Patients with diabetes HbA1c 7.0 or less measured in the last 15 months 

Hospital admissions caused by unintentional or deliberate injuries to children and 

young people 

Cancer screening uptake rates 

Chlamydia screening uptake rates 

Access to genito-urinary medicine clinics 



Smoking in pregnancy 

Influenza immunisation uptake rates 

Admissions from falls in the over 65s 

There are also a variety of new potential outcomes measures such as: 

Under 75 respiratory disease mortality 

Under 75 chronic liver disease mortality 

Rate of emergency readmissions within 30 days 

Percentage of adults meeting national exercise guidelines 

Rate of smoking quitters per 100,000 population 

Rate of uptake of NHS Health Checks 

Treatment completion rates for tuberculosis 

Incidence of domestic abuse 

Fuel poverty 

Social connectedness 

As it is not yet known which outcome measures and targets will be retained, progress 

towards the main targets used previously will be discussed for this Release 3 of the 

Joint Strategic Needs Assessment Foundation Profile. 



3.4 Local Surveys, Definitions and Statistical Methods 

Further information on the local adult Health and Lifestyle Surveys conducted during 

2003 and 2007, the Young People Health and Lifestyle Surveys conducted during 2002 

and 2008-09, and the Social Capital Surveys conducted during 2004 and 2009 are given 

in the APPENDIX on page 790. 

Definitions of risk factors used in the local surveys, and information on the classification 

of diseases and medical conditions, and classifications of surgical codes and 

procedures are also given in the APPENDIX on page 805. 

A glossary and further information is also given in section 12 on page 758 on statistical 

terms and methods, this includes information on synthetic estimates, confidence 

intervals, significance testing, standardisation, statistical considerations when 

interpreting data for which there are only a small number of events. Knowledge of these 

statistical methods is essential for many tables and figures in order to interpret the 

information correctly. 



3.5 Abbreviations 

A&E ......................... Accident and Emergency (department) 

AAA ......................... Abdominal Aortic Aneurysm 

AAACMR ................. All Age All Cause Mortality Rate 

ACORN ................... A Classification of Residential Neighbourhoods 

ASH ......................... Action on Smoking and Health 

BME ......................... Black and Minority Ethnic 

BMI .......................... Body Mass Index 

BP ............................ Blood Pressure 

C&LG ....................... Communities and Local Government 

C&YP ....................... Children and Young People 

CABG ...................... Coronary Artery Bypass Graft 

CAF ......................... Common Assessment Framework 

CAMHS ................... Children and Adolescent Mental Health Service 

CARAT .................... Counselling, Assessment, Referral, Advice and Throughcare (substance misuse) 

CHD ......................... Coronary Heart Disease 

CHS ......................... Child Health System 

CKD ......................... Chronic Kidney Disease 

CO ........................... Carbon Monoxide (in relation to Smoking Cessation Service) 

COPD ...................... Chronic Obstructive Pulmonary Disease 

CVD ......................... Cardiovascular Disease 

CI ............................. Confidence Interval 

DCSF ....................... Department for Children, School and Families 

DIR .......................... Drug Intervention Record 

DMF ......................... Decayed, Missing or Filled (teeth) 

DNA ......................... Did Not Attend 

DoH ......................... Department of Health 

DSR ......................... Directly Standardised Rate 

DSRR ...................... Direct Standardised Registration Ratio 

DTP ......................... Diphtheria, Tetanus and Pertussis (whooping cough) 

DWP ........................ Department for Work and Pensions 

eGFR ....................... estimated Glomerular Filtration Rate 

EH ........................... Eastern Hull (Primary Care Trust pre 2006) 

ERoY ....................... East Riding of Yorkshire (Local Authority) 

ESP ......................... European Standard Population 

EY ............................ East Yorkshire (Primary Care Trust pre 2006) 

FNF ......................... Fractured Neck of the Femur 

GCSE ...................... General Certificate of Secondary Education 

GHS ......................... General Household Survey (now General Lifestyle Survey) 

GLS ......................... General Lifestyle Survey (previously General Household Survey) 

GOYH ...................... Government Office for Yorkshire and the Humber 

GP ........................... General Practitioner 

GUM ........................ Genitourinary Medicine 

H&L ......................... Health and Lifestyle (Survey) 

HCC ......................... Hull City Council 

HDL ......................... High Density Lipoprotein (cholesterol) 

HEA ......................... Health Equity Audits 

HERHIS ................... Hull and East Riding Health Information Service 

HES ......................... Hospital Episode Statistics 

HH ........................... Healthy Heart programme in Hull (Stay Healthy Live Longer) 

HIA .......................... Health Impact Assessments 

HIV .......................... Human Immuno-deficiency Virus 

HNA ......................... Health Needs Assessments 

HPV ......................... Human Papillomarvirus 

HPA ......................... Health Protection Agency 

HSE ......................... Health Survey for England 

HUI .......................... Health Utilities Index (scale measuring health status) 

IB ............................. Incapacity Benefit 

IC ............................. Information Centre 

ICD .......................... International Classification of Diseases 



IMD .......................... Index of Multiple Deprivation 

JSNA ....................... Joint Strategic Needs Assessment 

KuH ......................... Kingston-upon-Hull (Local Authority) 

LA ............................ Local Authority 

LAA .......................... Local Area Agreement 

LDL .......................... Low Density Lipoprotein (cholesterol) 

LLSOA ..................... Lower Layer Super Output Area (defined geographical area) 

LSP .......................... Local Strategic Partnership 

MHI .......................... Mental Health Index (part of Short Form SF36 questionnaire) 

MMR ........................ Measles, Mumps and Rubella 

N&EY&NL ................ North and East Yorkshire and Northern Lincolnshire 

N/A .......................... Not Applicable 

NCMP ...................... National Children Measurement Programme 

NE ........................... North East 

NHS ......................... National Health Service 

NI ............................. National Indicator 

NICE ........................ National Institute for Health and Clinical Excellence 

NYCRIS ................... Northern and Yorkshire Cancer Registry and Information Service 

ONS ......................... Office for National Statistics 

OPCS ...................... Office of Population Censuses and Surveys (now ONS) 

PBMA ...................... Programme Budgeting and Marginal Analysis 

PBS ......................... (Y&H) PHO, Brent PCT & ScHARR model for estimating diabetes prevalence 

PCI .......................... Percutaneous Coronary Intervention 

PCIS ........................ Primary Care Information System (Open Exeter) 

PCMD ...................... Primary Care Mortality Database 

PCT ......................... Primary Care Trust 

PHBF ....................... Public Health Births File 

PHMF ...................... Public Health Mortality File 

PHO ......................... Public Health Observatory 

POPPI ..................... Projecting Older People Population Information System 

PPV ......................... Pneumococcal Polysaccharide Vaccination 

PRU ......................... Pupil Referral Units 

PSHE ....................... Personal, Social and Health Education (classes at school) 

PSA ......................... Public Service Agreements 

PWC ........................ Price Waterhouse Cooper 

QMAS ...................... Quality Management and Analysis System 

QOF ......................... Quality and Outcomes Framework 

RCGP ...................... Royal College of General Practitioners 

ScHARR .................. School of Health and Related Research 

SC ........................... Social Capital (Survey) 

SDA ......................... Severe Disablement Allowance 

SDP ......................... Strategic Delivery Partnership 

SHA ......................... Strategic Health Authority 

SMR ........................ Standardised Mortality (or Morbidity) Ratio 

SOA ......................... Super Output Area (defined geographical area) 

SRR ......................... Standardised Registration Ratio 

STI ........................... Sexually Transmitted Infection 

TIA ........................... Transient Ischaemic Attack 

TPAR ....................... Total Period Abortion Rate 

TPFR ....................... Total Period Fertility Rate 

u75 .......................... Under 75 years in age (relating to premature mortality) 

UK ........................... United Kingdom 

WCC ........................ World Class Commissioning 

WCCDP ................... World Class Commissioning Datapacks 

WH .......................... West Hull (Primary Care Trust, pre 2006) 

Y&H ......................... Yorkshire and The Humber (Region/SHA) 

YW&C ...................... Yorkshire Wolds and Coast (Primary Care Trust pre 2006) 



4 GEOGRAPHICAL AREA 

4.1 Hull 

This report covers all three NHS Localities and the seven local authority Areas in Hull. 

The boundaries of NHS Hull (formerly known as Hull Teaching Primary Care Trust 

(PCT)) are identical to the boundaries for the local authority. Some information is also 

produced for the 23 wards within Hull. Comparison information may be presented for 

the local Yorkshire and Humber (Y&H) Strategic Health Authority (SHA) and England as 

a whole 4 . Figure 5 illustrates the location of Hull (red) and the other PCTs within the 

Y&H SHA in relation to the England and Wales. 

Figure 5: Location of Hull 

4 Before 1 st October 2006, Kingston-upon-Hull was divided into two Primary Care Trusts (PCTs): Eastern 

Hull PCT and West Hull PCT, but these have now merged into a single PCT (Hull Teaching PCT now 

known as NHS Hull). Furthermore, prior to 1 st October 2006, Hull was within the North and East Yorkshire 

and Northern Lincolnshire (N&E Y & NL) Strategic Health Authority (SHA), but SHAs have also changed 

and Hull is now within the Yorkshire and The Humber (Y&H) SHA. 



Figure 6 illustrates the local PCTs within the Yorkshire and the Humber SHA. 

Figure 6: Primary Care Trusts within Yorkshire and the Humber Strategic Health 

Authority 



4.2 Wards Within Hull 

There are 23 wards in Hull which are illustrated in Figure 7, and Figure 8 is a map of 

Hull also showing the ward boundaries in relation to the main roads and built-up areas. 

Figure 7: Wards within Hull 



Figure 8: Map of Hull 

Derringham 

Derringham 

Boothferry 

Boothferry 

Pickering 

Pickering 

Orchard 

Orchard 

Park Park and 

and 

Greenwood 

Greenwood 

Bricknell 

Bricknell 

University 

University 

Newington 

Newington 

4.3 Ward Profiles 

Avenue 

Avenue 

St St Andrew's 

Andrew's 

Kings Kings Park 

Park 

Beverley 

Beverley 

Newland 

Newland 

Myton 

Myton 

Bransholme 

Bransholme 

East 

East 

Bransholme 

Bransholme 

West 

West 

Sutton 

Sutton 

Holderness 

Holderness 

Drypool 

Drypool 

© Crown Copyright 2008. 

All rights reserved. 

Licence number 100019918. 

Southcoates 

Southcoates 

South- South- South- East 

East 

coates 

coates 

West 

West 

Longhill 

Longhill 

Marfleet 

Marfleet 

Two-page summaries for each ward, area and locality are also available which provide 

information from the Health and Lifestyle Survey 2007 and mortality rates contained in a 

76-page report “Public Health Profiles for Hull”. Similar information is also given on the 

interactive Hull Atlas, where you can highlight wards to show survey and mortality 

information, and compare wards throughout Hull. All this information is available at 



Ings 

Ings


4.4 Localities and Area Committee Areas 

There are seven local authority area committee areas (Areas) and three NHS Localities 

within Hull (Table 5). None of the wards are split when creating the area committee 

areas or the Localities, i.e. each ward is within a single Area and within a single Locality. 

However, this is not the case for area committee areas; one Area (Riverside) is split into 

two with one of its wards in one Locality (East) and the remaining three wards in another 

Locality (West). As a result information will be presented for „Riverside (East)‟ and 

„Riverside (West)‟ separately in most analyses. The three NHS Localities are 

highlighted in the tables and figures where possible using yellow for North Locality, 

green for East Locality and orange for West Locality. 

Table 5: Area committee areas and localities in Hull 

Locality Area committee area (Area) Ward 

Bransholme East 

North Carr 

Bransholme West 

North 

Kings Park 

Beverley 

Northern 

Orchard Park and Greenwood 

University 

Ings 

East 

Longhill 

Sutton 

East 

Park 

Holderness 

Marfleet 

Southcoates East 

Southcoates West 

Riverside (East) Drypool 

Myton 

Riverside (West) 

Newington 

St Andrews 

Boothferry 

West West 

Derringham 

Pickering 

Avenue 

Wyke 

Bricknell 

Newland 



Figure 9 illustrates the boundaries of the wards and the area committee areas in Hull. 

Figure 9: Wards, area committee areas and localities in Hull 



5 DEMOGRAPHY AND DEMOGRAPHICS 

5.1 Population Structure 

5.1.1 Difference in GP Registered Population and Resident Population 

Different population estimates are available from different sources. One source is the 

2001 Census, which provides the number of residents for different geographical areas, 

including for wards, local authorities and PCTs. This forms a baseline figure for 

biannual projections completed by the Office for National Statistics (ONS). Another 

population estimate source is from General Practitioner (GP) registrations 5 . The people 

registered with GPs can then be either assigned to a geographical area based on their 

postcode of residence or the postcode of their GP practice. In many cases, these are 

the same, but not always particularly the smaller the geographical area. Residents of 

East Riding of Yorkshire (ERoY) who live near Hull may be registered with General 

Practices within Hull and vice versa. However, the local registration files contain 

patients registered with GPs from both Hull and East Riding of Yorkshire (as well as 

some in the immediately surrounding area), and therefore, the majority of Hull residents 

who are registered with a GP will be included in this file. When people move address 

and need to change their GP, there are often delays associated with this, particularly so 

for the young who do not regularly attend a GP. However, it is hoped that the numbers 

and characteristics of people who are down as registered with a local GP who have 

moved away roughly balance with those people who are new to the area who have not 

yet registered with a local GP. However, it is likely that the GP registration file 

overestimates the population as there will be some individuals who have emigrated 

abroad or moved to Scotland, and have not informed their GP (their records will not be 

automatically updated). 

The GP registration file is also important with regard to obtaining an estimate of the 

registered population for Hull. Table 6 illustrates the difference between resident and 

registered population using the GP registration file. In October 2010, there were 

289,698 patients registered with Hull GPs and 265,257 Hull residents. Some postcodes 

of practices or patients were missing and are included in the „outwith area‟ group. 

Table 6: Estimated resident and/or registered population of Hull for October 2010 

Number of Hull/ERoY residents and/or 

Hull/ERoY patients 

Residence 

of patient 

Location of General Practice 

Hull East Riding Outwith Total 

of Yorkshire area/missing 

Hull 261,266 3,985 6 265,257 

East Riding of Yorkshire 28,360 307,655 7,771 343,786 

Outwith area/missing 72 347 N/A 419 

Total 289,698 311,987 7,777 609,462 

5 Unless otherwise stated, most of the analyses in this document use (registered or resident) population 

estimated from General Practitioner registrations (because it is available at individual patient level and this 

format is required for the majority of the analyses). 



NHS Hull is responsible for the residents of Hull, which is approximately 265 thousand 

persons (an increase of almost 2,000 since October 2009). 

A similar pattern between registered and resident population estimates is evident at the 

Locality level as illustrated in Table 7 which shows the number of people registered with 

Hull General Practices (only Hull residents and/or patients of Hull GPs are included). 

The Practices 6 are divided between the three Hull Localities according to where the 

main surgery is located (Table 8). For many practices there are substantial numbers of 

people who are registered with the practice but who live in a different Locality to the one 

of their practice (or live in East Riding of Yorkshire or another PCT). The extent of this 

effect can be seen by the percentages in Table 9 and Table 10. 

Table 7: Estimated resident and registered population of each locality in Hull for October 

2010 

Number of Hull residents 

and/or Hull patients 

Residence 

of patient 


Hull Locality ERoY Other/ Total 

North East West 

missing 

Hull 

Locality 

North 

East 

West 

44,146 

14,810 

5,189 

2,572 

76,636 

608 

16,046 

3,327 

97,169 

356 

182 

3,447 

160 

228 

375 

63,280 

95,183 

106,788 

ERoY 4,870 3,337 20,153 N/A N/A 28,360 

Other/missing 21 13 38 N/A N/A 72 

Total 69,036 83,166 136,733 3,985 763 293,683 

General Practices are allocated to Localities on the basis of the site of their main 

premises as shown in Table 8 as at April 2010. It is inevitable that some of their 

practice populations will live outside the Locality of which the practice is within. The 

reference refers to the location (postcode) on the map (Figure 10). 

Table 8: Locality of General Practices, April 2010 

Code Practice name Partnership name Postcode Ref 

B81002 Dr A Kumar-Choudhary Dr Kumar-Choudhary A HU7 4DW 1 

B81018 Dr R K Awan & Partners Dr Awan RK & Partners HU6 9BS 2 

B81020 Dr P C Mitchell & Partners Dr Mitchell PC & Partners HU7 4PT 3 

B81021 Faith House Surgery Dr Crick DLA & Partners HU6 7ER 4 

B81049 Dr V A Rawcliffe & Partners Dr Rawcliffe VA & Partners HU6 8QF 5 

B81094 Dr A K Datta Dr Datta AK HU7 4BJ 6 

B81095 Dr Cook Dr Cook BF HU6 7HP 7 

B81112 Dr Ghosh Raghunath & Partners Dr Ghosh PC & Partners HU7 4DW 1 

6 The practices illustrated in the table are the practices as at April 2010. Three relatively new practices 

were established during the end of 2009 and beginning of 2010 so this intermediate GP registration 

population file was used for some of the analyses, whereas other analyses used information relating to the 

GP registration file for October 2009. 




B81119 Dr G Palooran & Partners Dr Palooran G & Partner HU7 4DW 1 

B81616 Dr G T Hendow Dr Hendow GT HU7 4DW 1 

B81631 Dr R Raut Dr Raut R HU7 5DD 8 

B81634 Dr J Venugopal Dr Venugopal J HU7 4DW 1 

B81662 Mizzen Road Surgery Dr(s) at Mizzen Road Surgery HU6 7AG 9 

B81685 Dr N A Poulose Dr Poulose NA HU7 4DW 1 

B81688 Dr K V Gopal Dr Gopal KV HU7 4DW 1 

B81690 Dr S K Ray Dr Ray SK HU7 4YG 10 

Y02344 Northpoint Dr(s) at Northpoint HU7 4DW 1 

Y02747 Kingswood Surgery Dr(s) at Kingswood Surgery HU7 3JQ 11 

Y02748 Haxby Orchard Park Surgery Dr(s) at Haxby Orchard Pk Surg HU6 9BX 12 

B81001 Dr Ali & Partners Dr Ali RA & Partners HU9 3JR 13 

B81008 Dr J S Parker & Partners Dr Parker JS & Partners HU9 2LJ 14 

B81040 Dr P F Newman & Partners Dr Newman PF & Partners HU9 5HH 15 

B81053 Diadem Medical Practice Dr Maung M & Partners HU9 4AL 16 

B81066 Dr G M Chowdhury Dr Chowdhury GM HU9 3JR 13 

B81074 Dr A K Rej Dr Rej AK HU9 2LR 17 

B81080 Dr G S Malczewski Dr Malczewski GS HU8 9RW 18 

B81081 Dr K M Tang & Partner Dr Tang KM & Partner HU9 2LJ 14 

B81085 Dr J W Richardson & Partners Dr Richardson JW & Partners HU8 8JS 19 

B81089 Dr Witvliet Dr Witvliet L HU9 5AD 20 

B81097 Dr R D Yagnik Dr Yagnik RD HU9 3JR 13 

B81635 Dr G Dave Dr Dave G HU114AR 21 

B81644 Dr K K Mahendra Dr Mahendra KK HU8 9LF 22 

B81645 East Park Practice Dr(s) at East Park Practice HU9 3JR 13 

B81646 Dr M Shaikh Dr Shaikh M HU8 9RW 18 

B81674 Dr J C Joseph Dr Joseph JC HU8 9RW 18 

B81682 Dr M Shaikh & Partners Dr Shaikh M & Partner HU8 9RW 18 

B81011 Wheeler Street Healthcare Dr Yu DYF & Partners HU3 5QE 23 

B81017 Kingston Medical Group Dr(s) at Kingston Medical Group HU3 1TY 24 

B81027 St Andrews Group Practice Dr Raghunath AS & Partners HU3 3BH 25 

B81032 Dr A W Hussain & Partners Dr Hussain AW & Partners HU3 2SE 26 

B81035 Dr W G T Sande & Partners Dr Sande WGT & Partners HU5 3TJ 27 

B81038 Dr A A Mather & Partners Dr Mather AA & Partners HU4 6RT 28 

B81046 Dr J D Blow & Partners Dr Blow JD & Partners HU3 3BH 25 

B81047 Dr J N Singh & Partners Dr Singh JN & Partners HU3 1DS 29 

B81048 Dr S M Hussain & Partners Dr Hussain SM & Partners HU5 2NT 30 

B81052 Dr J Musil & P J Queenan Dr Musil J & Partner HU5 3QA 31 

B81054 Dr M J Varma & Partners Dr Varma MJP & Partners HU5 2ST 32 

B81056 The Springhead Medical Centre Dr Price JD & Partners HU5 5JT 33 

B81057 Dr S MacPhie & Koul Dr MacPhie S HU3 6BX 34 

B81058 Dr M Foulds & Partner Dr Foulds M & Partner HU3 2TA 35 

B81072 Dr R Percival & Partners Dr Percival R & Partners HU5 2NT 30 




B81075 Dr M K Mallik Dr Mallik MK HU5 5BE 36 

B81104 Dr J K Nayar Dr Nayar JK HU5 2EG 37 

B81675 Dr AH Tak & Dr EG Stryjakiewicz Dr Tak AH & Partner HU3 6BX 34 

B81683 Dr A S Raghunath & Partners Dr Raghunath AS & Partners HU3 6BX 34 

B81692 The Quays Medical Centre Dr(s) at Quays Medical Centre HU1 2PS 38 

Y00955 Riverside Medical Centre Dr(s) at Riverside Medical Centre HU3 2RA 39 

Y01200 The Calvert Practice Dr(s) at Calvert Practice HU4 6BH 40 

Y02786 Priory Surgery Dr(s) at Priory Surgery HU5 5RU 41 

Y02896 Story St Practice & Walk In Centr Dr(s) at Story Street Practice HU1 3TD 42 

Figure 10 illustrates the location of the practices in Hull based on their postcode. The 

distribution illustrated does not take into account the number of GPs within each practice 

or the size of the practices. The location reference numbers are given in Table 8. 

Figure 10: Location of General Practices in Hull, April 2010 



Table 9 shows, for each area where people live (the rows), what percentage are 

registered with practices allocated to a particular Locality (October 2010). Only 70% of 

the resident population of the North Locality are registered with a North Locality practice, 

with over a quarter (25%) registered with a West Locality practice. Eight in ten of East 

residents are registered with a practice in East Locality with 16% registered with a 

practice in North Locality. Ninety-one percent of those residing in the West Locality are 

registered with a West Locality Practice, with 4.9% of West Locality residents registered 

with East Riding of Yorkshire (ERoY) practices. 

Table 9: Registered practices of people within Localities for October 2010 

Percentage of resident 

population registered with 

GPs in different localities 

Locality of 

residence of 

patient 


Hull Locality ERoY Other/ Total 


missing 

North 69.8 4.1 25.4 0.6 0.3 100 

East 15.6 80.5 3.5 0.2 0.2 100 

West 4.9 0.6 91.0 3.2 0.4 100 

Total 24.2 30.1 43.9 1.5 0.3 100 

The same underlying data from Table 9 is analysed by columns, rather than rows, in 

Table 10. This shows for people registered with Practices allocated to the North 

Locality, only 64% actually live in the North Locality area, with nearly a quarter (22%) of 

North Locality‟s Practices‟ patients living in East Locality. Higher proportions of people 

registered with GPs allocated to the East and West Localities live within the areas, but 

15% of patients registered with West Locality practices live in East Riding of Yorkshire. 

Table 10: Residence of people within practice-based Localities for October 2010 

Percentage of registered population Location of General Practice 

living in different localities 

North East West Total 

Residence 

of patient 

Hull 

Locality 

ERoY 

North 

East 

West 

63.9 

21.5 

7.5 

7.1 

3.1 

92.1 

0.7 

4.0 

11.7 

2.4 

71.1 

14.7 

21.5 

32.4 

36.4 

9.7 

Total 100 100 100 100 

All these percentages are for the Localities as a whole, but some individual practices will 

have much greater flows across geographical boundaries as illustrated by Figure 11, 

Figure 12 and Figure 13 for North, East and West Localities respectively. The 

percentage of the registered population which lives in each Locality and in East Riding 

of Yorkshire is given for each GP practice in Hull 7 . The underlying data for these figures 

is given in the APPENDIX on page 818. 

7 The East Riding of Yorkshire patients who live in Hull and the Hull patients who live outside the 

Hull/ERoY area have been excluded. 



Figure 11: Residence of patients who are registered with a practice in the North Locality 

(October 2010) 

Percentage of patients living in each Hull Locality, 

ERoY or elsewhere 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

B81002: Dr A Kumar-Choudhary 

B81018: Dr R K Awan And Partners 

B81020: Dr P C Mitchell And Partners 

B81021: Faith House Surgery 

B81049: Dr V A Rawcliffe And Partners 

B81094: Dr A K Datta 

B81095: Dr Cook 

B81112: Dr Ghosh Raghunath And Partners 

B81119: Dr G Palooran And Partners 

B81616: Dr G T Hendow 


B81631: Dr R Raut And Partner 

B81634: Dr J Venugopal 

B81662: Mizzen Road Surgery 

Practice in North Locality 

B81685: Dr N A Poulose 

B81688: Dr K V Gopal 

B81690: Dr S K Ray 

Y02344: Northpoint 

Y02747: Kingswood Surgery 

Y02748: Haxby Orchard Park Surgery 

Other/missing 

ERoY 

West 

East 

North


Figure 12: Residence of patients who are registered with a practice in the East Locality 




100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

B81001: Dr A E Ogunba And Partners 

B81008: Dr J S Parker & Partners 

B81040: Dr P F Newman And Partners 

B81053: Diadem Medical Practice 

B81066: Dr G M Chowdhury 

B81074: Dr AK Rej 

B81080: Dr G S Malczewski 

B81081: Dr K M Tang And Partner 

B81085: Dr J W Richardson And Partners 


B81089: Dr Witvliet 

B81097: Dr R D Yagnik 

B81635: Dr G Dave 

B81644: Dr K K Mahendra 

Practice in East Locality 

B81645: East Park Practice 

B81646: Dr M Shaikh 

B81674: Dr J C Joseph 

B81682: Dr M Shaikh & Partners 

Other/missing 

ERoY 

West 

North 

East


Figure 13: Residence of patients who are registered with a practice in the West Locality 




100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

B81011: Wheeler Street Healthcare 

B81017: Kingston Medical Group 

B81027: St Andrews Group Practice 

B81032: Dr A W Hussain And Partners 

B81035: The Avenues Medical Centre 

B81038: Dr A A Mather And Partners 

B81046: Dr J D Blow And Partners 

B81047: Dr J N Singh And Partners 

B81048: Dr S M Hussain And Partners 

B81052: Dr J Musil And P J Queenan 

B81054: Dr M J Varma And Partners 

B81056: The Springhead Medical Centre 

Practice in West Locality 

B81057: Dr S Macphie 


B81058: Dr M Foulds & Partner 

B81072: Dr R Percival And Partners 

B81075: Dr M K Mallik 

B81104: Dr J K Nayar 

B81675: Dr A H Tak & Dr E G Stryjakiewicz 

B81683: Dr A S Raghunath And Partners 

B81692: The Quays Medical Centre 

Y00955: Riverside Medical Centre 

Y01200: The Calvert Practice 

Y02786: Priory Surgery 

Y02896: Story Street Practice And Walk … 

Other/missing 

ERoY 

East 

North 

West


5.1.2 Age and Gender Structure of Resident Population 

As shown above, the registered (patient) population differs from the estimated resident 

population. The number of patients registered with Hull GPs is higher than the number 

of people who live within Hull. Estimates of the resident population are available from 

the Census. The most recent Census conducted in April 2001 estimated the population 

of Hull to be 243,589. However, the Census population of Hull was later revised up by 

6,600 to 250,189. The Office for National Statistics (ONS) estimates resident population 

for each local authority from the Census figures by adjusting for births, deaths and 

ageing, and estimating migration (using information from GP registrations to assess 

national/local migration and limited travel survey information to assess international 

migration). Table 11 gives the population estimates for mid-year 2009 for Hull from the 

ONS (which measures to the nearest 100 residents). The population estimate for midyear 

2008 was 258,700. 

Table 11: Mid-year resident population estimate for Hull for 2009 (from the Office for 

National Statistics) 

Age (years) Estimated resident population of Hull, mid-year 2009 (ONS data) 

Male Female Total 

0 1,900 1,700 3,500 

1 to 4 6,600 6,200 12,800 

5 to 9 6,900 6,200 13,000 

10 to 14 7,600 7,000 14,600 

15 to 19 9,200 9,000 18,100 

20 to 24 13,800 13,400 27,200 

25 to 29 12,500 11,400 23,900 

30 to 34 9,400 8,000 17,300 

35 to 39 8,900 8,300 17,200 

40 to 44 9,500 8,800 18,200 

45 to 49 9,300 8,700 17,900 

50 to 54 7,800 7,400 15,200 

55 to 59 7,000 6,800 13,800 

60 to 64 6,700 6,600 13,300 

65 to 69 4,600 4,900 9,400 

70 to 74 4,400 4,700 9,100 

75 to 79 3,400 4,200 7,700 

80 to 84 2,100 3,400 5,500 

85 to 89 1,000 2,000 3,100 

90+ 400 1,000 1,400 

TOTAL 132,800 129,600 262,400 

Based on ONS‟s mid-year population estimates, the population of Hull increased by 

3,700 (1.4%) people between mid-year 2008 and mid-year 2009. Between mid-year 

2008 and mid-year 2009, ONS estimated that the number of births decreased by 100, 



but there was an increase of 500 for children aged 1-4 years, no change for those aged 

5-9, and a decrease of 700 for those aged 10-14 years. There were increases in the 

ONS estimated resident population in Hull for those aged 15-19, 20-24, 25-29 and 30-34 

years (of 200, 2,600, 600 and 500 respectively). The estimated resident population 

decreased for those aged 35-39 and 40-44 years (by 500 and 400 respectively), with 

increases for those aged 45-49 and 50-54 years (of 400 and 200 respectively). There 

was an estimated decrease of 100 for those aged 55-59 years, and an increase of 600 

for those aged 60-64 years. There was an estimated decrease of 200 people in the 65- 

59 year age group, and no change in the age groups 70-74, 75-79 and 80-84 years, with 

an increase of 100 in the 85+ year age group. Therefore, the largest change occurred 

within the 20-24 year age group, which represented 70% of the overall estimated 

increase in Hull. 

Table 12, Table 13 and Table 14 give the age and gender structure of the resident 

population estimated from all General Practitioner registrations within North, East and 

West Localities respectively for October 2010. NHS Hull is responsible for the health of 

Hull‟s residents, so when population estimates are required, these tables should be 

used rather than registered population which is given on subsequent pages (starting on 

page 91) unless an analysis is being undertaken specifically at practice level. 

Table 12: Number of residents living in North Locality, October 2010 (estimated from 

General Practitioner registrations) 

Age (years) Resident population – living in North Locality, 2010 


0 433 405 838 

1 to 4 1,921 1,783 3,704 

5 to 9 2,083 1,905 3,988 

10 to 14 2,031 1,854 3,885 

15 to 19 2,505 2,420 4,925 

20 to 24 3,085 3,235 6,320 

25 to 29 2,422 2,461 4,883 

30 to 34 2,095 2,076 4,171 

35 to 39 2,235 2,079 4,314 

40 to 44 2,326 2,121 4,447 

45 to 49 2,262 2,095 4,357 

50 to 54 1,802 1,735 3,537 

55 to 59 1,576 1,576 3,152 

60 to 64 1,574 1,629 3,203 

65 to 69 1,045 1,141 2,186 

70 to 74 980 1,092 2,072 

75 to 79 725 879 1,604 

80 to 84 393 607 1000 

85+ 238 457 695 

TOTAL 31,731 31,550 63,281 



Table 13: Number of residents living in East Locality, October 2010 (estimated from 


Age (years) Resident population – living in East Locality, 2010 


0 631 568 1,199 

1 to 4 2,489 2,358 4,847 

5 to 9 2,756 2,541 5,297 

10 to 14 2,831 2,808 5,639 

15 to 19 3,349 3,150 6,499 

20 to 24 3,413 3,419 6,832 

25 to 29 3,355 3,371 6,726 

30 to 34 3,056 2,799 5,855 

35 to 39 3,338 3,208 6,546 

40 to 44 3,595 3,194 6,789 

45 to 49 3,637 3,475 7,112 

50 to 54 3,232 3,081 6,313 

55 to 59 2,833 2,736 5,569 

60 to 64 2,844 2,745 5,589 

65 to 69 1,815 1,860 3,675 

70 to 74 1,569 1,786 3,355 

75 to 79 1,284 1,714 2,998 

80 to 84 934 1,439 2,373 

85+ 630 1,343 1,973 

TOTAL 47,591 47,595 95,186 



Table 14: Number of residents living in West Locality, October 2010 (estimated from 


Age (years) Resident population – living in West Locality, 2010 


0 638 657 1,295 

1 to 4 2,614 2,559 5,173 

5 to 9 2,667 2,538 5,205 

10 to 14 2,784 2,494 5,278 

15 to 19 3,327 3,148 6,475 

20 to 24 4,787 5,140 9,927 

25 to 29 5,132 4,413 9,545 

30 to 34 4,626 3,594 8,220 

35 to 39 4,555 3,409 7,964 

40 to 44 4,350 3,535 7,885 

45 to 49 4,155 3,528 7,683 

50 to 54 3,509 3,161 6,670 

55 to 59 3,070 2,591 5,661 

60 to 64 2,815 2,577 5,392 

65 to 69 1,863 1,886 3,749 

70 to 74 1,675 1,808 3,483 

75 to 79 1,329 1,601 2,930 

80 to 84 836 1,388 2,224 

85+ 643 1,388 2,031 

TOTAL 55,375 51,415 106,790 

Between October 2009 and October 2010, the increases in the estimated resident 

population was approximately 600 for North Locality, approximately 500 for East Locality 

and approximately 700 for West Locality. 



Figure 14 illustrates the difference in the resident population structures among the 

Localities. North Locality tends to have a slightly higher percentage of people aged 0-19 

years with West Locality having the lowest percentage. However, West Locality has the 

highest percentage of people aged in the 20s and 30s, and the location of the University 

is an influential factor in this. There are relatively small differences in the percentage of 

people aged in their 40s among the three Localities, but East has a higher percentage 

aged 50+ years among the Localities for each age decade. Comparing North with West 

Locality, there are similar percentages of people in their 60s and 70s, with East Locality 

having slightly higher percentages. East Locality has the highest percentage of those 

aged 80+ years which is slightly higher than West Locality, but the percentage aged 80+ 

years in North Locality is considerably lower. The underlying data for this figure is given 

in the APPENDIX on page 819. 

Figure 14: Comparison of resident population structure among Localities for October 

2010 (estimated from General Practitioner registrations) 

Resident population October 2010 (%) 

20 

18 

16 

14 

12 

10 

8 

6 

4 

2 

0 

0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ 

Age (years) 

North East West Hull 



Table 15 gives the number of residents living within Hull for October 2010 estimated 

from all General Practitioner registrations. 

Table 15: Number of residents living in Hull, October 2010 (estimated from General 

Practitioner registrations) 

Age (years) Resident population – living in Hull, 2010 


0 1,702 1,630 3,332 

1 to 4 7,024 6,700 13,724 

5 to 9 7,506 6,984 14,490 

10 to 14 7,646 7,156 14,802 

15 to 19 9,181 8,718 17,899 

20 to 24 11,285 11,794 23,079 

25 to 29 10,909 10,245 21,154 

30 to 34 9,777 8,469 18,246 

35 to 39 10,128 8,696 18,824 

40 to 44 10,271 8,850 19,121 

45 to 49 10,054 9,098 19,152 

50 to 54 8,543 7,977 16,520 

55 to 59 7,479 6,903 14,382 

60 to 64 7,233 6,951 14,184 

65 to 69 4,723 4,887 9,610 

70 to 74 4,224 4,686 8,910 

75 to 79 3,338 4,194 7,532 

80 to 84 2,163 3,434 5,597 

85+ 1,511 3,188 4,699 

TOTAL 134,697 130,560 265,257 

This represents an increase of approximately 1,800 residents between October 2009 

and October 2010. 

Comparison of the mid-year 2009 resident population estimates from the Office for 

National Statistics (ONS) given in Table 11 and the resident population estimates for 

October 2010 given in Table 15 reveal a discrepancy of just under 3,000. The 

estimated resident population in the local population file is estimated to be higher than 

that for ONS. It is not known which figure is more accurate. It is likely that some 

patients are included in the GP registration file after they have died or moved away and 

that their information has not been updated, particularly so for those who have moved 

abroad as there is no specific system or requirement to inform your GP if you are due to 

emigrate. The GP registration file should be automatically updated once a patient 

registers with another GP provided that new GP is within England. 



Figure 15 gives the population pyramid for Hull (represented by the bars) compared to 

the estimate for England for 2009 (represented by the line). Hull‟s population is 

relatively young compared to England with a lower percentage of people aged over 50 

years. The number of people in their early 20s is higher than England due to Hull being 

a University city. There are also fewer people aged 50+ in Hull compared to England. 

The underlying data are given in Table 15 for Hull and in the APPENDIX on page 820 

for England. 

Figure 15: Population pyramid for Hull (compared to England), October 2010 

Hull 

MalesFemales 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

15,000 10,000 5,000 0 5,000 10,000 15,000 

Population from GP registration file, October 2010 

Line: 2009 England data from ONS Population Estimation Unit. Crown Copyright. 



5.1.3 Total Resident Population at Ward, Area and Locality Level 

The estimated resident population for October 2010 is given in Table 16 for each ward, 

Area and Locality in Hull (based on General Practitioner registrations). 

Table 16: Estimated resident population for October 2010 

Ward Estimated resident population as at October 2010 

Ward Area Locality Total 

Bransholme East 11,020 

Bransholme West 8,753 

Kings Park 9,435 

Beverley 8,317 

Orchard Park & Greenwood 15,008 

University 10,748 

Ings 12,540 

Longhill 12,445 

Sutton 13,167 

Holderness 13,693 

Marfleet 13,734 

Southcoates East 8,747 

Southcoates West 8,101 

Drypool 

12,759 

North Carr 

29,208 North 

Northern 

34,073 

East 

38,153 

Park 

44,275 

Riverside (East) 

12,759 

Myton 

Newington 

St Andrews 

15,645 

12,623 

8,828 


37,096 

Boothferry 

Derringham 

Pickering 

12,579 

11,520 

12,159 

West 

36,258 

Avenue 

Bricknell 

Newland 

13,537 

8,548 

11,351 

Wyke 

33,436 

5.1.4 Resident Population Pyramids 

63,281 

East 

95,186 

West 

106,790 


Hull 

265,257 

Population pyramids have also been produced for each of the wards, Areas and 

Localities (represented by the bars) within Hull compared to Hull‟s overall population 

(represented by the line; residents based on the GP registration file for October 2010). 

Figure 16, Figure 17 and Figure 18 give the population pyramids for North, East and 

West Localities respectively. The underlying data for these figures is given in Table 12, 

Table 13 and Table 14, with the comparison Hull figures given in Table 15.


Figure 16: Population pyramid for North Locality (compared to Hull), October 2010 

North Locality 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

5,500 4,500 3,500 2,500 1,500 500 500 1,500 2,500 3,500 4,500 5,500 


Figure 17: Population pyramid for East Locality (compared to Hull), October 2010 

East Locality 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

5,500 4,500 3,500 2,500 1,500 500 500 1,500 2,500 3,500 4,500 5,500 


Figure 18: Population pyramid for West Locality (compared to Hull), October 2010 

West Locality 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

5,500 4,500 3,500 2,500 1,500 500 500 1,500 2,500 3,500 4,500 5,500 




Figure 19, Figure 20 and Figure 21 give the population pyramids for each Area (first 

row) and each ward (subsequent rows with wards in alphabetical order) for North, East 

and West Localities respectively. The underlying data are given in the APPENDIX on 

page 821 with the comparison data for Hull in Table 15. Note that the Area population 

pyramids and all the ward population pyramids are created on the same scale, but that 

the Area pyramids and ward pyramids are on a different scale. The Area pyramids have 

a maximum of 3,000 along the axis (total maximum 6,000 persons for men and women 

combined), where as the ward pyramids maximum is 1,400 (total 2,800). This is most 

evident for the Riverside (East) Area and Drypool pyramids which show the same 

information. The line represents Hull‟s resident population structure. 

Figure 19: Population pyramids for each Area and Ward within North Locality (compared 

to Hull), October 2010 

North Carr Area 

NORTH CARR NORTHERN 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

3,000 2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 3,000 



Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 



Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Kings Park 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Northern Area 

Males Females 

80 and over 


75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

3,000 2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 3,000 


Beverley 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Orchard Park & Greenwood 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


University 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 

Population from GP registration file, October 2010


Figure 20: Population pyramids for each Area and Ward within East Locality (compared 


East Area 

EAST PARK RIVERSIDE (E) 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

3,000 2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 3,000 


Ings 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Longhill 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Sutton 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Park Area 

Males Females 

80 and over 

75 to 79 

70 to 74 

30 to 34 

25 to 29 


65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

3,000 2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 3,000 


Holderness 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Marfleet 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 



Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 



Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Riverside East Area 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 


Drypool 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 



Figure 21: Population pyramids for each Area and Ward within West Locality (compared 


RIVERSIDE (W) WEST WYKE 

Riverside West Area 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 


Myton 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Newington 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


St Andrew's 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


West Area 

Males Females 

80 and over 

75 to 79 

70 to 74 

30 to 34 

25 to 29 

Population pyramids have been produced within the 76 page Public Health Profiles for 

Hull for each ward, local authority Area and NHS Hull‟s three Localities (available at 

www.hullpublichealth.org) for the population as at October 2008. The populations will 

be similar to those give above, but the figures are larger so that the details are clearer. 


65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

3,000 2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 3,000 


Boothferry 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Derringham 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Pickering 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Wyke Area 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

3,000 2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 3,000 


Avenue 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Bricknell 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 


Newland 

Males Females 

80 and over 

75 to 79 

70 to 74 

65 to 69 

60 to 64 

55 to 59 

50 to 54 

45 to 49 

40 to 44 

35 to 39 

30 to 34 

25 to 29 

20 to 24 

15 to 19 

10 to 14 

5 to 9 

Under 5 

1,400 1,050 700 350 0 350 700 1,050 1,400 



5.1.5 Change in Resident Population from 2007 to 2008 

Using the local GP registration files, the changes in resident population between 

October 2007 and October 2008 were compared in order to get an idea of the level of 

migration in Hull 8 . The information is presented here just to give an impression of the 

level of migration rather than provide definitive figures. Table 17 summarises the 

change in the resident population over this time period. The overall estimated resident 

population changed little over the year, increasing by 1,342 people (0.5%) mainly due to 

the difference between births and deaths (as inbound and outbound migration estimates 

were very similar). Contrary to the migration estimates below, Yorkshire Forward 

estimate that approximately 2,500 people moved away from Hull, and it is likely that 

those with more qualifications and better employment prospects move to live nearer 

better jobs and better schools. 

Table 17: Changes in estimated resident population in Hull between 2007 and 2008 

Status 

N 

HULL 

% of 2007 population 

No change to address 228,198 87.4 

Address changed (within ward) 6,306 2.4 

Ward changed (within area) 3,624 1.4 

Area changed (within locality) 4,771 1.8 

Locality changed (within Hull) 6,080 2.3 

Left Hull (to ERoY) 3,125 1.2 

Left Hull (to beyond ERoY) 7,077 2.7 

Left Hull (death) 2,059 0.8 

New to Hull (from ERoY) 2,627 1.0 

New to Hull (from beyond ERoY) 7,624 2.9 

New to Hull (birth) 3,352 1.3 

Still living within Hull 248,979 95.3 

Left Hull including deaths 12,261 4.7 

New to Hull including births 13,603 5.2 

Increase in Hull‟s population 1,342 0.5 

Still living within Hull 248,979 95.3 

Left Hull (migration) 10,202 3.9 

New to Hull (migration) 10,251 3.9 

Increase in Hull‟s pop due to migration 49 0.0 

Total population - October 2007 261,240 

Total population - October 2008 262,582 

8 By using the GP registration files for 2007 and 2008, it was possible to examine births and deaths which 

occurred/were registered during 2007 and 2008 (at the time of undertaking the analysis April 2010, the 

latest available birth and mortality files were for 2008). 



The changes have also been examined in relation to the eight Areas (Table 18) and the 

three Localities (Table 19). Certain Areas have larger population changes and this will 

influence the level of migration. In addition, the presence and location of the 

Universities has a strong influence on migration. The numbers represent the estimated 

number of residents in each category (or the percentage change in population where 

indicated). Note that Drypool ward within Riverside Area is in East Locality rather than 

West Locality (as are the three other wards within Riverside Area). This information has 

also been produced at ward level (and can be supplied on request by the Public Health 

Science team) . 

Table 18: Changes in estimated resident population for each Area in Hull between 

October 2007 and October 2008 

Status Area Committee Area (initial area as at October 2007 or area moved into 

as at October 2008) 

N Carr Northern East Park Riverside West Wyke 

No changes to address 24,833 29,863 34,774 39,353 40,378 32,460 26,537 

Address changed (within ward) 594 785 597 1,065 1,790 598 877 

Left ward but within area 416 411 325 729 822 360 561 

Left area but within locality 131 199 618 854 1,610 593 766 

Left locality but within Hull 946 1,083 627 768 1,388 420 848 

Left Hull (to ERoY) 212 419 354 360 562 768 450 

Left Hull (to beyond ERoY) 380 1,241 438 539 1,899 483 2,097 

Left ward (death) 155 193 388 371 413 303 236 

New to area (from within locality) 199 131 643 909 1,452 742 695 

New to locality (from within Hull) 1,158 1,155 774 832 1,087 332 742 

New to ward (from ERoY) 219 337 250 243 432 488 658 

New to ward (from beyond ERoY) 435 982 341 607 2,614 458 2,187 

New to ward (birth) 452 447 412 604 685 394 358 

Still living within area 25,843 31,059 35,696 41,147 42,990 33,418 27,975 

Left area including deaths 1,824 3,135 2,425 2,892 5,872 2,567 4,397 

New to area including births 2,463 3,052 2,420 3,195 6,270 2,414 4,640 

Increase in area population 639 -83 -5 303 398 -153 243 

Still living within area 25,843 31,059 35,696 41,147 42,990 33,418 27,975 

Left area (migration) 1,669 2,942 2,037 2,521 5,459 2,264 4,161 

New to area (migration) 2,011 2,605 2,008 2,591 5,585 2,020 4,282 

Inc in area pop due to migration 342 -337 -29 70 126 -244 121 

Total population - October 2007 27,667 34,194 38,121 44,039 48,862 35,985 32,372 


Left area (% of total in 2007) 6.6 9.2 6.4 6.6 12.0 7.1 13.6 

New to area (% of total in 2008) 8.7 8.9 6.3 7.2 12.7 6.7 14.2 

Inc in area pop (% 2007 to 2008) 2.3 -0.2 -0.0 0.7 0.8 -0.4 0.8 



Table 19: Changes in estimated resident population for each Locality in Hull between 

October 2007 and October 2008 

Status Locality (initial locality as at October 2007 

or locality moved into as at October 2008) 


No changes to address 54,696 74,127 99,375 

Address changed (within ward) 1,379 1,662 3,265 

Left ward but within area 827 1,054 1,743 

Left area but within locality 330 1,472 2,969 

Left locality but within Hull 2,029 1,395 2,656 

Left Hull (to ERoY) 631 714 1,780 

Left Hull (to beyond ERoY) 1,621 977 4,479 

Left ward (death) 348 759 952 

New to locality (from within Hull) 2,313 1,606 2,161 

New to ward (from ERoY) 556 493 1,578 

New to ward (from beyond ERoY) 1,417 948 5,259 

New to ward (birth) 899 1,016 1,437 

Still living locality 57,232 78,315 107,352 

Left locality including deaths 4,629 3,845 9,867 

New to locality including births 5,185 4,063 10,435 

Increase in locality population 556 218 568 

Still living within locality 57,232 78,315 107,352 

Left locality (migration) 4,281 3,086 8,915 

New to locality (migration) 4,286 3,047 8,998 

Inc in locality pop due to migration 5 -39 83 

Total population - October 2007 61,861 82,160 117,219 

Total population - October 2008 62,417 82,458 117,707 

Left locality (% of total in 2007) 7.5 4.7 8.4 

New to locality (% of total in 2008) 8.3 4.9 8.9 

Inc in locality pop (% 2007 to 2008) 0.9 0.4 0.4 

As mentioned earlier, the Universities mean that many young people come to Hull to 

study and often leave when they finish their University course. However, this will also 

apply to other educational establishments, which will draw in students from the 

immediately surrounding area such as those from East Riding of Yorkshire. Table 20 

illustrates the change in population by age for Hull as a whole. From more detailed 

previous analyses examining changes between 2004 and 2005, many of the University 

students appeared to live in East Riding of Yorkshire initially (halls of residence) and 

then moved into Hull in their second year. 



Table 20: Changes in estimated resident population for selected age groups in Hull 

between October 2007 and October 2008 

Status 

Age on 1st October 2007 (or on 1st October 2008 if new to Hull) 

0-16 17-24 25-34 35-44 45-64 65+ Total 

No changes to address 43,571 26,486 30,703 34,771 57,840 34,827 228,198 

Address changed but within Hull 1,590 1,280 1,415 869 834 318 6,306 

Left ward but still within Area 852 758 831 507 440 236 3,624 

Left Area but still within Locality 1,030 854 1,123 728 665 371 4,771 

Left Locality but still within Hull 1,368 1,365 1,364 857 814 312 6,080 

Left Hull (to ERoY) 678 405 646 566 572 258 3,125 

Left Hull (to beyond ERoY) 818 1,926 2,144 896 777 516 7,077 

Left Hull (death) 9 6 22 47 331 1,644 2,059 

New to Hull (from ERoY) 330 931 560 301 358 147 2,627 

New to Hull (from beyond ERoY) 1,473 2,030 2,279 968 736 138 7,624 

New to Hull (birth) 3,352 0 0 0 0 0 3,352 

Still living within Hull 48,411 30,743 35,436 37,732 60,593 36,064 248,979 

Left Hull including deaths 1,505 2,337 2,812 1,509 1,680 2,418 12,261 

New to Hull including births 5,155 2,961 2,839 1,269 1,094 285 13,603 

Increase in Hull‟s pop (overall) 3,650 624 27 -240 -586 -2,133 1,342 

Still living within Hull 3,308 5,298 5,651 2,778 2,774 2,703 22,512 

Left Hull (migration) 1,496 2,331 2,790 1,462 1,349 774 10,202 

New to Hull (migration) 1,803 2,961 2,839 1,269 1,094 285 10,251 

Inc in Hull‟s pop due to migration 307 630 49 -193 -255 -489 49 



Left Hull incl deaths (% of 2007) 3.0 7.1 7.4 3.8 2.7 6.3 4.7 

New to Hull incl births (% of 2008) 9.6 8.8 7.4 3.3 1.8 0.8 5.2 

It is useful to know a bit more about which people are more likely to move and move out 

of Hull. Table 21 gives the information by local deprivation quintile (for more information 

about the Index of Multiple Deprivation 2007 and local quintiles see section 6.9.1 on 

page 131). The table shows that people living in the most deprived areas of Hull are 

more likely to change address within the year but the majority remain in Hull, whereas 

slightly higher percentages in the less deprived areas move out of Hull. Together with 

changes in the births and deaths between the quintiles, the overall population in the 

more deprived areas is increasing whereas it is decreasing in less deprived areas. 



Table 21: Changes in estimated resident population by local deprivation quintile in Hull 

between October 2007 and October 2008 

Status Number of residents by Hull’s local IMD 2007 quintile as at October 

2007 (or October 2008 if new to Hull) 

Most 

2 3 4 Least 

deprived 

deprived 

No changes to address 45,162 45,956 46,063 44,136 46,881 

Address changed but ward 1,878 1,482 1,234 937 772 

Left ward but still within Area 1,005 830 793 629 367 

Left Area but still within Locality 962 1,206 1,212 873 518 

Left Locality but still within Hull 1,602 1,404 1,217 864 991 

Left Hull (to ERoY) 457 440 664 732 832 

Left Hull (to beyond ERoY) 1,303 1,270 1,451 1,513 1,540 

Left Hull (death) 335 369 625 692 606 

New to Hull (from ERoY) 1,862 1,592 1,612 1,335 1,223 

New to Hull (from beyond ERoY) 460 445 489 357 308 

New to Hull (birth) 869 714 680 536 553 

Still living within Hull 50,609 50,878 50,519 47,439 49,529 

Left Hull including deaths 2,095 2,079 2,740 2,937 2,978 

New to Hull including births 3,191 2,751 2,781 2,228 2,084 

Increase in Hull‟s pop (overall) 1,096 672 41 -709 -894 

Still living within Hull 4,417 4,116 4,841 4,629 4,509 

Left Hull (migration) 1,760 1,710 2,115 2,245 2,372 

New to Hull (migration) 2,322 2,037 2,101 1,692 1,531 

Inc in Hull‟s pop due to migration 562 327 -14 -553 -841 

Total population - October 2007 52,704 52,957 53,259 50,376 52,507 

Total population - October 2008 53,800 53,629 53,300 49,667 51,613 

Moved address – number (%*) 9,529 (17.4) 8,669 (15.9) 8,672 (15.8) 7,240 (14.1) 6,551 (12.3) 

Moved within Hull – number (%*) 5,447 (10.0) 4,922 (9.0) 4,456 (8.1) 3,303 (6.4) 2,648 (5.0) 

Moved out of Hull – number (%*) 1,760 (3.2) 1,710 (3.1) 2,115 (3.9) 2,245 (4.4) 2,372 (4.4) 

Moved into Hull – number (%*) 2,322 (4.2) 2,037 (3.7) 2,101 (3.8) 1,692 (3.3) 1,531 (2.9) 

Left Hull incl deaths (% of 2007) 4.0 3.9 5.1 5.8 5.7 

New incl births (% of 2008) 5.9 5.1 5.2 4.5 4.0 

* Out of those living in Hull as at October 2007 or October 2008 but excluding births and deaths. 



It is also possible to examine this in relation to ACORN and Health ACORN (see 

section 6.10 on page 138 for more information about ACORN) . 

The full report (at www.hullpublichealth.org) gives the numbers and percentages 

remaining in the same home, moving home but remaining in Hull, moving away from 

Hull, moving to Hull from ERoY and who died based on the original ACORN categories 

as at 1 st October 2007 for ACORN categories, groups and types respectively. ACORN 

classifications are available for Hull and East Riding of Yorkshire, so if the individual was 

a resident of ERoY in October 2007 and moved to Hull within the year then their 

ACORN classification is generally known and they were included in the full report. 

ACORN classifications were not available for people who moved to Hull from beyond 

ERoY between October 2007 and October 2008 as their postcode prior to moving to 

Hull is not recorded. However, there were still over 13,000 residents who are not 

assigned an ACORN classification. 

Those in the “Urban Prosperity” group are more likely to move away from Hull, and the 

“Wealthy Achievers” group are more likely to move into Hull. It may be a surprise that 

7% of this latter group move from East Riding of Yorkshire into Hull, but it is likely that 

this is in part due to the age profile of this group and the pre-selection within the original 

file 9 , and some of these people may be moving into cheaper accommodation or into 

nursing or retirement homes within Hull. 

Out of those who moved address within the year and who were living in Hull as at 1 st 

October 2007, over half moved to ERoY or beyond ERoY (rather than moved within 

Hull) for the following ACORN categories (where more than 35 people moved in total): 

“Wealthy Mature Professionals, Large Houses” (83% of the „movers‟ moved away from 

Hull); “Wealthy Working Families with Mortgages” (62%); “Older Families, Prosperous 

Suburbs” (54%); “Well-Off Professionals, Larger Houses & Converted Flats” (58%); 

“Suburban Privately Renting Professionals” (53%); “Student Terraces” (61%); and 

“Retired Home Owners” (56%). In contrast for the following categories had fewer than 

30% who moved to ERoY or beyond out of those living in Hull who did moved address 

within the year (provided number of people moving address was 35 or more): “Young 

Working Families” (27%); “Home Owning Families, Terraces” (30%); “Low Income, 

Routine Jobs, Terraces and Flats” (20%); “Low Income Families, Terraced Estates” 

(22%); “Families and Single Parents, Semis and Terraces” (19%); “Large Families and 

Single Parents, Many Children” (19%); “Single Elderly People, Council Flats” (29%); 

Single Parents and Pensioners, Council Terraces” (22%); and “Singles and Single 

Parents, High Rise Estates” (29%). 

With regard to Health ACORN, a slightly higher percentage of the “Healthy” group 

moved away from Hull, but this is perhaps not surprising and it is possible that the effect 

will be confounded with age, i.e. younger people tend to move out of Hull and the young 

9 There are few people in this category for Hull, so it is more likely that people within this category live in 

ERoY and with the pre-selection of the file (i.e. only those living in Hull as at 1 st October 2007 and/or as at 

1 st October 2008) it is more likely that these people will move to Hull within the year. 



tend to be healthier, therefore it is expected that the healthier groups will move of out 

Hull (and this effect is at least partially explained by the age). 

Out of those who moved address within the year and who were living in Hull as at 1 st 

October 2007, over half moved to ERoY or beyond ERoY (rather than moved within 

Hull) for the following Health ACORN categories (where more than 35 people moved in 

total): “Affluent professionals, high alcohol consumption, dining out” (65%); and 

“Students and young professionals, living well” (58%). In contrast for the following 

categories had fewer than 30% who moved to ERoY or beyond out of those living in Hull 

who did moved address within the year (provided number of people moving address 

was 35 or more): “Vulnerable disadvantaged, smokers with high levels of obesity” 

(28%); “Post industrial pensioners with long term illness” (26%); “Deprived 

neighbourhoods with poor diet, smokers” (22%); “Disadvantaged neighbourhoods with 

poor diet and severe health issues” (26%); “Poor single parent families with lifestyle 

related illnesses” (19%); “Multi-ethnic, high smoking, high fast food consumption” (25%); 

and “Urban estates with sedentary lifestyle and low fruit and vegetable consumption” 

(20%). 

Overall, the analysis of the changes in population between 2007 and 2008, show that a 

relatively high percentage of people who move into or out of Hull tend to be students, 

with a tendency for people in the more deprived areas to move, but they are more likely 

to be remain in Hull, whereas people in the less deprived areas are less likely to move 

overall but when they do move they are more likely to move out of Hull than people 

living in more deprived areas of Hull. The ACORN and Health ACORN analysis also 

indicates that some older people move into Hull from East Riding of Yorkshire, perhaps 

into nursing or retirement homes, but overall, Table 20 shows that the population in the 

65+ age group has decreased within the year by almost 500 people. 



5.1.6 Population Density 

Figure 22 gives the population density at lower layer super output area (LLSOA) level 

for 2007. These geographical areas have a minimum population size of 1,000 and a 

mean population size of 1,500. The underlying data is available on request. The 

population in Kings Park has increased over the last few years due to housing 

developments, so it is possible that the population density for 2011 is higher than for 

2007. Myton covers the city centre so there will be a relatively high proportion of 

business addresses rather than residential buildings. The A63 duel carriageway runs 

along the southern boundary of Hull and there are a number of business and industrial 

areas along this. There are also a number of industrial areas in Marfleet. The course of 

the river runs through the middle from South to North, so there are fewer residential 

areas here. 

Figure 22: Population density, 2007 



5.1.7 Age and Gender Structure of Registered (Patient) Population 

Table 22, Table 23 and Table 24 give the age and gender structure of the registered 

(patient) population for General Practices within North, East and West Localities 

respectively for October 2010. 

Table 22: Number of patients registered with GPs in North Locality, October 2010 

Age (years) Patients registered with GPs in North Locality, 2010 


0 477 427 904 

1 to 4 2,007 1,873 3,880 

5 to 9 2,154 2,017 4,171 

10 to 14 2,185 2,055 4,240 

15 to 19 2,651 2,448 5,099 

20 to 24 2,723 2,699 5,422 

25 to 29 2,431 2,466 4,897 

30 to 34 2,267 2,201 4,468 

35 to 39 2,456 2,356 4,812 

40 to 44 2,642 2,366 5,008 

45 to 49 2,463 2,348 4,811 

50 to 54 2,050 2,068 4,118 

55 to 59 1,887 1,987 3,874 

60 to 64 1,997 2,095 4,092 

65 to 69 1,327 1,389 2,716 

70 to 74 1,181 1,280 2,461 

75 to 79 889 1,049 1,938 

80 to 84 496 733 1,229 

85+ 293 603 896 

TOTAL 34,576 34,460 69,036 



Table 23: Number of patients registered with GPs in East Locality, October 2010 

Age (years) Patients registered with GPs in East Locality, 2010 


0 535 486 1021 

1 to 4 2,119 2,047 4,166 

5 to 9 2,434 2,217 4,651 

10 to 14 2,451 2,431 4,882 

15 to 19 2,905 2,761 5,666 

20 to 24 2,991 2,967 5,958 

25 to 29 2,904 2,887 5,791 

30 to 34 2,559 2,420 4,979 

35 to 39 2,795 2,709 5,504 

40 to 44 3,039 2,752 5,791 

45 to 49 3,199 3,078 6,277 

50 to 54 2,892 2,744 5,636 

55 to 59 2,558 2,380 4,938 

60 to 64 2,446 2,383 4,829 

65 to 69 1,611 1,649 3,260 

70 to 74 1,394 1,625 3,019 

75 to 79 1,155 1,555 2,710 

80 to 84 859 1,368 2,227 

85+ 585 1,276 1,861 

TOTAL 41,431 41,735 83,166 



Table 24: Number of patients registered with GPs in West Locality, October 2010 

Age (years) Patients registered with GPs in West Locality, 2010 


0 762 796 1,558 

1 to 4 3,210 3,089 6,299 

5 to 9 3,434 3,236 6,670 

10 to 14 3,705 3,366 7,071 

15 to 19 4,583 4,296 8,879 

20 to 24 6,542 6,777 13,319 

25 to 29 6,065 5,327 11,392 

30 to 34 5,369 4,327 9,696 

35 to 39 5,494 4,288 9,782 

40 to 44 5,484 4,637 10,121 

45 to 49 5,377 4,677 10,054 

50 to 54 4,484 4,041 8,525 

55 to 59 3,863 3,386 7,249 

60 to 64 3,738 3,405 7,143 

65 to 69 2,447 2,595 5,042 

70 to 74 2,332 2,463 4,795 

75 to 79 1,819 2,142 3,961 

80 to 84 1,079 1,654 2,733 

85+ 782 1,662 2,444 

TOTAL 70,569 66,164 136,733 

Between October 2009 and October 2010, the population registered with Hull GPs 

remained the same for North Locality, increased by less than 100 for East Locality and 

increased by over 1,000 for West Locality. 



Figure 23 illustrates the differences in the registered (patient) population age-structure 

of Localities for October 2010. GPs in East and particularly North Localities have a 

higher percentage of children and adolescents compared to West Locality. Practices in 

West Locality have a much higher percentage of patients in their 20s which is influenced 

by the location of the University. Practices in East Locality have a higher percentage of 

patients who are 50 years or older. 

The underlying data for this figure is given in the APPENDIX on page 829. 

Figure 23: Comparison of registered population (patient) age-structure among Localities, 

October 2010 

Registered population October 2010 (%) 

20 

18 

16 

14 

12 

10 

8 

6 

4 

2 

0 

0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ 

Age (years) 




Table 25 gives the number of patients registered with all GPs across Hull for October 

2010. 

Table 25: Number of patients registered with GPs in Hull, October 2010 

Age (years) Patients registered with GPs in Hull, 2010 


0 1,775 1,709 3,484 

1 to 4 7,346 7,016 14,362 

5 to 9 8,045 7,486 15,531 

10 to 14 8,353 7,860 16,213 

15 to 19 10,165 9,521 19,686 

20 to 24 12,339 12,484 24,823 

25 to 29 11,459 10,709 22,168 

30 to 34 10,251 8,962 19,213 

35 to 39 10,805 9,375 20,180 

40 to 44 11,218 9,780 20,998 

45 to 49 11,085 10,119 21,204 

50 to 54 9,453 8,862 18,315 

55 to 59 8,335 7,757 16,092 

60 to 64 8,196 7,891 16,087 

65 to 69 5,393 5,637 11,030 

70 to 74 4,913 5,370 10,283 

75 to 79 3,868 4,749 8,617 

80 to 84 2,438 3,758 6,196 

85+ 1,671 3,545 5,216 

TOTAL 147,108 142,590 289,698 



5.1.8 Total Registered (Patient) Population at Area and Locality Level 

The estimated registered (patient) population for October 2010 is given in Table 26 for 

each Area and Locality in Hull. 

Table 26: Estimated registered (patient) population for October 2010 

Ward Estimated registered (patient) population as at 

October 2010 

Area Locality Total 



Kings Park 

Beverley 


University 

Ings 

Longhill 

Sutton 

Holderness 

Marfleet 



Drypool 

Myton 

Newington 

St Andrews 

Boothferry 

Derringham 

Pickering 

Avenue 

Bricknell 

Newland 

North Carr 

39,508 North 

Northern 

29,528 

East 

25,866 

Park 

35,274 

Riverside (East) 

22,026 


64,777 

West 

26,328 

Wyke 

45,628 

69,036 

East 

83,166 

West 

136,733 


Hull 

289,698


5.1.9 Total Registered (Patient) Population at Practice Level 

Table 27 gives the patient list sizes for each of the general practices in Hull as at April 

2010. 

Table 27: Total patient population for each general practice in Hull, April 2010 

Code Practice name Partnership name List size 

B81002 Dr A Kumar-Choudhary Dr Kumar-Choudhary A 3,833 

B81018 Dr R K Awan & Partners Dr Awan RK & Partners 6,549 

B81020 Dr P C Mitchell & Partners Dr Mitchell PC & Partners 7,369 

B81021 Faith House Surgery Dr Crick DLA & Partners 7,275 

B81049 Dr V A Rawcliffe & Partners Dr Rawcliffe VA & Partners 9,345 

B81094 Dr A K Datta Dr Datta AK 1,876 

B81095 Dr Cook Dr Cook BF 4,203 

B81112 Dr Ghosh Raghunath & Partners Dr Ghosh PC & Partners 3,491 

B81119 Dr G Palooran & Partners Dr Palooran G & Partner 4,566 

B81616 Dr G T Hendow Dr Hendow GT 2,570 

B81631 Dr R Raut Dr Raut R 3,397 

B81634 Dr J Venugopal Dr Venugopal J 3,031 

B81662 Mizzen Road Surgery Dr(s) at Mizzen Road Surgery 1,794 

B81685 Dr N A Poulose Dr Poulose NA 2,400 

B81688 Dr K V Gopal Dr Gopal KV 2,022 

B81690 Dr S K Ray Dr Ray SK 1,710 

Y02344 Northpoint Dr(s) at Northpoint 1,779 

Y02747 Kingswood Surgery Dr(s) at Kingswood Surgery 1,231 

Y02748 Haxby Orchard Park Surgery Dr(s) at Haxby Orchard Pk Surg 271 

B81001 Dr Ali & Partners Dr Ali RA & Partners 3,352 

B81008 Dr J S Parker & Partners Dr Parker JS & Partners 15,031 

B81040 Dr P F Newman & Partners Dr Newman PF & Partners 16,760 

B81053 Diadem Medical Practice Dr Maung M & Partners 10,388 

B81066 Dr G M Chowdhury Dr Chowdhury GM 2,483 

B81074 Dr A K Rej Dr Rej AK 3,626 

B81080 Dr G S Malczewski Dr Malczewski GS 2,201 

B81081 Dr K M Tang & Partner Dr Tang KM & Partner 3,515 

B81085 Dr J W Richardson & Partners Dr Richardson JW & Partners 5,294 

B81089 Dr Witvliet Dr Witvliet L 3,593 

B81097 Dr R D Yagnik Dr Yagnik RD 1,692 

B81635 Dr G Dave Dr Dave G 2,966 

B81644 Dr K K Mahendra Dr Mahendra KK 2,245 

B81645 East Park Practice Dr(s) at East Park Practice 2,133 

B81646 Dr M Shaikh Dr Shaikh M 1,886 

B81674 Dr J C Joseph Dr Joseph JC 2,238 

B81682 Dr M Shaikh & Partners Dr Shaikh M & Partner 3,743 

B81011 Wheeler Street Healthcare Dr Yu DYF & Partners 5,230 

B81017 Kingston Medical Group Dr(s) at Kingston Medical Group 6,724 

B81027 St Andrews Group Practice Dr Raghunath AS & Partners 5,974 

B81032 Dr A W Hussain & Partners Dr Hussain AW & Partners 2,416 



Code Practice name Partnership name List size 

B81035 Dr W G T Sande & Partners Dr Sande WGT & Partners 6,117 

B81038 Dr A A Mather & Partners Dr Mather AA & Partners 7,709 

B81046 Dr J D Blow & Partners Dr Blow JD & Partners 9,129 

B81047 Dr J N Singh & Partners Dr Singh JN & Partners 7,425 

B81048 Dr S M Hussain & Partners Dr Hussain SM & Partners 9,119 

B81052 Dr J Musil & P J Queenan Dr Musil J & Partner 5,743 

B81054 Dr M J Varma & Partners Dr Varma MJP & Partners 10,794 

B81056 The Springhead Medical Centre Dr Price JD & Partners 13,612 

B81057 Dr S MacPhie & Koul Dr MacPhie S 3,301 

B81058 Dr M Foulds & Partner Dr Foulds M & Partner 8,672 

B81072 Dr R Percival & Partners Dr Percival R & Partners 7,684 

B81075 Dr M K Mallik Dr Mallik MK 2,233 

B81104 Dr J K Nayar Dr Nayar JK 7,661 

B81675 Dr AH Tak & Dr EG Stryjakiewicz Dr Tak AH & Partner 9,417 

B81683 Dr A S Raghunath & Partners Dr Raghunath AS & Partners 1,672 

B81692 The Quays Medical Centre Dr(s) at Quays Medical Centre 1,738 

Y00955 Riverside Medical Centre Dr(s) at Riverside Medical Centre 2,492 

Y01200 The Calvert Practice Dr(s) at Calvert Practice 1,781 

Y02786 Priory Surgery Dr(s) at Priory Surgery 289 

Y02896 Story St Practice & Walk In Centr Dr(s) at Story Street Practice 319 

5.1.10 Mean Age of Patients at Practice Level 

Within section 10 starting on page 434, the diagnosed prevalence of different diseases 

is given from the Quality Outcomes and Framework (QOF). As the prevalence figures 

are unadjusted for influencing factors, such as the age of the patients and deprivation. 

Practices with a high proportion of elderly patients and practices in the most deprived 

areas will tend to have a higher prevalence of disease (and generally a higher 

prevalence of undiagnosed disease). See section 12.13 on page 782 for more 

information on QOF and issues associated with presenting the prevalence at practice 

level. For this reason, it is useful to examine the prevalence of disease considering the 

effects of age and deprivation for each practice. Practices have been grouped (see 

section 3.3.3.3 on page 47) into similar groups with respect to the age and deprivation 

scores of their patients, so practices can be compared more easily (say in relation to the 

prevalence of disease on QOF disease registers). Table 28 gives the mean age of the 

practice patients as at April 2010. The practice with the lowest mean age of the patients 

has been given the rank of 1 (the practice with high proportion of students) and the 

practice with the highest mean age of the patients has been given the rank of 60. This 

represents a very crude summary measure of the age of patients for each practice in 

Hull (the Index of Multiple Deprivation 2007 scores at practice level are given in Table 

49). 



Table 28: Mean age of patients for each General Practice, April 2010 

Rank 

(out of 

60) 

Code Practice name List size 

Apr 2010 

Mean age 

of patients 

Apr 2010 

10 B81002 Dr A Kumar-Choudhary 3,833 34.6 

17 B81018 Dr R K Awan & Partners 6,549 35.9 

44 B81020 Dr P C Mitchell & Partners 7,369 40.4 

43 B81021 Faith House Surgery 7,275 40.3 

29 B81049 Dr V A Rawcliffe & Partners 9,345 38.5 

41 B81094 Dr A K Datta 1,876 40.2 

54 B81095 Dr Cook 4,203 42.9 

7 B81112 Dr Ghosh Raghunath & Partners 3,491 34.2 

14 B81119 Dr G Palooran & Partners 4,566 35.3 

33 B81616 Dr G T Hendow 2,570 39.3 

4 B81631 Dr R Raut 3,397 31.8 

8 B81634 Dr J Venugopal 3,031 34.2 

58 B81662 Mizzen Road Surgery 1,794 44.6 

11 B81685 Dr N A Poulose 2,400 34.7 

9 B81688 Dr K V Gopal 2,022 34.3 

34 B81690 Dr S K Ray 1,710 39.4 

16 Y02344 Northpoint 1,779 35.9 

2 Y02747 Kingswood Surgery 1,231 30.3 

3 Y02748 Haxby Orchard Park Surgery 271 30.6 

30 B81001 Dr Ali & Partners 3,352 38.8 

28 B81008 Dr J S Parker & Partners 15,031 38.4 

26 B81040 Dr P F Newman & Partners 16,760 37.9 

46 B81053 Diadem Medical Practice 10,388 40.5 

36 B81066 Dr G M Chowdhury 2,483 39.7 

38 B81074 Dr A K Rej 3,626 40.0 

56 B81080 Dr G S Malczewski 2,201 43.3 

45 B81081 Dr K M Tang & Partner 3,515 40.4 

55 B81085 Dr J W Richardson & Partners 5,294 43.3 

21 B81089 Dr Witvliet 3,593 36.6 

59 B81097 Dr R D Yagnik 1,692 45.3 

57 B81635 Dr G Dave 2,966 43.5 

20 B81644 Dr K K Mahendra 2,245 36.6 

50 B81645 East Park Practice 2,133 41.6 

39 B81646 Dr M Shaikh 1,886 40.0 

18 B81674 Dr J C Joseph 2,238 36.0 

35 B81682 Dr M Shaikh & Partners 3,743 39.7 

47 B81011 Wheeler Street Healthcare 5,230 40.6 

32 B81017 Kingston Medical Group 6,724 39.2 

40 B81027 St Andrews Group Practice 5,974 40.2 

31 B81032 Dr A W Hussain & Partners 2,416 39.1 



Rank 

(out of 

60) 


Apr 2010 

Mean age 

of patients 

Apr 2010 

51 B81035 Dr W G T Sande & Partners 6,117 41.7 

52 B81038 Dr A A Mather & Partners 7,709 42.0 

23 B81046 Dr J D Blow & Partners 9,129 36.8 

27 B81047 Dr J N Singh & Partners 7,425 38.4 

19 B81048 Dr S M Hussain & Partners 9,119 36.0 

22 B81052 Dr J Musil & P J Queenan 5,743 36.8 

42 B81054 Dr M J Varma & Partners 10,794 40.2 

37 B81056 The Springhead Medical Centre 13,612 40.0 

49 B81057 Dr S MacPhie & Koul 3,301 41.5 

53 B81058 Dr M Foulds & Partner 8,672 42.2 

24 B81072 Dr R Percival & Partners 7,684 37.5 

60 B81075 Dr M K Mallik 2,233 47.7 

1 B81104 Dr J K Nayar 7,661 26.4 

13 B81675 Dr AH Tak & Dr EG Stryjakiewicz 9,417 35.2 

15 B81683 Dr A S Raghunath & Partners 1,672 35.8 

5 B81692 The Quays Medical Centre 1,738 32.9 

12 Y00955 Riverside Medical Centre 2,492 35.1 

48 Y01200 The Calvert Practice 1,781 41.4 

6 Y02786 Priory Surgery 289 33.1 

25 Y02896 Story St Practice & Walk In Centr 319 37.8 

5.2 Fertility 

From the Compendium, the total period fertility rate (TPFR) for women aged 11-49 years 

for 2008 is given in Table 29 for England and Hull (see section 12 on page 770 for 

explanation of TPFR and confidence intervals (CIs)). The rate in Hull is statistically 

significantly lower than England. The TPFR for England has increased between 2005 

and 2008 (1.79 for 2005, 1.85 for 2006, 1.91 for 2007 and 1.97 for 2008). The TPFR for 

Hull was 1.77 for both 2005 and 2007 and 1.81 for 2006, so has been lower than 

England for the last four years. 

Table 29: Total period fertility rate for 2008 

Area TPFR for women aged 11-49 

years for 2008 (95% CI) 

England 1.97 (1.96, 1.97) 

Y&H SHA 1.93 (1.91, 1.94) 

Hull 1.83 (1.77, 1.89) 

The Compendium also gives the number of live births by maternal age (Figure 24). 

Note that whilst the youngest age group starts at age 11 years, there will be extremely 



low numbers of live births at this age nationally (certainly this is the case for Hull). For 

those aged 11-15 years, the highest number of these live births nationally and locally will 

occur within the 15 year age group. The underlying data are given in the APPENDIX on 

page 829. 

Further information about sexual health including the number of abortions, abortion rate 

and the under 16 and under 18 conception rates are given in section 10.10 on page 

712. 

Figure 24: Maternal age of live births 

Births for each maternal age group (%) 

60 

50 

40 

30 

20 

10 

0 

England, 2005 

England, 2006 

England, 2007 

England, 2008 

Hull, 2005 

Hull, 2006 

Hull, 2007 

Hull, 2008 

11-15 16-19 20-24 25-34 35-39 40+ 

Maternal age (years) 



5.3 Annual Number of Births and Deaths 

The annual number of live births (so does not include stillbirths) and the annual number 

of deaths for Hull is available from Population Trends (Office for National Statistics 

2008). This information is also produced within the Compendium. The number of live 

births and deaths are calculated on the basis of the usual residence of the mother or the 

deceased respectively. Deaths and mortality rates produced by the Compendium are 

based on year of registration of the death rather than year of death. 

Deaths should be registered within five days of the death. However, delays can occur if 

the death needs to be investigated by the local coroner. In these cases, which involve 

unexplained or suspicious deaths including suicides, the registration date of the death 

can be several months after the date of the death. Therefore, for the majority of deaths 

the year of the death and the year of the registration of the death will be within the same 

calendar year. The deaths which occur within the last few days of one calendar year 

could well be registered during the next calendar year. However, in relation to the 

difference in the number of deaths based on year of death and year of registration of 

death, this will be balanced to a certain degree as this will occur at the start and end of 

each calendar year. See section 12.9 on page 778 for more information. 

Table 30 gives the number of live births to Hull residents occurring during 2002 to 2009 

and the number of deaths to Hull residents which were registered during 2002 to 2009. 

Table 30: Annual number of live births and deaths 

Year of 

event 

Number of live births 

to Hull residents occurring 

during the year 

Number of deaths 

of Hull residents registered 

during the year 

2002 2,797 2,628 

2003 2,970 2,730 

2004 3,212 2,536 

2005 3,203 2,577 

2006 3,500 2,582 

2007 3,471 2,555 

2008 3,682 2,453 

2009 3,560 2,445 

ONS also provides individual-level data on births (live births and stillbirths) and deaths 

through the Public Health Births File (PHBF) and the Public Health Mortality File (PHMF) 

respectively. However, there was a recognition that the information provided for prior to 

2003 for births may have included errors in the figures particularly in relation to the 

number of stillbirths. The number of births and deaths in Table 30 may differ slightly 

from those given in the local PHBF and PHMF because of differences in the distribution 

and dissemination of the data. If there is a delay in distributing or disseminating the data 

then it is possible that new information could be added to the file such as deaths 



resulting in late registration like those that involve a Coroner‟s Inquest. Furthermore, 

with respect to deaths, previous analyses – including those for Release 1 – used year of 

death so are not comparable to analyses in this report which reports deaths based on 

year of registration. Nevertheless, from these local files provided by ONS, it is possible 

to estimate the number of live births and deaths for each Locality (Table 31). 

Table 31: Annual number of live births and deaths by Locality 

Year of 

event 

Number of live births to Hull 

residents by Locality by the year in 

which the birth occurred 

Number of deaths of Hull 

residents by Locality by the year in 

which the death was registered 

North East West North East West 

2001 741 1,062 1,054 440 991 1,140 

2002 708 1,035 1,055 475 1,009 1,144 

2003 795 1,079 1,095 504 1,067 1,159 

2004 817 1,180 1,216 474 944 1,118 

2005 830 1,151 1,222 456 1,002 1,119 

2006 904 1,228 1,368 483 978 1,121 

2007 900 1,232 1,338 439 1,063 1,053 

2008 967 1,272 1,443 423 1,003 1,027 

2009 928 1,203 1,429 505 960 980 



5.4 Projected Populations 

The Office for National Statistics estimates the projected population every two years. 

Figure 25 gives the projected population (in thousands) to 2033 for Hull based mid-year 

2008 estimates (Office for National Statistics 2008). The information provided in this 

figure is detailed in the APPENDIX on page 830. 

Figure 25: Projected population estimates for Hull 



Table 32 gives the total numbers projected for all ages combined based on mid-year 

2008 population estimates. 

Table 32: Projected resident population estimates for Hull (thousands) 

Year Projected population (thousands) 

Change from 2008 

Number Number Percentage 

2008 261.1 0.0 0.0 

2009 263.4 2.3 0.9 

2010 266.1 5.0 1.9 

2011 268.8 7.7 2.9 

2012 271.3 10.2 3.9 

2013 273.8 12.7 4.9 

2014 276.2 15.1 5.8 

2015 278.6 17.5 6.7 

2016 281.0 19.9 7.6 

2017 283.3 22.2 8.5 

2018 285.6 24.5 9.4 

2019 287.9 26.8 10.3 

2020 290.0 28.9 11.1 

2021 292.2 31.1 11.9 

2022 294.3 33.2 12.7 

2023 296.6 35.5 13.6 

2024 298.8 37.7 14.4 

2025 301.0 39.9 15.3 

2026 303.2 42.1 16.1 

2027 305.4 44.3 17.0 

2028 307.6 46.5 17.8 

2029 309.8 48.7 18.7 

2030 311.9 50.8 19.5 

2031 313.9 52.8 20.2 

2032 315.9 54.8 21.0 

2033 317.9 56.8 21.8 

Further information from the Projecting Older People Population Information (POPPI) 

System is available in section 10.13.1 on page 737, which includes projecting the 

number of people who have specific medical conditions or care needs in the future. It 

also includes information on the numbers of people aged 65+ years expected to live 

alone or to live in care homes. 



5.5 Ethnicity 

From the 2001 Census, the numbers and percentages of people within each ethnic 

group are given in Table 33 and Table 34 respectively for each of the wards in Hull 

(Office for National Statistics 2008). 

Table 33: Numbers within each ethnic group within Hull from 2001 Census 

Ward/Area/Locality All White Mixed Asian or 

Asian 

British 

Black or 

Black 

British 

Chinese 

or Other 

Ethnic 

Group 

Bransholme East 9,991 9,865 51 29 32 14 

Bransholme West 8,754 8,674 38 19 17 6 

Kings Park 5,903 5,845 19 7 12 20 

Area: North Carr 24,648 24,384 108 55 61 40 

Beverley 8,582 8,387 47 46 41 61 

Orchard Park & Greenwood 14,001 13,848 77 19 37 20 

University 9,541 8,939 97 167 99 239 

Area: Northern 32,124 31,174 221 232 177 320 

Locality: North 56,772 55,558 329 287 238 360 

Ings 12,143 12,033 53 29 16 12 

Longhill 11,382 11,292 54 16 13 7 

Sutton 12,882 12,764 57 21 20 20 

Area: East 36,407 36,089 164 66 49 39 

Holderness 13,242 13,125 49 9 16 43 

Marfleet 13,211 13,030 68 65 22 26 

Southcoates East 8,167 8,081 38 19 12 17 

Southcoates West 8,187 8,122 25 20 9 11 

Area: Park 42,807 42,358 180 113 59 97 

Drypool 12,529 12,217 80 94 46 92 

Area: Riverside (East) 12,529 12,217 80 94 46 92 

Locality: East 91,743 90,664 424 273 154 228 

Myton 11,908 11,234 161 292 114 107 

Newington 11,297 10,957 75 158 52 55 

St Andrew‟s 6,781 6,544 82 74 44 37 

Area: Riverside (West) 29,986 28,735 318 524 210 199 

Boothferry 12,394 12,215 50 76 14 39 

Derringham 11,441 11,346 46 26 8 15 

Pickering 11,165 11,007 54 59 24 21 

Area: West 35,000 34,568 150 161 46 75 

Avenue 12,307 11,428 222 398 90 169 

Bricknell 7,958 7,797 50 69 10 32 

Newland 9,830 9,189 128 199 128 186 

Area: Wyke 30,095 28,414 400 666 228 387 

Locality: West 95,081 91,717 868 1,351 484 661 

HULL 243,596 237,939 1,621 1,911 876 1,249 



Table 34: Percentages within each ethnic group within Hull from 2001 Census 

Ward/Area/Locality All (pop) White Mixed Asian or 

Asian 

British 

Black or 

Black 

British 

Chinese 

or Other 

Ethnic 

Group 

Bransholme East 9,991 98.7 0.5 0.3 0.3 0.1 

Bransholme West 8,754 99.1 0.4 0.2 0.2 0.1 

Kings Park 5,903 99.0 0.3 0.1 0.2 0.3 

Area: North Carr 24,648 98.9 0.4 0.2 0.2 0.2 

Beverley 8,582 97.7 0.5 0.5 0.5 0.7 

Orchard Park & Greenwood 14,001 98.9 0.5 0.1 0.3 0.1 

University 9,541 93.7 1.0 1.8 1.0 2.5 

Area: Northern 32,124 97.0 0.7 0.7 0.6 1.0 

Locality: North 56,772 97.9 0.6 0.5 0.4 0.6 

Ings 12,143 99.1 0.4 0.2 0.1 0.1 

Longhill 11,382 99.2 0.5 0.1 0.1 0.1 

Sutton 12,882 99.1 0.4 0.2 0.2 0.2 

Area: East 36,407 99.1 0.5 0.2 0.1 0.1 

Holderness 13,242 99.1 0.4 0.1 0.1 0.3 

Marfleet 13,211 98.6 0.5 0.5 0.2 0.2 

Southcoates East 8,167 98.9 0.5 0.2 0.1 0.2 

Southcoates West 8,187 99.2 0.3 0.2 0.1 0.1 

Area: Park 42,807 99.0 0.4 0.3 0.1 0.2 

Drypool 12,529 97.5 0.6 0.8 0.4 0.7 

Area: Riverside (East) 12,529 97.5 0.6 0.8 0.4 0.7 

Locality: East 91,743 98.8 0.5 0.3 0.2 0.2 

Myton 11,908 94.3 1.4 2.5 1.0 0.9 

Newington 11,297 97.0 0.7 1.4 0.5 0.5 

St Andrew‟s 6,781 96.5 1.2 1.1 0.6 0.5 

Area: Riverside (West) 29,986 95.8 1.1 1.7 0.7 0.7 

Boothferry 12,394 98.6 0.4 0.6 0.1 0.3 

Derringham 11,441 99.2 0.4 0.2 0.1 0.1 

Pickering 11,165 98.6 0.5 0.5 0.2 0.2 

Area: West 35,000 98.8 0.4 0.5 0.1 0.2 

Avenue 12,307 92.9 1.8 3.2 0.7 1.4 

Bricknell 7,958 98.0 0.6 0.9 0.1 0.4 

Newland 9,830 93.5 1.3 2.0 1.3 1.9 

Area: Wyke 30,095 94.4 1.3 2.2 0.8 1.3 

Locality: West 95,081 96.5 0.9 1.4 0.5 0.7 

HULL 243,596 97.7 0.7 0.8 0.4 0.5 

It is difficult to collect information on ethnic background, and the information from the 

Census is now relatively out of date. 



Hull City Council, within its Hull City Council Black and Minority Ethnic (BME) Housing 

Strategy and Action Plan published September 2005 (Hull City Council 2005), estimated 

that the BME population of Hull was approximately 5%. The report provided information 

on asylum seekers, the Gypsy and Traveller population, service users, etc. 

ONS have produced mid-year 2007 estimates of ethnicity for each locality authority 

(Office for National Statistics 2008). Table 35 gives the estimated population in 

thousands and the percentage for each BME group compared to England. 

Table 35: Percentages within each ethnic group within Hull estimated by ONS (mid- 

2007) 

Gender Ethnicity England % Hull N 000s Hull % 

All males 100.0 129.7 100.0 

British 83.4 116.9 90.1 

White 

Irish 1.1 0.4 0.3 

Other White 3.4 3.4 2.6 

White & Black Caribbean 0.6 0.3 0.2 

Mixed 

White & Black African 

White & Asian 

0.2 

0.5 

0.3 

0.6 

0.2 

0.5 

Other Mixed 0.4 0.5 0.4 

Males 

Indian 2.6 1.0 0.8 

Asian or Asian Pakistani 1.9 0.7 0.5 

British Bangladeshi 0.7 0.5 0.4 

Other Asian 0.7 1.0 0.8 

Black or Black 

British 

Black Caribbean 

Black African 

Other Black 

1.1 

1.5 

0.2 

0.3 

1.4 

0.1 

0.2 

1.1 

0.1 

Chinese or British Chinese 0.8 1.4 1.1 

Other Ethnic group 0.7 0.9 0.7 

All females 100.0 127.2 100.0 

British 86.7 117.3 90.4 

White 

Irish 1.2 0.4 0.3 



Mixed 


White & Asian 

0.2 

0.5 

0.2 

0.5 

0.2 

0.4 


Females 

Indian 2.6 0.8 0.6 





British 


Black African 

Other Black 

1.3 

1.4 

0.2 

0.2 

1.0 

0.1 

0.2 

0.8 

0.1 





Gender Ethnicity England % Hull N 000s Hull % 

All persons 100.0 257.0 100.0 

British 83.6 234.2 91.1 

White 

Irish 1.1 0.8 0.3 



Mixed 


White & Asian 

0.2 

0.5 

0.5 

1.0 

0.2 

0.4 


Persons 

Indian 2.6 1.7 0.7 





British 


Black African 

Other Black 

1.2 

1.4 

0.2 

0.5 

2.4 

0.2 

0.2 

0.9 

0.1 



ONS have also produced this information (for mid-2007) for three different age groups: 

young (0-15 years), working (16-64 years for males and 16-59 years for females) and 

retired (65+ years for males and 60+ years for females). The figures are rounded to the 

nearest 100 people for each group and are given in Table 36. However, due to 

rounding errors (e.g. numbers of males and females for the Non-White category are 

rounded to zero), the total numbers are lower than the numbers in Table 35. The 

differences range from zero to 500 for each of the nine age-gender groups, and 

difference in the total number of males, females and persons are 800, 600 and 1,000 

respectively. 

Table 36: Numbers within each ethnic group within Hull mid-year 2007 estimates 

Gender and age group White Mixed Asian or 

Asian 

British 

Black or 

Black 

British 

Chinese or 

Chinese 

British 

Other 

Ethnic 

Group 

Young males (0-15) 23,300 400 700 200 100 100 

Males of working-age (16-64) 81,800 700 2500 1500 1300 800 

Males of retirement age (65+) 15,600 0 0 0 0 0 

All males 120,700 1,100 3,200 1,700 1,400 900 

Young females (0-15) 21,700 400 500 200 100 100 

Females of working-age (16-59) 72,300 500 1900 1100 1000 600 

Females of retirement age (60+) 26,300 0 0 0 0 0 

All females 120,300 900 2,400 1,300 1,100 700 

Young persons 44,900 700 1100 400 200 200 

Persons of working-age 154,300 1300 4500 2500 2300 1400 

Persons of retirement age 41,900 0 100 100 100 0 

All persons 241,100 2,000 5,700 3,000 2,600 1,600 



Public Health Sciences conducted an adult Health and Lifestyle Survey during early 

2007 which involved quota sampling to obtain a sample of residents who were broadly 

similar to Hull‟s population in terms of their gender, age and where they lived. A total of 

4,086 people took part in the survey, and from this information, it is estimated that the 

BME population of Hull is now 16 thousand (having nearly doubled in the last 6 years), 

and that 93.4% of Hull‟s population identify themselves as White British (and a further 

0.4% as Irish). Together with the adult BME Health and Lifestyle Survey conducted at 

the same time involving 1,163 residents of Hull, these two surveys found 70 different 

nationalities with at least 60 different languages spoken in homes in Hull. However, due 

to the methodology involved in obtaining survey responders for the BME Survey, the 

survey is not necessarily representative of the BME population of Hull. A further survey 

was conducted using the same questionnaire involving 100 Gypsy and Travellers; again 

it is not known if they are representative of Hull‟s overall population of Gypsy and 

Travellers, but it provides useful local knowledge about their health and risk factors. 

More information about these local surveys is given in section 13.2.1 on page 790. The 

survey reports which details their health and lifestyle characteristics are available at 

www.hullpublichealth.org. A summary of the findings from the BME Health and Lifestyle 

Survey are given in section 8.2.1 on page 239, and from the Gypsy and Traveller 

Health and Lifestyle Survey in section 8.2.2 on page 242. 



6 DEPRIVATION AND ASSOCIATED MEASURES 

6.1 Introduction 

Unemployment, poor housing, lack of qualifications, crime and many other social and 

environmental factors all indirectly affect the health of the population. Different scales 

and scores have been produced which attempt to measure deprivation. In general, in 

relation to national averages, Hull has a higher unemployment rate, more poor housing, 

residents qualified to a lower level and higher levels of crime. Increased deprivation 

means that there is poorer health, but this is compounded as poor health also affects 

other measures such as employment and motivation to improve employment, education 

and the person‟s environment such as housing. In addition, those who live in the most 

deprived area are more likely to have risk factors for ill health such as smoking, poor 

diet, lack of exercise, etc. It is also generally more difficult to change lifestyle behaviour 

if the environment is more stressful resulting from poorer employment prospects and 

housing, increased debt, relationship problems, etc. 

6.2 Inequity 

Owing to the relationship between deprivation and ill health, one would expect „need‟ for 

healthcare to increase as deprivation increases, and that a positive relationship would 

be obtained say between rates of hospital admissions or treatment and deprivation. If 

such a relationship did not exist, then it could mean that treatment is not reflecting „need‟ 

and that there may be inequity present. Premature death is generally defined as death 

occurring under the age of 75 years, and this is generally used when examining inequity. 

Risk factor data was collected as part of the Health and Lifestyle Surveys (Public Health 

Development Team 2005; Porter, Sheikh Iddenden et al. 2008; Sheikh Iddenden, Porter 

et al. 2008) and the Social Capital Survey (Hunter, Lee et al. 2005) (see section 13.2 on 

page 790 and section 13.4 on page 805 both in APPENDIX for details of survey and 

definitions used for risk factors respectively). 

It is possible to assign an Index of Deprivation (IMD) 2007 score (see page 131 for more 

information about this index) based on the lower layer super output area (LLSOA) which 

included their postcode (of residence) for people taking part in surveys or based on the 

deceased‟s postcode for analysis involving mortality information (from the Public Health 

Mortality File; for more information on the PHMF see section 12.9 on page 778). The 

individuals were then grouped into one of five deprivation quintile groups according to 

the distribution of the local quintiles for the LLSOAs 10 . 

10 See section 3 on deprivation. There are 163 LLSOAs in Hull which are ranked according to their IMD 

2007 deprivation score. Those LLSOAs in the most deprived quintile locally have a rank of 1 to 33, those 

in the second most deprived group are ranked 34 to 65, those lower layer SOAs in the middle group are 

ranked 66 to 98, those in the second least deprived group are ranked 99 to 130 and those LLSOAs in the 

least deprived fifth locally equate to a rank of 131 to 163. 



Differences in relation to deprivation are illustrated within each section. For instance, 

the difference in the prevalence of smoking among the deprivation quintiles can be 

found within the section on smoking. 

Health equity audits have also been completed for coronary heart disease 2004/2005 

(Public Health Sciences 2005), cancer 2005/2006 (Taylor, Lee et al. 2006), mental 

health 2006/2007 (Porter and Taylor 2007) and diabetes 2007/2008 (Porter and Taylor 

2008). These reports are available at www.hullpublichealth.org. A further health equity 

audit on chronic obstructive pulmonary disease is currently underway. 

6.3 Rates of Unemployment 

The Official Labour Market Statistics (NOMIS) (Office for National Statistics 2010) gives 

information on the labour market for each Local Authority from the ONS annual 

population survey. Table 37 gives some information on the labour market in Hull for the 

period January 2009 to December 2009 compared to the Yorkshire and the Humber 

region and Great Britain. The percentages are given out of the working-age population 

with the exception of working-age population which is the percentage out of the total 

population. There are considerably higher rates of unemployment in Hull, with the 

model-based unemployment rate increasing from 12.5% for men and 7.8% for females 

from the previous period July 2008 to June 2009. 

Table 37: Labour market for those of working age, January 2009 to December 2009 

Gender Employment status Hull Y&H GB 

N % % % 

Population 2009 132,800 

Working-age population 2009 92,400 69.6 66.5 66.0 

Economically active 71,100 79.4 81.7 83.1 

In employment 58,000 64.8 73.4 75.8 

Males 

Employees 

Self-employed 

49,900 

7,900 

55.8 

8.7 

61.5 

11.5 

62.7 

12.7 

Unemployed (model-based) 13,100 18.4 10.0 8.6 

Economically inactive 18,300 20.6 18.3 16.9 

Wanting a job 4,500 5.0 5.5 4.7 

Not wanting a job 13,800 15.5 12.8 12.2 




In employment 49,000 57.0 64.3 65.7 

Females 

Employees 

Self-employed 

46,600 

2,400 

54.1 

2.8 

59.7 

4.2 

60.0 

5.2 



Wanting a job 5,500 6.5 6.5 6.4 




Gender Employment status Hull Y&H GB 

N % % % 




In employment 107,000 61.0 68.8 70.7 

Persons 

Employees 

Self-employed 

96,400 

10,300 

54.9 

5.8 

60.6 

7.8 

61.4 

9.0 



Wanting a job 10,000 5.8 6.0 5.5 


Table 38 shows that the socio-economic grouping of those people in employment in Hull 

is lower than the local region and Great Britain for the period January to December 

2009, and the percentages in the lowest skills groups have increased since the period 

July 2008 to June 2009. The earnings are also lower in Hull compared to the regional 

average and GB average. For 2009, full-time male workers in Hull had a median 11 

weekly gross earnings of £437 compared to £491 for Yorkshire and the Humber region 

and £534 for GB, whereas full-time female workers in Hull had median weekly gross 

earnings of £372 compared to £395 and £427 for the region and GB respectively. This 

equates to rates of £10.48, £11.98 and £13.167 hourly earnings for men for Hull, the 

region and GB respectively, and £9.67, £10.60 and £11.45 for females respectively. 

Between 2008 and 2009, there were relatively small increases in hourly earnings for 

men of 2.5%, 3.2% and 3.5% for Hull, the region and GB respectively, but larger 

increases for females of 10.8%, 7.9% and 4.5% respectively. 

Table 38: Occupational grouping, January 2009 to December 2009 

Occupational group Hull Y&H GB 

N % % % 

Soc 2000 major group 1-3 31,100 29.1 40.3 44.1 

1. Managers and senior officials 8,200 7.7 14.7 15.7 

2. Professional occupations 9,800 9.1 11.7 13.6 

3. Associate professional & technical 13,100 12.2 13.7 14.7 


4. Administrative & secretarial 11,600 10.9 10.9 11.2 

5. Skilled trade occupations 15,100 14.1 10.5 10.4 


6. Personal service occupations 10,700 10.0 9.2 8.6 

7. Sales & customer service occupations 9,800 9.1 8.0 7.4 


8. Process plant & machine operatives 9,800 9.2 8.2 6.7 

9. Elementary occupations 18,800 17.6 12.7 11.3 

11 See section 12.8 for explanation of median. 



6.4 Benefit Claimants 

6.4.1 All Benefit Claimants 

Figures on the number of benefit claimants are available at ward level from the 

Department for Work and Pensions (DWP) (Department for Work and Pensions 2008). 

The data relates to 100% counts of benefit claimants, disaggregated to ward level. 

DWP provides the number of claimants by main reason for claim by ward for those 

people claiming benefits who are working age. There is also information at ward level 

for the number of claimants of specific benefits such as Attendance Allowance, Disability 

Living Allowance, Incapacity Benefit (IB) and Severe Disablement Allowance (SDA) or 

the new Employment and Support Allowance (ESA), Income Support, Jobseekers 

Allowance, Pension Credit and State Pension. All this information is updated quarterly, 

the latest available quarter refers to claimants as at May 2009. The total number of 

benefit claimants and the number claiming IB/SDA/ESA are both given below. However, 

note that the totals for the Areas and the Localities (and Hull for IB/SDA) might be 

slightly different from the true figure as they have been calculated from the sum of the 

ward figures which have been rounded to the nearest five individuals. The figure for Hull 

overall for all benefits has been obtained from the total provided by DWP (rather than 

summing up the wards) so is accurate to the nearest ten individuals. 

Using the information provided by DWP on all claimants of working age, and using 

resident population estimates from the GP registration files, it is possible to calculate the 

percentage of claimants as well as provide the absolute number of claimants at ward 

level. Table 39 gives the number and Table 40 gives the percentage of claimants for 

each ward in Hull by the type of the benefit for the working-age population (16-64 years 

for men and 16-59 years for women). The numbers of working-age claimants have 

been adjusted so that people claiming more than one benefit are only included in one 

„main reason (for interacting with the benefit system)‟ category. The number of 

claimants is given based on this main reason for the claim for Jobseeker Allowance, 

IB/SDA/ESA, Lone Parent, Carer, other income-related benefit, Disabled and Bereaved. 



Table 39: Number of benefit claimants, May 2009 

Ward/Area/Locality Number of working age claimants 

Job seekers 

Incapacity 

benefit etc 

Lone parents 


Carer 

Other incomerelated 

benefits 

Bransholme East 690 750 480 160 65 95 15 2,255 

Bransholme West 515 645 265 145 65 75 15 1,725 

Kings Park 265 245 45 70 10 75 10 720 

Area: North Carr 1,470 1,640 790 375 140 245 40 4,700 

Beverley 190 240 35 50 25 50 15 605 

Orchard Park & Greenwood 1,195 1,335 705 215 115 150 10 3,725 

University 430 510 215 85 35 60 10 1,345 

Area: Northern 1,815 2,085 955 350 175 260 35 5,675 

Locality: North 3,285 3,725 1,745 725 315 505 75 10,375 

Ings 410 595 125 125 45 80 10 1,390 

Longhill 550 770 325 160 70 100 25 2,000 

Sutton 440 605 195 110 60 105 30 1,545 

Area: East 1,400 1,970 645 395 175 285 65 4,935 

Holderness 395 335 80 90 40 70 20 1,030 

Marfleet 915 1,035 530 190 85 125 20 2,900 

Southcoates East 555 620 330 125 60 65 10 1,765 

Southcoates West 415 355 135 65 55 55 15 1,095 

Area: Park 2,280 2,345 1,075 470 240 315 65 6,790 

Drypool 660 740 195 105 70 75 15 1,860 

Area: Riverside (East) 660 740 195 105 70 75 15 1,860 

Locality: East 4,340 5,055 1,915 970 485 675 145 13,585 

Myton 1,375 1,675 295 150 165 70 10 3,740 

Newington 820 855 300 145 95 100 20 2,335 

St Andrew's 640 745 245 90 80 50 10 1,860 

Area: Riverside (West) 2,835 3,275 840 385 340 220 40 7,935 

Boothferry 370 440 110 90 35 105 15 1,165 

Derringham 390 455 130 90 45 80 15 1,205 

Pickering 550 695 200 115 50 75 15 1,700 

Area: West 1,310 1,590 440 295 130 260 45 4,070 

Avenue 600 555 150 65 45 80 15 1,510 

Bricknell 200 225 45 60 20 65 10 625 

Newland 475 460 130 65 40 50 10 1,230 

Area: Wyke 1,275 1,240 325 190 105 195 35 3,365 

Locality: West 5,420 6,105 1,605 870 575 675 120 15,370 

HULL 13,050 14,900 5,260 2,570 1,370 1,830 320 39,310 

Disabled 

Bereaved 

Total


Table 40: Rate (per 100 working-age population) of benefit claimants, May 2009 

Ward/Area/Locality Percentage of working age claimants 

Job seekers 

Incapacity 

benefit etc 

Lone parents 


Carer 

Other incomerelated 

benefits 

Bransholme East 10.0 10.9 7.0 2.3 0.9 1.4 0.2 32.7 

Bransholme West 9.7 12.2 5.0 2.7 1.2 1.4 0.3 32.6 

Kings Park 4.3 4.0 0.7 1.1 0.2 1.2 0.2 11.6 

Area: North Carr 8.0 8.9 4.3 2.0 0.8 1.3 0.2 25.6 

Beverley 3.6 4.5 0.7 0.9 0.5 0.9 0.3 11.4 

Orchard Park & Greenwood 12.9 14.5 7.6 2.3 1.2 1.6 0.1 40.3 

University 5.8 6.9 2.9 1.2 0.5 0.8 0.1 18.2 

Area: Northern 8.3 9.5 4.4 1.6 0.8 1.2 0.2 25.9 

Locality: North 8.1 9.2 4.3 1.8 0.8 1.3 0.2 25.7 

Ings 5.5 8.0 1.7 1.7 0.6 1.1 0.1 18.7 

Longhill 7.5 10.5 4.4 2.2 1.0 1.4 0.3 27.3 

Sutton 5.2 7.1 2.3 1.3 0.7 1.2 0.4 18.2 

Area: East 6.0 8.5 2.8 1.7 0.8 1.2 0.3 21.2 

Holderness 4.5 3.8 0.9 1.0 0.5 0.8 0.2 11.6 

Marfleet 11.0 12.5 6.4 2.3 1.0 1.5 0.2 34.9 

Southcoates East 10.2 11.4 6.1 2.3 1.1 1.2 0.2 32.5 

Southcoates West 7.9 6.8 2.6 1.2 1.1 1.1 0.3 21.0 

Area: Park 8.2 8.4 3.9 1.7 0.9 1.1 0.2 24.4 

Drypool 7.7 8.7 2.3 1.2 0.8 0.9 0.2 21.8 

Area: Riverside (East) 7.7 8.7 2.3 1.2 0.8 0.9 0.2 21.8 

Locality: East 7.3 8.5 3.2 1.6 0.8 1.1 0.2 22.8 

Myton 12.7 15.4 2.7 1.4 1.5 0.6 0.1 34.4 

Newington 9.6 10.0 3.5 1.7 1.1 1.2 0.2 27.4 

St Andrew's 10.9 12.6 4.2 1.5 1.4 0.8 0.2 31.6 

Area: Riverside (West) 11.2 13.0 3.3 1.5 1.3 0.9 0.2 31.4 

Boothferry 4.7 5.6 1.4 1.1 0.4 1.3 0.2 14.9 

Derringham 5.6 6.5 1.9 1.3 0.6 1.1 0.2 17.2 

Pickering 7.4 9.4 2.7 1.6 0.7 1.0 0.2 23.0 

Area: West 5.9 7.1 2.0 1.3 0.6 1.2 0.2 18.3 

Avenue 6.2 5.8 1.6 0.7 0.5 0.8 0.2 15.6 

Bricknell 3.8 4.3 0.9 1.1 0.4 1.2 0.2 11.8 

Newland 5.5 5.3 1.5 0.7 0.5 0.6 0.1 14.2 

Area: Wyke 5.4 5.3 1.4 0.8 0.4 0.8 0.1 14.3 

Locality: West 7.6 8.6 2.3 1.2 0.8 0.9 0.2 21.6 

HULL 7.6 8.7 3.1 1.5 0.8 1.1 0.2 23.0 

Disabled 

Bereaved 

Total


6.4.2 Employment and Support Allowance (Incapacity Benefit) Claimants 

Employment and Support Allowance (ESA) replaced Incapacity Benefit and Income 

Support paid on the grounds of incapacity for new claims from 27th October 2008. The 

introduction of ESA for new claimants in October 2008 was accompanied by a new 

assessment, the Work Capability Assessment (WCA). The WCA is based on medical 

advice delivered by the DWP‟s medical services contractor, ATOS Healthcare. ESA 

claimants‟ longer term entitlement to claim the benefit is dependent on the outcome of 

the WCA. The possible outcomes of the WCA are that claimants can be assessed as: 

a) suitable for the ESA Support Group, b) suitable for the ESA Work Related Activity 

Group or c) fit for work and therefore not entitled to continue claiming, although there is 

a right of appeal. 

For sickness and disabilities which commenced prior to the 27 th October 2008, 

Incapacity Benefit (IB) is the benefit which is paid to people who are too sick or disabled 

to work. It was available for people who are over 16 and under State Pension age, who 

had made enough National Insurance contributions, and who were not able to work. 

People in receipt of IB will continue to receive IB, and between 2010 and 2013, this 

benefit will be replaced by the ESA. There are three different rates of IB payable 

depending on the duration of the illness: 3 days to 28 weeks, 29 weeks to 52 weeks and 

over 52 weeks. Severe Disablement Allowance (SDA) is no longer available for new 

claims as at April 2001, but people who were previously in receipt of SDA have 

continued to receive it, and they were paid this benefit if they had not been able to work 

for at least 28 weeks in a row because of ill health or disability. Table 41 gives the 

number of claimants as well as the rate of claimants per 100 resident population of 

working-age 12 as at May 2009. The DWP also gives the main reason for the claim for 

the five diseases and medical conditions where there are sufficient numbers to 

categorise (Table 42). 

Overall, for May 2009, there were 13,290 people in Hull claiming IB or SDA which 

represents 7.8% of Hull‟s working-age population (this differs slightly from the figure 

quoted in Table 39 and Table 40, and the reason for this is unclear, it could be related 

to definitions relating to „main reason for the claim‟). Men have a higher claimant rate 

(8.5%) compared to women (7.0%). The commonest disease group given as the reason 

for claiming is mental illness (3.0% of the working-age population and 39% of 

claimants). Myton ward has the highest rate of male (14.9%) and female (12.3%) 

claimants as well as the highest rate of claimants for mental illness (7.2%) with Orchard 

Park and Greenwood ward having only a marginally lower percentage of claimants. 

Orchard Park and Greenwood ward had this highest claimant rate where the main 

reason for the claim was muscoskeletal (2.7%). Claimant rates within the wards vary 

from 3.3% (both Kings Park and Holderness) to 13.9% (Myton) and further analysis 

revealed a strong association between the rate of claimants and the Index of Multiple 

Deprivation 2007 (see page 131). The total number of claimants decreased between 

August 2008 and May 2009 from 14,785 persons to 13,290 persons in Hull, falling from 

12 Resident population aged 16-64 years for men and 16-59 years for women estimated from the GP 

registration file. 



8.7% to 7.8% of Hull‟s working-age population. This is likely due to the new medical 

review for new claimants and reviews for long-term claimants. 

Further analysis of benefit claimants for the mental health reasons is given in the Mental 

Health Equity Audit in relation to age and gender of the claimant. Whilst the data in the 

equity audit refers to August 2006, the pattern of the claims in relation to wards and the 

Index of Multiple Deprivation 2007 is similar to that in Table 42. Further discussion 

about the claimants in relation to mental health in relation to cause or consequence and 

the sustaining cycle is also provided within the equity audit. The discussion revolves 

around the complex relationship between mental health and deprivation, in that people 

living in more deprived areas are more likely to suffer from poor mental health and 

mental illness, but people suffering from poor mental health and mental illness are more 

likely to live in cheaper or supported accommodation in more deprived areas. 



Table 41: Number (and rate per 100 working-age population) of claimants of Incapacity 

Benefit and Severe Disablement Allowance by gender, May 2009 

Ward/area/locality Number of claimants (rate per 100 working-age population) 

Benefit Gender 

IB and SDA 

Incapacity 

Benefit 

Severe 

Disablement 

Allowance 

Male Female 

Bransholme East 660 (9.6) 595 (8.6) 65 (0.9) 385 (10.8) 275 (8.2) 

Bransholme West 585 (11.1) 505 (9.6) 80 (1.5) 355 (12.4) 230 (9.5) 

Kings Park 205 (3.3) 185 (3.0) 20 (0.3) 100 (3.1) 105 (3.5) 

Area: North Carr 1,450 (7.9) 1,285 (7.0) 165 (0.9) 840 (8.8) 610 (6.9) 

Beverley 225 (4.2) 200 (3.8) 25 (0.5) 125 (4.4) 100 (4.1) 

Orchard Park & Greenwood 1,165 (12.6) 1,075 (11.6) 90 (1.0) 700 (14.3) 465 (10.7) 

University 445 (6.0) 405 (5.5) 40 (0.5) 270 (7.1) 175 (4.9) 

Area: Northern 1,835 (8.4) 1,680 (7.7) 155 (0.7) 1,095 (9.5) 740 (7.1) 

Locality: North 3,285 (8.1) 2,965 (7.4) 320 (0.8) 1,935 (9.1) 1,350 (7.1) 

Ings 570 (7.7) 445 (6.0) 125 (1.7) 320 (8.1) 250 (7.2) 

Longhill 685 (9.3) 600 (8.2) 85 (1.2) 400 (10.3) 285 (8.3) 

Sutton 550 (6.5) 485 (5.7) 65 (0.8) 315 (7.0) 235 (5.9) 

Area: East 1,805 (7.8) 1,530 (6.6) 275 (1.2) 1,035 (8.4) 770 (7.1) 

Holderness 290 (3.3) 265 (3.0) 25 (0.3) 155 (3.2) 135 (3.3) 

Marfleet 920 (11.1) 810 (9.8) 110 (1.3) 520 (11.9) 400 (10.2) 

Southcoates East 565 (10.4) 515 (9.5) 50 (0.9) 305 (10.7) 260 (10.0) 

Southcoates West 310 (5.9) 280 (5.4) 30 (0.6) 180 (6.4) 130 (5.4) 

Area: Park 2,085 (7.5) 1,870 (6.7) 215 (0.8) 1,160 (7.8) 925 (7.1) 

Drypool 660 (7.7) 590 (6.9) 70 (0.8) 380 (8.2) 280 (7.2) 

Area: Riverside (East) 660 (7.7) 590 (6.9) 70 (0.8) 380 (8.2) 280 (7.2) 

Locality: East 4,550 (7.6) 3,990 (6.7) 560 (0.9) 2,575 (8.1) 1,975 (7.1) 

Myton 1,510 (13.9) 1,330 (12.2) 180 (1.7) 1,010 (14.9) 500 (12.3) 

Newington 755 (8.8) 695 (8.1) 60 (0.7) 460 (9.8) 295 (7.7) 

St Andrew's 665 (11.3) 605 (10.3) 60 (1.0) 395 (12.0) 270 (10.4) 

Area: Riverside (West) 2,930 (11.6) 2,630 (10.4) 300 (1.2) 1,865 (12.6) 1,065 (10.1) 

Boothferry 410 (5.2) 340 (4.3) 70 (0.9) 230 (5.5) 180 (4.9) 

Derringham 405 (5.8) 360 (5.1) 45 (0.6) 220 (6.0) 185 (5.5) 

Pickering 625 (8.4) 540 (7.3) 85 (1.1) 365 (9.3) 260 (7.5) 

Area: West 1,440 (6.5) 1,240 (5.6) 200 (0.9) 815 (6.9) 625 (5.9) 

Avenue 490 (5.1) 445 (4.6) 45 (0.5) 275 (5.1) 215 (5.0) 

Bricknell 195 (3.7) 165 (3.1) 30 (0.6) 105 (3.7) 90 (3.7) 

Newland 400 (4.6) 365 (4.2) 35 (0.4) 255 (5.3) 145 (3.8) 

Area: Wyke 1,085 (4.6) 975 (4.1) 110 (0.5) 635 (4.9) 450 (4.3) 

Locality: West 5,455 (7.7) 4,845 (6.8) 610 (0.9) 3,315 (8.4) 2,140 (6.8) 

HULL 13,290 (7.8) 11,800 (6.9) 1,490 (0.9) 7,825 (8.5) 5,465 (7.0) 



Table 42: Number (and rate per 100 working-age population) of claimants of Incapacity 

Benefit and Severe Disablement Allowance by disease group, May 2009 

Ward/area/locality Number of claimants (rate per 100 working-age population) by disease 

Mental 

Nervous 

System 

Respiratory 

or 

Circulatory 

Musco- 

skeletal 

Injury, 

poisoning 


Other 

Bransholme East 250 (3.6) 55 (0.8) 55 (0.8) 140 (2.0) 25 (0.4) 135 (2.0) 

Bransholme West 190 (3.6) 55 (1.0) 50 (0.9) 120 (2.3) 30 (0.6) 140 (2.6) 

Kings Park 65 (1.1) 10 (0.2) 15 (0.2) 45 (0.7) 15 (0.2) 55 (0.9) 

Area: North Carr 505 (2.7) 120 (0.7) 120 (0.7) 305 (1.7) 70 (0.4) 330 (1.8) 

Beverley 75 (1.4) 25 (0.5) 20 (0.4) 45 (0.8) 15 (0.3) 45 (0.8) 

Orchard Pk & Greenwood 470 (5.1) 65 (0.7) 105 (1.1) 245 (2.7) 45 (0.5) 235 (2.5) 

University 170 (2.3) 35 (0.5) 35 (0.5) 100 (1.4) 15 (0.2) 90 (1.2) 

Area: Northern 715 (3.3) 125 (0.6) 160 (0.7) 390 (1.8) 75 (0.3) 370 (1.7) 

Locality: North 1,220 (3.0) 245 (0.6) 280 (0.7) 695 (1.7) 145 (0.4) 700 (1.7) 

Ings 200 (2.7) 45 (0.6) 50 (0.7) 100 (1.3) 20 (0.3) 155 (2.1) 

Longhill 235 (3.2) 45 (0.6) 70 (1.0) 140 (1.9) 30 (0.4) 165 (2.2) 

Sutton 150 (1.8) 55 (0.6) 55 (0.6) 110 (1.3) 30 (0.4) 150 (1.8) 

Area: East 585 (2.5) 145 (0.6) 175 (0.8) 350 (1.5) 80 (0.3) 470 (2.0) 

Holderness 90 (1.0) 20 (0.2) 25 (0.3) 65 (0.7) 20 (0.2) 70 (0.8) 

Marfleet 345 (4.2) 65 (0.8) 75 (0.9) 185 (2.2) 45 (0.5) 205 (2.5) 

Southcoates East 220 (4.1) 30 (0.6) 55 (1.0) 115 (2.1) 20 (0.4) 125 (2.3) 

Southcoates West 135 (2.6) 15 (0.3) 20 (0.4) 60 (1.1) 15 (0.3) 65 (1.2) 

Area: Park 790 (2.8) 130 (0.5) 175 (0.6) 425 (1.5) 100 (0.4) 465 (1.7) 

Drypool 235 (2.8) 55 (0.6) 60 (0.7) 130 (1.5) 20 (0.2) 160 (1.9) 

Area: Riverside (East) 235 (2.8) 55 (0.6) 60 (0.7) 130 (1.5) 20 (0.2) 160 (1.9) 

Locality: East 1,610 (2.7) 330 (0.6) 410 (0.7) 905 (1.5) 200 (0.3) 1,095 (1.8) 

Myton 780 (7.2) 80 (0.7) 90 (0.8) 215 (2.0) 60 (0.6) 285 (2.6) 

Newington 325 (3.8) 50 (0.6) 60 (0.7) 125 (1.5) 45 (0.5) 150 (1.8) 

St Andrew's 295 (5.0) 35 (0.6) 45 (0.8) 110 (1.9) 30 (0.5) 150 (2.5) 

Area: Riverside (West) 1,400 (5.5) 165 (0.7) 195 (0.8) 450 (1.8) 135 (0.5) 585 (2.3) 

Boothferry 135 (1.7) 35 (0.4) 35 (0.4) 80 (1.0) 15 (0.2) 110 (1.4) 

Derringham 120 (1.7) 45 (0.6) 35 (0.5) 80 (1.1) 25 (0.4) 100 (1.4) 

Pickering 225 (3.0) 40 (0.5) 55 (0.7) 110 (1.5) 45 (0.6) 150 (2.0) 

Area: West 480 (2.2) 120 (0.5) 125 (0.6) 270 (1.2) 85 (0.4) 360 (1.6) 

Avenue 240 (2.5) 40 (0.4) 30 (0.3) 70 (0.7) 10 (0.1) 100 (1.0) 

Bricknell 70 (1.3) 10 (0.2) 10 (0.2) 35 (0.7) 10 (0.2) 60 (1.1) 

Newland 180 (2.1) 25 (0.3) 25 (0.3) 60 (0.7) 25 (0.3) 85 (1.0) 

Area: Wyke 490 (2.1) 75 (0.3) 65 (0.3) 165 (0.7) 45 (0.2) 245 (1.0) 

Locality: West 2,370 (3.3) 360 (0.5) 385 (0.5) 885 (1.2) 265 (0.4) 1,190 (1.7) 

HULL 5,200 (3.0) 935 (0.5) 1,075 (0.6) 2,485 (1.5) 610 (0.4) 2,985 (1.7)


6.5 Housing Stock and Environment 

In Hull City Council‟s Housing Strategy 2005-2008 (Hull City Council 2005), they state 

that “findings from our research clearly indicate that the supply of housing in the city 

does not meet people‟s preferences, with an oversupply of small terraced homes, and 

an undersupply of houses in the higher Council Tax bands.” In March 2007, GVA 

Grimley LLP was commissioned by Hull City Council to undertake a Housing Market 

Assessment. Within the Executive Summary report (Hull City Council 2008), it is stated 

that “more than half of Hull‟s housing is terraced which is almost twice as high as the 

national average (26%). Over 30% of Hull‟s housing stock is social rented which is 

considerably higher than the national average (18.5%). Hull has notably low proportions 

of larger family housing (three bedrooms or more) and only 6% of stock is classified as 

being detached. House prices in Hull have consistently remained below regional and 

national comparators. Furthermore, Hull has a disproportionately high rate of private 

sector vacant properties.” 

As part of the Local Area Agreement (LAA2), there is a target to improve the percentage 

of decent homes. Hull City Council has approximately 28,000 council properties (Hull 

City Council 2009) and had a baseline of 50% reaching the Decent Homes Standard 13 

for 2007/2008. The LAA2 target (ONE HULL 2006; ONE HULL 2009) is 37% for 

2008/2009, 19% for 2009/2010 and 0% for 2010/2011. The target for 2009/10 (19%) 

was achieved (www.places.communities.gov.uk). 

6.6 Educational Attainment and Absence in Hull Schools 

Table 43 gives the percentage of 15-16 year olds achieving five or more A-C grade 

GCSEs (or equivalent) between 2007 and 2009 (Department of Education 2009). As 

anticipated with Hull‟s higher levels of deprivation, educational attainment of year 11 

pupils (15-16 year olds) is considerably lower for Hull schools overall compared to 

England. The Locality of the schools is also highlighted within the table (yellow for North 

Locality, green for East Locality and orange for West Locality). Most of the schools will 

take pupils who live within the same Locality as the school, but there will also be some 

pupils from different Localities. Furthermore, there are some schools (Trinity House for 

Boys, Newland School for Girls, St Mary‟s and Hymers) who take pupils from across the 

city. Winfred Holtby is within East Locality, but mainly takes pupils from North and East 

Localities. Sirius Academy opened after January 2009 so is not included in the table. 

13 To meet the Decent Home standard, a home should be: (i) meet the current legal standard for housing; 

(ii) be in a reasonable state of repair; (iii) have reasonably modern facilities and services; and (iv) provide 

a reasonable degree of warmth. More specific information is provided at www.hullcc.gov.uk 



Table 43: Educational attainment, 2007-2009 

School Number 15 

year olds 

2008/09 

Achieving 5+ A-C GCSEs 

including England and Maths (%) 

2007 2008 2009 

Hull Average 30.0 29.6 36.9 

England Average 46.3 47.6 49.8 

Andrew Marvell 232 33 38 44 

Archbishop Sentamu 172 19 26 28 

David Lister 279 29 10 18 

Endeavour High 196 18 18 26 

Hull Trinity House # 62 64 69 71 

Hymers* # 106 27 13 22 

Kelvin Hall 195 49 48 57 

Kingswood 207 17 10 24 

Malet Lambert 266 45 51 57 

Newland Girls # 152 38 33 51 

Pickering High** 165 23 18 29 

Sir Henry Cooper 109 19 21 17 

St Mary‟s # 251 51 57 60 

Sydney Smith 247 30 23 34 

Winifred Holtby ## 300 27 32 30 

*Private school with different types of examinations taken so not comparable for English and 

Maths. 

# In a particular Locality but takes pupils from across Hull. 

## In East Locality but takes pupils from mainly North and East Locality. 

**Now closed. 

Table 44 gives the levels of absence and persistent absence for 2008/09 for maintained 

mainstream schools. Overall absence is defined as the percentage of half-days 

recorded as absent for the following reasons: 

Authorised absence due to: 

o illness; 

o medical or dental appointments; 

o religious observance; 

o study leave; 

o traveller absence; 

o agreed family holiday; 

o agreed extended family holiday; 

o excluded pupil with no alternative provision; 

o other authorised circumstances, or 

Unauthorised absence due to: 

o family holiday not agreed or excess days of an agreed family holiday; 

o pupil arriving after registers closed; 

o other unauthorised absence (missed sessions). 



Persistent absence is defined as the percentage of pupils enrolments equalling or 

exceeding the threshold number of half-day absences (set to 20% of the national 

average number of possible half-day sessions) over the Autumn and Spring terms 

combined. The persistent absence threshold for Autumn and Spring 2008/09 was 52 or 

more half-day sessions (so for all schools – for England overall – there were an average 

of 260 half-days where the school was open in the Autumn and Spring terms). 

In general, Hull schools have higher absence rates compared to the England average. 

The overall authorised and unauthorised absence rate is 9.2% for Hull schools 

combined compared to 7.3% for England. However, there is considerable variability 

among the schools with absence rates ranging from 5% to almost 15%. The persistent 

absence rates are considerably higher in Hull compared to England. One in ten pupils 

missed 20% or more half-days in the Autumn and Spring terms for 2008/2009 compared 

to 5.9% for England. Again, the percentages varied considerably among the schools 

ranging from less than 2% for St Mary‟s to 16% for David Lister, 20% for Endeavour 

High and 21% for Sir Henry Cooper. 

Table 44: Absence and persistent absence, 2008/2009 

School Absence (%), 2008/09 

Overall absence Persistent absence 

Hull Average 9.2 10.1 

England Average 7.3 5.9 

Andrew Marvell 8.0 8.6 

Archbishop Sentamu 8.5 7.5 

David Lister 11.9 15.9 

Endeavour High 14.6 19.9 

Hull Trinity House # 5.0 2.4 

Kelvin Hall 7.4 7.0 

Kingswood 9.7 11.9 

Malet Lambert 6.8 5.0 

Newland Girls # 8.2 10.6 

Pickering High** 10.0 9.1 

Sir Henry Cooper 14.2 21.2 

St Mary‟s # 5.0 1.8 

Sydney Smith 10.1 10.3 

Winifred Holtby ## 11.1 13.2 

# In a particular Locality but takes pupils from across Hull. 

## In East Locality but takes pupils from mainly North and East Locality. 

**Now closed. 



6.7 Qualifications 

From the 2001 Census, 41% of residents in Hull had no qualifications and 10% were 

qualified to degree level or higher. This compares to 29% and 20% for England and 

Wales. 

Information was collected on the highest educational qualification in the local Health and 

Lifestyle Survey in 2007 (Figure 26) for each locality. It can be seen that over one third 

of respondents in North (35%) and East (36%) Localities had no qualifications compared 

to 28% in West locality. Around one in five respondents from North and East localities 

had a degree or postgraduate qualification (19% and 21% respectively), compared with 

almost one-quarter of respondents from West locality (24%). This will be influenced by 

the location of the University and there will be a number of students who have already 

obtained a degree qualification and are currently studying for a post-graduate 

qualification. In relation to the Census, the response categories of the questions differed 

slightly, the local survey only included a sample of residents (whereas the census, in 

theory, included everyone) and the questions were completed at different times (April 

2001 for the census and January to March for the 2007 local survey). These three 

factors could have explained some of the differences observed, but the differences are 

relatively large between the two sources and this must be borne in mind when 

interpreting the results. The underlying data for this figure is given in the APPENDIX on 

page 831. 

Highest educational attainment (%) 

Figure 26: Highest educational qualification by Locality, 2007 

100% 

80% 

60% 

40% 

20% 

0% 


Locality 

None O-level A-level 

Degree/HNC Postgraduate Other 

The percentage of survey responders with no qualifications, GCSE or „A‟ levels or 

equivalent, and qualified to degree level or higher is given in Table 45 for each ward in 

Hull. There is considerable variability among the wards. In eight of the 23 wards in Hull 

more than 40% of survey respondents had no qualifications. It can be seen that wards 

near to the University have a much higher percentage of people with a degree, with the 



highest percentage in Avenue ward (41%) followed by University ward (38%). However, 

there are a number of wards where less than 15% of survey respondents had a degree 

or post-graduate qualification. 

Table 45: Highest educational qualification for responders in Hull Spring 2007 

Ward/area/locality Number 

answering 

question 

None or Basic 

Qualifications 

Highest qualification (%) 

O or A levels 

or equivalent 

HNC, degree 

or higher 

Bransholme East 22 22.7 68.2 9.1 

Bransholme West 122 51.6 44.3 4.1 

Kings Park 109 15.6 50.5 33.9 

Area: North Carr 253 33.6 49.0 17.4 

Beverley 150 35.3 41.3 23.3 

Orchard Park & Greenwood 228 50.9 41.2 7.9 

University 119 25.2 37.0 37.8 

Area: Northern 497 40.0 40.2 19.7 

Locality: North 750 37.9 43.2 18.9 

Ings 227 35.2 42.7 22.0 

Longhill 155 43.2 38.7 18.1 

Sutton 168 43.5 37.5 19.0 

Area: East 550 40.0 40.0 20.0 

Holderness 441 33.1 43.5 23.4 

Marfleet 57 54.4 38.6 7.0 

Southcoates East 100 42.0 50.0 8.0 

Southcoates West 60 46.7 38.3 15.0 

Area: Park 658 37.5 43.6 18.8 

Drypool 207 30.0 40.1 30.0 

Area: Riverside (East) 207 30.0 40.1 30.0 

Locality: East 1,415 37.4 41.7 20.9 

Myton 199 34.2 40.2 25.6 

Newington 176 34.1 49.4 16.5 

St Andrews 101 59.4 30.7 9.9 

Area: Riverside (West) 476 39.5 41.6 18.9 

Boothferry 267 33.3 50.6 16.1 

Derringham 191 34.6 45.0 20.4 

Pickering 58 6.9 72.4 20.7 

Area: West 516 30.8 51.0 18.2 

Avenue 226 23.0 36.3 40.7 

Bricknell 60 26.7 40.0 33.3 

Newland 265 26.4 41.5 32.1 

Area: Wyke 551 25.0 39.2 35.8 

Locality: West 1,543 31.4 43.9 24.7 

HULL 3,708 35.0 42.9 22.1 



6.8 Crime 

Humberside Police provide a snapshot of recorded crime data and Command and 

Control data to Citysafe from their live system on a monthly basis, and Citysafe have 

provided the information below. The information is correct when given, but the crime 

data is subject to change as records are updated; amendments are not reflected in the 

statistics held by the Crime and Disorder Reduction Partnership. 

Crime classifications are also subject to Home Office counting rules 14 which in general 

means that different crimes which are reported at the same time (and often occurred at 

the same time) are generally only counted once with the most serious crime recorded as 

having occurred. Furthermore, there will be some crimes that are not reported to the 

police. It is generally recognised from other sources such as the British Crime Survey 

(Home Office 2009) that perhaps as low as 25% of all crimes are reported. Therefore, 

the figures will be very misleading if it is assumed that these figures related to all 

recorded crime. Nevertheless, the number of reported crimes presented in Table 46 will 

give an indication of the level of crime across the different wards of Hull. Whilst some of 

the actual numbers are small, these are produced at ward level on the internet (by the 

Police) so are in the public domain. 

It can be seen that Myton has the highest level of crime due to its city centre location. 

The number of crimes does not take into account the number of dwellings, number of 

businesses, population (resident, daytime or evening visitors, etc), number of vehicles, 

etc. Therefore, it is not surprising that Myton ward has the highest levels of crime as the 

daytime and evening visitors will be higher than the resident population, and the number 

of businesses and vehicles will also be higher. 

14 Details available from http://www.homeoffice.gov.uk/rds/countrules.html 



Table 46: Number of reported crimes during the financial year 2009/10 

Ward, Area or 

Locality 

All crimes 

Serious violent 

crime 

Serious acquisitive 

crime 

Assault with less 

serious injury 

crime 

Number of reported crimes during 2009/10 by type of crime 

Deliberate primary 

fires 

Deliberate 

secondary fires 

Bransholme East 930 6 149 147 26 159 78 77 74 7 34 34 295 7 652 

Bransholme West 1045 4 141 122 10 74 69 62 119 9 24 45 292 11 591 

Kings Park 881 5 120 44 9 54 23 41 96 3 19 58 169 6 389 

North Carr 2,856 15 410 313 45 287 170 180 289 19 77 137 756 24 1,632 

Beverley 534 2 131 19 4 18 9 48 91 4 8 72 93 2 222 

Orch Pk & Grnwd 1726 14 311 240 41 112 175 152 103 24 42 104 469 13 1103 

University 1057 10 208 92 5 36 53 101 87 2 10 96 210 35 530 

Northern 3,317 26 650 351 50 166 237 301 281 30 60 272 772 50 1,855 

NORTH 6,173 41 1,060 664 95 453 407 481 570 49 137 409 1,528 74 3,487 

Ings 861 2 166 49 20 39 43 35 89 7 19 107 176 3 404 

Longhill 1003 11 144 109 15 50 52 69 54 4 19 57 247 4 582 

Sutton 768 8 149 69 10 63 50 61 106 8 29 52 198 2 503 

East 2,632 21 459 227 45 152 145 165 249 19 67 216 621 9 1,489 

Holderness 854 7 144 55 4 29 34 46 154 10 19 71 154 7 466 

Marfleet 1389 11 192 140 39 130 83 72 149 7 48 69 341 8 923 

Southcoates East 708 5 101 79 13 69 62 44 59 6 18 33 175 6 452 

Southcoates West 640 7 103 83 7 18 37 49 40 2 13 37 156 0 358 

Park 3,591 30 540 357 63 246 216 211 402 25 98 210 826 21 2,199 

Drypool 1848 24 278 169 26 68 76 69 210 19 52 142 323 28 988 

Riverside East 1,848 24 278 169 26 68 76 69 210 19 52 142 323 28 988 

EAST 8,071 75 1,277 753 134 466 437 445 861 63 217 568 1,770 58 4,676 

Myton 6,284 64 523 765 46 94 172 165 260 50 79 232 790 187 2,473 

Newington 1,534 17 247 176 23 112 119 115 91 24 36 77 326 20 950 

St Andrews 1,683 13 289 161 27 78 85 150 136 21 28 89 298 21 905 

Riverside West 9,501 94 1,059 1,102 96 284 376 430 487 95 143 398 1,414 228 4,328 

Boothferry 649 2 142 29 3 17 22 55 151 5 20 65 112 6 361 


Domestic violence 

(flagged) 

Domestic burglary 

Other burglary 

Personal robbery 

Theft of vehicle 

Theft from vehicle 

Criminal damage 

Theft from person 

Anti-social 

behaviour


Ward, Area or 

Locality 

All crimes 

Serious violent 

crime 


crime 


serious injury 

crime 

Number of reported crimes during 2009/10 by type of crime 


fires 

Deliberate 

secondary fires 

Derringham 625 4 158 28 10 9 22 53 175 2 22 84 125 1 378 

Pickering 1,271 2 198 113 10 56 47 92 158 9 43 57 307 16 964 

West 2,545 8 498 170 23 82 91 200 484 16 85 206 544 23 1,703 

Avenue 1,255 7 215 87 10 19 41 84 135 15 39 79 225 18 641 

Bricknell 581 0 125 39 6 9 16 42 159 3 12 70 95 2 214 

Newland 1,138 11 290 111 6 26 60 149 76 7 49 88 182 19 548 

Wyke 2,974 18 630 237 22 54 117 275 370 25 100 237 502 39 1,403 

WEST 15,020 120 2,187 1,509 141 420 584 905 1,341 136 328 841 2,460 290 7,434 

HULL 29,264 236 4,524 2,926 370 1,339 1,428 1,831 2,772 248 682 1,818 5,758 422 15,597 

Table 47: Rate of reported crimes per 1,000 resident population during the financial year 2009/10 

Ward, Area or 

Locality 

All crimes 

Serious violent crime 


crime 



(flagged) 


Rate of reported crimes per 1,000 resident population during 2009/10 by type of crime 


serious injury crime 


fires 

Deliberate secondary 

fires 


(flagged) 

Bransholme East 85 0.55 13.6 13.40 2.37 14.49 7.11 7.02 6.74 0.64 3.10 3.10 26.9 0.64 59.4 

Bransholme West 120 0.46 16.1 13.97 1.15 8.47 7.90 7.10 13.63 1.03 2.75 5.15 33.4 1.26 67.7 

Kings Park 98 0.56 13.4 4.91 1.00 6.03 2.57 4.58 10.72 0.33 2.12 6.48 18.9 0.67 43.4 

North Carr 100 0.52 14.3 10.92 1.57 10.01 5.93 6.28 10.08 0.66 2.69 4.78 26.4 0.84 56.9 

Beverley 64 0.24 15.7 2.27 0.48 2.15 1.08 5.75 10.89 0.48 0.96 8.62 11.1 0.24 26.6 

Orch Pk & Grnwd 116 0.94 20.8 16.08 2.75 7.51 11.73 10.19 6.90 1.61 2.81 6.97 31.4 0.87 73.9 

University 98 0.93 19.4 8.57 0.47 3.35 4.94 9.41 8.11 0.19 0.93 8.94 19.6 3.26 49.4 














Anti-social 

behaviour 

Anti-social 

behaviour


Ward, Area or 

Locality 

All crimes 

Serious violent crime 


crime 

Rate of reported crimes per 1,000 resident population during 2009/10 by type of crime 


serious injury crime 


fires 

Deliberate secondary 

fires 


(flagged) 

Northern 98 0.76 19.1 10.32 1.47 4.88 6.97 8.85 8.26 0.88 1.76 8.00 22.7 1.47 54.5 

NORTH 98 0.65 16.9 10.59 1.52 7.23 6.49 7.67 9.09 0.78 2.19 6.53 24.4 1.18 55.6 

Ings 68 0.16 13.1 3.87 1.58 3.08 3.40 2.77 7.04 0.55 1.50 8.46 13.9 0.24 31.9 

Longhill 81 0.89 11.7 8.85 1.22 4.06 4.22 5.60 4.38 0.32 1.54 4.63 20.1 0.32 47.3 

Sutton 59 0.61 11.4 5.29 0.77 4.83 3.83 4.67 8.12 0.61 2.22 3.98 15.2 0.15 38.5 

East 69 0.55 12.1 5.97 1.18 4.00 3.81 4.34 6.55 0.50 1.76 5.68 16.3 0.24 39.2 

Holderness 63 0.51 10.6 4.03 0.29 2.13 2.49 3.37 11.29 0.73 1.39 5.21 11.3 0.51 34.2 

Marfleet 102 0.81 14.1 10.29 2.87 9.56 6.10 5.29 10.95 0.51 3.53 5.07 25.1 0.59 67.8 

Southcoates East 81 0.57 11.6 9.04 1.49 7.90 7.10 5.04 6.75 0.69 2.06 3.78 20.0 0.69 51.7 

Southcoates West 79 0.87 12.8 10.31 0.87 2.23 4.59 6.08 4.97 0.25 1.61 4.59 19.4 0.00 44.4 

Park 82 0.68 12.3 8.11 1.43 5.59 4.90 4.79 9.13 0.57 2.23 4.77 18.8 0.48 49.9 

Drypool 146 1.90 22.0 13.36 2.05 5.37 6.01 5.45 16.60 1.50 4.11 11.22 25.5 2.21 78.1 

Riverside East 146 1.90 22.0 13.36 2.05 5.37 6.01 5.45 16.60 1.50 4.11 11.22 25.5 2.21 78.1 

EAST 85 0.79 13.5 7.95 1.41 4.92 4.61 4.70 9.09 0.67 2.29 6.00 18.7 0.61 49.4 

Myton 411 4.19 34.2 50.09 3.01 6.16 11.26 10.80 17.02 3.27 5.17 15.19 51.7 12.24 161.9 

Newington 120 1.32 19.2 13.71 1.79 8.73 9.27 8.96 7.09 1.87 2.80 6.00 25.4 1.56 74.0 

St Andrews 191 1.47 32.7 18.23 3.06 8.83 9.62 16.98 15.40 2.38 3.17 10.08 33.7 2.38 102.5 

Riverside West 257 2.54 28.7 29.83 2.60 7.69 10.18 11.64 13.18 2.57 3.87 10.77 38.3 6.17 117.2 

Boothferry 52 0.16 11.4 2.32 0.24 1.36 1.76 4.41 12.10 0.40 1.60 5.21 9.0 0.48 28.9 

Derringham 55 0.35 13.8 2.45 0.88 0.79 1.93 4.64 15.32 0.18 1.93 7.35 10.9 0.09 33.1 

Pickering 105 0.16 16.3 9.29 0.82 4.60 3.86 7.57 12.99 0.74 3.54 4.69 25.2 1.32 79.3 

West 71 0.22 13.8 4.71 0.64 2.27 2.52 5.55 13.42 0.44 2.36 5.71 15.1 0.64 47.2 

Avenue 93 0.52 16.0 6.46 0.74 1.41 3.04 6.23 10.02 1.11 2.89 5.86 16.7 1.34 47.6 

Bricknell 68 0.00 14.7 4.59 0.71 1.06 1.88 4.94 18.70 0.35 1.41 8.23 11.2 0.24 25.2 

Newland 102 0.99 26.0 9.97 0.54 2.34 5.39 13.38 6.83 0.63 4.40 7.90 16.3 1.71 49.2 

Wyke 90 0.54 19.0 7.16 0.66 1.63 3.53 8.31 11.17 0.76 3.02 7.16 15.2 1.18 42.4 

WEST 142 1.13 20.6 14.22 1.33 3.96 5.50 8.53 12.64 1.28 3.09 7.93 23.2 2.73 70.1 

HULL 111 0.90 17.2 11.10 1.40 5.08 5.42 6.95 10.52 0.94 2.59 6.90 21.9 1.60 59.2 









Anti-social 

behaviour


The information in Table 47 (“all crimes” column) is also presented in map format in 

Figure 27. The same caveats to the data apply as for the table, in that the data will not 

include all crimes, and the figures do not take into account the number of households or 

businesses, daytime or evening populations or number of cars, etc. As Myton is in the 

city centre, the daytime and evening populations and the number of cars parked during 

the day within Myton are much higher than its resident population will reflect. All but 

three wards, as illustrated in Figure 27 and Table 47, have 120 or fewer reported 

crimes per 1,000 resident population. However, the three wards that have the highest 

rates differ substantially, with St Andrew‟s having a rate of 191, Drypool having a rate of 

146 and Myton having a rate of 411 crimes per 1,000 resident population. The 

underlying data for the figure is given in Table 47. 

Figure 27: Reported crimes during financial year 2009/2010 per 1,000 resident 

population 



6.9 Index of Deprivation 

6.9.1 Index of Deprivation 2007 

6.9.1.1 For Geographical Areas of Hull 

The Index of Multiple Deprivation (IMD) 2007 15 (Communities and Local Government 

2007) score is a measure of deprivation derived for lower layer Super Output Area 

(LLSOA). These geographical areas have a minimum population size of 1,000 and a 

mean population size of 1,500. The IMD 2007 index is based on seven domains which 

are weighted according to their relative importance in relation to the overall score 

(weights in brackets): (i) income deprivation (22.5%); (ii) employment deprivation 

(22.5%); (iii) health deprivation and disability (13.5%); (iv) education, skills and training 

deprivation (13.5%); (v) barriers to housing and services (9.3%); (vi) living environment 

deprivation (9.3%); and (vii) crime (9.3%). The IMD 2007 score measures deprivation, 

but is not such a good measure of affluence. As it is applied to a geographical area, it 

relates to average levels of deprivation within an area. Therefore, there will be could 

well be some residents of the area who are very much more deprived than the average 

and some very much better-off relative to the average. 

Using the IMD 2007 score, Hull is ranked 11 th out of the 152 PCTs (within bottom 8%) 

and also 11 th out of the 354 local authorities (within bottom 4%). The scores for the IMD 

2007 were produced in November 2007, and represented an update to the IMD 2004. 

Hull‟s ranking improved from 2004 to 2007, from the 9 th most deprived local authority to 

the 11 th most deprived local authority. Further detailed analysis of the changes between 

the IMD 2004 and the IMD 2007 at ward, area and locality level overall and for the 

individual domains are given in a report available at www.hullpublichealth.org 

The IMD 2007 scores for all of England‟s 32,482 LLSOAs have been divided into five 

approximately equal-sized groups ranging from the 20% most deprived areas to the 

20% least deprived areas. These five groups are referred to as national quintiles. The 

national quintiles give an indication of how Hull‟s LLSOAs compare with England in 

terms of deprivation. See section 12.8 for more information about quintiles. 

Since the levels of deprivation across Hull are different from those observed nationally in 

that more deprivation is observed in Hull and that none of the 163 LLSOAs in Hull are in 

the least deprived quintile nationally and very few in the second least deprived quintile 

nationally, local comparisons of different deprivation groups have used local quintiles, 

i.e. IMD 2007 score is divided into five approximately equal-sized groups based on the 

local distribution of the score. 

The IMD 2007 scores have also been produced for each of the 23 wards (larger 

geographical areas than LLSOAs) in Hull using the scores for each LLSOA within the 

wards weighted by the estimated resident population of that LLSOA (as at October 

15 http://www.communities.gov.uk/communities/neighbourhoodrenewal/deprivation/deprivation07/ 



2007). Similarly, IMD scores have been produced for all 7,932 wards in England and 

have then been divided into five approximately equal groups in terms of their ward 

deprivation score. Table 48 gives the IMD scores for the wards of Hull. The higher the 

IMD score, the worse the deprivation. The local ranks are provided with the a value of 1 

denoting the most deprived ward locally and 23 denoting the least deprived ward locally. 

The national ranking is also given, and similarly a low value denotes more deprivation. 

The national rank percentile is provided. For example, if the value is 10, it means that 

that the ward is in the bottom 10% of deprived wards nationally or alternatively 90% of 

the wards across the country are less deprived. For Hull, the highest national percentile 

is 44 (for King‟s Park) so this means that all of Hull‟s wards are within the most deprived 

44% of all wards in England, i.e. 66% of all the wards in England are less deprived. In 

addition, eight of Hull‟s 23 wards are in the bottom 2% of wards nationally in terms of 

deprivation (St Andrew‟s being the most deprived followed by Orchard Park and 

Greenwood, Myton, Southcoates East, Marfleet, Bransholme East, Newington and 

Bransholme West). The IMD 2007 is given in brackets after each Locality and Area, 

with the exception of Riverside (East) and Riverside (West) which have been combined 

to give an average score of 53.6. The IMD 2007 score for Hull is 38.3 (compared to 

40.3 in 2004). The IMD 2007 score for England is 21.7 (as it was for the IMD 2004). 

Table 48: Index of Multiple Deprivation 2007 scores and ranks of wards in Hull 

Locality 

(IMD 

2007 

score) 

North 

(42.4) 

East 

(36.5) 

West 

(39.1) 

Area (IMD 2007 

score) 

North Carr 

(41.0) 

Northern 

(43.6) 

East 

(34.4) 

Park 

(38.5) 

Ward Index of Multiple Deprivation 2007 

IMD 

2007 

score 

(ward) 

Local 

ward rank 

(out of 23) 

National 

ward rank 

(out of 

7,932) 

National 

ward 

percentile 

Bransholme East 53.0 6 84 2 

Bransholme West 50.2 8 131 2 

Kings Park 16.4 23 2,349 44 

Beverley 16.9 21 2,842 42 

Orchard Park/Greenwood 66.0 2 28 1 

University 34.1 11 699 12 

Ings 30.1 16 1,019 16 

Longhill 44.5 9 247 4 

Sutton 28.8 17 1,315 18 

Holderness 17.6 20 2,830 40 

Marfleet 53.4 5 78 2 

Southcoates East 53.6 4 77 1 

Southcoates West 31.2 15 1,064 15 

Riverside (East) Drypool 35.6 10 866 10 


West 

(27.6) 

Wyke 

(28.7) 

Myton 63.0 3 34 1 

Newington 50.4 7 136 2 

St Andrew's 67.0 1 15 1 

Boothferry 22.1 19 1,880 29 

Derringham 26.4 18 1,598 21 

Pickering 34.0 12 749 12 

Avenue 32.1 14 784 14 

Bricknell 16.7 22 2,258 43 

Newland 33.4 13 598 12 



Figure 28 gives the national quintiles for each of the 163 LLSOAs within Hull. Over half 

(87; 53%) are within the most deprived 20% of LLSOAs nationally, one-quarter (40; 

25%) are within the second most deprived quintile, 24 (15%) in the middle quintile and 

12 (7%) in the second least deprived quintile nationally. 

Figure 28: Index of Multiple Deprivation 2007 national quintiles (at LLSOA level) 

Index of Multiple Deprivation 2007: national quintiles 

(at low er layer super output area level) 

Most deprived 

2 

3 

4 

Least deprived 

WEST 

WEST 

LOCALITY 

LOCALITY 

Derringham 

Derringham 

Boothf Boothf erry 

erry 

Pickering 

Pickering 

NORTH 

NORTH 

LOCALITY 

LOCALITY 

WEST 

WEST 

Orchard 

Orchard 

Park Park and 

and 

Greenwood 

Greenwood 

NORTHERN 

NORTHERN 

Bricknell 

Bricknell 

Univ Univ ersity 

ersity 

Newington 

Newington 

WYKE 

WYKE 

Av Av enue 

enue 


Andrew's 


Park 

Bev Bev erley 

erley 

Newland 

Newland 

My My ton 

ton 

RIVERSIDE 

RIVERSIDE 

Bransholme 

Bransholme 

East 

East 

NORTH NORTH CARR 

CARR 

Bransholme 

Bransholme 

West 

West 

Sutton 

Sutton 

Holderness 

Holderness 

Dry Dry pool 

pool 

EAST 

EAST 

Southcoates 

Southcoates 


East 

coates 

coates 

West 

West 

Longhill 

Longhill 

Marf Marf leet 

leet 


Ings 

Ings 

EAST 

EAST 

LOCALITY 

LOCALITY 

PARK 

PARK 

Source: ONS, Super Output Area Boundaries. Crown 

copyright 2004. Crown copyright material is reproduced 

with the permission of the Controller of HMSO.


Figure 29 gives the local deprivation quintiles calculated over the 163 LLSOAs for Hull. 

Figure 29: Index of Multiple Deprivation 2007 local quintiles (at LLSOA level) 

Index of Multiple Deprivation 2007: local quintiles 

(at low er layer super output area level) 

Most deprived 

2 

3 

4 

Least deprived 

WEST 

WEST 

LOCALITY 

LOCALITY 

Derringham 

Derringham 

Boothf Boothf erry 

erry 

Pickering 

Pickering 

NORTH 

NORTH 

LOCALITY 

LOCALITY 

WEST 

WEST 

Orchard 

Orchard 

Park Park and 

and 

Greenwood 

Greenwood 

Bricknell 

Bricknell 

6.9.1.2 For General Practices 

NORTHERN 

NORTHERN 

Univ Univ ersity 

ersity 

Newington 

Newington 

WYKE 

WYKE 

Av Av enue 

enue 


Andrew's 


Park 

Bev Bev erley 

erley 

Newland 

Newland 

My My ton 

ton 

RIVERSIDE 

RIVERSIDE 

Bransholme 

Bransholme 

East 

East 

NORTH NORTH CARR 

CARR 

Bransholme 

Bransholme 

West 

West 

Sutton 

Sutton 

Holderness 

Holderness 

Dry Dry pool 

pool 

EAST 

EAST 

Southcoates 

Southcoates 


East 

coates 

coates 

West 

West 

Longhill 

Longhill 

Marf Marf leet 

leet 

In a similar manner to calculating IMD 2007 at ward level, by calculating a populationweighted 

average over the LLSOAs within that ward (population as at April 2010), it is 

possible to calculate an IMD 2007 score for each general practice in Hull based on the 

deprivation scores (at LLSOA level) of the postcodes of their registered patients. In 

undertaking this calculation, there is an assumption that, in general, patients registered 

with that particular practice have a similar deprivation score based on their postcode as 

the average deprivation score of all the people living in that LLSOA geographical area 

(on average, 1,500 residents live within each LLSOA). This might not necessarily be the 

case. It is possible that the people living in the most deprived areas within a LLSOA 

might be more likely to be registered with a particular general practice due to their 

characteristics. If this is the case, the population-weighted deprivation score may result 


Ings 

Ings 

EAST 

EAST 

LOCALITY 

LOCALITY 

PARK 

PARK 

Source: ONS, Super Output Area Boundaries. Crown 

copyright 2004. Crown copyright material is reproduced 

with the permission of the Controller of HMSO.


in a lower (less deprived) score that under-estimates the level of deprivation. For 

instance, ethnicity of the patient and GP may influence the practice where the patient 

registers, people with mobility problems or do not have access to a car may be more 

likely to be registered with practices along bus routes, practices may specialise in 

particular types of patients who may live in the most deprived areas 16 , etc. Some GPs 

may have moved their practices and their practice population may live in an area that is 

not immediately nearby the practice (although the calculation above takes this into 

consideration). Therefore, the scores given in Table 49 should be used as a guide to 

the level of deprivation within each practice. Further information at practice level is 

included on the Index of Multiple Deprivation 2007 report available at 

www.hullpublichealth.org (but note that some of the practice names have changed and 

there is one new practice since the population-weighted deprivation scores were 

calculated in 2007 – the table below gives the scores weighted to an updated population 

as at April 2010 so that the score is given for new practices). The higher scores denote 

higher levels of deprivation. The ranks are also given (the most deprived practice has 

the rank of 60). 


is given from the Quality Outcomes and Framework (QOF). As the prevalence figures 

are unadjusted for influencing factors, such as the age of the patients and deprivation. 

Practices with a high proportion of elderly patients and practices in the most deprived 

areas will tend to have a higher prevalence of disease (and generally a higher 

prevalence of undiagnosed disease). See section 12.13 on page 782 for more 


level. For this reason, it is useful to examine the prevalence of disease considering the 

effects of age and deprivation for each practice. Practices have been grouped (see 

section 3.3.3.3 on page 47) into similar groups with respect to the age and deprivation 

scores of their patients, so practices can be compared more easily (say in relation to the 

prevalence of disease on QOF disease registers). 

Table 49: Index of Multiple Deprivation 2007 scores and ranks for each Hull practice 

Rank Practice 

List size Mean IMD 

code Practice name 

Apr 2010 2007 score 

44 B81002 Dr A Kumar-Choudhary 3,833 42.6 

59 B81018 Dr R K Awan & Partners 6,549 56.8 

17 B81020 Dr P C Mitchell & Partners 7,369 27.2 

15 B81021 Faith House Surgery 7,275 27.0 

20 B81049 Dr V A Rawcliffe & Partners 9,345 31.5 

8 B81094 Dr A K Datta 1,876 23.5 

13 B81095 Dr Cook 4,203 26.8 

42 B81112 Dr Ghosh Raghunath & Partners 3,491 42.5 

16 For example, The Quays practice has a relatively high proportion of patients who are homeless, drug 

addicts, asylum seekers, etc. It is likely that these patients will live in the most deprived areas of an SOA 

geographical area, and assigning the average score for the SOA to these patients may under-estimate 

their true deprivation score. 



Rank Practice 




41 B81119 Dr G Palooran & Partners 4,566 42.4 

32 B81616 Dr G T Hendow 2,570 37.1 

48 B81631 Dr R Raut 3,397 44.4 

43 B81634 Dr J Venugopal 3,031 42.6 

5 B81662 Mizzen Road Surgery 1,794 21.5 

39 B81685 Dr N A Poulose 2,400 41.3 

46 B81688 Dr K V Gopal 2,022 43.1 

11 B81690 Dr S K Ray 1,710 25.6 

45 Y02344 Northpoint 1,779 42.6 

1 Y02747 Kingswood Surgery 1,231 11.7 

57 Y02748 Haxby Orchard Park Surgery 271 53.5 

21 B81001 Dr Ali & Partners 3,352 32.9 

30 B81008 Dr J S Parker & Partners 15,031 35.2 

50 B81040 Dr P F Newman & Partners 16,760 45.4 

38 B81053 Diadem Medical Practice 10,388 41.3 

33 B81066 Dr G M Chowdhury 2,483 37.7 

28 B81074 Dr A K Rej 3,626 34.7 

35 B81080 Dr G S Malczewski 2,201 37.9 

24 B81081 Dr K M Tang & Partner 3,515 34.1 

14 B81085 Dr J W Richardson & Partners 5,294 26.9 

52 B81089 Dr Witvliet 3,593 47.7 

10 B81097 Dr R D Yagnik 1,692 24.4 

4 B81635 Dr G Dave 2,966 19.0 

12 B81644 Dr K K Mahendra 2,245 26.4 

23 B81645 East Park Practice 2,133 33.3 

26 B81646 Dr M Shaikh 1,886 34.5 

40 B81674 Dr J C Joseph 2,238 41.5 

29 B81682 Dr M Shaikh & Partners 3,743 35.0 

31 B81011 Wheeler Street Healthcare 5,230 36.0 

54 B81017 Kingston Medical Group 6,724 50.6 

49 B81027 St Andrews Group Practice 5,974 45.4 

55 B81032 Dr A W Hussain & Partners 2,416 51.8 

6 B81035 Dr W G T Sande & Partners 6,117 21.8 

27 B81038 Dr A A Mather & Partners 7,709 34.6 

56 B81046 Dr J D Blow & Partners 9,129 52.0 

47 B81047 Dr J N Singh & Partners 7,425 43.8 

16 B81048 Dr S M Hussain & Partners 9,119 27.1 

22 B81052 Dr J Musil & P J Queenan 5,743 33.2 

37 B81054 Dr M J Varma & Partners 10,794 40.7 

2 B81056 The Springhead Medical Centre 13,612 17.0 

25 B81057 Dr S MacPhie & Koul 3,301 34.1 

34 B81058 Dr M Foulds & Partner 8,672 37.9 

18 B81072 Dr R Percival & Partners 7,684 27.7 



Rank Practice 




9 B81075 Dr M K Mallik 2,233 23.9 

7 B81104 Dr J K Nayar 7,661 22.8 

36 B81675 Dr AH Tak & Dr EG Stryjakiewicz 9,417 39.4 

51 B81683 Dr A S Raghunath & Partners 1,672 47.4 

58 B81692 The Quays Medical Centre 1,738 55.1 

60 Y00955 Riverside Medical Centre 2,492 66.1 

3 Y01200 The Calvert Practice 1,781 18.2 

19 Y02786 Priory Surgery 289 30.1 

53 Y02896 Story St Practice & Walk In Centre 319 47.8 

6.9.2 Index of Deprivation 2004 and Change From 2004 to 2007 

Hull was ranked as the 9 th most deprived local authority (out of 354) based on the IMD 

2004 but improved to the 11 th most deprived based on the IMD 2007. Only one of the 

163 LLSOAs in Hull had reduced to a more deprived national quintile category (second 

least deprived national quintile to middle deprivation quintile) compared to 21 LLSOAs 

which had improved to a less deprived national quintile category 17 . For the income, 

employment, and health & disability domains less than 15% of Hull‟s LLSOAs showed 

deterioration relative to England. Whereas for the education, skills & training, crime and 

living environment domains approximately half of Hull‟s LLSOAs deteriorated relative to 

England. Eighty percent of Hull‟s LLSOAs deteriorated in relation to the barriers to 

housing and services domain with the West and North Localities more affected than 

East Locality for this domain. Therefore, the income, employment and health domains 

showed the best improvement relative to other LLSOAs within England, education, 

crime and living environment changed relatively little overall, and the access to services 

deteriorated. Of the seven domains, the greatest improvement in terms of lower 

national ranking was shown by the health domain with a 14% fall in the number of 

LLSOAs within the bottom fifth nationally. Based on the national rank of the wards, only 

two wards deteriorated in relation to other wards nationally. The national rank for 

Orchard Park and Greenwood ward fell from 28 th worst to 23 rd worst (out of 7,932) a fall 

of 18% and the rank for Drypool ward fell from 866 th worst to 825 th worst, a fall of 5%. 

The national rank for Myton ward remained exactly the same being the 34 th worst ward 

nationally. Six of the 23 wards in Hull improved their ranking nationally by more than 

40% (King‟s Park 48%; Bricknell 50%; Bransholme East 51%; Southcoates East 52%; 

Marfleet 54%; and Newlands 65%). 

Further information on the previous IMD introduced in 2004 as well as changes between 

2004 and 2007 is given in a report available at www.hullpublichealth.org 

17 However, it is possible that the deprivation score for some SOAs deteriorated, but not sufficiently to 

change quintile category. 



6.10 ACORN Classifications 

Various classifications models of different characteristics of residents have been 

produced. These classifications use various data to create groups of people who are 

deemed to be similar with regard to certain characteristics. The information used to 

assess the similarity of the people differs depending on the classification system, and 

the information is not divulged by the companies producing the classifications. 

However, in general, the type of information used are responses from the 2001 Census, 

and information relating to employment, car ownership, financial behaviour, health and 

hospital admissions, shopping behaviour, and for health specifically information from 

food consumption, and health and lifestyle surveys. Most of this information is applied 

at output area or postcode level. One such classification in common usage is the 

ACORN classification (A Classification of Residential Neighbourhoods), and there is 

also an ACORN classification specifically for health. For both the ACORN and Health 

ACORN classifications, the proportions of the resident population within each category 

will depend on levels of deprivation as well as the age structure of the population. 

As with the Index of Multiple Deprivation, the ACORN classifications are applied at a 

geographical basis, and there will be some people living in the area whose 

characteristics are very much different from the dominant ACORN category for that area. 

Therefore, the classifications for a particular area should be used as a guide only as to 

the characteristics of residents. Further information is available from CACI 18 . 

6.10.1 ACORN 

Figure 30 shows the proportion of residents within each of the five ACORN Categories 

by ward (dominant ACORN Category over all output areas within ward). The most 

homogenous wards in terms of ACORN Categories are Orchard Park and Greenwood 

and Bransholme West, in which 99% and 96% respectively of residents in October 2009 

were defined as „Hard Pressed‟ on the basis of their postcodes. The highest proportion 

of „Wealthy Achievers‟ were found in Kings Park (27%). Ten of Hull‟s 23 wards 

contained no postcodes where residents were defined as „Wealthy Achievers‟, whereas 

only one ward had no postcodes where residents were defined as „Hard Pressed‟ 

(Beverley). The underlying data, with percentages based on October 2009 population, 

are given in Table 50. 

18 http://www.caci.co.uk/ACORN/downloads/New%20ACORN%20brochure.pdf 



Figure 30: ACORN categories at ward level (pie charts) 

The dominant ACORN Categories (the highest level ACORN classification) at output 

area level 19 are shown in Figure 31. In October 2009 41% of Hull residents lived in 

output areas classified as being „Hard Pressed‟, the most deprived ACORN Category, 

with a further 32% living in output areas defined as „Moderate Means‟, the second most 

deprived ACORN Category. Only 4% of Hull‟s residents lived in output areas classified 

as „Wealthy Achievers‟, the least deprived ACORN Category, with a further 5% living in 

output areas defined as „Urban Prosperity‟, the second least deprived ACORN Category. 

The remainder, 18%, reside in output areas defined as „Comfortably Off‟. It should be 

noted that while 27% of residents of Kings Park are defined as „Wealthy Achievers‟ on 

the basis of their postcodes, when the dominant, that is most common, ACORN 

Category by output area as extracted from Insite is used, only 4% of residents are 

defined as „Wealthy Achievers, with only one output area within King‟s Park having a 

19 There are 834 output areas in Hull (which are combined to form the 163 lower layer super output areas 

on which the Index of Multiple Deprivation are based). 



majority of residents with a postcode that is defined as „Wealthy Achievers‟. One output 

area, in the industrial/dockland area of Marfleet, was unclassified for ACORN. 

Figure 31: ACORN dominant categories at output area level 

Table 50 gives the percentages of residents classified as each ACORN Category 

respectively for each ward, Area and Locality based on the postcode-level ACORN 

Categories, applied to the October 2009 population. 



Table 50: ACORN Categories by ward, area and Locality (postcode level ACORN 

classifications mapped to October 2009 population) 

Ward/area/locality 

Pop 

(Oct 

09) 

Wealthy 

Achievers 

Urban 

Prosperity 

ACORN (%) 

Comfortably 

Off 

Moderate 

Means 

Hard 

Pressed 

Bransholme East 10,973 4.8 0.0 4.8 1.5 88.6 

Bransholme West 8,733 0.0 0.0 0.5 2.8 95.9 

Kings Park 8,957 26.6 0.0 63.6 1.8 7.5 

Area: North Carr 28,663 10.2 0.0 21.8 2.0 65.5 

Beverley 8,353 2.5 7.3 48.7 41.2 0.0 

Orchard Pk&Greenwd 14,923 0.0 0.0 0.2 1.0 98.9 

University 10,734 2.2 18.2 15.9 19.2 41.6 

Area: Northern 34,010 1.3 7.5 17.0 16.6 56.5 

Locality: North 62,673 5.4 4.1 19.2 9.9 60.6 

Ings 12,651 12.0 0.0 27.3 20.1 40.0 

Longhill 12,315 0.7 0.0 16.3 3.4 79.6 

Sutton 13,051 10.9 0.4 35.4 20.1 32.1 

Area: East 38,017 8.0 0.1 26.5 14.7 50.1 

Holderness 13,640 5.1 0.3 42.9 50.5 1.2 

Marfleet 13,605 0.0 0.0 1.4 9.9 88.0 

Southcoates East 8,738 0.6 0.0 8.0 13.4 78.0 

Southcoates West 8,054 0.0 1.5 3.7 82.5 9.3 

Area: Park 44,037 1.7 0.4 16.0 36.4 44.7 

Drypool 12,654 7.0 6.3 22.9 46.1 16.5 

Area: Riverside (E) 12,654 7.0 6.3 22.9 46.1 16.5 

Locality: East 94,708 4.9 1.1 21.1 29.0 43.1 

Myton 15,272 0.0 12.9 1.4 13.7 68.9 

Newington 12,835 0.0 1.1 7.6 71.8 19.2 

St Andrew's 8,832 0.0 4.4 0.1 54.8 39.8 

Area: Riverside (W) 36,939 0.0 6.8 3.2 43.7 44.6 

Boothferry 12,475 7.0 0.1 19.4 51.9 21.5 

Derringham 11,421 0.0 0.0 13.5 63.7 22.7 

Pickering 12,161 1.2 0.7 25.0 26.8 46.0 

Area: West 36,057 2.8 0.3 19.4 47.2 30.1 

Avenue 13,477 0.0 26.3 34.8 33.0 5.1 

Bricknell 8,501 10.3 0.0 23.4 49.4 15.4 

Newland 11,134 0.0 24.8 5.5 63.7 4.0 

Area: Wyke 33,112 2.6 19.1 22.0 47.5 7.4 

Locality: West 106,108 1.8 8.4 14.6 46.1 28.1 

HULL 263,489 3.8 4.7 18.1 31.3 41.2 



There are 17 ACORN Groups and 56 ACORN Types within the five ACORN Categories. 

Table 51 gives the percentage of residents as at October 2009 within each of the 

ACORN Types, Groups and Categories (again as defined at postcode-level), for each 

Locality and for Hull overall. Specific characteristics and behaviour traits have been 

assigned to each ACORN classification, full details of which may be available from 

CACI 20 . The most common ACORN Group in Hull is 5.N „Struggling Families‟ which 

encompasses 25% of Hull‟s residents, including 49% in North Locality. This ACORN 

Group contains the second most common ACORN Type in Hull, 5.N.47 „Low Income 

Families, Terraced Estates‟, comprising 13% of Hull‟s October 2009 population, 

including one quarter of residents of North Locality. This was the most common 

ACORN Type in North Locality and in East Locality, accounting for 15% of residents) 

The most common ACORN Type was 4.M.42 „Home Owning Families, Terraces‟ with 

15% of residents, including 24% of West Locality residents, and the most common 

ACORN Type in West Locality. Only one other ACORN Type accounted for more than 

10% of Hull residents, this being „5.O.51 Single Parents and Pensioners, Council 

Terraces‟ with 11% of residents, fairly evenly spread across the three Localities. 

Table 51: ACORN classifications by Locality (postcode level ACORN classifications 

mapped to October 2009 population) 

ACORN classifications: Category, Group and Type Percentage of Locality population 

2009 by ACORN classification 

Locality 

Hull 


1.A.1 Wealthy Mature Professionals, Large Houses 0.0 0.0 0.4 0.2 

1.A.2 Wealthy Working Families with Mortgages 0.5 0.6 0.0 0.3 

1.A.3 Villages with Wealthy Commuters 0.0 0.0 0.0 0.0 

1.A.4 Well-Off Managers, Larger Houses 0.0 0.0 0.0 0.0 

1.A Wealthy Executives 0.5 0.6 0.5 0.5 

1.B.7 Old People, Detached Homes 0.0 0.2 0.0 0.1 

1.B.8 Mature Couples, Smaller Detached Homes 0.0 0.2 0.0 0.1 

1.B Affluent Greys 0.0 0.4 0.0 0.2 

1.C.9 Older Families, Prosperous Suburbs 0.4 0.2 0.8 0.5 

1.C.10 Well-Off Working Families with Mortgages 4.5 3.2 0.5 2.4 

1.C.11 Well-Off Managers, Detached Houses 0.0 0.4 0.0 0.2 

1.C.12 Large Families and Houses in Rural Areas 0.0 0.1 0.0 0.0 

1.C Flourishing Families 4.9 3.9 1.3 3.1 

1. Wealthy Achievers 5.4 4.9 1.8 3.8 

2.D.13 Well-Off Profess‟ls, Larger Houses & Converted Flats 0.2 0.0 1.5 0.6 

2.D.14 Older Professionals in Suburban Houses & Apartments 0.0 0.0 0.1 0.0 

2.D Prosperous Professionals 0.2 0.0 1.6 0.7 

2.E.16 Prosperous Young Professionals, Flats 0.0 0.0 0.1 0.0 

2.E.17 Young Educated Workers, Flats 0.0 0.0 1.0 0.4 

2.E.19 Suburban Privately Renting Professionals 0.4 0.7 0.6 0.6 






Locality 

Hull 


2.E Educated Urbanites 0.4 0.7 1.7 1.0 

2.F.20 Student Flats and Cosmopolitan Sharers 0.5 0.0 1.9 0.9 

2.F.21 Singles and Sharers, Multi-Ethnic Areas 0.1 0.0 0.1 0.0 

2.F.22 Low Income Singles, Small Rented Flats 0.1 0.4 1.4 0.7 

2.F.23 Student Terraces 2.9 0.0 1.7 1.4 

2.F Aspiring Singles 3.5 0.4 5.2 3.1 

2. Urban Prosperity 4.1 1.1 8.4 4.7 

3.G.24 Young Couples, Flats and Terraces 0.2 1.3 0.4 0.7 

3.G.25 White Collar Singles and Sharers, Terraces 1.7 0.7 5.4 2.8 

3.G Starting Out 1.9 1.9 5.9 3.5 

3.H.26 Younger White Collar Couples with Mortgages 4.0 1.8 1.2 2.1 

3.H.27 Middle Income, Home Owning Areas 0.0 0.1 0.2 0.1 

3.H.28 Working Families with Mortgages 1.6 3.8 1.2 2.2 

3.H.29 Mature Families in Suburban Semis 0.9 1.3 1.1 1.1 

3.H.30 Established Home Owning Workers 4.8 8.1 2.9 5.2 

3.H Secure Families 11.4 15.1 6.6 10.8 

3.I.32 Retired Home Owners 1.1 0.7 0.6 0.7 

3.I.33 Middle Income, Older Couples 0.7 1.2 0.3 0.7 

3.I.34 Lower Incomes, Older People, Semis 3.8 2.0 1.2 2.1 

3.I Settled Suburbia 5.6 3.9 2.0 3.6 

3.J.35 Elderly Singles, Purpose Built Flats 0.0 0.1 0.1 0.1 

3.J.36 Older People, Flats 0.4 0.1 0.0 0.2 

3.J Prudent Pensioners 0.4 0.2 0.1 0.2 

3. Comfortably Off 19.2 21.1 14.6 18.1 

4.K.38 Low Income Asian Families 0.0 0.0 0.1 0.1 

4.K Asian Communities 0.0 0.0 0.1 0.1 

4.L.39 Skilled Older Families, Terraces 3.5 3.9 5.4 4.4 

4.L.40 Young Working Families 1.0 6.6 3.7 4.1 

4.L Post Industrial Families 4.5 10.5 9.1 8.5 

4.M.41 Skilled Workers, Semis and Terraces 1.5 1.7 2.4 1.9 

4.M.42 Home Owning Families, Terraces 2.9 12.5 23.6 14.7 

4.M.43 Older People, Rented Terraces 1.0 4.3 10.8 6.1 

4.M Blue Collar Roots 5.4 18.5 36.8 22.8 

4. Moderate Means 9.9 29.0 46.1 31.3 

5.N.44 Low Income Larger Families, Semis 0.3 0.7 0.1 0.4 

5.N.45 Low Income, Older people, Smaller Semis 0.1 1.6 1.0 1.0 

5.N.46 Low Income, Routine Jobs, Terraces and Flats 0.3 0.1 0.1 0.2 

5.N.47 Low Income Families, Terraced Estates 24.6 14.8 5.2 13.3 

5.N.48 Families and Single Parents, Semis and Terraces 9.3 6.1 2.2 5.3 

5.N.49 Large Families and Single Parents, Many Children 14.1 4.6 0.4 5.2 





Locality 

Hull 


5.N Struggling Families 48.9 27.9 9.1 25.3 

5.O.50 Single Elderly People, Council Flats 0.6 1.5 2.7 1.8 

5.O.51 Single Parents and Pensioners, Council Terraces 9.4 12.0 11.4 11.1 

5.O.52 Families and Single Parents, Council Flats 0.1 0.1 0.1 0.1 

5.O Burdened Singles 10.2 13.6 14.2 13.0 

5.P.53 Old People, Many High Rise Flats 1.1 1.2 3.1 1.9 

5.P.54 Singles and Single Parents, High Rise Estates 0.5 0.4 1.8 1.0 

5.P High Rise Hardship 1.6 1.6 4.8 2.9 

5. Hard Pressed 60.6 43.1 28.1 41.2 

Total population as at October 2009 62,673 94,708 106,108 263,489 

6.10.2 Health ACORN 

While not a measure of deprivation, the Health ACORN geo-demographic profiles 

indicate where current and future health needs are likely to be greatest. Figure 32 

shows the proportion of residents within the four Health ACORN Groups (the top level 

classification) by ward (dominant category over all output areas within that ward). The 

underlying data, using the October 2009 population, are given in Table 52. Seven of 

Hull‟s 23 wards have more than half their residents defined as „Healthy‟ based on 

postcode of residence, including at least two thirds of residents of Beverley (74%), 

Holderness (69%) and Avenue (66%). Only two wards had more than half their 

residents living in output areas defined as having „Existing Problems‟; Longhill (66%) 

and Ings (56%). A further ten wards had more than half their residents living in output 

areas defined as having „Future Problems‟, including three wards with at least 80% 

defined as „Future Problems‟; Bransholme East (88%), Orchard Park and Greenwood 

(85%) and St Andrews (80%). When „Existing Problems‟ and „Future Problems‟ were 

combined 11 of Hull‟s 23 wards have more than half their residents in one of these two 

Health ACORN Groups, including more than 90% of residents of six wards; Bransholme 

West (99.5%), Orchard Park and Greenwood (99%), St Andrews (99%), Myton (95%), 

Marfleet (93%) and Bransholme East (91%). 



Figure 32: Health ACORN categories at ward level (pie charts) 

The dominant Health ACORN Groups (the highest level Health ACORN classification) at 

output area level 21 are shown in Figure 33. In October 2009 21% of Hull residents lived 

in output areas classified as being „Existing Problems‟, the least healthy Health ACORN 

Group, with a further 36% living in output areas defined as „Future Problems‟, the 

second least healthy Health ACORN Group. A further 11% of Hull‟s residents lived in 

output areas classified as „Possible Future Concerns‟, while 31% of Hull‟s residents lived 

in output areas defined as „Healthy‟. Three output areas, covering the University as well 

as industrial/dockland areas of Marfleet and Myton, were unclassified for Health 

ACORN. 

21 There are 834 output areas in Hull (which are combined to form the 163 lower layer super output areas 

on which the Index of Multiple Deprivation are based). 



Figure 33: Dominant Health ACORN Groups at output area level 

Table 52 gives the percentages of residents classified as each Health ACORN Group 

for each ward, Area and Locality based on the postcode-level Health ACORN Groups, 

applied to the October 2009 population. 



Table 52: Health ACORN Groups by ward, area and Locality (postcode level ACORN 


Ward/area/locality Population 

(Oct 2009) Existing 

Healthy ACORN (%) 

Future Possible Future Healthy 

Problems Problems Concerns 

Bransholme East 10,973 2.7 88.0 0.0 9.2 

Bransholme West 8,733 47.8 51.7 0.5 0.0 

Kings Park 8,957 4.7 7.0 34.7 53.6 

Area: North Carr 28,663 17.1 51.6 11.0 20.3 

Beverley 8,353 10.6 0.0 15.1 74.3 

Orchard Pk & Greenwd 14,923 14.5 84.6 1.0 0.0 

University 10,734 14.3 32.6 15.2 29.3 

Area: Northern 34,010 13.5 47.4 8.9 27.5 

Locality: North 62,673 15.1 49.3 9.9 24.2 

Ings 12,651 56.4 7.0 9.7 26.8 

Longhill 12,315 66.4 18.6 7.9 7.1 

Sutton 13,051 13.5 31.1 6.6 48.8 

Area: East 38,017 44.9 19.1 8.1 28.0 

Holderness 13,640 3.9 10.5 16.7 68.9 

Marfleet 13,605 34.9 58.3 4.9 0.3 

Southcoates East 8,738 26.9 57.9 5.2 10.0 

Southcoates West 8,054 7.9 25.8 32.2 34.1 

Area: Park 44,037 18.8 37.5 13.6 29.6 

Drypool 12,654 14.8 34.8 18.1 32.2 

Area: Riverside (E) 12,654 14.8 34.8 18.1 32.2 

Locality: East 94,708 28.7 29.7 12.0 29.3 

Myton 15,272 25.7 69.3 0.5 2.8 

Newington 12,835 9.6 67.5 15.3 7.6 

St Andrew's 8,832 18.5 80.0 1.5 0.0 

Area: Riverside (W) 36,939 18.4 71.2 5.9 3.8 

Boothferry 12,475 22.7 1.9 17.1 58.2 

Derringham 11,421 23.6 0.8 26.3 49.3 

Pickering 12,161 48.6 18.8 8.9 23.6 

Area: West 36,057 31.7 7.3 17.3 43.8 

Avenue 13,477 6.1 20.4 7.6 65.8 

Bricknell 8,501 21.9 0.0 15.6 62.5 

Newland 11,134 10.2 39.0 11.6 39.2 

Area: Wyke 33,112 11.5 21.4 11.0 56.0 

Locality: West 106,108 20.8 33.9 11.4 33.7 

HULL 263,489 22.3 36.1 11.2 29.9 



There are 25 Health ACORN Types within the four health ACORN Groups. Table 53 

gives the percentage of people within the 25 health ACORN Types and 4 Health 

ACORN Groups (again as defined at postcode-level) for each Locality and for Hull 

overall. Full details of the specific characteristics assigned to each Health ACORN 

classification may be available from CACI 22 . The most common Health ACORN Group 

in Hull and for each Locality was „Future Problems‟ which encompasses 36% of Hull‟s 

residents, including half of North Locality residents. This Health ACORN Group contains 

the most common Health ACORN Type in Hull, 2.11 „Urban estates with sedentary 

lifestyle and low fruit and vegetable consumption‟, comprising 14% of Hull‟s October 

2009 population, and the most common Health ACORN Type in North Locality (22% of 

residents) and East Locality (11% of residents). The most common ACORN Type in 

West Locality was 2.13 „Disadvantaged multi ethnic younger adults, with high levels of 

smoking‟ at almost 13%, closely followed by 4.23 „Towns and villages with average 

health and diet‟ at more than 12%. East Locality had the highest proportion of residents 

defined as having „Existing Problems‟, at 29% almost double the proportion in North 

Locality, while West Locality had the highest proportion of residents defined as „Healthy‟ 

at 34%, compared with 29% and 25% in East and North Localities respectively. 

Table 53: Health ACORN classifications by Locality (postcode level Health ACORN 


Health ACORN classifications: Group and Type Percentage of locality population 


Locality Hull 


1.1 - Older couples, traditional diets, cardiac issues 0.6 1.2 1.4 1.1 

1.2 - Disadvantaged elderly, poor diet, chronic health 0.5 1.6 1.9 1.4 

1.3 - Vulnerable disadvantaged, smokers with high obesity levels 2.8 1.8 2.5 2.3 

1.4 - Post industrial pensioners with long term illness 1.2 5.1 2.4 3.1 

1.5 - Deprived neighbourhoods with poor diet, smokers 3.5 5.9 4.9 4.9 

1.6 - Elderly with associated health issues 1.3 4.0 2.1 2.6 

1.7 - Home owning pensioners, traditional diets 0.7 1.2 0.7 0.9 

1.8 - Disadvntgd neighbrhoods – poor diet & severe health issues 4.7 8.1 4.9 6.0 

1 Existing Problems 15.3 28.8 20.8 22.4 

2.9 - Poor single parent families with lifestyle related illnesses 17.5 5.8 0.7 6.5 

2.10 - Multi-ethnic, high smoking, high fast food consumption 8.9 1.8 5.1 4.8 

2.11 - Urban estates with sedentary lifestyle and low 5-A-DAY 22.1 11.5 10.4 13.6 

2.12 - Deprived multi-ethnic estates, smokers and overweight 1.4 5.6 5.1 4.4 

2.13 - Disadvntgd multi ethnic younger adults, high smoking levels 0.2 5.1 12.6 7.0 

2 Future Problems 50.1 29.8 34.0 36.3 

3.14 - Less affluent neighbrhoods, high fast food, sedentary lifstyle 2.2 1.9 2.5 2.2 

3.15 - Affluent healthy pensioners dining out 0.0 0.4 0.1 0.2 

3.16 - Home owning older couples, high levels fat & confectionary 0.7 1.3 0.4 0.8 

3.17 - Affluent professionals, high alcohol consumption, dining out 0.6 0.0 1.4 0.7 




Health ACORN classifications: Group and Type Percentage of locality population 


Locality Hull 


3.18 - Low income families with some smokers 2.2 7.5 7.1 6.1 

3.19 - Affluent families with some dietary concerns 4.3 1.0 0.0 1.4 

3 Possible Future Concerns 10.0 12.0 11.4 11.3 

4.20 - Young mobile population with good health and diet 4.5 4.9 11.2 7.3 

4.21 - Younger affluent, healthy professionals 1.9 3.0 1.8 2.3 

4.22 - Students and young professionals, living well 3.2 2.2 1.1 2.0 

4.23 - Towns and villages with average health and diet 7.7 8.9 12.4 10.0 

4.24 - Mixed communities with better than average health 3.7 6.2 4.3 4.8 

4.25 - Affluent towns and villages with excellent health and diet 3.6 4.3 3.1 3.6 

4 Healthy 24.6 29.4 33.8 30.0 

Total population as at October 2009 62,673 94,708 106,108 263,489 



7 MEASURES OF GENERAL HEALTH STATUS 

7.1 General Health 

The local Health and Lifestyle Survey conducted during 2007 and the more recent 

Prevalence Survey conducted during 2009 collected information on general health. 

More information about the local surveys is available in section 13.2 on page 790 and 

more information about definitions from these surveys in section 13.4 on page 805. 

Responders were asked to rate their health as excellent, very good, good, fair or poor. 

Figure 34 illustrates their responses from the Prevalence Survey for each Locality. It 

can be seen that there is very little variation among the three Localities. The underlying 

data are given in the APPENDIX on page 832. 

Health Status (%) 

Figure 34: Self-rated general health by Locality, 2009 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 


Locality 

Table 54 gives the percentage rating their health as „excellent‟ or „very good‟, as „good‟ 

or as „fair‟ or „poor‟ for each ward, Area and Locality in Hull from the Prevalence Survey 

2009. There is more variability in the percentage of survey responders rating their health 

as „fair‟ or „poor‟ among the wards compared to among the localities, with the percentages 

ranging from 11.1% in Beverley to 47.7% in Bransholme West. 


Poor 

Fair 

Good 

Very good 

Excellent


Table 54: General health status in adults, 2009 


answering 

question 

General health status, 2009 (%) 

Excellent or 

very good Good Fair or poor 

Bransholme East 65 41.5 33.8 24.6 

Bransholme West 44 13.6 38.6 47.7 

Kings Park 58 50.0 32.8 17.2 

Area: North Carr 167 37.1 34.7 28.1 

Beverley 54 53.7 35.2 11.1 

Orchard Park & Greenwood 82 29.3 43.9 26.8 

University 84 35.7 45.2 19.0 

Area: Northern 220 37.7 42.3 20.0 

Locality: North 387 37.5 39.0 23.5 

Ings 90 40.0 34.4 25.6 

Longhill 80 31.3 41.3 27.5 

Sutton 84 33.3 32.1 34.5 

Area: East 254 35.0 35.8 29.1 

Holderness 89 38.2 42.7 19.1 

Marfleet 81 29.6 46.9 23.5 

Southcoates East 70 35.7 25.7 38.6 

Southcoates West 55 32.7 27.3 40.0 

Area: Park 295 34.2 36.9 28.8 

Drypool 84 48.8 33.3 17.9 

Area: Riverside (East) 84 48.8 33.3 17.9 

Locality: East 633 36.5 36.0 27.5 

Myton 95 27.4 43.2 29.5 

Newington 86 26.7 41.9 31.4 

St Andrews 62 35.5 35.5 29.0 

Area: Riverside (West) 243 29.2 40.7 30.0 

Boothferry 85 41.2 34.1 24.7 

Derringham 81 45.7 33.3 21.0 

Pickering 62 30.6 37.1 32.3 

Area: West 228 39.9 34.6 25.4 

Avenue 99 47.5 38.4 14.1 

Bricknell 55 52.7 27.3 20.0 

Newland 98 50.0 38.8 11.2 

Area: Wyke 252 49.6 36.1 14.3 

Locality: West 723 39.7 37.2 23.1 

HULL 1,743 38.0 37.2 24.8 



Table 55 gives the general health status of young people in the Young People Health 

and Lifestyle Survey 2008-09 by gender and school year. 

Table 55: General health status in young people, 2008-09 

Gender School Number General health (ignoring do not know) (%) 

year answering 

Very 

question Excellent good Good Fair Poor 

7 305 23.6 36.4 31.5 7.9 0.7 

8 274 19.3 41.2 30.7 6.9 1.8 

Males 

9 

10 

260 

320 

18.5 

18.4 

38.1 

38.8 

32.3 

32.8 

9.6 

6.9 

1.5 

3.1 

11 186 21.5 40.3 29.6 6.5 2.2 

Total 1,345 20.2 38.8 31.5 7.6 1.9 

7 310 19.0 37.1 33.2 9.4 1.3 

8 283 9.5 42.0 38.5 8.1 1.8 

Females 

9 

10 

255 

330 

11.4 

4.2 

34.5 

34.5 

42.0 

42.1 

10.6 

17.3 

1.6 

1.8 

11 262 9.2 31.7 41.2 16.0 1.9 

Total 1,440 10.6 36.0 39.3 12.4 1.7 



7.1.1 General Health in Relation to Deprivation 

For Hull, as illustrated in Figure 35, there is a clear trend with deprivation, with 31.3% of 

those living in the most deprived areas rating their health as „fair‟ or „poor‟ compared to 

only 17.2% of those living in the least deprived areas from the local Prevalence Survey 

2009. The trend is statistically significant ( 2 test for trend, X=26.1, p


7.2 Long-Standing Illness or Disability 

From the Compendium, the standardised limiting long-term illness (LLI) ratio for 2001 is 

given in Table 56. The local ratios are compared with England and Wales (100). It can 

be seen that Hull PCTs have a ratio that is over 20% higher in those aged less than 65 

years compared to England and Wales but lower than that for the Office for National 

Statistics Area Classification group Industrial Hinterlands to which Hull belongs. The 

percentage with LLI becomes closer to England and Wales as age increases. 

Table 56: Standardised limited long-term illness ratios for 2001 

Geographical area Limiting long-term illness standardised ratio, 2001 

Males aged (years) Females aged (years) 


Figure 37: Limiting illness and disability for East Locality, 2009 

Figure 38: Limiting illness and disability for West Locality, 2009 

Limiting long-term illness or disability (%) 

Limiting long-term illness or disability (%) 

50 

40 

30 

20 

10 

0 

50 

40 

30 

20 

10 

0 

Myton 

Ings 

Newington 

Longhill 

St Andrews 

Sutton 

Area: Riverside (West) 

Area: East 

Boothferry 

Holderness 

Marfleet 


Ward, Area or Locality 

Derringham 

Pickering 

Ward, Area or Locality 

Area: West 


Avenue 

Area: Park 


Bricknell 

Drypool 

Newland 

Area: Wyke 

Area: Riverside (East) 

Locality: West 

Locality: East


The population projections for the estimated number of people aged 65+ years with 

limiting long-term illness and disability for 2010 and 2025 are given in Table 385. 

Table 57 gives the percentage of young people who state that they have a limiting longterm 

illness or disability in the Young People Health and Lifestyle Survey 2008-09 by 

gender and school year. Just less than 10% stated that they had a limiting long-term 

illness or disability that limited their activities. 

Table 57: Limiting long-term illness in young people, 2008-09 

Gender School Number answering Stating they have limiting long-term 

year 

question 

illness of disability (%) 

7 300 24 (8.0) 

8 269 16 (6.0) 

Males 

9 

10 

261 

316 

25 (9.6) 

35 (11.1) 

11 180 17 (9.4) 

Total 1,326 117 (8.8) 

7 304 34 (11.2) 

8 280 23 (8.1) 

Females 

9 

10 

248 

327 

25 (10.1) 

35 (10.7) 

11 260 19 (7.3) 

Total 1,419 136 (9.6) 



7.2.1 Long-Standing Limiting Illness or Disability in Relation to Deprivation 

There is a clear positive trend in the percentage of adults reporting a limiting illness or 

disability with deprivation as illustrated in Figure 39 (30.6% of those in the most 

deprived group compared to 18.4% in the least deprived group, 2 test for trend, X=24.1, 

p


7.3 Learning Disabilities 

7.3.1 Diagnosed and Modelled Prevalence, 

As part of the Quality and Outcomes Framework (QOF), general practices compile 

disease and medical condition registers. From these registers, the prevalence of these 

various conditions can be estimated. However, there may be a high proportion of 

patients who have the disease or medical condition, but it is undiagnosed and the 

patient is not included on the register(s). Furthermore, the figures are unadjusted for 

influencing factors, such as the age of the patients and deprivation. Practices with a 

high proportion of elderly patients and practices in the most deprived areas will tend to 

have a higher prevalence of disease (and generally a higher prevalence of undiagnosed 

disease) so practices have been grouped based on age and deprivation into similar 

groups (see section 3.3.3.3 on page 47). See section 12.13 on page 782 for more 


level. Also see Table 49 for mean deprivation scores for each practice (which will 

influence the prevalence on the disease registers). There is one such register for 

learning disabilities for those aged 18+ years, and for this condition specifically, there is 

no reason to suppose that the prevalence will increase with increasing age of the 

practice patients (unlikely the majority of the other QOF registers). 

Table 58 presents the information for learning disabilities for patients aged 18+ years for 

all the general practices in Hull for 2009/10. Frequently the QOF „prevalence‟ figures 

are presented out of the total registered population, but this is not an accurate measure 

of prevalence in the population if it differs from the numerator. The numerator for 

learning disabilities is the number of people aged 18+ years who have learning 

disabilities, so the denominator also uses the population aged 18+ years. The QOF 

takes the prevalence as at 31 st March 2010 and the practice population as at 1 st January 

2010, therefore, there can be a biased prevalence estimate if the practice population 

has changed considerably over the three month period (such as new practices). 

The latest list size refers to the registered population as at 1 st January 2010, but the 

number and prevalence on the disease register is as at 31 st March 2010 (the same 

definitions used in QOF), and this means that the prevalence can be biased if large 

population changes have occurred over this three month period (e.g. Y02747, Y02786, 

Y02896 and Y02748 all opened between 5 th October 2009 and 11 th January 2010). 



Table 58: Prevalence of diagnosed learning disabilities for those aged 18+ years based 

on GP disease registers 2009/10 

Practice 

code 

Practice name Registered 

population 

Registered 

population 

aged 18+ 

years 

Prevalence on learning 

disabilities on GP disease 

registers 2009/10 

Number % 

B81035 Dr Sande & Partners 6,114 4,891 16 0.33 

B81056 Springhead Med Centr 13,489 10,387 28 0.27 

B81104 Dr J K Nayar 7,721 5,559 2 0.04 

B81635 Dr G Dave 2,967 2,403 4 0.17 

B81662 Mizzen Road Surgery 1,856 1,540 4 0.26 

Y01200 The Calvert Practice 1,765 1,359 5 0.37 

Y02747 Kingswood Surgery 902 667 2 0.30 

B81020 Dr Mitchell & Partners 7,512 5,859 34 0.58 

B81021 Faith House Surgery 7,257 5,660 27 0.48 

B81075 Dr M K Mallik 2,263 1,924 2 0.10 

B81085 Dr Richardson & Partrs 5,299 4,292 8 0.19 

B81094 Dr A K Datta 1,925 1,540 2 0.13 

B81095 Dr Cook 4,242 3,394 11 0.32 

B81097 Dr R D Yagnik 1,688 1,418 2 0.14 

B81690 Dr S K Ray 1,734 1,353 1 0.07 

B81001 Dr Ali & Partners 3,358 2,552 6 0.24 

B81008 Dr Parker & Partners 15,062 11,598 65 0.56 

B81048 Dr SM Hussain & Ptrs 9,048 6,876 17 0.25 

B81049 Dr Rawcliffe & Partners 9,354 7,016 24 0.34 

B81052 Dr Musil & Queenan 5,740 4,477 8 0.18 

B81072 Dr Percival & Partners 7,807 6,011 10 0.17 

B81644 Dr K K Mahendra 2,245 1,684 2 0.12 

Y02786 Priory Surgery 141 92 1 1.09 

B81011 Wheeler St Healthcare 5,243 4,090 22 0.54 

B81038 Dr Mather & Partners 7,732 6,108 28 0.46 

B81057 Dr S MacPhie & Koul 3,345 2,676 12 0.45 

B81074 Dr A K Rej 3,639 2,838 8 0.28 

B81081 Dr K M Tang & Partner 3,520 2,746 6 0.22 

B81645 East Park Practice 2,128 1,724 4 0.23 

B81646 Dr M Shaikh 1,949 1,501 6 0.40 

B81682 Dr M Shaikh & Partners 3,726 2,795 11 0.39 

B81053 Diadem Med Practice 10,232 7,879 31 0.39 

B81054 Dr Varma & Partners 10,851 8,681 10 0.12 

B81058 Dr M Foulds & Partner 8,722 7,065 26 0.37 

B81066 Dr G M Chowdhury 2,522 1,942 7 0.36 

B81080 Dr G S Malczewski 2,216 1,795 7 0.39 

B81616 Dr G T Hendow 2,571 1,954 6 0.31 

B81002 Dr A Kumar-Choudhary 3,844 2,691 18 0.67 

B81112 Dr Ghosh Raghunath & Ptnrs 3,498 2,484 31 1.25 

B81119 Dr Palooran & Partners 4,593 3,307 22 0.67 

B81634 Dr J Venugopal 3,044 2,192 17 0.78 



Practice 

code 


population 

Registered 

population 

aged 18+ 

years 

Prevalence on learning 

disabilities on GP disease 


Number % 

B81674 Dr J C Joseph 2,241 1,591 5 0.31 

B81675 Drs Tak & Stryjakiewicz 9,476 7,012 13 0.19 

B81685 Dr N A Poulose 2,444 1,735 10 0.58 

B81688 Dr K V Gopal 2,009 1,446 13 0.90 

Y02344 Northpoint 1,645 1,201 4 0.33 

B81027 St Andrews Grp Practic 5,976 4,661 27 0.58 

B81040 Dr Newman & Partners 16,805 12,436 23 0.18 

B81047 Dr Singh & Partners 7,377 5,828 16 0.27 

B81089 Dr Witvliet 3,583 2,580 10 0.39 

B81631 Dr R Raut 3,425 2,329 22 0.94 

B81683 Dr Raghunath & Ptnrs 1,644 1,217 4 0.33 

Y02896 Story St Pract & WalkIn 343 267 0 0.00 

B81017 Kingston Medical Grp 6,800 5,440 28 0.51 

B81018 Dr Awan & Partners 6,602 4,753 19 0.40 

B81032 Dr AW Hussain & Ptnrs 2,478 2,007 5 0.25 

B81046 Dr J D Blow & Partners 9,068 6,620 20 0.30 

B81692 Quays Medical Centre 1,814 1,560 6 0.38 

Y00955 Riverside Med Centre 2,556 1,968 11 0.56 

Y02748 Haxby Orchard Pk Surg 60 39 0 0.00 

North Locality 68,517 51,160 267 0.52 

North Locality* 67,555 50,454 265 0.53 

East Locality 83,180 63,772 205 0.32 

West Locality 137,513 106,775 317 0.30 

West Locality* 137,029 106,417 316 0.30 

HULL 289,210 221,707 789 0.36 

HULL* 287,764 220,643 786 0.36 

*North Locality excludes Y02747 and Y02748, and West Locality excludes Y02786 and Y02896 

as these only opened in October 2009 or thereafter, so the prevalence could be biased due to 

the timing associated with QOF with population measured in January and numbers on the 

register measured in March. 



Table 59 presents the prevalence of diagnosed learning disabilities for those aged 18+ 

years for 2009/10 for Hull and comparator areas (see section 3.3.3 on page 44) and 

England. Hull has the lowest prevalence estimates in relation to its comparators. 

Table 59: Prevalence of diagnosed learning disabilities based on GP registers 2009/10, 

Hull versus comparator areas 

PCT Number 

of 

practices 

Total practice 

population 

Population 

18+ 

On learning 

disabilities GP 

register 

N % 

England 8,305 54,836,561 42,613,280 179,064 0.42 

Hull 60 289,210 221,707 789 0.36 

Sunderland 55 284,551 223,324 1,227 0.55 

Middlesbrough 25 153,187 116,030 745 0.64 

Salford 54 242,922 186,193 944 0.51 

Derby City 33 294,438 225,334 972 0.43 

Leicester City 66 360,251 267,528 1,343 0.50 

Coventry 65 357,743 271,656 1,159 0.43 

Wolverhampton 55 258,235 198,457 884 0.45 

Sandwell 67 339,020 257,006 1,152 0.45 

Stoke-On-Trent 57 280,265 215,633 1,375 0.64 

Plymouth 43 270,338 209,693 1,299 0.62 

Average of 10 520 2,840,950 2,170,855 11,100 0.51 

NE Lincs 34 169,565 131,676 724 0.55 

The number of patients with diagnosed learning disabilities and the prevalence as 

recorded on the GP QOF disease registers (aged 18+ years) is illustrated over time in 

Table 60 for 2006/07 to 2008/09 (the disease registers commenced 2004/05, but the 

learning disabilities was a new measure introduced 2006/07). The latest list size refers 

to the registered population as at 1 st January 2010, but the number and prevalence on 

the disease register is as at 31 st March 2010 (the same definitions used in QOF), and 

this means that the prevalence can be biased if large population changes have occurred 

over this three month period (e.g. Y02747, Y02786, Y02896 and Y02748 all opened 

between 5 th October 2009 and 11 th January 2010). The latest list size for B81668 (Dr 

EG Stryjakiewicz) relates to 2006/07. Some practices were not in existence for all the 

years so information is not applicable (N/A). 



Table 60: Numbers and prevalence of diagnosed learning disabilities (aged 18+ years) 

on GP QOF disease registers, 2006/07 to 2009/10 

Code Latest 

pop 

18+ 

Number and prevalence on learning disabilities QOF register 18+ 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81035 4,891 13 0.21 10 0.20 10 0.20 16 0.33 

B81056 10,387 9 0.07 9 0.09 19 0.19 28 0.27 

B81104 5,559 2 0.03 1 0.02 2 0.04 2 0.04 

B81635 2,403 6 0.19 4 0.16 4 0.16 4 0.17 

B81662 1,540 7 0.30 8 0.42 5 0.28 4 0.26 

Y01200 1,359 3 0.19 4 0.30 4 0.30 5 0.37 

Y02747 667 N/A N/A N/A N/A N/A N/A 2 0.30 

B81020 5,859 17 0.23 19 0.33 36 0.60 34 0.58 

B81021 5,660 23 0.32 24 0.42 24 0.41 27 0.48 

B81075 1,924 2 0.08 2 0.10 2 0.10 2 0.10 

B81085 4,292 1 0.02 7 0.16 6 0.14 8 0.19 

B81094 1,540 2 0.09 3 0.16 4 0.23 2 0.13 

B81095 3,394 9 0.23 8 0.24 9 0.27 11 0.32 

B81097 1,418 2 0.12 1 0.07 2 0.14 2 0.14 

B81690 1,353 1 0.06 1 0.07 1 0.07 1 0.07 

B81001 2,552 6 0.21 5 0.22 5 0.20 6 0.24 

B81008 11,598 53 0.36 51 0.44 52 0.45 65 0.56 

B81048 6,876 2 0.02 3 0.04 15 0.21 17 0.25 

B81049 7,016 26 0.31 25 0.37 23 0.33 24 0.34 

B81052 4,477 10 0.19 6 0.14 7 0.16 8 0.18 

B81072 6,011 9 0.13 7 0.12 7 0.12 10 0.17 

B81644 1,684 3 0.13 2 0.12 3 0.18 2 0.12 

B81668 2,546 0 0.00 N/A N/A N/A N/A N/A N/A 


B81011 4,090 22 0.40 6 0.14 8 0.19 22 0.54 

B81038 6,108 28 0.36 30 0.48 29 0.47 28 0.46 

B81057 2,676 11 0.30 11 0.38 11 0.40 12 0.45 

B81074 2,838 9 0.14 9 0.19 5 0.17 8 0.28 

B81081 2,746 4 0.11 4 0.15 4 0.15 6 0.22 

B81645 1,724 3 0.11 2 0.09 3 0.16 4 0.23 

B81646 1,501 7 0.28 6 0.32 6 0.37 6 0.40 

B81682 2,795 6 0.16 4 0.14 8 0.28 11 0.39 

B81053 7,879 25 0.25 29 0.37 26 0.33 31 0.39 

B81054 8,681 6 0.05 7 0.08 8 0.09 10 0.12 

B81058 7,065 27 0.29 17 0.23 22 0.30 26 0.37 

B81066 1,942 9 0.37 5 0.26 5 0.25 7 0.36 

B81080 1,795 11 0.43 10 0.52 10 0.54 7 0.39 

B81616 1,954 3 0.11 2 0.10 3 0.15 6 0.31 

B81002 2,691 10 0.33 11 0.51 13 0.59 18 0.67 

B81112 2,484 17 0.46 32 1.24 37 1.42 31 1.25 

B81119 3,307 10 0.22 9 0.27 17 0.49 22 0.67 

B81634 2,192 14 0.45 15 0.66 15 0.67 17 0.78 

B81674 1,591 2 0.11 2 0.14 3 0.20 5 0.31 



Code Latest 

pop 

18+ 

Number and prevalence on learning disabilities QOF register 18+ 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81675 7,012 5 0.10 5 0.12 4 0.06 13 0.19 

B81685 1,735 9 0.35 6 0.33 8 0.44 10 0.58 

B81688 1,446 2 0.10 3 0.20 6 0.40 13 0.90 

Y02344 1,201 N/A N/A N/A N/A 3 0.20 4 0.33 

B81027 4,661 27 0.46 29 0.62 29 0.61 27 0.58 

B81040 12,436 9 0.05 14 0.11 21 0.16 23 0.18 

B81047 5,828 15 0.21 7 0.12 8 0.14 16 0.27 

B81089 2,580 3 0.09 3 0.12 9 0.35 10 0.39 

B81631 2,329 23 0.73 20 0.88 20 0.84 22 0.94 

B81683 1,217 4 0.26 3 0.28 2 0.18 4 0.33 


B81017 5,440 4 0.06 4 0.07 11 0.20 28 0.51 

B81018 4,753 20 0.29 21 0.43 21 0.43 19 0.40 

B81032 2,007 1 0.04 1 0.05 2 0.09 5 0.25 

B81046 6,620 16 0.18 16 0.25 13 0.20 20 0.30 

B81692 1,560 3 0.16 3 0.20 2 0.13 6 0.38 

Y00955 1,968 5 0.30 6 0.35 8 0.40 11 0.56 


Using national prevalence estimates of mild/moderate and severe learning disabilities 

(Department of Health 2001) the estimated number of people with mild/moderate or 

severe learning disabilities in each Locality can be produced (Table 61). It is 

acknowledged that it is difficult to measure the prevalence of learning disabilities, and 

that this will influence the confidence in the prevalence. In addition, the prevalence of 

learning disabilities might be higher or lower than the national average. As these figures 

are very approximate anyway, they have not been updated with a more recent 

population file, as it will make relatively little difference. The following estimates should 

be treated with caution. 

Table 61: Estimated number of people in each Locality with mild/moderate and severe 

learning disabilities (based on 2005 population figures and national estimates of 

prevalence) 

Age 

(yrs) 

Estimated people with learning disabilities by severity and Locality, 2005 

Mild/mod Severe Mild/mod Severe Mild/mod Severe Mild/mod Severe 

North North East East West West HULL HULL 

0-4 113 26 159 36 160 36 432 98 

5-19 340 68 481 96 456 91 1,276 256 

20-29 261 54 305 63 442 91 1,008 208 

30-39 238 44 363 67 444 82 1,045 193 

40-59 366 74 635 129 649 132 1,649 335 

60-74 164 18 273 30 284 31 721 79 

75-84 54 3 132 8 128 8 314 19 

85+ 12 1 34 2 42 2 88 4 

Total 1,499 262 2,316 405 2,533 443 6,348 1,111 



Doncaster PCT has created a model which can be used to produce the estimated 

number of people with diagnosed learning disabilities (Doncaster PCT 2008). In general 

when such models have been produced, the model is based on research undertaken 

elsewhere in the UK examining the prevalence of diagnosed disease in the community, 

which has then been modelled and applied to different populations such as those living 

in a particular PCT area. Therefore, the accuracy of the estimates depends on the 

quality of the initial research and the modelling itself. If the original research did not 

include very deprived areas, it is very difficult to generalise and apply the model to very 

deprived areas like Hull. Furthermore, there are many reasons why the prevalence 

could differ among practices (see section 12.13 on page 782 for more information). 

Further information about problems associated with models can be found in the 

Association of Public Health Observatories Technical Briefing (Association of Public 

Health Observatories 2011) and in section 12.1 on page 770. Further information 

about problems associated with models can be found in the Association of Public Health 

Observatories Technical Briefing (Association of Public Health Observatories 2011) and 

in section 12.1 on page 770. Therefore, just because practices have a particularly low 

prevalence or a relatively large difference between the registers and the model, it does 

not necessarily mean that they are performing badly in any way relative to other general 

practices. Nevertheless, a comparison of the differences between the modelled 

prevalence and the practice list registers can act as a starting point for investigation. 

Practices with a low prevalence or a relatively large difference between the model and 

the register estimates can be examined further and considered in relation to patient 

characteristics using local knowledge. Differences might just reflect that the model is 

not a very good fit for Hull. For reference, the mean age of practice patients (Table 28) 

and mean deprivation scores (Table 49) for each practice may be examined. 

The results of the modelling and the actual diagnosed numbers of patients with learning 

disabilities are given in Table 62. The model does not necessarily represent the actual 

number of people who should be diagnosed with learning disabilities for each practice; it 

is only a guide. The characteristics of each practice differ and need to be considered. 

The age-specific prevalence estimates for learning disabilities used by Doncaster PCT 

are derived from research undertaken by Emerson and Hatton and they state that it is 

an estimate of "true prevalence" defined as "people with severe learning disabilities who 

would be known to services and people with less severe learning disabilities who 

probably would not be known to services" (Emerson and Hatton 2004). Therefore, the 

model estimates are considerably higher than the numbers on the practice registers as 

the model includes those people with less severe learning disabilities who they expect 

would not be known to services. Whilst clinical definitions may exist as to what 

constitutes mild or moderate learning disabilities, in practice it may be difficult to 

ascertain, and different definitions and how learning disabilities is defined could change 

the estimates considerably, for example, including or not including “mild” learning 

disabilities may influence the estimates considerably. Despite this potential problem 

with definitions, the estimates used by Doncaster PCT are reasonably similar to those 

given in Table 61. Assuming that two-fifteenths of those aged 5-19 years with learning 

disabilities are aged 18-19 years, then it is estimated that 5,601 people who are 

estimated to have learning disabilities are aged 18+ years from Table 61 which is not 



too dissimilar to the figure of 5,053 given in Table 62. The modelled estimates do not 

take into account ethnicity or deprivation. 

The prevalence on the disease registers used to form the official QOF information is 

extracted from the Quality Management and Analysis System (QMAS) at the end of 

March. However, this information can be extracted at any time point from the local 

QMAS system and the information in Table 62 gives this information as at September 

2010. 

Table 62: Actual diagnosed and modelled learning disabilities numbers, September 

2010 

Code Practice name List size Numbers with diagnosed learning 

(Sept 

disability 

2010) QMAS Sept Modelled Difference 

2010 estimate 

(actual (guide 

diagnosed) only) 

B81035 Dr WGT Sande & Partners 6,160 17 107 -90 

B81056 Springhead Medical Centre 13,813 29 234 -205 

B81104 Dr JK Nayar 6,553 2 145 -143 

B81635 Dr G Dave 2,979 4 53 -49 

B81662 Mizzen Road Surgery 1,720 4 31 -27 

Y01200 The Calvert Practice 1,815 6 30 -24 

Y02747 Kingswood Surgery 1,380 2 24 -22 

B81020 Dr PC Mitchell & Partners 7,436 32 128 -96 

B81021 Faith House Surgery 7,372 26 127 -101 

B81075 Dr MK Mallik 2,197 2 40 -38 

B81085 Dr JW Richardson & Ptnrs 5,302 8 92 -84 

B81094 Dr AK Datta 1,790 2 34 -32 

B81095 Dr Cook 4,145 11 57 -46 

B81097 Dr RD Yagnik 1,689 4 31 -27 

B81690 Dr SK Ray 1,650 1 30 -29 

B81001 Dr Ali & Partners 3,333 1 57 -56 

B81008 Dr JS Parker & Partners 14,936 66 258 -192 

B81048 Dr SM Hussain & Partners 8,915 16 164 -148 

B81049 Dr VA Rawcliffe & Partners 9,221 25 158 -133 

B81052 Dr J Musil And PJ Queenan 5,736 9 105 -96 

B81072 Dr R Percival & Partners 7,574 12 136 -124 

B81644 Dr KK Mahendra 2,229 2 39 -37 

Y02786 Priory Surgery 813 1 13 -12 

B81011 Wheeler Street Healthcare 5,212 22 90 -68 

B81038 Dr AA Mather & Partners 7,690 28 131 -103 

B81057 Dr S MacPhie & Koul 3,185 10 58 -48 

B81074 Dr AK Rej 3,534 9 62 -53 

B81081 Dr KM Tang & Partner 3,556 6 61 -55 

B81645 East Park Practice 2,176 4 39 -35 

B81646 Dr M Shaikh 1,822 9 32 -23 



Code Practice name List size Numbers with diagnosed learning 

(Sept 

disability 

2010) QMAS Sept Modelled Difference 

2010 estimate 



B81682 Dr M Shaikh & Partners 3,780 11 62 -51 

B81053 Diadem Medical Practice 10,642 33 178 -145 

B81054 Dr MJ Varma & Partners 10,690 10 195 -185 

B81058 Dr M Foulds & Partner 8,680 61 157 -96 

B81066 Dr GM Chowdhury 2,460 7 43 -36 

B81080 Dr GS Malczewski 2,168 7 39 -32 

B81616 Dr GT Hendow 2,539 5 42 -37 

B81002 Dr A Kumar-Choudhary 3,837 20 62 -42 

B81112 Dr Ghosh Raghunath & Ptnrs 3,454 30 57 -27 

B81119 Dr G Palooran & Partners 4,528 22 75 -53 

B81634 Dr J Venugopal 3,018 14 50 -36 

B81674 Dr JC Joseph 2,246 5 36 -31 

B81675 Dr Tak & Dr Stryjakiewicz 9,111 28 158 -130 

B81685 Dr NA Poulose 2,394 9 39 -30 

B81688 Dr KV Gopal 2,023 14 33 -19 

Y02344 Northpoint 2,021 4 33 -29 

B81027 St Andrews Group Practice 5,954 26 103 -77 

B81040 Dr PF Newman & Partners 16,721 27 281 -254 

B81047 Dr JN Singh & Partners 7,505 17 139 -122 

B81089 Dr Witvliet 3,593 10 60 -50 

B81631 Dr R Raut 3,438 21 56 -35 

B81683 Dr AS Raghunath & Partners 1,749 3 29 -26 

Y02896 Story St Practice/Walk In 944 2 20 -18 

B81017 Kingston Medical Group 6,725 29 125 -96 

B81018 Dr RK Awan & Partners 6,518 18 109 -91 

B81032 Dr AW Hussain & Partners 2,328 6 45 -39 

B81046 Dr JD Blow & Partners 9,247 20 155 -135 

B81692 The Quays Medical Centre 1,677 5 38 -33 

Y00955 Riverside Medical Centre 2,460 17 47 -30 

Y02748 Haxby Orchard Park Surgery 552 3 8 -5 

HULL 288,935 860 5,053 -4,193 

7.3.2 Programme Budgeting 

As illustrated in Figure 1, expenditure on problems of learning disabilities per head for 

2008/2009 in Hull was £42.62 compared to £57.30 for the Industrial Hinterlands 

average, £105.65 for North East Lincolnshire and £56.11 for England. Therefore, 

expenditure was lower in Hull (ranked 112 out of 152 PCTs). 



7.4 Caring and Self-Care 

7.4.1 Population Projections for Those Aged 65+ Years 

The projected number of people in Hull aged 65+ years as at 2010 and 2025 who are 

unpaid carers or who cannot undertake at least one domestic, self-care or mobility 

activity is given in section 10.13.1 on page 737. 

7.4.2 Responsible for the Long-Term Care of Others 

The local Health and Lifestyle Survey conducted in 2003 23 asked responders if they 

were responsible for the long term care of a sick or disabled partner, children, other 

relatives or friends, elderly relatives, parents or someone else. Figure 40 gives the 

percentage of residents in each Locality who reported that they were responsible for the 

long term care of someone. Whilst the majority who are responsible for the long term 

care of someone are only responsible for the long term care of one specified group of 

individuals, a small number of people are responsible for the care of someone in more 

than one group (e.g. responsible for the care of a disabled or ill partner as well as elderly 

parents). In North Locality, 1.6% of residents are responsible for two or more specified 

groups of individuals compared to 1.1% for East Locality and 1.8% for West Locality. A 

summary is provided in the final column of Figure 40 giving the percentage of residents 

who are responsible for the long term care of anyone. The data underlying the figure is 

given in the APPENDIX on page 834. 

The percentage of people who were responsible for the care of someone also differed 

across the genders and age groups (Table 63). 

23 The Health and Lifestyle survey in 2007 did not ask this question, so no more recent data is available. 



Figure 40: Responsible for the long term care of someone by Locality, 2003 

Percentage responsible for the care of someone 

20 

18 

16 

14 

12 

10 

8 

6 

4 

2 

0 

Table 63: Responsible for the long term care of someone by age and gender, 2003 

Age 

(years) 

Sick/disabled 

partner 

Number 

answering 

question 


Sick/disabled 

child 

Sick/disabled 

relative 

Elderly relatives 

Men Women 

Responsible for 

the long-term care 

of someone (%) 

Sick/disabled 

friend 

Number 

answering 

question 

Responsible for 

the long-term care 

of someone (%) 

16-24 142 4.2 242 7.4 

25-34 173 6.4 260 8.8 

35-44 225 7.6 286 22.0 

45-54 209 16.3 255 23.1 

55-64 223 17.0 238 24.8 

65-74 157 17.8 182 19.2 

75+ 87 24.1 101 21.8 

Total 1,216 12.7 1,564 17.8 

Young people within the Young People Health and Lifestyle Survey were asked 

“Thinking about caring, do you help look after any of these people? No, no-one, disabled 

or ill mother, disabled or ill father, disabled or ill brother or sister, elderly grandparents or 

someone else”. The percentages that help look after anyone are given in Table 64 and 

in Figure 41 (underlying data on page 835). The percentages are relatively high, and it 


Parents 

Someone else 

Anyone 

(summary)


is possible that it could have been interpreted as looking after people in general or if 

they have ever looked after an ill parent or sibling, etc. For Figure 41, some stated they 

care for more than one category of person. 

Table 64: Young people who help look after someone, 2008-09 

Gender School Number answering Helps look after 

year 

question 

anyone (%) 

7 264 38.6 

8 239 40.2 

Males 

9 

10 

230 

290 

29.1 

36.6 

11 163 26.4 

Total 1,186 34.9 

7 264 38.6 

8 258 34.9 

Females 

9 

10 

235 

298 

36.2 

35.6 

11 232 34.5 

Total 1,287 36.0 

Figure 41: Young people who help look after someone, 2008-09 

Caring (%) 

25 

20 

15 

10 

5 

0 

Year 7 Year 8 Year 9 Year 10 Year 11 Year 7 Year 8 Year 9 Year 10 Year 11 

Boys Girls 

Gender / school year 

Disabled or ill mother Disabled or ill father Disabled or ill sibling 

Elderly grandparents Someone else 



7.4.3 Long-term Care of Others in Relation to Deprivation 

Twenty-two percent of adults living in the most deprived category were responsible for 

the long term care of at least one other person compared to around 15% of the 

remaining deprivation quintiles (Figure 42) with the difference being statistically 

significant ( 2 test for trend, p=0.0002). The underlying data are given in the APPENDIX 

on page 835. 

Figure 42: Responsible for the long term care of someone by deprivation for Hull 

Responsible for long-term care of 

someone 2003 (%) 

25 

20 

15 

10 

5 

0 

Most 

deprived 

7.5 Use of Healthcare Services 

2 3 4 Least 

deprived 

Index of Multiple Deprivation 2004 local quintile 

The Health and Lifestyle Survey conducted during 2007 collected information on dental 

health services. Responders were asked if they had attended an NHS dentist or a 

private dentist the last time they had visited a dentist, and how long ago they last 

attended. The previous Health and Lifestyle Survey conducted during 2003 collected 

information on usage of local health services within the last year, and whilst this is 

relatively old information now, this is the latest available data locally as these questions 

were not asked during the 2007 survey. 



7.5.1 Dental Health 

7.5.1.1 National Adult Dental Health Survey 

The Information Centre (Information Centre for Health and Social Care 2010) has 

published preliminary findings from the Adult Dental Health Survey 2009. The survey 

consisted of a questionnaire interview with all adults aged over 16 years at all sampled 

households, and an oral examination of the mouth and teeth of all those adults who had 

at least one natural tooth. The sample size for the survey was 13,400 households (1,150 

in each English Strategic Health Authority and Wales, and 750 households in Northern 

Ireland). A total of 11,380 individuals were interviewed, and 6,469 dentate adults were 

examined, making this the largest ever epidemiological survey of adult dental health in 

the United Kingdom. 

The main purpose of these surveys has been to get a picture of the dental health of the 

adult population and how this has changed over time. A summary of the findings can be 

found in Table 65. 

Table 65: Summary results from national adult dental health survey, 2009 

Sub-group 

Dentate 

(%) 

Number of 

natural teeth (%) 

21 or Fewer 

more than 21 

Mean 

number of 

teeth 

All 94 86 14 25.6 

Gender 

Men 

Women 

95 

93 

86 

86 

14 

14 

25.8 

25.5 

16-24 100 100 0 28.6 

25-34 100 99 1 28.8 

35-44 100 97 3 27.6 

Age (years) 

45-54 

55-64 

99 

95 

91 

74 

9 

26 

26.0 

23.1 

65-74 85 61 39 20.9 

75-84 70 40 60 17.1 

85+ * 53 26 74 14.0 

Socio- Managerial & professional 97 91 9 26.5 

economic Intermediate occupations 95 85 15 25.3 

group Routine & manual 90 79 21 24.6 

*Figures in italics represent an unreliable estimate. Any analysis using these figures may be 

invalid. 

There are clear gradients in the proportion of respondents with their natural teeth by age 

as may be expected, ranging from 100% of those aged 16-24 to 53% of those aged 85+. 

In addition there is a clear gradient in the proportion of adults with 21 or more natural 



teeth by socio-economic households, from 91% in managerial and professional 

households to 79% from routine and manual occupation households. 

Whilst this does not provide information for Hull residents as the sample size was too 

small at this geographical area, it could be assumed that dental health in Hull would be 

poorer than England due to Hull‟s increased deprivation. However, it is unknown to 

what extent dental health would be poorer. 

7.5.1.2 Clinical Dental Statistics 

The Information Centre (Information Centre for Health and Social Care 2010) has 

published experimental statistics on NHS clinical dental activity in England and Wales 

for 2008/09 and 2009/10 (Table 66). Because of the experimental nature of these 

statistics caution should be taken when using the data. In particular, increases in the 

completion of clinical data sets during 20-09-10 may mean that 2008-09 data is underrepresentative 

of actual activity as analysis has shown that where the clinical dataset 

completion increases so does the resulting treatment rate. It is possible, due to Hull‟s 

increased deprivation, that the percentage of courses of treatment that involve fillings 

and extractions could be higher. 

Table 66: Summary results from national clinical dental report, 2008/09 to 2009/10 

Adult or Financial Total Percentage of courses of treatment involving: 

child year number of Permanent Radiograph(s) Extractions 

courses of fillings and 

treatment sealant 

restorations 

Adults 2008/09 26,228,120 27.4 18.7 7.3 

2009/10 27,225,300 27.5 19.9 7.5 

Children 2008/09 10,267,820 23.3 5.2 5.2 

2009/10 10,415,590 22.5 5.3 5.2 



7.5.1.3 Registered With a Dentist 

Table 67 gives the percentage of men and women in Hull who attended an NHS or 

private dentist the last time they visited a dentist when asked at the time of the Health 

and Lifestyle Survey 2007. As the percentages differed between those people who had 

some natural teeth and those who had no natural teeth the figures are presented 

separately for these groups. 

Table 67: NHS or private dentist at time of last visit, 2007 

Gender Natural 

teeth? 

Males 

Females 

None 

Some 

None 

Some 

Age 

(yrs) 

Number 

answering 

question 

Last time at dentist (%) 

NHS Private Don’t 

know 

Never been 

to a dentist 

18-24 0 

25-34 5 20.0 40.0 40.0 0.0 

35-44 8 37.5 12.5 50.0 0.0 

45-54 17 64.7 11.8 23.5 0.0 

55-64 41 80.5 12.2 4.9 2.4 

65-74 64 71.9 17.2 9.4 1.6 

75+ 91 76.9 17.6 4.4 1.1 

18-24 288 60.8 25.7 9.7 3.8 

25-34 356 59.0 29.2 7.6 4.2 

35-44 363 68.9 22.9 4.1 4.1 

45-54 265 63.0 28.3 7.9 0.8 

55-64 197 79.7 15.7 2.5 2.0 

65-74 156 71.2 27.6 0.6 0.6 

75+ 82 72.0 23.2 1.2 3.7 

18-24 6 50.0 16.7 33.3 0.0 

25-34 2 0.0 100.0 0.0 0.0 

35-44 5 40.0 60.0 0.0 0.0 

45-54 25 88.0 8.0 4.0 0.0 

55-64 64 79.7 14.1 6.3 0.0 

65-74 94 84.0 9.6 6.4 0.0 

75+ 97 76.3 15.5 8.2 0.0 

18-24 258 70.2 15.5 10.1 4.3 

25-34 374 72.7 20.6 3.5 3.2 

35-44 364 78.0 18.1 2.7 1.1 

45-54 289 75.8 20.8 2.8 0.7 

55-64 235 74.5 23.8 1.7 0.0 

65-74 150 75.3 22.7 2.0 0.0 

75+ 77 67.5 26.0 6.5 0.0 



7.5.1.4 Years Since Last Dental Visit 

In 2007, between 50% and 60% of those aged less than 75 years had visited a dentist in 

the last year, but less than 40% for those aged 75+ years (Figure 43). The underlying 

data are given in the APPENDIX on page 836. However, in the main survey and the 

Black and Minority Ethnic (BME) Health and Lifestyle Surveys 2007 combined, the 

percentage who had never attended a dentist was high. Between one-third and twothirds 

of refugees, asylum seekers and failed asylum seekers had never attended the 

dentist, and around 20% of those who were students or were working in the UK longterm 

(Figure 44). The underlying data are given in the APPENDIX on page 836. 

Figure 43: Years since last dental visit for Hull residents at time of survey 2007 

Time since last detnal visit (%) 

70 

60 

50 

40 

30 

20 

10 

0 

18-24 25-34 35-44 45-54 55-64 65-74 75+ 

Age group 

Between 1-2 years ago Between 2-5 years ago More than 5 years ago Never 



Figure 44: Years since last dental visit by status in UK 2007 

Time since last detnal visit (%) 

70 

60 

50 

40 

30 

20 

10 

0 

British Student Granted 

asylum 

Failed 

asylum 

seeker 

Refugee Working in 

UK 

temporarily 

Status in UK (main and BME surveys combined) 

Working in 

UK longterm 


Other 

Between 1-2 years ago Between 2-5 years ago More than 5 years ago Never


Young people in the Young People Health and Lifestyle Survey were asked when they 

last attended a dentist. Over 70% stated they had attended within the last 6 months 

(Figure 45). The underlying data are given in the APPENDIX on page 837. 

Figure 45: Time since last dental visit for young people 2008-09 

Time since last dental visit (%) 

35 

30 

25 

20 

15 

10 

5 

0 

Year 7 Year 8 Year 9 Year 10 Year 11 Total Year 7 Year 8 Year 9 Year 10 Year 11 Total 

Males Females 

School year / gender 

7-12 months ago 1-2 years ago >2 years ago Never 

7.5.1.5 Programme Budgeting and Outcomes 

As illustrated in Figure 1, expenditure on dental problems per head for 2008/2009 in 

Hull was £74.27 compared to £63.50 for the Industrial Hinterlands average, £64.89 for 

North East Lincolnshire and £62.44 for England. Therefore, expenditure was higher in 

Hull (ranked 22 nd highest out of 152 PCTs). Information on three dental outcomes are 

also available within the information produced by the Yorkshire and Humber Public 

Health Observatory (Y&H PHO) programme budgeting tool for each PCT, Industrial 

Hinterlands and England. The outcomes measures are given in Table 68 for Hull and 

comparator areas (see section 3.3.3 on page 44 for more on comparators). Hull has a 

higher percentage of more than zero decayed, missing or filled (DMF) teeth in five year 

olds for 2007/2008 compared to England and Industrial Hinterlands, but is not an outlier 

in relation to the comparators. For both adults and children, a higher percentage in Hull 

had had a dental appointment within the last two years (as at 31 st March 2009) 

compared to England and Industrial Hinterlands. 



Table 68: Dental outcomes in Y&H PHO programme budgeting tool 

Area Percentage more than 

zero DMF teeth in 5 yr 

olds, 2007/08 

Dental appointment within last 2 years 

as at 31 th March 2009 

Adults Children 

% Rank % Rank % Rank 

England 31 50 69 

Industrial Hinterlands 39 61 73 

Hull 43 129 71 2 86 4 

North Tyneside* 35 98 53 66 76 37 

Hartlepool* 34 88 65 9 69 85 

Plymouth Teaching 29 56 50 82 78 27 

Salford 42 128 57 38 79 18 

Knowsley* 43 130 51 79 58 145 

Darlington* 40 121 62 14 78 28 

Gateshead* 35 100 59 25 73 56 

South Tyneside* 37 105 68 5 76 34 

Sunderland Teaching* 43 132 61 18 77 33 

Middlesbrough* 53 152 69 3 82 14 

Tameside and Glossop* 37 106 58 32 73 49 

Coventry Teaching 30 59 55 53 69 80 

Wolverhampton 24 28 61 16 78 30 

Derby City 38 110 50 84 72 62 

County Durham* 38 112 52 74 66 108 

Sefton PCT* 29 57 63 12 69 83 

Wirral PCT* 30 64 65 8 73 54 

Halton and St Helens* 40 118 58 29 71 71 

Leicester 49 145 54 64 83 7 

Sandwell 35 95 66 6 76 35 

Stoke on Trent* 42 127 53 65 71 72 

Redcar & Cleveland* 40 122 63 11 73 57 

North East Lincolnshire 37 109 58 35 66 107 

*Within Industrial Hinterlands group. 

7.5.2 Health Service Attendances Within Last Year 

Table 69 gives the percentage of people in Hull who had used various health services 

and specifically ones available at their GP surgery. The information comes from the 

Health and Lifestyle Survey conducted during 2003 (as these questions were not asked 

in more recent surveys). 



Table 69: Use of health services by Hull residents, 2003 

Service used Use of services by Locality (%) 

North 

(n=790) 

East 

(n=1408) 

West 

(n=1257) 

General health services 

A&E 18.7 15.3 17.5 

Minor injury unit 6.1 2.8 1.9 

Out-patient 26.5 26.6 28.5 

Counsellor 2.3 2.4 2.7 

Physiotherapist 6.1 5.2 7.2 

In-patient 9.4 8.0 9.3 

Daycase 7.6 7.8 9.3 

Ante-natal 2.2 2.1 2.1 

Other 2.3 1.9 2.0 

NHS Direct 6.8 4.3 6.7 

Genito-urinary clinic 0.4 0.6 0.9 

Family planning clinic 3.4 2.8 2.1 

Health services within GP practice 

GP consultation 69.1 71.0 70.6 

Mother & baby clinic 4.1 3.4 3.7 

Ante-natal 1.9 1.5 2.1 

Physiotherapist 3.0 1.7 2.5 


Chiropodist 4.1 4.5 5.0 

Dietician 1.6 1.8 2.1 

Nurse 35.2 33.0 33.8 

Other 3.3 3.2 3.5 

No GP services used 12.7 12.9 12.4 

7.5.3 Use of Private or Other Health Services 

Table 70 gives the percentage of people in Hull who had used different or other health 

services rather than ones provided by their GP, from the Health and Lifestyle Survey 

conducted during 2003 (these questions were not asked in the most recent 2007 

survey). Those who stated they used no services do not appear to correspond to those 

who stated they used some services (but the responses stated in the table are as they 

were stated on the questionnaire). 



Table 70: Use of health services rather than services at their GP for Hull residents, 2003 

Service used instead of 

Use of services by Locality (%) 

those at GP surgery 

North 

East 

West 

(n=790) (n=1408) (n=1257) 

A&E 8.7 6.7 7.4 

Private doctor 1.5 2.1 2.1 

Private physiotherapist 1.0 1.0 2.2 

NHS Direct 7.8 5.0 6.4 


Family planning clinic 2.7 2.1 1.8 

Chiropractor 0.5 1.5 1.5 

Osteopath 0.6 0.8 1.0 

Other 1.8 2.3 2.2 

No services 43.0 43.8 41.9 

7.6 Inpatient Hospital Admissions 

Inpatient admission rates provide useful information about the general level of illness 

and the use of hospital services within geographical areas. Patients admitted to a bed 

for elective surgery, but discharged the same day are classed as daycases, and these 

are included within inpatients in this document, unless otherwise stated. However, it is 

very important to note that admission rates depend on how willing people are to make 

use of medical services, the location and accessibility of services, as well as differences 

in referral patterns and practices within primary and secondary care. These factors may 

differ between geographical areas, and may explain different levels of hospital activity 

rather than differences in the prevalence of disease. For example, in general, people 

who live in more deprived areas are less likely to visit their GP than people with similar 

levels of symptoms who live in more affluent areas. Referral rates can vary dramatically 

among different GPs which can influence admission rates. Therefore, these findings 

should be interpreted cautiously with regard to assessing the general level of illness. 

Nevertheless, analysis of inpatient admission rates will give an indication of the usage of 

hospital services by patients or residents of different geographical areas. From Hospital 

Episode Statistics, the annual age-gender-standardised (age bands: 0, 1-4, 5-9, 10-14, 

etc to 85+ years standardised to Hull‟s 2009 population) rate of hospital in-patient 

admission (first clinician episode) for the three financial years 2007/08 to 2009/10 for 

residents of Hull is given in Table 71. 



Table 71: Age-gender-standardised inpatient admission rate for the three financial years 

2007/08 to 2009/10 combined for Hull 

Area/Area/Locality Three year total inpatient admissions for financial 

years 2007/08 to 2009/10 per 1,000 Hull residents 

Inpatient Resident Crude Annual 

admissions population rate standardised 

rate (95% CI) 

Bransholme East 9,044 10,864 277 324 (316 to 331) 

Bransholme West 7,978 8,815 302 305 (299 to 312) 

Kings Park 6,695 8,582 260 295 (288 to 303) 

Area: North Carr 23,717 28,261 280 307 (303 to 311) 

Beverley 7,376 8,384 293 268 (262 to 274) 

Orchard Park & Greenwood 13,990 15,087 309 329 (324 to 335) 

University 7,670 10,608 241 262 (256 to 268) 

Area: Northern 29,036 34,079 284 291 (287 to 294) 

Locality: North 52,753 62,340 282 296 (294 to 299) 

Ings 12,756 12,784 333 287 (282 to 293) 

Longhill 11,629 12,257 316 300 (295 to 306) 

Sutton 10,574 13,038 270 275 (270 to 280) 

Area: East 34,959 38,079 306 287 (284 to 290) 

Holderness 9,982 13,721 242 251 (246 to 256) 

Marfleet 13,059 13,562 321 327 (321 to 332) 

Southcoates East 8,363 8,977 311 318 (311 to 325) 

Southcoates West 7,087 8,049 293 288 (281 to 295) 

Area: Park 38,491 44,309 290 293 (291 to 296) 

Drypool 11,091 12,439 297 298 (292 to 303) 

Area: Riverside (East) 11,091 12,439 297 298 (292 to 303) 

Locality: East 84,541 94,827 297 292 (290 to 294) 

Myton 14,636 14,806 330 326 (320 to 331) 

Newington 10,717 13,042 274 293 (287 to 299) 

St Andrew's 8,729 8,913 326 331 (324 to 338) 

Area: Riverside (West) 34,082 36,761 309 315 (312 to 319) 

Boothferry 10,033 12,375 270 261 (255 to 266) 

Derringham 10,131 11,257 300 280 (275 to 286) 

Pickering 11,862 12,175 325 301 (295 to 306) 

Area: West 32,026 35,807 298 281 (277 to 284) 

Avenue 9,380 13,249 236 251 (245 to 256) 

Bricknell 6,823 8,464 269 252 (246 to 258) 

Newland 7,419 10,875 227 266 (260 to 273) 

Area: Wyke 23,622 32,588 242 251 (248 to 254) 

Locality: West 89,730 105,156 284 282 (280 to 284) 

HULL 227,361 262,323 289 289 (288 to 290) 



7.7 Life Expectancy at Birth 

Life expectancy at birth is a commonly used method of assessing health, improvements 

in health over time, and differences in health between different groups (defined on the 

basis of time, geography, deprivation, social class, smoking status, etc). A common 

misconception is that life expectancy at birth measures the expected duration of life for a 

newborn; it does not. It is a measure of life expectancy assuming that the current agespecific 

mortality rates continue throughout an entire lifetime. This is an unrealistic 

assumption and therefore life expectancy figures are an indication of current health 

status of a population rather than an expectation of the duration of life (see section 

12.10 on page 780 for more information on life expectancy). 

7.7.1 Life Expectancy at Birth in Hull Compared to England and Comparator 

Areas 

Figure 46 and Figure 47 illustrate life expectancy at birth (obtained from the 

Compendium) for males and females respectively for Hull, England and the Yorkshire 

and The Humber SHA. The underlying data for this figure is given in the APPENDIX on 

page 838 and Table 72 gives the figures for the most recent period 2006-2008. 

Table 72 gives the life expectancy at birth 2006-2008 for Hull and some comparator 

areas (see section 3.3.3 on page 44 for more information on the problems of 

comparator areas for Hull). 

The rank is given out of the 324 local authorities (based on boundaries April 2009) 

where life expectancy is calculated (there are two local authorities where life expectancy 

is not calculated due to the low population size: City of London and Isles of Scilly). 

Hull‟s life expectancy figures are in the bottom 3% of local authorities for 2006-2008 

(ranks 316 and 314 for males and females respectively) which is similar to its ranking for 

deprivation (ranked 344 th out of 354 local authorities – based on April 2006 boundaries 

for local authorities; see section 6.9.1 on page 131). The average life expectancy 

figure is given for the 10 comparator areas combined, and this will be an estimate of the 

true life expectancy which will not be exactly the same as the life expectancy figure if it 

were properly calculated from population and mortality information (if the data were 

available). However, it is unlikely to differ substantially to the true calculated value. 

Similarly, the average rank is given for the 10 comparator areas and this is not weighted 

in any way for population size. 



Figure 46: Trends in male life expectancy at birth – Hull compared to England and SHA 

Figure 47: Trends in female life expectancy at birth – Hull compared to England and 

SHA 

Female life expectancy (years) 

Male life expectancy (years) 

79 

78 

77 

76 

75 

74 

73 

72 

71 

70 

69 

83 

82 

81 

80 

79 

78 

77 

76 

1991-1993 

1991-1993 

1992-1994 

1992-1994 

England Hull Yorkshire & The Humber SHA 

1993-1995 

1994-1996 

1995-1997 

1996-1998 

1997-1999 

1998-2000 

Period 

England Hull Yorkshire & The Humber SHA 

1993-1995 

1994-1996 

1995-1997 

1996-1998 

1997-1999 

1998-2000 

Period 


1999-2001 

1999-2001 

2000-2002 

2000-2002 

2001-2003 

2001-2003 

2002-2004 

2002-2004 

2003-2005 

2003-2005 

2004-2006 

2004-2006 

2005-2007 

2005-2007 

2006-2008 

2006-2008


Table 72: Life expectancy at birth for comparator areas, 2006-2008 

Area or local 

authority 

Life expectancy at birth 2006-2008 (yrs & rank) 

Males Females 

Value (95% CI) Rank (/324) Value (95% CI) Rank (/324) 

England 77.9 (77.9, 78.0) - 82.0 (82.0, 82.1) - 

Hull 75.0 (74.6, 75.5) 316 79.5 (79.1, 79.9) 314 

Y&H SHA 77.1 (77.0, 77.2) - 81.3 (81.2, 81.4) - 

Wolverhampton 75.7 (75.2, 76.2) 294 80.5 (80.1, 80.9) 284 

Salford 74.5 (74.0, 75.0) 318 79.0 (78.6, 79.5) 319 

Derby 77.2 (76.7, 77.6) 232 81.5 (81.1, 81.9) 227 

Stoke-on-Trent 75.4 (74.9, 75.8) 305 79.8 (79.4, 80.2) 308 

Coventry 76.5 (76.0, 76.9) 264 81.1 (80.7, 81.5) 255 

Plymouth 77.2 (76.8, 77.7) 232 82.0 (81.6, 82.4) 191 

Sandwell 74.3 (73.9, 74.7) 321 80.0 (79.7, 80.4) 303 

Middlesbrough 75.4 (74.8, 76.0) 305 79.8 (79.2, 80.3) 308 

Sunderland 75.4 (75.0, 75.8) 305 80.4 (80.1, 80.8) 290 

Leicester 75.5 (75.1, 75.9) 301 79.9 (79.5, 80.3) 306 

Above 10 (mean) 75.7 (-------------) 288 80.4 (-------------) 279 

NE Lincolnshire 75.9 (75.3, 76.5) 287 80.8 (80.3, 81.3) 270 

7.7.2 Life Expectancy at Birth in Hull Wards 

In 2006, the Office for National Statistics published experimental life expectancy at birth 

estimates for each ward in England and Wales (Office for National Statistics 2006), but 

the information was relatively old as life expectancy estimates were produced for the 

period 1999-2003. It is necessary to calculate life expectancy based on a number of 

years‟ data at ward level owing to the variability associated with the year on year 

number of deaths. However, ONS have not updated this information and it is relatively 

old now. It is possible to calculate life expectancy using the local Public Health Mortality 

File and the estimates of resident population from the GP registration file. The life 

expectancy estimate for Hull overall calculated in this way will differ slightly from those 

produced nationally by ONS due to slight differences in the population used (see Table 

11 and Table 15). Life expectancy at birth calculated at ward level is also available on 

the Hull Atlas (www.hullpublichealth.org). 

Male and female life expectancy calculated using local data (Public Health Mortality File 

and GP registration file for resident population estimates) is given in Figure 48 and Figure 

49 respectively (with 95% confidence intervals). The data underlying these figures are 

given in the APPENDIX on page 839. For men, life expectancy estimates differ by up to 

10.0 years across the wards ranging from 71.0 years in St Andrews to 81.0 years in 

Beverley ward. For women, the differences are slightly larger at 10.2 years, with St 

Andrews having the lowest female life expectancy of 74.2 years and Bricknell having the 

highest female life expectancy of 84.4 years. This compares with the maximum difference 

in life expectancy among wards in 2006-2008 of 10.7 years for men and 9.7 years for 

women, so a reduction in the gap for men and a small increase for women in 2007-2009. 



Figure 48: Male life expectancy at birth in years for 2007-2009 by ward 

Male life expectancy at birth (years) 

90 

85 

80 

75 

70 

65 

60 



Kings Park 

Beverley 

Orchard Pk & Greenwd 

University 

Ings 

Longhill 

Sutton 

Holderness 

Marfleet 



Drypool 

Myton 

Newington 

St Andrews 

Boothferry 

Derringham 

Pickering 

Avenue 

Bricknell 

Newland 

Hull 

Figure 49: Female life expectancy at birth in years for 2007-2009 by ward 

Female life expectancy at birth (years) 

90 

85 

80 

75 

70 

65 

60 



Kings Park 

Beverley 

Orchard Park and … 

University 

Ings 

Longhill 

Sutton 

Holderness 

Marfleet 

Ward (in Locality order) 



Drypool 

Myton 

Newington 

St Andrews 

Boothferry 

Derringham 

Pickering 

Avenue 

Bricknell 

Newland 

Hull 

Ward (in Locality order) 



Table 73 gives the life expectancy at birth for males and females for the period 2007- 

2009 for each Area and Locality. As these represent larger geographical areas relative 

to wards, there is less variability associated with the estimates and narrower confidence 

intervals (compared to those in Figure 48 and Figure 49). For both men and women, 

Riverside Area had the lowest life expectancy, and West Area had the highest life 

expectancy. The largest difference in life expectancy between the Areas was 

approximately 4.3 and 4.5 years for men and women respectively. There were few 

differences in life expectancy between Localities. 

Table 73: Life expectancy at birth for 2007-2009 by Area and Locality 

Area/Locality Life expectancy at birth (in years) for 2007-09, 95% CIs 

Males Females 

North Carr 74.5 (73.2, 75.9) 79.8 (78.7, 81.0) 

Northern 76.7 (75.3, 78.0) 81.4 (80.2, 82.7) 

Locality: North 75.8 (74.8, 76.7) 80.5 (79.7, 81.4) 

East 76.0 (75.0, 77.0) 79.7 (78.6, 80.8) 

Park 75.6 (74.5, 76.6) 79.8 (78.9, 80.8) 

Locality: East 75.6 (75.0, 76.3) 80.1 (79.4, 80.7) 

Riverside* 72.6 (71.6, 73.6) 77.8 (76.7, 78.8) 

West 76.9 (75.6, 78.2) 82.3 (81.1, 83.5) 

Wyke 76.8 (75.6, 78.0) 81.4 (80.2, 82.5) 

Locality: West 75.1 (74.4, 75.8) 79.9 (79.2, 80.6) 

HULL 75.4 (75.0, 75.8) 80.1 (79.7, 80.5) 

*Riverside not split into “East” and “West” for this table so it includes Drypool ward which 

is in East Locality. 

7.7.3 Relationship Between Deprivation and Life Expectancy at Birth 

It is apparent when comparing the life expectancy estimates in Figure 48 and Figure 49 

with deprivation illustrated in Figure 29 and Table 48 that there is a strong association 

locally between deprivation and life expectancy at birth. However, to illustrate the strong 

association at a national level, Figure 50 and Figure 51 show the IMD 2007 score and 

life expectancy at birth for 2006-2008 (see section 6.9 on page 131 for more on the 

IMD and section 12.10 on page 780 for more information on life expectancy) for 315 of 

the local authorities for England 24 for males and females respectively. The association 

is stronger for males than it is for females. In Hull, it can be seen that males and 

females have a lower life expectancy compared to the „predicted‟ life expectancy based 

on deprivation (plotted linear regression line). The underlying data are given in the 

APPENDIX on page 840. 

24 Life expectancy is available for 324 of the 326 local authorities (two local authorities have too smaller 

populations for reliable estimates to be produced). The IMD 2007 has not been updated following 

boundary changes in April 2009 as a result it is not available for all 326 of the current local authorities. As 

a result, the figure illustrates deprivation and life expectancy in 315 of the 326 local authorities. 



Figure 50: Relationship between deprivation and male life expectancy at birth 2006- 

2008 for local authorities in England 

Male life expectancy at birth (2006-08) 

86 

84 

82 

80 

78 

76 

74 

y = -0.161x + 81.323 

R 2 = 0.7056 

72 

0 5 10 15 20 25 30 35 40 45 50 

Index of Multiple Deprivation 2007 score (higher score more deprived) 

Local authorties (all except Hull) Hull 

Figure 51: Relationship between deprivation and female life expectancy at birth 2006- 


Female life expectancy at birth (2006-08) 

90 

88 

86 

84 

82 

80 

y = -0.1131x + 84.434 

R 2 = 0.5066 

78 

0 5 10 15 20 25 30 35 40 45 50 

Index of Multiple Deprivation 2007 score (higher score more deprived) 

Local authorties (all except Hull) Hull 



There is also a strong trend locally between life expectancy (calculated using the Public 

Health Mortality File and GP registration file for estimates of resident population) and 

local Index of Multiple Deprivation 2007 quintile (Figure 52 and Figure 53). The 

underlying data are given in the APPENDIX on page 849 and on page 849 respectively. 

Figure 52: Trends in male life expectancy in Hull by local deprivation quintile 

Figure 53: Trends in female life expectancy in Hull by local deprivation quintile 



82 

80 

78 

76 

74 

72 

70 

68 

66 

64 

86 

84 

82 

80 

78 

76 

74 

72 

70 

Year 

Year 

Least 

deprived 

Quintile 4 

Quintile 3 

Quintile 2 

Most 

deprived 

Least 

deprived 

Quintile 4 

Quintile 3 

Quintile 2 

Most 

deprived 



7.7.4 Deprivation and Life Expectancy at Birth – Hull and Comparators 

Given that Hull is the 11 th most deprived local authority in England, it would be expected 

that Hull‟s life expectancy would continue to remain much lower than many comparator 

areas. However, life expectancy can be estimated by deprivation quintile for comparator 

areas, and these can then be compared with Hull, to assess whether the most deprived 

people in Hull, for example, have seen better or worse improvements in life expectancy 

than the most deprived people in comparator areas. This section contains the results of 

some analyses that did just this, using national mortality data as well as population 

estimates at lower layer super out area (LLSOA) for the entire country. This work was 

possible due to the assistance of the Yorkshire and Humber Public Health Observatory, 

who hold a copy of the national mortality file (Public Health Mortality Files for all 

geographical areas combined) and have commissioned Office for National Statistics 

(ONS) to produce the LLSOA population estimates. At the time the analyses were 

undertaken, the most recent period for which data were available was 2008. It should 

be noted that, because the LLSOA population estimates are derived from resident 

population estimates, which tend to be different to the GP registered populations used 

locally, the life expectancy estimates produced will not be the same as those produced 

using local data. It should also be noted that, in order to make comparisons with other 

areas, the analyses were performed using national quintiles of IMD 2007, which means 

that there were no Hull life expectancy estimates for the least deprived quintile, as none 

of the LLSOAs in Hull lie within the least deprived fifth of LLSOAs nationally (see 

section 6.9.1 on page 131). Comparisons were made between Hull and North East 

Lincolnshire, as well as the averages for the 10 comparator PCTs (see section 3.3.3.1 

on page 44), Spearhead PCTs, the 20 most deprived PCTs in England, the Industrial 

Hinterlands group of local authorities, the Yorkshire and Humber region and England. 

Figure 54 and Figure 55 show the life expectancy at birth 2006-2008 for men and 

women respectively living in areas that lie within the most deprived 20% of areas 

nationally. Some 53% of Hull residents live in areas in the most deprived 20% of areas 

nationally. Men in Hull living in the most deprived 20% of areas nationally had lower life 

expectancy than each of the comparators, statistically significantly lower than the 

average for the 20 most deprived PCTs and England, based on non-overlapping 

confidence intervals. The difference in life expectancy between Hull and England was 

much lower among men living in the most deprived fifth of areas nationally (0.9 years 

lower in Hull) than among all men combined (2.4 years lower in Hull). Life expectancy at 

birth amongst women in Hull living in areas in the most deprived 20% of areas nationally 

was also lower than each comparator area shown, and was statistically significantly 

lower than the average for women in comparator PCTs, Spearhead PCTs, the 20 most 

deprived PCTs, the Yorkshire and Humber region and England. Again, the differences 

between Hull and England were lower for women living in the most deprived fifth of 

areas nationally (1.4 years lower in Hull) than among all women combined (2.5 years 

lower in Hull). The underlying data are given in Table 74 and Table 75. 



Figure 54: Life expectancy at birth 2006-2008 in the most deprived men in Hull and 

comparators 


75 

74 

73 

72 

71 

70 

Figure 55: Life expectancy at birth 2006-2008 in the most deprived women in Hull and 

comparators 


80 

79 

78 

77 

76 

75 



Table 74 shows life expectancy at birth in men by national deprivation quintiles of IMD 

2007 for Hull and comparator areas for 2001-2003 and 2006-2008 together with the 

change in life expectancy at birth between these two periods. Over this period life 

expectancy increased for Hull men for the three most deprived national quintiles, 

although the increases were greatest in the middle deprivation quintile (2.4 years) than 

in the most deprived or second most deprived quintiles (1.0 and 1.5 years respectively). 

For most deprived men, Hull‟s 1.0 year increase was the joint smallest increase along 

with comparator PCTs. Amongst the 20 most deprived PCTs the average increase was 

1.5 years, equal to that for England. The 1.5 year increase in life expectancy in Hull 

men in the second most deprived quintile equalled that for England and Spearhead PCT 

average, exceeding the comparator PCTs and regional averages, but lower than for 

average increase in the 20 most deprived PCTs and the Industrial Hinterlands group. 

The 2.4 year increase in life expectancy in men in Hull in the middle national deprivation 

quintile exceeded the increases in all comparator areas apart from North East 

Lincolnshire. Amongst men in Hull in the second least deprived quintile life expectancy 

decreased by 1 year, while increases ranging from 0.6 years to 2 years were seen for 

comparator areas. 

Table 75 shows a similar analysis for changes to life expectancy at birth in women. 

Women in the most deprived quintile in Hull (accounting for more than half of women in 

Hull) saw life expectancy decrease between 2001-03 and 2006-08 by 0.8 years. While 

North East Lincolnshire also saw a (smaller) decrease in life expectancy over this time, 

for each other comparator area life expectancy in the most deprived national quintile 

increased by between 0.6 and 1.1 years. In the second most deprived national quintile 

life expectancy in Hull women increased by 1 year, which was similar to most 

comparator areas except North East Lincolnshire which saw a 2 year increase. In the 

middle deprivation quintile, life expectancy for women in Hull increased by 0.7 years 

between 2001-03 and 2006-08, a smaller increase than for each comparator area 

except North East Lincolnshire which saw a 0.5 year decrease. Increases in other 

comparators ranged between 1.0 and 1.2 years. In the second least deprived national 

quintile, the 1.3 years increase in life expectancy in women between 2001-03 and 2006- 

08 exceeded the increases seen for most other comparator areas, equalling the 

increase for England and with only the Industrial Hinterlands average increasing slightly 

more at 1.4 years. 



Table 74: Summary of trends in life expectancy at birth in men in Hull and comparators 

by national deprivation quintiles of IMD 2007 

Deprivation quintile and area 

Life expectancy at birth (years) in men 

(95% confidence interval) 

Change 

(years) 

2001-03 2006-08 01-03 to 06-08 

Hull 71.3 (70.7 to 72.0) 72.3 (71.7 to 72.9) 1.0 

North East Lincolnshire 71.0 (70.1 to 71.9) 72.3 (71.4 to 73.3) 1.3 

Comparator PCTs 71.7 (71.5 to 71.9) 72.7 (72.4 to 72.9) 1.0 

Spearhead PCTs 71.7 (71.6 to 71.8) 72.9 (72.9 to 73.0) 1.3 

20 most deprived PCTs 71.6 (71.5 to 71.7) 73.1 (73.0 to 73.3) 1.5 

Industrial Hinterlands 71.3 (71.1 to 71.5) 72.6 (72.4 to 72.8) 1.3 

Yorks & Humber SHA 71.7 (71.5 to 71.9) 72.8 (72.6 to 73.0) 1.1 

England 71.7 (71.7 to 71.8) 73.1 (73.1 to 73.2) 1.4 

Hull 75.7 (74.8 to 76.5) 77.2 (76.3 to 78.1) 1.5 







England 74.9 (74.8 to 75.0) 76.4 (76.4 to 76.5) 1.5 

Hull 77.3 (76.3 to 78.4) 79.7 (78.6 to 80.8) 2.4 







England 76.9 (76.8 to 77.0) 78.6 (78.5 to 78.7) 1.7 

Hull 80.2 (78.7 to 81.7) 79.2 (77.7 to 80.7) -1.0 







England 78.1 (78.1 to 78.2) 79.9 (79.8 to 80.0) 1.8 

Most deprived 

Second most 

deprived 

Second least 

deprived 

Middle quintile 



Table 75: Summary of trends in life expectancy at birth in women in Hull and 

comparators by national deprivation quintiles of IMD 2007 

Deprivation quintile and area 

Life expectancy at birth (years) in women 

(95% confidence interval) 

Change 

(years) 

2001-03 2006-08 01-03 to 06-08 

Hull 78.1 (77.5 to 78.6) 77.3 (76.7 to 77.9) -0.8 

North East Lincolnshire 79.0 (78.1 to 79.9) 78.5 (77.5 to 79.4) -0.5 






England 77.7 (77.6 to 77.8) 78.7 (78.6 to 78.8) 1.0 

Hull 80.4 (79.6 to 81.3) 81.4 (80.7 to 82.2) 1.0 







England 79.8 (79.8 to 79.9) 81.0 (81.0 to 81.1) 1.2 

Hull 81.7 (80.7 to 82.6) 82.4 (81.2 to 83.6) 0.7 

North East Lincolnshire 81.9 (80.7 to 83.2) 81.4 (80.2 to 82.6) -0.5 






England 81.2 (81.1 to 81.2) 82.4 (82.3 to 82.5) 1.2 

Hull 82.2 (80.8 to 83.6) 83.5 (82.1 to 84.9) 1.3 







England 82.0 (81.9 to 82.0) 83.2 (83.2 to 83.3) 1.3 

Most deprived 

Second most 

deprived 

Second least 

deprived 

Middle quintile 

Deprivation-specific life expectancy at birth in 2006-2008 and changes in life expectancy 

since 2001-2003 are shown in Table 76 and Table 77 for individual PCTs within the 

Humber and Yorkshire region and the group of 10 comparator PCTs respectively. In the 

most deprived national quintile, Hull men had the joint third lowest life expectancy in the 

region while Hull women had the second lowest. In the second most deprived quintile 

men in Hull had the highest life expectancy in the region while Hull women had the 

second highest. In terms of changes to life expectancy since 2001-2003, Hull‟s best 

performance relative to other Yorkshire and Humber PCTs was in the middle and 



second most deprived quintiles for men (3 rd and 5 th largest improvement respectively) 

and in the second most deprived quintile for women (5 th largest improvement). 

Comparing against comparator PCTs (Table 77), Hull had lower life expectancy than 

most comparator PCTs for the most deprived and second least deprived national 

deprivation quintiles, but within the second most deprived quintile life expectancy in Hull 

men and women was higher than all but one comparator PCT, while in the middle 

quintile life expectancy among Hull men was also higher than all but one comparator 

PCT, while among women only two PCTs had higher life expectancy than Hull. In terms 

of changes to life expectancy since 2001-2003, Hull‟s best performance relative to the 

10 comparator PCTs was in the middle and second most deprived quintiles for men 

(only 1 and 3 comparator PCTs respectively had larger improvements in life expectancy) 

and in the second most deprived quintile for women (only 4 comparator PCTs saw a 

larger improvement in life expectancy). 



Table 76: Life expectancy at birth (years) in 2006-2008 by national deprivation quintile of IMD 2007, plus the change in life 

expectancy (in years) since 2001-2003, Yorkshire and Humber PCTs 

Males 

Females 

Life expectancy at birth (years) in 2006-2008 by national deprivation quintile of IMD 2007, plus the 

PCT 

Most deprived 

change in life expectancy (in years) since 2001-2003 

2 nd most deprived Middle quintile 2 nd least deprived 

Life expectancy Chg Life expectancy Chg Life expectancy Chg Life expectancy Chg 

Hull 72.3 (71.7, 72.9) 1.0 77.2 (76.3, 78.1) 1.5 79.7 (78.6, 80.8) 2.4 79.2 (77.7, 80.7) -1.0 

Barnsley 73.4 (72.6, 74.1) 1.2 76.2 (75.3, 77.0) 1.8 77.6 (76.8, 78.5) 0.9 80.8 (79.5, 82.1) 1.7 

Bradford and Airedale 72.1 (71.5, 72.6) 0.6 76.9 (76.2, 77.7) 2.2 78.1 (77.3, 78.9) 1.4 79.1 (78.2, 80.0) 2.2 

Calderdale 72.4 (71.2, 73.6) 0.5 76.3 (75.2, 77.4) 2.1 78.4 (77.3, 79.4) 3.2 79.5 (78.5, 80.4) 0.7 

Doncaster 73.1 (72.4, 73.8) 1.0 76.2 (75.4, 77.0) 0.7 78.4 (77.4, 79.3) 1.0 80.1 (79.1, 81.1) 1.4 

East Riding of Yorkshire 72.6 (70.9, 74.3) 0.6 75.6 (74.5, 76.8) 0.7 78.8 (77.9, 79.6) 2.2 79.4 (78.7, 80.1) 1.6 

Kirklees 72.1 (71.4, 72.9) 0.4 75.8 (75.0, 76.5) 1.9 77.0 (76.1, 77.8) 1.5 79.5 (78.8, 80.2) 1.4 

Leeds 72.4 (71.9, 73.0) 1.7 75.6 (75.0, 76.3) 0.8 78.2 (77.6, 78.9) 1.2 79.5 (79.0, 80.1) 1.2 

North East Lincolnshire 72.3 (71.4, 73.3) 1.3 76.3 (74.9, 77.7) 0.7 78.1 (76.8, 79.5) 2.9 77.8 (76.6, 79.0) 0.6 

North Lincolnshire 71.7 (70.3, 73.2) 0.5 74.2 (72.8, 75.6) 0.3 76.9 (75.7, 78.1) 1.0 81.1 (80.3, 82.0) 3.7 

North Yorkshire and York 72.8 (71.6, 74.1) 0.8 75.3 (74.5, 76.1) 1.1 78.3 (77.8, 78.8) 1.7 79.6 (79.2, 80.0) 1.7 

Rotherham 73.3 (72.5, 74.0) 1.1 75.7 (74.8, 76.6) 0.9 78.3 (77.4, 79.2) 1.6 79.8 (78.9, 80.7) 1.7 

Sheffield 74.2 (73.6, 74.7) 1.6 76.1 (75.4, 76.8) 0.9 78.9 (78.2, 79.6) 1.7 81.0 (80.2, 81.8) 3.0 

Wakefield District 72.8 (72.0, 73.5) 0.8 76.4 (75.7, 77.1) 1.2 77.1 (76.1, 78.1) 0.7 80.1 (79.1, 81.1) 2.1 

Hull 77.3 (76.7, 77.9) -0.8 81.4 (80.7, 82.2) 1.0 82.4 (81.2, 83.6) 0.7 83.5 (82.1, 84.9) 1.3 

Barnsley 78.0 (77.3, 78.7) 0.3 80.5 (79.7, 81.2) 0.4 81.3 (80.5, 82.0) 0.7 84.7 (83.4, 85.9) 1.6 

Bradford and Airedale 77.5 (76.9, 78.0) 0.5 80.5 (79.9, 81.2) 0.2 82.6 (81.9, 83.3) 1.7 82.1 (81.5, 82.8) 1.5 

Calderdale 77.5 (76.4, 78.5) -0.2 81.1 (80.1, 82.0) 0.4 82.0 (81.0, 83.0) 2.0 84.1 (83.2, 85.0) 2.5 

Doncaster 79.1 (78.4, 79.8) 1.0 79.9 (79.2, 80.7) 0.8 83.5 (82.8, 84.2) 2.1 83.5 (82.6, 84.5) 1.5 

East Riding of Yorkshire 78.8 (77.4, 80.2) 2.9 80.8 (79.7, 81.8) 0.9 82.1 (81.4, 82.9) 1.3 82.9 (82.3, 83.6) 1.4 

Kirklees 77.7 (77.0, 78.4) 1.5 79.9 (79.2, 80.5) 0.8 81.8 (81.0, 82.5) 1.5 82.4 (81.8, 83.1) 1.1 

Leeds 78.9 (78.4, 79.4) 0.9 80.9 (80.2, 81.5) 0.6 82.5 (81.9, 83.0) 1.0 83.1 (82.5, 83.6) 1.3 

North East Lincolnshire 78.5 (77.5, 79.4) -0.5 81.1 (79.9, 82.2) 2.0 80.9 (79.6, 82.1) -0.5 83.2 (82.2, 84.2) 0.3 

North Lincolnshire 76.1 (74.7, 77.4) -1.1 80.2 (78.9, 81.5) 0.2 81.2 (80.2, 82.2) -0.1 82.9 (82.1, 83.8) 0.7 

North Yorkshire and York 79.1 (78.0, 80.2) 1.6 82.2 (81.5, 82.8) 1.8 82.3 (81.8, 82.8) 0.6 82.6 (82.2, 83.0) 0.5 

Rotherham 79.0 (78.2, 79.7) 1.2 79.9 (79.0, 80.8) 0.1 81.7 (80.9, 82.5) 1.5 82.5 (81.6, 83.5) 1.9 

Sheffield 79.3 (78.8, 79.8) 0.7 80.9 (80.2, 81.6) 2.0 82.1 (81.4, 82.7) 0.9 83.0 (82.2, 83.7) 1.0 

Wakefield District 78.0 (77.3, 78.7) 0.4 80.9 (80.3, 81.6) 1.1 81.2 (80.4, 82.0) 1.4 82.9 (82.0, 83.8) 1.0 



Table 77: Life expectancy at birth (years) in 2006-2008 by national deprivation quintile of IMD 2007, plus the change in life 

expectancy (in years) since 2001-2003, Hull and comparator PCTs 

Males 

Females 

Life expectancy at birth (years) in 2006-2008 by national deprivation quintile of IMD 2007, plus the 

PCT 

Most deprived 

change in life expectancy (in years) since 2001-2003 

2 nd most deprived Middle quintile 2 nd least deprived 

Life expectancy Chg Life expectancy Chg Life expectancy Chg Life expectancy Chg 

Hull 72.3 (71.7, 72.9) 1.0 77.2 (76.3, 78.1) 1.5 79.7 (78.6, 80.8) 2.4 79.2 (77.7, 80.7) -1.0 

Wolverhampton City 73.1 (72.4, 73.8) 0.8 76.0 (75.0, 77.1) 1.1 78.6 (77.5, 79.8) 2.1 80.1 (78.9, 81.3) 1.1 

Salford 71.5 (70.7, 72.2) 1.3 75.9 (75.1, 76.7) 1.3 77.1 (75.8, 78.4) 0.6 80.5 (78.9, 82.0) 1.0 

Derby City 72.9 (72.0, 73.8) 1.2 75.9 (75.1, 76.8) 0.4 78.3 (77.2, 79.4) 2.0 80.6 (79.3, 81.9) 1.0 

Stoke-on-Trent 73.6 (73.0, 74.3) 2.5 75.7 (74.8, 76.6) 1.3 79.4 (78.2, 80.6) 2.3 79.5 (78.3, 80.7) 1.6 

Coventry 72.6 (71.8, 73.4) 1.2 75.8 (75.0, 76.5) 0.7 78.5 (77.6, 79.3) 0.8 79.8 (78.7, 80.8) 0.0 

Plymouth 74.4 (73.5, 75.3) 1.5 75.1 (74.1, 76.0) -0.4 79.0 (78.0, 79.9) 2.6 80.5 (79.7, 81.4) 2.7 

Sandwell 72.1 (71.5, 72.7) 0.2 75.8 (74.9, 76.7) 0.4 79.4 (78.4, 80.5) 1.6 81.5 (78.7, 84.2) 2.1 

Middlesbrough 71.7 (70.9, 72.6) 0.7 77.4 (75.7, 79.0) 3.8 80.1 (78.7, 81.4) 2.0 82.0 (80.5, 83.5) 2.5 

Sunderland 72.1 (71.4, 72.7) 0.3 76.5 (75.7, 77.2) 2.4 78.3 (77.4, 79.3) 1.3 80.8 (79.6, 82.0) 2.2 

Leicester 73.3 (72.7, 74.0) 0.8 76.4 (75.6, 77.1) 2.5 77.9 (76.8, 79.1) 0.5 81.3 (79.8, 82.7) 2.1 

Comparator average 72.7 (72.4, 72.9) 1.0 76.0 (75.7, 76.2) 1.2 78.6 (78.3, 79.0) 1.6 80.4 (80.1, 80.8) 1.5 

Hull 77.3 (76.7, 77.9) -0.8 81.4 (80.7, 82.2) 1.0 82.4 (81.2, 83.6) 0.7 83.5 (82.1, 84.9) 1.3 

Wolverhampton City 78.9 (78.2, 79.5) -0.1 81.1 (80.1, 82.0) 0.4 81.9 (80.9, 83.0) 1.0 82.6 (81.4, 83.8) 0.9 

Salford 76.9 (76.1, 77.6) 1.5 79.4 (78.6, 80.2) 0.4 81.7 (80.4, 82.9) 1.1 84.5 (83.0, 86.0) 1.8 

Derby City 78.4 (77.5, 79.3) 0.8 80.8 (79.9, 81.7) 0.9 81.3 (80.3, 82.3) 0.9 84.2 (82.8, 85.5) 1.1 

Stoke-on-Trent 78.6 (78.0, 79.2) 0.7 80.5 (79.7, 81.4) 1.3 81.1 (79.7, 82.4) 0.2 81.1 (79.8, 82.3) -0.3 

Coventry 78.6 (77.8, 79.5) 0.8 80.1 (79.4, 80.8) 1.0 83.2 (82.4, 84.1) 1.6 82.9 (82.0, 83.8) 0.6 

Plymouth 80.6 (79.7, 81.4) 2.5 82.5 (81.7, 83.3) 1.8 81.7 (80.8, 82.6) 1.4 83.4 (82.4, 84.3) 0.5 

Sandwell 78.9 (78.4, 79.4) 1.2 80.0 (79.1, 80.9) 0.5 83.5 (82.6, 84.3) 1.1 87.0 (84.9, 89.1) 3.7 

Middlesbrough 77.5 (76.7, 78.2) 1.4 79.5 (77.8, 81.2) 0.6 82.3 (81.1, 83.4) 2.0 87.2 (85.7, 88.6) 1.8 

Sunderland 79.0 (78.4, 79.5) 1.5 80.4 (79.7, 81.1) 1.5 80.6 (79.8, 81.4) 0.9 86.4 (85.3, 87.4) 1.7 

Leicester 78.4 (77.8, 79.0) 0.6 80.6 (79.9, 81.4) 1.4 81.1 (80.1, 82.1) 0.4 85.5 (83.9, 87.0) 1.7 

Comparator average 78.5 (78.3, 78.7) 1.1 80.5 (80.2, 80.8) 1.0 81.8 (81.5, 82.1) 1.0 83.6 (83.2, 84.0) 0.9 



7.7.5 Progress Towards Targets 

To improve life expectancy at birth was a compulsory metric outcome measure for World 

Class Commissioning (WCC), and there was also a target for reducing the gap between 

life expectancy among the most deprived and least deprived areas locally. There is also 

a Public Service Agreement (PSA) 2004 target (MH Treasury, 2004) “to increase male 

life expectancy to 78.6 years and increase female life expectancy to 82.5 years in 

England by 2009-2011”. However, individual targets for PCTs were subsequently 

changed from life expectancy at birth to the all age all cause mortality rate (AAACMR) 

(see section 7.8.4.5 on page 223). There are also other PSA targets associated with 

narrowing the gap between most and least deprived geographical areas, but, in general, 

the gap is widening between Hull and England (as can be seen in Figure 46 and Figure 

47). Furthermore, one of the compulsory metric outcomes for WCC for year 1 was a 

change in the average Index of Multiple Deprivation score, but for year 2 the outcome 

has been changed to reducing the intra-area variability in life expectancy at birth. This 

„slope index‟ measures the difference in life expectancy in years between the local 

bottom deprivation decile (10%) and local top deprivation decile (10%). 

The WCC targets for year 1 and year 2 of the WCC strategy continuing to 2014 as 

illustrated in Table 78. Following the change in the government in May 2010, new 

outcomes are now under consultation (see section 3.3.6.2 on page 52). It is possible 

that life expectancy will not be an outcome, but AAACMR will be used instead. 

However, there is a proposal for the “differences in life expectancy between the 

communities” to be an outcome measure. It is possible that the “between the 

communities” will be defined as the same as the slope index. However, it will probably 

be a few months‟ time before it is known what outcomes measures will be used, and 

their definitions. Nevertheless, progress towards life expectancy and the slope index 

targets are discussed below. 

The updated life expectancy estimates (involving deaths registered in 2009) are 

normally published on the Compendium at the end of the following year (November or 

December 2010), but as at February 2011, the estimates are not yet available and are 

due to be published later on in February or in March 2011. Local estimates of life 

expectancy can be calculated using the Public Health Mortality File (PHMF) and the GP 

registration file. The number of deaths in the local PHMF and the official mortality 

statistics will be the same, but the Compendium uses ONS mid-year population 

estimates which differ from the estimates of the number of residents from the GP 

registration file. Therefore, locally calculated figures differ slightly from the official 

figures published in the Compendium, with life expectancy likely to be around 0.1-0.2 

years higher with locally estimated figures. In the absence of the official statistics, the 

locally derived estimates can provide a guide. 

If the locally derived estimates are approximate estimates or around 0.1-0.2 years 

higher than the official figures, then Hull‟s life expectancy target for 2007-2009 will not 

be achieved (Table 78). However, it does appear that there may have been a relatively 



high increase in life expectancy for women in Hull with life expectancy increasing by 

around one year or just lower between 2004-2006 and 2007-2009. 

Table 78: WCC life expectancy targets in Hull 

Period Life expectancy for males (years) Life expectancy for females (years) 

Hull Hull England Industrial Hull Hull England Industrial 

actual target 

Hinterlands actual target 

Hinterlands 

2004-06 74.7 74.72 77.32 75.2 79.0 79.25 81.55 79.8 

2005-07 74.8 75.13 77.65 75.6 79.1 79.60 81.81 80.2 

2006-08 75.0 75.55 77.93 79.5 79.95 82.02 

2007-09 *75.4 75.97 *80.1 80.30 

2008-10 76.38 80.65 

2009-11 76.80 81.00 

2010-12 77.22 81.35 

2011-13 77.63 81.70 

2012-14 78.05 82.05 

*Locally derived estimates of life expectancy which are likely to be around 0.1-0.2 years higher 

than the official estimates due to be published in February/March 2011. 

The rationale for selecting the life expectancy targets for Hull is as follows: local life 

expectancy targets had already been calculated up to 2009-2011 by NHS Hull for 

inclusion on the local authority Community Strategy (based on the PSA 2004 mentioned 

above). At the time of calculating the local targets, the latest available life expectancy 

data was for 2002-2004, and the rate of change needed between 2002-2004 and 2009- 

2011 for England to achieve its targets was 2.68% (from 76.55 years to 78.6 years) and 

1.97% (from 80.91 years to 82.5 years) for males and females respectively. The targets 

for Hull included an element to reduce the gap in life expectancy, with the percentage 

difference between 2002-2004 and Hull‟s local 2009-2011 target set to be around 25% 

higher than England (i.e. an increase of 3.36% for males and 2.53% for females). This 

equated to local targets of 76.8 years for men and 81.0 years for women. The absolute 

improvement from 2002-2004 and 2009-2011 is 0.416 years for men and 0.350 years 

for women. Continuing these improvements to 2012-2014 gives life expectancy targets 

of 78.048 years for men and 82.050 years for women in Hull. 

One of the compulsory metric outcome for WCC for year 1 was a change in the average 

Index of Multiple Deprivation score, but for year 2 the outcome was been changed to 

reducing the intra-area variability in life expectancy at birth. The „slope index‟ measures 

the difference in life expectancy in years between the local bottom deprivation decile 

(10%) and local top deprivation decile (10%). 

Table 79 gives the „slope index‟ for males and females for Hull, England and the Office 

for National Statistics (ONS) Industrial Hinterlands Classification (Hull has been 

classified as being within this group) as well as the local targets for the „slope index‟. 

The rationale for selecting the „slope index‟ targets for Hull is as follows: examining the 

changes from 2001-2005 to 2003-2007 for Hull, and examining the other 15 PCTs within 



the Hull‟s Classification Area Industrial Hinterlands, slope targets of 9.51 years for men 

and 6.49 years for women have been chosen. Hull‟s current slope index is 11.4 for men 

and 8.1 years for women with the range from other PCTs within the Industrial 

Hinterlands ranging from 7.5 to 12.7 years for men and from 5.0 to 10.7 years for 

women. The national slope is currently 8.7 for men and 5.65 for women. The targets for 

Hull were chosen on the basis of achieving a slope that was in the top quintile for the 

ONS Industrial Hinterlands group with the target improvement gradually increasing 

towards 2010-2014 (by 0.02) as new programmes come into effect and have an 

influence on mortality and life expectancy. For males, the target reduction in the slope is 

0.21 the first year increasing to 0.23 the second year until the final reduction in year 7 is 

0.33. For females, the target reduction in the slope is 0.17 the first year increasing to 

0.19 the second year until the final reduction in year 7 is 0.29. 

The latest figures from 2005-09 are available from the Yorkshire and Humber Public 

Health Observatory and show that in males the slope index is the same as fro 2002-06 

whereas in women the slope index has increased by over one-quarter from 7.2 years in 

2002-06 to 9.1 years for 2005-09. Therefore, the ambitious WCC targets have not been 

achieved. 

Table 79: WCC „slope index‟ values and targets for Hull 

Period Slope index for males (years) Slope index for females (years) 

Hull Hull England Industrial Hull Hull England Industrial 

actual target 

Hinterlands actual target 

Hinterlands 

2002-06 11.7 8.28 11.1 7.2 5.50 7.3 

2003-07 11.4 8.70 11.2 8.1 5.65 8.1 

2004-08 11.19 7.93 

2005-09 11.7 10.96 9.1 7.74 

2006-10 10.71 7.53 

2007-11 10.44 7.30 

2008-12 10.15 7.05 

2009-13 9.84 6.78 

2010-14 9.51 6.49 



7.8 Mortality 

7.8.1 Causes of Death 

The main causes of death in Hull are cancer and coronary heart disease (CHD), and 

these two causes account for more than half of all deaths under the age of 75 years. A 

sizeable proportion of cancer deaths are due to lung cancer. There were some 

differences between males and females as illustrated by Figure 56 and Figure 57 which 

show the main causes of death for men and women respectively who die under the age 

of 75 years in the three year period 2007-2009. The percentage of deaths in those aged 

under 75 years that were caused by cancer were higher in women (43%) than in men 

(33%), although the number of cancer deaths in those aged under 75 years remained 

higher in men (597) than women (484), due to the propensity of men to die earlier than 

women. The percentage of under 75 deaths in men due to CHD (18%) was two thirds 

higher than for women (11%). The total number of deaths over the three year period is 

given adjacent to the category label. 

There was little difference in the cause of death for males aged under 75 years among 

the three Localities (Figure 58, Figure 59 and Figure 60). 

Amongst women dying under the age of 75 years those in the North Locality were more 

likely to die from cancer or CHD (60%) than women in East (53%) or West (50%) 

Localities (Figure 61, Figure 62 and Figure 63). 

The underlying data are given within the figures, and also given in the APPENDIX on 

page 850. 



Figure 56: Main causes of death for Hull males under 75 years, 2007-2009 

External causes of 

death, 144, 8% 

Diseases of the 

digestive system, 

143, 8% 

Other diseases of 

the respiratory 

system, 49, 3% 

Chronic obstructive 

pulmonary disease, 

98, 6% 

Influenza and 

pneumonia, 42, 

2% 

Other causes of 

death, 236, 13% 


the circulatory 


Stroke, 70, 4% 

Lung cancer, 204, 

11% 

Coronary heart 

disease, 329, 18% 

Other cancers, 393, 

22% 

Figure 57: Main causes of death for Hull females under 75 years, 2007-2009 

External causes 

of death, 40, 3% 



61, 5% 






82, 7% 

Influenza and 

pneumonia, 29, 3% 





death, 171, 15% 



13% 


disease, 127, 11% 


30% 



Figure 58: Causes of death for males under 75 years in North Locality, 2007-2009 



36, 9% 






23, 6% 

Influenza and 







12% 


disease, 77, 19% 


21% 

Figure 59: Causes of death for males under 75 years in East Locality, 2007-2009 




Influenza and 


3% 


death, 31, 8% 


death, 43, 6% 



49, 7% 



38, 6% 


death, 44, 11% 






10% 


disease, 119, 18% 


24% 

Figure 60: Causes of death for males under 75 years in West Locality, 2007-2009 


death, 70, 9% 



58, 8% 






37, 5% 

Influenza and 


2% 


death, 87, 13% 


death, 105, 14% 






12% 


20% 


disease, 133, 18% 



Figure 61: Causes of death for females under 75 years in North Locality, 2007-2009 

External causes 

of death, 6, 2% 



Other diseases 15, of 6% 


system, 4, 2% 



20, 8% 

Influenza and 





Stroke, 7, 3% 




13% 


34% 

Figure 62: Causes of death for females under 75 years in East Locality, 2007-2009 


death, 12, 3% 



18, 4% 



system, 9, 2% 



36, 8% 


death, 31, 12% 


death, 67, 16% 

Influenza and 







13% 




29% 

Figure 63: Causes of death for females under 75 years in West Locality, 2007-2009 


death, 73, 16% 


death, 22, 5% 



28, 6% 






26, 6% 

Influenza and 







13% 




27% 



The primary cause of death is examined in more detail in Table 80 for Hull residents 

giving the total number of deaths registered during the period 2007-2009. For some 

causes, the number of deaths is small and it has been necessary to combine categories. 

In most cases, the numbers are small across most of the four age/gender combinations. 

Over the three year period, there were a total of 596 and 484 cancer 25 deaths in men 

and women respectively who were aged under 75 years, and a further 526 and 534 

cancer deaths in men and women respectively who were aged 75 years or older. There 

were a total of 493 and 249 circulatory disease deaths in men and women respectively 

who were aged under 75 years, and a further 651 and 865 circulatory disease deaths in 

men and women respectively who were aged 75 years and over. 

Table 80: Primary cause of death for Hull residents, 2007-2009 

Primary cause of death Total number of deaths 2007-2009 

Aged


Primary cause of death Total number of deaths 2007-2009 

Aged


7.8.2 Causes of Death by Age 

It is useful to examine the different causes of death at the ages they occur. Figure 64 

gives the total number of deaths over the three year period 2005-2007 by cause of 

death and the age at which they occur for men and women combined. This could be 

updated for 2007-2009, but the pattern will essentially be similar with the same causes 

of death predominant at the different ages. 

Figure 64: Total number of deaths by cause of death and age, 2005-2007 

Total number of deaths (2005-2007) 

1500 

1250 

1000 

750 

500 

250 

0 

0 

1-4 

Other causes 

External causes of death 

Senility 

Disease of the digestive system 

Other diseases of the respiratory system 

Chronic obstructive pulmonary disease 

Influenza and pneumonia 

Other diseases of the circulatory system 

Stroke 

Coronary heart disease 

Dementia 

Other cancers 

Lung cancer 

Digestive system cancers 

Infant (


the 80-84 year age group. With such small numbers in the younger age groups, just 

one single death from a particular cause can make a relatively large difference to the 

percentages within that age group, and influence interpretation unduly. 

Figure 65: Total number of deaths by cause of death and age for men, 2005-2007 

Total number of deaths in men (2005-2007) 

800 

700 

600 

500 

400 

300 

200 

100 

0 

0 

1-4 

5-9 

10-14 

15-19 

20-24 

25-29 

30-34 

35-39 

40-44 

Figure 66: Total number of deaths by cause of death and age for women, 2005-2007 

Total number of deaths in women (2005-2007) 

800 

700 

600 

500 

400 

300 

200 

100 

0 

0 

1-4 

Other causes 

External causes of death 

Senility 






Stroke 


Dementia 

Other cancers 

Lung cancer 


Infant (

Male deaths in Hull 2005-2007 


Figure 67: Percentage of deaths by cause of death and age for men, 2005-2007 

100% 

80% 

60% 

40% 

20% 

0% 

0-19 (n=54) 

20-24 (n=31) 

25-29 (n=37) 

30-34 (n=53) 

35-39 (n=54) 

40-44 (n=88) 

45-49 (n=93) 

50-54 (n=133) 

55-59 (n=209) 

Age at death in years (total number of deaths) 

60-64 (n=238) 

65-69 (n=346) 

70-74 (n=465) 

75-79 (n=591) 


80-84 (n=687) 

85-89 (n=424) 

90-94 (n=196) 

95+ (n=42) 

Other causes 

Other external causes of death 

Deaths requiring investigation 

Suicide & undetermined injury 

Other external causes of accidental injury 

Accidental poisoning (alcohol or drugs) 

Deaths caused by transport vehicles 

Senility 

Perinatal/congenital conditions 






Stroke 


Nervous system, eye, ear, etc 

Other mental & behavioural disorders 

Substance misuse 

Dementia 

Other endocrine, nutritional & metabolic diseases 

Diabetes 

Other cancers 

Lymphoid & haematopoietic cancers 

Prostate cancer 

Lung cancer 


Certain infectious & parasitic disease 

Infant (

Female deaths in Hull 2005-2007 


Figure 68: Percentage of deaths by cause of death and age for women, 2005-2007 

100% 

80% 

60% 

40% 

20% 

0% 

0-24 (n=53) 

25-34 (n=32) 

35-39 (n=30) 

40-44 (n=34) 

45-49 (n=61) 

50-54 (n=84) 

55-59 (n=142) 

60-64 (n=157) 

Age at death in years (total number of deaths) 

65-69 (n=238) 

70-74 (n=370) 

75-79 (n=586) 

80-84 (n=730) 


85-89 (n=686) 

90-94 (n=522) 

95-99 (n=213) 

100+ (n=35) 

Other causes 

Other external causes of death 

Deaths requiring investigation 

Suicide & undetermined injury 

Other external causes of accidental injury 

Accidental poisoning (alcohol or drugs) 

Deaths caused by transport vehicles 

Senility 

Perinatal/congenital conditions 




Influenza & pneumonia 


Stroke 


Nervous system, eye, ear, etc 

Other mental & behavioural disorders 

Substance misuse 

Dementia 

Other endocrine, nutritional & metabolic diseases 

Diabetes 

Other cancers 

Lymphoid & haematopoietic cancers 

Breast cancer 

Lung cancer 


Certain infectious & parasitic disease 

Infant (


7.8.3 Stillbirths and Infant Mortality Rate 

7.8.3.1 Stillbirths 

From the Compendium, Table 81 gives the total number of stillbirths over the three year 

period 2006-2008 and the crude rate per 1,000 births. Hull had a higher stillbirth rate 

compared to England and most of its comparators for 2008, but a lower rate compared 

to England and most of its comparators for 2007, highlighting the fact that these figures 

are subject to random year-on-year variation. Averaged out over the last three years, 

the rate for Hull is identical to that for England and the Industrial Hinterlands, but lower 

in Hull compared to the regional average and the average of the 10 comparator areas. 

Table 81: Stillbirth rate, 2006-2008 

Geographical area Total births Stillbirth number/rate per 1,000 births 

over 3 years Total 3yr number Rate (95% CI) 

England 1,974,173 10,259 5.2 (5.1, 5.3) 

Hull 10,709 56 5.2 (4.0, 6.8) 

Y&H SHA 194,589 1,090 5.6 (5.3, 5.9) 

Indust Hinterl’ds 131,937 688 5.2 (4.8, 5.6) 

Wolverhampton 9,962 66 6.6 (5.2, 8.4) 

Salford 9,541 52 5.5 (4.2, 7.1) 

Derby 10,282 64 6.2 (4.9, 7.9) 

Stoke-on-Trent 10,883 60 5.5 (4.3, 7.1) 

Coventry 13,272 65 4.9 (3.8, 6.2) 

Plymouth 9,466 41 4.3 (3.2, 5.9) 

Sandwell 13,441 83 6.2 (5.0, 7.7) 

Middlesbrough 5,779 27 4.7 (3.2, 6.8) 

Sunderland 9,843 67 6.8 (5.4, 8.6) 

Leicester 15,071 115 7.6 (6.4, 9.2) 

Average above 10 107,540 640 6.0 (5.5, 6.4) 

NE Lincolnshire 5,910 31 5.2 (3.7, 7.4) 

7.8.3.2 Infant Mortality Rate 

From the Compendium, the number of deaths and the crude mortality rates are given in 

Table 82 for deaths occurring under the ages of 1 year. The crude mortality rate for 

2006-2008 is slightly higher than England, and similar to that for the Industrial 

Hinterlands group, but considerably lower than the average of the 10 comparator groups 

and lower than the regional average. However, none of these differences with Hull are 

statistically significant. 



Table 82: Crude infant mortality rate, 2006-2008 

Geographical area Total live 

births 2006-08 

Number and infant mortality rate per 

1,000 live births 2006-2008 

Total 3yr number Rate (95% CI) 

England 1,963,914 9,503 4.8 (4.7, 4.9) 

Hull 10,653 54 5.1 (3.9, 6.6) 

Y&H SHA 193,499 1,079 5.6 (5.3, 5.9) 

Industrial Hinterlands 131,249 659 5.0 (4.7, 5.4) 


Salford 9,489 56 5.9 (4.5, 7.7) 

Derby 10,218 58 5.7 (4.4, 7.3) 

Stoke-on-Trent 10,823 63 5.8 (4.5, 7.4) 

Coventry 13,207 79 6.0 (4.8, 7.5) 

Plymouth 9,425 46 4.9 (3.7, 6.5) 

Sandwell 13,358 113 8.5 (7.0, 10.2) 


Sunderland 9,776 39 4.0 (2.9, 5.5) 

Leicester 14,956 107 7.2 (5.9, 8.6) 

Average above 10 106,900 653 6.1 (5.6, 6.6) 


Since 1999, the infant mortality rate in Hull has been generally lower than the national 

rate, with exceptions in the years 2000, 2003, 2006 and 2008. In 2006, the crude infant 

mortality rate was considerably higher than England, rising from 4.4 per 1,000 live births 

(95% CI 2.6, 7.4) with 14 deaths in 2005 to 6.9 per 1,000 live births (95% CI 4.6, 10.2) 

with 24 deaths in 2006, 16 of which occurred within the first seven day of life. This was 

of immediate concern, and the records of the infants who died were examined to assess 

if there was a specific cause of death or set of circumstances that might have increased 

the rate. The circumstances of all infant deaths were examined: 13 of these deaths (and 

possibly one further death) would normally not have been classified as infant deaths as 

they were „not viable‟. The 13 deaths were infants born before 22 weeks gestation, 

terminations of pregnancy at 20 weeks, or multiple births born extremely early and not 

expected to survive. However a research survey (Epicure Study) was conducted during 

the year 2006 which involved more detailed examination of infants delivered between 20 

and 26 weeks gestation. It appears that with the survey taking place, some infants were 

classified as a live birth but were actually unviable, and without the occurrence of the 

survey would not have been recorded as a live birth. The definition of a live birth is not 

straightforward. It appears, particularly in the light of the Hull mortality figures for 2007 

which were lower than England, that the occurrence of the study may have influenced 

the recording of what constituted a „live‟ birth. The rate for 2008 for Hull (4.9 deaths per 

1,000 live births; 95% CI 3.1 to 7.7) was similar to the England average (4.7 deaths per 

1,000 live births; 95% CI 4.6 to 4.9). 



7.8.3.3 Progress Towards Targets 

The target relating to children and young people within the local World Class 

Commissioning (WCC) Strategy was to reduce the under one year mortality rate per 

1,000 live births to that of England. The baseline year was 2006, which as noted above 

was probably artificially high compared to the trends in the previous few years. At the 

time of setting the target, this was not known and a period of seven years was set to 

return to England‟s mortality rates as the rate in Hull for 2006 was 38% higher than 

England. Since that time, more recent information on the crude mortality rate for 2007 

and 2008 has shown the consistency with previous years. The WCC targets are noted 

in Table 83. Following the change in the government in May 2010, new outcomes are 

now under consultation (see section 3.3.6.2 on page 52). However, one of the 

outcomes is infant mortality, so it is possible that this could be an outcome and targets 

would be retained. 

Table 83: World Class Commissioning Targets for the infant mortality rate 

Year Crude infant mortality rate per 1,000 live births 

England (modelled) Hull (target) Hull (actual) 

2007 4.85 6.41 3.5 

2008 4.75 5.92 4.9 

2009 4.66 5.43 

2010 4.56 4.95 

2011 4.46 4.46 

2012 4.36 4.36 

2013 4.26 4.26 


n/a


7.8.4 All Cause Mortality 

In general, as all people must die, it is preferable to examine premature mortality rather 

than mortality at any age (all ages). Therefore, within this document, the focus is 

generally on premature mortality relating to deaths which occurred under the age of 75 

years. Nevertheless, Department of Health targets exist for life expectancy and the all 

age all cause mortality rate (AAACMR), so this „all age‟ measure is presented within this 

section as well as the under 75 mortality rates. Both the under 75 year and all age rates 

are standardised for age. The AAACMR uses direct standardisation, and results in a 

mortality rate per 100,000 standard population. It is possible to use direct 

standardisation for the under 75 year rate as well, but within the section below indirect 

standardisation is used and the standardised mortality ratios (SMRs) are presented. 

See section 12.3 on page 773 for more information on standardisation. 

7.8.4.1 Under 75 Year All Cause Mortality Ratio 

From the Public Health Mortality File (PHMF), the age standardised mortality ratios 

(SMRs) from deaths from all causes for males and females under the age of 75 years 

are given in Table 84 for each ward in Hull for the period 2007 to 2009. The rates are 

compared with England (that is, the value 100). A value higher than 100 denotes that 

the mortality is higher than England and a value lower than 100 denotes a lower allcause 

mortality than England. Thus the overall mortality rate for Hull was just over 30% 

higher than the mortality rate in England. As expected the majority of wards in Hull had 

higher under 75 mortality rates compared to England, with Beverley the only ward that 

had a mortality rate that was statistically significantly lower than England 26 . Of the 

Areas, Riverside (not shown) had the highest under 75 mortality rate being 73% higher 

(95% CI 61% to 87% higher) than England. West and Wyke have the lowest mortality 

rates in Hull with Wyke having a similar under 75 mortality rate to England and West‟s 

rate being around 10% higher than England. The rest of the areas had under 75 

mortality rates around 30% higher than England and were all significantly higher than 

England (the 95% lower confidence limit was higher than 100). The Localities each had 

under 75 mortality rates statistically significantly higher than England, with the lowest in 

North Locality (28% higher than England) and the highest in West Locality (33% higher 

than England). There was more variability at ward level due to the smaller number of 

deaths, with the SMRs ranging from 75 (Beverley) and 85 (Holderness) to 201 (St 

Andrew‟s) and 213 (Myton). 

Whilst the absolute mortality rates are higher for males compared to females in Hull (see 

directly standardised mortality rates in section 7.8.4.4 and life expectancy in section 

7.7), mortality in Hull women relative to women in England (31% higher than England) is 

26 If the 95% CI does not include 100 then the rate differs significantly than the national rate (see section 

12.4 and section 12.5 for more information). However, even when there was no difference between the 

local and national mortality rates, one would expect 5% of statistical comparisons to be classified 

„statistically significant‟ by chance, so this must be borne in mind. Is it a true difference or could it be by 

chance as a number of statistical comparisons have been made? 



similar to mortality in Hull men compared with men in England (30% higher than 

England). 

Table 84: Under 75 all cause age-standardised mortality ratio for Hull, 2007-2009 

Ward/area/locality Age-standardised mortality ratio (SMR) 

for persons aged


Note that these locally derived SMRs are lower from those quoted in the official statistics 

(available on the Compendium) from the Office for National Statistics (ONS). The 

reason for this is that the population estimates used in the local figures are slightly 

higher. Local resident population estimates from the GP registration file have been used 

in Table 84 whereas the mid-year population estimates produced by ONS are used in 

the official estimates. The official estimates for the under 75 SMR for the period 2006- 

2008 (the most recent period for which this data were available at the time of writing) for 

Hull were 134 (95% CI 128 to 140) for men, 138 (95% CI 131 to 147) for women and 

136 (95% CI 131 to 141) for men and women combined, whereas using local population 

data the equivalent SMRs for 2006-2008 were 127 (95% CI 121 to 133) for men, 134 

(95% CI 127 to 142) for women and 131 (95% CI 126 to 136) for men and women 

combined. The trends in the under 75 SMRs at ward, Area and Locality level are 

available for 1999-2001 to 2006-2008 for mortality from all causes on the Hull Atlas 

(www.hullpublichealth.org). 

7.8.4.2 Under 75 Year All Cause Mortality Ratio in Relation to Deprivation 

The all cause standardised mortality ratio (SMR) for those persons aged less than 75 

years is given in Figure 69 by deprivation quintile for Hull (for the period 2007 to 2009). 

There is a strong relationship between deprivation and the under 75 year SMR. Those 

residents in Hull living in the areas within the most deprived quintile in Hull had a 

standardised mortality rate that was 92% higher than England‟s average, but those 

residents living in areas which are classified as the least deprived quintile in Hull had a 

mortality rate that was 21% lower than England. While this might seem surprising as all 

of Hull is relatively deprived (in the worst 60% of areas in England), two thirds of the 

least deprived fifth of areas in Hull lie within the middle deprivation quintile nationally, 

with the remainder in the second least deprived fifth of areas nationally. It might have 

been anticipated therefore that the mortality rate in Hull‟s least deprived quintile would 

be similar to, or slightly lower than, the England average, rather than significantly lower. 

The underlying data are given in the APPENDIX on page 851. 



Figure 69: Standardised all cause mortality ratio for persons aged under 75 years by 

deprivation for Hull for 2007-2009 

Under 75 SMRs (95% CI) 

250 

200 

150 

100 

50 

0 

Most deprived Quintile 2 Quintile 3 Quintile 4 Least deprived 

Local deprivation quintile (IMD 2007) 

7.8.4.3 Under 75 Year All Cause Mortality Rate in Relation to Deprivation for Hull and 

Comparator Areas 

This section contains analyses of all cause SMRs within national deprivation quintiles, 

using national mortality data as well as population estimates at lower layer super out 

area (LLSOA) for the entire country. This work was possible due to the assistance of 

the Yorkshire and Humber Public Health Observatory, who hold a copy of the national 

mortality file and commissioned ONS to produce the LLSOA population estimates. At 

the time the analyses were undertaken, the most recent period for which mortality data 

were available was 2008. It should be noted that, because the LLSOA population 

estimates are derived from resident population estimates, which tend to be different to 

the GP registered populations used locally, the SMRs produced will not be the same as 

those produced using local data. It should also be noted that, in order to make 

comparisons with other areas, the analyses were performed using national quintiles of 

IMD 2007, which means that there were no Hull SMRs for the least deprived quintile, as 

none of the LLSOAs in Hull lie within the least deprived fifth of LLSOAs nationally. 

Comparisons were made between Hull and North East Lincolnshire, as well as the 

averages for the 10 comparator PCTs (described elsewhere in this report), Spearhead 

PCTs, the 20 most deprived PCTs in England, the Industrial Hinterlands group of local 

authorities and the Yorkshire and Humber region, using England deprivation-specific 

reference rates. 



Figure 70 and Figure 71 show trends, for men and women respectively, in all cause 

under 75 standardised mortality ratios for Hull and comparator areas by national 

deprivation quintiles of IMD 2007. The underlying data are given in the APPENDIX on 

page 852 and page 853 respectively. 

Looking first at residents living in areas that lie within the most deprived 20% of areas in 

England, which for Hull amounts to more than half of all residents, there was a 

decreasing trend in under 75 SMRs for men in Hull until 2005-2007, followed by an 

increase for 2006-2008. While a similar increase was seen for North East Lincolnshire 

each other comparator saw the decreases continue into 2006-08. Together with smaller 

decreases in Hull than in comparator areas, this meant that in 2006-2008 the under 75 

SMR for Hull‟s most deprived men was higher than each comparator, excluding North 

East Lincolnshire, and statistically significantly higher than for spearhead PCTs and the 

20 most deprived PCTs. For men in the second most deprived and middle quintiles, 

Hull saw decreasing trends in under 75 all cause SMRs in men, with SMRs lower for 

each year among Hull men in the second most deprived national quintile than for each 

comparator area while, in the middle quintile, Hull‟s SMR was the same as the 20 most 

deprived PCTs until 2003-2005 and then it decreased rapidly to end the period lower 

than each comparator, and statistically significant lower than each except the 20 most 

deprived PCTs. The variability for Hull men in the second least deprived quintile (Hull‟s 

least deprived national quintile) is due to the relatively small numbers of death in this 

group, which accounts for only 8% of Hull‟s population and 4% of under 75 deaths. 



Figure 70: Trends in standardised all cause mortality ratio for men aged under 75 years 

by national deprivation quintiles for Hull and comparators for 2001-03 to 2006-08 

Hull women in each national quintile of IMD 2007 saw increases in under 75 all cause 

SMRs for the first part of the period. Women in the most deprived national quintile in 

Hull saw year-on-year increases in under 75 all cause SMRs such that by 2006-2008 

Hull‟s SMR was higher than each comparator, statistically significantly higher than all 

except North East Lincolnshire, with decreasing trends for most other comparators. In 

the second most deprived quintile, Hull women had the lowest SMR of all comparators 

in 2001-2003 and in 2006-2008, although the gap between Hull and comparators 

decreased over the period, as small increases were seen in Hull for the first two years, 

followed by smaller decreases than seen in most comparators. Hull women in the 

middle national deprivation quintile had under 75 all cause SMRs at the start and end of 

the period similar to comparators, while in the second least deprived quintile the under 

75 all cause SMR ended up much lower than the comparators, although not statistically 

significantly lower, due to the relatively small numbers of deaths in this group in Hull 

(accounting for 8% of Hull‟s population and 5% of under 75 deaths). 



Figure 71: Trends in standardised all cause mortality ratio for women aged under 75 

years by national deprivation quintiles for Hull and comparators for 2001-03 to 2006-08 

7.8.4.4 All Age All Cause Mortality Rate 

From the Compendium, the directly standardised all age all cause mortality rates 

(AAACMR) per 100,000 persons are given in Figure 72 for males for 1993-1995 to 

2006-2008 for Hull and comparator areas. The AAACMR has decreased for all areas 

and group areas over the period of time examined. For 1993-1995, Hull‟s AAACMR 

(1,049 deaths per 100,000 men) was lower than the Industrial Hinterlands group (1,106), 

North East Lincolnshire (ONS nearest comparator; 1,031), the Spearhead group (1,111) 

and the average of 10 other comparators (see section 3.3.3 on page 44 for list of 

comparators; 1,102). However, the decrease in Hull‟s AAACMR is not as large as the 

other areas, and males in Hull have the highest AAACMR for the most recent period 

2006-2008 with a mortality rate of 868 per 100,000 men compared to 822 for the 

average of the 10 comparators which is the next highest. Over the entire period 1993- 

1995, Hull‟s AAACMR for men has changed by –17.2% whereas the decreases for 

England (–28.5%) and regionally (–27.1%) have been considerably higher. For 

comparator areas, the decreases have all been higher than Hull‟s (Industrial Hinterlands 



–26.5%; average of 10 comparators –25.4%; NE Lincs –22.1% and Spearheads – 

26.3%). If another period is taken as the „baseline‟ for comparison, it makes little 

difference to Hull‟s performance relative to the other areas (with the exception of NE 

Lincolnshire where the decreased is reduced to a difference similar to Hull‟s). Further 

information on the AAACMR in relation to targets is given in section 7.8.4.5 on page 

223. 

Figure 73 gives the equivalent information for females, and shows a similar pattern to 

males. For 1993-1995, the AAACMR in Hull was 693 per 100,000 women, which was 

only slightly lower than the Spearhead group average (696) and Industrial Hinterlands 

group (707), but slightly higher than the average of the 10 comparators (687) and North 

East Lincolnshire (638). However, for 2006-2008, Hull‟s AACMR was 615 per 100,000 

women which was considerably higher than the comparators with the next highest 

mortality rate (Industrial Hinterlands 576; Spearheads 568; and average of 10 

comparator groups 569). The AAACMR for women changed by –11.2% in Hull 

between 1993-95 and 2006-08, whereas all other areas showed a larger improvement 

(England –20.3%; SHA –18.6%; Industrial Hinterlands –18.5%; Spearheads –18.4%; 

average of 10 comparators –17.1%; and NE Lincs –14.9%). Again, if another year was 

chosen for the „baseline‟ year, it makes relatively little difference to the conclusions. Hull 

still shows the lowest decreases over the period (with the exception of NE Lincolnshire 

which shows similar decrease if a different „baseline‟ year is chosen). 

The underlying data for these figures is given in the APPENDIX on page 854 and on 

page 855 respectively. 



Figure 72: Trend in directly standardised all-cause all-age mortality rate per 100,000 

males, 1993-2008 

Directly standardised mortality rate per 100,000 males 

1200 

1000 

800 

600 

400 

200 

0 

1993-1995 

1994-1996 

1995-1997 

1996-1998 

1997-1999 

1998-2000 

Figure 73: Trend in directly standardised all-cause all-age mortality rate per 100,000 

females, 1993-2008 

Directly standardised mortality rate per 100,000 

females 

800 

700 

600 

500 

400 

300 

200 

100 

0 

1993-1995 


1999-2001 

Period 

England Hull 

Yorkshire & The Humber SHA Industrial Hinterlands (ONS group) 

Average of 10 comparator areas North East Lincolnshire (ONS nearest comparator) 

Spearheads 

1994-1996 

1995-1997 

1996-1998 

1997-1999 

1998-2000 

1999-2001 

Period 

England Hull 



Spearheads 

2000-2002 

2000-2002 

2001-2003 

2001-2003 

2002-2004 

2002-2004 

2003-2005 

2003-2005 

2004-2006 

2004-2006 

2005-2007 

2005-2007 

2006-2008 

2006-2008


Table 85 gives the all age all cause mortality rate for Hull and these comparators for the 

most recent period 2006-2008. For men, the AAACMR for the 10 comparator areas 

combined (822), Spearhead group average (819) and Industrial Hinterlands 

classification area (813) are all similar, but around 6% lower than Hull‟s AAACMR. For 

women, the pattern is similar to men with the 10 comparator areas combined (569), 

Spearhead group average (568) and Industrial Hinterlands (576) all having similar 

AACMRs, whereas Hull has a higher AAACMR (636) and the difference is more marked 

than in men as Hull‟s AAACMR is around 8% higher than the comparator areas. 

Table 85: All age all cause mortality rate Hull versus comparator areas 

Area/Group All age all cause mortality rate per 100,000 

persons (standardised to European 

Standard Population), 2006-2008 

Men Women Persons 

England 692 491 582 

Hull 868 615 733 

Yorkshire & The Humber SHA 736 523 619 

Industrial Hinterlands 813 576 682 

Wolverhampton 802 554 671 

Salford 910 637 761 

Derby 733 513 614 

Stoke-on-Trent 856 599 712 

Coventry 773 530 641 

Plymouth 730 491 597 

Sandwell 890 586 726 

Middlesbrough 836 606 711 

Sunderland 851 579 701 

Leicester 838 596 706 

Average of 10 comparators 822 569 684 

North East Lincolnshire 803 543 661 

Spearhead Group Authorities 819 568 682 

Table 86 gives the AAACMR by ward, Area and Locality, standardised to the European 

Standard Population. The calculations have been undertaken using mortality 

information from the Public Health Mortality File and estimates of resident population 

from the GP registration file. As the population estimates differ from those used by the 

Office for National Statistics presented in the Compendium, the AAACMR for Hull differs 

slightly from that quoted in Table 85. The confidence intervals have been presented 

within Table 86, and this is very important as the number of deaths is relatively small at 

ward level. It can be seen that the confidence intervals are relatively wide. For 

instance, whilst the AAACMR for males in North Locality is 806 per 100,000 men and is 

4.6% lower than that of Hull overall (845 per 100,000 men), the confidence interval for 

North Locality (747 to 870) overlaps the confidence interval for Hull overall (818 to 873). 



This suggests that there is no significant difference in the AAACMR between North 

Locality and Hull overall, but it would be necessary to undertake a statistical test to 

confirm this as the North Locality AAACMR is not within the confidence interval for Hull. 

One of the compulsory metric outcomes for the World Class Commissioning for year 1 

was a change in the average Index of Multiple Deprivation Score, but for year 2 the 

outcome has been changed to reducing the intraward variability in the AAACMR. 

Table 86: All age all cause mortality rate by ward, Area and Locality, 2007-2009 

Ward, Area or 

Locality 

All age all cause mortality rate per 100,000 persons (standardised to 

European Standard Population), 2007-2009 


Bransholme East 1,258 (1,040 to 1,506) 798 (657 to 959) 1,016 (891 to 1,152) 

Bransholme West 770 (628 to 934) 568 (465 to 687) 679 (590 to 777) 

Kings Park 868 (664 to 1,111) 603 (463 to 771) 730 (610 to 867) 

Area: North Carr 914 (812 to 1,025) 639 (567 to 717) 778 (716 to 843) 

Beverley 544 (436 to 669) 429 (340 to 533) 479 (409 to 557) 

Orchard Pk & Gnwd 916 (787 to 1,059) 685 (582 to 800) 792 (710 to 880) 

University 729 (596 to 882) 507 (406 to 624) 608 (525 to 699) 

Area: Northern 743 (670 to 822) 544 (487 to 606) 635 (589 to 683) 

Locality: North 806 (747 to 870) 574 (530 to 621) 685 (648 to 722) 

Ings 812 (711 to 922) 626 (549 to 709) 711 (648 to 777) 

Longhill 811 (699 to 935) 485 (402 to 578) 623 (555 to 696) 

Sutton 935 (804 to 1,082) 697 (600 to 804) 805 (726 to 890) 

Area: East 840 (776 to 909) 600 (550 to 652) 705 (666 to 747) 

Holderness 653 (548 to 772) 441 (366 to 527) 536 (473 to 605) 

Marfleet 1,014 (882 to 1,160) 604 (517 to 701) 800 (721 to 884) 

Southcoates East 901 (748 to 1,076) 769 (640 to 914) 833 (733 to 942) 

Southcoates West 954 (801 to 1,128) 662 (553 to 784) 785 (694 to 883) 

Area: Park 862 (795 to 933) 609 (560 to 661) 726 (686 to 769) 

Drypool 884 (757 to 1,027) 488 (407 to 580) 678 (603 to 758) 

Area: Riverside (E) 884 (757 to 1,027) 488 (407 to 580) 678 (603 to 758) 

Locality: East 856 (813 to 902) 587 (555 to 621) 710 (684 to 738) 

Myton 1,062 (938 to 1,196) 771 (661 to 892) 924 (841 to 1,012) 

Newington 993 (853 to 1,149) 721 (610 to 845) 857 (768 to 954) 

St Andrews 1,170 (993 to 1,368) 909 (761 to 1,074) 1,035 (921 to 1,158) 

Area: Riverside (W) 1,063 (980 to 1,151) 785 (715 to 859) 926 (872 to 982) 

Boothferry 614 (516 to 726) 444 (369 to 529) 517 (456 to 584) 

Derringham 608 (508 to 721) 452 (374 to 539) 516 (454 to 583) 

Pickering 929 (809 to 1,061) 542 (461 to 631) 719 (648 to 795) 

Area: West 721 (659 to 788) 480 (434 to 529) 587 (549 to 626) 

Avenue 773 (649 to 913) 624 (526 to 732) 701 (623 to 786) 

Bricknell 725 (596 to 873) 411 (333 to 500) 546 (474 to 625) 

Newland 930 (759 to 1,126) 590 (466 to 734) 732 (630 to 845) 

Area: Wyke 785 (707 to 869) 534 (477 to 595) 647 (600 to 697) 

Locality: West 849 (806 to 893) 586 (554 to 620) 710 (683 to 737) 

HULL 845 (818 to 873) 584 (564 to 605) 706 (689 to 723) 




The Public Service Agreement (PSA) 2004 target (MH Treasury 2004) was “to increase 

male life expectancy to 78.6 years and increase female life expectancy to 82.5 years in 

England by 2009-2011”. However, the Department of Health changed these targets 

from individual life expectancy targets for PCTs to individual targets for the all age all 

cause mortality rate 27 . The actual figures and year-on-year changes since 2000 are 

given in Table 87 and Figure 74 together with the Department of Health‟s suggested 

trajectories for Hull. The AAACMR for 2008 is 867 per 100,000 males for Hull and 572 

per 100,000 females for Hull. Based on linear regression over the period 1993 to 2008, 

the AAACMR has reduced by an average of 15.1 per 100,000 males and 6.2 per 

100,000 females in Hull. As Hull‟s mortality rate for 2008 is higher than the target for 

2008, for the next three years, if the target were to be achieved the average reduction 

each year would need to be 63 per 100,000 men and 22 per 100,000 women. This 

represents 4.2-fold and 3.5-fold increases on previously observed increases between 

1993 and 2008. Therefore, it is very unlikely that the Department of Health‟s AAACMR 

will be achieved in Hull by 2011. However, following the change in the government in 

May 2010, new outcomes are now under consultation (see section 3.3.6.2 on page 52). 

However, one of the outcomes is the AAACMR, so it is possible that this could be an 

outcome and targets would be retained. 

The updated mortality rates (involving deaths registered in 2009) are normally published 

on the Compendium at the end of the following year (November or December 2010), but 

as at February 2011, the estimates are not yet available and are due to be published 

later on in March 2011. Local mortality rates can be calculated using the Public Health 

Mortality File (PHMF) and the GP registration file. The number of deaths in the local 

PHMF and the official mortality statistics will be the same, but the Compendium uses 

ONS mid-year population estimates which differ from the estimates of the number of 

residents from the GP registration file. Therefore, locally calculated figures differ slightly 

from the official figures published in the Compendium, with mortality rates likely to be 

slightly lower with locally estimated figures. In the absence of the official statistics, the 


27 The methodology used to change the life expectancy targets to AAACMR targets was seriously flawed 

statistically, and further contained numerical errors for a very small number of PCTs. Hull was not one of 

the PCTs with errors, but despite the methodological flaws, it will make relatively little difference to the 

achievability of the targets for Hull. 



Table 87: Actual rates, year-on-year changes and suggested Department of Health 

trajectories for Hull for the all age all cause mortality rate 

Year Directly standardised all-cause all-age mortality rate per 100,000 persons 

Males in Hull Females in Hull 

Actual Projected Target Actual Projected Target 

2000 969 649 

2001 988 593 

2002 942 631 

2003 984 654 

2004 887 641 

2005 903 634 

2006 889 637 

2007 848 637 

2008 867 778 572 553 

2009 *845 852 742 *562 566 537 

2010 837 709 560 521 

2011 822 677 553 506 

*Locally derived estimates of the mortality rate which are likely to be slightly lower than the 

official estimates due to be published in March 2011. 

Figure 74: Actual directly standardised all-cause all-age mortality rate per 100,000 

population relative to Department of Health targets 

AAACMR per 100,000 population 

1,200 

1,000 

800 

600 

400 

200 

0 

1993 

1994 

1995 

1996 

1997 

1998 

1999 

2000 

2001 

Males (actual) 

Year 

Males (projected) Males (target) 

Females (actual) Females (projected) Females (target) 

2002 


2003 

2004 

2005 

2006 

2007 

2008 

2009 

2010 

2011


There are many issues around having AAACMR targets, and whilst the following are not 

considered „excuses‟ it is useful to have some knowledge about the difficulties involved 

around the targets and achieving the targets (some based on speculation). The 

following are more general comments that could be applied to any geographical area. 

Calculating the AAACMR is more complex relative to the calculation of other 

targets such as the 18 week treatment waiting target. 

Life expectancy at birth, AAACMR and standardised mortality ratios (SMRs) all 

measure slightly different aspects of mortality and differ due to differences in the 

calculation and standard population. Therefore, just because one measure 

improves does not necessarily mean that another measure will improve (to the 

same degree). 

AAACMR is used as a proxy for life expectancy. The Department of Health 

changed their targets from life expectancy to AAACMR. They used statistical 

modelling to obtain the AAACMR targets from original life expectancy targets. 

Their methodology contained serious statistical flaws as well as a very small 

number of minor numerical errors. 

AAACMR (and other measures of mortality such as SMRs) are dependent on the 

age structure (and therefore choice of) the „standard‟ population. This is less of 

an issue for the AAACMR it is generally standardised to the European Standard 

Population (ESP) which is fixed, although it is an artificial population that is not 

representative of Hull‟s or England‟s population as there are too few people in the 

older age groups for the ESP. 

The AAACMR is an annual measure, which it must be in order to be useful, as 

the number of deaths changes with seasonality (generally more deaths in winter). 

However, this means that one year is a relatively long time to wait to assess 

progress towards the target. 

A major issue with using such mortality measures as targets as AAACMR and life 

expectancy measure, is that they are targets on dying and not quality of life. It 

may be possible to extend the life of terminally ill patients by a few weeks and 

improve mortality rates, but quality of life would be poor. A good target should be 

to delay mortality by extending the period of high quality life. 

Age is considered as a five year age band, so it is possible that improvements 

may not register. For example, increasing the age at death from 72 years to 74 

years will make relatively little difference to the AAACMR. However, increasing 

the age at death from 74 years to 75 years will make a bigger difference as the 

death is included in the next five year age band. 

The AAACMR and life expectancy are subject to year-on-year variability, due to 

local influenza outbreaks, major accidents, mild winters, etc. 

AAACMR and life expectancy are difficult to influence in the short-term. With 

smoking cessation, the probability of death is reduced over time for most causes 

of death, but it can take up to 30 years for the risk to reduce to the same as a 

„never‟ smoker for some particular causes of death. For example, reducing the 

prevalence of obesity may improve prognosis in relation to diabetes, but it may 



not necessarily „cure‟ a patient of diabetes. There are similar issues associated 

with increasing exercise levels, improving 5-A-DAY and diet, etc. 

There is also an issue of influencing factors in relation to public health versus 

clinical changes. Public health initiatives as mentioned above generally influence 

life expectancy and AAACMR in the long-term. Clinical initiatives tend to be more 

short-term, e.g. statins, improvements in surgical procedures, etc. However, the 

problem is that if there is a focus on clinical initiatives without the underlying 

improvements in public health, any short-term clinical effects would be swamped 

in the long-term without public health improvements. 

There are also a number of issues more specific to Hull, and some of these points will 

apply to other geographical areas. 

AAACMR and life expectancy calculations do not take into account deprivation 

and „case mix‟ of the population. In more deprived areas such as Hull, as 

mentioned previously, there is a higher prevalence of behavioural risk factors 

such as smoking, lack of exercise and poor diet (see section 8 on page 233) and 

more general risk factors such as poor housing, education, stress, etc. People in 

Hull also tend to have lower health expectations and fewer GPs per population so 

there are more likely to be delays in diagnosis and treatment which will influence 

survival. There will also be a higher percentage of patients with co-morbidities 

(e.g. diabetes, CHD, etc) which will influence mortality. 

The infant mortality rate can have a relatively large impact on life expectancy, but 

less so on the AAACMR. However, Hull is relatively unique compared to other 

similarly-deprived areas in that the infant mortality rate in Hull is similar to the rate 

for England and this has been the case for a number of years (see section 7.8.3 

on page 209). Therefore, it is not as simple as reducing the infant mortality rate 

in Hull as it is already relatively low. 

There also tends to be differences between first and late adopters in relation to 

models of change between people living in the most deprived and the least 

deprived areas. People living in more affluent areas tend to be „first adopters‟ 

and be among the first to initiate positive health changes. People living in more 

deprived areas find it more difficult to change due to increased pressures on life, 

e.g. poor housing, debt, stress, unemployment, etc. There may also be more 

barriers in relation to access to health improvement services such as financial 

barriers, transport issues, access to local cheap good quality fresh fruit and 

vegetables, etc. It is generally more difficult to encourage „late adopters‟ into 

public health services like smoking cessation. 

Another problem relatively unique to Hull is its tight geographical boundaries. 

Most cities such as Hull are relatively deprived, but most other local authority and 

PCT boundaries for that city cover some more affluent areas. Hull has very few 

affluent areas, and it is estimated that around 2,500 of people in Hull move to the 

„leafy suburbs‟ in East Riding of Yorkshire just outside Hull‟s boundary. The 

people that tend to move will generally move because of children and better 

schools, better quality and choice of housing, etc. The more aspirational and 



motivated people will tend to have increased mobility. This also affects the 

employment profile of Hull. 

Due to Hull‟s location, people may be less likely to influenced by factors and 

changes occurring elsewhere in other geographical areas. 

It is possible to model some potential changes in mortality to assess the effects on 

SMRs and the AAACMR. Table 88 illustrates that some relatively large changes in the 

number of deaths need to occur relative to the recent level of deaths (2005-2007) with 

much smaller relative effects noticed on the SMR and AAACMR. The local Public 

Health Mortality File and GP registration file (to estimate resident population) have been 

used in these calculations, and therefore, the estimates are not equivalent to those 

derived nationally from the Compendium. Furthermore, for the SMR, the effect is likely 

to be lower than this as if the mortality rate in Hull changes by the magnitude noted in 

the first column it is likely that changes will also be occurring in England. If this is the 

case, then the mortality rates used to calculate the SMR will change as the mortality rate 

in the standard population has changed. Whilst initially, it does not appear realistic that 

a 50% reduction in the number of deaths occurring under the age of 14 years would 

have such a small influence on the AAACMR, it must be remembered that the absolute 

number of deaths in this age group is very small. There were 17 deaths to those aged 

under 14 years that were registered during the year 2007 out of a total of 2,555 deaths 

for all ages. Therefore, if this number were more than halved to eight deaths this would 

mean that the total number of deaths in Hull would fall from 2,555 to 2,547 which is a 

relatively small difference. Similarly, the total number of deaths registered during 2007 

for Hull residents aged under 65 years was 515, so a reduction of 10% would result in 

the total number deaths falling by 52 from 2,555 to 2,503; again a relatively small 

change in the total number of deaths. 

Table 88: Changes in the number of deaths and influence on SMRs and AAACMR 

Reduction in deaths by age Effect on SMR Effect on AAACMR 

Local deaths 0-14 yrs falls by 50% From 115.6 to 115.2 (–0.3%) From 816 to 812 (–0.5%) 

Local deaths 0-65 yrs falls by 10% From 115.6 to 110.2 (–5%) From 816 to 773 (–5%) 

Local deaths 0-65 yrs falls by 20% From 115.6 to 104.7 (–9%) From 816 to 729 (–11%) 



7.8.5 Deaths at Home 

The location of the death is recorded on death certificates, so it is possible to examine 

the percentage of deaths that occurred at home. Each type of establishment in England 

is assigned a code with the type of establishments ranging from hospitals, mental 

nursing homes, private nursing homes, residential homes, home for the disabled or 

blind, children‟s‟ homes, prisons, hospices, etc. If the death occurred at person‟s home 

then the location is coded „H‟ and if the death occurred elsewhere, such as on a road, in 

a park, shopping centre, etc it is coded as „E‟. The Compendium provides information 

on the percentage of deaths occurring at home (based on having coded as „H‟), which 

does not include deaths at other establishments that might be considered to be the 

home of the individual such as residential homes, children‟s‟ homes, etc. Table 89 

gives the percentage of deaths registered during 2006-2008 which occurred at home 

coded as „H‟ for Hull and comparator areas (see section 3.3.3 on page 44 for more on 

comparator areas). The percentage of deaths occurring at home is significantly higher 

for men compared to women presumably because men tend to die earlier and they are 

more likely to have someone at home to look after them. Overall, 18.0% of deaths occur 

at home in Hull which is joint lowest of the comparators listed (with the highest 

percentage for Sunderland 22.3%). There will be a number of influential factors such as 

the knowledge and information available about dying at home, influences of medical 

professionals, the type of care that might be received at home, the suitability of the 

home, etc. It is possible that due to knowledge and suitability of the home, patients may 

be less willing to want to die at home in more deprived areas. However, whilst 

Sunderland is less deprived than Hull the differences are not substantial, with Hull rated 

as 11 th (bottom 7%) out of the 152 PCTs in England and Sunderland rated 29 th (bottom 

19%) in terms of the Index of Multiple Deprivation 2007. 

Table 89: Percentage of deaths occurring at home, 2006-2008 

Area Total Deaths occurring at home 2006-2008, % (95% CI) 

deaths Men Women Persons 

England 1,413,908 22.8 (22.7, 22.9) 16.4 (16.3, 16.5) 19.5 (19.4, 19.5) 

Hull 7,600 21.2 (20.0, 22.6) 14.9 (13.8, 16.1) 18.0 (17.2, 18.9) 

Y&H SHA 150,406 22.8 (22.5, 23.1) 15.9 (15.7, 16.2) 19.2 (19.0, 19.4) 

Indust Hinterlands 115,966 23.7 (23.3, 24.0) 17.5 (17.2, 17.8) 20.4 (20.2, 20.7) 

Wolverhampton 7,600 21.8 (20.5, 23.2) 15.3 (14.2, 16.4) 18.5 (17.7, 19.4) 

Salford 7,293 20.7 (19.4, 22.1) 15.8 (14.7, 17.0) 18.1 (17.3, 19.0) 

Derby 6,783 22.0 (20.6, 23.5) 15.9 (14.7, 17.2) 18.9 (18.0, 19.9) 

Stoke-on-Trent 7,861 20.6 (19.4, 21.9) 15.6 (14.5, 16.7) 18.0 (17.2, 18.9) 

Coventry 8,522 23.5 (22.2, 24.8) 17.5 (16.4, 18.7) 20.5 (19.6, 21.3) 

Plymouth 7,028 27.5 (26.0, 29.0) 16.3 (15.1, 17.5) 21.6 (20.6, 22.6) 

Sandwell 9,371 22.5 (21.4, 23.8) 16.4 (15.4, 17.5) 19.4 (18.7, 20.3) 

Middlesbrough 4,195 23.6 (21.8, 25.6) 19.5 (17.9, 21.2) 21.5 (20.2, 22.7) 

Sunderland 8,857 25.8 (24.6, 27.2) 19.0 (17.8, 20.1) 22.3 (21.5, 23.2) 

Leicester 7,591 22.9 (21.6, 24.3) 16.8 (15.6, 18.0) 19.8 (18.9, 20.7) 

Average above 10 75,101 23.1 (22.6, 23.5) 16.7 (16.4, 17.1) 19.8 (19.5, 20.1) 

NE Lincolnshire 5,097 23.8 (22.2, 25.5) 15.7 (14.3, 17.1) 19.6 (18.5, 20.7) 



The cause of death will influence the percentage dying at home, and it is also useful to 

examine the location of death for the main causes of death. The Public Health Mortality 

File records the location of where the death occurred so it is possible to examine the 

number of deaths that occurred at home for Hull residents. In addition, to each 

establishment being assigned a code, each establishment is assigned a code for the 

type of establishment. Table 90 examines the percentage of deaths by cause of death 

and location of death for deaths which were registered during 2007-2009. Due to small 

numbers, the percentages of deaths occurring in „other‟ locations and „elsewhere‟ have 

been combined for many of the main causes of death. The causes of death listed are 

the main causes of death, with all cancers, all circulatory disease and all cancers given 

at the bottom of the table. 

Most deaths (61%) registered during 2007-2009 occurred in NHS establishments 

(mostly hospitals). The highest percentage of deaths which occurred at home, 

excluding those from suicide and undetermined injury, was for coronary heart disease 

where one-third of deaths were at home. The percentage for people with cancer dying 

at home was 21% with the highest percentage for lung cancer (23%); these percentages 

were slightly higher than that for all causes combined (18%). Most deaths occurring at 

„other‟ locations were deaths from cancers, which is to be expected as this category 

including hospices. Few deaths from causes other than cancer died at „other‟ locations. 

Few deaths occurred „elsewhere‟ with the exception of suicide and undetermined injury. 



Table 90: Percentage of deaths by location of death and cause of death in Hull 2007- 

2009 

Cause of death Total 

number 

of 

deaths 

Percentage of deaths 2007-2009 by location of 

death (%) 

Home 


Residential home 

NHS establishment 

Non-NHS nursing 

home 

Other (prison, 

hospices, residential 

education/training, 

religious retreats, etc) 

Infant death (


7.8.6 Winter Deaths 

According to the Office for National Statistics (Office for National Statistics 2009), in the 

winter period of December to March 2008/09 there were an estimated 36,700 more 

deaths in England and Wales, compared with the average for the non-winter period. 

This was an increase of 49% compared with the number in the previous winter 2007/08. 

This is the highest number of excess winter deaths since the winter of 1999/2000, when 

excess winter mortality was nearly a third higher than in 2008/09. 

Excess winter mortality is calculated as winter deaths (deaths occurring in December to 

March) minus the average of non-winter deaths (April to July of the current year and 

August to November of the previous year). 

The elderly population experiences the greatest increase in deaths each winter. In the 

winter of 2008/09 there were 29,400 more deaths among those aged 75 and over, 

compared with levels in the non-winter period. In contrast, there were 7,300 excess 

winter deaths among those under the age of 75. 

The number of extra deaths occurring in winter varies depending on temperature, the 

level of disease in the population, and other factors. Increases in deaths from 

respiratory and circulatory diseases are responsible for most of the excess winter 

mortality. Influenza is often implicated in winter deaths as it can cause complications 

such as bronchitis and pneumonia, especially in the elderly, although relatively few 

deaths are attributed to influenza itself. According to the Health Protection Agency 

(HPA) influenza activity started early and reached moderate levels during the winter of 

2008/09, but did not reach the epidemic levels seen in the winter of 1999/2000. 

Excess winter mortality can be calculated in Hull using the Public Health Mortality File 

and the Primary Care Mortality Database. 

From National Energy Action, levels of excess winter mortality in Hull were slightly below 

the regional average for the winter of 2007/08, the most recent year for which 

comparative figures are available at PCT level (Figure 75). The excess winter mortality 

index is the number of winter deaths divided by the number of non-winter deaths 28 . 

When excess winter mortality in each of Hull‟s local deprivation quintiles is used to 

calculate their excess winter mortality index, as shown in Figure 76, there is no 

evidence for higher levels in the more deprived areas of Hull for the period 2004/05 to 

2008/09. 

The underlying data for these figures is given in the APPENDIX on page 856 and on 

page 856 respectively. 

28 Number of deaths over time period, i.e. same number of months. So if there were 275 and 230 deaths 

on average per month in winter and non-winter respectively for a particular geographical area, then this 

would give a value of 1.196 (275÷230) or an index of 19.6. 



Figure 75: Excess winter mortality index 2007/08 for Hull and local PCTs 

Excess winter mortality index 2007/08, % 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

Barnsley 

Doncaster 

Rotherham 

Sheffield 

Bradford 

Calderdale 

Kirklees 

Leeds 

Figure 76: Excess winter mortality index by local deprivation quintile for Hull 

Excess winter mortality index 

2004/05 to 2008/09 

30 

25 

20 

15 

10 

5 

0 

Wakefield 

Hull 


East Riding of Yorkshire 

Local authority within Yorkshire and Humber 

Most deprived 2 3 4 Least deprived 

Local Index of Multiple Deprivation 2007 quintile 

North East Lincolnshire 

North Lincolnshire 

York 

Craven 

Hambleton 

Harrogate 

Richmondshire 

Ryedale 

Scarborough 

Selby


8 LIFESTYLE RISK FACTORS 

This section covers the behavioural / lifestyle risk factors of smoking, obesity, diet, 

exercise, alcohol and substance misuse. There are a number of more fixed risk factors 

for poor health such as gender, age, ethnicity and genetics which are not covered within 

this section (other than providing estimates of these in relation to Hull‟s population; see 

section 5 starting on page 63). Section 6 starting on page 111 covers other risk 

factors for poor health which are related to deprivation, such as the Index of Multiple 

Deprivation, unemployment, housing, etc. 

8.1 Main Risk Factors 

Information relating to smoking, obesity, diet, exercise and alcohol in relation to 

cardiovascular disease is given on Patient UK website (Patient UK 2009) as well as 

information on less modifiable risk factors such as hypertension and cholesterol levels. 

Cancer Research UK has also produced information on their website about reducing the 

risk of cancer (Cancer Research UK 2009) which cover similar risk factors to those for 

cardiovascular disease with the addition of exposure to sunlight. More specific 

information is given in the smoking, obesity, diet, exercise and alcohol sections below 

and within section 10 starting on page 434 which gives information on specific diseases 

and medical conditions. 

8.1.1 Definitions of Risk Factors 

Information on the main lifestyle risk factors for poor health, such as smoking, alcohol, 

exercise and obesity, were collected as part of the local Health and Lifestyle Survey 

conducted during 2007. Further information on the questions asked and the definitions 

used to define the risk factors within this profile are given within section 13.4 on page 

805. 

8.1.2 Total Estimated Resident Adults With Main Risk Factors 

From the local adult Health and Lifestyle Survey conducted during 2007, it is possible to 

obtain estimates of the prevalence of the main lifestyle risk factors such smoking, lack of 

exercise, alcohol consumption, obesity, etc. It is then possible to apply these estimates 

to the total adult resident population for Hull to obtain an estimate of the total number of 

adults in Hull who may have each risk factor. The Health and Lifestyle Survey used 

quota sampling so that the survey responders were representative of Hull‟s overall 

population in terms of age, gender and geography. More information on the survey is 

available in section 13.2.1.2 on page 791. 

Table 91 gives the prevalence from the Health and Lifestyle Survey and the estimated 

total number of adult (18+ years) residents with these risk factors when applying the 

prevalence to the resident population as at October 2008 (103,760 men and 101,570 



women aged 18+ years). In an attempt to compensate for people over-estimating their 

height and under-estimating their weight when asked their measurements, height and 

weight were adjusted prior to calculating the body mass index (BMI) which was used to 

define overweight and obesity (see section 13.4 on page 805 for more information). 

Numbers rounded to the nearest 100 people. 

Table 91: Estimated total of residents with lifestyle risk factors, 2007 

Risk 

factor 

Smoking 

Weight 

(adjusted) 

Diet 

Mod/vig 

exercise 

30+ 

Definition* Percentage and estimated total resident 

population aged 18+ years with specified risk 

factor 


% N % N % N 

Daily or occasional smoker 33.6 34,900 29.9 30,400 31.7 65,100 

Daily smoker 27.0 28,000 25.8 26,200 26.4 54,200 

Low impact of quitting** 12.5 13,000 7.3 7,400 9.8 20,100 

Smoke 20+ cigarettes per day 11.0 11,400 9.6 9,800 10.1 20,700 

Overweight (BMI 25-29.9) 48.6 50,400 32.7 33,200 40.6 83,400 

Obese (BMI 30+) 18.4 19,100 23.2 23,600 20.8 42,700 

Morbidly obese (BMI 40+) 1.8 1,900 3.4 3,500 2.6 5,300 

Overweight/obese (BMI 25+) 66.9 69,400 55.8 56,700 61.4 126,100 

Healthy diet - no 20.8 21,600 15.0 15,200 17.8 36,500 

Healthy diet - don‟t know 9.3 9,700 5.8 5,900 7.5 15,400 

Healthy diet - no/don't know 30.1 31,200 20.7 21,000 25.3 51,900 

5-A-DAY (50M, >35F) 6.5 6,700 1.0 1,000 3.7 7,600 

*Out of all population unless otherwise specified (e.g. number smoking 20+ cigarettes daily out 

of all people rather than out of smokers) 

**Impact on health of quitting is fairly small, very small or no impact. 

***Exercise less than five times a week means that moderate or vigorous exercise was 

undertaken in sessions of 30 minutes or more during the week, but the number of sessions was 

less than the national recommended guideline of at least five times a week. 



Table 92, Table 93 and Table 94 give the equivalent information for residents of North, 

East and West Localities respectively. The estimates are based on 23,270 men and 

23,720 women adults living in North Locality, 36,560 men and 37,190 women adults 

living in East Locality, and 43,930 men and 40,660 women adults living in West Locality. 

Numbers rounded to the nearest 100 people. 

Table 92: Estimated total of residents with lifestyle risk factors, North Locality, 2007 

Risk 

factor 

Smoking 

Weight 

(adjusted) 

Diet 

Mod/vig 

exercise 

30+ 



factor in North Locality 


% N % N % N 


Daily smoker 28.4 6,600 34.8 8,300 31.7 14,900 




Obese (BMI 30+) 15.9 3,700 21.9 5,200 18.9 8,900 

Morbidly obese (BMI 40+) 3.1 700 5.7 1,400 4.4 2,100 





5-A-DAY (50M, >35F) 7.3 1,700 0.5 100 3.8 1,800 









Table 93: Estimated total of residents with lifestyle risk factors, East Locality, 2007 

Risk 

factor 

Smoking 

Weight 

(adjusted) 

Diet 

Mod/vig 

exercise 

30+ 



factor in East Locality 


% N % N % N 


Daily smoker 24.6 9,000 24.3 9,000 24.5 18,100 




Obese (BMI 30+) 16.0 5,900 19.4 7,200 17.8 13,100 

Morbidly obese (BMI 40+) 1.7 600 2.1 800 1.9 1,400 





5-A-DAY (50M, >35F) 5.4 2,000 0.6 200 2.9 2,100 









Table 94: Estimated total of residents with lifestyle risk factors, West Locality, 2007 

Risk 

factor 

Smoking 

Weight 

(adjusted) 

Diet 

Mod/vig 

exercise 

30+ 



factor in West Locality 


% N % N % N 


Daily smoker 28.3 12,400 22.6 9,200 25.5 21,600 




Obese (BMI 30+) 17.4 7,600 19.0 7,700 18.2 15,400 

Morbidly obese (BMI 40+) 1.2 500 3.4 1,400 2.3 1,900 





5-A-DAY (50M, >35F) 7.0 3,100 1.6 700 4.3 3,600 









8.1.3 Total Estimated Resident Young People With Main Risk Factors 

From the 2008-09 Young People Health and Lifestyle Survey, the prevalence of lifestyle 

risk factors has been calculated for each school year (7-11; aged 11-12 years to 15-16 

years), and then applied the resident population estimates (October 2008) to obtain the 

estimated total number of young people with the risk factors (Table 95). The prevalence 

of the individual risk factors are not presented as it differs substantially with age 

(prevalence is given within the specific sections relating to each individual risk factor). 

The survey did not ask young people their height or weight so measures of obesity 

cannot be ascertained from the survey. Data is available on overweight and obesity for 

those attending Primary Schools from the National Children Measurement Programme, 

where children in reception year (aged 4-5 years) and Year 6 (aged 10-11 years) have 

their heights and weights measured by school nurses (see section 8.5.4 on page 280). 

Numbers rounded to the nearest 100 young people. 

Table 95: Estimated young people aged 11-16 years with lifestyle risk factors, 2008-09 

Risk 

factor 

Smoking 

Weight 

Diet 

Exercise 

Alcohol 

Drugs 

Definition Estimated total resident population 

aged 11-16 years with specified risk 

factor, 2008-09 (total Oct 08 pop) 

Males Females Total 

(n=8,445) 

(n=7,888) 

(n=16,333) 

Smoked in last week 600 1,200 1,800 

Regular or occasional smoker 500 1,200 1,700 

Regular smoker 300 700 1,000 

Don‟t smoke now but may in future 600 700 1,300 

I would like to lose weight 3,300 5,200 8,500 

I would like to gain weight 1,700 800 2,500 

Healthy diet - no 1,900 1,700 3,600 

Healthy diet - don‟t know 1,500 1,600 3,100 

Healthy diet - no/don't know 3,300 3,300 6,600 

I would like to eat a healthier diet 4,900 6,000 10,800 

5-A-DAY (


8.2 Risk Factors for Different Black and Minority Ethnic groups 

8.2.1 Black and Minority Ethnic Groups 

The main risk factors for poor health have also been examined for different black and 

minority ethnic (BME) groups participating in the BME Health and Lifestyle Survey 2007 

(see section 13.2.1.3 on page 791), as well as other information on general health, 

measures of deprivation, numbers of people in household, measures of social capital, 

etc. Whilst the survey responders are not necessarily representative of Hull‟s BME 

population, it is the only source of local information for which the prevalence of risk 

factors in the local BME population can be examined. Since the findings of the survey 

cannot necessarily be generalised to Hull‟s BME population, the results should be 

treated with caution. 

The full report and a summary report have been produced and both are available at 

www.hullpublichealth.org. The full report examined each question on the survey 

questionnaire for the main survey responders and the BME survey responders 

combined in relation to BME group and in relation to status in the UK (British, student, 

asylum seeker, failed asylum seeker, refugee, working in the UK short-term, working in 

the UK long-term). 

A summary of the findings are as follows: 

As well as the BME survey, a larger survey was completed in Hull with survey 

responders being representative of Hull‟s population. Findings from the BME Survey 

were compared with all responders in the main survey (of whom 6.6% were from BME 

backgrounds). 

The majority of those participating in the BME Survey were Africans (31%), Other 

Asians (25%), Non-British White (24%) and Chinese (9%). In terms of status in UK, 

the biggest groups were those working temporarily in the UK (22%), failed asylum 

seekers (18%), refugees (15%) and students (15%). However, due to the sampling 

method we do not know how representative the survey participants are in relation to 

Hull‟s BME population. 

Three-quarters of the Non-British White survey responders were working temporarily 

in the UK and most were Polish. Over 60% of Other Asians were asylum seekers or 

failed asylum seekers and a further 30% were refugees (mainly Iraqi and Kurdish). 

Almost 40% of Africans were asylum seekers or failed asylum seekers (mainly 

Congolese) and a further 22% were students. 

A high percentage of BME survey responders were young males with the exception of 

Chinese whose age-gender distribution more closely matched that of the main survey. 

Over 80% of the BME survey responders lived in West Locality and 15% lived in North 

Locality. Over half lived in Myton (28%) or Newland (24%) wards. 

Over 60% of Other Asians, one-third of Africans and around 50% or more of asylum 

seekers and refugees lived in the most deprived 20% of Hull, compared to 17% of 

main survey responders. 



Approximately one-third of asylum seekers, refugees and those working temporarily in 

the UK had poor fluency in spoken English. 

The highest percentage without qualifications were for asylum seekers and failed 

asylum seekers (both 38%) and main survey responders (33%). 

Asylum seekers, refugees and those working temporarily in the UK were more likely to 

live in households with a high number of adults, mainly adults not related to them. 

The household size for students was slightly lower. Almost two-thirds of main survey 

responders lived in a household with no children under 18 years. This percentage 

was higher for all other BME groups except for Bangladeshis and Pakistanis (51%) 

and Caribbeans (62%). 

Over 60% of main survey responders lived in a house that was owned or mortgaged 

compared to 11% for BME survey responders (all groups combined). 

Many people did not answer the income question (overall 42%, but ranging from 14% 

to 78%). Of those that did, 31% of main survey responders had a net household 

income more than the national average, but the percentage was much lower for 

Indians (8%), Bangladeshis and Pakistanis (7%), Other Asians (10%), Africans (9%) 

and Chinese (11%). Students, refugees and asylum seekers had the lowest incomes. 

Physical health was slightly poorer for main survey responders and Chinese due to 

their increased age, and worst for asylum seekers and refugees, particularly failed 

asylum seekers. 

Mental health was considerably poorer for asylum seekers (particularly failed) and 

refugees. One-third of failed asylum seekers were classified as being „so unhappy 

that life was not worthwhile‟. Cognition was also poorer for Chinese, asylum seekers 

and refugees. 

Almost one-quarter main survey responders had an illness or disability that lasted 

longer than a month which limited activity compared to 13% of Chinese, 11% of 

Bangladeshis and Pakistanis and less than 5% of other BME groups. Nine percent of 

main survey responders were registered disabled compared to less than 5% of BME 

survey responders. 

Dental health was poor for Other Asians, Africans, asylum seekers, failed asylum 

seekers and refugees with over 40% having never visited a dentist (2% for main 

survey responders). 

Less than 10% had a lack of knowledge as to what constituted a healthy diet, except 

for Non-British White, Other Asians, Africans and Chinese (nearer 25%). The majority 

of the rest ate a healthy diet except for Other Asians. Of those with knowledge about 

a healthy diet, the majority had eaten healthier in the last year (up to 80% for main 

survey responders) with the exception of failed asylum seekers where the percentage 

was slightly less than 50%. 

Only one-quarter of main survey responders ate five or more portions of fruit and 

vegetables daily and similar percentages for Mixed, Caribbean and Chinese survey 

responders, and fewer than 15% for other groups. 

For most groups with the exception of those working short-term in the UK, there was a 

clear pattern of frequently eating meals cooked with fresh ingredients and rarely 

eating microwave meals and other convenience foods. This was particularly true for 

asylum seekers and refugees in particular failed asylum seekers. This may be 

associated with cost of such meals. 



Approximately one-quarter of main and Mixed survey responders never drank alcohol. 

The percentage was lower for Non-British White survey responders (15%), but higher 

for all other BME groups (33% for Caribbeans to 76% for Bangladeshis and 

Pakistanis). Just over one-quarter of all main survey responders either had drank 

more than the recommended weekly alcohol units the previous week or exceeded the 

recommended daily alcohol units more than once a week. This percentage was 

similar for Indians, but higher for Non-British White (29%) and Other Asian (32%) 

survey responders, and for failed asylum seekers (26%) and those working short-term 

in the UK (29%). The percentage was approximately 20% or less for other groups. 

Twenty-six percent of main survey responders smoked daily and 5% smoked 

occasionally. One third of Non-British White and half of Other Asian survey 

responders smoked daily, with a similar 5% smoking occasionally. Similar daily 

smoking rates were observed for Mixed and Caribbean survey responders, but 

occasional smoking rates differed for these two groups (25% and 0% respectively). 

One third of asylum seekers and those working short-term in the UK smoked daily but 

around 40% of failed asylum seekers smoked daily. 

Twenty percent of main survey responders were classified obese; similar for Mixed 

and Chinese survey responders and failed asylum seekers, but higher for Caribbeans 

(29%). More Indians (71%), Other Asians (58%) and failed asylum seekers (59%) 

were overweight compared to main survey responders (61%). Combining overweight 

and obese, the prevalence was higher for Indians (77%), Caribbeans (67%), Other 

Asians (63%) and failed asylum seekers (64%) compared to the main survey 

responders (61%). 

Thirty percent of main survey responders exercised at a moderate level for at least 30 

minutes for at least five times per week. This was higher for Bangladeshis and 

Pakistanis (52%) and Caribbeans (40%) but lower for Other Asians (15%). The 

percentage was also higher for students (45%), but lower for failed asylum seekers 

(13%). 

Fourteen percent of main survey responders felt „a bit unsafe‟ or „very unsafe‟ in their 

area during the daytime; it was considerably higher for Other Asians (44%), failed 

asylum seekers (54%) and asylum seekers (33%). Relatively few people spoke with 

non-household family, friends and neighbours rarely (1.2% in main survey), but this 

was higher for Mixed, Indian, Other Asian, African, asylum seekers especially failed 

asylum seekers and refugees (up to 15%). However, the groups that did not have 

many relatives and friends living nearby or spoke rarely with non-household family 

and friends, tended to live in households with a number of friends that could be called 

upon in a crisis in particular those working short-term in the UK and failed asylum 

seekers. 



8.2.2 Gypsies and Travellers 

The main risk factors for poor health have also been examined for 100 Gypsies and 

Travellers who participated in the Health and Lifestyle Survey 2007 (see section 

13.2.1.3 on page 791) , as well as other information on general health, measures of 

deprivation, numbers of people in household, measures of social capital, etc. 

A brief report is available at www.hullpublichealth.org. 

A summary of the main findings is as follows: 

SMSR, the company who undertook the Health and Lifestyle Surveys on behalf of NHS 

Hull, liaised very closely with the Gypsy and Traveller Project Co-ordinator at Hull GATE/ 

DOC. It was agreed that The Project Co-Coordinator along with two members of the 

Gypsy and Traveller community would administer the questionnaire on a face-to-face 

basis. A £10 high street gift voucher was provided as an incentive to participate. It is 

not known if the 100 Gypsies and Travellers surveyed are representative of the Gypsy 

and Traveller population within Hull, but will give an indication of health status, health 

risk factors and social capital of the local Gypsy and Traveller population. The 100 

Gypsy and Traveller Survey responders compared to 4,086 survey responders 

(representative of Hull‟s population in terms of age, gender, geography and 

employment) were more likely to (*=differences “substantial” – arbitrarily defined): 

have poorer physical health* 

report long-term illness or disability which affects daily activities* 

be registered as disabled* 

have poorer mental health (particularly the women*) 

have fewer teeth and to have never visited a dentist* 

report they ate unhealthily* 

eat fewer portions of fruit and vegetables 

never drink alcohol (particularly the women)* 

not drink excessively nor binge drink (women only) 

be current smokers* 

not fulfil the national exercise guidelines 

be obese* 

be morbidly obese (particularly the women)* 

have no qualifications* 

be unemployed* 

live in households with a high number of adults* 

live in households with a higher number of children* 

not own their home* 

feel very unsafe when walking alone in their local area* 

not feel well informed about things which affected their local area* 

not be involved in local organisations* 



to have acted to solve a local problem* 

trust their neighbours 

feel that their neighbours looked out for one another* 

speak daily with family, friends and neighbours* 

have someone to turn to if ill in bed or in a crisis* 

Therefore, in general, Gypsies and Travellers have poorer health and a higher 

prevalence of health risk factors. Whilst Gypsies and Travellers have strong social 

networks and support, it is likely that this is bonding social capital which could be 

negative and produce group isolation rather than the bridging social capital which is 

more positive as it strengthens links between different groups. 



8.3 Perceived Impact of Changing Lifestyle on Health 

As part of the 2009 Social Capital Survey, respondents were asked to state the level of 

effect that different lifestyle changes could have on a person‟s health (not necessarily 

their own). Figure 77 below shows survey responders‟ perceptions of the impact of 

changes to someone‟s health. Overall, a majority of respondents felt that each lifestyle 

change would have a very big effect on a person‟s health, however there was some 

variance noted between the responses to different lifestyle changes. The responses 

stating a „very big effect‟ ranged from 57.9% for reducing alcohol levels to 78.1% for 

quitting smoking. The underlying data are given in the APPENDIX on page 857. 

Figure 77: Perceived impact that changes to lifestyle risk factors could have on health 

Further information by gender, age, Locality and local deprivation quintile is given in the 

full Social Capital Survey 2009 report. Attitudes to smoking, diet obesity and alcohol 

consumption were collected as part of Reflector Groups following the 2007 Health and 

Lifestyle Survey (see section 13.2.2.2 on page 795) and the 2008-09 Young Person 

Health and Lifestyle Survey (see section 13.2.2.3 on page 796), as well as in the 

Attitudes to Health Focus Groups conducted during 2007 (see section 13.2.2.1 on page 

794). All these reports are available at www.hullpublichealth.org. Further information on 

social marketing undertaken in Hull is given within each section below (section 8.4.7 for 

smoking; section 8.5.8 for obesity, section 8.6.7 for exercise, section 8.7.10 for diet 

and section 8.8.10 for alcohol consumption). 



8.4 Smoking 

8.4.1 Smoking as a Risk Factor 

Action on Smoking and Health (ASH) has collated information on the contribution of 

smoking to mortality from different causes of death. From ASH‟s factsheet (Action on 

Smoking and Health 2008), “One in two long-term smokers will die prematurely as a result 

of smoking – half of these in middle age. The most recent estimates show that around 

114,000 people in the UK are killed by smoking every year, accounting for one fifth of all 

UK deaths (Peto, Lopez et al. 2006). Most die from one of the three main diseases 

associated with cigarette smoking: lung cancer, chronic obstructive lung disease 

(bronchitis and emphysema) and coronary heart disease. Table 96 shows the 

percentage and numbers of deaths attributable to smoking, based on 2002 deaths (Royal 

College of Physicians 2000; General Register Office for Scotland 2002; Office for National 

Statistics 2002; Registrar General Northern Ireland and Statistics Research Agency 

2002). Deaths caused by smoking are five times higher than the 22,833 deaths arising 

from: traffic accidents (3,439); poisoning and overdose (881); alcoholic liver disease 

(5,121); other accidental deaths (8,579); murder and manslaughter (513); suicide 

(4,066); and HIV infection (234) in the UK during 2002.” 

Table 96: Estimated number and percentage of deaths attributable to smoking in the UK 

by cause of death, 2002 

Cause of death Deaths in the UK from disease estimated 

to be caused by smoking 2002 

Men Women Tot Men Women Tot 

Cancer 

Respiratory 

N N N % % % 

Lung 18,002 10,032 28,034 89 75 84 

Upper respiratory 525 85 610 74 50 66 

Oesophagus 3,248 1,743 4,991 71 65 68 

Bladder 1,521 318 1,839 47 19 37 

Kidney 788 72 860 40 6 27 

Stomach 1,385 266 1,651 35 11 26 

Pancreas 670 923 1,593 20 26 23 

Myeloid Leukaemia 264 131 395 19 11 15 

COPD 13,193 10,685 23878 86 81 84 

Pneumonia 3,162 2,900 6062 23 13 17 

Ischaemic heart disease 14,182 6,361 20,543 22 12 17 

Cerebrovascular disease 3,064 3,764 6,828 12 9 10 

Circulatory Aortic aneurysm 3,652 1,939 5,591 61 52 57 

Myocardial degeneration 6,670 2,936 9,606 22 12 15 

Atherosclerosis 63 56 119 15 7 10 

Digestive Stomach/duodenum ulcer 907 1,008 1,915 45 45 45 

Total caused by smoking 71,296 43,219 114,597 

Preventable Parkinson's 1,369 549 1,918 55 28 43 

by smoking Endometrium cancer 260 260 17 17 

Total prevented by smoking 1,369 809 2,178 

Deaths from all causes due to 

smoking (causes less prevented) 

69,927 42,410 112,337 



As illustrated in Table 96, some studies have shown that smoking appears to have a 

protective effect against the onset of some diseases such as endometrial cancer. 

However, the positive effect is so small in comparison with the overwhelming toll of 

death and disease caused by smoking that there is no direct public health benefit. 

8.4.2 Prevalence 

8.4.2.1 Adults 

The General Lifestyle Survey (completed every two years), which was previously known 

as the General Household Survey, collects information on smoking status. Almost four 

in ten (39%) people smoked in 1980, and the prevalence has decreased steadily since. 

Overall, for 2008, it was estimated that nationally 22% of men and 21% of women 

currently smoke (Figure 78), but the percentages are higher in the younger age groups. 


Figure 78: National cigarette smoking prevalence by age group for those aged 16+ 

years 

Percentage smoking cigarettes 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

16-19 

20-24 

25-34 

35-49 

50-59 

60+ 


Overall 

Men Women 

1998 2000 2001 2002 2003 2004 2005 2006 2007 2008 

16-19 

20-24 

25-34 

35-49 

50-59 

60+ 

Overall


The prevalence of smoking in Hull is higher compared to the England average. The 

local Health and Lifestyle Surveys conducted during 2003, 2007 and 2009, and the local 

Social Capital Surveys conducted during 2004 and 2009 all collected information on 

smoking status. In contrast to the General Lifestyle Survey (Economic and Social Data 

Service 2008), smoking status was not restricted to cigarettes and the responses were 

slightly different in that information was collected on the number who smoked daily, 

smoked occasionally, were ex-smokers and who had never smoked. Figure 79 gives 

the percentage of daily or occasional smokers for each Locality in Hull using the same 

age groups as the General Lifestyle Survey, based on the findings from the most recent 

Prevalence Survey conducted during 2009. The underlying data are given in the 

APPENDIX on page 858. The prevalence of smoking in Hull was 38.1% for men, 32.2% 

for women and 35.1% for men and women combined, compared to 24% for men and 

20% for women from the Health Survey for England 2008 (Health Survey for England 

2008). 

Figure 79: Percentage of daily and occasional smokers for each Locality in Hull by age 

and gender, 2009 

Percentage smoking daily (darker shaded) or 

occasionally (lightly shaded) 

60 

50 

40 

30 

20 

10 

0 

N E W N E W N E W N E W N E W N E W N E W N E W N E W N E W N E W N E W 

18-24 25-34 35-49 50-59 60+ Overall 18-24 25-34 35-49 50-59 60+ Overall 

Men Women 

A report from the findings from the Prevalence Survey 2009 and a report specifically on 

smoking using information from the 2007 Health and Lifestyle Survey have been 

produced as well as a main report from this survey. These reports examine smoking in 

more detail. For example, the prevalence of heavy smoking (20+ cigarettes per day), 

attitudes to smoking and risk factors for smoking. 



Further information on the prevalence of smoking is also available at ward level without 

taking into account age or gender in the 76 page Public Health Profiles for Hull, as well 

as in the Hull Atlas. 

All these reports as well as the Hull Atlas are available at www.hullpublichealth.org. 

Table 97 summarises the information in Figure 78 and Figure 79 by giving the latest 

national information for 2008 (Health Survey for England 2008) compared to recent local 

surveys. The prevalence estimates from the Health and Lifestyle Survey conducted 

during 2003 and the Social Capital Survey conducted during 2004 have been combined 

(as the prevalence estimates differed among the surveys). Table 97 also provides the 

prevalence from the Health and Lifestyle Survey conducted during 2007 and the 

Prevalence Survey conducted during 2009. 

Table 97: Trends in percentage of daily and occasional smokers in Hull 2003-2009 and 

percentage of cigarette smokers in England in 2008 by age and gender 

Gender Age 

(yrs) 

Percentage of smokers 

Hull England 

Weighted average 

2003, 2004 

2007 2009 2008* 

18-24 52 43 41 28 

25-34 46 38 47 34 

35-44 43 39 43 30 

Men 

45-54 

55-64 

46 

38 

33 

29 

44 

35 

22 

18 

65-74 32 23 13 13 

75+ 21 18 19 6 

Overall 41 34 38 24 

18-24 49 34 32 25 

25-34 39 37 43 25 

35-44 37 34 39 25 

Women 

45-54 

55-64 

39 

35 

32 

29 

33 

35 

20 

16 

65-74 22 22 15 13 

75+ 21 13 14 8 

Overall 36 30 32 20 

*The Health Survey for England also includes those aged 16-17 years in their youngest age 

group. 

It can be seen that there are quite marked differences among the age groups with 

regard to the number of daily and occasional smokers, and the prevalence of smoking is 

much higher than England. In particular, the difference in prevalence is much larger in 

the younger age groups, with the prevalence of daily and occasional smoking in Hull 

being around 40% higher than that of England. It can also be seen that whilst the 

prevalence has decreased, for most age groups, between 2003-2004 and 2009, that the 



prevalence has increased for between 2007 and 2009 for men and women aged 25-64 

years. The reason for this is unknown, but it could be due to random variation and 

simply differences in the types of people surveyed 29 . Furthermore, the total number of 

people surveyed in the Prevalence Survey 2009 is less than half that of the Health and 

Lifestyle Survey 2007, and in some age groups the numbers are relatively small. For 

instance, there are fewer than 40 men surveyed who were aged 75+ years. 

As the distribution of the age differs among the wards, it is useful to standardise the 

percentages for age when comparing the prevalence across the wards. As the number 

of survey responders are relatively low in the Prevalence Survey 30 , the prevalence 

estimates have been produced for the Prevalence Survey 2009 and Social Capital 

Survey 2009 combined (which gives a total of almost 6,000 survey responders). Figure 

80, Figure 81 and Figure 82 give the age-adjusted percentages of men, women and 

persons who are current smokers for the wards in North, East and West Localities 

respectively. The underlying data are given in the APPENDIX on page 859. The 95% 

confidence intervals are displayed. For all wards there is considerable overlap in the 

confidence intervals for men and women, suggesting that there is no statistically 

significant difference in the prevalence of smoking between men and women. However, 

there is a statistically significant difference in the prevalence of smoking among the 

wards. 

If pairs of the 95% confidence intervals do not overlap, then there is a statistically 

significant difference in the rates between the two wards. However, if there is only a 

small overlap, the difference could still be statistically significant, but further statistical 

analysis needs to be undertaken to establish whether this is the case or not 31 . 

In North Locality, the prevalence of smoking is significantly lower in King‟s Park, 

Beverley and University compared to Bransholme East, Bransholme West and Orchard 

Park and Greenwood. 

29 Residents were approached to participate in the 2007 and 2009 surveys through the same method 

(face-to-face contact at home; knocking on doors), the completion method differed. The majority of the 

surveys completed during 2007 were self-completion, with the company undertaking the survey agreeing 

with the householder to return at a specific date and time to collect the completed questionnaire, whereas 

in the most recent survey, the (shorter) questionnaire was completed by interview. Response rates for 

surveys do tend to decrease with increasing social class, and literacy levels are relatively low in Hull, so it 

is possible that people in lower social class groups (which include a higher percentage of smokers) were 

less likely to participate in the 2007 survey. This may well explain some of the differences found among 

the two latest surveys. 

30 Especially when examining subgroups by gender, age and Locality (for example, number of men aged 

75+ in North Locality is only 10 in the Prevalence Survey). 

31 For these comparisons a logistical regression model including age group as a dummy variable has been 

used to assess if there is a difference between two wards. Any test examining males and females 

combined will not be independent of the test for males or females. Furthermore, even if there were no 

differences in the prevalence rates, one would expect 5% of comparisons to be statistically significant due 

to chance. Therefore, when comparing a number of wards, it is possible that statistically significant 

differences are obtained when there is no underlying real difference. 



In East Locality, the differences are less marked, but nevertheless there is a significant 

difference in the prevalence of smoking in Ings and Holderness compared to Longhill, 

Marfleet and Southcoates East (but not for Holderness compared to Longhill). There is 

also statistically significant difference in the prevalence in Longhill compared to Sutton 

and Drypool for women, and in Sutton compared to Marfleet and Southcoates East for 

men. In addition, the prevalence in Marfleet is statistically significant compared to 

Drypool and Southcoates West for men. 

For West Locality, there are statistically significant differences between Myton, 

Newington and St Andrew‟s wards compared to Boothferry, Derringham, Pickering, 

Avenue and Bricknell wards. For women, there are also statistically significant 

differences in the prevalence of smoking in Newland compared to Myton and St 

Andrew‟s, and between Newington and St Andrew‟s. 

Figure 80: Age-adjusted percentages smoking daily or occasionally for wards in North 

Locality, 2009 

Age standardised smoking prevalence (%) 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Bransholme 

East 

Bransholme 

West 

Kings Park Beverley Orchard Park 

and 

Greenwood 

Ward in North Locality 

University 

Males 

Females 

Persons 



Figure 81: Age-adjusted percentages smoking daily or occasionally for wards in East 



90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Ings Longhill Sutton Holderness Marfleet Southcoates 

East 

Southcoates 

West 

Drypool 

Figure 82: Age-adjusted percentages smoking daily or occasionally for wards in West 



90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Ward in East Locality 

Myton Newington St Andrews Boothferry Derringham Pickering Avenue Bricknell Newland 

Ward in West Locality 


Males 

Females 

Persons 

Males 

Females 

Persons


8.4.2.2 Young People 

The 2008-09 Young People Health and Lifestyle Survey (see section 13.2.1.6 on page 

792 for more information on the survey) collected information on smoking behaviour. 

The results are presented in Table 98 by gender and school year. Year 7 young people 

are aged 11-12 years, and Year 11 young people are aged 15-16 years. 

Table 98: Smoking behaviour in young people in Hull, 2008-09 

Gender Smoking behaviour Smoking behaviour by school year (%) 

Yr 7 Yr 8 Yr 9 Yr 10 Yr 11 All 

Smoke regularly 0.0 0.8 3.0 5.2 8.9 3.2 

Smoke occasionally 0.0 1.2 2.1 3.4 5.3 2.2 

Males 

Used to smoke 

Tried smoking 

2.5 

7.2 

4.9 

10.3 

5.1 

17.9 

5.5 

20.3 

8.3 

22.5 

5.0 

15.2 

Never smoked 90.3 82.7 71.8 65.5 55.0 74.4 

Ever smoked 9.7 17.3 28.2 34.5 45.0 25.6 

Smoke regularly 1.7 1.1 6.5 12.1 20.7 8.3 

Smoke occasionally 1.4 1.5 6.0 10.1 12.0 6.2 

Females 

Used to smoke 

Tried smoking 

4.5 

10.3 

6.5 

13.0 

8.6 

23.7 

12.1 

21.2 

9.6 

25.5 

8.3 

18.5 

Never smoked 82.1 77.8 55.2 44.6 32.3 58.7 

Ever smoked 17.9 22.2 44.8 55.4 67.7 41.3 

Using information from the 2007 Health Survey for England (Health Survey for England 

2008), among boys Hull had lower percentages that had ever smoked than England with 

the exception of boys aged 11 years (Table 99). For each age, the percentage of boys 

that were regular or occasional smokers was lower in Hull then England, with the 

exception of boys aged 13 years, where the percentages were similar. 

Among girls, the percentages that had ever smoked were higher for Hull than England 

for all except girls aged 15 years, where percentages were similar. Despite this, 

percentages of regular or occasional smokers were lower for girls in Hull than England 

for each age except girls aged 12 years, where the percentages were similar. 



Table 99: Smoking behaviour in young people in Hull 2008-09 compared to England 

Gender Smoking 

behaviour 

Smoke 

regularly 

Smoke 

occasionally 

Used to 

smoke 

Males 

Tried 

smoking 

Never 

smoked 

Ever 

smoked 

Smoke 

regularly 

Smoke 

occasionally 

Used to 

smoke 

Females 

Tried 

smoking 

Never 

smoked 

Ever 

smoked 

Area Smoking behaviour by school year (%) 

Yr 7 Yr 8 Yr 9 Yr 10 Yr 11 All 

Hull 0.0 0.0 3.2 3.4 8.3 2.9 

England 1 1 3 7 12 5 

Hull 0.0 1.2 2.4 2.3 3.4 1.9 

England 1 2 3 7 8 4 

Hull 3.4 3.5 4.8 5.3 8.7 5.1 

England 2 3 5 8 10 6 

Hull 8.0 8.9 14.8 18.4 22.8 14.7 

England 8 12 18 20 20 16 

Hull 88.6 86.5 74.8 70.7 56.8 75.3 

England 89 82 72 59 50 69 

Hull 11.4 13.5 25.2 29.3 43.2 24.7 

England 11 18 28 41 50 31 

Hull 0.6 2.1 3.5 10.9 16.9 7.3 

England 1 1 4 12 19 8 

Hull 1.2 1.0 3.5 8.7 12.1 5.7 

England 0 2 5 10 13 6 

Hull 6.2 4.5 8.5 13.0 7.4 8.0 

England 1 4 7 10 12 7 

Hull 7.5 12.5 21.2 21.4 24.3 18.2 

England 6 10 19 18 18 15 

Hull 84.5 79.9 63.3 46.0 39.3 60.8 

England 93 86 66 50 39 64 

Hull 15.5 20.1 36.7 54.0 60.7 39.2 

England 7 17 34 50 61 36 

The prevalence of smoking is compared in Table 100 with the previous local Health and 

Lifestyle Survey which was conducted during 2002. The analysis is restricted to pupils 

in years 7 to 10, as the 2002 survey only included pupils in these school years. Among 

boys, the percentages that smoked regularly or occasionally in 2008-09 had halved 

since 2002 for each year group except year 10 where the percentage had decreased by 

a third. The difference in the percentages that had ever smoked between 2008-09 and 

2002 decreased as year group increased, such that in year 7, 63% fewer boys in 2008- 

09 had ever smoked compared with 2002, while in year 10, 24% fewer boys in 2008-09 

had ever smoked compared with 2002. Thus the prevalence of smoking in boys was 

lower in 2008-09 compared to 2002, and in addition, they started smoking at an older 

age. 

Among girls, the percentages of regular or occasional smokers in 2008-09 were less 

than half the equivalent percentages in 2002 for girls in each year group with the 

exception of year 7, where the percentage in 2008-09 was 20% lower than in 2002. The 

percentages that had ever smoked were between 22% and 34% lower in 2008-09 than 



2002, although the differences between 2008-09 and 2002 showed no discernible trend 

with school year. 

Table 100: Smoking behaviour in young people in Hull, 2002 versus 2008-09 

Gender Smoking 

behaviour 

Smoke 

regularly 

Smoke 

occasionally 

Used to 

smoke 

Males 

Tried 

smoking 

Never 

smoked 

Ever 

smoked 

Smoke 

regularly 

Smoke 

occasionally 

Used to 

smoke 

Females 

Tried 

smoking 

Never 

smoked 

Ever 

smoked 

Survey Smoking behaviour by school year (%) 

year Yr 7 Yr 8 Yr 9 Yr 10 All 

2008 0.0 0.8 3.0 5.2 2.3 

2002 1.4 3.3 6.4 5.5 4.4 

2008 0.0 1.2 2.1 3.4 1.7 

2002 2.8 0.8 3.6 7.3 3.5 

2008 2.5 4.9 5.1 5.5 4.5 

2002 4.1 9.0 7.3 8.2 7.0 

2008 7.2 10.3 17.9 20.3 14.0 

2002 17.9 17.2 24.5 24.5 21.4 

2008 90.3 82.7 71.8 65.5 77.5 

2002 73.8 69.7 58.2 54.5 63.7 

2008 9.7 17.3 28.2 34.5 22.5 

2002 26.2 30.3 41.8 45.5 36.3 

2008 1.7 1.1 6.5 12.1 5.5 

2002 2.2 5.0 15.3 25.5 11.9 

2008 1.4 1.5 6.0 10.1 4.9 

2002 1.7 2.5 10.7 20.4 8.7 

2008 4.5 6.5 8.6 12.1 8.0 

2002 5.0 7.5 7.9 13.4 8.3 

2008 10.3 13.0 23.7 21.2 16.9 

2002 16.2 18.6 23.3 19.1 19.5 

2008 82.1 77.8 55.2 44.6 64.8 

2002 74.9 66.5 42.8 21.7 51.5 

2008 17.9 22.2 44.8 55.4 35.2 

2002 25.1 33.5 57.2 78.3 48.5 

The Young People Health and Lifestyle Survey 2008-09 report includes information on 

anticipated future intentions regarding smoking status, age when the young person 

started smoking, number of cigarettes smoked, where young people buy their cigarettes, 

etc. (see www.hullpublichealth.org). 

8.4.2.3 Smoking in Pregnancy 

Unsurprisingly given the higher than national prevalence of smoking in young women, 

the prevalence of smoking in pregnancy is higher in Hull than England overall. Data on 

the percentage of women known to be smokers at the time of delivery in the 2009/2010 

financial year was made available through the Department of Health (Department of 

Health 2009). For this financial year, 23.1% of women were known to be smokers at the 

time of delivery in Hull (Figure 83), compared to 14.0% for England, 22.2% for the 



Industrial Hinterlands average, 17.1% for the Yorkshire and the Humber SHA and 18.0% 

for the average of the 10 comparators (highest Middlesbrough at 28.9% and Hull at 

23.1% and lowest for Derby City at 14.0%). The underlying data are given in the 

APPENDIX on page 860. The prevalence of smoking during pregnancy has decreased 

for Hull during the period 2006/2007 to 2009/2010 from 27.7% to 23.1%. For more 

information see the section 8.4.11 on page 270 relating to targets for reducing the 

prevalence of smoking in pregnancy. 

Figure 83: Percentage of women known to be smokers at time of delivery, 2009/2010 

Percentage of women known to be smokers at 

time of delivery, 2009/10 

35 

30 

25 

20 

15 

10 

5 

0 

8.4.3 Mortality 

Hull 

Plymouth 

Salford 

Sunderland 

Middlesbrough 

Coventry 

PCT England Industrial Hinterlands Yorkshire & Humber SHA Average of 10 comparators 

Using the percentages quoted in Table 96, and the number of deaths to Hull residents for 

different causes of deaths (from the Public Health Mortality File (PHMF), Table 101 gives 

the estimated number of deaths in Hull caused by smoking for all ages and for premature 

death (aged under 75 years at death) for deaths which were registered during the 

calendar year 2007. Note that the International Classification of Disease (ICD) codes are 

not provided within the table on the ASH website and it is difficult to obtain the original 

references. The causes of death within Table 96 have been „translated‟ into ICD (version 

10) codes, so that the number of deaths from the PHMF can be derived. It is possible that 

the causes as quoted in Table 96 do not correspond directly to the ICD10 codes used in 

Table 101. However, even if any are incorrect, it is likely that the differences in the total 

number of deaths would not be substantial if the correct codes were used. 

Given the high prevalence of smoking and the high percentage of deaths from lung 

cancer and COPD that are caused by smoking, it is not surprising that there are large 


Wolverhampton City 

Derby City 

Leicester City 

Sandwell 

Stoke-on-Trent 

NE Lincolnshire


numbers of people who died from these diseases which are estimated to be attributable to 

smoking. During 2009 it was estimated that 198 deaths were registered (105 of them 

before the age of 75 years) that were caused by lung cancer and were directly attributable 

to smoking, and a further 148 deaths (48 before the age of 75 years) caused by COPD 

which were directly attributable to smoking. Overall, in Hull it was estimated that around 

550 deaths (and just over 230 premature deaths) were registered during 2009 which were 

due to smoking, i.e. just over 46 per month of which 19 were premature deaths. 

Table 101: Estimated number of deaths in Hull during 2009 which were caused by 

smoking 

Cause of death (ICD10) Deaths in Hull estimated 

to be caused by smoking 2009 

All ages Under 75 

Men Women Tot Men Women Tot 

Lung cancer C33, C34 115.7 81.8 197.5 62.3 42.8 105.1 

Upper respiratory cancer C00-C14, C32 9.6 0.5 10.1 8.9 0.5 9.4 

Oesophagus cancer C15 19.9 8.5 28.3 11.4 1.3 12.7 

Bladder cancer C67 3.8 2.3 6.0 1.4 0.8 2.2 

Kidney cancer C64 4.8 0.2 5.0 2.8 0.1 2.9 

Stomach cancer C16 5.3 1.1 6.4 2.1 0.3 2.4 

Pancreas cancer C25 3.8 4.7 8.5 2.8 1.8 4.6 

Myeloid leukaemia C92 1.0 0.3 1.3 0.2 0.2 0.4 

COPD J40-J44 73.1 74.5 147.6 25.8 21.9 47.7 

Pneumonia J16-J18 12.4 9.4 21.8 3.45 1.0 4.5 

Ischaemic heart disease I20-I25 47.7 18.7 66.5 22.9 5.6 28.5 

Cerebrovascular disease I60-I69 10.2 9.5 19.7 2.8 1.3 4.0 

Aortic aneurysm I71 15.9 6.2 22.1 5.5 0 5.5 

Myocardial degeneration I50 2.4 1.9 4.3 0 0 0.0 

Atherosclerosis I70 0.0 0.1 0.1 0 0 0.0 

Stomach/duodenum ulcer K25-K27 5.0 3.6 8.6 1.8 0.9 2.7 

Total caused by smoking 330 223 554 154 78 232 

For deaths registered during 2009, there were 606 deaths for men aged under 75 years, 

641 for men aged 75+ years, 356 deaths for women aged under 75 years and 842 for 

women aged 75+ years. The total number of deaths to Hull residents that were 

registered during the calendar year 2009 was 2,445 of which 962 were before the age of 

75 years. Therefore, it is estimated that in 2009 approximately 23% of all deaths and 

24% of all premature deaths in Hull were attributable to smoking. Note that many more 

deaths will be due to smoking-related illnesses as Table 101 includes only a proportion 

of these deaths (e.g. only 22% of ischaemic heart disease deaths in men – see Table 

96). 



8.4.4 Attitudes Towards Smoking 

Percieved impact on health after quitting smoking is presented in section 8.3 on page 

244 from the Social Capital Survey 2009, with additional information examining 

differences among the genders, age groups, Localities and deprivation quintiles 

available in the Social Capital Survey 2009 report. Further information on factors 

influencing smoking prevalence is given in section 8.4.7 on page 259 and in the 2007 

Health and Lifestyle Survey Smoking report. Attitudes to smoking were collected as part 

of Reflector Groups following the 2007 Health and Lifestyle Survey (see section 

13.2.2.2 on page 795) and the 2008-09 Young Person Health and Lifestyle Survey (see 

section 13.2.2.3 on page 796). The Smoking report, full survey reports from all surveys 

and reflector group reports are available at www.hullpublichealth.org. Opinions and 

attitudes were also collected during focus groups as part of the Attitudes to Health 

project conducted during 2007 (see section 13.2.2.1 on page 794). 

8.4.5 Smoking in Relation to Deprivation 

The percentage of persons who smoked daily or occasionally is given in Figure 84 by 

local deprivation quintile in Hull. As can be seen based on local deprivation quintiles, a 

higher proportion of people from the most deprived areas smoke daily or occasionally 

(54%) compared to the least deprived areas (20%). The trend is quite dramatic and 

statistically significant ( 2 test for trend, X=176, p


This relationship between deprivation or social class and smoking status is also noted 

nationally. Figure 85 shows the percentage of current cigarette smoking by social class 

from the General Lifestyle Survey 2008 (Economic and Social Data Service, 2008) 

previously known as the General Household Survey. The underlying data are given in 

the APPENDIX on page 861. 

Figure 85: Percentage of adult cigarette smokers from the General Lifestyle Survey by 

social class, 2001-2008 

Current cigarette smoker (%) 

40 

35 

30 

25 

20 

15 

10 

5 

0 

Managerial and 

professional 

Intermediate Routine and 

manual 

Managerial and 

professional 

Men Women 

Gender / social class 

2001 2002 2003 2004 2005 2006 2007 2008 

8.4.6 Smoking in Relation to Employment Status 

Intermediate Routine and 

manual 

It is also possible to examine smoking status in relation to employment status using the 

information from the local Prevalence Survey conducted during 2009. Figure 86 shows 

that those smoking prevalence was much higher for people looking after the home or 

family (46%), those who were not working due to long-term sickness or disability (61%), 

and those who were unemployed or not working (63%). These percentages were 

considerably lower for the 2007 Health and Lifestyle Survey (41%, 43% and 54% 

respectively), and it could be associated with the differing survey methodology (see 

footnote 29 on page 249). Furthermore, the total number of people surveyed in the 

Prevalence Survey 2009 is less than half that of the Health and Lifestyle Survey 2007 so 

the estimates are subject to more variability. The differences in the percentages in 

Figure 86 are statistically significant ( 2 test, X=136, df=5, p


Figure 86: Percentage of responders who smoke daily or occasionally by employment 

status for Hull (from Prevalence Survey conducted 2009) 

Percentage of smokers 

70 

60 

50 

40 

30 

20 

10 

0 

Working 

Student 

Daily Occasionally 

Employment status 

Retired 

Looking after 

family/home 

Unemployed or not 

working 

Long-term sick or 

disabled 

8.4.7 Social Marketing and Factors Influencing Smoking Behaviour 

Considerable Social Marking work has been undertaken examining smoking behaviour 

and attitudes to smoking in Hull with the aim of providing more relevant information to 

help people quit smoking. For example, it has been found that men prefer one-to-one 

support rather than group sessions so changes have been made to accommodate this 

preference in the Smoking Cessation Service. 

A report specifically on smoking using information from the 2007 Health and Lifestyle 

Survey also examines associations between smoking behaviour and attitudes, and other 

factors such as general health, measures of deprivation, and other risk factors such as 

alcohol, etc. This report found that smoking prevalence was higher for people living in 

more deprived areas, with lower educational attainment, who had a lower household 

income, who were not working due to long-term illness or disability, or were 

unemployed, who had poorer health, who drank alcohol excessively or undertook binge 

drinking, and who had a poorer diet. Smoking prevalence was lower for people who 



were obese. This report also includes additional information on the prevalence of 

smoking heavily and factors predicting higher levels of smoking, etc. The report is 

available at www.hullpublichealth.org. 

Further information on attitudes to smoking is given in section 8.3 on page 244 and in 

section 8.4.4 on page 257. 

Social marketing work has been undertaken in relation to smoking and COPD (see 

section 10.5.3.11 on page 631 for more information). An important finding with regard 

to smoking was that there was a perceived health danger relating to quitting smoking 

“quit and you‟ll die!”. 

“She snuffed it with lung cancer after she chucked it for three years.” 

“He stopped, the year after he died.” 

“I think you can do a lot of harm, you will be dead within six months.” 

“My wife‟s mother … she died of cancer but she never had it when she smoked.” 

“People smoke all these years and then stop, they get a disease or something.” 

8.4.8 Stop Smoking Service 

Smoking cessation statistics by financial year are published each year by the NHS 

Information Centre for Health and Social Care (Information Centre for Health and Social 

Care 2010). PCT level summaries are provided, together with breakdowns at PCT level 

by broad age band and by gender, although not age band within gender. Data are also 

produced by ethnicity, but not at a PCT level, so are not presented here. Data that are 

published at a PCT level includes the number and rate per 100,000 setting quit dates, 

the number and rate per 100,000 of successful quitters (4-week quits), where “A client is 

counted as a „self-reported 4-week quitter‟ if when assessed 4 weeks after the 

designated quit date, they declare that they have not smoked, even a single puff on a 

cigarette, in the past two weeks.” (Information Centre for Health and Social Care 2010). 

Also published by PCT were the numbers lost to follow-up and the numbers of 4-week 

quits that were confirmed by carbon monoxide (CO) validation. Rates in each case 

have been recalculated using the ONS mid-year population estimates for 2009. 

Table 102 contains the smoking cessation statistics for 2009/10 broken down by 

gender, for Hull, comparator PCTs (see section 3.3.3 on page 44), Spearhead PCTs, 

plus regional and national comparisons. The rate of quit dates set in Hull during 

2009/2010 was around 10% higher than the comparator PCT average, 14% higher than 

the Spearhead PCT average, and 40-50% higher than the regional and national 

averages. Hull was more successful than comparators in converting quit dates set into 

self-reported 4-week quits, achieving a conversion rate of 62%, compared with 43% in 

comparator PCTs, 47% in Spearhead PCTs, 53% across the region and 49% nationally, 

giving self-reported 4-week quit rates between 40% and 100% higher than in 

comparators, with the greatest difference in women. Hull was also more successful at 



following up clients at 4 weeks, with only 11% lost to follow up at 4 weeks, compared 

with the comparator PCT average of 32%, the Spearhead PCT average of 37% and the 

regional and national averages of 25% and 24% respectively. Where Hull was less 

successful than comparators was in confirming self-reported quits at 4- weeks using CO 

validation. The percentage of self-reported 4-week quits confirmed by CO validation 

was 53% for Hull, compared with the comparator PCT average of 69%, the Spearhead 

PCT average of 67%, the regional average of 74% and the national average of 69%. 

The Information Centre Report states that: “Carbon Monoxide (CO) validation measures 

the level of carbon monoxide in the bloodstream and provides an indication of the level 

of use of tobacco: it is a motivational tool for clients as well as validation of their smoking 

status. CO validation should be attempted on all clients who self-report as having 

successfully quit at the 4-week follow-up, except those who were followed up by 

telephone.” (Information Centre for Health and Social Care 2010). 

What are not clear from the data are the reasons for the lower percentage of confirmed 

4-week quits in Hull compared with comparators. It may be that clients in Hull that selfreport 

stopping smoking at 4-weeks are more likely to fail the carbon monoxide test; it 

may be that the smoking cessation service in Hull conducts more of its follow-up by 

telephone than elsewhere; it may be that clients in Hull are more likely to refuse to have 

their carbon monoxide levels to be tested than elsewhere; it may be that the smoking 

cessation service in Hull is more reluctant than elsewhere to ask clients to undertake 

carbon monoxide validation. 

A similar breakdown of smoking cessation statistics for 2009/10 by broad age band is 

presented in Table 103. Rates of quit dates set were higher in Hull than for England or 

the Yorkshire and Humber region for each age band. Rates were also higher than the 

comparator PCTs and Spearhead PCTs averages for all except the youngest age band. 

The rate of 4-week quits in Hull for each age band were higher than for each comparator 

area, with more than half of those in each age band in Hull setting quit dates going on to 

quit at 4 weeks, with the percentage of successful quits increasing with age band from 

56% aged 16-34 years to 71% of those aged 60 years and over. Hull was more 

successful than comparators at following up those that had set quit dates, with 

percentages lost to follow up in each age band in Hull less than half the equivalent 

percentages for the comparator PCTs and Spearhead PCTs averages, with the 

differences increasing with age. The area where Hull performed worse than 

comparators for each age was the percentage of successful quits confirmed by carbon 

monoxide validation. The percentages in Hull were lower than for each comparator area 

for each age band, with Hull percentages ranging from 47% in those aged 16-34 years 

to 57% in those aged 45-59 years. This highest percentage in Hull was lower than the 

lowest percentage of any comparator area, the Spearhead PCTs average of 62% of 

those aged 16-34 years. The potential reasons for why percentages of confirmed 4week 

quits might be lower than comparators were explored above. 



Table 102: Smoking cessation statistics 2009/10 by gender 

Area 

Gender 

Smoking cessation statistics 2009/10 for Hull, East Riding, Yorkshire & Humber, and England 

Setting a 

quit date 

4-week 

quits 1 

Numbers 

Lost to 

follow 

up / not 

known 

Confirmed 

4-week 

quits 2 

Rates per 

100,000 

Quit 

dates 

set 

4week 

quits 1 

Successful 

quits 3 

Percentages 

Confirmed 

successful 

quits 4 

Hull Males 2,606 1,626 310 829 2,410 1,503 62 51 

Females 3,031 1,874 318 1,027 2,840 1,756 62 55 

Comparator 

PCTs 

Spearhead 

PCTs 

Yorkshire & 

Humber 

All 5,637 3,500 628 1,856 2,623 1,629 62 53 

Males 22,852 10,090 7,361 7,092 2,274 1,004 44 70 

Females 26,365 11,196 8,231 7,622 2,517 1,069 42 68 

All 49,217 21,286 15,592 14,714 2,398 1,037 43 69 

Males 160,577 76,551 43,985 51,539 2,205 1,051 48 67 

Females 181,353 82,514 48,829 55,597 2,391 1,088 45 67 

All 341,930 159,065 92,814 107,136 2,300 1,070 47 67 

Males 35,209 19,012 8,520 13,961 1,681 908 54 73 

Females 39,908 20,582 9,886 15,256 1,826 941 52 74 

All 75,117 39,594 18,406 29,217 1,755 925 53 74 

Males 363,732 184,066 89,092 126,438 1,772 897 51 69 

England Females 393,805 189,888 95,788 130,275 1,828 882 48 69 

All 757,537 373,954 184,880 256,713 1,801 889 49 69 

1 Self-reported successful quits at the 4-week follow-up (client reported he/she not smoked at all since two weeks after the quit date) 

2 Self-reported successful quits confirmed by CO validation 

3 Percentage of all 4-week quits out of all those setting a quit date 

4 Percentage of 4-week quits that were confirmed by CO validation 



Table 103: Smoking cessation statistics 2009/10 by age band 

Smoking cessation statistics 2009/10 for Hull, East Riding, Yorkshire & Humber, and England 

Age 

Numbers Rates per 100,000 Percentages 

Area band 

(yrs) 

Setting 

a quit 

date 

4-week 

quits 1 

Lost to 

follow up / 

not known 

Confirmed 

4-week 

quits 2 

Quit 

dates 

set 

4-week 

quits 1 

Successful 

quits 3 

Confirmed 

successful 

quits 4 

16-34 1,863 1,040 297 490 2,245 1,253 56 47 

Hull 

35-44 

45-59 

1,363 

1,528 

847 

989 

158 

142 

463 

566 

3,844 

3,251 

2,389 

2,104 

62 

65 

55 

57 

60+ 883 624 31 337 1,786 1,262 71 54 

16-34 17,905 6,562 6,829 4,132 2,490 912 37 63 

Comparator 35-44 11,590 5,244 3,614 3,660 3,276 1,482 45 70 

PCTs 45-59 12,563 5,687 3,621 4,113 2,744 1,242 45 72 

60+ 7,159 3,793 1,528 2,809 1,372 727 53 74 

16-34 120,715 48,831 39,668 30,213 2,456 994 40 62 

Spearhead 35-44 81,712 39,197 22,193 26,872 3,044 1,460 48 69 

PCTs 45-59 89,505 43,769 21,667 30,753 2,594 1,268 49 70 

60+ 49,998 27,268 9,286 19,298 1,309 714 55 71 

16-34 27,245 12,221 8,523 8,664 1,994 895 45 71 

Yorkshire & 35-44 17,613 9,596 4,230 7,092 2,390 1,302 54 74 

Humber 45-59 19,238 10,910 4,059 8,230 1,909 1,083 57 75 

60+ 11,021 6,867 1,594 5,231 942 587 62 76 

16-34 260,195 112,286 78,335 71,682 2,005 865 43 64 

England 

35-44 

45-59 

184,578 

197,355 

93,943 

101,814 

44,700 

43,036 

65,272 

72,508 

2,425 

1,985 

1,234 

1,024 

51 

52 

69 

71 

60+ 115,409 65,911 18,809 47,251 1,000 571 57 72 

1 Self-reported successful quits at the 4-week follow-up (client reported he/she not smoked at all since two weeks after the quit date) 

2 Self-reported successful quits confirmed by CO validation 

3 Percentage of all 4-week quits out of all those setting a quit date 

4 Percentage of 4-week quits that were confirmed by CO validation 



Trend data for PCTs (in their current configuration) are available from 2006/2007 

onwards, although no breakdown by gender or age bands were available for 2006/2007. 

Rates of quit dates set and 4-week quits achieved have been recalculated using ONS 

mid-year resident population estimates. The 16+ population has been estimated by 

summing all age groups aged 20-24 and higher plus 80% of those aged 15-19 years. 

The results for Hull and comparator areas are shown in Table 104. 

Table 104: Smoking cessation data by quarter and year, Hull and comparison areas 

Measure Area Financial year 

2006/07 2007/08 2008/09 2009/10 

Hull 1,682 1,272 1,902 2,623 

Quit dates set 

per 100,000 

Comparator PCTs 

Spearhead PCTs 

Yorkshire & Humber 

2,154 

1,848 

1,338 

2,292 

2,094 

1,583 

2,154 

2,026 

1,639 

2,398 

2,300 

1,755 

England 1,461 1,642 1,607 1,801 

Hull 1,084 839 1,252 1,629 

4-week quits 

per 100,000 

Comparator PCTs 

Spearhead PCTs 

Yorkshire & Humber 

1,037 

928 

693 

1,049 

1,019 

843 

948 

972 

861 

1,037 

1,070 

925 

England 778 847 807 889 

Hull 64 66 66 62 

4-week quits as Comparator PCTs 48 46 44 43 

a percentage of Spearhead PCTs 50 49 48 47 

quit dates set Yorkshire & Humber 52 53 53 53 

England 53 52 50 49 

Figure 87 presents annual trends in the rate of quit dates set for Hull and comparison 

areas, while the change in the percentage of the rate of quit dates set are shown in 

Table 105. In 2007/2008, the rate of quit dates set in Hull decreased by a quarter from 

2006/2007 despite increasing in each comparator area. After this, the performance of 

the smoking cessation service in Hull improved dramatically, with annual increases in 

2008/2009 and 2009/2010 of 50% and 38% respectively, outperforming each 

comparator area. The rate of quit dates set in Hull in 2009/2010 exceeded the rates in 

each comparator area, having been lower than both Comparator PCTs and Spearhead 

PCTs in 2006/2007 and lower than each comparator area in 2007/2008. Overall, the 

rate of quit dates set increased in Hull between 2006/2007 and 2009/2010 by 56%, a 

statistically significantly larger increase than seen for any of the comparator areas. This 

was five times the increase seen for the 10 comparator PCTs, more than twice the 

increase seen for Spearhead PCTs and England, and 80% higher than the increase 

seen across the Yorkshire and Humber region. See Table 104 for underlying data. 



Figure 87: Trends in quit dates set per 100,000 residents aged 16+ years 

Quit dates set per 100,000 residents 

aged 16+ years 

3,000 

2,500 

2,000 

1,500 

1,000 

500 

0 

2006/07 2007/08 2008/09 2009/10 

Financial year 

Hull Comparator PCTs Spearhead PCTs Yorkshire & Humber SHA England 

Table 105: Percentage change in quit dates set (95% confidence intervals) 

Percentage change in quit dates set (95% confidence intervals) 

Area 

2006/07 to 

Annual change 

2007/08 to 2008/09 to 

Total change 

2006/07 to 

2007/08 

2008/09 

2009/10 

2009/10 

Hull -24.4 (-28.1 to -20.5) 49.5 (42.4 to 57.0) 37.9 (32.5 to 43.6) 56.0 (49.6 to 62.7) 

Comparator PCTs 6.4 (5.0 to 7.8) -6.0 (-7.2 to -4.8) 11.3 (9.9 to 12.7) 11.3 (9.9 to 12.8) 

Spearhead PCTs 13.3 (12.7 to 13.9) -3.2 (-3.7 to -2.7) 13.5 (12.9 to 14.0) 24.4 (23.8 to 25.0) 

Yorkshire & Humber 18.3 (16.9 to 19.6) 3.6 (2.5 to 4.7) 7.1 (6.0 to 8.2) 31.1 (29.7 to 32.6) 

England 12.4 (12.0 to 12.8) -2.1 (-2.4 to -1.8) 12.0 (11.7 to 12.4) 23.2 (22.8 to 23.7) 

Figure 88 shows the annual trends in the rate of 4-week quits for Hull and comparison 

areas, while the percentage changes in the rate of quit dates set are shown in Table 

106. In 2006/2007 the rate of 4-week quits in Hull was similar to the rate in the 10 

comparator PCTs, but in 2007/2008 the rate in Hull had decreased by almost a quarter 

to the level seen in England and the region, reflecting the decrease in quit dates set that 

was mentioned above. Subsequently large increases in the rate of 4-week quits, again 

reflecting the increases in quit dates set, were seen for Hull, such that by 2009/2010, 4week 

quit rates in Hull were more than 50% higher than in any of the comparator areas. 

Between 2006/2007 and 2009/2010 the rate of 4-week quits increased in Hull by 50%, a 

statistically significantly higher increase than seen in any of the comparator areas. The 

10 comparator PCTs saw no overall increase during this period, while the increase for 



Hull was more than three times as high as those in Spearhead PCTs and England, and 

50% higher than the regional average increase in 4-week quits. See Table 104 for 

underlying data. 

Figure 88: Trends in 4-week quits per 100,000 residents aged 16+ years 

4-week quits per 100,000 

residents aged 16+ years 

1,800 

1,600 

1,400 

1,200 

1,000 

800 

600 

400 

200 

0 

2006/07 2007/08 2008/09 2009/10 



Table 106: Percentage change in 4-week quits (95% confidence intervals) 

Percentage change in quit dates set (95% confidence intervals) 

Area 

2006/07 to 

Annual change 

2007/08 to 2008/09 to 

Total change 

2006/07 to 

2007/08 

2008/09 

2009/10 

2009/10 

Hull -24.4 (-28.1 to -20.5) 49.5 (42.4 to 57.0) 37.9 (32.5 to 43.6) 56.0 (49.6 to 62.7) 

Comparator PCTs 6.4 (5.0 to 7.8) -6.0 (-7.2 to -4.8) 11.3 (9.9 to 12.7) 11.3 (9.9 to 12.8) 

Spearhead PCTs 13.3 (12.7 to 13.9) -3.2 (-3.7 to -2.7) 13.5 (12.9 to 14.0) 24.4 (23.8 to 25.0) 

Yorkshire & Humber 18.3 (16.9 to 19.6) 3.6 (2.5 to 4.7) 7.1 (6.0 to 8.2) 31.1 (29.7 to 32.6) 

England 12.4 (12.0 to 12.8) -2.1 (-2.4 to -1.8) 12.0 (11.7 to 12.4) 23.2 (22.8 to 23.7) 

Figure 89 shows annual trends in the ratio of 4-week quits achieved to quit dates set 

(expressed as a percentage), while the percentage changes in this ratio are shown in 

Table 107. Hull out-performed each of the comparison areas in this indicator for each of 

the four years with more than 60% of quit dates set being converted to 4-week quits in 

each year, although seeing small decreases in the ratio of 4-week quits to quit dates set 

between 2008/2009 and 2009/2010. Each comparator area saw decreases for each 

year except for the Yorkshire and Humber region where only 2008/2009 saw a 

decrease. It may be that the ratio of 4-week quits to quit dates set may decrease as the 

rate of quit dates set increases, as less committed quitters are recruited. However, this 

is just speculation at this stage. Overall, the ratio of 4-week quits to quit dates set 

decreased by almost 4% in Hull between 2006/2007 and 2009/2010, compared with 



decreases of 10% in the 10 comparator PCTs, 7% among Spearhead PCTs and 

England as a whole, although the Yorkshire and Humber region saw an increase over 

this period of almost 2%. See Table 104 for the underlying data. 

Figure 89: Trends in 4-week quits as a percentage of quit dates set 

4-week quits as percentage of 

quit dates set 

70 

60 

50 

40 

30 

20 

10 

0 

2006/07 2007/08 2008/09 



Table 107: Percentage change in ratio of 4-week quits to quit dates set (95% confidence 

intervals) 

Percentage change in ratio of 4-week quits to quit dates set (95% 

confidence intervals) 

Area 

Annual change Total change 

2006/07 to 2007/08 to 2008/09 to 2006/07 to 

2007/08 2008/09 2009/10 

2009/10 

Hull 2.3 (-3.8 to 8.9) -0.2 (-6.0 to 6.0) -5.7 (-10.3 to -0.8) -3.7 (-8.6 to 1.6) 

Comparator PCTs -5.0 (-6.7 to -3.1) -3.8 (-5.7 to -2.0) -1.8 (-3.6 to 0.2) -10.2 (-11.9 to -8.5) 

Spearhead PCTs -3.0 (-3.7 to -2.3) -1.5 (-2.2 to -0.8) -3.0 (-3.7 to -2.3) -7.3 (-8.0 to -6.7) 

Yorkshire & Humber 2.8 (1.2 to 4.4) -1.4 (-2.8 to 0.1) 0.3 (-1.1 to 1.8) 1.8 (0.2 to 3.3) 

England -3.2 (-3.6 to -2.7) -2.6 (-3.1 to -2.2) -1.7 (-2.1 to -1.2) -7.3 (-7.7 to -6.9) 

8.4.9 Stop Smoking Cessation Service and Predictive Modelling in Relation to 

Life Expectancy 

Predictive modelling with sensitivity analyses has been undertaken to assess the effect 

of increasing the smoking cessation service to achieve life expectancy targets. The life 

expectancy for 2003-2005 (74.3 years for men and 78.9 years for women in Hull) was 

examined in relation to a local target of life expectancy for 2009-2011, taking into 

account the local prevalence of smoking and the number of people quitting smoking at 



four weeks through the local smoking cessation service. The reduction in the number of 

deaths required locally to meet the local life expectancy target was calculated. 

Information on the number of deaths caused by smoking (using equivalent information 

as in Table 101) was calculated, and assumptions were made as to the percentage of 

smokers who would no longer die having quit smoking through the smoking cessation 

service. 

Whilst the life-time risk is generally quoted as one in two, there is very little information 

on the year-on-year risk so it is not straightforward to estimate the effect on quitting 

smoking. The year-on-year relative risk of dying cannot be assumed to be twice as high 

for smokers compared to non-smokers as smoking only causes specific diseases and 

the time delay will vary depending on the disease. Furthermore, it is necessary to have 

some information on the reduction in risk of death following smoking cessation. Some 

information is available here, but it is generally limited to mortality from specific diseases 

and then not denoted as year-on-year reductions in risk. 

Therefore, as this year-on-year risk is not readily available, an assumption was made 

about the percentage of smoking-related deaths that would be prevented within the next 

five years, and the effect on the smoking cessation service was calculated. 

The local life expectancy targets were calculated on the same basis as the Public 

Service Agreement (PSA) 2004 target (MH Treasury 2004) for England (see section 

7.7.5 on page 196 for more information). The same percentage change was applied to 

Hull‟s baseline life expectancy to calculate the local targets for 2009-2011 which were to 

increase life expectancy in Hull to 76.8 years for men and 81.0 years for women. In 

order to achieve this, it was estimated that there should be a reduction of 545 deaths in 

the annual number of deaths to 2009-2011. 

If 50% of smokers die of smoking-related causes, and if was assumed that 5% would die 

from smoking-related causes within the next five years and their deaths are prevented 

then what would the effect on life expectancy be? In order to achieve the local life 

expectancy targets, then the annual average number of deaths for 2009-2011 would 

need to be 545 fewer than 2003-2005. In order for the average annual number of 

deaths to be this much lower, if 5% of smokers who would have died within the next few 

years (prior to 2011) no longer die because they have quit smoking, then there would 

need to be 10,900 current smokers who permanently quit (545 divided by 0.05). For 

2005/2006, approximately 900 quit at four weeks, and if it is assumed that all of them 

continued to not smoke in the long-term (70% long-term quit rate), then the service 

would need to be increased 12-fold. Whereas, if it assumed that 30% of those who quit 

at four weeks started to smoke again (resulting in long-term quit rate of 49%), then the 

service would need to increase 17-fold. If only 2% of smokers would have died within 

the next few years (prior to 2011), then there would need to be 27,250 current smokers 

who quit permanently (545 divided by 0.02). If the four-week quit rate is maintained then 

the smoking cessation service would need to increase 30-fold, and if 20% of the fourweek 

quitters start smoking again (resulting in a long-term quit rate of 56%), then the 

service would need to increase 38-fold. Table 108 summarises further examples of the 

increase in the smoking cessation service necessary. 



Table 108: Increase in smoking cessation service necessary to achieve reduction of 545 

deaths in annual number of deaths by 2009-2011 (from 2003-2005) 

Increase in smoking cessation service 

necessary to reduced deaths by 545 

% who maintain 4-week quit rate: 100% 90% 80% 70% 60% 50% 40% 

Long-term quit rate: 70% 63% 56% 49% 42% 35% 28% 

Smoker deaths prevented 

prior to 2011 

10% 6.1 6.7 7.6 8.7 10.1 12.1 15.1 

9% 6.7 7.5 8.4 9.6 11.2 13.5 16.8 

8% 7.6 8.4 9.5 10.8 12.6 15.1 18.9 

7% 8.7 9.6 10.8 12.4 14.4 17.3 21.6 

6% 10.1 11.2 12.6 14.4 16.8 20.2 25.2 

5% 12.1 13.5 15.1 17.3 20.2 24.2 30.3 

4% 15.1 16.8 18.9 21.6 25.2 30.3 37.8 

3% 20.2 22.4 25.2 28.8 33.6 40.4 50.5 

2% 30.3 33.6 37.8 43.3 50.5 60.6 75.7 

1% 60.6 67.3 75.7 86.5 100.9 121.1 151.4 

Without extensive literature searches to obtain background information on the relative 

and absolute risks of smoking and the reduction of risks following smoking cessation, 

and without further definitive information on long-term (permanent) smoking cessation 

quit rates, it is difficult to estimate by how much the smoking cessation service would 

need to expand in order for the life expectancy targets to be achieved. 

However, it is probably unlikely that 10% of deaths would be prevented by 2011 and it is 

probably more likely that the figure is less than 5%. If the figure is 5%, even at the 

highest long-term quit rate, the service would need to increase 12-fold. It could be that 

1% or 2% is a more realistic figure, and if this was the case with the highest long-term 

quit rate the service would need to increase 30-fold. 

8.4.10 Stop Smoking Strategy 

Further information about available services is given at www.nhshull.nhs.uk. 

Hull has a free phone telephone number for support to stop smoking. One-to-one, group 

sessions, and telephone or online support are all offered by the Hull and East Riding 

Stop Smoking Service (www.readytostopsmoking.co.uk/). Nicotine replacement 

therapies are available from a range of different providers across the City. People can 

access support from GPs, pharmacies, smoking cessation specialists within CHCP or 

those employed a local voluntary/community organisation: Goodwin Development Trust. 

One to one and group sessions are held throughout Hull on an appointment or drop in 

basis. A local Smoke Free Families Services assists pregnant women to quit smoking. 

There is also the Smokefree Homes initiative which supports local families especially 

those with expectant women and/or young children and aims to eliminate smoking within 



the home or limit smoking to specific rooms within the home. Social Marketing 

advertising campaigns have been commissioned following insight work into why people 

smoke locally and information gathered from this has been used to reconfigure and 

commission new services. 

The Humber Alliance on Tobacco (HALT) is a multi-agency partnership. The Alliance 

has a five year plan that incorporates all recommendations covered in 2008 tobacco 

control document (Department of Health 2008). The National Support Team visit to Hull 

described HALT as “a well established and effective Tobacco Control Alliance”. 

Smokesnojoke (www.smokesnojoke.com) is a web-site for children parents and 

teachers, developed in consultation with its users. The site is a one-stop-shop for 

information and resources and has recently been nominated for a Regional Health and 

Social Care Award. 

All commissioned smoking cessation interventions follow NICE and Department of 

Health Guidelines. 

NHS Hull has commissioned the production of an information booklet for local people 

with details of local healthy lifestyles services and support. This booklet will help to 

increase access to, and awareness of, a number of services that are available to help 

local people to improve their lifestyles e.g. lose weight, be more active, stop smoking, 

manage alcohol consumption. 


As part of its World Class Commissioning (WCC) Strategy, Hull set ambitious targets of 

a minimum one percentage point reduction in smoking prevalence among adults each 

year for the next 5 years (starting at 31% for 2008/2009 reducing to 27% for 2012/2013). 

The WCC target smoking prevalence for children is similarly a one percentage point 

reduction each year (starting at 14% for 2008/2009 reducing to 10% for 2012/2013), and 

the WCC target for women smoking during pregnancy is a two percentage point 

reduction each year (starting at 25% for 2008/2009 reducing to 17% for 2012/2013). 

Following the change in the government in May 2010, new outcomes are now under 

consultation (see section 3.3.6.2 on page 52). The prevalence of adult smoking and 

smoking in pregnancy are both included in the proposed list of outcomes, so it is 

possible that these measures and the local targets could be retained. 

Assessing progress towards these prevalence-based targets is difficult as accurate 

information can only really be based on survey information (as opposed to modelled or 

synthetic smoking estimates; see section 12.1 on page 770). The initial targets were 

based on the prevalence observed for the 2007 Health and Lifestyle Survey, where the 

prevalence was estimated to be 31.7%. The 2009 Prevalence Survey and the 2009 

Social Capital Survey have both been completed since. However, the prevalence 

increased slightly in the 2009 Prevalence Survey (to 35.1%). On further investigation, 

an adjusted smoking prevalence was slightly higher than the unadjusted smoking 



prevalence when weighting by the resident population estimates for each ward 32 (which 

increased the prevalence from 32% to 34%). Furthermore, the majority of the 2007 

Health and Lifestyle Survey questionnaires were self-completed rather than completed 

through interview. It is possible that the more motivated people more interested in their 

health (and less likely to be smokers) could have completed the questionnaire. Thus, 

despite the quota sampling, it is possible that the true smoking prevalence was slightly 

higher in 2007 than the estimate from the survey. Furthermore, the 2009 Prevalence 

Survey only involved 1,750 survey responders (fewer than half the number compared to 

the 2007 Health and Lifestyle Survey) and as a result, the estimates are more likely to 

be influenced by year-on-year random variation. This highlights the fact that it is not 

easy to estimate the prevalence of smoking even through a survey involving sound 

methodology which is far better than using modelled estimates. The 2009 Social Capital 

Survey also collected information on the prevalence of smoking, and provided an 

estimated prevalence of 32.7% (from 4,052 survey responders). The age-adjusted 

estimated prevalence is 34.0% from the 2009 Prevalence Survey and 2009 Social 

Capital Survey combined (see page 859), compared to 31.9% for the 2007 Health and 

Lifestyle Survey (but 34% if the figure was weighted by ward population). Based on 

these two surveys, it is possible that the prevalence of smoking has remained the same 

or increased slightly since 2007. 

The targets for the smoking prevalence in young people were based on the prevalence 

from the 2002 Young People Health and Lifestyle Survey. The subsequent survey in 

2008-09 (see report at www.hullpublichealth.org) had a smoking prevalence of 5.4% for 

boys and 14.5% for girls in secondary school (school years 7-11; aged 11-16 years), 

with 3.2% of boys and 8.3% of girls smoking regularly, and 2.2% of boys and 6.2% of 

girls smoking occasionally. Overall, 5.9% smoked regularly, and 4.3% smoked 

occasionally, giving a smoking prevalence of 10.1% for boys and girls combined across 

all year groups. Therefore, the target of 14% for 2008/09 has been achieved; indeed the 

target for 2012/2013 of 10% has almost been achieved. 

A key part in achieving these targets will be played by the social marketing initiatives 

that are being developed in Hull. These are aimed at improving awareness and 

motivating smokers to access the local smoking cessation services. They will address 

reasons why women in the two most deprived quintiles have seen increasing numbers 

smoking, contrary to both local and national trends. Initial work has suggested that men 

attending smoking cessation through one-to-one sessions rather than in groups, and 

changes are currently been made to the service to accommodate this preference. 

These initiatives are informing the development of the targeted interventions that it is 

hoped will assist Hull to achieve its ambitious World Class Commissioning targets. 

32 Holderness ward had a relatively low prevalence of smoking (possibly due to its slightly older 

population) and had a much higher percentage of people participating in the survey (12%) compared to its 

relatively size in relation to Hull‟s population (5%), whereas Bransholme East had a relatively high 

prevalence of smoking and a relatively young population but only 0.6% of the survey responders 

compared to 4% of the population in Hull who lived in the ward. 



The prevalence of smoking during pregnancy and after birth was 29% at baseline 

(2005/2006) and the target was to reduce the prevalence to 25% with a „stretch‟ target to 

reduce the prevalence to 24%. The 2007/2008 figure of 27.2% was slightly short of the 

target of 27%, but the 2008/2009 figure of 25.6% exceeded the target of 26%. The two 

year average prevalence is 26.4% requiring a reduction of 1.4 percentage points to 

achieve the 2009/2010 target. The prevalence for the first quarter of 2009/2010 (April to 

June 2009) was considerably lower with 904 maternities of whom 168 were smokers at 

the time of delivery representing a prevalence of 18.6%. However, this was particularly 

low and the overall prevalence for the whole year 2009/2010 was 23.1% (Figure 83), 

which was only 0.1 percentage points higher than the target of 23%. 

There was also a WCC target for the number of people who stop smoking through 

attendance at the Stop Smoking Service which was measured at four weeks (the target 

was 2,610 people in the first year 2008/2009 and 3,000 annually thereafter until 

2012/2013). These are challenging targets, given that in 2007/2008, 1,772 4-week quits 

were achieved amongst referrals to the Hull‟s Stop Smoking Service. This did, however, 

represent two-thirds of all who had set a quit date, which was one of the highest 

conversion rates in England, and substantially higher than the 52% of quit dates set 

converted to 4-week quits in England. If the percentage of successful quitters in Hull is 

maintained at around two-thirds, then this will require at least 4,500 people to set a quit 

date after referral to the Stop Smoking Service to provide an annual number of 3,000 4week 

quitters. The number of 4-week quits was 3,500 for 2009/2010 (Table 102) with 

1,856 confirmed by carbon monoxide validation. Therefore, the target of 3,000 4-week 

quits for 2009/10 was achieved. It is possible that the number of 4-week quits will not be 

a national target, but it could be retained as a local target, and it is anticipated that there 

will generally be a link between the rate of 4-week quits and overall smoking prevalence. 



8.5 Overweight and Obesity 

8.5.1 Obesity as a Risk Factor 

There is an increase risk of premature mortality and morbidity with obesity. According to 

the NHS (NHS Choices 2007), “Obesity causes 9,000 premature deaths in England 

every year, and on average reduces life expectancy by a whopping nine years. It is also 

linked to serious health problems including type 2 diabetes, heart disease and cancers 

of the breast, colon and prostate. Obesity-related health problems cost the NHS around 

£1bn a year.” Obesity also increases the risk of degenerative joint disease which 

impacts greatly on mobility and therefore morbidity. 

Nationally the relatively high and increasing prevalence of obese and overweight 

children is very concerning as obesity is a strong risk factor in adulthood for many 

diseases and medical conditions, including heart disease and diabetes. This is why the 

government has set a national target to “halt the increase in obesity among children 

under the age of 11 by 2010” (MH Treasury 2004); however the goalposts have now 

been moved 10 years further into the future, when in October 2007 the government 

announced a revised target which stated “by 2020, we aim to reduce the proportion of 

overweight and obese children to 2000 levels” (Cavendish 2008). Classifying children 

as obese is more an indicator of possible future problems for an individual, should their 

BMI continue to be greater than most of their peers. Not all overweight or obese five 

year olds will be overweight or obese when they are older children or adults; however 

the purpose of the epidemiological analysis below is to examine the situation and recent 

trends for Hull as a whole, rather than to assess the health of individuals. 

8.5.2 Definition of Overweight and Obesity 

Definitions of underweight, desirable weight, overweight and obesity are defined on the 

basis of the body mass index (BMI) which is a measure of the weight to height ratio. It is 

calculated by taking the weight (in kilograms) and dividing it by the square of height (in 

metres). In adults, the cut-off values for BMI vary for defining underweight and desirable 

weight, with some defining underweight as having a BMI of less than 18.5 whereas 

others define underweight as having a BMI of less than 20. For the purposes of the 

analysis below the local data uses underweight defined as having a BMI of less than 20. 

In practice, differences in the definitions of underweight are not of particular concern 

within this report as the focus is on presenting information on overweight and obesity 

rather than underweight. Desirable weight is defined as having a BMI more than (18.5 

or) 20 but less than 25, overweight as having a BMI of 25 or more but less than 30, and 

obesity is defined as having a BMI of 30 or more. Within this latter category, morbidly 

obese is defined as having a BMI of 40 or more. It is well-recognised that people tend to 

over-estimate their true height and under-estimate their true weight when it is selfreported 

rather than measured. To attempt to compensate for this, height and weight 

from the local Health and Lifestyle Surveys were adjusted prior to calculating the BMI 

(see section 13.4.1.1 on page 805 for more information). 



There is little consensus on the “best” definition of childhood obesity in terms of BMI 

owing to the marked changes of BMI profile in populations of children across time and 

countries as well as over age. However, BMI remains the measure of choice in 

assessing obesity in children. Approximations to the definitions of overweight and obese 

children used by the Department of Health to produce Local Delivery Plan (LDP) target 

figures for the childhood obesity indicator PSA10a will be used throughout this report 

(MH Treasury 2004). This means the figures presented here may differ slightly from 

those for Hull quoted in forthcoming reports from the NHS Information Centre and Public 

Health Observatories. Children are defined as obese if their BMI is above the 95 th centile 

of the reference curve for their age and sex according to the UK BMI centile 

classification (Cole, Freeman et al. 1995). Similarly children are classified as overweight 

if their BMI is above the 85 th centile. Since expected BMI measurements vary over the 

ages 4½ years to 6 years, and 10 to 12 years, BMI thresholds for weight categories 

were defined at 6 monthly intervals and used to classify underweight, desirable weight, 

overweight and obese. Further details are given in section 13.4.1 on page 805. 

8.5.3 Prevalence of Overweight and Obesity in Adults 

The Health Survey for England (Health Survey for England, 2008) collects information 

on obesity in the form of BMI which is calculated from measured height and measured 

weight from those aged 16+ years. The local Health and Lifestyle Survey (see section 

13.2.1.2 on page 791 for more information on survey) also collected height and weight, 

but it was self-reported and collected on those aged 18+ years. An adjustment was 

made to height and weight prior to calculating BMI to attempt to compensate for the fact 

that people tend to over-estimate their height and under-estimate their weight (see 

section 13.4.1.1 on page 805 for more information about the adjustment). The 

percentages of people who are defined as overweight, obese or morbidly obese for the 

Health Survey for England and the local survey are given in Figure 90 for men and in 

Figure 91 for women. The underlying data are given in the APPENDIX on page 862. It 

can be seen that for both men and women, the prevalence of overweight and obesity is 

similar for England and Hull. The largest differences appears to occur for men aged 

less than 25 years, where the prevalence of overweight and obesity combined is 33% 

for England compared to 44% for Hull. There are 285 men aged 18-24 in the local 

survey so the numbers are not particularly small, therefore, it is not easy to know 

whether this is a true reflection in Hull or a slightly biased sample of men in terms of 

their obesity. However, the prevalence of obesity is similar for the youngest men. 

Further information on the prevalence of obesity at ward level without taking into 

account age or gender, is given in the 76 page Public Health Profiles for Hull as well as 

in the Hull Atlas (www.hullpublichealth.org). A report specifically on Obesity and 

Exercise from the 2007 Health and Lifestyle Survey also examines factors which 

influence the prevalence of obesity such as general health, measures of deprivation and 

other risk factors such as alcohol consumption, etc. These reports as well as the 2009 

Prevalence Survey report can be found at www.hullpublichealth.org. 



Figure 90: Percentage of men overweight or obese from the Health Survey for England 

2008 (measured height and weight) and local Prevalence Survey 2009 (adjusted selfreported 

height and weight) 

Percentage of men 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Eng Hull Eng Hull Eng Hull Eng Hull Eng Hull Eng Hull Eng Hull 

16/18-24 25-34 35-44 45-54 55-64 65-74 75+ 

Age / area 

Morbidly obese Obese Overweight 



Figure 91: Percentage of women overweight or obese from the Health Survey for 

England 2008 (measured height and weight) and local Prevalence Survey 2009 

(adjusted self-reported height and weight) 

Percentage of women 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Eng Hull Eng Hull Eng Hull Eng Hull Eng Hull Eng Hull Eng Hull 

16/18-24 25-34 35-44 45-54 55-64 65-74 75+ 

Age / area 

Morbidly obese Obese Overweight 

The total number of people surveyed in the Prevalence Survey 2009 is less than half 

that of the Health and Lifestyle Survey 2007, and in some age groups the numbers are 

relatively small. For instance, there are only 10 men surveyed who were aged 75+ 

years in North Locality. Therefore, some caution should be exerted when interpreting 

the results where the numbers surveyed is relatively low. As a result the numbers are 

presented for the Health and Lifestyle Survey 2007 as well as the Prevalence Survey 

2009 in Table 109, Table 110 and Table 111 for North, East and West Localities 

respectively. 



Table 109: Percentage of men and women overweight or obese from the local surveys 

who live in the North Locality, 2007 and 2009 

Survey Age 

Men and women overweight or obese in the North Locality (%) 

(yrs) 

Men Women 

N Over- Obese Overweight N Over- Obese Overweight 

weight 

or obese 

weight 

or obese 

18-24 58 29.3 3.4 32.8 49 20.4 12.2 32.7 

25-34 68 48.5 13.2 61.8 77 26.0 22.1 48.1 

35-44 73 52.1 19.2 71.2 60 33.3 26.7 60.0 

2007 45-54 60 53.3 25.0 78.3 52 32.7 36.5 69.2 

55-64 43 51.2 32.6 83.7 69 30.4 36.2 66.7 

65-74 46 52.2 26.1 78.3 54 42.6 33.3 75.9 

75+ 35 45.7 17.1 62.9 26 38.5 23.1 61.5 

18-24 30 46.7 10.0 56.7 31 22.6 9.7 32.3 

25-34 33 48.5 18.2 66.7 33 30.3 30.3 60.6 

35-44 40 45.0 27.5 72.5 34 38.2 23.5 61.8 

2009 45-54 29 34.5 37.9 72.4 24 41.7 37.5 79.2 

55-64 26 34.6 23.1 57.7 28 39.3 32.1 71.4 

65-74 18 33.3 38.9 72.2 15 40.0 53.3 93.3 

75+ 10 50.0 20.0 70.0 15 33.3 13.3 46.7 


who live in the East Locality, 2007 and 2009 

Survey Age 

Men and women overweight or obese in the East Locality (%) 

(yrs) 

Men Women 


weight 

or obese 

weight 

or obese 

18-24 114 46.5 8.8 55.3 70 14.3 14.3 28.6 

25-34 110 49.1 12.7 61.8 131 30.5 13.7 44.3 

35-44 121 50.4 20.7 71.1 147 27.9 22.4 50.3 

2007 45-54 98 46.9 23.5 70.4 114 43.9 26.3 70.2 

55-64 95 56.8 28.4 85.3 119 37.0 30.3 67.2 

65-74 84 51.2 20.2 71.4 94 38.3 26.6 64.9 

75+ 79 55.7 8.9 64.6 77 45.5 14.3 59.7 

18-24 41 29.3 7.3 36.6 35 31.4 14.3 45.7 

25-34 52 38.5 19.2 57.7 48 45.8 12.5 58.3 

35-44 62 43.5 30.6 74.2 53 17.0 32.1 49.1 

2009 45-54 59 44.1 37.3 81.4 53 49.1 37.7 86.8 

55-64 47 31.9 51.1 83.0 43 30.2 25.6 55.8 

65-74 28 42.9 35.7 78.6 32 37.5 40.6 78.1 

75+ 25 32.0 20.0 52.0 35 37.1 17.1 54.3 




who live in the West Locality, 2007 and 2009 

Survey Age 

Men and women overweight or obese in the West Locality (%) 

(yrs) 

Men Women 


weight 

or obese weight 

or obese 

18-24 113 32.7 10.6 43.4 115 23.5 6.1 29.6 

25-34 173 43.9 13.9 57.8 131 22.9 11.5 34.4 

35-44 170 49.4 15.9 65.3 134 29.1 28.4 57.5 

2007 45-54 119 50.4 27.7 78.2 127 33.1 29.9 63.0 

55-64 99 49.5 22.2 71.7 100 41.0 37.0 78.0 

65-74 89 53.9 29.2 83.1 88 44.3 27.3 71.6 

75+ 56 60.7 16.1 76.8 65 38.5 16.9 55.4 

18-24 61 31.1 11.5 42.6 50 18.0 14.0 32.0 

25-34 74 39.2 20.3 59.5 63 23.8 31.7 55.6 

35-44 69 44.9 23.2 68.1 53 49.1 18.9 67.9 

2009 45-54 57 56.1 26.3 82.5 48 41.7 25.0 66.7 

55-64 49 59.2 20.4 79.6 43 32.6 27.9 60.5 

65-74 30 53.3 16.7 70.0 33 42.4 21.2 63.6 

75+ 23 65.2 8.7 73.9 35 40.0 8.6 48.6 

As the distribution of the age differs among the wards, it is useful to standardise the 


of survey responders are relatively low in the Prevalence Survey 33 , the prevalence 



92, Figure 93 and Figure 94 give the age-adjusted percentages of men and women 

who are overweight or obese for the wards in North, East and West Localities 

respectively. The underlying data are given in the APPENDIX on page 863. 





Figure 92: Age-adjusted percentage overweight or obese for wards in North Locality, 

2009 

Age standardised prevalence of overweight and 

obesity (%) 

120 

100 

80 

60 

40 

20 

0 

Bransholme 

East 

Bransholme 

West 


and 

Greenwood 


University 

Figure 93: Age-adjusted percentage overweight or obese for wards in East Locality, 

2009 


obesity (%) 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Ings Longhill Sutton Holderness Marfleet Southcoates Southcoates 

East West 


Drypool 


Males 

Females 

Persons 

Males 

Females 

Persons


Figure 94: Age-adjusted percentage overweight or obese for wards in West Locality, 

2009 


obesity (%) 

120 

100 

80 

60 

40 

20 

0 



8.5.4 Prevalence of Overweight and Obesity in Children 

8.5.4.1 National Child Measurement Programme 

Primary school children have their heights and weights measured as part of the National 

Child Measurement Programme (NCMP) in reception year (year R aged 4 to 5 years) 

and in year 6 (aged 10 to 11 years). Measurements have been taken for four years for 

year 6 children, but Hull started measuring year 6 children one year earlier than the start 

of the NCMP. Furthermore, reception year children have been measured in Hull 

considerably longer than the start of the NCMP with measurements taken since the 

1999/2000 school year. Measurements were taken by school nurses, and data 

collected under the NCMP from Hull was recorded on the Child Health System (CHS) 

until 2007/2008 and then on SystmOne. Extracts from these systems forms the basis of 

the analyses below, but a more detailed report on childhood obesity is available at 



Males 

Females 

Persons


8.5.4.2 Data Completeness 

For the 2008/2009 school year in Hull schools there were 2,614 reception year children 

eligible for NCMP measurement, and of these 2,592 (99.2%) children had valid height 

and weight measurements recorded. 

For children in Year 6 there were 2,979 10 and 11 year olds eligible for measurement at 

Hull state schools of which 2,402 (80.6%) had weight and height measurements 

recorded and submitted. This uptake rate of 81% is below both the target of 85% and 

last year‟s 84% rate and was affected by the replacement of the former information 

system with a new one. National reports have identified a non-response bias for 

children with larger BMI which might affect the reliability of these figures; however 

because the cause of the lower take-up was problems with the new information system 

there is no reason to believe the data is differently biased in comparison to earlier years, 

so for trends over time in Hull this bias should not be a problem. Likewise, results can 

reasonably be generalised to all of Hull‟s young people. 

8.5.4.3 Hull Reception Year Children Aged 4–5 Years 

Table 112 shows that in the most recent year, 2008/2009, three-quarters of year R girls 

and 72% of year R boys were in the healthy BMI category. The prevalence of obesity 

was 11.0% in boys and 9.7% in girls, with a further 16.1% of boys and 14.0% of girls 

classified as overweight. 

Table 112: Numbers and percentages of year R children in Hull schools by BMI 

category, 2008/2009 

BMI category Number (percentage) of year R children (aged 4–5 years) 

Boys (n=1,376) Girls (n=1,216) 

Underweight 7 (0.5) 8 (0.7) 

Healthy weight 996 (72.4) 920 (75.7) 

Overweight 221 (16.1) 170 (14.0) 

Obese 152 (11.0) 118 (9.7) 

Table 113 shows the trend over time in overweight and obesity in year R children. The 

totals differ very slightly in Table 113 compared to Table 112, because they were 

calculated based on the PCT of the child‟s school whereas the trends and all other 

figures in this section are based on the residence of children (using their postcode). It 

can be seen in girls that the increase in prevalence of overweight and obesity has 

slowed in recent years and has reduced for the most recent school year to 23.7%, but 

for boys the prevalence has increased over time to a high of 29.3% in 2008/09 then 

reducing slightly for the most recent school year to 27.1%. 



Figure 95 and Figure 96 give the trend in the BMI classifications over time with the 

underlying data given in the APPENDIX on page 866. 

Table 113: Percentages of overweight and obese year R children, Hull 1999/2000 to 

2008/2009 

School year 

when measured 

Overweight and obesity for year R children (aged 4–5 years) 

Male Female 

% obese % overweight/obese % obese % overweight/obese 

1999/2000 9.0 20.6 8.7 18.3 

2000/2001 9.8 21.5 7.8 18.1 

2001/2002 10.7 22.7 9.0 19.2 

2002/2003 10.0 22.6 9.9 21.8 

2003/2004 11.8 25.7 8.9 21.7 

2004/2005 13.1 28.7 12.5 24.4 

2005/2006 12.0 28.4 10.7 24.7 

2006/2007 13.4 27.9 9.6 25.0 

2007/2008 13.4 29.3 10.7 24.2 

2008/2009 11.0 27.1 9.7 23.7 

Figure 95: Trend in BMI categories of year R boys, Hull 1999/2000 to 2008/2009 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

1999- 

2000 

2000- 

2001 

2001- 

2002 

2002- 

2003 

2003- 

2004 

2004- 

2005 

2005- 

2006 

2006- 

2007 

2007- 

2008 

2008- 

2009 

Underweight 

Healthy Weight 

Overweight 

Obese 



Figure 96: Trend in BMI categories of year R girls, Hull 1999/2000 to 2008/2009 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

1999- 

2000 

2000- 

2001 

2001- 

2002 

2002- 

2003 

2003- 

2004 

2004- 

2005 

2005- 

2006 

2006- 

2007 

2007- 

2008 

2008- 

2009 

Underweight 


Overweight 

Obese 



The number of children classified as overweight and obese is given in Table 114. 

Table 114: Number of year R children by BMI classification, Hull 1999/2000 to 

2008/2009 

Gender School 

year when 

Boys 

Girls 

measured 

Number of 

children 

measured 

Number of year R children (aged 4–5 years) 

within each BMI category 

Obese Overweight Healthy weight Underweight 

1999/00 879 79 102 661 37 

2000/01 1,270 124 149 954 43 

2001/02 1,482 159 178 1,081 64 

2002/03 1,427 142 180 1,083 22 

2003/04 1,326 156 185 959 26 

2004/05 1,216 159 190 844 23 

2005/06 1,294 155 212 920 7 

2006/07 1,254 168 182 895 9 

2007/08 1,172 157 184 822 9 

2008/09 1,423 155 227 1,034 7 

1999/00 832 72 80 657 23 

2000/01 1,271 99 131 1,011 30 

2001/02 1,295 117 132 1,012 34 

2002/03 1,369 135 164 1,045 25 

2003/04 1,207 108 154 927 18 

2004/05 1,118 140 133 828 17 

2005/06 1,217 130 170 910 7 

2006/07 1,082 104 167 806 5 

2007/08 1,196 128 161 899 8 

2008/09 1,271 123 181 959 8 

Obesity levels for lower layer Super Output Areas (LLSOA; a geographical area of 

around 1,500 people) were plotted against deprivation score, measured by the Index of 

Multiple Deprivation (IMD) 2007. The results for year R and year 6 pupils were used to 

assess the link between deprivation levels and obesity in children. However both ages‟ 

figures show only a very slight association, with increasing levels of deprivation (higher 

IMD 2007 scores) being associated with slightly higher obesity levels. The association is 

so small as to be negligible for most practical purposes. For instance this means there 

would be no reason to target an anti-obesity campaign at poorer areas within Hull, 

although the diverging patterns of obesity for boys and girls suggests it might be helpful 

to use gender to make psychographic distinctions for Social Marketing purposes. 

Furthermore, there were differences in the prevalence of overweight and obesity among 

the seven Areas and three Localities, but the 95% confidence intervals were relatively 

wide and were overlapping. This suggests that there is no statistically significant 

difference in the prevalence of overweight or obesity in children among these 

geographical areas. 



8.5.4.4 Hull Year 6 Children Aged 10–11 Years 

Table 115 shows that for Hull schools in the most recent year, 2008/2009, 64% of both 

year 6 girls and year 6 boys were in the healthy weight BMI category. The prevalence of 

obesity was 21.4% in boys and 20.5% in girls, with a further 13.9% of boys and 14.5% of 

girls classified as overweight. 

Table 115: Numbers and percentages of year 6 children in Hull schools by BMI 

category, 2008/2009 

BMI category Number (percentage) of year 6 children (aged 10–11 years) 

Boys (n=1,310) Girls (n=1,184) 

Underweight 9 (0.8) 11 (0.9) 

Healthy weight 777 (64.0) 759 (64.2) 

Overweight 162 (13.9) 171 (14.5) 

Obese 271 (21.4) 242 (20.5) 

Table 116 shows the trend over time in overweight and obesity in year 6 children. The 

figures differ very slightly in Table 116 compared to Table 115 because they include 

private schools and were calculated based on the PCT of the child‟s school whereas the 

trend and all other figures in this section are based on the residence of children (using 

their postcode). For year 6 girls, the prevalence of obesity and the prevalence of 

overweight and obesity combined have remained at similar levels for the last three 

years. Likewise for boys, no clear trend is apparent, with the most recent figures falling 

back from the higher levels of 2007/08. Figure 97 and Figure 98 also illustrate the 

trend over these four years for girls and boys respectively (the underlying data given in 

the APPENDIX on page 866), and Table 117 gives the number of children for each BMI 

classification. 

Table 116: Percentages of overweight and obese year 6 children, Hull 2005/2006 – 

2008/2009 

School year 

when measured 

Overweight and obesity for year 6 children (aged 10–11 years) 

Male Female 

% obese % overweight/obese % obese % overweight/obese 

2005/2006 22.6 39.1 22.6 38.2 

2006/2007 21.1 36.6 20.9 36.3 

2007/2008 24.2 40.0 20.3 34.0 

2008/2009 22.9 36.4 20.6 35.0 



Table 117: Number of year 6 children by BMI classification, Hull 2005/2006 – 2008/2009 

Gender School 

year when 

Boys 

Girls 

measured 

Number of 

children 

measured 

Number of year 6 children (aged 10–11 years) 



2005/06 1,253 283 207 750 13 

2006/07 1,059 223 165 659 12 

2007/08 1,304 316 206 766 16 

2008/09 1,330 305 180 834 11 

2005/06 1,175 265 184 713 13 

2006/07 1,117 234 171 698 14 

2007/08 1,183 240 162 765 16 

2008/09 1,264 260 182 809 13 

Figure 97: Trend in BMI categories of year 6 boys, Hull 2005/2006 to 2008/2009 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

2005-2006 2006-2007 2007-2008 2008-2009 

Underweight 


Overweight 

Obese 



Figure 98: Trend in BMI categories of year 6 girls, Hull 2005/2006 to 2008/2009 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

As mentioned earlier within section 8.5.4.3, there was only a slight association between 

deprivation and the prevalence of obesity for year R and year 6 pupils. The association 

is so small as to be negligible for most practical purposes, in that an anti-obesity 

campaign would need to target all groups by deprivation rather than just the most 

deprived. There was also no significant difference in the prevalence of overweight or 

obesity in children among the seven Areas or three Localities. 

8.5.4.5 Hull Children Measured in Year R and Six Years Later in Year 6 

Some of the children aged 10–11 years who had their height and weight measured in year 

6 during the 2005/2006, 2006/2007 and 2007/2008 school years, had had their height and 

weight measured when they were 4–5 years of age six years earlier during the 1999/2000, 

2000/2001 and 2001/2002 school years. It was possible to „pair‟ or „match‟ these children 

on the basis of their unique reference number in the Child Health System 34 . An initial 

report examined the relationship from this „paired analysis‟ for children measured during 

the first two years (1999/2000 and 2000/2001 versus 2005/2006 and 2006/2007) is 

available at www.hullpublichealth.org. The analysis was repeated the next year including 

data from the school year (year 6 children measured during 2007/2008 where children had 

34 The Child Health System includes a record for every child registered with a GP in Hull (or East Riding of 

Yorkshire). 

2005-2006 2006-2007 2007-2008 2008-2009 

Underweight 


Overweight 

Obese 



been measured previously six years earlier in year R during the 2001/2002 school year). 

The results of this analysis is presented below. It is intended that this analysis is repeated 

using the latest data once the data becomes available 35 . 

There were 6,062 children on the Child Health System in year R for 2001/2002 who 

were matched to their record on the Child Health System at year 6 for 2007/2008. 

However, not all these children had their height and weight measured on both occasions 

with approximately 72% having measurements at both ages. Overall, there were 4,348 

Hull children with height and weight measured at both year R and year 6. The BMI 

weight classifications using Table 410 were used to define underweight, desirable 

weight, overweight and obesity. 

The Child Health System should include a record for every single child registered with a 

General Practitioner within the Hull or East Riding of Yorkshire area. Therefore, in most 

cases, if there was no record within the file for a child, it is very likely that the child was 

not registered with a GP within the area at one of the ages but was registered with a 

local GP at the other age, i.e. because they had moved out of the area or moved into the 

area between the ages of 4–5 and 10–11 years. This would result in unmatched 

records. 

The children with height or weight not recorded could have been away from school on 

the day the measurements were taken or not measured for some other reason, for 

example, the parents requested that their child was not measured. 

Table 118 and Table 119 give the number of boys and girls respectively by BMI category 

at year R and year 6. Any estimate of prevalence at these two ages should be treated with 

caution as they do not include all those children measured only those who had 

measurements taken at both time periods (for overall prevalence see Table 113 and 

Table 116). This same information is displayed graphically in Figure 99 and Figure 100. 

From this information, it is evident that the majority of children are within the „desirable 

weight‟ category at both years R and 6. 

35 The intention is to repeat the analysis for year 6 children measured over five years between 2005/2006 

and 2009/2010 who were previously measured six years earlier in year R between 1999/2000 and 

2003/2004. However, the original Child Health System database is no longer used and the original database 

has been migrated to another system (SystemOne). The original child identifier was not transfers, and 

another unique child identifier was transferred instead (NHS number). The existing data held by Public Health 

Sciences included the old identifier which means that it is not possible to link records from the same children 

over time. Therefore, it is necessary that the entire dataset (from 1999/2000) is (re-)obtained (which contains 

the new identifier). The request for this data has been made, but the data has not yet been obtained. 



Table 118: BMI classification for year R and year 6 boys (numbers in paired analysis) 

BMI classification 

at year R (aged 4- 

5 yrs) measured 

2001/2002 

BMI classification at year 6 (aged 10–11) measured 2007/08 

Underweight Desirable 

weight 

Overweight Obese Total 

Underweight 11 80 8 6 105 

Desirable weight 11 1,187 266 257 1,721 

Overweight 0 102 65 88 255 

Obese 0 26 34 129 189 

Total 22 1,395 373 480 2,270 

Table 119: BMI classification for year R and year 6 girls (numbers in paired analysis) 




2001/02 

BMI classification at year 6 (aged 10–11) measured 2007/08 


weight 


Underweight 7 47 3 2 59 

Desirable weight 18 1,263 209 158 1,648 

Overweight 0 72 60 89 221 

Obese 0 19 19 112 150 

Total 25 1,401 291 361 2,078 

Figure 99: BMI classification for year R and year 6 boys (numbers in paired analysis) 

Number of boys 

2000 

1800 

1600 

1400 

1200 

1000 

800 

600 

400 

200 

0 

BMI classification in year 6 (aged 10-11 years) measured 2007/2008 

Underweight Desirable weight Overweight Obese 


BMI classification in year R (aged 4-5 years) measured 2001/2002 



Number of girls 

Figure 100: BMI classification for year R and year 6 girls (numbers in paired analysis) 

1800 

1600 

1400 

1200 

1000 

800 

600 

400 

200 

0 

BMI classification in year 6 (aged 10-11 years) measured 2007/2008 



BMI classification in year R (aged 4-5 years) measured 2001/2002 

Table 120 and Table 121 give the information above in a different format, illustrating the 

percentage of children who were underweight, desirable weight, overweight or obese at 

year 6 depending on their weight classification six years earlier in year R. These tables as 

well as the figures above illustrate the relationship between overweight or obesity at year R 

and overweight or obesity at year 6. 

Of the 105 boys who were underweight at year R, 76.2% of them were within the desirable 

weight classification, 7.6% were overweight and 5.7% were obese at year 6. This 

illustrates the wide variation in weight measurements and classifications with a few boys 

moving from underweight to obese in six years. A higher percentage of Year R boys who 

were desirable weight in year R were classified as overweight or obese in year 6, and this 

pattern was repeated for overweight and obese Year R boys. Almost 70% of the 189 boys 

who were classified as obese in year R were still classified as obese in year 6. None of the 

boys who were classified as overweight or obese in year R were classified as underweight 

at year 6, but a sizeable percentage were classified as having desirable weight at year 6 

with 40% of the 255 overweight boys and 14% of the 189 obese boys in year R having 

desirable weight in year 6. Thus, whilst there is a relatively strong association between 

weight classification at year R and at year 6, there is considerable variation. Programmes 

for reducing overweight and obesity in year 6 children should not concentrate on those who 

were overweight or obese in year R. Similarly, children who were overweight or obese in 

year R may no longer have a problem with their weight in year 6. 



Table 120: BMI classification for year R and year 6 boys (row percentages in paired 

analysis) 




2001/02 

BMI classification in year 6 (aged 10–11) measured 2007/08 


weight 


Underweight 10.5 76.2 7.6 5.7 100 

Desirable weight 0.6 69.0 15.5 14.9 100 

Overweight 0.0 40.0 25.5 34.5 100 

Obese 0.0 13.8 18.0 68.3 100 

A similar pattern was observed for girls with 9.6% of girls who were of desirable weight 

at year R being classified as obese in year 6, compared to 40.3% of those girls who 

were overweight in year R and 74.7% of those girls who were obese in year R. The 

same conclusion refers to girls as it did boys; whilst there is a strong association 

between year R and year 6 weight classifications, children who were overweight or 

obese at one particular age may not necessarily be overweight or obese at the other 

age. This implies a general approach is necessary, and it is not possible to simply 

target overweight and obese year R children in order to reduce obesity levels in year 6 

children. 

Table 121: BMI classification for year R and year 6 girls (row percentages in paired 

analysis) 




2001/02 

BMI classification in year 6 (aged 10–11) measured 2007/08 


weight 


Underweight 11.9 79.7 5.1 3.4 100 

Desirable weight 1.1 76.6 12.7 9.6 100 

Overweight 0.0 32.6 27.1 40.3 100 

Obese 0.0 12.7 12.7 74.7 100 

As mentioned, despite this relatively strong relationship, there is considerable variability 

in BMI in year R compared to BMI in year 6 for some children. It is difficult to compare 

the actual values of BMI in year R and in year 6 directly due to the different values of 

BMI relating to different levels of overweight and obesity at different ages. For instance, 

having a BMI of 20.5 between the ages of 4–5 years would be classified as „obese‟ 

whereas having a BMI of 20.5 at age 10–11 years would be classified as having a 

„desirable weight‟ (see Table 410 for BMI classifications for year R and year 6 children). 

Figure 101 and Figure 102 illustrate BMI at the two different ages in the same boys and 

in the same girls respectively. The figures have not been updated for the most recent 



school year 36 and relate to the same children measured during the 1999/2000 and 

2000/2001 school years at year R and again six years later during the 2005/2006 and 

2006/2007 school years at year 6 (a total of 1,919 boys and 1,906 girls including in the 

figures). As the BMIs cannot be compared directly, references lines are included to 

denote the approximately four weight categories (mean cut-off values from Table 410 as 

it is not possible to present all four cut-off values for the different half-yearly age groups). 

The linear regression line is also presented which illustrates that for every one point 

increase on the BMI scale at 4–5 years, the BMI is increased by 1.22 points and 1.28 

points at 10-11 years for boys and girls respectively. Some of this increase will be 

expected as BMI does tend to increase with age until adulthood. 

Figure 101: Comparison of BMI in year R and in year 6 for boys 

36 A very similar pattern of change for this paired analysis was observed so the figures were not updated. 



Figure 102: Comparison of BMI in year R and in year 6 for girls 

8.5.5 Attitudes Towards Obesity 

The local 2007 Health and Lifestyle Survey and the Social Capital Surveys asked survey 

responders about their perceived impact on health of achieving and maintaining a 

healthy weight. The information is presented in section 8.3 on page 244 from the 

Social Capital Survey 2009, with additional information examining differences among the 

genders, age groups, Localities and deprivation quintiles available in the Social Capital 

Survey 2009 report at www.hullpublichealth.org. 

Further information on factors influencing overweight and obesity prevalence is given in 

section 8.5.8 on page 296 and in the 2007 Health and Lifestyle Survey Obesity and 

Exercise report. Attitudes to obesity were collected as part of Reflector Groups following 

the 2007 Health and Lifestyle Survey (see section 13.2.2.2 on page 795). The full 

report from this Reflector Group as well as the full survey reports are available at 

www.hullpublichealth.org. Information about opinions and attitudes to obesity were also 



collected within focus groups as part of the Attitudes to Health project conducted during 

2007 (see section 13.2.2.1 on page 794). 

8.5.6 Overweight and Obesity in Relation to Deprivation 


The percentage of persons living in Hull classified as overweight or obese (with a BMI of 

25-29.9 and with a BMI of 30 or more respectively) from the Prevalence Survey 2009 is 

given in Figure 103 by local deprivation quintile. There is a statistically significant trend 

over the deprivation quintiles for the percentage obese ( 2 test for trend, 6.5, p=0.01). 

However, whilst there is a statistically significant difference in the percentage overweight 

and obese combined among the five deprivation quintiles ( 2 test, 12.7, df=1, p=0.013), 

there is no statistically significant trend over the five deprivation quintiles ( 2 test for trend, 

2.1, p=0.65). Therefore, given this association and the relatively high prevalence in all 

quintile groups, there is a necessity to have a broad approach to reducing obesity across 

all of Hull. The underlying data for the figure is given in the APPENDIX on page 867. 

Figure 103: Percentage of overweight and obese by deprivation for Hull 

Percentage overweight / obese 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Most deprived 

locally 

2 3 4 Least deprived 

locally 

Local Index of Multiple Deprivation 2007 quintile 

Overweight Obese 



8.5.6.2 Children 

Obesity levels for lower layer Super Output Areas (LLSOA; a geographical area of 

around 1,500 people) were plotted against deprivation score, measured by the Index of 

Multiple Deprivation (IMD) 2007. The results for year R and year 6 pupils were used to 

assess the link between deprivation levels and obesity in children. However both ages‟ 

figures show only a very slight association, with increasing levels of deprivation (higher 

IMD 2007 scores) being associated with slightly higher obesity levels. The association is 

so small as to be negligible for most practical purposes. For instance this means there 

would be no reason to target an anti-obesity campaign at poorer areas within Hull, 

although the diverging patterns of obesity for boys and girls suggests it might be helpful 

to use gender to make psychographic distinctions for Social Marketing purposes. 

Furthermore, there were differences in the prevalence of overweight and obesity among 

the seven Areas and three Localities, but the 95% confidence intervals were relatively 

wide and were overlapping. This suggests that there is no statistically significant 

difference in the prevalence of overweight or obesity in children among these 

geographical areas. 

8.5.7 Overweight and Obesity in Relation to Employment Status 

The percentage of persons living in Hull classified as overweight or obese (with a BMI of 

25-29.9 and with a BMI of 30 or more respectively) is given in Figure 104 by 

employment status for those participating in the local Prevalence Survey 2009. There is 

a statistically significant difference in the prevalence among the employment categories 

for overweight and obese combined ( 2 test, 44.9, df=5, p


make it more difficult to lose and maintain a desirable weight. It is likely to be a 

combination of these factors, and it is possible that the causation, if it exists, is cyclic. 

Figure 104: Percentage of overweight and obese by employment status for Hull 

Percentage overweight / obese 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Working Full-time 

education 

Unemployed Long term 

sickness or 

disabilty 


Overweight Obese 

8.5.8 Social Marketing and Factors Influencing Obesity 

Retired Looking after 

the home or 

family 

Considerable Social Marketing work has been undertaken examining behaviour and 

attitudes to diet, exercise and obesity in Hull with the aim of providing more relevant 

information to help people lose and maintain their weight. A report specifically on 

Obesity and Exercise using information from the 2007 Health and Lifestyle Survey also 

examines associations between the prevalence of obesity (and exercise) and other 

factors such as general health, measures of deprivation, and other risk factors such as 

alcohol, etc. This report showed that the prevalence of overweight and obesity were 

higher for people living in more deprived areas who tended to have a higher prevalence 

of overweight and obesity, and people who exercised less frequently were more likely to 

be overweight or obese and people with poorer health were more likely to be overweight 

or obese. However, many of these factors are interrelated and are confounding factors 

(see section 12.2 on page 772 for explanation of a confounding factor). This report is 


Further information on attitudes to obesity are given in section 8.3 on page 244 and in 




Social marketing work was carried out to look at the link between alcohol and calories, 

as an alternative approach to reduce alcohol related harm. Insight work has provided us 

with the evidence that many people are not aware of the calorie content within alcohol 

and also of the physical exercise required to burn off these excess calories. This is a 

non-typical approach to promoting awareness and the safe drinking message is also 

reinforced. 

8.5.9 Weight Loss Programmes 

A single access telephone number was set up in Hull for weight loss programmes in Hull 

in 2008, and there was also a drop-in centre for the service in the city centre. However, 

following the opening of the Health Central, also in the city centre, weight management 

services as well as other healthy lifestyle services are currently based at the healthy 

lifestyle centres at Health Central, Health West (KC Stadium) and, from April 2011 

onwards, at Health East (Craven Park) it was agreed to cease the single point of access 

telephone number. Weight management sessions are available at these centres and 

many additional community venues throughout Hull. 

Currently, services available include: 

Why Weight? This service is open to anyone aged 18-74 years and focuses on 

healthier eating and cookery skills. The 10-week programme targets a 5% to 

10% weight loss with taster sessions for physical activity. Described as fun, 

friendly and free – people can expect to benefit from increased confidence, 

improved mobility, and an improved diet. 

Fit Fans. This service is ideal for sports fans and works in partnership with Hull 

City AFC and is open to everyone. The free 12-week programme includes oneto-one 

consultations with specifically tailored targets and advice. There‟s a sports 

and physical activity theme throughout with nutritional advice included. Once 

completed, follow-up support is available to help achieve long-term health 

benefits. 

Fit Fans for Her. This service focuses on overweight/obese women aged 40 to 

65, though not exclusively so. The fitness and weight loss programme offers the 

same dietary and activity information a professional sports player receives in 

order to achieve and maintain a healthy weight. The 12 week programme targets 

a minimum 5% weight loss for those taking part. 

Active Lifestyles Service. This service is available to anyone over 18 who 

currently lead a sedentary lifestyle. Free consultations are available with an 

Active Lifestyles Advisor at a range of venues citywide. The advisors help make 

small changes to lifestyle to get more active. This could involve a bit more activity 

everyday, doing more walking, dancing or even attending a local gym or activity 

class. Consultations are followed up by a phone call to monitor progress. 

Looking Good Feeling Good. This service is available for everyone aged 18-74 

years. It is a free 12-week programme for just two hours per week which aims to 



help achieve a 5% weight loss. Sessions include physical activity and healthy 

eating advice. There are around 20 sessions per year for the person to “look 

good and feel even better”. 

Nutrition and Dietetics Service. Dieticians provide tailor-made advice to people 

who want to lose weight but also have other physical health problems. They 

provide one-to-one sessions for adults and groups, and classes for children and 

families. Dieticians can advice on the full range of treatments available. 

BME. This service provides free advice on healthy living and weight management 

for people from Black and Minority Ethnic (BME) groups. It offers home visits and 

group sessions as appropriate to individual needs. It is for anyone in Hull 

belonging to a black or minority ethnic group. 

Bariatric. This is a bespoke intensive weight loss programme for morbidly obese 

adult patients who have requested bariatric surgery as an aid to weight loss. It 

offers both one-to-one and group sessions as needed. A full and detailed 

assessment is initially carried out to assess the patient needs and to help 

produce individual detailed weight loss plans for clients taking part. The 24 week 

programme targets a minimum 5% weight loss and for patients to be removed 

from the bariatric surgery waiting list. The programme is due to commence on 1 

April 2011. 

As part of the National Children Measurement Programme school nurse teams 

proactively follow-up all children who are not a healthy weight and offer a range of 

support and advice, as well as signposting to other services. 

The Eat Well Do Well Service offers a range of personalised and group programmes for 

children who are not a healthy weight within a family approach. This programme is due 

to be decommissioned at the end of March 2011, but NHS Hull is in the process of 

commissioning a replacement service. 

There is also a paediatric community dietetic service, and the service specification is 

currently (as at February 2011) been finalised. 

8.5.10 Evaluation of Weight Loss Programmes 

8.5.10.1 Geographical Spread of Adults Using Weight Loss Programmes 

In order to evaluate that people using the service were distributed throughout Hull, a 

series of maps have been produced which show the geographical distribution of those 

people accessing the various weight loss programmes as at November 2010. When the 

single point of access telephone number was in use, details of number of adults using 

the possible referral services was noted together with the postcode of the individual. The 

distribution of referrals are given in Figure 105, where each star represents the 

postcode of a person referred into a service. There may be more than one person at 

each point. It can be seen that there is a wide distribution across Hull with all wards 

covered. The main areas where there are few „points‟ are areas which are not 



residential (the area up the middle of the map along the river beside some industrial 

premises – between East and West Locality and to the North of this, and in Marfleet 

which is industrial – see Figure 22 for population density). It can also be seen that a 

few residents of East Riding of Yorkshire have also been referred (it is possible that they 

could be registered with GPs in Hull). Maps are available for each service separately on 

request (Active Lifestyles, Bariatric, BME, Dietetics, Fit Fans, Fit Fans for Her, Health 

Trainers, Looking Good Feeling Good, Shapes and Why Weight?). 

Figure 105: Distribution of people attending all services referred from the single point of 

access, November 2010 



8.5.10.2 Success of Weight Loss Programmes in Terms of Improvements in Physical 

and Mental Health 

An evaluation was undertaken of individuals participating in the Shapes Slimming Club 

which was part of the Stay Healthy Live Longer project using the SF-36v2 TM 

questionnaire. Participants completed the questionnaire initially and then six months 

later in order to assess health status and change in health status over the six-month 

period. Sixty-five individuals completed the questionnaire in January 2006 and 50 of 

these individuals also completed the questionnaire in July 2006. 

The SF-36v2 TM questionnaire is a frequently used questionnaire to asses various 

components of health. As well as a „health transition‟ question which compares current 

health with health one year ago, eight different health scores are created from the 

responses to the 36 questions which measure various aspects of health as follows: 

Physical functioning: Extent to which health limits physical activities such as selfcare, 

walking, climbing stairs, bending, lifting, and moderate and vigorous 

exercises. 

Role–physical: Extent to which physical health interferes with work or other daily 

activities, including accomplishing less than wanted, limitations in the kind of 

activities, or difficulty in performing activities. 

Bodily pain: Intensity of pain and effect of pain on normal work, both inside and 

outside the home. 

General health: Personal evaluation of health, including current health, health 

outlook, and resistance to illness. 

Vitality: Feeling energetic and full of life versus feeling tired and worn out. 

Social functioning: Extent to which physical health or emotional problems 

interfere with normal social activities. 

Role–emotional: Extent to which emotional problems interfere with work or other 

daily activities, including decreased time spent on activities, accomplishing less, 

and not working as carefully as usual. 

Mental health: General mental health, including depression, anxiety, behaviouralemotional 

control, general positive affect. 

These scores range from zero representing the worst health to 100 representing the 

best health. 

The difference or change in score was calculated as the score at six months minus the 

score at baseline. So a difference of zero represents no change and a positive 

difference represents an improvement in health. In the figure below, the dots represent 

the actual mean change for each health component calculated for the 50 individuals in 

the weight loss programme, with 95% confidence intervals (see section 12.5 on page 

775 for more information about confidence intervals). 



All other scores with the exception of the social functioning and physical functioning 

components of the SF-36v2 TM also show significant improvement (see section 12.4 on 

page 774 for more information on statistical testing). This can be seen in Figure 106 as 

the 95% confidence intervals do not include the value of zero (which represents no 

change). The two exceptions still show an improvement, but not enough to rule out the 

possibility that the improvement was just random variation or due to chance. Given that 

only a small number of individuals completed the questionnaire initially and at the end of 

the six months, it is very surprising that there are statistically significant differences. It 

illustrates that the benefits to and changes in personal perception of physical and mental 

health are evident following weight loss programmes. The underlying data are given in 


Figure 106: Evaluation of local Shapes Slimming Club programme examining change in 

mental and physical health status over six months, 2006 

Change in score over six months (original 

scores range from 0 to 100) 

18 

16 

14 

12 

10 

8 

6 

4 

2 

0 

-2 

-4 

General health 

Vitality 

Social functioning 

Role emotional 

SF36 health component 

People being referred into the new single point of access point are being asked to 

complete an SF-36v2 TM questionnaire initially and at the end of the programme so that 

these programmes can be evaluated. These programmes include Fit Fans, Active 

Lifestyles and Why Weight? 

An analysis has been completed on some of the first men participating in the Fit Fans 

programme (see section 8.5.9). Figure 107 gives the change in the SF-36v2 TM scores 

over the 12 week period. Men completed the baseline questionnaires in September 


Mental health 

Bodily pain 

Role physical 

Physical functioning


2009 and the follow-up forms at the end of the programme 12 weeks later in December 

2009. Despite only 31 men completing questionnaires at both baseline and follow-up 

and the relatively short duration of the weight loss / fitness programme, there were 

statistically significant improvements in the general health, vitality and mental health 

components of the SF-36v2 TM . The underlying data are given in the APPENDIX on page 

868. 

Figure 107: Evaluation of local Fit Fans programme examining change in mental and 

physical health status over 12 weeks, 2009 



8.5.11 Obesity Strategy 

The Hull and East Riding of Yorkshire Integrated Obesity Strategy was published in 

January 2007. The report covered the prevalence of obesity in children and adults in 

Hull and East Riding of Yorkshire, mapping of services available in relation to severity of 

the overweight or obesity problems and suggested care pathways for children and 

adults who want to lose weight. This strategy covered all people so it is possible that 

people who are more health-conscious or have more co-morbidities will access these 

services. 

In Hull, two groups were formed from the Integrated Obesity Group, the Paediatric 

Obesity Task Group and the Adult Obesity Task Group. Local action plans and care 

pathway services were developed from these groups. The objectives for Hull‟s action 

plans were to: 

bring together local key partners to oversee the development and implementation 

of obesity-related initiatives; 

develop a Hull Weight Management Service including a range of different 

services to help all sectors of the community in Hull (adults as well as children 

and young people) to successfully lose or manage their weight; 

raise awareness of obesity and overweight issues and develop promotion and 

marketing strategies to increase access to weight management services; 

help local health practitioners to identify, support and refer overweight and obese 

patients to appropriate services; and 

develop and implement a range of approaches to prevent overweight and obesity. 

Different levels of overweight and obesity are also being mapped to services. Level 1 

refers to basic intervention at the population level involving opportunistic advice on 

general healthy eating and physical activity advice sign-posting services; the Health 

Trainers signpost appropriate people to relevant weight management services. Level 2 

refers to weight management services for clients with a BMI 25 to 39.9 without comorbidities, 

and referral to services such as Looking Good Feeling Good, Why Weight?, 

Fit Fans, etc. Level 3 refers to weight management services for clients with a BMI 30 to 

34.9 with co-morbidities involving a multi-disciplinary approach, such as involving the 

dietetic service. Level 4 refers to specialist weight management services for clients with 

a BMI 35 or more with significant co-morbidities or a BMI 40 or more. 






To reduce the prevalence of obesity, people need good quality education and advice 

about diet, weight loss and exercise. To help general practice staff provide consistent 

advice, leaflets are distributed by the Locality Development Managers in Hull. 




In the local World Class Commissioning (WCC) strategy, there were targets for reducing 

obesity and overweight in adults and children. All the targets were set for a one 

percentage point reduction in the prevalence each year (Table 122). So for instance the 

target for obesity in men, from a baseline of 17%, is a reduction to 16% for 2009/10 and 

to 15% for 2010/11 reducing to 13% for 2012/13. 

Table 122: World Class Commissioning overweight and obesity targets to 2012/2013 

Target 2008/09 baseline 2012/13 target 

Obesity – men 17 13 

Obesity – women 22 18 

Overweight (BMI 25–


overweight was 14.7%, 15.2% and 14.3% for the 2007/08, 2008/09 and 2009/10 school 

years respectively, and the percentages obese were 11.8%, 10.3% and 11.5% 

respectively. Therefore, the targets for year R children have not been achieved. With 

year-on-year random variation, it is difficult to describe the recent trend, but the 

prevalence of overweight appears to have decreased, but the prevalence of obesity has 

remained similar. For year 6 children, the prevalence of overweight was 15.4%, 14.0% 

and 13.9% or the 2007/08, 2008/09 and 2009/10 school years respectively, so the target 

was achieved for 2008/09 but not for the most recent school year 2009/10. The 

prevalence of obesity in year 6 children was 22.3%, 21.5% and 20.7% respectively so 

the targets were not achieved. 

Prior to new Government in May 2010, there was also a Local Area Agreement (LAA) 

stretch (ONE HULL 2009) target of 650 adults losing 5% or more of their body weight 

and maintaining it for 12 weeks after completing a local weight management intervention 

programme over a two year period (325 per year). In the first three quarters of the first 

year 2008/2009, 144 adults have achieved this target with an anticipated 52 achieving 

this target in the final quarter. Therefore, at that time there was some way to go to 

achieve the total of 650 adults over the two year period. However, the target was 

cumulative, and a number of additional weight loss programmes started subsequently 

including the single point of access for obesity (which has now discontinued). As a 

result, the target and the stretch target were both achieved. 

However, following the change in the government in May 2010, new outcomes are now 

under consultation (see section 3.3.6.2 on page 52). Obesity in children and adults are 

outcomes under consultation, but they are phased in terms of the percentages who are 

within the healthy weight category, rather than in the obese category. In which case, the 

targets would need to be revised in terms of the percentages of children and adults 

within the healthy weight category. 



8.6 Exercise 

8.6.1 Lack of Exercise as a Risk Factor 

By regularly exercising in conjunction with a balanced diet, the risk of obesity is reduced, 

and helps maintain weight levels. Obesity as a risk factor has already been discussed 

within section 8.5.1 on page 273. However, exercise is also an independent risk factor 

for poor health such as cardiovascular disease. Furthermore, regular exercise can 

reduce the risk of injury from falls and conditions such as osteoporosis later in life. It is 

also important in improving mental health. 



The Health Survey for England (Health Survey for England 2008) collects information on 

exercise undertaken by survey participants. The last such survey which collected 

information on exercise levels was conducted during 2008. The local Prevalence 

Survey conducted during 2009 also collected information on exercise levels (see 

section 13.2.1.4 on page 791 for more details on survey and see section 13.4.3 on 

page 808 for more details on the exercise definitions used locally). Whilst it is relatively 

difficult to collect information to determine if people achieve a certain level of exercise as 

the perception of the intensity of exercise will differ and there are no standard methods 

or questions which are used in different surveys, the questions are sufficiently similar 

that it is likely that results will be comparable (unless the perception of intensity differs 

substantially). The national recommendation for adults is to undertake exercise for a 

minimum of five days a week which lasts for 30 minutes or more and is moderateintensity 

activity 38 . The Health Survey for England classifies survey responders into 

three categories: fulfilling the national recommended exercise levels, undertaking „some 

activity‟ or undertaking „low activity‟. Survey responders from the local Prevalence 

Survey were classified as fulfilling the national recommendation (i.e. 5+ times per week 

of moderate or vigorous exercising lasting 30 minutes or more), undertaking moderate 

or vigorous exercise of 30 minutes or more but less than the five times weekly or 

undertaking only light exercise or not exercising at all. Therefore, it is possible that the 

definitions (with the exception of fulfilling the national exercise recommendations) differ 

between these surveys. Nevertheless, examining the prevalence of exercise levels will 

give an indication of exercise levels in Hull relative to national levels, and the percentage 

fulfilling the national exercise guidelines will be more comparable between the surveys. 

The prevalence estimates are given in Figure 108 and Figure 109 for men and women 

respectively. The underlying data are given in the APPENDIX on page 869 and on 

page 869. 

38 Which makes the heart beat faster and makes breathing heavier than usual, such as brisk walking. 



In general, men in Hull and women in Hull have lower percentages who exercise to the 

national recommended levels. The exceptions are for men aged 65-74 years and for 

women aged 75+ years where the percentages are slightly higher for Hull than England. 

The differences appear more marked in the younger age groups especially for men. 

Furthermore, the percentage undertaking light or no exercise is higher in Hull than the 

percentage undertaking „low activity‟ nationally, although differences in the definitions of 

this lower activity level may explain this difference. 

From the Prevalence Survey 39 report (available at www.hullpublichealth.org), the ageadjusted 

percentage fulfilling the national exercise guidelines are 35% in Hull for men 

compared to 39% for England, and 25% for women in Hull compared to 28% nationally. 

Table 123, Table 124 and Table 125 give the similar information for each of the three 

Localities in Hull from the Prevalence Survey 2009. Note that the numbers of survey 

responders are relatively small for some groups, so the information is also presented 

from the Health and Lifestyle Survey 2007. 

Figure 108: Exercise levels in men for England 2008 and Hull 2009 

Percentage of men 

100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Hull England Hull England Hull England Hull England Hull England 

16-24 25-44 45-64 65-74 75+ 

Age / area 

Fulfils national guidelines Somc activity Low activity 

39 The prevalence estimates are combined from the Prevalence Survey and the Social Capital Survey 

both completed during 2009 as the survey numbers combined are high (almost 6,000). 



Figure 109: Exercise levels in women for England 2008 and Hull 2009 

Percentage of women 

Table 123: Exercise levels for men and women, North Locality 2009 

Local 

survey 

2007 

2009 

100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Hull England Hull England Hull England Hull England Hull England 

Age 

(yrs) 

16-24 25-44 45-64 65-74 75+ 

Number 

answering 

question 

Exercise levels for men and women living in North Locality (%) 

Men Women 

5+ times 

per wk 


Table 124: Exercise levels for men and women, East Locality 2009 

Local 

survey 

2007 

2009 

Age 

(yrs) 

Number 

answering 

question 

Exercise levels for men and women living in East Locality (%) 

5+ times 

per wk 

Men Women 


As the distribution of the population age structure differs among the wards, it is useful to 

standardise the percentages for age when comparing the prevalence across the wards. 

As the number of survey responders are relatively low in the Prevalence Survey 40 , the 

prevalence estimates have been produced for the Prevalence Survey 2009 and Social 

Capital Survey 2009 combined (which gives a total of almost 6,000 survey responders). 

Figure 110, Figure 111 and Figure 112 give the age-adjusted percentages of men and 

women who never exercise or only undertake light exercise for the wards in North, East 

and West Localities respectively, and Figure 113, Figure 114 and Figure 115 give the 

percentages who fulfil national guidelines for exercise for the three Localities. The 

underlying data are given in the APPENDIX on page 870 and on page 871 respectively. 

Figure 110: Age-adjusted percentages never exercising or undertaking only light 

exercise for wards in North Locality, 2009 

Age standardised percentage who never 

exercise or undertake light exercise only 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Bransholme 

East 

Bransholme 

West 


and 

Greenwood 


University 

Males 

Females 

Persons 






exercise for wards in East Locality, 2009 



90 

80 

70 

60 

50 

40 

30 

20 

10 

0 


East West 


Drypool 

Males 

Females 

Persons 


exercise for wards in West Locality, 2009 



90 

80 

70 

60 

50 

40 

30 

20 

10 

0 



Males 

Females 

Persons 



Figure 113: Age-adjusted percentages exercising to national guideline levels for wards 

in North Locality, 2009 

Age standardised percentage exercising to 

national guideline levels 

70 

60 

50 

40 

30 

20 

10 

0 

Bransholme 

East 

Bransholme 

West 


and 

Greenwood 


University 

Males 

Females 

Persons 

Figure 114: Age-adjusted percentages exercising to national guideline levels for wards 

in East Locality, 2009 



70 

60 

50 

40 

30 

20 

10 

0 


East West 


Drypool 

Males 

Females 

Persons 



Figure 115: Age- adjusted percentage exercising to national guideline levels for wards in 

West Locality, 2009 



70 

60 

50 

40 

30 

20 

10 

0 


Further information on the prevalence of exercising at ward level without taking into 

account age or gender, is given in the 76 page Public Health Profiles for Hull, as well as 

in the Hull Atlas. An Obesity and Exercise report which examined factors predicting 

those people who never exercise and those who fulfil the national exercise guidelines 

was produced from the 2007 Health and Lifestyle Survey. It was found that people with 

fewer qualifications and with worse physical and mental health were less likely to fulfil 

the national exercise guidelines, and people living in more deprived areas, on lower 

incomes, with lower levels of qualifications and poorer physical and mental health were 

more likely to never exercise. The Hull Atlas, Obesity and Exercise report as well as the 

survey reports (Health and Lifestyle Survey 2007 and Prevalence Survey 2009) are all 




Males 

Females 

Persons 

It is recommended that children and young people undertake at least one hour of 

physical activity every day. Young people in the 2008-09 Health and Lifestyle Survey 

were asked to provide an estimate of the number of hours they had undertaken sporting 

and other physical activity the previous week. Table 126 illustrates the percentage who 

reported that they had been active for seven or more hours the previous week by school 



year and gender, and Figure 116 shows the distribution of daily hours in more detail. 


Table 126: Percentage of young people engaging in at least one hour of sports and 

physical activities per day on average, 2008-09 

School 

year 

Percentage of pupils engaged in at least 1 hour of sports and 

physical activities per day on average 

Males Females All 

N % N % N % 

Year 7 147 49.2 80 27.8 228 38.7 

Year 8 129 48.5 106 39.0 235 43.7 

Year 9 119 49.6 75 32.9 195 41.6 

Year 10 142 46.6 85 30.1 228 38.7 

Year 11 82 44.8 102 41.1 184 42.7 

Total 619 47.9 448 34.0 1,070 40.9 

Figure 116: Exercise levels in young people in Hull 2008-09 

100% 

80% 

60% 

40% 

20% 

0% 

None Less than 1 hour per day 1-2 hours per day More than 2 hours per day 


Males Females 



8.6.3 Reasons For Not Exercising 

In the adult Health and Lifestyle Survey conducted during 2003 (this question not asked 

in later surveys), people who felt they did not undertake enough exercise were asked 

the reasons why this was the case. Their responses are presented in Table 127. 

People could provide more than one reason so the percentages across each row may 

sum to more than 100%. Relatively few reported lack of transport was an issue in 

undertaking insufficient exercise for most wards (6% or less) with the exception of 

Bransholme East (8%), Bransholme West (9%), University (10%) and Avenue (14%). 

Less than 10% of residents in West Hull reported no facilities near their home as a 

reason for their lack of exercise with the exception of Avenue (12%) and Newland 

(13%). Up to one quarter of Hull residents reported that cost was a reason they did not 

take enough exercise, and this was mainly in the most deprived areas of Hull. However, 

the three most common reasons for not exercising enough were insufficient time, lack of 

will power, and illness or disability. 

Table 127: Reasons why people did not exercise enough in Hull 

Ward in Area/Locality 

order 

People 

(N) 

No 

time 

Percentage of people (out of N) giving this as their reason for not exercising sufficiently 

Do not like 

No facilities 

exercise 

No Near Near No will Ill or Too In In Other 

transport home work power disabled expensive public general reason 

Bransholme East 60 28 8 7 0 32 28 20 20 15 8 

Bransholme West 75 32 9 3 5 25 35 20 13 7 9 

Kings Park 66 58 5 5 5 38 23 18 6 9 9 

Beverley 74 54 1 4 4 36 19 14 3 9 12 

OrchardPk&Greenwd 88 30 6 8 0 24 44 25 7 6 7 

University 80 49 10 9 5 28 21 20 11 9 10 

Ings 114 49 3 3 3 25 28 12 8 11 6 

Longhill 104 35 3 5 3 34 34 16 7 4 13 

Sutton 116 47 3 3 6 32 24 18 6 12 9 

Holderness 124 45 5 3 6 42 20 16 14 6 7 

Marfleet 87 33 5 5 9 28 38 21 15 11 6 

Southcoates East 46 37 4 4 0 28 37 15 22 4 9 

Southcoates West 72 54 3 1 1 36 22 13 8 11 7 

Drypool 110 45 2 3 4 40 23 14 15 5 7 

Myton 65 34 6 6 2 34 34 20 9 6 9 

Newington 59 56 2 3 3 27 29 15 10 15 5 

St Andrew's 43 42 5 2 0 35 23 16 12 9 9 

Boothferry 100 45 4 2 4 38 28 21 6 9 7 

Derringham 91 41 3 4 5 45 30 21 15 11 10 

Pickering 115 33 5 4 5 30 33 17 6 15 11 

Avenue 85 48 14 12 6 35 25 19 13 7 9 

Bricknell 62 55 2 3 5 44 23 10 5 18 0 

Newland 62 45 5 13 5 40 29 19 13 13 10 



8.6.4 Attitudes Towards Exercise 


responders about their perceived impact on health of undertaking more exercise. The 

information is presented in section 8.3 on page 244 from the Social Capital Survey 

2009, with additional information examining differences among the genders, age groups, 

Localities and deprivation quintiles available in the Social Capital Survey 2009 report at 


Further information on factors influencing the prevalence of never exercising and 

exercising to national guideline levels is given the 2007 Health and Lifestyle Survey 

Obesity and Exercise report. It was found that people with fewer qualifications and with 

worse physical and mental health were less likely to fulfil the national exercise 

guidelines, and people living in more deprived areas, on lower incomes, with lower 

levels of qualifications and poorer physical and mental health were more likely to never 

exercise. The Hull Atlas, Obesity and Exercise report as well as the survey reports 

(Health and Lifestyle Survey 2007 and Prevalence Survey 2009) are all available at 


Attitudes to exercise were collected as part of Reflector Groups following the 2007 

Health and Lifestyle Survey (see section 13.2.2.2 on page 795) and the 2008-09 Young 

Person Health and Lifestyle Survey (see section 13.2.2.3 on page 796). The full 

reports from both of these Reflector Groups as well as the full survey reports are 

available at www.hullpublichealth.org. Information and attitudes to exercise were also 

collected in the focus groups conducted as part of the Attitudes to Health project 

conducted during 2007 (see section 13.2.2.1 on page 794). 

8.6.5 Exercise in Relation to Deprivation 

The relationship between exercise levels and local deprivation quintile is illustrated in 

Figure 117 using information from the local 2009 Prevalence Survey. Similar 

percentages of survey responders across the deprivation quintiles fulfil the national 

exercise guidelines. This finding differs from the 2007 Health and Lifestyle Survey 

which found (as noted in section 8.6.4 on page 316), that the percentages exercising to 

national exercise guideline levels decreased with increased deprivation. In the 2009 

Prevalence Survey (Figure 117), of those who do not fulfil the national exercise 

guidelines, those people living in the least deprived areas tend to exercise to higher 

levels than those in the most deprived areas. For instance, 36% of people in the least 

deprived areas exercise for at least 30 minutes to moderate or vigorous levels but less 

than five times a week compared to only 18% in the most deprived areas, and 6.1% in 

the least deprived areas never exercise compared to 8.8% in the most deprived areas. 

The trend is statistically significant ( 2 test for trend, 22.6, p


Figure 117: Percentage of responders by exercise level by deprivation for Hull 

Percentage of survey responders 

100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 


Local deprivation quintile 

5+ per week


Figure 118: Percentage of responders by exercise level by employment status for Hull 

Percentage 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

Working Full-time 

education 

Unemployed Long term 

illness or 

disabilty 


8.6.7 Social Marketing and Factors Influencing Exercise 

Retired Looking after 

the 

home/family 

5+ per week


8.6.8 Exercise Programmes 

Further information about available services such as Fit Fans, Active Lifestyles and 

HeartLink are given at www.nhshull.nhs.uk. Maps of walks within East Hull are also 

available to print from the website. 

Further information about the Active Lifestyles and Why Weigh services and about 

Health Trainers is available at www.chcphull.nhs.uk/pages/active-lifestyle-service. 

A number of the programmes mentioned in the section 8.5.9 on page 297 which are 

available across the city to tackle weight loss which include elements or a large 

proportion of exercise or physical activity. Why Weight? services includes a range of 

taster sections involving exercise and physical activity (gym sessions, soccer 

sensations, salsa/aerobics, boxercise, fit to be a parent, keep-fit, men‟s health football, 

etc). Fit Fans is predominately aimed at men and sports fans with a focus on physical 

activity, and the service is in partnership with Hull City AFC. A Fit Fans for Women 

service has more recently been set up, which is similar to the service set up for men. 

The Active Lifestyle Service is available to anyone over 18 years who is not very active 

and requires referral from a health professional. The service encourages people to 

make small changes to their lifestyles to get more active whether this is walking more, 

dancing, going to the gym etc. The Looking Good Feeling Good service includes 

physical activity sessions. There are also various community-based programmes which 

improve the physical activity and fitness of people attending. These range from sports 

groups, walking groups, dancing classes, etc. A number of these programmes in Hull 

focus on people living in the more deprived areas, but it is likely that people who are 

more health-conscious will be more likely to participate in these activities. 

There are also a number of initiatives set up by Hull City Council, including those around 

Sport England. 

The specific initiatives for families and children also include elements of exercise and 

physical activity build into the programme to increase self-confidence and confidence 

about sport, exercising and physical activity. 

8.6.9 Evaluation of Exercise Programmes 

A pilot survey was carried out in 2006, by Community Health Development Workers 

employed by NHS Hull, to study the impact on the health of individuals participating in 

community groups which provide physical activity of various types. The pilot was 

conducted in the West and Riverside Areas of the city, and found evidence that 

community groups have the capacity to offer long-term, sustainable, and low-cost health 

interventions, and in particular to: increase the frequency of physical exercise taken; 

lengthen the periods of activity taken; increase stamina outside group sessions; and 

improve mobility. 



Hull has a strong history of community-led activity, particularly in wards with high levels 

of deprivation. Community groups of varying sizes and types meet in church halls, 

community centres and on sports fields for a variety of physical activities, e.g. to dance, 

keep fit and play team games. The aim of the survey was to discover whether, and to 

what extent, participation in community groups can impact on a range of health 

indicators. 

Following the success of the pilot, a more lengthy evaluation was undertaken in the form 

of the Community Physical Activity Survey. There were four rounds of data collection at 

six-monthly periods across a range of such community groups. The questionnaire 

included questions on exercise, mobility, diet, the Mental Health Index (MHI), changes 

over the last six months, as well as information about the community group itself. The 

key outcome measures were the levels of exercise undertaken and mental health as 

measured by the MHI. 

A total of 621 questionnaires were completed in a total of four rounds from 360 different 

individuals, with just under a half of these participants participating in two or more 

rounds. The majority of the participants were women aged over 55 years. 

Table 128 gives the details of the analyses for the physical activity frequency and 

mental health index for those individuals who completed at least two rounds of the 

survey. The first column details the variable or criteria being considered, the next four 

columns gives the number of people who participated and answered the questions in 

two different rounds and their responses in their first round relative to their responses in 

their last round. For instance, 27 participants stated that they undertook physical activity 

on five or more occasions during the week in their first round surveyed but did not 

participate in this frequency of exercise when asked in their last survey round. The next 

two columns (6 th and 7 th columns) give the percentage fulfilling the criteria for their first 

round and their last round. The next column gives the difference in these percentages 

with a 95% confidence interval (see section 12.5 on page 775 for more explanation). If 

the 95% confidence interval includes the value of zero, it implies there is no statistically 

significant difference in the two percentages between the first round and the last round. 

A p-value is also given which is the result of a statistical test (McNemar‟s test for paired 

percentages) undertaken to compare the differences (see section 12.4 on page 774 for 

more explanation). 

It was found that percentage of survey responders who exercised using the three 

measures of exercise fell slightly between their first and last survey round 41 . Between 

the first and last rounds, the mental health index improved. The mental health index 

ranges from zero denoting the worst mental health to 100 denoting the best mental 

health. The differences in the MHI were not statistically significant (although the 

41 As frequency of exercising was relatively high, one may expect this to decrease (a statistical 

phenomenon referred to as „regression to the mean‟). If exercising to the most frequent category 

response in their first round, it is impossible to exercise more frequently in later survey rounds, and any 

change must be a reduction in the frequency. This also occurs at the other extreme, people exercising at 

the least frequent category response in their first round, can only exercise at that same frequency level or 

at a higher frequency level in the last round (not lower as there is no such response on the questionnaire). 



percentage reduction in those with poor mental health was approaching the 5% 

statistically significance level) with 33% having poor mental health in their first round 

compared to 24% in their second round. 

Table 128: Paired analysis of survey in terms of key outcome measures 

Variable/criteria Responses in first / 

last round (number 

of people) 

Percentage fulfilling criteria p 

Y/Y Y/N N/Y N/N First Last Difference 

(95% CI) 

Activity 5+ times a week 59 27 21 52 54.1 50.3 3.8 (-4.8, 12.3) 0.39 

Mod/vig exercise undertakn 118 13 12 11 85.1 84.4 0.6 (-5.7, 7.0) 0.84 

Fulfilling national guidelines 47 27 21 57 48.7 44.7 3.9 (-5.0, 12.9) 0.39 

MHI < 60 (poor MH)* 21 23 12 79 32.6 24.4 8.1 (-0.4, 16.7) 0.063 

MHI > 80 (good MH)* 7 10 15 103 12.6 16.3 -3.7 (-11.0, 3.6) 0.32 

*“Good” and “poor” mental health arbitrarily defined in terms of score. Mental Health Index 

ranges from 0 to 100. 

Table 129 illustrates the frequency per week of exercising at a moderate or vigorous 

level for 30 minutes (from the Health and Lifestyle Survey 2007; see section 13.2.1.2 on 

page 791 for more information) in relation to the frequency of exercise and intensity 

level questions combined in the Community Physical Activity Survey. There was a slight 

difference in the questions so it is possible that this could have a small influence on the 

results. 

For both men and women aged 45 years or older, there was a statistically significantly 

higher percentage of Community Physical Activity Survey participants exercising to 

national guidelines compared to the local Health and Lifestyle Survey 2007. Whilst it is 

possible that community group participants over-estimated their physical activity levels, 

the differences are very marked. Therefore, with such large differences, it is likely that 

there is a real effect as over-estimation and the slight differences in questions are likely 

to have made only a small difference. This suggests that community groups are useful 

for increasing exercise levels in the community. 



Table 129: Difference in percentage fulfilling national exercise guidelines between 

Community Physical Activity Survey and Health and Lifestyle Survey responders 

Gender Age Fulfilling national exercise guidelines Difference in 

Community H&L Survey percentages 

Physical Activity 2007 (95% confidence 

Number 

ans Q 

% % 

interval) 


Table 130: Difference in percentage with good mental health between Community 

Physical Activity Survey and Health and Lifestyle Survey responders 

Gender Age Good mental health (MHI>80) Difference in 

Community H&L Survey percentages 

Physical Activity 200707 (95% confidence 

Number 

ans Q 

% % 

interval) 


8.6.10 Physical Activity Strategy 

Hull‟s Physical Activity Strategy – Pride, Passion and Participation 2008-2013 was 

developed by a multi-sector group and following its launch a Steering Group was 

established to lead its implementation. This group fed into the Health and Wellbeing 

Strategic Delivery Partnership. 

The Active Hull Strategy and Action Plan (2006-2011) complement the above and aims 

to raise awareness of the importance of being physically active, strengthen partnership 

working around physical activity, and drive forward work to increase activity levels in 

Hull. Implementation of Active Hull was overseen by the Hull Physical Activity 

Development Group – a multi-agency group with partners from a wide range of 

organisations including NHS, local authority, university, sports clubs, schools etc. 

Following the major NHS reorganisations, there will be changes to the structure of the 

NHS and public health (see section 3.3.6 on page 51), which will influence the way the 

strategies are implemented. 

Local people were offered free swimming and gym/activity vouchers which enabled 

them to one free session in a local authority leisure centre. This aimed to encourage 

people to be more active and to use their local authority leisure facilities. Initially the 

vouchers are being offered to NHS Hull members (as an incentive for becoming a 

member; see section 13.2.5.1 on page 799), but will eventually be offered to all local 

residents e.g. via local press. 






More information about the services available can be found in section 8.6.8 on page 

319. 




There have been previous targets relating to obesity and exercise such as the one for 

the Local Area Agreement 2 (LAA2), which was to increase the levels of exercise in 

children and young people (ONE HULL 2009) by involving children and young people in 

“high-quality physical education and sport”. The target was to achieve 81% of children 

and young people participating in high quality physical education and sport by 

2009/2011. This target was managed by the Learning Strategic Delivery Partnership of 

ONE HULL, and figures are not available in relation to the progress towards this target. 

However, following the change in government in May 2010, the LAA have been 

replaced, and new outcome measures are currently under consultation (see section 

3.3.6.2 on page 52), so it is not yet known which will become the new indicators. 

However, one of the possible listed measures relates to the percentage of adults 

meeting the recommended 30 minutes or more of moderate or vigorous exercise five or 

more times per week. If this indicator was used, then there is no indication of how it 

would be measured, and there would be a possibility that the indicator would be based 

on synthetic or modelled data (see section 12.1 on page 770). If this was the case, it 

would not be an appropriate measure as modelled estimates cannot be used for 

accessing changes over time. In Hull, following the 2009 Prevalence Survey, baseline 

data would exist in order to derive targets if this were to become an outcome measure. 



8.7 Diet 

8.7.1 Collecting Information in Diet 

It is difficult to collect and interpret information on diet owing to the wide range of foods 

which can be eaten in varying quantities. In addition, there are often „healthy‟ and 

„unhealthy‟ versions of the same type of foods and different cooking methods. For 

simplicity, the frequency of eating the recommended five daily portions of fruit and 

vegetables has been used as indicative of diet. People were also asked to state if they 

felt they had a healthy diet or not, and these responses will also be presented. The 

most recently completed survey was the Prevalence Survey undertaken during 2009, 

and the people were asked about 5-A-DAY and whether they felt they ate a healthy diet, 

but more detailed information was not collected as the questionnaire was relatively 

short. More information on diet such as the frequency of eating take-away food and 

ready-meals was collected within the 2007 Health and Lifestyle Survey, and the 2008-09 

Young People Health and Lifestyle Survey. The Social Capital Surveys 2004 and 2009 

also collected some information on diet. Reports on these surveys together with more 

detailed information from the young people‟s survey, and information at ward level in the 

76 page Public Health Profiles for Hull and within the Hull Atlas are all available at 


8.7.2 Poor Diet as a Risk Factor 

Diet has been linked to several types of cancer including cancer of the bowel, stomach, 

breast, lung, prostate, pancreas, oesophagus and bladder (Cancer Research UK 2009). 

A fatty salty diet is also a risk factor for cardiovascular disease as fatty build-ups within 

the arteries can cause heart attacks, stroke and other cardiovascular events and salt 

increases the risk of hypertension which is also a risk factor for cardiovascular disease 

(BBC 2009; NHS Choices 2009). 

8.7.3 Healthy Diet 

As part of the Health and Lifestyle Survey 2007, the Prevalence Survey 2009 and the 

Young People Health and Lifestyle Survey 2008-09, survey responders were asked if 

they felt they had a healthy diet. The responses were “yes”, “no”, “don‟t know if what a 

healthy diet is” and “don‟t know if I have a healthy diet”. Survey responders in the 

Health and Lifestyle Survey 2007 were also asked if they felt had eaten healthier in the 

last year. 




Seven in ten men and eight in ten women in Hull felt they had a healthy diet (Table 

131), and the percentage had increased between 2007 and 2009, although the 

percentage reporting that they did not eat a healthy diet remained virtually the same. 

The difference occurred in relation to knowledge about a healthy diet, with the 

percentages stating they did not know what a healthy diet was or that they did not know 

if their diet was healthy fell between 2007 and 2009. 

Table 131: Percentage of Hull adults eating a healthy diet, 2007 versus 2009 by gender 

Gender Survey 

year 

Males 

Females 

Number of 

respondents 

Percentage eating a healthy diet 

Yes No Don’t know 

what a healthy 

diet is 

Don’t know 

if I have a 

healthy diet 

2007 1,981 69.9 20.8 2.5 6.8 

2009 875 76.1 21.3 0.6 2.1 

2007 2,084 79.3 15.0 1.1 4.7 

2009 868 82.5 14.6 0.5 2.4 

From the most recent Health and Lifestyle Survey 2007, the younger ages were less 

likely to report eating a healthy diet (Table 132) and virtually all of those aged 75+ years 

reported eating a healthy diet. 

Table 132: Percentage of Hull adults eating a healthy diet, by age, 2009 

Age 

(yrs) 

Number of 

respondents 


Yes No Don’t know what a 

healthy diet is 

Don’t know if I 

have a healthy 

diet 

18-24 265 67.5 27.9 0.8 3.8 

25-44 645 75.5 21.2 0.6 2.6 

45-64 520 81.3 16.3 0.4 1.9 

65-74 165 91.5 7.3 0.6 0.6 

75+ 147 95.9 3.4 0.0 0.7 

From this survey, there were also slight differences among the Areas and Localities 

(Table 133). Just under three-quarters of residents in North Carr and Riverside ate a 

healthy diet compared to over 80% in Northern, Wyke and West Areas. 



Table 133: Percentage of Hull adults eating a healthy diet, by geographical area 2009 

Area committee 

area / Locality 

Number of 

respondents 



what a healthy 

diet is 

Don’t know 

if I have a 

healthy diet 

North Carr 167 74.9 19.8 1.2 4.2 

Northern 225 80.4 17.8 0.0 1.8 

North Locality 392 78.1 18.6 0.5 2.8 

East 252 79.8 17.1 0.4 2.8 

Park 293 77.1 20.1 0.3 2.4 

Riverside (East) 84 73.8 23.8 1.2 1.2 

East Locality 629 77.7 19.4 0.5 2.4 

Riverside (West) 243 74.5 23.9 0.8 0.8 

West 227 86.8 9.3 0.4 3.5 

Wyke 252 82.9 15.5 0.4 1.2 

West Locality 722 81.3 16.3 0.6 1.8 

Hull 1,743 79.3 18.0 0.5 2.2 

Further information on the whether people felt they had eaten healthier in the last year at 

ward level (taken from the 2007 Health and Lifestyle Survey), is given in the 76 page 

Public Health Profiles for Hull, as well as in the Hull Atlas (www.hullpublichealth.org). 


Young people were also asked if they ate a healthy diet. The responses for the two 

“don‟t know” categories have been combined. It can be seen in Table 134 that the 

percentage who think they eat a healthy diet declines with age. 

Table 134: Percentage of Hull young people eating a healthy diet 

Generally speaking, do you eat a healthy diet? 

Males Females 

School Total (N) Yes (%) Don’t Total (N) Yes (%) Don’t 

year 

know (%) 

know (%) 

Year 7 304 68.1 17.1 306 66.7 20 

Year 8 276 64.9 18.5 279 63.1 21.8 

Year 9 263 59.3 18.6 253 62.1 17.8 

Year 10 318 55.7 19.8 328 53.7 21 

Year 11 182 54.9 12.6 262 47.3 21 

Total 1,343 61.0 17.7 1,428 58.6 20.3 



8.7.4 Young People’s Involvement in Cookery 

Young people were also asked in the 2008-09 Health and Lifestyle Survey if they helped 

make meals or cook at home. Around a third of boys and around one in ten girls helped 

make meals or cook at home rarely or never, with the majority helping often or 

sometimes (Table 135). 

Table 135: Young people helping make meals or cook at home 

Percentage of pupils who help make meals or cook at home 

School 

Males Females 

year Total Yes, Yes, Total (N) Yes, Yes, 

(N) often sometimes 

often sometimes 

Year 7 305 16.4 55.7 306 23.5 60.5 

Year 8 276 17.4 50.0 282 20.6 61.7 

Year 9 261 16.5 48.3 253 21.7 59.7 

Year 10 315 16.8 51.1 331 22.1 57.4 

Year 11 180 17.8 49.4 262 27.9 55.0 

Total 1,337 16.9 51.2 1,434 23.1 58.9 

Young people were also asked if they would be or were leaning cookery as part of Food 

Technology or other lessons within school during that school year, and if they attended 

an after school cookery club. For years 7-9, 95% of girls and 90% of boys were involved 

in some cookery activity, and whilst for years 10-11 this percentage did decrease, 

nevertheless around 70% of boys and just under 85% of girls were involved in some 

type of cookery activity at home or at school (Table 136). 

Table 136: Young people involvement in any type of cookery activity 

School 

year 

Percentage of pupils involved in any type of cookery activity (at 

home, during lessons or at after-school clubs) 


N % N % N % 

Year 7 270 89.1 292 94.8 564 92 

Year 8 257 93.1 269 95.7 526 94.4 

Year 9 222 85.4 238 94.1 462 89.7 

Year 10 227 71.6 272 82.2 501 77.1 

Year 11 126 70.4 222 84.7 348 78.9 

Total 1,102 82.5 1,293 90.1 2,401 86.5 



8.7.5 5-A-DAY 


Figure 119 and Figure 120 give the number of portions of fruit and vegetables 

consumed daily for men and women respectively in Hull compared to England (from 

local Prevalence Survey 2009 and Health Survey for England 2008 respectively). The 

percentage eating the recommended five or more portions daily was higher in England 

for all age groups. The underlying data are given in the APPENDIX on page 874. 

Table 137 gives the percentage eating 5-A-DAY. As noted in Figure 119 and Figure 

120, the percentage of people in Hull eating five or more portions of fruit and vegetables 

was lower than in England with the exception of Hull women aged 75+ years. The lower 

percentage in Hull was most marked for women aged under 35 years. 

Daily portions of fruit & vegetables for men (%) 

Figure 119: Fruit and vegetable consumption in males, Hull 2009 versus England 2008 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

Hull 

England 

Hull 

England 

Hull 

England 

Hull 

England 

16/18-24 25-34 35-44 45-54 55-64 65-74 75+ All 

Age / area 

None One Two Three Four Five or more 


Hull 

England 

Hull 

England 

Hull 

England 

Hull 

England


Figure 120: Fruit and vegetable consumption in females, Hull 2009 versus England 2008 

Daily portions of fruit & vegetables for women (%) 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

Hull 

England 

Hull 

England 

Hull 

Table 137: 5-A-DAY in adults by age, Hull 2009 versus England 2008 

England 

Hull 

England 

16/18-24 25-34 35-44 45-54 55-64 65-74 75+ All 

Age / area 

None One Two Three Four Five or more 

Age (years) 5-A-DAY (%) 

Men Women 

Hull England Hull England 

16/18-24* 11.9 17.6 16.8 20.6 

25-34 17.0 25.8 30.5 28.3 

35-44 26.1 23.4 29.7 29.8 

45-54 24.5 26.0 31.8 32.8 

55-64 28.5 31.6 31.7 36.3 

65-74 25.3 29.8 42.5 29.5 

75+ 19.0 23.2 36.7 23.8 

Total 21.8 25.1 30.5 29.0 

*Aged 16 for HSE and aged 18 for local survey. 


Hull 

England 

Hull 

England 

Hull 

England 

Hull 

England


Table 138 and Table 139 shows the number of portions of fruit and vegetables eaten 

the previous day and the percentage eating 5-A-DAY by Locality. Residents of North 

Locality had a slightly lower percentage eating 5-A-DAY (24%) compared to East 

Locality (25%) and West Locality (28%). Park and Riverside West Areas had the lowest 

percentage eating 5-A-DAY (22% and 23% respectively) whereas East Area and West 

Area had the highest percentages (29% and 33% respectively). Given this information, 

it is not surprising that Park and Riverside West also had the highest percentages of 

residents who did not eat any portions (around 10% of survey responders) or only ate 

one portion (a further 12-14% of survey responders) of fruit or vegetables the previous 

day. 

Table 138: Portions of fruit and vegetables eaten previous day in adults by area of 

residence, Hull 2009 

Area committee Number of Daily portions of fruit or vegetables (%) 

area / locality respondents 0 1 2 3 4 5 6 7+ 

North Carr 167 8.4 9.6 16.8 27.5 13.2 23.4 1.2 0.0 

Northern 225 8.9 7.1 16.4 28.0 15.6 18.7 3.1 2.2 

North Locality 392 8.7 8.2 16.6 27.8 14.5 20.7 2.3 1.3 

East 255 7.8 8.2 15.7 22.7 16.1 25.9 2.0 1.6 

Park 295 10.2 11.5 18.6 22.7 14.9 18.0 2.0 2.0 

Riverside (East) 84 8.3 7.1 14.3 23.8 21.4 20.2 2.4 2.4 

East Locality 634 9.0 9.6 16.9 22.9 16.2 21.5 2.1 1.9 

Riverside (West) 243 9.9 13.6 19.3 23.5 10.7 19.8 1.2 2.1 

West 228 2.2 7.9 21.1 23.2 12.7 24.1 1.8 7.0 

Wyke 253 4.7 11.9 15.0 28.1 12.6 18.6 4.3 4.7 

West Locality 724 5.7 11.2 18.4 25.0 12.0 20.7 2.5 4.6 

Hull 1,750 7.5 9.9 17.4 24.9 14.1 21.0 2.3 2.9 

Table 139: 5-A-DAY in adults by area of residence, Hull 2009 

Area committee Number of 5-a-day guideline met (%) 

area / locality respondents Yes No 

North Carr 167 24.6 75.4 

Northern 225 24.0 76.0 

North Locality 392 24.2 75.8 

East 255 29.4 70.6 

Park 295 22.0 78.0 

Riverside (East) 84 25.0 75.0 

East Locality 634 25.4 74.6 

Riverside (West) 243 23.0 77.0 

West 228 32.9 67.1 

Wyke 253 27.7 72.3 

West Locality 724 27.8 72.2 

Hull 1,750 26.1 73.9 



As the age distribution differs among the wards, it is useful to standardise the 


of survey responders was relatively low in the Prevalence Survey 42 , the prevalence 



121, Figure 122 and Figure 123 give the age-adjusted percentages of men and women 

eating five or more portions daily of fruit and vegetables for the wards in North, East and 

West Localities respectively. The underlying data are given in the APPENDIX on page 

875. 

Figure 121: Age-adjusted percentages of men eating 5-A-DAY for wards in North 


Age standardised 5-A-DAY fruit and veg 

prevalence (%) 

60 

50 

40 

30 

20 

10 

0 

Bransholme 

East 

Bransholme 

West 


and 

Greenwood 


University 

Males 

Females 

Persons 





Figure 122: Age-adjusted percentages of men eating 5-A-DAY for wards in East 




60 

50 

40 

30 

20 

10 

0 


East West 


Drypool 

Males 

Females 

Persons 

Figure 123: Age-adjusted percentages of men eating 5-A-DAY for wards in West 




60 

50 

40 

30 

20 

10 

0 



Males 

Females 

Persons 



Further information on the prevalence of 5-A-DAY at ward level without taking into 

account age or gender, is given in the 76 page Public Health Profiles for Hull, as well as 

in the Hull Atlas (www.hullpublichealth.org). 


Table 140 gives the percentages of young people eating 5-A-DAY in Hull by school year 

from the 2008-09 Young People Health and Lifestyle Survey. The majority of year 7 

pupils stated that they ate five or more portions of fruit and vegetables daily, but the 

percentage fell with age to 40% for boys and 35% for girls in year 11. The changes are 

comparable with perceptions of eating a healthy diet in Table 134 with the decreases 

with age more apparent in female pupils. 

Table 140: 5-A-DAY in young people by school year, Hull 2008-09 

Percentage of pupils eating 5-A-DAY fruits and vegetables 

School Males Females All 

year N % N % N % 

Year 7 162 55.7 165 54.6 328 55.1 

Year 8 120 47.1 136 49.6 256 48.4 

Year 9 105 42.5 91 37.9 197 40.3 

Year 10 122 40.3 131 41.7 254 41.1 

Year 11 68 39.5 83 32.7 151 35.4 

Total 577 45.5 606 43.8 1,186 44.6 

The Health Survey for England also includes information on 5-A-DAY in young people. 

Table 141 illustrates the percentage eating 5-A-DAY by age. It is not directly 

comparable to Table 140 due to the differences in the ages, but the percentage 

reporting that they eat five or more portions of fruit and vegetables in Hull was 

considerably higher than England. There is no reason to suppose that this might be 

correct. With Hull‟s increased deprivation, it is likely that fruit and vegetable 

consumption is lower as it has been noted in adults. Therefore, it is more likely that the 

young people in the local survey are over-reporting their fruit and vegetable 

consumption, perhaps because they have over-estimated the number of portions eaten. 

Whilst the survey was self-completion, it did give examples of what constituted a portion. 

Young people were asked “How many portions or pieces of fruit did you eat yesterday? 

(a portion is 1 banana, 1 apple, 1 pear, 2 plums, handful of grapes, etc. Do not include 

glasses of juice).” They were also given examples of a portion of vegetables: “How 

many portions of vegetables did you eat yesterday (not potatoes)? (a portion is about a 

handful or three medium-sized spoons of vegetables like peas, carrots or sweetcorn, or 

a medium-sized tomato).” Young people were also asked “How many glasses of real 

fruit juice (e.g. Tropicana) did you drink yesterday (not squash or juice drinks)?”. 



Table 141: 5-A-DAY in young people in England, 2007 

Gender 5-A-DAY by age for England 2007 (%) 

11 12 13 14 15 

Males 18.9 19.4 23.3 18.2 19.2 

Females 24.5 20.6 21.1 21.3 20.7 

More information on diet, number of portions of fruit and vegetable consumed the 

previous day (including 5-A-DAY) is given in the full report on the Young Person Health 

and Lifestyle Survey. A separate short report specifically examines diet for these young 

people. Both of these reports are available at www.hullpublichealth.org. 

8.7.6 Breakfast and Lunch Food Items Eaten by Young People 

Within the survey, pupils were asked in more detail about their diet, and a separate short 

report is available at www.hullpublichealth.org. Pupils were asked how frequently they 

ate breakfast on a school day before coming to school, on the way to school and at 

school, and how frequently they ate school dinners, a packed lunch, lunch brought 

outside school and lunch at home. 

Pupils were also asked what they ate and drank for breakfast (that morning) and for 

lunch (the last time they were at school) 43 . Pupils were asked to tick from a list of food 

items each food item they had eaten. They were also provided with an „other – please 

specify‟ option for additional items not listed. As noted earlier, it is relatively difficult to 

assess if diets or food items are healthy or not without detailed food diaries which 

specify the exact food item (manufacturer, brand, quantity, etc). For example in the 

case of breakfast, cereals with too much sugar or salt are unhealthy, or spreads used on 

bread and toasts could be unhealthy whereas some cooked breakfasts could be healthy. 

Within the short diet report, an attempt was made to classify food items as „healthy‟ or 

„unhealthy‟. From this report, it appears that where pupils bought and/or ate their lunch 

was predictive or influential of the healthiness of their diet. 

The report also contains a map detailing all takeaway establishments and schools within 

Hull, and the frequency with which pupils ate school dinners, packed lunches, lunch 

outside school and lunch at home for each school separately. 

The majority ate breakfast every day before coming to school (52%), but 12% never ate 

breakfast before coming to school, on the way to school or at school. The largest 

percentage had had cereal or porridge oats (39%) and/or bread or toast (24%) for 

breakfast the morning they completed the questionnaire. One in five (20%) had had a 

hot drink, 11% a milk drink, 14% a fruit drink (juice or smoothie), 9% had had another 

type of cold drink such as squash or water, and 5% had had a fizzy drink. Pupils were 

asked to tick all food items in the list, so it is possible that some pupils had more than 

43 Pupils were also asked what they ate and drank for their evening meal (the previous evening) but the 

information was not included within the report. 



one type of drink such as a fruit drink and a hot drink. Pupils that ate breakfast on the 

way to school more frequently were more likely to eat a breakfast classified as 

„unhealthy‟, but relatively few ate breakfast on the way to school most days (around 160 

pupils; 5.7% ate breakfast everyday or 3-4 days on the way to school). 

There was more variation for lunch, with the largest percentage having lunch bought 

outside school everyday (19.1%) followed by school dinners everyday (14.3%) and 

packed lunches everyday (10.5%). A further 4.8% ate lunch at home everyday, and a 

further 2.2% never ate lunch. The remaining 49% of pupils ate lunch bought outside 

school, school dinners, packed lunch, lunch at home and no lunch in combination for a 

different number of days. For instance, 3.4% had school dinners „3-4 days per week‟ 

and „never‟ had packed lunch, lunch outside school or lunch at home, and a further 2.6% 

of pupils has school dinners „1-2 days per week‟ and packed lunch „3-4 days per week‟ 

(and „never‟ for lunch bought outside school or lunch at home), and a further 2.5% of 

pupils had school dinners „3-4 days per week‟ and lunch bought outside school „1-2 days 

per week‟ (and „never‟ for packed lunch or lunch at home). These were the three 

highest percentages with a combination of difference sources for lunch, and only 

account for a further 8.5% of pupils in total. Therefore, there was a great variation in the 

source of lunch over a „usual‟ school week. 

Around one in twenty pupils stated that they had had nothing for lunch (or snacks during 

the day). The most commonly drink was a fizzy drink (28%), followed by a fruit drink 

(26%) and any other (non-milk) cold drink (22%), with around one in ten having a milk 

drink and around one in twenty having a hot drink. The most frequently eaten lunch 

items were cold sandwiches (40%), chocolate bars (22%), crisps (20%), chips (16%), 

sweets (15%), fruit (14%), pasta (12%), biscuits (11%) and pudding or dessert (10%). 

Pupils were asked to tick as many boxes that applied, and therefore, the percentages 

sum to more than 100%. 

8.7.7 Attitudes Towards Diet 


responders about their perceived impact on health of eating a healthier diet. The 





Attitudes to diet were collected as part of Reflector Groups following the 2007 Health 

and Lifestyle Survey (see section 13.2.2.2 on page 795) and the 2008-09 Young 

Person Health and Lifestyle Survey (see section 13.2.2.3 on page 796). The full report 

from both of these Reflector Groups as well as the full survey reports are available at 

www.hullpublichealth.org. Information on opinions and attitudes to diet were also 

collected within the focus groups for the Attitudes to Health project conducted during 

2007 (see section 13.2.2.1 on page 794). 



8.7.8 Diet in Relation to Deprivation 

8.7.8.1 5-A-DAY 

In Hull, the number of portions of fruit and vegetables consumed daily differs among the 

five deprivation quintiles with consumption tending to be lower for people living in the 

most deprived areas of Hull (Figure 124). The percentage eating 5-A-DAY is 19.9% for 

people living in the most deprived areas of Hull compared to 29.1% and 26.2% for those 

living in the second least and least deprived areas of Hull respectively, with the trend in 

this percentage over the deprivation quintiles statistically significant ( 2 test for trend, 

X=14.5, p


8.7.8.2 Type of Fat or Oil Used For Frying Food 

Local people participating in the Health and Lifestyle Survey (conducted 2003) were 

asked what fat or oil they used when they cooked fried food. 

Figure 125 illustrates the percentage of responders from Hull who used butter, lard or 

dripping when cooking fried food and the percentage of responders who did not eat fried 

food by local deprivation quintile. As can be seen there was an increasing trend of using 

butter, lard or dripping with increasing deprivation. Eight percent used these products in 

the most deprived group compared to 3% in the least deprived group, and the trend was 

statistically significant ( 2 test for trend, p


8.7.9 5-A-DAY in Relation to Employment Status 

In Hull, the number of portions of fruit and vegetables consumed daily differed 

depending on employment status (Figure 126). In a similar way to exercise as noted in 

section 8.6.6, responses will be confounded with age and deprivation (see section 12.2 

on page 772) as the young and people living in the more deprived areas both tend to 

eat fewer portions of fruit and vegetables, and age and deprivation are also related to 

employment status. The differences in the percentage eating 5-A-DAY among the 

employment status groups is statistically significant ( 2 test, X=39.5, df=15, p=0.001). 


Figure 126: Daily portions of fruit and vegetables by employment status in Hull 

Daily portions of fruit & vegetables (%) 

100 

80 

60 

40 

20 

0 

Working Student Unemployed Long-term 

sick or 

disabled 


8.7.10 Social Marketing and Factors Influencing Diet 

Unemployed Looking after 

family/home 

None, one or two Three Four Five or more 

Considerable Social Marking work has been undertaken examining behaviour and 

attitudes to diet, exercise and obesity in Hull with the aim of providing more relevant 

information to help people eat healthily. All the reports from the Health and Lifestyle 

Surveys and Social Capital Surveys reports examine diet in more detail including a 

report on diet following the Young Person Health and Lifestyle Survey (see section 

8.7.6 on page 336). Further work has been completed within reflector groups following 

the 2007 Health and Lifestyle Survey and 2008-09 Young People Health and Lifestyle 

Survey. All these reports are available at www.hullpublichealth.org. 



Further information on attitudes to diet are given in section 8.3 on page 244 and in 


8.7.11 Dietary Advice and Improving Cookery Skills 

From the Attitudes to Health Survey (see page 794) completed during 2007 in Hull for 

people aged 40-60 years and the reflector group work following the 2007 Health and 

Lifestyle Survey (see page 795), it is apparent, even in a relatively deprived area like 

Hull, that lack of knowledge is not necessarily an issue in terms of knowledge about risk 

factors for poor health. Participants knew reasonably well what a healthy weight was, 

what a healthy diet consisted of, and that they should exercise regularly. It is likely that 

people who are more health conscious and have more knowledge about healthy diets 

and feel more confident cooking would participate in such focus groups. Participants 

attributed lack of cooking skills to others, and felt that there had been a loss of skills and 

knowledge across several generations in relation to home cooking and that the family 

practice of preparing meals no longer exists in many homes. Many people saw low 

income as a barrier to eating healthily and thought that people did not know how to cook 

on a budget. Processed foods, supermarkets and advertising were seen as the source 

of the problem. Older people were concerned about who would teach the young. 

Therefore, there could be a need for more education on home cooking in particular on 

how to cook simple meals on a budget. 

Further information about available services may be found at www.nhshull.nhs.uk and 

www.chcphull.nhs.uk/pages/active-lifestyle-service, and a number of the weight loss and 

exercise programmes incorporate a dietary advice element. Some of these services are 

mentioned in section 8.5.9 on page 297 and are available across the city to tackle 

weight loss. A number include dietary advice and/or taster sessions or sessions or 

information on improving cookery skills. The Why Weight? Service focuses on healthier 

eating and cookery skills including menu planning, basic cooking skills, family recipes 

and meals on a budget. Nutritional and healthy eating advice is included in the Fit Fans 

and Looking Good Feeling Good services. The Nutrition and Dietetics Service includes 

tailor-made advice on diet and nutrition for people with physical health problems. The 

local structured education programmes available to people with diabetes also include 

elements about diet and nutrition. 


There are no specific targets around diet. However, there are recommendations 

regarding the Eat Well Plate and 5-A-DAY, and there are targets around reducing the 

levels of obesity and increasing the levels of exercise. 



8.8 Alcohol Consumption 

8.8.1 Alcohol as a Risk Factor 

Alcohol is a risk factor for some cancers, particularly of the colon and breast (BBC 

2009), and excessive alcohol consumption can lead to liver damage, stomach problems, 

fatal alcohol poisoning, increased risk of cardiovascular disease, etc (NHS Choices 

2009). There are also more short-term effects such as dizziness, falling over, being 

sick, injuries resulting from accidents and violence, hangovers, impotence, memory loss, 

etc. There is some evidence that people who drink moderately who do not binge drink 

may have a lower risk for cardiovascular disease compared to people who never drink, 

but people who drink excessively or binge drink increase their risk (BBC 2009). 

However, this could be related to health status in that people who have poorer health 

who may be more likely to have cardiovascular disease are more likely to never drink. 

Therefore the association between alcohol and health is more complex, but it is clear 

that excessive alcohol consumption and binge drinking are both risk factors for 

cardiovascular disease, some cancers and liver disease. 

8.8.2 National Recommendations for Alcohol Consumption and Definitions 

There are two different national recommendations for alcohol consumption, both are 

based on the quantity of alcohol units consumed. It is recommended that alcohol 

consumption is limited over the week and for any particular day. For more information 

on alcohol units and definitions see section 13.4.2 on page 807. Information on 

exceeding the recommended daily units of alcohol was not collected as part of the 2003 

local Health and Lifestyle Survey so it is not possible to examine binge drinking trends 

over time. However, information on the frequency of alcohol consumption and weekly 

consumption was collected so it is possible to examine some local trends over time with 

regard to total weekly alcohol consumption. 

8.8.2.1 Excessive Weekly Alcohol Consumption 

Excessive total alcohol consumption over the week was defined as drinking more than 21 

units for men and more than 14 units for women during the previous week. 

8.8.2.2 Binge Drinking 

Binge drinking was defined as drinking eight or more units for men and six or more units for 

women on a single day at least once a week on average. That is twice the recommended 

daily units. 



8.8.3 Knowledge About Recommended Alcohol Units 

As part of the 2009 Social Capital Survey, survey respondents who reported that they 

drank alcohol were asked to state what they thought the current recommended daily and 

weekly alcohol unit limits were. Figure 127 gives the percentages of men and women 

by age who correctly specified the recommended daily alcohol units (


Figure 128: Knowledge of weekly recommended alcohol units 

Specifying correct number of weekly 

recommended alcohol units (%) 

100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 



16-24 25-34 35-44 45-54 55-64 65-74 75+ 16-24 25-34 35-44 45-54 55-64 65-74 75+ 

Male Female 

Age group / gender 

From the local adult surveys conducted during 2003 and 2009, it is possible to examine 

the frequency of alcohol consumption in men and women (Figure 129 and Figure 130 

respectively). The frequency is denoted as the number of days per week (dpw) or days 

per month (dpm) alcohol is usually consumed. Between 2003 and 2009, the proportion 

of men aged 18-24 years who drank everyday was lower in 2009, with the proportion 

drinking 4-6 days per week lower in every age band for 2009. For women, the proportion 

drinking everyday was highest in the majority of age bands for 2009, whilst the 

proportion of women drinking 4-6 days per week was lowest in the majority of age bands 

for 2009, with the proportion of women never drinking higher in 2009.The underlying data 

for the figures are given in the APPENDIX on page 878. 

There were only minor differences in the frequency of drinking alcohol among the three 

Localities as illustrated in Figure 131 and Figure 132 with the most noticeable 

differences being in the percentages of men and women who drank alcohol 4-6 days per 

week falling between 2003 and 2009 in West Locality. The underlying data are given in 




Figure 129: Frequency of alcohol consumption for Hull men by age, 2003 versus 2009 

Frequency of alcohol consumption 

for male survey respondents (%) 

100% 

80% 

60% 

40% 

20% 

0% 

2003 2009 2003 2009 2003 2009 2003 2009 2003 2009 

18-24 25-44 45-64 65-74 75+ 

Survey year/Age (years) 

Everyday 4-6 dpw 1-3 dpw 1-3 dpm


Figure 131: Frequency of alcohol consumption for Hull by Locality for men, 2003 v 2009 


for male survey respondents (%) 

100% 

80% 

60% 

40% 

20% 

0% 

2003 2009 2003 2009 2003 2009 


Figure 132: Frequency of alcohol consumption for Hull by Locality for women, 2003 v 

2009 


for female survey respondents (%) 

Survey year/Locality 

Everyday 4-6 dpw 1-3 dpw 1-3 dpm


Lifestyle Surveys. There were much higher percentages of younger men drinking 51+ 

units or 22-50 units and younger women drinking 36+ units or 15-35 units compared to 

older age groups. It can be seen that there are only minor differences between 2003 

and 2009 with regard to men and women drinking 51+; 36+ units and 22-50; 15-35 units. 

However, a notable difference is in the percentage of survey responders who did not 

drink any alcohol the previous week where the percentage increased across all age 

bands for men, similarly for women with the exception of those aged over 65 years. The 

underlying data for this figure is given in the APPENDIX on page 880. 

Figure 133: Weekly units of alcohol consumed by age for men, Hull 2003 v 2009 

Units of alcohol consumed 

for male respondents (%) 

100% 

80% 

60% 

40% 

20% 

0% 

2003 2009 2003 2009 2003 2009 2003 2009 2003 2009 

18-24 25-44 45-64 65-74 75+ 

Survey year/age (years) 

None* 1-21 22-50 51+ 

Figure 134: Weekly units of alcohol consumed by age for women, Hull 2003 v 2009 

Units of alcohol consumed 

for female respondents (%) 

100% 

80% 

60% 

40% 

20% 

0% 

2003 2009 2003 2009 2003 2009 2003 2009 2003 2009 

18-24 25-44 45-64 65-74 75+ 

Survey year/Age (years) 

None* 1-14 15-35 36+ 



The Health Survey for England (Health Survey for England 2008) and the General 

Lifestyle Survey (Economic and Social Data Service 2008), previously called the 

General Household Survey, both collect information on alcohol consumption. However, 

the way in which the questions are asked differs from the questions asked as part of the 

local survey. For instance, the Health Survey for England asked about the number of 

alcohol units consumed on the heaviest drinking day the previous week, and the 

General Lifestyle Survey asked about weekly and daily alcohol units in a slightly 

different way again. However, broad comparisons can be made between these surveys 

and the local survey (more information about the national surveys and comparison with 

the local survey is available on the Alcohol report from the 2007 Health and Lifestyle 

Survey available at www.hullpublichealth.org). 

From the General Lifestyle Survey, the number of units consumed locally can be 

compared with England (Table 142 and Table 143). It can be seen that in Hull for 2009, 

the percentage of males drinking 22-50 units and 51+ units of alcohol was lower than 

that of England for 2008, similarly for women drinking 15-35 units and 36+ units. A 

higher percentage of men and women in Hull did not drink alcohol the previous week 

compared to England. 

Table 142: Excessive weekly alcohol consumption for men, Hull 2003-2009 versus 

England 2005-2008 

Survey Weekly number of alcohol units (%) 

None 1-21 22-50 51+ 

Hull 2003 33 50 14 3 

Hull 2007 39 39 15 6 

Hull 2009 39 46 12 4 

England 2005 19 57 18 6 

England 2008 19 53 20 7 

Table 143: Excessive weekly alcohol consumption for women, Hull 2003-2009 versus 

England 2005-2008 

Survey Weekly number of alcohol units (%) 

None 1-14 15-35 36+ 

Hull 2003 51 42 6 1 

Hull 2007 55 37 7 1 

Hull 2009 59 33 7 1 

England 2005 35 51 11 2 

England 2008 33 47 15 5 

From the local Prevalence Survey 2009, the prevalence of excessive drinking and binge 

drinking differed considerably between men and women and among different age 

groups as illustrated in Table 144. 



Table 144: Excessive alcohol consumption and binge drinking by age and gender, Hull 

2009 

Gender Age 

(yrs) 

Men 

Women 

Number of 

responders 

Alcohol (excessively: 21+/14+ units for men/women weekly 

and/or binge: 8+/6+ units for men/women > 1 per week), % 

Problem drinkers 

Never drinks 

Acceptable 

weekly units, 

no binge 

Acceptable 

weekly 

units, binge 

Excessive 

weekly 

units, no 

binge 

Excessive 

weekly 

units, binge 

18-24 135 14.1 45.9 17.0 3.7 19.3 

25-44 334 14.1 50.6 15.9 4.8 14.7 

45-64 270 16.7 50.7 18.5 4.4 9.6 

65-74 79 24.1 60.8 12.7 2.5 0.0 

75+ 57 35.1 56.1 8.8 0.0 0.0 

All 875 17.1 51.2 16.1 4.0 11.5 

18-24 130 19.2 56.9 9.2 3.8 10.8 

25-44 312 25.0 56.4 9.3 5.1 4.2 

45-64 252 31.7 52.8 6.3 2.4 6.7 

65-74 87 42.5 48.3 3.4 5.7 0.0 

75+ 90 54.4 43.3 1.1 1.1 0.0 

All 871 30.9 53.3 7.0 3.8 5.1 

As noted earlier (in Table 142 and Table 143), the prevalence of excessive alcohol 

consumption was lower in Hull compared to England. However, the prevalence of binge 

drinking (at least weekly) was considerably higher in Hull compared to England as 

illustrated in Table 145. A lower percentage of respondents drank beyond the 

recommended weekly guidelines (19% of men and 11% of women) compared to 

England (34% of men and 29% of women). A higher percentage of men repeatedly 

binge drink (33%) compared to England (26%), with the percentage of men in Hull binge 

drinking but staying within the recommended weekly guidelines double the percentage 

for England. The percentage of women binge drinking was lower (18%) compared with 

England (22%), although the percentage drinking within the recommended weekly limits 

and binge drinking was higher (11%) compared to England (9%). 

Table 145: Excessive alcohol consumption and binge drinking in Hull and England 

Gender Survey Binge drinking and weekly guidelines (%) 

Within weekly guidelines Above weekly guidelines 

Binge drinking Binge drinking 

No Yes No Yes 

Men 

Hull 2009 62 19 5 14 

Women 

England 2008 57 9 17 17 

Hull 2009 78 11 4 7 

England 2008 63 9 16 13 



Table 146 gives the percentages who drank excessively and/or were binge drinkers by 

Locality and gender. There are only very minor differences among the Localities for 

men, with slightly higher percentages drinking excessively and/or binge drinking in East 

Locality (34%) compared to 30% for North Locality 31% for West locality. For women, 

North Locality residents had a slightly higher percentage of problem drinkers (17%) 

compared to East Locality (16%) and West Locality (15%). 

Table 146: Excessive alcohol consumption and binge drinking by Locality 

Gender Locality 

Men 

Women 

Number of 

responders 

Alcohol (excessively: 21+/14+ units for men/women 

weekly and/or binge: 8+/6+ units for men/women > 1 

per week), % 

Problem drinkers 

Never drinks 

Acceptable 

weekly units, 

no binge 

Acceptabl 

e weekly 

units, 

binge 

Excessive 

weekly 

units, no 

binge 

Excessive 

weekly 

units, 

binge 

North 188 18.1 52.1 16.5 4.8 8.5 

East 315 15.6 50.5 18.4 4.4 11.1 

West 367 18.3 51.2 13.9 3.3 13.4 

North 200 32.5 50.5 7.5 3.5 6.0 

East 317 29.3 54.9 8.2 3.5 4.1 

West 355 31.5 53.2 5.6 4.2 5.4 

As the age distribution of the wards differ, it is useful to standardise the percentages for 

age when comparing the prevalence across the wards. As the number of survey 

responders was relatively low in the Prevalence Survey 44 , it was not possible to use the 

most recent prevalence estimates. For smoking, obesity and exercise, the information 

from the Prevalence Survey and the Social Capital Survey, both completed during 2009, 

were combined. However, the Social Capital survey responders were not asked about 

their binge drinking, so it is not possible to combine the estimates from these surveys. 

As there are a number of measures for assessing alcohol consumption (i.e. excessively 

weekly units and/or binge drinking), the numbers by age and gender become relatively 

small at ward level when examining each alcohol measure separately. Therefore, 

estimates for the Health and Lifestyle Survey 2007 have been used to give agestandardised 

prevalence estimates at Area and Locality level (rather than at ward level). 

Figure 135 and Figure 136 give the age-adjusted percentages of men never drinking 

alcohol, drinking excessively, binge drinking, and drinking excessively and/or binge 

drinking (“problem drinking”) for each area for men and women respectively. The 

underlying data are given in the APPENDIX on page 881 and page 881 respectively. 

44 Especially when examining subgroups by gender, age and Locality (for example, only 10 men aged 75+ 

in North Locality participated in the Prevalence Survey). 



Figure 135: Age-adjusted percentages of men never drinking and with problem drinking 

by Area and Locality, 2007 

Figure 136: Age-adjusted percentages of women never drinking and with problem 

drinking by Area and Locality, 2007 

Age-standardised percentage (and 95% CIs) 

Age-standardised percentage (and 95% CIs) 

70 

60 

50 

40 

30 

20 

10 

60 

50 

40 

30 

20 

10 

0 

0 

North Carr 

North Carr 

Northern 

Northern 

East 

Park 

Riverside East 

Riverside West 

Area / Locality / Hull 


West 

Never Above weekly units Binge drinking Problem drinking 

East 

Park 

Riverside East 

Riverside West 

Area / Locality / Hull 

West 

Never Above weekly units Binge drinking Problem drinking 

Wyke 

Wyke 

NORTH 

NORTH 

EAST 

EAST 

WEST 

WEST 

HULL 

HULL


This information on the prevalence of problem drinking at ward level is given in the 76 

page Public Health Profiles for Hull and the Hull Atlas (www.hullpublichealth.org). 

As part of the 2009 Social Capital Survey, survey respondents were asked the 

frequency at which they drank their alcohol in (i) pubs, clubs and restaurants, etc; (ii) a 

home or at the homes of friends and family; and (iii) elsewhere. Figure 137 illustrates 

the responses drinking alcohol in these locations “almost always”, “often” and 

“sometimes”. The underlying data are given in the APPENDIX on page 882. 

Drinking within one‟s own home, the home of friends or family and in pubs and 

restaurants was reported as “almost always” by around 30% of respondents. Seven in 

ten (70.6%) of respondents never drank in locations other than homes or pubs and 

restaurants with those aged 16-24 more likely to have drunk alcohol in other locations 

(19.3% drinking elsewhere either sometimes, often or almost always), possibly due to 

the fact that a small proportion of this age group would be underage and unable to drink 

in alcohol-serving establishments or not allowed to drink within the home. Other than 

this there were no clear trends in terms of location of alcohol consumption by sub-group. 

Figure 137: Percentage drinking alcohol almost always, often or sometimes in specific 

locations, 2009 



It is possible to examine the alcohol consumption in a number of different ways, and it is 

not possible to present all the information available from the local 2007 Health and 

Lifestyle Survey and 2009 Prevalence Surveys within this report. The Social Capital 

Survey 2009 also asked where survey responders drank their alcohol and about their 

knowledge of recommended weekly and daily alcohol units. Further information is 

available in the main survey reports for these surveys. Following the 2007 survey, a 

report specifically on alcohol was produced, which examined factors that predicted 

excessive alcohol consumption and binge drinking in more detail. All these reports are 



It is possible to examine the alcohol consumption in a number of different ways, and it is 

not possible to present all the information available from the local Young People Health 

and Lifestyle Survey 2008-09 within this report. Further information is available in the 

survey report at www.hullpublichealth.org. 

The percentages of pupils that had ever drunk a whole alcoholic drink, by school year 

and gender, are presented in Figure 138 from the local Young People Health and 

Lifestyle Survey 2008-09 and from the Health Survey for England (HSE) 2007. The 

patterns in Hull and in the rest of England with respect to age and gender were similar. 

Some differences were apparent, however. At each age, a higher percentage of both 

boys and girls in Hull had drunk alcohol than boys and girls in England as a whole in 

2007, with the possible exception of boys aged 15 years. In Hull, there was little 

difference in the percentage of boys aged 11 and 12 years that had ever drunk alcohol 

(both around 42%), whereas for England the percentage of boys aged 12 years that had 

ever drunk alcohol (31%) was one third higher than for boys aged 11 years (23%). 

Higher percentages of girls than boys had ever drunk alcohol in Hull from the age of 13 

years onwards, whereas in England it was from the age of 14 years onwards. The 

difference between girls and boys aged 14 and 15 years was greater in Hull than in 

England, contributing to the higher overall percentage of girls in Hull having drunk 

alcohol than boys, whereas in England, the percentage was the same. The underlying 

data for this figure is given in the APPENDIX on page 882. 



Figure 138: Ever had an alcoholic drink by age (11-15 years only) and gender, Hull 

2008-09 versus England 2007 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

11 years 12 years 13 years 14 years 15 years 

England Hull England Hull 

Males Females 

Pupils were asked how much alcohol they had drunk over the past week, by various 

types of alcoholic drinks. These were then converted to units. The percentage drinking 

above the recommended weekly guideline amounts for adults are presented in Table 

147. The recommended adult maximum alcohol consumption for males is 21 units and 

for females 14 units. The percentages exceeding the recommended weekly limits were 

higher among girls than boys for each year group, with the exception of year 11. 1 in 12 

girls in year 10 and 1 in 10 girls in year 11 had exceeded the adult guidelines, as had 1 

in 7 boys in year 11. While the numbers exceeding the adult recommended limits were 

small in years 7-9, 3.5% of year 9 girls had exceeded these adult limits. Overall, 4% of 

boys who had drunk alcohol in the past week had exceeded the recommended 

maximum amounts for adult men, while 5% of girls who had drunk alcohol in the past 

week had exceeded the recommended maximum amounts for adult women. 



Table 147: Percentage of pupils drinking more alcohol over the past week than the 

recommended guideline amounts for adults by gender and school year 

School 

year 

Drank more than recommended adult guideline amount in past week 


N % N % N % 

Year 7 1 0.4 2 0.7 3 0.5 

Year 8 3 1.2 4 1.5 7 1.4 

Year 9 3 1.3 8 3.5 11 2.4 

Year 10 15 5.2 24 8.2 39 6.7 

Year 11 22 13.4 25 10.2 47 11.5 

Years 7-11 44 3.7 63 4.7 107 4.2 

Age-gender-adjusted percentages of pupils exceeding the weekly recommended 

maximum number of units of alcohol for adults are presented by deprivation quintiles in 

Figure 139. The underlying data for this figure is given in the APPENDIX on page 883. 

The percentages exceeding these adult guideline limits (21 units for males, 14 units for 

females) were small for each quintile. Nonetheless, there were differences between the 

quintiles, with more than 5% of pupils living in the three most deprived fifths of areas in 

Hull exceeding these limits, highest in the middle quintile at 5.6%. This compared to just 

over 4% of pupils living in the least deprived fifth of areas in the city and just over 3% 

living in the second least deprived fifth of areas. So, although pupils living in the three 

most deprived fifths of areas were less likely to have ever had an alcoholic drink than 

those living in the least deprived areas, they were more likely to drink excessively. 

Figure 139: Age-gender-adjusted percentage of pupils drinking more alcohol over the 

past week than the recommended guideline amounts for adults by deprivation quintile 

6% 

5% 

4% 

3% 

2% 

1% 

0% 




Pupils were asked how often they usually drank alcohol. The percentages of pupils that 

reported drinking alcohol every week are presented in Table 148. Overall, 12% of boys 

and 10% of girls reported drinking alcohol every week. The percentages increased 

rapidly with increasing age. 2% of year 7 pupils drank alcohol each week, rising to 35% 

of year 11 boys and 22% of year 11 girls. More boys than girls in years 10-11 drank 

alcohol weekly, with similar percentages before that, except year 9 where 6% of boys 

and 3% of girls drank alcohol each week. 

Table 148: Drinks alcohol every week by gender and school year 

School year Drinks alcohol every week 


N % N % N % 

Year 7 5 1.7 6 2.0 11 1.9 

Year 8 15 5.7 8 2.9 23 4.3 

Year 9 19 7.7 20 8.5 39 8.1 

Year 10 48 15.8 46 14.6 94 15.2 

Year 11 62 35.4 56 21.9 118 27.4 

Years 7-11 149 11.7 136 9.9 285 10.7 

The frequency of getting drunk was also reported, with the results, by gender and school 

year, presented in Figure 140. Among girls 80% in year 11 had been drunk, half of 

whom got drunk at least once a month. Among boys, 71% had been drunk, again with 

half of those getting drunk at least once a month. Higher percentages of girls than boys 

in each school year except year 7 had ever been drunk. Few in years 7 to 9 reported 

getting drunk weekly or monthly, although percentages were higher in year 9 girls than 

boys. The underlying data for this figure is given in the APPENDIX on page 883. 



Figure 140: How often do you get drunk, by gender and school year 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 


Males Females 

Never drunk 

alcohol 

Never been 

drunk 

Less than 

monthly 

Monthly 

Weekly 

Pupils that had ever drunk alcohol were also asked about some of the things that had 

happened to them after drinking alcohol. The results for boys are presented in Figure 

141 and for girls in Figure 142. The information is presented for 665 boys and 768 girls 

who answered the question(s). Overall, 745 boys and 860 girls had said they had 

previously been drunk (Figure 140). More girls than boys reported getting drunk (66% 

and 54% respectively); were sick or vomited (38% and 29% respectively); had 

unprotected sex (10% and 7% respectively); tried smoking (17% and 8% respectively) or 

had memory loss (21% and 11% respectively). More boys than girls had committed a 

crime (12% and 9% respectively); had committed an act of vandalism or damaged 

property (11% and 8% respectively); got into an argument (19% and 14% respectively) 

or had attended casualty (9% and 7% respectively). The underlying data for this figure is 




Figure 141: Percentage of males that had ever drunk alcohol who had suffered ill effects 

after drinking alcohol in the past year 

Caused others to complain to the police 

Arrested 

Vandalised or damaged property 

Committed a crime 

Passed out 

Had memory loss 

Tried illegal ldrugs 

Tried smoking for the first time 

Had unprotected sex 

Was sick/vomited 

Missed school 

Attended casualty (A&E) 

Got into a fight 

Got into an argument 

Got drunk 

0% 10% 20% 30% 40% 50% 60% 

Figure 142: Percentage of females that had ever drunk alcohol who had suffered ill 

effects after drinking alcohol in the past year 

Caused others to complain to the police 

Arrested 

Vandalised or damaged property 

Committed a crime 

Passed out 

Had memory loss 

Tried illegal ldrugs 

Tried smoking for the first time 

Had unprotected sex 

Was sick/vomited 

Missed school 

Attended casualty (A&E) 

Got into a fight 

Got into an argument 

Got drunk 

0% 10% 20% 30% 40% 50% 60% 70% 



While two thirds of boys overall that had ever drunk alcohol had experienced at least 

one of these ill-effects after drinking alcohol, three-quarters of girls had done so (Table 

149). The percentage of pupils that had ever drunk alcohol that reported ill-effects from 

that consumption increased with age, from 47% of boys and 54% of girls in year 7 to 

85% of boys and 89% of girls in year 11. In each year, the percentage of girls that had 

ever drunk alcohol and had experienced any ill-effects from that consumption was 

greater than the percentage of boys. 

Table 149: Percentage of pupils that had ever drunk alcohol and had experienced any ill 

effects from that consumption, by gender and school year 

School year Percentage of pupils that had ever drunk alcohol and had 

experienced any ill effects from that consumption 


N % N % N % 

Year 7 46 46.5 33 54.1 79 49.4 

Year 8 50 51.5 63 52.1 113 51.8 

Year 9 78 56.9 103 69.6 181 63.3 

Year 10 134 74.0 167 79.5 301 77.0 

Year 11 121 84.6 201 88.9 322 87.3 

Years 7-11 429 65.3 567 74.0 996 69.9 

Further information such as where young people obtain their alcohol is available in the 

survey report at www.hullpublichealth.org. 

8.8.5 Inpatient Hospital Admissions 

During the three financial years 2006/07 to 2008/09, there were 266,889 clinician 

episodes for daycase or inpatient admissions for Hull residents (for explanation of 

clinician episodes see section 12.12 on page 781). Less than 1% of these clinician 

episodes (1,834) had a primary diagnosis that was alcohol-related (for medical 

conditions see Table 417). The majority of these were due to mental and behavioural 

disorders due to use of alcohol or alcoholic liver disease. Overall, 1,234 of the clinician 

episodes were due to mental and behavioural disorders due to use of alcohol (mainly 

560 acute intoxication, 17 harmful use, 192 dependence syndrome and 449 withdrawal 

state with or without delirium), 44 were due to alcoholic gastritis, 407 due to alcoholic 

liver disease and 122 due to alcohol-induced chronic pancreatitis. Overall, there were 

7,575 clinician episodes (2.8%) that had a primary or secondary 45 diagnosis that was 

alcohol-related. Table 150 examines the number of patient stays/admissions where any 

clinician episode has an alcohol-related primary diagnosis and the number of patients 

this relates to separately over the three year period. It is not surprising that the number 

of admissions are higher than the number of patients as the same patients may be 

45 Up to four secondary diagnosis codes are recorded for the hospital episode statistics. 



admitted more than once within the year. The total number of patients over the three 

Localities and over the three years do not necessarily sum to the total for Hull and the 

total for over the three years respectively. It is possible that a small number of patients 

within a year have lived in more than one Locality, and if this is the case they will be 

counted/included in Table 150 for each Locality they have lived in during that year but 

will only count once for the Hull total. When calculating the total number of patients 

admitted over the three year period, it is highly likely that there will be some patients 

who have been admitted during two or three of the financial years, as some of these are 

long-term medical conditions. Table 151 presents the same information but relative to 

the total population as estimated from the GP registration file (October 2008). It is not 

unsurprising that West Locality has the highest admission rate per 100,000 resident 

population and the highest number of patients admitted at some point during the 

financial year per 100,000 resident population as this Locality covers the centre of the 

city. People who may have alcohol dependence may be more likely to live in this 

Locality due to the cost and type of accommodation provided within West Locality. Note 

that Table 151 does not take into consideration the age structure of the population, and 

this could have an influence on the admission rate. However, despite this limitation, the 

tables give an indication on the absolute number of admissions and patients, and the 

relative difference among the three Localities in terms of the rates. 

Table 150: Total number of alcohol-related (primary diagnosis) daycase and inpatient 

admissions and patients admitted over three year period 2006/07 to 2008/09 

Financial 

year 

Total number of alcohol- related primary diagnosis inpatient 

admissions (and patients admitted) by Locality, 2006/07–2008/09 


2006/07 106 (82) 123 (98) 249 (200) 478 (375) 

2007/08 101 (91) 149 (122) 230 (175) 480 (386) 

2008/09 96 (79) 136 (106) 270 (204) 502 (385) 

Total 303 (221) 408 (292) 749 (493) 1,460 (983) 

Table 151: Alcohol-related (primary diagnosis) daycase and inpatient admissions and 

patients admitted over three years, annual rate per 100,000 resident population 

Financial 

year 

Annual rate of alcohol- related primary diagnosis inpatient admissions 

(and patients admitted) by Locality per 100,000 population 


2006/07 170 (132) 130 (103) 237 (190) 182 (143) 

2007/08 162 (146) 157 (129) 219 (166) 183 (147) 

2008/09 154 (127) 143 (112) 257 (194) 191 (147) 

Average 162 (118) 143 (103) 237 (156) 186 (125) 



8.8.6 Mortality From Alcohol-Related Diseases and Conditions 

Whilst cirrhosis can be caused by Hepatitis B, C and D and other genetic disorders such 

as diabetes or Wilson‟s disease, a common cause is alcoholism. From the 

Compendium, mortality from chronic liver disease including cirrhosis is given in Table 

152 for Hull and comparators (see section 3.3.3 on page 44) for 2006-2008 from the 

Compendium. 

For virtually all of the local authorities, the numbers dying aged 75+ is generally less 

than three so the data is not presented due to confidentiality reasons. The mortality rate 

in Hull overall (all ages) is lower than the Industrial Hinterlands and the average of the 

10 comparators for both men and women. However, the total number of deaths are 

relatively small. In Hull, there were only 17 and 7 deaths for men and women 

respectively on average per year. 

Table 152: Mortality from chronic liver disease including cirrhosis for 2006-2008 in Hull 

and comparator areas 

Area Mortality from chronic liver disease including cirrhosis per 

100,000 population, 2006-2008 

Males, aged (years) Females, aged (years) 

35-64 65-74 75+ All ages 35-64 65-74 75+ All ages 

England 26.7 30.8 21.0 15.1 13.2 17.5 14.2 8.4 

Hull 32.7 * * 15.9 10.1 * * 6.1 

Y&H SHA 27.8 27.3 15.7 15.0 13.2 15.9 14.6 8.4 

Ind Hinterlands 39.0 37.2 21.0 21.5 21.0 19.7 15.2 12.4 

Wolverhampton 68.4 * * 32.9 24.6 * 19.7 14.7 

Salford 53.4 59.8 * 27.7 34.4 51.0 * 18.5 

Derby 34.4 44.6 * 18.0 20.4 * 14.6 10.4 

Stoke-on-Trent 41.2 51.2 * 24.5 27.1 25.2 * 14.7 

Coventry 43.4 40.5 26.3 20.6 22.9 * * 10.6 

Plymouth 21.5 49.8 * 13.7 11.6 * * 7.2 

Sandwell 53.7 56.4 23.9 28.7 23.7 * * 12.8 

Middlesbrough 43.2 33.0 * 21.4 16.3 * 32.9 11.0 

Sunderland 46.7 51.4 * 24.7 17.1 * 18.1 10.6 

Leicester 35.8 43.5 * 16.5 12.6 24.2 9.3 7.3 

Avr’ge 10 above 44.2 46.9 19.9 22.9 21.1 23.6 16.5 11.8 

NE Lincolnshire 22.3 14.6 * 11.8 4.2 * * 4.2 

*Rates too small to present (N


The Compendium only examines this single alcohol-related disease. As mentioned 

above, cirrhosis can be caused by Hepatitis B, C and D and other genetic disorders 

such as diabetes or Wilson‟s disease, so alcohol may not be a factor for all people dying 

of chronic liver disease. There are also other alcohol-related causes of death. It is 

possible to examine this wider range of alcohol-related causes of death using the cause 

of death from the Public Health Mortality File. The causes of death covered by this are 

given in Table 417 on page 813. The total number of deaths (over all ages) registered 

over the three year period 2007-2009 and the average annual directly standardised 

mortality rate (DSR) per 100,000 persons are given in Table 153 for men and women 

respectively. It can be seen that the total number of deaths were small; only 92 in total 

with an average of 23 deaths per year in men and seven deaths per year in women. The 

95% confidence intervals are given for the DSRs and it is more important to examine 

these rather than the actual DSRs as, due to the small number of deaths, the confidence 

intervals are wide suggesting uncertainty associated with the DSR estimates. 

Of the 69 deaths for men, 29 were registered during 2009 with 19 registered in 2007 and 

21 in 2007. The majority of these deaths were due to alcoholic liver disease (n=57) or 

mental and behavioural disorders due to use of alcohol (n=8) which includes acute 

intoxication, harmful use and dependence syndrome, and a further four deaths were 

classified as accidental poisoning by and exposure to alcohol. All the alcohol-related 

deaths for women were due to alcoholic liver disease (n=16) or mental and behavioural 

disorders due to use of alcohol (n=7). 

Table 153: Deaths from alcohol-related diseases and medical conditions in Hull, 2007- 

2009 

Locality Deaths from alcohol-related diseases and medical conditions in Hull 2007-09 

Men Women 

Total number Average annual DSR Total number Average annual DSR 

2007-2009 per 100,000 men 2007-2009 per 100,000 women 

North 20 23.6 (14.3 to 36.5) 3 3.7 (0.7 to 11.0) 

East 22 14.6 (9.1 to 22.2) 4 2.9 (0.8 to 7.5) 

West 27 16.4 (10.8 to 24.0) 16 10.5 (5.9 to 17.2) 

HULL 69 17.2 (13.4 to 21.8) 23 6.0 (3.8 to 9.1) 

8.8.7 Attitudes Towards Alcohol 


responders about their perceived impact on health of reducing the amount of alcohol 

consumed. The information is presented in section 8.3 on page 244 from the Social 

Capital Survey 2009, with additional information examining differences among the 

genders, age groups, Localities and deprivation quintiles available in the Social Capital 

Survey 2009 report at www.hullpublichealth.org. 

Further information on factors influencing the prevalence of never drinking alcohol, 

excessive weekly units, binge drinking or excessively weekly units and/or binge drinking 



is given in section 8.8.10 on page 364 and in the 2007 Health and Lifestyle Survey 

Alcohol report. Attitudes to alcohol consumption were collected as part of Reflector 

Groups following the 2007 Health and Lifestyle Survey (see section 13.2.2.2 on page 

795) and the 2008-09 Young Person Health and Lifestyle Survey (see section 13.2.2.3 

on page 796). The full reports from both of these Reflector Groups as well as the full 

survey reports are available at www.hullpublichealth.org. Information on opinions and 

attitudes towards alcohol were collected within focus groups as part of the Attitudes to 

Health project conducted during 2007 (see section 13.2.2.1 on page 794). 

8.8.8 Alcohol Consumption in Relation to Deprivation 

Which groups of people never drank alcohol or drank excessive amounts and/or binge 

drank was examined in a report specifically on alcohol consumption (from the Health 

and Lifestyle Survey 2007). The full report is available at www.hullpublichealth.org. 

This report found that measures of deprivation (Index of Multiple Deprivation, household 

income, highest educational attainment, etc) were related to alcohol consumption with 

people in the more deprived areas being more likely to never drink alcohol. However, 

deprivation was neither associated with excessive alcohol consumption nor binge 

drinking. Using information from the local 2009 Prevalence Survey, a similar finding 

was observed, with a trend in non-drinking from the most deprived quintile (28.7%) to 

least deprived quintile(17.2%), but no other trends are identified for other sub-categories 

of alcohol consumption (Figure 143). Overall, there was not a statistically significant 

relationship between deprivation and alcohol consumption ( 2 test for trend, 5.2, p=0.23). 

The underlying data for this figure is given in the APPENDIX on page 884. 

Figure 143: Prevalence of alcohol consumption by local deprivation quintile 



8.8.9 Alcohol Consumption in Relation to Employment Status 

The level of alcohol consumption differs among the six employment categories, with 

consumption tending to be lower (i.e. never drinking or within weekly limits with no binge 

drinking) for people either retired or looking after the home (Figure 144). Also, those in 

full-time education have one of the larger proportions of non-drinkers but this is likely to 

include a large number of respondents who were below the legal drinking age (aged 16- 

17). The trend in the percentages over the employment categories is statistically 

significant ( 2 test, 151, p


underage and the need for a campaign for „proxy buyers‟ promoting their responsibility 

not to purchase for young people. A creative company was commissioned to take this 

work forward. The company was also working in partnership with Hull City Council to 

explore using the Clued Up in Hull website with the potential of tapping into this popular 

young people‟s resource. 

A report specifically on Alcohol using information from the 2007 Health and Lifestyle 

Survey also examines associations between the prevalence of (i) never drinking; (ii) 

excessive drinking; (iii) binge drinking; and (iv) excessive and/or binge drinking 

(„problem drinking‟) and other factors such as general health, measures of deprivation, 

and other risk factors such as smoking, etc. The report found that numerous factors 

associated with deprivation such as educational attainment and household income were 

strong predictors for those who never drank alcohol (it is speculated that alcohol was 

relatively too expensive and people living in deprived areas preferred to spend their 

money on tobacco). However, few factors were predictive of drinking excessively and/or 

binge drinking. Younger people, males and smokers more likely to drink excessively or 

binge drink. For men only, there was a relationship with 5-A-DAY in that men who ate 

few portions of fruit and vegetables were also more likely to drink to excess or binge 

drink. This means that a broad approach is necessary as specific groups other than 

those defined on the basis of age, gender and smoking status cannot really be targeted 

in terms of reducing their alcohol intake. 

Attitudes to alcohol consumption were collected as part of Reflector Groups following 

the 2007 Health and Lifestyle Survey (see section 13.2.2.2 on page 795) and the 2008- 

09 Young Person Health and Lifestyle Survey (see section 13.2.2.3 on page 796), as 

well as in the Attitudes to Health Focus Groups conducted during 2007 (see section 

13.2.2.1 on page 794). Further information on attitudes to alcohol are given in section 

8.3 on page 244 and in section 8.8.7 on page 362. The survey and reflector group 

reports all all available at www.hullpublichealth.org. 

8.8.11 Alcohol Strategy 

A multi agency partnership previously produced the Hull and East Riding Alcohol 

Strategy and this was being replaced by a Strategy for Hull only, with the new Strategy 

and Action Plan focusing on the Local Area Agreements (LAA) 2 indicators and 

particularly addressing alcohol-harm related hospital admissions. Following the change 

in the government in May 2010, the LAA2 has been replaced, but it is likely that the 

same elements and programmes will continue as least in the short-term. 


In the local World Class Commissioning (WCC) strategy, there were targets for alcohol 

which were related to activity such as the number of people given brief and extended 

intervention or signposting, number of schools and colleges engaged, etc. The targets 

start from 2009/2010 with a target of 2,600 people per annum given brief intervention or 



signposting regarding their alcohol intake, with 1,040 of these people being given 

extended brief interventions with 520 young people addressing their drinking as a result. 

The brief interventions and signposting will be undertaken by a broad range of 

individuals not exclusively within healthcare, and this approach uses a multi-disciplinary 

approach. 


under consultation (see section 3.3.6.2 on page 52). One of the outcomes under 

consultation is the under 75 mortality rate from chronic liver disease, presumably in 

order to measure alcohol-related liver disease. However, this would be a poor outcome 

measure. Firstly, a number of chronic liver disease deaths occur due to other conditions 

such as Hepatitis B, C and D and other genetic disorders such as diabetes or Wilson‟s 

disease. Secondly, the numbers of deaths are small, and there is considerable year-onyear 

variability, which makes measuring trends over time incredibly difficult. 

Another measure within the proposals is hospital admissions for alcohol-related harm. 

The numbers are higher for this measure so it is not as dependent on small numbers. 

However, the measure is highly dependent on coding, and it is possible that the coding 

of alcohol as a factor could vary over time, and could differ depending on the clinicians‟ 

specialist interest and knowledge. The quality of the coding could also be influenced by 

national and local campaigns relating to alcohol. Furthermore, admission rates could 

differ depending on care pathways and local healthcare services, e.g. the decision to 

admit or discharge a patient following presentation at A&E. Note that this measure is an 

existing outcome measure, and the definitions of this differ from the definition used in 

Table 151. 



8.9 Drug and Substance Abuse 



It is difficult to estimate the number of problem drug users, and there are generally two 

methods used. The multiple indicator method is a regression analysis which produces a 

modelled estimate using information typically drawn from health (e.g. client lists supplied 

by drug treatment agencies) and/or criminal justice (e.g. police records and probation 

data) sources, but some of the information included in the model is modelled itself using 

the capture-recapture method 46 . 

More recent estimates are available for 2008/2009 from the University of Glasgow which 

is presented in Hull‟s Adult Substance Misuse Needs Assessment 2011/2012 (Hull 

Community Safety Partnership 2011). The numbers of problematic drug users 47 for Hull 

for 2008/2009 was estimated to be 3,464 in their model which was a reduction of 185 

from 2006/2007. The overall prevalence was estimated to be 19.2 per 1,000 population 

aged 15-64 years (assuming a population of 180,800 for those aged 15-64 years). A 

significant change has been seen in the prevalence rates for the opiate-using drug 

group. The prevalence rate fell for opiate use from 20.3 to 16.3 per 1,000 population 

aged 15-64 years (with estimated numbers falling by 554 from 3,506 to 2,952). 

However, the prevalence of crack rates remained unchanged. 

The estimated number of drug users are given in Table 154 for 2006/2007 and 

2008/2009 (with 95% confidence intervals for the most recent year). 

Despite a reduction in the rate, Hull‟s prevalence of problem drug users is the 7 th highest 

in the country. The rate of opiates use in Hull is the 5 th highest nationally, and the crack 

prevalence is the 41 st highest nationally 48 . Figures are not available for 2008/2009 

regarding the injecting of drugs, however historically these rates have been high in Hull 

and continue to remain high. 

46 Hay (Hay, Gannon et al. 2006) describes the method “Capture-recapture methods were first developed 

over a century ago to estimate the size of animal or fish populations. In its basic form the method involves 

capturing a sample of animals, marking and then releasing them. A second sample is then captured; the 

population of marked animals in this second sample is assumed to be equivalent to the proportion of 

animals in the population that were in the first sample. Thus if 100 fish were caught, marked and 

released, and a further sample of fish is caught of which 10% were previously marked, then the 100 fish in 

the first sample is equivalent to 10% of the population, hence the population size is 1,000”. 

47 „Problem Drug Use‟ refers to use of opiates and/or crack cocaine, including those who inject either of 

these drugs. It does not include the use of cocaine in a powder form, amphetamine, ecstasy or cannabis, 

or injecting by people who do not use opiates or cocaine. Although many opiate and/or crack users also 

use these drugs it is very difficult to identify exclusive users of these drugs from the available data 

sources. 

48 Presumably out of 354 local authorities (pre April 2009) or 326 current local authorities (as at April 

2009), but report does not say geographical areas being rated or whether it is England or UK. 



Table 154: Estimated number of drug users in Hull 

Period Users Number (95% CI) Prevalence per 1,000 

population aged 15- 

2006/2007* 

64 years (95% CI) 

Problem drug users 3,649 (3,231 to 4,397) 20.9 

Opiate users 3,506 (3,123 to 4,412) 20.3 

Crack users 1,291 (1,056 to 1,633) 7.4 

Problem drug users 3,464 (3,039 to 3,918) 19.2 (16.8 to 21.7) 

2008/2009 Opiate users 2,952 (2,644 to 3,274) 16.3 (14.6 to 18.1) 

Crack users 1,348 (959 to 1,724) 7.5 (5.3 to 9.5) 

*The numbers differ from those quoted in Release 2 of the JSNA Foundation Profile as these 

figures were updated by the University of Glasgow when they estimated the number of drug 

users for 2008/2009. Confidence intervals are also not available for the prevalence estimates. 

Figure 145 gives the prevalence estimates by age for 2008/2009 per 1,000 population 

(with 95% confidence intervals). The underlying data for this figure is given in the 

APPENDIX on page 885. The rates of problem drug users in Hull are statistically 

significantly higher than both the Yorkshire and Humber region and England for all three 

age groups. However, given the increased deprivation in Hull compared to the average 

for the Yorkshire and Humber region and England, it is not surprising that this is the 

case. 

Figure 145: Rate of problem drug users per 1,000 population by age in Hull, Yorkshire 

and Humber and England, 2008/2009 

Rate per 1,000 population (95% confidence intervals) 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

15-24 25-34 35-64 

Age (years) 

Hull Yorkshire & Humber England 



The local adult Health and Lifestyle Survey 2007 did not ask about drug usage so 

prevalence information cannot be estimated from this source. Mortality information is 

included within the mental health section (see section 10.9.8 on page 706). 

8.9.1.2 Prisoners 

Directly from Hull‟s Adult Substance Misuse Needs Assessment 2011/2012 report: “In 

the centre of Hull is Her Majesty‟s Prison (HMP) Hull, a community and local prison 

holding remand, sentenced and convicted adult males and young offenders. Hull prison 

receives prisoners from Hull, York and Grimsby Crown Courts and Magistrates Courts 

from around the Yorkshire region. It has an operational capacity of 1,044 prisoners, and 

approximately 3,600 annual receptions, the prison has a high number of short sentences 

and remand prisoners, resulting in a high throughput of prisoners. Almost half (45%) of 

prisoners are likely to be in the prison for one month or less, and this leads to distinct 

challenges when providing health and social care services. Discharges are mostly into 

the local area, or to training prisons within Yorkshire and the Humber. Over 80% of the 

prison population had a local address (within approximately 50 miles of the prison).” 

(Hull Community Safety Partnership 2011). 

Table 155 provides estimates of total prisoners with drug problems within HMP Hull. 

Figures have been provided for the total number of prisoners with drug problems, but 

the prevalence figures were not provided. However, within the local needs assessment 

(Hull Community Safety Partnership 2011), the prevalence estimates have been 

estimated assuming that there are a total of 3,600 people going through the prison 

within the course of a year and using information from the Drug Intervention Record 

(DIRWeb) for the CARAT service (Counselling, Assessment, Referral, Advice and 

Throughcare 49 ) for the financial year 2009/2010. The high rates of drug use in particular 

opiate use will have an impact on reoffending rates. 

Table 155: Estimated number of drug users in Hull Prison 

Drug All prisoners 

Estimated 

number 

Estimated prevalence per 1,000 prisoners 

Crack 117 32.5 (26.9, 39.0) 

Heroin 502 139 (128, 152) 

Methadone 32 8.89 (6.08, 12.55) 

Subutex 34 9.44 (6.54, 13.20) 

Opiates 568 158 (145, 171) 

Problem drug users 573 159 (146, 173) 

49 The CARAT service was established in 1999 as a universal drug treatment service in every prison 

establishment across England and Wales. CARAT services (CARATs) are a major element of the Prison 

Service Drug Strategy. 




The Young People Health and Lifestyle Survey 2008-09 asked pupils if anyone had 

offered or encouraged them to try any drugs in the last three months, and if they had 

ever used or tried any drugs. 

Around 1 in 10 pupils reported they had been offered or encouraged to try drugs in the 

last three months (Table 156), 9% of boys and 11% of girls. Percentages increased 

with school year with the exception of year 7, where higher percentages reported being 

offered or encouraged to try drugs than in year 8. It is not clear whether this reflect the 

reality or whether there were some comprehension issues around what constituted 

illegal drugs among these pupils. In either case, the numbers are relatively small. 

By year 11, almost 1 in 5 pupils reported they had been offered or encouraged to try 

drugs in the preceding three months, again slightly higher in girls. In years 7 and 8 

larger percentages of boys reported being offered or encouraged to use drugs, while in 

years 9 to 11, the percentages were higher among girls. 

Table 156: Has anyone offered or encouraged you to try any drugs in the last three 

months, by gender and school year 

School 

year 

Has anyone offered you or encouraged you to try drugs in 

the last three months? 


N % N % N % 

Year 7 16 6.0 14 5.0 30 5.4 

Year 8 9 3.9 9 3.4 18 3.6 

Year 9 20 8.8 30 13.0 50 10.9 

Year 10 32 11.5 43 14.3 75 12.9 

Year 11 30 18.5 50 19.8 80 19.3 

Years 7-11 107 9.2 146 11.0 253 10.1 

The types of drugs that pupils reported being offered or encouraged to try are presented 

in Figure 146 restricted to pupils in years 9 to 11. The drug that pupils most commonly 

reported they were offered or encouraged to try was cannabis which 13% of girls and 

more than 8% of boys reported being offered or encouraged to try. The next most 

common was ecstasy for girls and cocaine for boys, each around 2%. The underlying 




Figure 146: What drugs have you been offered or encouraged to try in the last three 

months, by gender (years 9 to 11 only) 

Females Males 

Pupils were also asked if they had ever used or tried drugs, as well as the type of drug 

they had used or tried, and when they had last used or tried them. The percentages that 

had ever used drugs, by school year and gender are presented in Table 157. Only a 

very small number of pupils in years 7 and 8 reported ever using drugs. Among the 

older year groups, the percentages increased with school year, and were higher in girls 

than boys for each year group. By year 11, 22% of girls and 18% of boys reported that 

they had used or tried drugs. 

Table 157: Have you ever used or tried any drugs, by gender and school year 

School 

year 

Anabolic steroids 

Cannabis 

Cocaine 

Ecstasy 

Heroin 

LSD 

Solvents 

Other drugs 


Cannabis 

Cocaine 

Ecstasy 

Heroin 

LSD 

Solvents 

Other drugs 

0% 2% 4% 6% 8% 10% 12% 14% 

Have you ever used or tried any drugs? 


N % N % N % 

Year 7 0 0.0 3 1.1 3 0.5 

Year 8 4 1.7 3 1.2 7 1.4 

Year 9 11 5.0 22 9.6 33 7.3 

Year 10 20 7.2 37 12.3 57 9.9 

Year 11 29 18.4 55 21.8 84 20.5 

Years 7-11 64 5.5 120 9.1 184 7.4 



Data for pupils in years 9 to 11 are presented in Figure 147 in relation to which drugs 

they had used or tried, and when. Cannabis was by far the most common drug that 

pupils reported using or trying, with almost 13% of girls and half that percentage of boys 

reporting they had used or tried cannabis at some point, with 5% of girls and 2% of boys 

saying that they had done so in the past 4 weeks. Among girls the most commonly used 

drugs after cannabis were cocaine, ecstasy and solvents, although in each case fewer 

than 2% of girls reported ever using these drugs. Among boys the most commonly used 

drugs after cannabis were cocaine and LSD, again with fewer than 2% of boys reporting 

using each of these. All other drugs were used by 1% or fewer pupils. The underlying 


Figure 147: Which drugs have you used*, by gender (years 9 to 11 only) 

Females Males 


Cannabis 

Cocaine 

Ecstacy 

Heroin 

LSD 

Solvents 

Other 


Cannabis 

Cocaine 

Ecstacy 

Heroin 

LSD 

Solvents 

Other 

0% 2% 4% 6% 8% 10% 12% 14% 

*Solid colour=within last 4 weeks; stripes=within past year; chequerboard=more than 1 year ago 

The age-gender-adjusted percentages of pupils, in years 9 to 11 only, reporting that they 

had ever used drugs are presented in Figure 148 by deprivation quintiles. There is a 

clear gradient with the percentage reporting ever using or taking drugs increasing as the 

level of deprivation increased. The only quintile where this was not the case was the 

most deprived quintile, where the percentage was slightly lower than the second most 

deprived quintile. Nine percent of pupils in the least deprived fifth of areas in Hull 

reported ever using or taking drugs. This was more than 40% lower than the 13% and 

16% of pupils in the most deprived and second most deprived fifths of areas in Hull, 

respectively. The underlying data for this figure is given in the APPENDIX on page 886. 



Figure 148: Age-gender-adjusted percentage of pupils reporting they had ever used or 

tried drugs, by deprivation quintile (years 9 to 11 only) 

16% 

14% 

12% 

10% 

8% 

6% 

4% 

2% 

0% 


In the 2008-09 Health and Lifestyle Survey the format of the questions on drug use was 

changed from those used in the previous survey. Pupils were first asked (question 66) 

whether anyone had offered or encouraged them to try any drugs in the last three 

months. If the answer was yes, pupils were asked in question 67 to tick which drugs 

they had been offered or encouraged to try, from a list of 9 different types of drugs. If 

the answer to question 66 was no, they were asked to skip to question 68. This 

question asked whether they had ever used or tried any drugs. If they answered yes to 

question 68 pupils were asked to answer question 69, which listed the 9 types of drugs 

again, with tick boxes against each one for when the drug was last used or tried. Again, 

if pupils ticked no to question 68 they were asked to skip to question 70. 

In the 2002 survey the two filter questions outlined above were not asked, so all pupils 

were asked to answer the questions on the types of drugs they had been offered or 

encouraged to try in the last three months and on the types of drugs they had used or 

tried, each with a list of 17 different types of drugs. 

A comparison of the two surveys (restricting to those aged 15 years and under) in Table 

158 shows a steep fall in the percentages of pupils in years 7 to 10 reporting they had 

been offered or encouraged to try drugs in the last three months, decreasing by 64% in 

boys 65% in girls. 



Table 158: Has anyone offered or encouraged you to try any drugs in the last three 

months by gender and school year (years 7 to 10 only), with comparisons to Hull 2002 

School 

year 

Percentage of pupils offered or encouraged to try drugs in 

the last three months 


2008 2002 2008 2002 2008 2002 

Year 7 6.0 10.0 5.0 8.7 5.4 9.3 

Year 8 3.9 9.2 3.4 13.2 3.6 11.5 

Year 9 8.8 22.2 13 31.3 10.9 26.7 

Year 10 11.5 46.2 14.3 48.3 12.9 47.5 

Years 7-10 7.7 21.2 8.9 25.3 8.3 23.4 

Similar large decreases were seen in the percentages of year 7 to 10 boys and girls 

reporting they had ever used drugs (Table 159), where the percentage of boys 

decreased by 71% since 2002 and the percentage of girls decreased by 67%. These 

decreases are so great, that it seems probable that the change in the format of the 

drugs questions had a very large impact on the results. 

Table 159: Have you ever used or tried any drugs, by gender and school year (years 7 

to 11 only), with comparisons to Hull 2002 

School 

year 

Percentage of pupils that ever used or tried drugs 


2008 2002 2008 2002 2008 2002 

Year 7 0.0 2.9 1.1 6.0 0.5 4.6 

Year 8 1.7 4.7 1.2 8.1 1.4 6.7 

Year 9 5.0 12.3 9.6 22.5 7.3 17.4 

Year 10 7.2 29.9 12.3 37.2 9.9 34.1 

Years 7-10 3.5 11.9 6.1 18.5 4.8 15.5 

This impression is reinforced when comparing with the level of drug use among young 

people reported for England in 2007, as well as changes in these percentages for 

England between 2001 and 2007, which are presented in Figure 149. Between 2001 

and 2007 the overall percentage of young people in England aged 11 to 15 years that 

reported using drugs decreased by 13% in boys and 14% in girls, with percentages for 

both years substantially higher than Hull 2008-09. The underlying data are given in the 


Consequently, comparisons with the previous Hull Health and Lifestyle Survey, and 

indeed with the England Survey, should be undertaken with extreme caution. 

Nonetheless, the comparisons have been included here for completeness. 



Figure 149: Have you ever used drugs by age and gender, Hull 2002 and 2008-09, 

England 2001 and 2007 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

A Children and Young People Alcohol and Substance Misuse Health Needs 

Assessment is currently been undertaken by the local authority in partnership with NHS 

Hull and other key stakeholders (see section 13.3.2 on page 802). 


Mortality from drug misuse can be found in section 10.9.8 on page 706. 

8.9.3 Young People’s Attitude Towards Drugs 

England 2001 England 2007 Hull 2002 Hull 2008 

11 years 12 years 13 years 14 years 15 years 16 years 11 years 12 years 13 years 14 years 15 years 16 years 

Males Females 

Attitudes to drugs were collected as part of Reflector Groups following the 2008-09 

Young Person Health and Lifestyle Survey (see section 13.2.2.3 on page 796), and the 

full report is available at www.hullpublichealth.org. 



8.10 Prevalence of Multiple Risk Factors 

8.10.1 From Adult Health and Lifestyle Survey 2007 

From the Attitudes to Health Survey (see page 794) completed during 2007 in Hull for 

people aged 40-60 years, the reflector group work following the 2007 Health and 

Lifestyle Survey (see page 795), and more detailed analysis completed for the reports 

on obesity and exercise, alcohol and smoking completed following the latter survey, it is 

clear that there is an association between risk factors in particular a relationship 

between alcohol and smoking, and between lack of exercise, diet and obesity. For all of 

these risk factors, gender, age and deprivation are confounders (see section 12.2 on 

page 772) with a tendency for certain groups to have multiple risk factors. For example, 

young men and women have a higher prevalence of both smoking and alcohol 

consumption. For some diseases and medical conditions, there is evidence that the 

presence of multiple risk factors increases the risk of developing the disease or dying 

prematurely from that disease. Therefore, in assessing risk of future disease, it is useful 

to examine the prevalence of multiple risk factors, and it is possible to examine this 

using the information collected as part of the adult Health and Lifestyle Survey. 

Table 160 and Table 161 present information on the prevalence of multiple risk factors 

using the 2007 survey information 50 for men and women respectively. The risk factors 

are defined in the following manner (see section 13.4 on page 805 for more 

information): 

Smoking: smoking daily or occasionally; 

Alcohol: exceeding the weekly recommended alcohol units in the week prior to 

the survey (21 units for men and 14 units for women) and/or binge drinking 

usually at least once a week (exceeding twice the daily recommended alcohol 

units, i.e. exceeding 8 units for men and 6 units for women on a single day); 

Lack of exercise: not undertaking the recommended weekly guidelines for 

exercise, i.e. not undertaking at least 30 minutes of moderate or vigorous 

exercise on at least five days a week; 

Obesity: defined as obese on the basis of having a body mass index or 30 or 

more (based on adjusted height and adjusted weight – see section 13.4.1.1 on 

page 805 for more information); 

5-A-DAY: less than five portions of fruit and vegetables usually consumed each 

day. 

Table 160 shows the estimated number and percentage of men in the survey for the 

combination of risk factors, and estimates the total number of men aged 18+ years for 

Hull if the prevalence is multiplied up by the estimated resident population (103,760 men 

as at October 2008). The estimated percentage is based on the number of men who 

50 The estimates have not been updated for the more recent data as the numbers surveyed during the 

2009 Prevalence Survey were fewer than half that of the 2007 Health and Lifestyle Survey. 



answered all five of the questions relating to these risk factors, which was 1,787 (89.6% 

of those participating in the survey). It can be seen that there were only 73 men 

representing 4.1% of the men in the survey who had none of these five risk factors (top 

row), and 27 men representing 1.5% of the men in the survey who had all five risk 

factors (bottom row). 

Table 160: Prevalence of multiple risk factors in men, Hull 2007 

Presence of risk factor (highlighted if present) In survey Estimated 

Smoking Alcohol Lack of Obesity


It is useful to summarise this information as the number of men with zero, one, two, 

three, four and five risk factors (Figure 150). Younger men tend to have a slightly 

higher percentage with more risk factors, but there is not a large difference among the 

age groups with the exception of men aged 75+ years who tend to have fewer risk 

factors. Overall, 1.5% of men had five of the risk factors, 13.1% had four, 30.9% had 

three, 34.6% had two, 15.9% had one and 4.1% had none of the five risk factors. The 

underlying data are given in the APPENDIX on page 887. 

Number of risk factors out of five (%) 

Figure 150: Percentage of men by number of five risk factors, Hull 2007 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

18-24 25-44 45-64 65-74 75+ 

Age of man 

Five Four Three Two One Zero 

Table 161 and Figure 151 gives the equivalent information for women. Examining the 

first and last rows, it can be seen that 67 (4.3%) women had none of the risk factors and 

10 (0.6%) women had all five of the risk factors. Women tend to have less multiple risk 

factors compared to men with a similar pattern across the age groups, i.e. similar 

proportions of women with multiple risk factors across the age groups for those aged 

under 75 years with women aged 75+ years having fewer multiple risk factors. It should 

be noted that information is available on all five risk factors for only 75% of women 

(1,573 out of the 2,092 women participating in the survey). It is not known whether this 

biases the information presented or not. It is possible that women who do not have the 

risk factor did not answer the question as they felt it was irrelevant to them in which case 

the prevalence of multiple risk factors would be over-estimated in the information 

presented below. However, it is also possible that women were more aware of these 

risk factors and were more reluctant to report that they smoked, drank too much alcohol, 

weighed too much, etc. If women did not answer the questions because they had these 

risk factors but were reluctant to complete the information on the questionnaire, then the 



prevalence of multiple risk factors would be under-estimated in the table below. It is 

likely that there is a combination of the above influences present, but it is not known 

which might be the dominant response (possibly the latter). Overall, 0.6% of women 

had five of the risk factors, 7.3% had four, 30.0% had three, 39.3% had two, 18.4% had 

one and 4.3% had none of the five risk factors. The underlying data are given in the 


Table 161: Prevalence of multiple risk factors in women, Hull 2007 

Presence of risk factor (highlighted if present) In survey Estimated 

Smoking Alcohol Lack of Obesity


Figure 151: Percentage of women by number of five risk factors, Hull 2007 

Number of risk factors out of five 

(%) 

100% 

80% 

60% 

40% 

20% 

0% 

18-24 25-44 45-64 65-74 75+ 

Age of woman 

Five Four Three Two One Zero 

8.10.2 From Young People Health and Lifestyle Survey 2008-09 

Using the information from the Young People Health and Lifestyle Survey it is possible 

to examine the prevalence of multiple risk factors in a similar manner as undertaken for 

adults in section 8.10.1. 

The risk factors are defined in the following manner (see section 13.4 on page 805 for 

more information): 

Smoking: smoking occasionally or regularly; 

Alcohol: exceeding the weekly recommended alcohol units in the week prior to 

the survey (21 units for men and 14 units for women) for adults; 

Lack of exercise: not undertaking the recommended weekly guidelines for 

exercise, i.e. not undertaking at least one hour daily; 

5-A-DAY: less than five portions of fruit and vegetables usually consumed each 

day; 

Drugs: previously tried drugs. 

In the same way as occurred for adults, the number of young people who answered all 

five questions relating to smoking status, alcohol consumption in the previous week, 

exercise, 5-A-DAY and drug use, was lower than the total participating in the survey. 

Overall, 981 boys (69.1% of the 1,420 participating in the survey) and 1,124 girls (76.2% 



of the 1,475 participating in the survey) answered all five questions. It is not known if 

the young people who failed to answer one or more of these questions are different in 

any way to the young people who answered all five questions whose information is 

presented below. If the young people who failed to answer all the questions are 

different with respect to their risk factor prevalence then this would introduce a bias into 

the survey results. Young people were told that their information was strictly confidential 

and that it would not be possible to identify their answers or attribute specific answers to 

individuals. They were also asked to complete all questions even those questions that 

they felt were not relevant to them. Nevertheless, it is possible that young people may 

have not answered the question as they did not want to admit that they has smoked, 

drank alcohol, tried drugs, etc. Furthermore, it is possible that young people did not 

answer the question as they felt it was irrelevant to them. It is also possible (particularly 

for the youngest age groups) that young people ran out of time and that the questions at 

the end of the questionnaire were incomplete (questionnaire order: exercise; 5-A-DAY; 

alcohol; smoking; and drug use). 

Table 162 gives the prevalence of multiple risk factors for boys by school year (Year 7 

aged 11-12 years to Year 11 aged 15-16 years) as well as the total estimated number of 

boys in Hull with this combination of risk factors. These figures should be interpreted 

cautiously. For many combinations of risk factors, there are only one or two boys who 

stated that they undertook that particular combination (out of the approximate 200 who 

answered all five questions 51 ) and therefore when extrapolating to the total estimated 

number of boys in Hull with this combination of risk factors the estimates could be quite 

different (as the totals are based on percentages which potentially are subject to 

considerable random variation). 

Table 162: Prevalence of multiple risk factors in boys, Hull 2008-09 

School Presence of risk factor (highlighted if present) In survey Estimated 

year Smoking Alcohol Lack of














8.10.3 From Healthy Heart Study 

The local Healthy Heart Study involved collecting information on age, gender, blood 

pressure, cholesterol, smoking status and whether or not the person had diabetes or 

not. The information was collated into a score (probability) relating to the „10-year risk of 

a cardiovascular event‟. The scoring used within the Healthy Heart Study is given in 

section 13.4.4 on page 810. The people who participated in the Healthy Heart Study 

are not necessarily a representative sample of Hull residents. Information was collected 

at different shopping centres in the East Locality of the city and at specific workplaces. 

Therefore, only certain people would have been able to participate as they happened to 

be at the shopping centre locations at that specific day or worked at the selected 

workplaces. Furthermore, it is likely that the people who were interested in participating 

in the study and having their details recorded were either people who were particularly 

interested in their health or who were concerned about their health. Table 164 gives the 

number and percentage of men and women aged 40-49, 50-59 and 60-69 years by their 

10-year cardiovascular disease (CVD) risk. It was necessary to combine some of the 

risk categories due to the small number of people within individual 5% risk bands. The 

risk tended to be higher for those people who took part at Northpoint shopping centre 

(and this could be associated with deprivation) and lower for those people who 

participated at their workplaces (and this could be that people who were not working due 

to long-term illness and disability were automatically excluded from this group). 

Table 164: CVD 10-year risk in Hull‟s Healthy Heart Study 

Gender CVD 10 

year risk 

Male 

Female 

Number (%) people with specified CVD risk 

by age (years) 

40-49 50-59 60-69 


important not to over-interpret this data. It has already been noted above that the 

participants of the Healthy Heart Study were not necessarily representative of the 

population of Hull. 

Table 165: CVD 10-year risk, England 

Gender Ten year Prevalence of risk of CVD event within 10 years (%) by age 

risk 40-49 50-59 60-69 70-79 Total 

10-


9 VACCINATIONS, IMMUNISATION & SCREENING 

9.1 Childhood Immunisations 

9.1.1 Schedule of Immunisations 

It is recommended that children are vaccinated against diphtheria, tetanus, pertussis 

(whooping cough), polio (inactivated polio vaccine – IPV), haemophilus influenzae type 

b (Hib), pneumococcal infection (pneumococcal conjugate vaccine – PCV), meningitis C 

(MenC), and measles, mumps and rubella (MMR) and that girls receive the human 

papillomavirus (HPV) for types 16 and 18 (NHS, 2009). The vaccines and boosters are 

given at different ages depending on the disease (Table 167) 53 . National targets for 

diphtheria, tetanus and pertussis (DTP) and MMR are both 95%. Non-routine 

vaccinations for babies are available for tuberculosis for babies more likely to come into 

contact with tuberculosis than the general population and for Hepatitis B for babies 

whose mothers are Hepatitis B positive. More detailed local vaccination information is 

available at ward level, practice level and by ethnicity from the Child Health System 

(SystmOne) for 2008/2009. 

Table 167: Schedule of recommended childhood immunisations 

Age of child Single injection for: 

2 months 

Diphtheria, tetanus, pertussis, polio & haemophilus influenzae type b. 

Pneumococcal infection. 

3 months 


Meningitis C. 


4 months Meningitis C. 


Around 12 mths Haemophilus influenzae type b & meningitis C. 

Around 13 mths 

Measles, mumps & rubella. 


3.3 to 5 years 

Diphtheria, tetanus, pertussis & polio. 

Measles, mumps & rubella. 

Girls 12-13 yrs Cervical cancer caused by human papillomavirus types 16 and 18 

13 to 18 years Diphtheria, tetanus & polio. 

53 Also depends on number of previous vaccines, but table assumes all vaccines given at stated age. 



9.1.2 Vaccination Uptake Rates for One Year Olds 

9.1.2.1 Hull Versus Comparator Areas 

The percentages of children aged one year who have had their diphtheria, tetanus and 

pertussis (DTP), polio (inactivated polio vaccine – IPV), haemophilus influenzae type b 

(Hib), meningitis C (MenC), and pneumococcal infection (pneumococcal conjugate 

vaccine – PCV) vaccinations during 2009/2010 are available from the Information 

Centre (Information Centre for Health and Social Care 2010). Table 168 gives these 

vaccinations rates for Hull and comparators areas. Hull‟s rates are similar to comparator 

areas. 

Table 168: One year child vaccination rates for Hull and comparator areas, 2009/2010 

Area Numbers One year olds vaccinated (%) 

aged 1 year DTP/IPV/Hib MenC PCV 

England 664,779 93.6 92.7 92.9 

Yorkshire & Humber 65,673 94.8 93.8 94.0 

Hull 3,690 94.9 93.9 94.1 

Coventry 4,191 96.6 95.6 95.9 

Derby City 3,824 93.1 92.6 92.8 

Leicester City 5,062 93.2 92.5 93.7 

Middlesbrough* 1,985 90.5 89.6 89.8 

Plymouth 3,163 96.0 95.5 95.7 

Salford 3,189 96.5 93.7 93.8 

Sandwell 4,771 94.0 93.6 93.7 

Stoke on Trent* 3,751 95.7 96.7 95.7 

Sunderland* 3,112 95.9 95.5 95.7 

Wolverhampton City 3,434 92.0 91.4 91.4 

Average of 10 comparators 36,482 94.4 93.8 94.0 

County Durham* 5,596 96.8 96.1 96.9 

Darlington* 1,307 95.3 95.1 95.2 

Gateshead* 2,362 94.9 94.7 94.4 

Halton & St Helens* 3,587 96.3 95.7 96.3 

Hartlepool* 1,134 92.0 91.6 91.4 

Knowsley* 1,898 91.4 91.4 91.6 

North Tyneside* 2,468 97.9 97.5 97.2 

Redcar & Cleveland* 1,461 95.3 94.9 95.2 

Sefton* 2,758 94.9 94.3 94.3 

South Tyneside* 1,660 97.7 97.1 97.0 

Tameside & Glossop* 3,005 95.9 94.9 94.7 

Wirral* 3,757 93.5 93.3 93.0 

Industrial Hinterlands 39,841 95.2 94.9 94.9 

NE Lincolnshire 1,992 95.2 94.5 95.1 




9.1.2.2 At Ward Level in Hull 

From the Child Health System, local vaccination information (as at 1 st April 2009) is 

available at the ward and practice level for children aged one year, two years and five 

years within the period 1 st April 2008 and 31 st March 2009. Vaccination data is also 

available by ethnicity. 


pertussis (DTP), polio, haemophilus influenzae type b, meningitis C and pneumococcal 

vaccinations during 2008/2009 are given in Figure 153, Figure 154 and Figure 155 for 

North, East and West Localities (based on the child‟s current postcode). The underlying 

data are given in the APPENDIX on page 889. Note that the figures start at 80% (not 

zero). 

Figure 153: One year child vaccination uptake rate by ward for North Locality for 

2008/2009 

Percentage of one year olds vaccinated 

100 

98 

96 

94 

92 

90 

88 

86 

84 

82 

80 

Bransholme 

East 

Bransholme 

West 


& Greenwood 


University 

DTP Polio Haemophilus influenzae type b Meningitis C Pneumococcal 



Figure 154: One year child vaccination uptake rate by ward for East Locality for 

2008/2009 


100 

98 

96 

94 

92 

90 

88 

86 

84 

82 

80 


E 


Southcoates 

W 

Drypool 




Figure 155: One year child vaccination uptake rate by ward for West Locality for 

2008/2009 


100 

98 

96 

94 

92 

90 

88 

86 

84 

82 

80 

Myton New ington St 

Andrew s 

Boothferry 

Derringham 


Pickering Avenue Bricknell New land 




9.1.2.3 At Practice Level in Hull 


pertussis (DTP), polio, haemophilus influenzae type b, meningitis C and pneumococcal 

vaccinations during 2008/2009 are given in Figure 156, Figure 157 and Figure 158 for 

general practices within North, East and West Localities. The figures show the 

variability among the practices. The underlying data in the APPENDIX on page 890. 

Note that the figures start at 70% (not zero). 

Figure 156: One year child vaccination uptake rate by general practice for North Locality 

for 2008/2009 


100 

98 

96 

94 

92 

90 

88 

86 

84 

82 

80 

78 

76 

74 

72 

70 

B81002:Dr Kumar- 

Choudhary 

B81018:Orchard 

2000 

B81020:Sutton 

Manor 

B81021:Faith 

House 

B81049:New Hall 

B81094:Dr AK 

Datta 

B81095:Dr Cook 

B81112:Dr Ghosh 

B81119:Drs 

Palooran & George 


B81616:Dr 

Hendow 


B81631:Dr Raut 

B81634:Dr 

Venugopal 

B81662:Mizzen 

Road 

B81685:Dr 

Poulose 

DTP Polio Hib Men C Pneumococcal 

B81688:Dr Gopal 

B81690:Dr Ray 

Y02344:Northpoint 

Y02747:Kingswood 

Surgery


Figure 157: One year child vaccination uptake rate by general practice for East Locality 

for 2008/2009 


100 

98 

96 

94 

92 

90 

88 

86 

84 

82 

80 

78 

76 

74 

72 

70 

B81001:Drs Ali & Ahmed 

B81008:Dr Tommins & Ptnrs 

B81040:Dr Newman & Ptnrs 

B81053:Dr Maung & Ptnrs 

B81066:Dr Chowdhury 

B81074:Dr Rej 

B81080:Dr Malczewski 

B81081:Dr Tang 


B81085:Dr Richardson & Ptnrs 



B81089:Dr Witvliet 

B81097:Dr Yagnik 

B81635:Dr Dave 

B81644:Dr Mahendra 

B81645:Dr Abraham 

B81646:Dr Austin 

B81674:Dr Joseph 

B81682:Dr Shaikh & Ptnrs


Figure 158: One year child vaccination uptake rate by general practice for West Locality 

for 2008/2009 


100 

98 

96 

94 

92 

90 

88 

86 

84 

82 

80 

78 

76 

74 

72 

70 

B81011:Wheeler Street 

B81017:Kingston Medical Grp 

B81027:St Andrews Group 

B81032:Dr Hussain & Ptnrs 

B81035:Dr Sande & Ptnrs 

B81038:Oaks Medical Centre 

B81046:Dr Blow & Ptnrs 

B81047:Wolseley Med Centre 

B81048:Newland Group 

B81052:Drs Musil & Queenan 

B81054:Dr Varma & Ptnrs 



B81056:Springhead Med Centre 


B81057:Drs MacPhie & Koul 

B81058:Sydenham House Group 

B81072:Dr Percival & Ptnrs 

B81075:Dr Mallik 

B81104:Dr Nayar 

B81675:Drs Tak&Stryjakiewicz 

B81683:Dr Koul 

B81692:Quays Medical Centre 

Y00955:Riverside Med Centre 

Y01200:Calvert Practice 

Y02786:Priory Surgery


9.1.3 Vaccination Uptake Rates for Two Year Olds 



pertussis (DTP), polio (inactivated polio vaccine – IPV), haemophilus influenzae type b 

(Hib), measles, mumps and rubella (MMR), haemophilus influenzae type b (Hib) and 

meningitis C (MenC) booster and pneumococcal infection (pneumococcal conjugate 

vaccine – PCV) booster vaccinations during 2009/2010 are available from the 

Information Centre (Information Centre for Health and Social Care 2010). Table 169 

gives these vaccinations rates for Hull and comparators areas. Hull‟s rates are similar to 

comparator areas. 

Table 169: Two year child vaccination rates for Hull and comparator areas, 2009/2010 

Area Numbers 

aged 2 

years 

Two year olds vaccinated (%) 

DTP/IPV/Hib MMR MenC Hib/MenC PCV 

England 662,217 95.3 88.2 94.2 90.0 87.6 

Yorkshire & Humber 65,042 96.3 89.2 96.1 93.0 89.8 

Hull 3,643 96.7 90.4 97.0 92.5 89.4 

Coventry 4,043 97.6 94.2 95.6 93.3 93.3 

Derby City 3,891 95.5 86.3 96.5 91.2 87.1 

Leicester City 5,024 96.4 90.1 97.1 92.1 90.2 

Middlesbrough* 2,021 93.2 84.0 94.9 89.4 81.9 

Plymouth 3,188 97.6 92.4 97.3 93.0 93.3 

Salford 3,155 97.1 94.3 92.7 94.5 91.0 

Sandwell 4,611 96.7 86.0 97.7 92.1 87.3 

Stoke on Trent* 3,834 97.8 92.9 95.8 96.6 94.1 

Sunderland* 3,281 97.5 89.4 98.1 95.2 91.1 

Wolverhampton City 3,458 93.3 84.4 91.9 88.6 86.2 

Average of 10 comparators 36,506 96.4 89.6 95.9 92.7 89.8 

County Durham* 5,800 97.3 92.9 97.2 95.3 93.1 

Darlington* 1,261 98.3 91.9 98.6 93.8 91.2 

Gateshead* 2,174 97.1 91.1 95.7 93.4 92.3 

Halton & St Helens* 3,594 97.1 90.2 95.8 91.5 86.6 

Hartlepool* 1,173 95.1 87.1 92.8 87.6 88.6 

Knowsley* 1,929 95.9 89.4 88.4 82.4 81.8 

North Tyneside* 2,418 99.2 94.7 98.2 97.3 94.6 

Redcar & Cleveland* 1,482 97.1 90.9 97.8 94.7 87.4 

Sefton* 2,774 96.2 91.3 94.2 92.7 88.7 

South Tyneside* 1,659 98.7 92.8 97.6 96.6 95.0 

Tameside & Glossop* 3,094 96.9 92.9 95.1 92.7 90.2 

Wirral* 3,779 96.5 89.8 96.1 92.8 88.8 

Industrial Hinterlands 40,273 97.0 91.1 95.9 93.3 90.1 

NE Lincolnshire 1,967 96.3 89.3 97.2 93.0 89.4 





The percentages of children aged two years who have had their measles, mumps and 

rubella (MMR), haemophilus influenzae type b (Hib) and meningitis C (MenC) booster 

and pneumococcal booster vaccinations during 2008/2009 are given in Figure 159, 

Figure 160 and Figure 161 for North, East and West Localities (based on the child‟s 

current postcode). The underlying data are given in the APPENDIX on page 892. Note 

that the figures start at 70% (not zero). 

Figure 159: Two year child vaccination uptake rate by ward for North Locality for 

2008/2009 

Percentage of two year olds vaccinated 

100 

95 

90 

85 

80 

75 

70 

Bransholme 

East 

Bransholme 

West 


& Greenwood 


MMR Hib MenC booster Pneumococcal booster 

University 



Figure 160: Two year child vaccination uptake rate by ward for East Locality for 

2008/2009 


100 

95 

90 

85 

80 

75 

70 


E 


Southcoates 

W 


Drypool 



Figure 161: Two year child vaccination uptake rate by ward for West Locality for 

2008/2009 


100 

95 

90 

85 

80 

75 

70 


Andrew s 

Boothferry 

Derringham 







The percentages of children aged two years who have had their measles, mumps and 

rubella (MMR), haemophilus influenzae type b (Hib) and meningitis C (MenC) booster 

and pneumococcal booster vaccinations during 2008/2009 are given in Figure 162, 

Figure 163 and Figure 164 for general practices within North, East and West Localities. 

The figures show the variability among the practices. The underlying data in the 

APPENDIX on page 893. Note that the figures start at 45% (not zero). 

Figure 162: Two year child vaccination uptake rate by general practice for North Locality 

for 2008/2009 


100 

95 

90 

85 

80 

75 

70 

65 

60 

55 

50 

45 


Choudhary 


2000 

B81020:Sutton 

Manor 

B81021:Faith 

House 


B81094:Dr AK 

Datta 



B81119:Drs 



B81616:Dr 

Hendow 



B81634:Dr 

Venugopal 

B81662:Mizzen 

Road 

B81685:Dr 

Poulose 

MMR Hib/MenC booster Pneumococcal booster 


B81690:Dr Ray 



Surgery


Figure 163: Two year child vaccination uptake rate by general practice for East Locality 

for 2008/2009 


100 

95 

90 

85 

80 

75 

70 

65 

60 

55 

50 

45 

B81001:Drs Ali & 

Ahmed 

B81008:Dr Tommins & 

Ptnrs 

B81040:Dr Newman & 

Ptnrs 

B81053:Dr Maung & 

Ptnrs 


B81074:Dr Rej 



B81085:Dr Richardson 

& Ptnrs 











B81682:Dr Shaikh & 

Ptnrs


Figure 164: Two year child vaccination uptake rate by general practice for West Locality 

for 2008/2009 


100 

95 

90 

85 

80 

75 

70 

65 

60 

55 

50 

45 

B81011:Wheeler Street 

B81017:Kingston Medical Grp 

B81027:St Andrews Group 

B81032:Dr Hussain & Ptnrs 

B81035:Dr Sande & Ptnrs 

B81038:Oaks Medical Centre 

B81046:Dr Blow & Ptnrs 

B81047:Wolseley Med Centre 

B81048:Newland Group 

B81052:Drs Musil & Queenan 

B81054:Dr Varma & Ptnrs 




B81056:Springhead Med Centre 

B81057:Drs MacPhie & Koul 

B81058:Sydenham House Group 

B81072:Dr Percival & Ptnrs 



B81675:Drs Tak&Stryjakiewicz 


B81692:Quays Medical Centre 

Y00955:Riverside Med Centre 

Y01200:Calvert Practice


9.1.4 Vaccination Uptake Rates for Five Year Olds 


The percentages of children aged one year who have had their primary and booster 

vaccinations for diphtheria, tetanus and pertussis (DTP), primary vaccination for 

haemophilus influenzae type b (Hib), and first and second doses for measles, mumps 

and rubella (MMR) during 2009/2010 are available from the Information Centre 

(Information Centre for Health and Social Care 2010). Table 170 gives these 

vaccinations rates for Hull and comparators areas. Hull‟s rates are similar to comparator 

areas. 

Table 170: Five year child vaccination rates for Hull and comparator areas, 2009/2010 

Area Numbers 

Five year olds vaccinated (%) 

aged 5 DTP Hib DTP MMR MMR 

years primary primary booster dose 1 dose2 

England 608,148 94.0 93.1 84.8 91.0 82.7 

Yorkshire & Humber 60,955 95.6 95.0 85.9 93.1 85.1 

Hull 3,197 97.1 95.8 89.2 94.5 87.6 

Coventry 3,304 97.0 97.3 92.2 96.4 90.2 

Derby City 3,468 94.3 93.6 85.3 92.8 84.1 

Leicester City 4,574 97.3 94.6 89.2 95.0 87.6 

Middlesbrough* 1,872 95.0 94.7 88.6 93.4 87.4 

Plymouth 2,512 97.9 98.0 94.2 95.8 91.3 

Salford 2,680 96.9 96.9 91.9 93.9 91.6 

Sandwell 3,982 95.6 94.5 86.2 92.8 83.1 

Stoke on Trent* 3,329 97.5 93.2 93.7 96.0 91.9 

Sunderland* 2,933 98.0 97.7 88.4 93.4 86.8 

Wolverhampton City 3,218 93.9 93.1 79.7 91.5 77.9 

Average of 10 comparators 31,872 96.4 95.2 88.7 94.1 86.9 

County Durham* 5,436 97.0 96.5 96.0 95.1 93.0 

Darlington* 1,239 97.7 97.1 91.7 94.2 90.2 

Gateshead* 2,067 96.2 95.7 85.4 94.4 82.9 

Halton & St Helens* 3,356 98.0 98.5 88.6 94.1 85.9 

Hartlepool* 1,089 94.5 94.5 86.0 95.2 84.8 

Knowsley* 2,015 94.0 86.0 85.2 91.2 84.2 

North Tyneside* 2,261 98.3 97.9 94.5 96.7 91.2 

Redcar & Cleveland* 1,471 95.2 95.2 92.2 93.4 89.9 

Sefton* 2,494 95.6 95.3 86.4 93.1 83.4 

South Tyneside* 1,500 98.3 97.9 91.1 95.1 87.8 

Tameside & Glossop* 2,718 97.2 96.2 90.4 95.7 89.7 

Wirral* 3,604 96.3 96.1 89.9 95.1 86.7 

Industrial Hinterlands 37,384 96.8 95.7 90.5 94.5 88.2 

NE Lincolnshire 1,896 97.9 97.5 90.9 93.5 89.5 





The percentages of children aged five years who have had their booster vaccinations 

during 2008/2009 for diphtheria, tetanus and pertussis (DTP), polio, and measles, 

mumps and rubella (MMR) given in Figure 165, Figure 166 and Figure 167 for North, 

East and West Localities (based on the child‟s current postcode). The underlying data 

are given in the APPENDIX on page 895. Note that the figures start at 60% (not zero). 

Figure 165: Five year child vaccination uptake rate by ward for North Locality for 

2008/2009 

Percentage of five year olds vaccinated 

100 

95 

90 

85 

80 

75 

70 

65 

60 

Bransholme 

East 

Bransholme 

West 


& Greenwood 


DTP booster Polio booster MMR booster 

University 



Figure 166: Five year child vaccination uptake rate by ward for East Locality for 

2008/2009 


100 

95 

90 

85 

80 

75 

70 

65 

60 


E 


Southcoates 

W 


Drypool 



Figure 167: Five year child vaccination uptake rate by ward for West Locality for 

2008/2009 


100 

95 

90 

85 

80 

75 

70 

65 

60 


Andrew s 

Boothferry 

Derringham 







The percentages of children aged five years who have had their booster vaccinations 

during 2008/2009 for diphtheria, tetanus and pertussis (DTP), polio, and measles, 

mumps and rubella (MMR) given in Figure 168, Figure 169 and Figure 170 for general 

practices within North, East and West Localities. The figures show the variability among 

the practices. The underlying data in the APPENDIX on page 896. Only three five-year 

old children are registered with the Priory Surgery in West Locality, and as this is a 

relatively new practice, this is likely why the vaccinations have not been completed. 

Figure 168: Five year child vaccination uptake rate by general practice for North Locality 

for 2008/2009 


100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 


Choudhary 


2000 

B81020:Sutton 

Manor 

B81021:Faith 

House 


B81094:Dr AK 

Datta 



B81119:Drs 



B81616:Dr 

Hendow 



B81634:Dr 

Venugopal 

B81662:Mizzen 

Road 

B81685:Dr 

Poulose 



B81690:Dr Ray 



Surgery


Figure 169: Five year child vaccination uptake rate by general practice for East Locality 

for 2008/2009 


100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

B81001:Drs Ali & Ahmed 

B81008:Dr Tommins & Ptnrs 

B81040:Dr Newman & Ptnrs 

B81053:Dr Maung & Ptnrs 


B81074:Dr Rej 





B81085:Dr Richardson & Ptnrs 









B81682:Dr Shaikh & Ptnrs


Figure 170: Five year child vaccination uptake rate by general practice for West Locality 

for 2008/2009 


100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

B81011:Wheeler 

Street 

B81017:Kingston 

Medical Grp 

B81027:St Andrews 

Group 

B81032:Dr Hussain 

& Ptnrs 

B81035:Dr Sande & 

Ptnrs 

B81038:Oaks 

Medical Centre 

B81046:Dr Blow & 

Ptnrs 

B81047:Wolseley 

Med Centre 

B81048:Newland 

Group 

B81052:Drs Musil & 

Queenan 

B81054:Dr Varma & 

Ptnrs 

B81056:Springhead 

Med Centre 

B81057:Drs 

MacPhie & Koul 

B81058:Sydenham 

House Group 

B81072:Dr Percival 

& Ptnrs 





B81675:Drs 

Tak&Stryjakiewicz 



B81692:Quays 

Medical Centre 

Y00955:Riverside 

Med Centre 

Y01200:Calvert 

Practice 

Y02786:Priory 

Surgery


9.1.5 Vaccination Uptake Rates by Ethnicity in Hull 

Table 171, Table 172 and Table 173 gives the vaccination uptake rates 2008/2009 for 

at one year, two years and three years respectively for each ethnic group 54 . The total 

number of children within each ethnic group are provided as well as the vaccination 

uptake rates for diphtheria, tetanus, pertussis (DTP), polio, haemophilus influenzae type 

b (Hib), pneumococcal infection (pneumococcal conjugate vaccine – PCV), meningitis C 

(MenC), and measles, mumps and rubella (MMR). Some of the number of children 

within each ethnic group are relatively small, so the results should be interpreted 

cautiously. Furthermore, there are 124 one year olds, 270 two year olds and 321 five 

year olds where ethnicity of the child has not been recorded. It appears that children 

without ethnicity recorded are more likely to not receive the vaccinations, which could be 

associated. 

Table 171: One year old children vaccination uptake rates by ethnicity 

Ethnic group Total number Vaccination uptake rates in one year olds (%) 

of children DTP Polio Hib MenC PCV 

White British 2,816 93.6 93.6 93.6 93.5 93.9 

White Other 140 95.7 95.7 95.7 95.7 95.7 

Mixed 115 93.9 93.9 93.9 93.9 94.8 

Black 35 94.3 94.3 94.3 94.3 94.3 

Indian 15 93.3 93.3 93.3 93.3 93.3 

Pakistani 22 95.5 95.5 95.5 95.5 95.5 

Bangladeshi 15 100.0 100.0 100.0 100.0 100.0 

Other Asian 27 96.3 96.3 96.3 96.3 96.3 

Chinese 12 100.0 100.0 100.0 100.0 100.0 

Other 34 94.1 94.1 94.1 94.1 97.1 

Missing 124 85.5 83.1 83.1 70.2 67.7 

Total 3,355 93.5 93.4 93.4 92.8 93.1 

54 Ethnicity coding varied from being very precise to quite general, so the precise coding was combined 

into the above groups. Some of the ethnic groups were combined either because they were not recorded 

into subgroups within the database (e.g. Black) or due to small numbers. 



Table 172: Two year old children vaccination uptake rates by ethnicity 

Ethnic group Total number Vaccination uptake rates in two year olds (%) 

of children 

Hib/MenC Pneumococcal 

MMR 

booster booster 

White British 2,716 89.9 88.3 85.4 

White Other 84 95.2 95.2 90.5 

Mixed 95 84.2 86.3 82.1 

Black 41 92.7 90.2 87.8 

Asian 48 95.8 95.8 93.8 

Chinese 4 100.0 100.0 75.0 

Other 32 96.9 100.0 96.9 

Missing 170 80.0 73.5 67.6 

Total 3,190 89.6 87.9 84.8 

Table 173: Five year old children vaccination uptake rates by ethnicity 

Ethnic group Total number Vaccination uptake rates in five year olds (%) 

of children DTP booster Polio booster MMR booster 

White British 2,370 84.4 84.3 83.1 

White Other 21 90.5 90.5 81.0 

Mixed 73 80.8 80.8 76.7 

Black 9 88.9 88.9 88.9 

Indian 7 85.7 85.7 85.7 

Pakistani 15 100.0 100.0 100.0 

Bangladeshi 11 100.0 100.0 100.0 

Other Asian 9 77.8 77.8 77.8 

Chinese 4 75.0 75.0 100.0 

Other 14 71.4 78.6 71.4 

Missing 321 66.0 65.4 61.7 

Total 2,854 82.3 82.2 80.6 





consultation (see section 3.3.6.2 on page 52), and a number of which are suggested for 

childhood vaccination (Table 174). 

Table 174: Potential outcomes measures 

Age of child Potential outcome measure (% uptake of vaccination) 

One year 

Two years 

Five years 

Diphtheria, tetanus, pertussis (whooping cough) (DTP), polio 

(inactivated polio vaccine – IPV) and haemophilus influenzae type b 

(Hib) 

Pneumococcal infection (pneumococcal conjugate vaccine – PCV) and 

meningitis C (MenC) 

Measles, mumps and rubella (MMR) 

Diphtheria, tetanus, pertussis (whooping cough) (DTP), polio 

(inactivated polio vaccine – IPV) 

Measles, mumps and rubella (MMR) 

As the national target for diphtheria, tetanus and pertussis (DTP) and measles, mumps 

and rubella (MMR) is 95%, it is possible that 95% will be the target locally. 

It would be possible to use the uptake rates within sections 9.1.2, 9.1.3 and 9.1.4 to 

target geographical areas or general practices with relatively low uptake of child 

vaccinations. 



9.2 Influenza and Pneumococcal Vaccinations 

9.2.1 Influenza Vaccination 

The Winter Influenza campaign for the elderly was started during 2000/01 when persons 

aged 75+ years were encouraged to have an influenza vaccination. The age limit was 

lowered the next winter to those aged 65+ years. The target uptake was 70% and 

uptake was recorded by the Humber Health Protection Unit (Humber Health Protection 

Unit, 2006). Uptake for Eastern Hull PCT was 70%, 71%, 75% and 75% for 2002/2003, 

2003/2004, 2004/2005 and 2005/2006 respectively. For West Hull PCT uptake was 

68%, 86%, 72% and 73% for 2002/2003, 2003/2004, 2004/2005 and 2005/2006 

respectively. 

More recent information is available in the World Class Commissioning datapacks 

published September 2009 provided by the Information Centre (Information Centre for 

Health and Social Care 2009) on the percentage of those aged 65+ years who were 

vaccinated for influenza. Table 175 presents this information for 2006/2007 and 

2007/2008 for Hull and comparator areas (see section 3.3.3 on page 44 for more about 

comparator areas). The uptake in Hull is similar to comparator PCTs. 

Table 175: Percentage uptake of influenza vaccination for those aged 65+ years, 

2006/2007 and 2007/2008 

PCT Influenza vaccination uptake in those aged 65+ years (%) 

2006/2007 2007/2008 

Hull 74.0 73.9 

Plymouth 75.9 74.1 

Salford 74.7 73.8 

Sunderland 77.0 76.8 

Middlesbrough 74.1 75.3 

Coventry 68.1 68.2 

Wolverhampton 72.5 71.6 

Derby 75.9 74.5 

Leicester 68.6 70.3 

Sandwell 68.8 69.6 

Stoke-on-Trent 73.1 73.0 

North East Lincolnshire 73.6 72.9 

The percentage uptake for 2009/2010 is available from the Information Centre 

(Information Centre for Health and Social Care 2010). Table 176 gives these 

vaccinations rates for Hull and comparators areas. Uptake between October 2009 and 

January 2010 for Hull is slightly higher than the comparator areas, being 6 th highest out 

of the 23 comparators listed. 



Table 176: Influenza vaccination rates for those aged 65+ years for Hull and comparator 

areas, 2009/2010 

Area Influenza vaccination rates (%) 

England 72.4 

Yorkshire & Humber 73.4 

Hull 74.6 

Coventry 66.5 

Derby City 74.0 

Leicester City 69.3 

Middlesbrough* 75.3 

Plymouth 73.5 

Salford 72.9 

Sandwell 68.4 

Stoke on Trent* 73.1 

Sunderland* 75.2 

Wolverhampton City 70.0 

County Durham* 71.2 

Darlington* 74.1 

Gateshead* 74.7 

Halton & St Helens* 74.0 

Hartlepool* 72.3 

Knowsley* 73.9 

North Tyneside* 73.8 

Redcar & Cleveland* 75.7 

Sefton* 74.2 

South Tyneside* 74.3 

Tameside & Glossop* 74.6 

Wirral* 73.6 

NE Lincolnshire 70.8 




consultation (see section 3.3.6.2 on page 52). One of the outcomes under 

consideration is the influenza vaccination rate. The figures in Table 175 and Table 176 

could be used to produce targets. 



9.2.2 Pneumococcal Vaccination 

The pneumococcal polysaccharide vaccination (PPV) scheme commenced during 2000 

with approximately 86% of GP practices within East Riding of Yorkshire and Hull 

participating. This increased in 2003 with all GP practices taking part in the scheme. 

The Humber Health Protection Unit (Humber Health Protection Unit 2006) estimated the 

number of persons aged 65+ years who have received the vaccination as at the end of 

2005 in Hull. They estimated that 9,719 residents of Eastern Hull PCT aged 65+ years 

out of 17,859 (54.4%) and 13,449 residents of West Hull PCT aged 65+ years out of 

24,292 (55.4%) had received their pneumococcal vaccination by the end of 2005. 

Uptake rates for 2007/2008 for each PCT are provided within a report produced jointly 

by the Department of Health and the Health Protection Agency (Begum and Pebody 

2008). Table 177 presents the numbers and percentages vaccinated during the 

2007/2008 financial year and the numbers and percentages vaccinated at any time up 

until the end of March 2008 for those practices who provided information. Not all 

general practices provided information, so information on the number of responding 

practices is also given. It is possible that the pneumococcal vaccination rates are lower 

in the practices that did not respond, so it is possible that the percentage vaccinated at 

any time until March 2008, is lower over all practices for Salford, Wolverhampton and 

Leicester as 75% or fewer practices responded. 

Table 177: Percentage uptake of pneumococcal vaccination in those aged 65+ years, 

2007/2008 

PCT Based on practices who responded Total number of practices 

Pop Pneumococcal vaccination and number/percentage 

65+ uptake in those aged 65+ years 

responding 

2007/2008 Anytime until Total Responding to 

March 2008 practices data request 

N % N % N % 

Hull 41,003 1,846 4.5 28,680 69.9 56 56 100 

Plymouth 46,271 2,684 5.8 30,044 64.9 45 44 98 

Salford 23,468 1,091 4.6 16,964 72.3 57 38 67 

Sunderland 44,901 1,919 4.3 33,000 73.5 54 53 98 

Middlesbrough 19,721 966 4.9 14,278 72.4 22 19 86 

Coventry 50,111 1,838 3.7 32,254 64.4 63 63 100 

Wolverhampton 24,063 995 4.1 15,820 65.8 57 33 58 

Derby 41,971 1,499 3.6 31,589 75.3 35 33 94 

Leicester 33,302 1,284 3.9 22,182 66.6 63 47 75 

Sandwell 47,560 3,364 7.1 32,033 67.4 63 57 91 

Stoke-on-Trent 43,480 1,823 4.2 30,385 69.9 56 55 98 

NE Lincs 28,461 1,230 4.3 19,734 69.3 34 34 100 



9.3 Screening 

Currently there are screening programmes in place for breast, cervical and colorectal 

cancers, and screening for abdominal aortic aneurysm is being rolled out nationally. 

Incidence and mortality information for these diseases can be found in section 10. 

9.3.1 Breast Cancer 

Currently, women aged 50-70 years are eligible for breast cancer screening (NHS 

Cancer Screening Programmes 2009). As the screening programme runs on a three 

year rolling programme, not all women will immediately be invited to attend on their 50 th 

birthday but they will be before their 53 rd birthday. As a result, screening participation 

rates are often quoted on the basis of the youngest age of 53 years. In addition, the age 

range for eligibility has also changed relatively recently from 50-64 years to 50-70 years, 

so the rates are quoted for women aged 53-64 years rather than up to the new age of 70 

years. There are plans in place to widen the age range from 47 to 73 years, and this is 

due to be phased in areas across England by 2012. 

9.3.1.1 Percentage of Women Screened 

From the Information Centre (Information Centre for Health and Social Care 2011), the 

estimated percentage (95% confidence intervals) of women aged 53-70 years attending 

breast cancer screening within the last three years as at 31 st March 2010 is given in 

Table 178 for Hull and comparator areas (see section 3.3.3 on page 44). 

Table 178: Percentage of women participating in breast cancer screening as at 31st 

March 2010 for Hull and comparator areas 

Area Breast cancer screening for women aged 53-70 years 

(attendance within last three years as at 31 st March 2010) 

Number eligible Percentage participating (95% CI) 

England 5,229,246 76.9 (76.9, 76.9) 

Hull 25,487 72.2 (71.6, 72.8) 

Y&H SHA 528,588 78.3 (78.2, 78.4) 

Wolverhampton City 22,897 73.0 (72.4, 73.6) 

Salford 20,468 70.0 (69.4, 70.6) 

Derby City 26,387 81.5 (81.0, 82.0) 

Stoke-on-Trent 26,422 75.1 (74.6, 75.6) 

Coventry 28,909 72.5 (72.0, 73.0) 

Plymouth 25,591 80.0 (79.5, 80.5) 

Sandwell 29,004 71.7 (71.2, 72.2) 

Middlesbrough 13,774 73.9 (73.2, 74.6) 

Sunderland 29,034 78.7 (78.2, 79.2) 

Leicester City 25,750 75.1 (74.6, 75.6) 

10 comparators 248,236 75.3 (75.1, 75.5) 

NE Lincolnshire 17,086 76.3 (75.7, 76.9) 



It can be seen that the estimated percentage of women participating in breast cancer 

screening is lower in Hull compared to England and the SHA. It is also one of the lowest 

of the 10 comparator areas, but still above the target for breast screening of 70%. 

Breast cancer screening rates are available at GP practice level for the year ending 

2009/2010 from the Primary Care Information System (Open Exeter). Figure 171, 

Figure 172 and Figure 173 provide the information for three years to the end of 

2009/2010 for North, East and West Localities respectively. The underlying data for the 

figures is available in the APPENDIX on page 897. The overall rate for Hull is 72.2% but 

ranges from 42.9% to 88.2% across the practices. Twenty-eight of the sixty practices 

have breast cancer screening rates lower than the target of 70%. Seven of the 19 

practices in North Locality have a breast cancer screening rate lower than 70% with the 

lowest for Dr Poulose (57%). 

Figure 171: Percentage of women participating in breast cancer screening as at 31st 

March 2010 for North Locality 

Screened for breast cancer as at 31 March 2010 (aged 53-70) 

100 

90 

80 

70 

60 

50 

B81002 - Kumar-Choudhary A 

B81018 - Awan And Partners 

B81020 - Mitchell And Partners 

B81021 - Faith House Surgery 

B81049 - Rawcliffe And Partners 

B81094 - Datta AK 

B81095 - Cook 

B81112 - Ghosh Raghunath And Partners 

B81119 - Palooran And Partners 


B81616 - Hendow GT 

Practice Code 

Percentage screened PCT 

B81631 - Raut R 

B81634 - Venugopal J 

B81662 - Mizzen Road Surgery 

B81685 - Poulose NA 

B81688 - Gopal KV 

B81690 - Ray SK 

Y02344 - Northpoint 

Y02747 - Kingswood Surgery 

Y02748 - Haxby Orchard Park Surgery


Eight of the 17 practices in East Locality have a breast cancer screening rate lower than 

70% with the lowest for Dr Joseph (65%). 


March 2010 for East Locality 


100 

90 

80 

70 

60 

50 

B81001 -Ali & Partners 

B81008 - Parker & Partners 

B81040 - Newman And Partners 

B81053 - Diadem Medical Practice 

B81066 - Chowdhury GM 

B81074 - Rej AK 

B81080 - Malczewski GS 

B81081 - Tang KM 


B81085 -Richardson JW 

Practice Code 


B81089 - Witvliet 

B81097 - Yagnik RD 

B81635 - Dave G 

B81644 - Mahendra KK 

B81645 - East Park Practice 

B81646 - Shaikh M 

B81674 - Joseph JC 

B81682 - Shaikh & Partners


Within West Locality, thirteen of the 24 practices have a rate lower than the target of 

70% with the Quays Medical Centre (43%) having the lowest rate. 


March 2010 for West Locality 


100 

90 

80 

70 

60 

50 

40 

B81011 - Wheeler Street Healthcare 

B81017 - Kingston Medical Group 

B81027 - St Andrews Group Practice 

B81032 - Hussain AW And Partners 

B81035 - Sande And Partners 

B81038 - Mather And Partners 

B81046 - Blow And Partners 

B81047 - Singh And Partners 

B81048 - Hussain SM And Partners 

B81052 - Musil & Queenan 

B81054 - Varma And Partners 


B81056 - Springhead Medical Centre 

Practice Code 


B81057 - MacPhie And Koul 

B81058 - Foulds & Partner 

B81072 - Percival And Partners 

B81075 - Mallik MK 

B81104 - Nayar JK 

B81675 - Tak & Stryjakiewicz 

B81683 - Raghunath And Partners 

B81692 - Quays Medical Centre 

Y00955 - Riverside Medical Centre 

Y01200 - The Calvert Practice 

Y02786 - Priory Surgery 

Y02896 - Story Street Practice&Walk In …



One of the World Class Commissioning outcomes was to increase the percentage of 

women aged 53-64 years who are offered screening for breast cancer. Following the 

change to the age of screening, the local target was changed to achieve a screening 

uptake rate of 79% of women aged 53-70 by 2013-14. From Figure 171, Figure 172 

and Figure 173 it is clear that some practices have a much lower attendance rate 

compared to others and it may be possible to target these practices specifically to 

increase breast cancer screening rates (although GPs are not directly involved in the 

screening process with programme being managed by the local Breast Screening Unit, 

GPs do have a role in encouraging women to attend their screening appointments). 


under consultation (see section 3.3.6.2 on page 52). However, one of the outcomes 

under consideration is the “uptake of national screening programmes”, so it is possible 

that the outcome and targets for breast screening uptake will be retained. 



9.3.2 Cervical Cancer 

It is estimated that the human papillomavirus (HPV) is responsible for approximately 

95% of all cervical cancers. The HPV vaccination programme started in September 

2008 with all 12- to 13-year-old and 17- to 18-year-old girls being offered the vaccine. A 

catch-up programme was also announced at this time with 13- to 18-year-old girls being 

offered the vaccine over the following two academic years. An accelerated catch-up 

programme was announced in December 2008 so that all girls born on or after 1 

September 1990 could be protected before the end of the academic year 2009/10 (NHS 

Cancer Screening Programme 2009). Further information about the vaccine is available 

at www.immunisation.nhs.uk/Vaccines/HPV/. However, it will be many years before the 

vaccination programme has an effect upon cervical cancer incidence so there are no 

changes planned to the Screening Programme yet. Vaccinated women are advised to 

continue accepting their invitations for cervical cancer screening as the vaccination will 

not prevent all types of cervical cancer. 

All women between the ages of 25 and 64 are eligible for a free cervical cancer 

screening test every three to five years. In the light of evidence published in 2003, the 

NHS Cervical Screening Programme now offers screening at different intervals 

depending on age. This means that women are provided with a more targeted and 

effective screening programme. Women are first invited to attend screening once they 

reach 25 years of age, and have screening offered every three years until they are 49 

years. Screening between the ages of 50 and 64 years is offered every five years. 

Screening is offered to women aged 65+ years if they have not been screened since 

they were aged 50 years or if they have had recent abnormal tests. 

9.3.2.1 Percentage of Women Screened 

The estimated percentage (95% CI) of women aged 25 to 64 years attending cervical 

cancer screening within the last five years as at 31 st March 2010 (Information Centre for 

Health and Social Care 2009) is given in Table 179 for Hull and comparator areas (see 

section 3.3.3 on page 44). The rates in Hull (79.2%) were slightly higher than England 

(78.9%) and the comparator areas average (78.1%). Similar to most other areas, in 

Hull, the target of 80% has not quite been achieved. 



Table 179: Percentage of women participating in cervical cancer screening as at 31st 

March 2010 for Hull and comparator areas 

Area Cervical cancer screening for women aged 25-64 years 

(attendance within last five years as at 31 st March 2010) by age 

Population (000s) Screened (%) 

25-49 50-64 25-64 25-49 50-64 25-64 

England 9,541.9 4,038.6 13,580.5 74.0 78.9 78.9 

Y&H SHA 897.1 402.5 1,299.6 76.0 79.9 80.2 

Hull 47.7 21.0 68.7 75.0 77.9 79.2 

Middlesbrough 24.6 11.1 35.7 69.2 73.4 74.1 

Sunderland 46.5 23.5 69.9 77.8 79.5 80.9 

Salford 41.9 15.7 57.6 72.4 76.8 77.4 

Derby City 51.7 20.2 71.9 76.1 81.9 81.0 

Leicester City 61.9 21.6 83.5 70.0 78.9 76.3 

Sandwell 58.9 22.7 81.6 72.8 77.0 77.5 

Coventry 59.6 22.5 82.1 71.3 77.5 76.6 

Stoke-on-Trent 45.4 19.9 65.4 74.8 78.1 79.1 

Wolverhampton 43.5 17.7 61.2 72.0 76.9 76.9 

Plymouth 44.8 19.2 64.0 74.7 80.1 79.9 

Average 10 above 478.7 194.1 672.8 73.2 78.3 78.1 

NE Lincs 26.5 12.6 39.1 78.2 80.0 81.6 

Information is available at General Practitioner level from the Primary Care Information 

System (Open Exeter) for the financial year 2009/2010 as well as providing the 

information for Hull overall and England. Figure 174, Figure 175 and Figure 176 give 

the cervical cancer screening rates for the practices in North, East and West Localities 

respectively. The underlying data for the figures is available in the APPENDIX on page 

899. 

To the 31 st March 2010 in Hull, 54,375 women were screened overall out of 68,678 

(79.2%), with a comparable but very slightly lower figure in England (10,711,679 women 

screened out of 13,580,499; 78.9%) 55 . However, there was considerable variability in 

the screening rates in Hull among the practices which ranged from 52% to 91%. In 

general, the lowest screening rates were observed for practices within West Locality. 

55 The rates from the PCIS differ slightly from those from the Information Centre. It is possible that those 

from the Information Centre include updated information as the percentages are slightly higher. 

Nevertheless, the pattern in screening appears similar with Hull having a similar rate (marginally higher 

compared to England, and that the percentage screened is lower than the target of 80%. 



Four of the 19 practices in North Locality had a cervical cancer screening rate lower 

than the target of 80% with Dr R K Awan & Partners having the lowest percentage at 

75%. 

Figure 174: Percentage of women participating in cervical cancer screening as at 31st 

March 2010 for North Locality 

% Screened for cervical cancer as 

of March 2010 (aged 25-64 years) 

100 

80 

60 

40 

20 

0 

B81002: Dr Kumar-Choudhary 

B81018: Dr Awan & Partners 

B81020: Dr Mitchell 

And Partners 


B81049: Dr Rawcliffe & Partners 

B81094: Dr Datta 


B81112: Dr Ghosh Raghunath & Partners 

B81119: Dr Palooran & Partners 


B81616: Dr Hendow 

Practice 

B81631: Dr Raut 

B81634: Dr Venugopal 


B81685: Dr Poulose 

B81688: Dr Gopal 

B81690: Dr Ray 



Y02748: Haxby Orchard Pk Surgery


Five of the 17 practices in East Locality had a cervical cancer screening rate less than 

the target of 80% with Dr Witvliet having the lowest rate at 71%. 


March 2010 for East Locality 



100 

80 

60 

40 

20 

0 

B81001: Dr Ali & Partners 

B81008: Dr Parker & Partners 

B81040: Dr Newman & Partners 


B81066: Dr Chowdhury 

B81074: Dr Rej 

B81080: Dr Malczewski 

B81081: Dr Tang & Partner 


B81085: Dr Richardson & Partners 

Practice 


B81097: Dr Yagnik 

B81635: Dr Dave 

B81644: Dr Mahendra 


B81646: Dr Shaikh 

B81674: Dr Joseph 

B81682: Dr Shaikh & Partners


Over half (15) of the 24 practices in West Locality had a screening rate for cervical 

cancer lower than the target of 80% with three practices having rates below 70% (Dr 

MacPhie & Dr Koul 69%; Dr AW Hussain & Partners 66%; Dr Nayar 52%). 


March 2010 for West Locality 



100 

80 

60 

40 

20 

0 

B81011: Wheeler St Healthcare 




B81032: Dr AW Hussain & Partners 

B81035: Dr Sande & Partners 

B81038: Dr Mather & Partners 

B81046: Dr Blow & Partners 

B81047: Dr Singh & Partners 

B81048: Dr SM Hussain & Partners 

B81052: Dr Musil & Queenan 

B81054: Dr Varma & Partners 



consideration is the “uptake of national screening programmes”, so it is possible that the 

uptake of cervical cancer screening rates will become an outcome measure. From 

Figure 174, Figure 175 and Figure 176 it is clear that some practices have a much 

lower attendance rate compared to others and it is likely that if this becomes a target, 

practices can use this information to target those with the lowest cervical cancer 

screening rates. 

Furthermore, the immunisation rate for human papillomavirus (HPV) for girls aged 12-13 

years is also a potential outcome measure under the new proposals. 


B81056: Springhead Medical Centre 

Practice 

B81057: Dr MacPhie & Koul 

B81058: Dr Foulds & Partner 

B81072: Dr Percival & Partners 

B81075: Dr Mallik 

B81104: Dr Nayar 

B81675: Dr Tak & Stryjakiewicz 

B81683: Dr Raghunath & Partners 

B81692: Quays Medical Centre 


Y01200: Calvert Practice 


Y02896: Story St Practice & Walk In Centre


9.3.3 Influences on Breast and Cervical Screening Rates 

9.3.3.1 Mean Age of Practice Patients 

The age of the women may influence whether or not they attend breast and/or cervical 

cancer screening appointments. The mean age of the practice patients (both men and 

women) has been illustrated in Table 28, and Figure 177 and Figure 178 show the 

mean age of the practice patients relative to breast and cervical cancer screening rates 

respectively. The underlying data are given in Table 28 and in the APPENDIX on page 

897 (breast cancer screening data) and on page 899 (cervical cancer screening data). 

Note that the figures give the mean age of all practice patients (i.e. all men and women 

registered with the practice) rather than the mean age of the patients eligible the 

screening. It can be seen that there is a relationship between the age of patients 

registered with the practice and screening rates despite the mean age representing only 

a very crude measure of the age structure of the practice population. It is possible that 

practices with relatively large numbers of younger patients tend to focus less on 

screening particularly breast cancer screening as it is less relevant to the majority of 

their population (the relationship between age and screening appears much stronger for 

breast screening compared to cervical cancer screening). 

Figure 177: Relationship between mean age of practice patients and breast cancer 

screening rates (three years to 2009/2010) 

Breast screening (%) 

90 

80 

70 

60 

50 

40 

25 30 35 40 45 50 

Mean age of all practice patients 



Figure 178: Relationship between mean age of practice patients and cervical cancer 

screening rates (five years to 2009/2010) 

Percentage of women aged 25-64 screened 

95 

90 

85 

80 

75 

70 

65 

60 

55 

50 

25 30 35 40 45 50 

9.3.3.2 Deprivation 

Mean age of practice patients 

Deprivation is likely to influence whether or not women attend breast and/or cervical 

cancer screening appointments. The deprivation scores at practice level have been 

illustrated in Table 49, and Figure 179 and Figure 180 show the practice deprivation 

scores relative to breast and cervical cancer screening rates respectively. The 

underlying data are given in Table 49, and in the APPENDIX on page 897 (breast 

cancer screening data) and on page 899 (cervical cancer screening data). Note that the 

figures give the mean deprivation score of all practice patients (i.e. all men and women 

registered with the practice) rather than the mean deprivation score of the patients 

eligible for screening. It can be seen that there is a relationship between practice 

deprivation scores and screening rates, and that the relationship is stronger for breast 

cancer screening then for cervical cancer screening. Practices with higher deprivation 

scores (more deprived practices) tend to have lower screening rates than less deprived 

practices. 



Figure 179: Relationship between practice deprivation score and breast cancer 


90 

80 

70 

60 

50 

40 

10 20 30 40 50 60 70 

Figure 180: Relationship between practice deprivation score and cervical cancer 


Percentage of women aged 25-64 screened 

95 

90 

85 

80 

75 

70 

65 

60 

55 

50 


Practice deprivation score (IMD 2007 - higher score more deprived) 

10 20 30 40 50 60 70 

Mean deprivation score of practice patients 



9.3.3.3 Comparison of Breast and Cervical Cancer Screening Rates at Practice Level 

There is no particular association with breast and cervical cancer screening rates, thus it 

appears that practices with low breast cancer screening rates (to 2009/2010) do not 

necessarily have low cervical cancer rates (to 2009/2010) as illustrated in Figure 181. 

The underlying data are given in the APPENDIX on page 897 (breast cancer screening 

data) and on page 899 (cervical cancer screening data). 

Figure 181: Relationship between breast and cervical cancer screening rates among 

practices 

Cervical screening (%) 

95 

90 

85 

80 

75 

70 

65 

60 

55 

50 

25 30 35 40 45 50 




9.3.4 Colorectal Cancer 

Following the pilot, the NHS Bowel Cancer Screening Programme was introduced in 

England in July 2006 and has been rolled out nationally achieving nationwide coverage 

by 2009 (NHS Cancer Screening Programmes 2009). The programme started in Hull 

during February 2007. 

The NHS Bowel Cancer Screening Programme offers screening every two years to all 

men and women aged 60 to 69. People over 70 can request a screening kit by calling a 

free phone helpline. 

9.3.4.1 Percentage Screened 

Table 180 gives the percentage uptake for colorectal cancer in Hull and East Riding of 

Yorkshire for men and women separately for 1 st January to 27 th October 2010, as well 

as the number and percentage with definite abnormalities. Around 60% took up the 

offer of screening, and on average 67 definite abnormalities were detected each month. 

Table 180: Percentage uptake for colorectal screening and numbers of definite 

abnormalities found, January to October 2010 for Hull and East Riding of Yorkshire 

combined 

Gender Month Number 

Screened Definite abnormalities 

of 2010 invited Number Percentage Number Percentage 

Jan 3,038 1,871 61.6 36 1.92 

Feb 2,889 1,846 63.9 36 1.95 

Mar 4,146 2,379 57.4 43 1.81 

Apr 3,013 1,838 61.0 31 1.69 

May 3,670 2,030 55.3 51 2.51 

Men Jun 4,209 2,320 55.1 49 2.11 

Jul 2,874 1,709 59.5 42 2.46 

Aug 2,813 1,705 60.6 25 1.47 

Sep 3,840 2,384 62.1 40 1.68 

Oct 3,237 1,975 61.0 28 1.42 

Total 33,729 20,057 59.5 381 1.90 

Jan 2,980 1,957 65.7 18 0.92 

Feb 3,018 2,037 67.5 31 1.52 

Mar 4,240 2,623 61.9 25 0.95 

Apr 3,201 2,063 64.5 35 1.70 

May 3,829 2,392 62.5 21 0.88 

Women Jun 4,321 2,668 61.7 43 1.61 

Jul 3,049 1,909 62.6 24 1.26 

Aug 2,838 1,829 64.5 22 1.20 

Sep 4,017 2,647 65.9 34 1.28 

Oct 3,293 2,087 63.4 34 1.63 

Total 34,786 22,212 63.9 287 1.29 



The figures for Hull are not available for men and women separately nor by month. 

However, they are available for each quarter of 2010 (Table 181). The data was 

extracted on the 27 th October 2010, so the fourth quarter only includes some of those 

invited during October. The overall screening uptake rates was 54% which was slightly 

lower than the rate in Table 180 which was for Hull and East Riding of Yorkshire 

combined. This is not really surprising that the uptake rate is higher in East Riding of 

Yorkshire given Hull‟s increased deprivation. 

Table 181: Percentage uptake for colorectal cancer screening and numbers of definite 

abnormalities found, January to October 2010 for Hull 

Quarter Number 

Screened Definite abnormalities 

of 2010 invited Number Percentage Number Percentage 

Jan-Mar 5,131 2,837 53 55.3 1.87 

Apr-Jun 4,815 2,465 43 51.2 1.74 

Jul-Sep 4,406 2,382 39 54.1 1.64 

Oct 1,428 786 14 55.0 1.78 

Total 15,780 8,470 149 53.7 1.76 

Figure 182, Figure 183 and Figure 184 give the percentages screened for each 

practice for the first three quarters of 2010 (January to September) for practices in 

North, East and West Localities respectively. There is considerable variability among 

the practices (25.0% to 71.3%). The underlying data are given in the APPENDIX on 

page 901. 

Figure 182: Percentage of men and women participating in colorectal cancer screening 

1 st January to 30 th September 2010 for North Locality 

Colorectal screening uptake (%), Jan-Sep 2010 

80 

70 

60 

50 

40 

30 

20 

10 

0 

B81002: Dr Kumar-Choudhary 

B81018: Dr Awan & Partners 

B81020: Dr Mitchell & Partners 


B81049: Dr Rawcliffe & Partners 

B81094: Dr AK Datta 


B81112: Dr Ghosh Raghunath & 

Partners 

B81119: Dr Palooran & Partners 


B81616: Dr Hendow 


B81631: Dr Raut 

B81634: Dr Venugopal 


B81685: Dr Poulose 

B81688: Dr Gopal 

B81690: Dr Ray 



Y02748: Haxby Orchard Park Surgery



1 st January to 30 th September 2010 for East Locality 

80 

70 

60 

50 

40 

30 

20 

10 

0 

B81001: Dr Ali & Partners 

B81008: Dr Parker & Partners 

B81040: Dr Newman & Partners 


B81066: Dr Chowdhury 

B81074: Dr Rej 

B81080: Dr Malczewski 

B81081: Dr Tang & Partner 


1 st January to 30 th September 2010 for West Locality 



80 

70 

60 

50 

40 

30 

20 

10 

0 

B81011: Wheeler Street Healthcare 



B81032: Dr AW Hussain & Partners 

B81035: Dr Sande & Partners 

B81038: Dr Mather & Partners 

B81046: Dr Blow & Partners 

B81047: Dr Singh & Partners 

B81048: Dr SM Hussain & Partners 

B81052: Dr Musil & Dr Queenan 


B81085: Dr Richardson & Partners 


B81054: Dr Varma & Partners 

B81056: Springhead Medical Centre 

B81057: Dr MacPhie & Dr Koul 


B81058: Dr Foulds & Partner 


B81072: Dr Percival & Partners 

B81097: Dr Yagnik 

B81075: Dr Mallik 

B81104: Dr Nayar 

B81635: Dr Dave 

B81668: Dr Stryjakiewicz 

B81644: Dr Mahendra 

B81675: Dr Tak & Dr Stryjakiewicz 

B81683: Dr Raghunath & Partners 


B81692: Quays Medical Centre 

B81646: Dr Shaikh 


Y01200: Calvert Practice 

B81674: Dr Joseph 


B81682: Dr Shaikh & Partners 

Y02896: Story Street Practice & Walk In 

Centre





consideration is the “uptake of national screening programmes”, so it is possible that the 

uptake of colorectal screening rates will become an outcome measure. 

9.3.5 Abdominal Aortic Aneurysm 

The NHS Abdominal Aortic Aneurysm (AAA) Screening Programme is being introduced 

gradually across England (NHS Screening Programmes 2009). Phased implementation 

commenced in March 2009 and it is anticipated that coverage across England will be 

achieved by March 2013. 

The NHS AAA Screening Programme has been introduced following research and 

analysis of data from existing local screening programmes in England which show a 

reduction in mortality from AAAs when men are offered ultrasound screening in their 65 th 

year. The evidence was assessed by the UK National Screening Committee against a 

set of internationally recognised criteria which have confirmed that screening all men 

aged 65 can deliver benefits to men at a reasonable cost. Once fully implemented the 

Programme will invite all men for screening during the year that they turn 65. Men who 

have an aneurysm detected through screening will be offered treatment or monitoring 

depending on the size of the aneurysm. 

The NHS AAA Screening Programme will be coordinated and led nationally. Local 

screening services will be delivered by PCTs who will provide screening for their 

population in line with national quality standards and protocols. 

Hull, in conjunction with partner organisations 56 , were successful in their application to 

become a third wave site, and local implementation began in December 2010. Full 

programme roll-out is progressing across the programme area. To date (February 

2011) around 500 men have been screened in Hull and East Riding with at least one 

man in each area identified as requiring surgery. 

56 East Riding of Yorkshire PCT, North Lincolnshire PCT, North East Lincolnshire PCT, North Yorkshire 

and York PCT and provider services (Hull and East Yorkshire programme centre). 



10 SPECIFIC DISEASES/AREAS 

10.1 Circulatory Disease 

There are three main types of circulatory (cardiovascular) disease: coronary heart 

disease (CHD), cerebrovascular disease and peripheral vascular disease. 

Cardiovascular disease is usually caused by a build-up of fatty deposits on the walls of 

the arteries. The fatty deposits, called atheroma, are made up of cholesterol and other 

waste substances. The build up of atheroma on the walls of the arteries makes the 

arteries narrower and restricts the flow of blood. This process is called atherosclerosis. 

CHD is caused by the narrowing of one or more of the coronary arteries, which can 

result in angina, heart attack or heart failure. Cerebrovasular disease (stroke and 

transient ischaemic attack (TIA)) results from disease of the arteries in the brain. The 

most common cause of a stroke is due to an artery in the brain becoming blocked by a 

blood clot which is usually formed over some atheroma. A TIA is a disorder caused by 

temporary lack of blood supply to a part of the brain. Peripheral vascular disease is also 

a disease resulting from narrowing of the arteries due to atheroma, but arteries other 

than those in the heart or brain (generally in the leg). See section 13.4.5 on page 811 

for more information about the definitions used to define these conditions. 

10.1.1 All Circulatory Disease 

10.1.1.1 Risk Factors 

The risk of developing atherosclerosis is significantly increased with smoking, high blood 

pressure, high blood cholesterol level, lack of exercise, thrombosis, and diabetes. Other 

risk factors for developing atherosclerosis include being overweight or obese, and 

having a family history of heart attack or angina. An unhealthy diet influences high 

blood pressure and cholesterol levels. 

10.1.1.2 Diagnosed Prevalence 






influencing factors, such as the age of the patients and deprivation, but practices have 

been grouped based on age and deprivation (see section 3.3.3.3 on page 47 for more 

information). Practices with a high proportion of elderly patients and practices in the 

most deprived areas will tend to have a higher prevalence of disease (and generally a 

higher prevalence of undiagnosed disease). See section 12.13 on page 782 for more 


level. Also see Table 28 and Table 49 for mean age of patients and mean deprivation 



scores for each practice (which will influence the prevalence on the disease registers). 

There are disease registers which cover CHD, stroke and transient ischaemic attack 

(TIA), heart failure, atrial fibrillation and hypertension 

Table 182 and Table 183 present the number and prevalence respectively for CHD, 

stroke and TIA, heart failure, atrial fibrillation and hypertension for all the general 

practices in Hull for 2009/10. 





Y02896 and Y02748 all opened between 5 th October 2009 and 11 th January 2010). 

Table 182: Number of patients diagnosed cardiovascular and associated medical 

conditions based on GP disease registers 2009/10 

Practice 

code 


population 

(Jan 10) 

Number on the disease registers 2009/10 (N) 

CHD Heart 

Failure 

Atrial 

Fibrillation 

Stroke 

& TIA 

Hypertension 

B81035 Dr Sande & Partners 6,114 193 34 75 111 719 

B81056 Springhead Med Centr 13,489 502 89 177 210 1,980 

B81104 Dr J K Nayar 7,721 22 7 10 17 149 

B81635 Dr G Dave 2,967 182 22 34 47 576 

B81662 Mizzen Road Surgery 1,856 80 20 33 23 352 

Y01200 The Calvert Practice 1,765 85 10 37 35 351 

Y02747 Kingswood Surgery 902 10 1 3 5 64 

B81020 Dr Mitchell & Partners 7,512 269 59 96 129 934 

B81021 Faith House Surgery 7,257 276 62 132 159 985 

B81075 Dr M K Mallik 2,263 70 8 13 16 257 

B81085 Dr Richardson & Partrs 5,299 275 28 80 102 866 

B81094 Dr A K Datta 1,925 45 2 15 12 226 

B81095 Dr Cook 4,242 159 29 67 75 731 

B81097 Dr R D Yagnik 1,688 62 5 15 16 316 

B81690 Dr S K Ray 1,734 55 9 9 13 339 

B81001 Dr Ali & Partners 3,358 130 11 58 48 407 

B81008 Dr Parker & Partners 15,062 532 64 138 185 1,748 

B81048 Dr SM Hussain & Ptrs 9,048 263 48 95 117 894 

B81049 Dr Rawcliffe & Partners 9,354 370 69 138 169 1,080 

B81052 Dr Musil & Queenan 5,740 164 27 50 70 610 

B81072 Dr Percival & Partners 7,807 288 69 53 146 810 

B81644 Dr K K Mahendra 2,245 69 10 15 14 306 

Y02786 Priory Surgery 141 7 2 3 5 34 

B81011 Wheeler St Healthcare 5,243 224 37 69 84 772 

B81038 Dr Mather & Partners 7,732 372 45 100 149 1,142 

B81057 Dr S MacPhie & Koul 3,345 131 16 33 34 477 

B81074 Dr A K Rej 3,639 136 32 49 50 672 



Practice 

code 


population 

(Jan 10) 

Number on the disease registers 2009/10 (N) 

CHD Heart 

Failure 

Atrial 

Fibrillation 

Stroke 

& TIA 

Hypertension 

B81081 Dr K M Tang & Partner 3,520 159 14 66 62 667 

B81645 East Park Practice 2,128 83 16 15 17 288 

B81646 Dr M Shaikh 1,949 62 7 11 17 248 

B81682 Dr M Shaikh & Partners 3,726 179 16 38 50 545 

B81053 Diadem Med Practice 10,232 519 79 164 295 1,595 

B81054 Dr Varma & Partners 10,851 465 99 155 184 1,541 

B81058 Dr M Foulds & Partner 8,722 418 94 140 201 1,317 

B81066 Dr G M Chowdhury 2,522 111 15 26 40 298 

B81080 Dr G S Malczewski 2,216 119 11 41 43 311 

B81616 Dr G T Hendow 2,571 116 17 30 41 391 

B81002 Dr A Kumar-Choudhary 3,844 166 23 26 54 532 

B81112 Dr Ghosh Raghunath & Ptnrs 3,498 144 20 24 47 281 

B81119 Dr Palooran & Partners 4,593 208 27 44 52 662 

B81634 Dr J Venugopal 3,044 107 6 12 27 310 

B81674 Dr J C Joseph 2,241 105 34 28 57 407 

B81675 Drs Tak & Stryjakiewicz 9,476 286 47 83 115 1,086 

B81685 Dr N A Poulose 2,444 88 28 14 33 275 

B81688 Dr K V Gopal 2,009 68 2 10 30 218 

Y02344 Northpoint 1,645 60 7 12 24 227 

B81027 St Andrews Grp Practic 5,976 307 58 87 132 897 

B81040 Dr Newman & Partners 16,805 697 60 140 237 1,925 

B81047 Dr Singh & Partners 7,377 217 30 67 99 751 

B81089 Dr Witvliet 3,583 127 31 30 48 449 

B81631 Dr R Raut 3,425 99 12 12 39 535 

B81683 Dr Raghunath & Ptnrs 1,644 66 19 21 23 198 

Y02896 Story St Pract & WalkIn 343 7 2 4 5 38 

B81017 Kingston Medical Grp 6,800 267 51 82 132 1,032 

B81018 Dr Awan & Partners 6,602 281 35 51 89 804 

B81032 Dr AW Hussain & Ptnrs 2,478 78 9 14 23 232 

B81046 Dr J D Blow & Partners 9,068 379 59 91 151 1,259 

B81692 Quays Medical Centre 1,814 19 2 1 10 61 

Y00955 Riverside Med Centre 2,556 100 15 30 38 354 

Y02748 Haxby Orchard Pk Surg 60 8 0 4 5 28 

North Locality 68,517 2,609 428 732 1,026 8,974 

North Locality* 67,555 2,591 427 725 1,016 8,882 

East Locality 83,180 3,547 455 948 1,328 11,624 

West Locality 137,513 4,930 877 1,490 2,107 16,961 

West Locality* 137,029 4,916 873 1,483 2,097 16,889 

HULL 289,210 11,086 1,760 3,170 4,461 37,559 

HULL* 287,764 11,054 1,755 3,156 4,441 37,395 







Table 183: Prevalence of diagnosed cardiovascular and associated medical conditions 

based on GP disease registers 2009/10 

Practice 

code 


population 

(Jan 10) 

Prevalence on disease registers 2009/10 (%) 

CHD Heart 

Failure 

Atrial 

Fibrillation 

Stroke 

& TIA 

Hypertension 

B81035 Dr Sande & Partners 6,114 3.16 0.56 1.23 1.82 11.8 

B81056 Springhead Med Centr 13,489 3.72 0.66 1.31 1.56 14.7 

B81104 Dr J K Nayar 7,721 0.28 0.09 0.13 0.22 1.9 

B81635 Dr G Dave 2,967 6.13 0.74 1.15 1.58 19.4 

B81662 Mizzen Road Surgery 1,856 4.31 1.08 1.78 1.24 19.0 

Y01200 The Calvert Practice 1,765 4.82 0.57 2.10 1.98 19.9 

Y02747 Kingswood Surgery 902 1.11 0.11 0.33 0.55 7.1 

B81020 Dr Mitchell & Partners 7,512 3.58 0.79 1.28 1.72 12.4 

B81021 Faith House Surgery 7,257 3.80 0.85 1.82 2.19 13.6 

B81075 Dr M K Mallik 2,263 3.09 0.35 0.57 0.71 11.4 

B81085 Dr Richardson & Partrs 5,299 5.19 0.53 1.51 1.92 16.3 

B81094 Dr A K Datta 1,925 2.34 0.10 0.78 0.62 11.7 

B81095 Dr Cook 4,242 3.75 0.68 1.58 1.77 17.2 

B81097 Dr R D Yagnik 1,688 3.67 0.30 0.89 0.95 18.7 

B81690 Dr S K Ray 1,734 3.17 0.52 0.52 0.75 19.6 

B81001 Dr Ali & Partners 3,358 3.87 0.33 1.73 1.43 12.1 

B81008 Dr Parker & Partners 15,062 3.53 0.42 0.92 1.23 11.6 

B81048 Dr SM Hussain & Ptrs 9,048 2.91 0.53 1.05 1.29 9.9 

B81049 Dr Rawcliffe & Partners 9,354 3.96 0.74 1.48 1.81 11.5 

B81052 Dr Musil & Queenan 5,740 2.86 0.47 0.87 1.22 10.6 

B81072 Dr Percival & Partners 7,807 3.69 0.88 0.68 1.87 10.4 

B81644 Dr K K Mahendra 2,245 3.07 0.45 0.67 0.62 13.6 

Y02786 Priory Surgery 141 4.96 1.42 2.13 3.55 24.1 

B81011 Wheeler St Healthcare 5,243 4.27 0.71 1.32 1.60 14.7 

B81038 Dr Mather & Partners 7,732 4.81 0.58 1.29 1.93 14.8 

B81057 Dr S MacPhie & Koul 3,345 3.92 0.48 0.99 1.02 14.3 

B81074 Dr A K Rej 3,639 3.74 0.88 1.35 1.37 18.5 

B81081 Dr K M Tang & Partner 3,520 4.52 0.40 1.88 1.76 18.9 

B81645 East Park Practice 2,128 3.90 0.75 0.70 0.80 13.5 

B81646 Dr M Shaikh 1,949 3.18 0.36 0.56 0.87 12.7 

B81682 Dr M Shaikh & Partners 3,726 4.80 0.43 1.02 1.34 14.6 

B81053 Diadem Med Practice 10,232 5.07 0.77 1.60 2.88 15.6 

B81054 Dr Varma & Partners 10,851 4.29 0.91 1.43 1.70 14.2 

B81058 Dr M Foulds & Partner 8,722 4.79 1.08 1.61 2.30 15.1 

B81066 Dr G M Chowdhury 2,522 4.40 0.59 1.03 1.59 11.8 

B81080 Dr G S Malczewski 2,216 5.37 0.50 1.85 1.94 14.0 

B81616 Dr G T Hendow 2,571 4.51 0.66 1.17 1.59 15.2 

B81002 Dr A Kumar-Choudhary 3,844 4.32 0.60 0.68 1.40 13.8 

B81112 Dr Ghosh Raghunath & Ptnrs 3,498 4.12 0.57 0.69 1.34 8.0 

B81119 Dr Palooran & Partners 4,593 4.53 0.59 0.96 1.13 14.4 

B81634 Dr J Venugopal 3,044 3.52 0.20 0.39 0.89 10.2 



Practice 

code 


population 

(Jan 10) 

Prevalence on disease registers 2009/10 (%) 

CHD Heart 

Failure 

Atrial 

Fibrillation 

Stroke 

& TIA 

Hypertension 

B81674 Dr J C Joseph 2,241 4.69 1.52 1.25 2.54 18.2 

B81675 Drs Tak & Stryjakiewicz 9,476 3.02 0.50 0.88 1.21 11.5 

B81685 Dr N A Poulose 2,444 3.60 1.15 0.57 1.35 11.3 

B81688 Dr K V Gopal 2,009 3.38 0.10 0.50 1.49 10.9 

Y02344 Northpoint 1,645 3.65 0.43 0.73 1.46 13.8 

B81027 St Andrews Grp Practic 5,976 5.14 0.97 1.46 2.21 15.0 

B81040 Dr Newman & Partners 16,805 4.15 0.36 0.83 1.41 11.5 

B81047 Dr Singh & Partners 7,377 2.94 0.41 0.91 1.34 10.2 

B81089 Dr Witvliet 3,583 3.54 0.87 0.84 1.34 12.5 

B81631 Dr R Raut 3,425 2.89 0.35 0.35 1.14 15.6 

B81683 Dr Raghunath & Ptnrs 1,644 4.01 1.16 1.28 1.40 12.0 

Y02896 Story St Pract & WalkIn 343 2.04 0.58 1.17 1.46 11.1 

B81017 Kingston Medical Grp 6,800 3.93 0.75 1.21 1.94 15.2 

B81018 Dr Awan & Partners 6,602 4.26 0.53 0.77 1.35 12.2 

B81032 Dr AW Hussain & Ptnrs 2,478 3.15 0.36 0.56 0.93 9.4 

B81046 Dr J D Blow & Partners 9,068 4.18 0.65 1.00 1.67 13.9 

B81692 Quays Medical Centre 1,814 1.05 0.11 0.06 0.55 3.4 

Y00955 Riverside Med Centre 2,556 3.91 0.59 1.17 1.49 13.8 

Y02748 Haxby Orchard Pk Surg 60 13.33 0.00 6.67 8.33 46.7 

North Locality 68,517 3.81 0.62 1.07 1.50 13.1 

North Locality* 67,555 3.84 0.63 1.07 1.50 13.1 

East Locality 83,180 4.26 0.55 1.14 1.60 14.0 

West Locality 137,513 3.59 0.64 1.08 1.53 12.3 

West Locality* 137,029 3.59 0.64 1.08 1.53 12.3 

HULL 289,210 3.83 0.61 1.10 1.54 13.0 

HULL* 287,764 3.84 0.61 1.10 1.54 13.0 





10.1.1.3 Inpatient Hospital Admissions 

During the three year period 2007/08 to 2009/10, there were 271,375 daycase and 

inpatient clinician episodes in total (for an explanation of clinician episodes see section 

12.12 on page 781), with 18,205 (6.7%) of them having a primary diagnosis of 

cardiovascular disease. Just under one-third of all clinician episodes were for CHD 

(ischaemic heart disease) with a further 15% for cerebrovascular disease and 15% for 

diseases of the veins, lymphatic vessels and lymph nodes (Table 184). 

In-patient admission rates provide useful information about the general level of illness 

and the use of hospital services within geographical areas. It is very important to note 

that admission rates depend on how willing people are to make use of medical services, 



the location and accessibility of services, as well as differences in referral patterns and 

practices within primary and secondary care (see page 179 for more discussion). 

Table 184: Total number of daycase and inpatient clinician episodes with primary 

diagnosis of cardiovascular disease over three year period 2007/08 to 2009/10 

ICD 10 code Description Total cardiovascular 

clinician episodes 

2007/08 to 2009/10 

Number Percentage 

I05-I09 Chronic rheumatic heart diseases 57 0.3 

I10-I15 Hypertensive diseases 648 3.6 

I20-I25 Ischaemic heart diseases 5,965 32.8 

I26-I28 Pulmonary heart disease etc 667 3.7 

I48 Atrial fibrillation and flutter 1,166 6.4 

I50 Heart failure 1,429 7.8 

I30-I52 ex I48&I50 Other forms of heart disease 1,269 7.0 

I60-I69 Cerebrovascular disease 2,740 15.1 

I71 Aortic aneurysm and dissection 203 1.1 

I70-I79 ex I71 Other artery, arteriole & capillary disease 1,037 5.7 

I80-I89 Diseases of the veins, lymphatic, etc 2,708 14.9 

I90-I99 Other & unspecified circulatory system disorders 315 1.7 

I00-I99 excl above Other 1 0.0 

Total cardiovascular clinician episodes 18,205 100.0 

From Hospital Episode Statistics, the annual age-gender-standardised 57 rates of hospital 

daycase and inpatient admissions where any of the clinician episodes within that stay 

had a primary diagnosis of cardiovascular disease for the three financial years 2007/08 

to 2009/10 for residents of Hull is given in Table 185 per 1,000 residents. 

57 Standardised to Hull‟s 2009 population (using age bands 0, 1-4, 5-9, etc to 85+ years). 



Table 185: Total three year admissions and annual age-gender-standardised inpatient 

admission rate with a primary diagnosis of cardiovascular disease for the three financial 

years 2007/08 to 2009/10 combined for Hull 

Area Total three year admissions and annual average 

DSR per 1,000 Hull residents (cardiovascular 

disease), 2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 

Bransholme East 269 22.9 (20.1 to 25.9) 204 19.2 (16.4 to 22.3) 

Bransholme West 321 24.6 (21.9 to 27.5) 201 15.4 (13.3 to 17.7) 

Kings Park 204 21.4 (18.4 to 24.8) 149 16.2 (13.4 to 19.5) 

Area: North Carr 794 22.4 (20.8 to 24.0) 554 16.7 (15.3 to 18.3) 

Beverley 242 15.1 (13.2 to 17.1) 226 15.4 (13.4 to 17.6) 

Orchard Park & Greenwood 543 28.1 (25.8 to 30.6) 318 17.3 (15.4 to 19.3) 

University 268 19.7 (17.4 to 22.3) 208 15.1 (13.1 to 17.3) 

Area: Northern 1,053 21.6 (20.3 to 22.9) 752 16.1 (14.9 to 17.3) 

Locality: North 1,847 21.8 (20.9 to 22.9) 1,306 16.3 (15.4 to 17.2) 

Ings 486 19.4 (17.7 to 21.3) 524 18.8 (17.1 to 20.5) 

Longhill 403 19.1 (17.3 to 21.2) 349 15.9 (14.3 to 17.8) 

Sutton 373 18.5 (16.6 to 20.5) 296 15.5 (13.7 to 17.4) 

Area: East 1,262 18.9 (17.9 to 20.0) 1,169 17.1 (16.1 to 18.1) 

Holderness 357 17.2 (15.4 to 19.1) 302 16.0 (14.2 to 18.0) 

Marfleet 456 23.5 (21.4 to 25.8) 338 16.9 (15.1 to 18.8) 

Southcoates East 311 24.9 (22.2 to 27.8) 264 20.2 (17.8 to 22.8) 

Southcoates West 291 23.2 (20.6 to 26.0) 187 14.7 (12.6 to 16.9) 

Area: Park 1,415 21.5 (20.4 to 22.7) 1,091 16.6 (15.7 to 17.7) 

Drypool 397 21.0 (18.9 to 23.2) 300 16.6 (14.8 to 18.6) 

Area: Riverside (East) 397 21.0 (18.9 to 23.2) 300 16.6 (14.8 to 18.6) 

Locality: East 3,074 20.3 (19.6 to 21.1) 2,560 16.8 (16.2 to 17.5) 

Myton 536 21.5 (19.7 to 23.4) 375 19.4 (17.5 to 21.5) 

Newington 386 21.9 (19.7 to 24.2) 269 17.6 (15.5 to 19.9) 

St Andrew's 279 21.5 (19.1 to 24.2) 210 17.3 (15.0 to 19.9) 

Area: Riverside (West) 1,201 21.6 (20.4 to 22.9) 854 18.2 (17.0 to 19.5) 

Boothferry 354 16.8 (15.1 to 18.7) 303 14.2 (12.6 to 15.9) 

Derringham 402 20.0 (18.1 to 22.1) 336 16.1 (14.4 to 17.9) 

Pickering 429 19.9 (18.0 to 21.9) 334 14.9 (13.3 to 16.6) 

Area: West 1,185 18.9 (17.9 to 20.1) 973 15.0 (14.1 to 16.0) 

Avenue 299 17.5 (15.5 to 19.7) 219 13.2 (11.5 to 15.1) 

Bricknell 263 17.4 (15.3 to 19.6) 243 15.5 (13.6 to 17.7) 

Newland 202 16.6 (14.2 to 19.2) 166 16.1 (13.7 to 18.8) 

Area: Wyke 764 17.2 (16.0 to 18.5) 628 14.6 (13.4 to 15.8) 

Locality: West 3,150 19.4 (18.8 to 20.1) 2,455 15.8 (15.2 to 16.4) 

HULL 8,073 20.3 (19.8 to 20.7) 6,326 16.3 (15.9 to 16.7) 



10.1.1.4 Mortality 

From the Compendium, the age-specific mortality rates for cardiovascular disease for 

2006-08 are given in Table 186 for Hull and comparator areas (see section 3.3.3 on 

page 44). The mortality rates for Hull residents are similar to comparators, except for 

those aged 65-74 years in particular for women where the mortality rates are higher in 

Hull. Using the PHMF and GP registration file (October 2007, 2008 and 2009), the rates 

have been calculated for each Area and Locality for deaths during 2007-09 (Table 187). 

Table 186: Cardiovascular age-specific mortality rates for 2006-2008 

Area CVD age specific mortality rates per 100,000 for 2006-2008 

Males Females 

35-64 65-74 75+ all ages 35-64 65-74 75+ all ages 

England 123 745 3,162 309 45.5 381 2,870 322 

Hull 157 974 3,276 304 60.6 633 2,849 316 

Y&H SHA 137 808 3,378 328 51.3 434 2,945 336 

Indust Hinterlands 152 901 3,330 353 61.5 494 2,992 362 

Wolverhampton 167 841 3,217 359 63.4 387 2,895 352 

Salford 186 997 3,796 358 73.9 528 3,417 392 

Derby 128 848 3,446 335 68.7 442 2,978 350 

Stoke-on-Trent 147 937 3,249 332 64.9 454 3,155 369 

Coventry 150 775 3,240 301 53.8 389 2,626 290 

Plymouth 155 797 3,463 328 45.8 390 2,955 337 

Sandwell 184 1,054 3,548 376 59.6 574 3,225 376 

Middlesbrough 164 865 2,988 305 60.0 558 2,799 314 

Sunderland 143 906 3,256 332 61.2 456 2,820 323 

Leicester 164 1,115 3,655 307 69.8 580 3,088 291 

Average above 10 159 914 3,386 333 62.1 476 2,996 339 

NE Lincolnshire 161 955 3,506 380 52.1 474 3,123 376 

Table 187: Cardiovascular age-specific mortality rates for 2007-2009 by Area in Hull 

Area/Locality CVD age specific mortality rates per 100,000 for 2007-2009 

Males Females 


North Carr 181 1,117 3,050 232 70 555 3,179 206 

Northern 122 807 2,719 238 46 471 1,780 182 

NORTH 149 934 2,828 235 57 505 2,262 193 

East 153 799 3,498 379 53 487 2,807 385 

Park 121 906 3,207 273 48 610 2,372 260 

Riverside (East) 162 1,381 2,009 250 70 568 2,568 277 

EAST 140 916 3,228 312 53 549 2,604 313 

Riverside (West) 222 1,336 3,417 309 125 660 3,118 325 

West 119 818 3,110 338 42 486 2,533 339 

Wyke 115 585 3,682 228 55 539 3,142 299 

WEST 155 939 3,345 293 72 551 2,866 322 

HULL 148 929 3,201 286 61 539 2,654 287 



There were a total of 1,144 deaths in men and 1,114 deaths in women due to circulatory 

disease over the period 2007-2009. The age-specific mortality rates for Hull differ 

slightly from the Compendium because different population estimates have been used, 

and it is not possible to present the information for all areas due to small numbers 

(marked with an asterisk in the table). 

Figure 185 illustrates the trend in the under 75 circulatory disease mortality rate over 

recent years for Hull and comparator areas. For 1993-1995, the mortality rate was 

higher in Hull (190 per 100,000 population) than England (154 per 100,000 population), 

the Yorkshire and The Humber SHA (168 per 100,000 population) and North East 

Lincolnshire (179 per 100,000 population), but very similar to the average (192 per 

100,000 population) of the 10 comparators (see section 3.3.3 on page 44), the 

Spearhead group average (191 per 100,000 population) and the Industrial Hinterland 

group (193 per 100,000 population). However, for the most recent period 2006-2008, 

Hull had one of the highest mortality rates (105 per 100,000 population); the mortality 

rates for the average of the 10 comparators and the Spearhead PCTs were 96 and 97 

per 100,000 population respectively. The underlying data are given in the APPENDIX 

on page 903. 

Figure 185: Trend in under 75 circulatory disease mortality rate 

Directly standardised mortality rate per 100,000 persons 

250 

200 

150 

100 

50 

0 

1993-1995 

1994-1996 

1995-1997 

1996-1998 

1997-1999 

1998-2000 

Period 

England Hull 


1999-2001 


2000-2002 


Spearheads 

2001-2003 

2002-2004 

2003-2005 

2004-2006 

2005-2007 

2006-2008


The under 75 2007-2009 directly standardised mortality rates (DSRs) for circulatory 

disease for each Area and Locality are given in Table 188 (standardised to the 

European Standard Population), as well as the total number of under 75 deaths over the 

three year period. The confidence intervals are given, and it can be seen that they are 

wide for the Areas and Localities, particularly for the former. Therefore, despite the 

relatively large differences among the Areas and Localities, the majority of the 

differences could well be due to random variation rather than related to true differences 

in the mortality rates. 

Table 188: Total deaths and under 75 directly standardised mortality rates for circulatory 

disease per 100,000 persons, Hull 2007-2009 

Area Total deaths over three years and under 75 DSRs for circulatory disease 

2007-2009 per 100,000 persons (95% CI) 

Males Females Persons 

N DSR N DSR N DSR 

North Carr 60 167 (127 to 216) 26 69 (45 to 102) 86 117 (93 to 145) 

Northern 53 112 (83 to 146) 28 55 (36 to 80) 81 83 (66 to 104) 

NORTH 113 136 (112 to 163) 54 62 (46 to 81) 167 98 (83 to 114) 

East 71 117 (92 to 148) 37 55 (39 to 76) 108 86 (70 to 104) 

Park 73 118 (93 to 149) 41 62 (45 to 85) 114 91 (75 to 109) 

Riverside (E) 31 171 (116 to 243) 13 73 (39 to 125) 44 123 (89 to 166) 

EAST 175 125 (107 to 144) 91 60 (48 to 74) 266 92 (81 to 104) 

Riverside (W) 102 193 (157 to 234) 45 103 (75 to 138) 147 152 (128 to 178) 

West 64 112 (86 to 143) 35 53 (36 to 74) 99 82 (66 to 100) 

Wyke 39 93 (65 to 127) 24 62 (39 to 92) 63 78 (60 to 100) 

WEST 205 135 (117 to 155) 104 70 (57 to 86) 309 104 (93 to 116) 

HULL 493 132 (120 to 144) 249 64 (57 to 73) 742 98 (91 to 106) 

The under 75 standardised mortality ratios (SMRs) are illustrated in Table 189 for 2006- 

2008. For males, Hull has a circulatory disease SMR for the under 75s which was 31% 

higher than England, and higher than the average of the 10 comparators and Industrial 

Hinterlands group. For women under 75 years, Hull had the highest SMR for circulatory 

disease with the exception of Leicester which was virtually the same as Hull. As Hull 

had the second highest SMR, it had an SMR which was higher than the average of the 

10 comparators and the Industrial Hinterlands group. The under 75 mortality rate for 

circulatory disease in women was 53% higher than England after adjusting for 

differences in the age and gender structures. 



Table 189: Under 75 standardised mortality ratios for circulatory disease for Hull and 

comparators, 2006-2008 

Area Under 75 SMRs for circulatory disease 2006-2008 (95% CI) 


England 100 (99, 101) 100 (99, 101) 100 (99, 101) 

Hull 131 (120, 143) 153 (135, 172) 138 (129, 148) 

Y&H SHA 110 (107, 112) 113 (110, 116) 111 (109, 112) 

Indust Hinterlands 121 (118, 124) 131 (126, 135) 124 (122, 126) 

Wolverhampton 124 (113, 136) 113 (99, 130) 121 (112, 130) 

Salford 141 (129, 154) 144 (126, 164) 142 (132, 153) 

Derby 110 (100, 122) 128 (112, 146) 116 (107, 126) 

Stoke-on-Trent 121 (110, 132) 127 (112, 144) 123 (114, 132) 

Coventry 115 (105, 125) 109 (96, 124) 113 (105, 122) 

Plymouth 114 (104, 125) 102 (88, 117) 110 (101, 119) 

Sandwell 150 (138, 161) 144 (128, 160) 148 (139, 157) 

Middlesbrough 124 (109, 140) 139 (118, 164) 129 (117, 142) 

Sunderland 118 (108, 128) 123 (109, 138) 120 (112, 128) 

Leicester 147 (135, 160) 154 (137, 174) 149 (139, 160) 

Average above 10 126 (123, 130) 127 (122, 132) 127 (124, 130) 

NE Lincolnshire 127 (114, 141) 120 (103, 141) 125 (114, 136) 

The trends in the under 75 SMRs at ward, Area and Locality level are available for 1999- 

2001 to 2007-2009 for circulatory disease on the Hull Atlas (which can be found at 

www.hullpublichealth.org/Pages/hull_atlas.htm). 


There are specific targets relating to CHD (section 10.1.2.10 on page 464) and stroke 

(section 10.1.3.11 on page 481). The Local Area Agreement (LAA) 2 target was to 

reduce the directly standardised mortality rate from circulatory disease for those aged 

under 75 years (standardised to European standard population). The single year targets 

commencing 2007 are given in Table 190 (see Figure 185 for trends over time). 

However, following the change in the government in May 2010, the LAA has been 

replaced, and new outcome measures are now under consultation (see section 3.3.6.2 

on page 52). One of the outcomes is the under 75 mortality rate from circulatory 

disease, so it is possible that this outcome measure and the targets would be retained. 

The directly standardised under 75 circulatory disease mortality rate for 2008 was 105.6 

which is above the target for that year. It is possible that this is random variation. The 

updated mortality rates (involving deaths registered in 2009) are normally published on 

the Compendium at the end of the following year (November or December 2010), but as 

at February 2011, the estimates are not yet available and are due to be published later 

on in March 2011. Local mortality rates can be calculated using the Public Health 










Table 190: Under 75 year circulatory disease mortality targets 

Year Under 75 year circulatory disease 

mortality rate per 100,000 population 

Target Actual 

2005 114.1 

2006 110.7 

2007 103.3 97.5 

2008 97.9 105.6 

2009 92.7 *94.7 

2010 87.7 

2011 83.0 




As illustrated in Figure 1, expenditure on problems of circulation per head for 2008/2009 

in Hull was £131.65 compared to £135.72 for the Industrial Hinterlands average, 

£145.82 for North East Lincolnshire and £129.94 for England. Therefore, whilst 

expenditure was slightly higher in Hull compared to England (ranked 67 th highest out of 

152 PCTs), it was lower than the Industrial Hinterlands average. 

Expenditure per head for 2008/2009 in Hull on coronary heart disease (CHD) was 

£41.65 (ranked 67 th ) compared to £45.79 for the Industrial Hinterlands average, £47.45 

for North East Lincolnshire and £41.20 for England. For cerebrovascular disease 

(stroke) the expenditures per head were £29.05, £20.40, £21.03 and £19.35 for Hull, 

Industrial Hinterlands, North East Lincolnshire and England respectively with Hull ranked 

7 th . For problems of rhythm, the expenditures per head were £9.41, £9.47, £7.69 and 

£8.43 for Hull, Industrial Hinterlands, North East Lincolnshire and England respectively 

with Hull ranked 40 th . The outcomes measures are given in Table 191 for Hull and 

comparator areas (see section 3.3.3 on page 44 for more on comparators). Hull had a 

higher under 75 directly standardised mortality rate (DSR per 100,000 European 

Standard Population) from all circulatory disease (ranked 133 st lowest out of 152 PCTs), 

from CHD (ranked 139 th ), from myocardial infarction (ranked 129 th ) and stroke (ranked 

140 th ) compared to England. The percentage of CHD patients with blood pressure 

measured within the last 15 months which was 150/90 or lower for 2008/2009 was the 



same as the national average (ranked 46 th ), similarly the percentage of CHD patients 

with cholesterol measured within the last 15 months which was 5mmol/l or lower for 

2008/2009 was the same as England (ranked 81 st ). 

Overall, circulatory disease outcomes were worse for Hull compared to England, 

although not substantially different from other comparators. Spend for 2008/2009 was 

slightly higher in Hull compared to England, but lower than the Industrial Hinterlands 

average. 

Table 191: Circulatory disease outcomes in Y&H PHO programme budgeting tool 

Area U75 DSR all 

circulatory 

2006-08 

CHD 

patients 

with blood 

pressure 

≤150/90, 

2008/09 

U75 DSR 

CHD 

2006-08 

U75 DSR MI 

2006-08 

CHD 

patients 

with 

cholesterol 

≤5mmol/l, 

2008/09 

U75 DSR 

stroke 

2006-08 

DSR Rnk % Rnk DSR Rnk DSR Rnk % Rnk DSR Rnk 

England 74.8 90 42.3 17.7 82 13.7 

Ind Hinterlands 92.6 90 54.7 22.8 83 16.7 

Hull* 104.6 133 90 46 63.1 139 26.1 129 82 81 20.5 140 

North Tyneside* 87.6 100 90 72 52.9 113 16.1 58 83 50 14.8 85 

Hartlepool* 95.0 122 90 83 50.2 96 29.0 138 84 20 21.9 147 

Plymouth 82.3 83 89 118 49.0 90 13.9 40 85 9 11.6 35 

Salford 108.1 139 91 18 63.1 140 28.1 132 83 39 18.5 128 

Knowsley* 115.1 145 90 33 69.3 145 28.1 133 79 134 21.9 146 

Darlington* 86.5 95 90 69 48.8 89 25.2 122 86 4 18.0 123 

Gateshead* 90.0 111 89 113 54.8 118 17.2 70 85 7 13.5 64 

South Tyneside* 91.6 116 90 54 55.3 120 13.9 39 84 22 14.8 84 

Sunderland* 88.9 106 91 27 51.9 110 20.6 94 86 3 14.5 81 

Middlesbrough* 95.8 126 90 36 58.0 131 30.2 144 82 68 19.6 137 

Tameside&Glos* 107.8 138 89 116 66.7 143 18.9 88 82 72 18.3 125 

Coventry 85.6 92 88 135 48.2 87 24.4 117 80 123 14.1 73 

Wolverhampton 92.3 117 87 148 49.6 94 24.5 118 77 147 18.8 130 

Derby City 87.3 99 90 45 51.1 104 18.7 86 86 2 14.9 87 

County Durham* 86.8 96 90 81 52.5 112 22.0 101 82 83 16.1 104 

Sefton* 79.9 80 89 121 46.8 84 21.1 98 81 93 16.1 103 

Wirral* 79.4 77 90 48 44.9 75 25.9 125 81 107 15.9 98 

Halton&St Hlens* 101.2 132 90 63 60.0 134 28.3 134 81 106 17.9 120 

Leicester City 112.6 144 89 122 71.3 148 23.7 112 80 120 18.9 131 

Sandwell 110.9 142 89 105 69.5 146 35.9 151 83 52 21.2 144 

Stoke on Trent* 90.0 110 89 112 51.1 103 15.1 52 83 58 16.2 105 

Redcar&Clvl‟d* 87.9 102 91 22 50.5 99 29.9 143 85 11 16.0 100 

NE Lincolnshire 94.6 120 89 111 56.4 124 29.4 141 83 55 15.7 96 




10.1.2 Coronary Heart Disease 


The risk factors have been mentioned already in section 10.1.1.1 on page 434. 

10.1.2.2 Diagnosed and Modelled Prevalence 

The prevalence of diagnosed CHD is given in section 10.1.1.2 on page 434 for each 

general practice in Hull for 2009/10 from local systems. Table 192 presents the 

prevalence of diagnosed CHD for 2009/10 for Hull and comparator areas (see section 

3.3.3 on page 44) and England. The prevalence in Hull is higher than that for England, 

and the average of the 10 comparators. 

Table 192: Prevalence of diagnosed CHD based on GP disease registers 2009/10, Hull 

versus comparator areas 

PCT Number of Total practice Number on CHD CHD unadjusted 

practices population disease register prevalence (%) 

England 8,305 54,836,561 1,885,089 3.44 

Hull 60 289,210 11,086 3.83 

Sunderland 55 284,551 14,860 5.22 

Middlesbrough 25 153,187 6,340 4.14 

Salford 54 242,922 10,410 4.29 

Derby City 33 294,438 10,130 3.44 

Leicester City 66 360,251 10,062 2.79 

Coventry 65 357,743 9,945 2.78 

Wolverhampton 55 258,235 9,964 3.86 

Sandwell 67 339,020 12,301 3.63 

Stoke-On-Trent 57 280,265 11,518 4.11 

Plymouth 43 270,338 9,878 3.65 

Average of 10 520 2,840,950 105,408 3.71 

NE Lincs 34 169,565 7,254 4.28 

The number of patients with diagnosed CHD and the prevalence as recorded on the GP 

QOF disease registers over time is illustrated in Table 193 for 2004/05 to 2008/09. The 

latest list size refers to the registered population as at 1 st January 2010, but the number 

and prevalence on the disease register is as at 31 st March 2010 (the same definitions 

used in QOF), and this means that the prevalence can be biased if large population 

changes have occurred over this three month period (e.g. Y02747, Y02786, Y02896 and 

Y02748 all opened between 5 th October 2009 and 11 th January 2010). The latest list 

size for B81676 (Dr PN Jones) relates to 2004/05 and the latest list size for B81668 (Dr 

EG Stryjakiewicz) relates to 2006/07. Some practices were not in existence for all the 

years so information is not applicable (N/A). 



Table 193: Numbers and prevalence of diagnosed CHD on GP QOF disease registers, 

2004/05 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on CHD QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81035 6,114 319 3.99 188 2.95 185 2.94 187 3.05 178 2.93 193 3.16 

B81056 13,489 379 3.35 415 3.51 459 3.74 460 3.65 470 3.62 502 3.72 

B81104 7,721 16 0.25 21 0.26 19 0.26 22 0.31 25 0.35 22 0.28 

B81635 2,967 192 5.90 183 5.72 181 5.75 182 5.99 188 6.26 182 6.13 

B81662 1,856 61 2.59 69 2.88 88 3.77 92 4.06 86 3.99 80 4.31 

B81676 2,738 5 0.18 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 

Y01200 1,765 N/A N/A 81 6.61 93 5.95 84 5.14 86 5.12 85 4.82 

Y02747 902 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 10 1.11 

B81020 7,512 217 3.15 220 3.03 234 3.23 250 3.41 272 3.57 269 3.58 

B81021 7,257 273 3.84 266 3.70 271 3.80 278 3.85 280 3.77 276 3.80 

B81075 2,263 30 1.09 60 2.22 65 2.57 68 2.80 74 3.14 70 3.09 

B81085 5,299 269 4.95 277 5.07 273 5.10 271 5.09 271 5.08 275 5.19 

B81094 1,925 47 2.11 49 2.14 51 2.20 53 2.35 49 2.27 45 2.34 

B81095 4,242 131 3.26 125 3.16 147 3.68 149 3.70 149 3.60 159 3.75 

B81097 1,688 58 3.48 60 3.68 58 3.58 54 3.28 60 3.59 62 3.67 

B81690 1,734 66 3.61 60 3.52 55 3.09 54 3.10 54 3.09 55 3.17 

B81001 3,358 180 5.94 148 5.03 140 4.87 139 4.62 139 4.22 130 3.87 

B81008 15,062 511 3.55 511 3.48 499 3.35 496 3.34 524 3.52 532 3.53 

B81048 9,048 284 3.18 294 3.20 274 3.00 263 2.89 266 2.86 263 2.91 

B81049 9,354 339 4.24 350 4.32 353 4.19 351 4.03 353 3.87 370 3.96 

B81052 5,740 142 2.73 154 2.75 153 2.90 162 2.91 158 2.85 164 2.86 

B81072 7,807 350 4.91 319 4.66 321 4.66 317 4.34 306 4.03 288 3.69 

B81644 2,245 50 2.21 51 2.28 63 2.81 66 3.00 67 3.03 69 3.07 

B81668 3,326 56 1.68 148 4.46 142 4.21 N/A N/A N/A N/A N/A N/A 


B81011 5,243 238 4.31 236 4.21 242 4.40 241 4.43 231 4.31 224 4.27 

B81038 7,732 379 4.83 360 4.62 366 4.65 372 4.79 382 5.03 372 4.81 

B81057 3,345 148 4.14 151 4.18 146 4.00 140 3.96 139 4.05 131 3.92 

B81074 3,639 234 3.66 234 3.67 244 3.82 241 3.95 140 3.68 136 3.74 

B81081 3,520 156 4.11 151 4.14 151 4.28 145 4.24 160 4.57 159 4.52 

B81645 2,128 112 4.28 109 4.11 98 3.70 98 3.69 83 3.66 83 3.90 

B81646 1,949 70 2.70 73 2.86 76 3.04 72 3.02 63 3.06 62 3.18 

B81682 3,726 195 5.34 192 5.19 187 5.06 186 5.08 184 4.99 179 4.80 

B81053 10,232 537 5.42 525 5.26 527 5.22 526 5.16 513 5.05 519 5.07 

B81054 10,851 497 4.41 506 4.51 468 4.15 455 4.08 468 4.21 465 4.29 

B81058 8,722 428 4.51 424 4.41 412 4.38 405 4.46 410 4.64 418 4.79 

B81066 2,522 113 4.45 104 4.22 100 4.14 110 4.51 121 4.78 111 4.40 

B81080 2,216 122 4.48 123 4.47 119 4.61 113 4.85 116 5.15 119 5.37 

B81616 2,571 104 3.80 107 3.96 112 4.06 105 3.88 99 3.78 116 4.51 

B81002 3,844 153 5.27 147 4.93 134 4.41 121 4.00 113 3.73 166 4.32 

B81112 3,498 148 3.74 143 3.74 137 3.73 139 3.86 137 3.79 144 4.12 

B81119 4,593 202 3.33 164 2.80 210 4.67 210 4.59 211 4.49 208 4.53 

B81634 3,044 100 3.21 102 3.28 112 3.59 115 3.72 108 3.53 107 3.52 

B81674 2,241 109 6.33 119 6.82 117 6.50 125 6.44 92 4.37 105 4.69 

B81675 9,476 151 3.43 138 3.21 136 2.83 270 5.01 263 2.74 286 3.02 

B81685 2,444 85 3.32 87 3.31 81 3.13 85 3.31 85 3.36 88 3.60 

B81688 2,009 62 3.08 62 3.04 68 3.28 66 3.14 69 3.27 68 3.38 



Code Latest 

list 

size 

Number and prevalence on CHD QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

Y02344 1,645 N/A N/A N/A N/A N/A N/A N/A N/A 87 4.41 60 3.65 

B81027 5,976 341 5.42 339 5.64 337 5.69 322 5.39 324 5.38 307 5.14 

B81040 16,805 695 4.24 703 4.27 763 4.55 719 4.23 713 4.22 697 4.15 

B81047 7,377 231 3.08 233 3.16 241 3.30 241 3.33 217 3.00 217 2.94 

B81089 3,583 120 3.75 121 3.73 119 3.58 125 3.69 126 3.55 127 3.54 

B81631 3,425 105 3.25 105 3.35 114 3.59 108 3.32 104 3.04 99 2.89 

B81683 1,644 53 3.45 56 3.53 50 3.28 47 3.24 60 3.96 66 4.01 


B81017 6,800 319 4.34 324 4.62 327 4.53 315 4.35 300 4.40 267 3.93 

B81018 6,602 266 4.06 270 4.12 291 4.29 281 4.18 272 4.08 281 4.26 

B81032 2,478 98 3.22 91 3.06 85 3.07 85 3.13 85 3.23 78 3.15 

B81046 9,068 327 3.84 332 3.92 344 3.82 357 4.07 368 4.12 379 4.18 

B81692 1,814 15 0.80 16 0.80 12 0.65 17 0.96 19 1.06 19 1.05 

Y00955 2,556 N/A N/A 37 5.51 55 3.32 76 3.41 83 3.27 100 3.91 


The Association of Public Health Observatories has produced estimates of the number 

of people in each PCT with CHD. Whist this is useful, it is probably more useful to 

examine this at practice level. Doncaster PCT has created a model which can be used 

to produce the estimated number of people with diagnosed CHD (Doncaster PCT 2008). 

In general when such models have been produced, the model is based on research 

undertaken elsewhere in the UK examining the prevalence of diagnosed disease in the 

community, which has then been modelled and applied to different populations such as 

those living in a particular PCT area. Therefore, the accuracy of the estimates depend 

on the quality of the initial research and the modelling itself. If the original research did 

not include very deprived areas, it is very difficult to generalise and apply the model to 

very deprived areas like Hull. Furthermore, there are many reasons why the prevalence 



















The Doncaster PCT model estimates the number of people with CHD by assuming the 

national prevalence of CHD for each gender and 10-year age band (step 1), adjusting 

the resulting estimates by the all age CHD mortality ratio (e.g. Hull‟s CHD 2006-2008 

SMR was 123 so the stage 1 numbers would be increased by 23 (step 2) and by then 

adjusting the resulting estimates by a deprivation score (UV67 derived from 2001 

Census information) produced at practice level (step 3). This practice deprivation score 

(from step 3) is first divided by the „expected‟ (UV67) score for Hull to avoid „doublecounting‟ 

the effect of deprivation (step 2 and step 3 both adjusted for deprivation). The 

results of the modelling and the actual diagnosed numbers of patients with CHD are 

given in Table 194. The model does not necessarily represent the actual number of 

people who should be diagnosed with CHD for each practice; it is only a guide. The 

characteristics of each practice differ and need to be considered. Furthermore, it does 

not estimate the number of people with undiagnosed CHD. In Hull, as mentioned 

previously, it is anticipated that there could be relatively large levels of undiagnosed 

disease compared to more affluent areas where people are more likely to present to 

their GP with symptoms, as well as having fewer risk factors. 

The original model was developed by John Soady and Bruce Laurence from Sheffield 

Health Authority, with staff at Doncaster PCT updating the model for more recent Health 

Survey for England prevalence information and using a different method of adjusting for 

deprivation. 





2010. 

Table 194: Actual diagnosed and modelled CHD numbers, September 2010 


Numbers with CHD 

(Sept QMAS Sept Modelled Difference 

2010) 2010 estimate 





B81104 Dr JK Nayar 6,553 26 44 -18 

B81635 Dr G Dave 2,979 185 167 18 






B81075 Dr MK Mallik 2,197 70 164 -94 


B81094 Dr AK Datta 1,790 46 76 -30 

B81095 Dr Cook 4,145 159 241 -82 









B81097 Dr RD Yagnik 1,689 67 108 -41 

B81690 Dr SK Ray 1,650 58 74 -16 












B81074 Dr AK Rej 3,534 130 184 -54 



B81646 Dr M Shaikh 1,822 66 98 -32 







B81616 Dr GT Hendow 2,539 114 124 -10 

B81002 Dr A Kumar-Choudhary 3,837 166 145 21 

B81112 Dr Ghosh Raghunath & Ptnrs 3,454 143 118 25 

B81119 Dr G Palooran & Partners 4,528 208 171 37 

B81634 Dr J Venugopal 3,018 112 102 10 

B81674 Dr JC Joseph 2,246 109 110 -1 


B81685 Dr NA Poulose 2,394 87 88 -1 

B81688 Dr KV Gopal 2,023 72 70 2 

Y02344 Northpoint 2,021 64 76 -12 




B81089 Dr Witvliet 3,593 127 170 -43 

B81631 Dr R Raut 3,438 102 96 6 


















HULL 288,935 11,177 13,451 -2,274 

Modelling has also been undertaken to predict the number of people in Hull aged 65+ 

years who have a long-standing condition due to having had a heart attack for the period 

2010 to 2025 (Table 390). 


Table 195 gives the total number of daycase and inpatient admissions over the three 

year period 2007/08 to 2009/10 and the average annual directly age standardised 

admission rate for admissions (DSR) where the primary diagnosis was CHD (for at least 

one of the clinician episodes during the hospital stay) per 100,000 resident population 

(standardised to Hull‟s 2009 population). As previously mentioned, usage of services 

will depend on many different things, such as prevalence of risk factors and disease, 

willingness of visit GPs, referral rates within Primary Care, accessibility of Primary and 

Secondary Care services, etc. For males, the North Locality tends to have higher 

inpatient admission rates for CHD. For females, the rates are similar for North and East 

Localities and slightly lower for West Locality. 

Table 195: Total three year admissions and annual average age-standardised CHD 

inpatient admission rate in Hull, financial years 2007/08 to 2009/10 

Area Total three year admissions and annual average DSR 

per 100,000 Hull residents (for CHD), 2007/08 to 

2009/10 (95% CI) 

Men Women 

N DSR N DSR 

Bransholme East 106 920 (749 to 1,118) 53 506 (369 to 674) 

Bransholme West 147 1,120 (944 to 1,320) 70 512 (398 to 650) 

Kings Park 79 802 (627 to 1,009) 28 293 (187 to 433) 

Area: North Carr 332 922 (824 to 1,028) 151 449 (378 to 529) 

Beverley 86 500 (399 to 619) 64 386 (295 to 494) 

Orchard Park & Greenwood 250 1,304 (1,146 to 1,477) 117 637 (525 to 765) 

University 105 781 (638 to 945) 57 419 (317 to 544) 

Area: Northern 441 899 (817 to 988) 238 494 (432 to 561) 

Locality: North 773 910 (846 to 977) 389 475 (428 to 525) 

Ings 178 734 (627 to 853) 157 544 (460 to 638) 

Longhill 164 771 (655 to 901) 104 467 (379 to 568) 




per 100,000 Hull residents (for CHD), 2007/08 to 

2009/10 (95% CI) 

Men Women 

N DSR N DSR 

Sutton 141 662 (555 to 782) 87 436 (347 to 540) 

Area: East 483 720 (657 to 788) 348 493 (443 to 548) 

Holderness 133 616 (515 to 731) 98 516 (417 to 631) 

Marfleet 165 869 (740 to 1,013) 96 467 (377 to 571) 

Southcoates East 135 1,082 (907 to 1,282) 82 635 (504 to 788) 

Southcoates West 88 697 (559 to 858) 45 354 (258 to 475) 

Area: Park 521 787 (721 to 858) 321 488 (436 to 545) 

Drypool 140 721 (606 to 852) 68 379 (294 to 480) 

Area: Riverside (East) 140 721 (606 to 852) 68 379 (294 to 480) 

Locality: East 1,144 751 (708 to 796) 737 477 (443 to 513) 

Myton 185 752 (647 to 868) 101 531 (432 to 646) 

Newington 150 860 (727 to 1,011) 73 482 (376 to 607) 

St Andrew's 99 758 (615 to 924) 58 502 (380 to 652) 

Area: Riverside (West) 434 788 (715 to 866) 232 513 (449 to 584) 

Boothferry 146 687 (580 to 809) 87 402 (322 to 496) 

Derringham 159 785 (667 to 919) 99 469 (380 to 572) 

Pickering 177 842 (720 to 977) 80 345 (273 to 430) 

Area: West 482 771 (703 to 844) 266 401 (354 to 453) 

Avenue 116 704 (579 to 848) 42 270 (194 to 365) 

Bricknell 109 719 (590 to 868) 77 477 (375 to 597) 

Newland 67 638 (490 to 814) 42 442 (318 to 599) 

Area: Wyke 292 684 (607 to 767) 161 389 (331 to 455) 

Locality: West 1,208 753 (711 to 797) 659 433 (400 to 467) 

HULL 3,125 786 (758 to 814) 1,786 461 (439 to 482) 

Angiography is an investigation of CHD undertaken to assess whether one of two 

common treatments are necessary: percutaneous coronary intervention (PCI) or 

coronary artery bypass graft (CABG). Whilst specific patients may be more suitable to 

either PCI or CABG, for most patients both treatments are equally effective and the 

choice of treatment depends on available resources and/or clinician preference. 

However, generally PCI is becoming more common as it is does not involve open 

surgery as CABG does. Overall treatment (revascularisation) rates are given for PCI 

and CABG combined rather than examining PCI rates and CABG rates separately. 

Table 196 and Table 197 give the total number of admissions and the annual average 

directly age-standardised rates (DSR) per 100,000 persons (of all ages) which involved 

angiography and revascularisation respectively over the three financial years 2007/08 to 

2009/10 for each Area and Locality (standardised to Hull‟s 2009 population). 



Table 196: Total number of admissions involving angiography and average annual agestandardised 

rate per 100,000 persons, financial years 2007/08 to 2009/10 

Area Total three year admissions and annual average DSR per 

100,000 Hull residents – admissions involving 

angiography 2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 

North Carr 180 490 (420 to 568) 130 344 (287 to 410) 

Northern 239 485 (426 to 551) 171 343 (293 to 399) 

NORTH LOCALITY 419 484 (438 to 532) 301 346 (308 to 388) 

East 262 400 (352 to 451) 209 309 (268 to 354) 

Park 257 388 (342 to 439) 204 307 (267 to 353) 

Riverside (East) 80 403 (319 to 503) 53 293 (219 to 384) 

EAST LOCALITY 599 396 (365 to 430) 466 307 (280 to 336) 

Riverside (West) 235 422 (369 to 479) 149 328 (277 to 385) 

West 237 393 (344 to 446) 171 270 (231 to 314) 

Wyke 154 361 (306 to 423) 99 244 (198 to 297) 

WEST LOCALITY 626 392 (362 to 424) 419 281 (255 to 309) 

HULL 1,644 413 (393 to 434) 1,186 307 (290 to 325) 

Table 197: Total number of admissions involving revascularisation and average annual 

age-standardised rate per 100,000 persons, financial years 2007/08 to 2009/10 


100,000 Hull residents – admissions involving 

revascularisation 2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 


Northern 48 97 (71 to 128) 21 41 (25 to 63) 


East 64 96 (74 to 122) 23 32 (20 to 48) 

Park 86 130 (104 to 161) 29 44 (30 to 64) 

Riverside (East) 18 93 (55 to 148) * * 



West 72 112 (87 to 141) 21 31 (19 to 47) 

Wyke 34 83 (57 to 116) 12 31 (16 to 54) 


HULL 427 107 (97 to 118) 135 35 (29 to 41) 

*Numbers too small to present. 




As can be seen from Figure 56 and Figure 57, coronary heart disease (CHD), stroke 

and other circulatory disease mortality make up a large proportion of total deaths in 

those aged under 75 years. 

From the Compendium, the age-specific mortality rates for CHD for 2006-2008 are given 

in Table 198 for Hull and comparator areas (see section 3.3.3 on page 44). Rates are 

not presented for deaths under 35 years as the numbers are too small. Hull‟s mortality 

rates were comparable to the Industrial Hinterlands group and the average of the 10 

comparator PCTs (albeit slightly higher for those aged 65-74 years). 

Table 198: CHD age-specific mortality rates for 2006-2008 

Area CHD age specific mortality rates per 100,000 for 2006-2008 

Males Females 


England 79.6 455 1,579 168 19.1 181 1,095 126 

Hull 103.7 647 1,757 179 31.7 305 1,145 133 

Y&H SHA 94.8 516 1,778 189 23.2 210 1,194 140 

Indust Hinterlands 102.8 561 1,762 203 29.4 251 1,218 154 

Wolverhampton 106.3 454 1,464 180 23.9 184 1,110 138 

Salford 116.3 642 1,934 201 32.8 284 1,352 162 

Derby 85.9 573 1,897 198 28.7 202 1,336 156 

Stoke-on-Trent 98.8 556 1,705 188 31.4 196 1,180 143 

Coventry 98.2 467 1,421 152 25.3 161 830 97 

Plymouth 101.6 534 1,908 194 22.6 174 1,064 127 

Sandwell 130.5 686 1,742 214 31.0 306 1,189 150 

Middlesbrough 115.2 555 1,507 175 27.5 268 986 119 

Sunderland 89.8 526 1,844 193 32.6 254 1,135 140 

Leicester 119.1 744 1,914 181 36.6 307 1,267 127 

Average above 10 106.2 574 1,734 187 29.2 233 1,145 136 

NE Lincolnshire 110.4 619 1,894 225 17.7 228 1,268 154 

Using the PHMF and GP registration file (October 2007, 2008 and 2009), the agespecific 

mortality rates have been calculated for each Area and Locality (Table 199). 

The figures for Hull differ slightly from the Compendium because different population 

estimates have been used, and it is not possible to present the information for all areas 

due to small numbers (marked with an asterisk in the table). Over the period 2007-2009 

there were a total of 674 deaths in men and 471 deaths in women due to CHD. 



Table 199: CHD age-specific mortality rates for 2007-2009 by Area in Hull 

Area/Locality CHD age specific mortality rates per 100,000 for 2007-2009 

Males Females 


North Carr 131 758 1,204 132 45 333 1,511 106 

Northern 69 640 1,576 148 28 298 904 98 

NORTH 97 688 1,453 141 36 312 1,113 102 

East 96 533 1,737 207 18 214 1,153 158 

Park 91 724 1,722 172 36 378 996 124 

Riverside (East) 93 731 1,300 146 * 325 1,014 * 

EAST 93 640 1,686 182 24 297 1,074 135 

Riverside (West) 126 927 1,770 179 74 270 1,004 120 

West 73 641 1,689 205 23 156 1,047 137 

Wyke 85 234 2,104 132 37 252 967 104 

WEST 96 642 1,818 173 43 213 1,013 121 

HULL 95 652 1,696 169 34 268 1,055 122 

The total number of under 75 deaths over the three year period 2007-2009 and the 

under 75 directly standardised mortality rates (DSRs) for CHD are given in Table 200 by 

Area and Locality. The DSRs are standardised to the European Standard Population. 

The confidence intervals are given, and it can be seen that they are wide for the Areas 

and Localities, particularly for the former. Therefore, despite the relatively large 

differences among the Areas and Localities, the differences could well due to random 

variation rather than related to true differences in the mortality rates. 

Table 200: Total deaths and under 75 directly standardised mortality rates for CHD per 

100,000 persons, Hull 2005-2007 

Area Total deaths over three years and under 75 DSRs for CHD 2005-2007 per 

100,000 persons (95% CI) 





NORTH 77 94 (74 to 117) 33 38 (26 to 54) 110 65 (54 to 79) 

East 46 76 (56 to 102) 15 22 (12 to 37) 61 49 (37 to 63) 

Park 56 91 (69 to 118) 27 42 (27 to 61) 83 66 (53 to 82) 


EAST 119 85 (70 to 102) 46 31 (23 to 41) 165 58 (49 to 67) 


West 46 81 (59 to 108) 13 19 (10 to 33) 59 49 (37 to 63) 

Wyke 23 55 (35 to 83) 13 34 (18 to 58) 36 45 (32 to 63) 

WEST 133 89 (74 to 105) 48 33 (25 to 44) 181 62 (53 to 71) 

HULL 329 88 (79 to 98) 127 33 (28 to 40) 456 61 (55 to 67) 



Table 201 gives under 75 SMRs for mortality from CHD for Hull and comparators for 

2006-2008. Hull‟s mortality rate is 39% and 67% higher than England for males and 

females respectively. For Hull men and women, the mortality rate was higher than the 

Industrial Hinterlands and the average of the 10 comparators, particularly for women. 

However, for Hull women, the mortality rate was higher than the Industrial Hinterlands 

group and the average of the 10 comparators. Of the comparator areas, only Leicester 

had a mortality rate higher than Hull for women. So whilst it can be seen from Table 

198, Table 199 and Table 200, the age-specific and overall mortality rates for women 

are considerably lower than men, when compared to England, women in Hull fare worse 

than men in Hull. 

Table 201: Under 75 standardised mortality ratios for CHD disease for Hull and 


Area Under 75 CHD SMR 2006-2008 (95% CI) 


England 100 (99, 101) 100 (99, 101) 100 (99, 101) 

Hull 139 (125, 155) 167 (140, 198) 146 (133, 160) 

Y&H SHA 115 (112, 118) 117 (112, 122) 116 (113, 118) 



Salford 144 (128, 161) 160 (133, 192) 148 (134, 163) 

Derby 118 (105, 133) 124 (101, 152) 120 (108, 133) 

Stoke-on-Trent 121 (108, 136) 126 (103, 152) 122 (111, 135) 

Coventry 115 (103, 129) 103 (84, 125) 112 (102, 123) 

Plymouth 121 (107, 135) 103 (83, 127) 116 (105, 128) 

Sandwell 161 (146, 176) 167 (143, 194) 162 (150, 176) 


Sunderland 114 (102, 127) 149 (126, 174) 123 (113, 134) 

Leicester 162 (146, 180) 183 (155, 216) 168 (154, 183) 

Average above 10 130 (126, 135) 136 (129, 145) 132 (128, 136) 



2001 to 2006-2008 for CHD on the Hull Atlas (www.hullpublichealth.org). 

The trends in the directly standardised mortality rates (DSRs) for CHD per 100,000 

persons for Hull and comparator areas is given in Figure 186. This figure refers to 

deaths for all ages as the World Class Commissioning target relates to all ages (see 

section 10.1.2.10 on page 464). It can be seen that for 1993-1995, the DSR per 

100,000 persons for Hull was similar but slightly lower than the comparator areas 

(Industrial Hinterlands, North East Lincolnshire and the average of the 10 comparator 

areas). However, for 2006-2008, Hull‟s DSR was similar but slightly higher than these 

comparator areas. The absolute gap between Hull and England has remained relatively 

constant over this period. The underlying data are given in the APPENDIX on page 

904. 



Figure 186: Trends over time in all age directly standardised mortality rates for CHD 


persons 

250 

200 

150 

100 

50 

0 

1993-1995 

10.1.2.5 Health Equity Audit 

1994-1996 

1995-1997 

1996-1998 

A health equity audit was conducted during 2004/2005 for Hull and East Riding of 

Yorkshire which examined potential inequalities in relation to CHD. The report 

examined the prevalence of risk factors, primary care prescribing, inpatient admissions 

and mortality. The full report is available at www.hullpublichealth.org. 

10.1.2.6 Diagnosed Prevalence in Relation to Deprivation 

1997-1999 

1998-2000 

1999-2001 

Period 

England Hull 



It is possible to assign a deprivation score to each general practice using the Index of 

Multiple Deprivation 2007 score assigned to each patient (based on their postcode) and 

calculate the mean IMD 2007 score for each practice (i.e. weighted by patient 

population). Table 202 shows the prevalence of diagnosed CHD on the practice 

disease registers for 2009/2010 grouping the practices into five groups. One would 

expect a relationship as factors associated with deprivation are risk factors for CHD, 

however, the mortality rate from CHD will also be higher in these deprived areas. 

Figure 187 shows the practice IMD 2007 scores and the prevalence of diagnosed CHD 

for each practice. The linear regression line is also shown and indicates that there is no 

association between the deprivation score and the prevalence of diagnosed CHD 

(p=0.89). One would expect an association to exist, so this suggests that patients are 

more likely in the most deprived areas to have CHD which is undiagnosed. The 



2000-2002 

2001-2003 

2002-2004 

2003-2005 

2004-2006 

2005-2007 

2006-2008


This information is for 2009/10 and comes from the Quality Management and Analysis 

System (QMAS) from which an extract is taken at the end of March and should be 

equivalent to the extract taken nationally which forms the QOF. 




population changes have occurred over this three month period. This is the case for 

practices Y02747, Y02786, Y02896 and Y02748 which all opened between 5 th October 

2009 and 11 th January 2010, so these four practices have not been included. 

Table 202: Diagnosed prevalence of CHD by deprivation quintile at practice level, 

2009/10 

Practice IMD 2007 Number of List size CHD numbers CHD prevalence (%) 

quintile 

practices* (Jan 10) 

Most deprived 10 57,367 2,321 4.05 

2 12 55,245 2,246 4.07 

3 12 66,252 2,686 4.05 

4 11 65,303 2,436 3.73 

Least deprived 11 43,851 1,365 3.11 

*Excludes Y02747, Y02786, Y02896 and Y02748. 

Figure 187: Diagnosed prevalence of CHD by deprivation score at practice level 



10.1.2.7 Inpatient Admissions and Treatment in Relation to Deprivation 

Figure 188 illustrates the average annual directly age-standardised daycase and 

inpatient admission rates which involve a primary diagnosis of CHD (any clinician 

episode within that hospital stay) by local deprivation quintile over three financial years 

2007/08 to 2009/10 (standardised to Hull‟s 2009 population). Figure 189 gives the 

equivalent information for angiography and revascularisation. The 95% confidence 

intervals are shown. There is a statistically significant difference in the rates among the 

quintiles for admissions, investigation and treatment. The underlying data for both of 

these figures is given in the APPENDIX on page 906. 

As expected, given the higher prevalence of lifestyle and behavioural risk factors, people 

living in the most deprived areas have a higher hospital admission rate for CHD as well as 

a higher rate of investigation and treatment. However, it is difficult to ascertain if this 

pattern is reflecting „need‟. It could be that the gradient between the most and least 

deprived quintiles should be steeper or less steep than the gradient observed. However, 

compared to the least deprived local quintile, the CHD admission rate is 57% higher in the 

most deprived local quintile compared to the least deprived quintile, and 51% for 

angiography and 42% for revascularisation. This may suggest the presence of some 

inequalities. It is possible that patients in the most deprived quintile are not having 

revascularisation as readily as people in the least deprived quintile based on the same 

need, or that people in the least deprived areas are having angiography unnecessarily (as 

the pattern of angiography and revascularisation differs over the deprivation quintiles). 

There could be many reasons why this is the case, for example, people in the most 

deprived quintiles may be less demanding in terms of obtaining investigation and 

treatment, and may be less likely to visit their GP with their symptoms. They may also be 

more likely to be admitted as an inpatient as an emergency case. 

Figure 188: Age-gender standardised CHD annual daycase and inpatient admission rate 

per 100,000 population for all ages by local deprivation quintile for Hull 



Figure 189: Age-gender standardised annual daycase and inpatient admission rate per 

100,000 population for admissions involving angiography and/or revascularisation for all 

ages by local deprivation quintile for Hull 

10.1.2.8 Mortality in Relation to Deprivation 

The directly age-standardised mortality rate (DSR) per 100,000 persons for deaths from 

coronary heart disease (CHD) for persons aged less than 75 years is given in Figure 

190 for Hull (for the period 2007 to 2009) in relation to local deprivation quintiles. The 

DSR is standardised to the European Standard Population. There is a clear and very 

strong trend for the under 75 DSR for CHD by deprivation. The premature mortality rate 

from CHD is almost three times higher in the two most deprived quintiles in Hull compared 

to the least deprived quintile in Hull. The under 75 DSR for the most deprived quintile has 

decreased substantially since Release 2 of this profile, by almost one quarter, while the 

DSRs for other quintiles are largely unchanged. The underlying data are given in the 




Figure 190: Under 75 directly standardised mortality rate per 100,000 persons for CHD 

by deprivation for Hull for 2007-2009 

Under 75 directly age-standardsied CHD 

mortality rate per 100,000 persons 

2007-2009 

120 

100 

80 

60 

40 

20 

0 

Most 

deprived 

local quintile 

Quintile 2 Quintile 3 Quintile 4 Least 

deprived 



10.1.2.9 Mortality Within the Most Deprived National Quintile – Hull and Comparators 

The data in this section are from a project looking at SMRs within national deprivation 

quintiles, using national mortality data as well as population estimates at lower layer 

super out area (LLSOA) for the entire country. This work was possible due to the 

assistance of the Yorkshire and Humber Public Health Observatory, who hold a copy of 

the national mortality file and have commissioned the Office for National Statistics 





locally, the SMRs produced will not be the same as those produced using local data. 


averages for the 10 comparator PCTs (see section 3.3.3.1 on page 44), Spearhead 




Figure 191 shows trends in under 75 standardised mortality ratios (SMRs) for CHD for 

Hull and comparator areas for those residents living in areas that lie within the most 

deprived 20% of areas in England, which for Hull amounts to more than half of all 

residents. 



Under 75 SMRs for men in Hull decreased between 2001-2003 and 2003-2005, 

thereafter remaining flat. However, the overall decrease in SMRs in Hull between 2001- 

2003 and 2006-2008 was similar to decreases seen in comparator areas, excluding 

North East Lincolnshire which saw its SMR in 2006-2008 barely changed from 2001- 

2003. In 2001-2003, women in Hull living in areas ranked in the most deprived fifth 

nationally saw under 75 CHD SMRs increase between 2001-2003 and 2004-2006, 

thereafter decreasing such that in 2006-2008 the SMR was 15% lower than in 2001- 

2003, albeit still higher than for each comparator, as it had been throughout the period. 

While a similar pattern was observed for North East Lincolnshire, albeit with lower SMRs 

for each year, other comparator areas saw a decreasing trend in under 75 CHD SMRs 

throughout 2001-2003 to 2006-2008. 


Figure 191: Trends in under 75 CHD standardised mortality ratios by national 

deprivation quintiles for Hull and comparators for 2001-03 to 2006-08 




The target relating to CHD within the local World Class Commissioning (WCC) Strategy 

was to reduce the all-age directly standardised mortality rate (DSR) per 100,000 

Standard European Population for CHD (ICD 10: I20-I25) between 2004-2006 and 

2011-2013 at a rate that is 20% higher than the average annual reduction seen in 

England from 1995-97 to 200406 58 . Between 1995-97 and 2006-08, England‟s all-age 

DSR for CHD fell by an average of 7.4 per 100,000 persons per annum, whereas the 

decrease in Hull was 7.7 per 100,000 persons, so the gap has decreased slightly. 

However, for 2006-08, Hull failed to achieve its target (Table 203). 











locally derived estimates can provide a guide. It is unlikely that the rates will differ 

substantially, and it is likely that the official estimate will be slightly higher due to the 

difference in the population estimates, therefore, it would appear that Hull has failed to 

achieve its target for 2007-09. 


consultation (see section 3.3.6.2 on page 52). One of the outcomes proposed is the 

under 75 mortality rate from circulatory disease, but there is no mention of a separate 

target for CHD. Therefore, it is possible that this outcome measure will no longer be a 

key outcome measure unless it is retained locally. 

58 Target given for 2011-13 within WCC strategy, but annual targets calculated here with equal increase 

between 2004-06 and 2011-13 (updated WCC strategy may not include staged rather than equal size 

improvements). 



Table 203: World Class Commissioning CHD mortality targets 

Year All-age CHD DSR per 100,000 persons 

England Hull 

DSR Change DSR Change Target 

1995-1997 168 191 

1996-1998 161 –7.06 182 –8.15 

1997-1999 153 –8.13 181 –1.47 

1998-2000 145 –7.88 175 –6.08 

1999-2001 137 –8.25 167 –7.73 

2000-2002 130 –6.92 157 –9.92 

2001-2003 125 –5.67 152 –5.04 

2002-2004 118 –6.88 144 –8.50 

2003-2005 110 –7.50 136 –7.95 

2004-2006 102 –8.36 127 –8.79 

2005-2007 95 –6.81 124 –3.34 118.0 

2006-2008 89 –5.84 115 –8.84 109.1 

Average –7.40 –7.73 

2007-2009 *109 –6.10 100.2 

2008-2010 91.3 

2009-2011 82.5 

2010-2012 73.6 

2011-2013 64.7 



10.1.2.11 Programme Budgeting 

Expenditure per head for 2008/2009 in Hull on CHD was £41.65 (ranked 67 th ) compared 

to £45.79 for the Industrial Hinterlands average, £47.45 for North East Lincolnshire and 

£41.20 for England. Further information on CHD outcomes used in the Yorkshire and 

the Humber Public Health Observatory Programme Budgeting toolkit is given in section 

10.1.1.6 on page 445. 



10.1.3 Stroke 




The prevalence of diagnosed stroke and transient ischaemic attack (TIA) is given in 

section 10.1.1.2 on page 434 for each general practice in Hull for 2009/10. Table 204 

presents the prevalence of diagnosed stroke and TIA for 2009/10 for Hull and 

comparator areas (see section 3.3.3 on page 44) and for England. The prevalence in 

Hull is lower than England and the average of the 10 comparators with only Plymouth 

having a lower prevalence for stroke and TIA. 

Table 204: Prevalence of diagnosed stroke and TIA based on GP disease registers 

2009/10, Hull versus comparator areas 

PCT 

Number on 

Stroke/TIA 

Stroke/TIA 

unadjusted 


Number of Total practice 

practices population disease register 

England 8,305 54,836,561 921,819 1.68 

Hull 60 289,210 4,461 1.54 

Coventry 55 284,551 6,241 2.19 

Derby City 25 153,187 2,816 1.84 



Plymouth 66 360,251 4,354 1.21 

Salford 65 357,743 5,600 1.57 

Sandwell 55 258,235 4,599 1.78 

Stoke-On-Trent 67 339,020 5,554 1.64 

Sunderland 57 280,265 5,480 1.96 


Average of 10 520 2,840,950 48,283 1.70 

NE Lincs 34 169,565 3,540 2.09 

The number of patients with diagnosed stroke and TIA and the prevalence as recorded 

on the GP QOF disease registers over time is illustrated in Table 205 for 2004/05 to 

2009/10. The latest list size refers to the registered population as at 1 st January 2010, 

but the number and prevalence on the disease register is as at 31 st March 2010 (the 

same definitions used in QOF), and this means that the prevalence can be biased if 

large population changes have occurred over this three month period (e.g. Y02747, 

Y02786, Y02896 and Y02748 all opened between 5 th October 2009 and 11 th January 

2010). The latest list size for B81676 (Dr PN Jones) relates to 2004/05 and the latest 



list size for B81668 (Dr EG Stryjakiewicz) relates to 2006/07. Some practices were not 

in existence for all the years so information is not applicable (N/A). 

Table 205: Numbers and prevalence of diagnosed stroke and TIA on GP QOF disease 

registers, 2004/05 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on stroke and TIA QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81035 6,114 145 1.81 107 1.68 109 1.74 103 1.68 109 1.80 111 1.82 

B81056 13,489 143 1.26 183 1.55 205 1.67 193 1.53 196 1.51 210 1.56 

B81104 7,721 6 0.09 5 0.06 9 0.12 8 0.11 13 0.18 17 0.22 

B81635 2,967 34 1.04 31 0.97 34 1.08 36 1.18 42 1.40 47 1.58 

B81662 1,856 10 0.42 12 0.50 18 0.77 20 0.88 25 1.16 23 1.24 


Y01200 1,765 N/A N/A 33 2.69 45 2.88 39 2.39 37 2.20 35 1.98 


B81020 7,512 138 2.00 149 2.06 144 1.99 140 1.91 137 1.80 129 1.72 

B81021 7,257 132 1.86 148 2.06 159 2.23 167 2.31 165 2.22 159 2.19 

B81075 2,263 10 0.36 9 0.33 19 0.75 20 0.82 17 0.72 16 0.71 

B81085 5,299 78 1.44 86 1.58 100 1.87 107 2.01 108 2.02 102 1.92 

B81094 1,925 14 0.63 14 0.61 15 0.65 15 0.67 13 0.60 12 0.62 

B81095 4,242 62 1.54 58 1.47 69 1.73 74 1.84 70 1.69 75 1.77 

B81097 1,688 5 0.30 4 0.25 5 0.31 7 0.42 7 0.42 16 0.95 

B81690 1,734 8 0.44 9 0.53 11 0.62 16 0.92 16 0.92 13 0.75 

B81001 3,358 33 1.09 48 1.63 51 1.77 53 1.76 48 1.46 48 1.43 

B81008 15,062 136 0.94 161 1.10 157 1.06 177 1.19 184 1.23 185 1.23 

B81048 9,048 72 0.81 91 0.99 103 1.13 105 1.15 108 1.16 117 1.29 

B81049 9,354 155 1.94 165 2.03 169 2.01 175 2.01 172 1.88 169 1.81 

B81052 5,740 60 1.15 64 1.14 67 1.27 69 1.24 70 1.26 70 1.22 

B81072 7,807 213 2.99 178 2.60 175 2.54 173 2.37 159 2.10 146 1.87 

B81644 2,245 4 0.18 7 0.31 9 0.40 9 0.41 12 0.54 14 0.62 



B81011 5,243 60 1.09 72 1.28 78 1.42 87 1.60 84 1.57 84 1.60 

B81038 7,732 122 1.56 126 1.62 131 1.66 141 1.82 143 1.88 149 1.93 

B81057 3,345 39 1.09 40 1.11 35 0.96 35 0.99 38 1.11 34 1.02 

B81074 3,639 56 0.88 61 0.96 74 1.16 76 1.25 47 1.23 50 1.37 

B81081 3,520 64 1.69 66 1.81 66 1.87 61 1.78 59 1.68 62 1.76 

B81645 2,128 18 0.69 20 0.75 17 0.64 22 0.83 19 0.84 17 0.80 

B81646 1,949 23 0.89 26 1.02 30 1.20 23 0.96 19 0.92 17 0.87 

B81682 3,726 44 1.20 47 1.27 48 1.30 45 1.23 47 1.28 50 1.34 

B81053 10,232 287 2.89 294 2.95 288 2.85 292 2.86 296 2.92 295 2.88 

B81054 10,851 119 1.05 135 1.20 164 1.45 168 1.51 184 1.65 184 1.70 

B81058 8,722 212 2.23 214 2.22 219 2.33 211 2.32 215 2.43 201 2.30 

B81066 2,522 26 1.02 30 1.22 31 1.28 28 1.15 34 1.34 40 1.59 

B81080 2,216 40 1.47 42 1.53 40 1.55 38 1.63 38 1.69 43 1.94 

B81616 2,571 38 1.39 41 1.52 34 1.23 37 1.37 35 1.34 41 1.59 

B81002 3,844 27 0.93 43 1.44 44 1.45 40 1.32 42 1.39 54 1.40 

B81112 3,498 28 0.71 44 1.15 43 1.17 45 1.25 44 1.22 47 1.34 

B81119 4,593 10 0.16 19 0.32 36 0.80 43 0.94 46 0.98 52 1.13 

B81634 3,044 21 0.67 23 0.74 25 0.80 24 0.78 26 0.85 27 0.89 

B81674 2,241 25 1.45 27 1.55 29 1.61 46 2.37 49 2.33 57 2.54 



Code Latest 

list 

size 

Number and prevalence on stroke and TIA QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81675 9,476 37 0.84 56 1.30 59 1.23 93 1.73 98 1.02 115 1.21 

B81685 2,444 24 0.94 29 1.10 32 1.24 32 1.25 30 1.18 33 1.35 

B81688 2,009 14 0.69 16 0.79 23 1.11 24 1.14 30 1.42 30 1.49 


B81027 5,976 139 2.21 144 2.40 143 2.41 137 2.29 137 2.28 132 2.21 

B81040 16,805 201 1.23 237 1.44 305 1.82 234 1.38 230 1.36 237 1.41 

B81047 7,377 93 1.24 103 1.39 108 1.48 106 1.47 101 1.40 99 1.34 

B81089 3,583 23 0.72 28 0.86 42 1.26 40 1.18 46 1.30 48 1.34 

B81631 3,425 30 0.93 32 1.02 34 1.07 39 1.20 48 1.40 39 1.14 

B81683 1,644 16 1.04 19 1.20 17 1.11 14 0.97 19 1.25 23 1.40 


B81017 6,800 139 1.89 149 2.12 161 2.23 160 2.21 146 2.14 132 1.94 

B81018 6,602 92 1.40 88 1.34 93 1.37 88 1.31 80 1.20 89 1.35 

B81032 2,478 17 0.56 20 0.67 15 0.54 16 0.59 23 0.87 23 0.93 

B81046 9,068 114 1.34 147 1.74 145 1.61 151 1.72 155 1.74 151 1.67 

B81692 1,814 5 0.27 6 0.30 10 0.54 10 0.56 10 0.56 10 0.55 

Y00955 2,556 N/A N/A 7 1.04 21 1.27 27 1.21 28 1.10 38 1.49 



number of people who have been diagnosed as having had a stroke or TIA (Doncaster 

PCT 2008). 











Health Observatories 2011) and in section 12.1 on page 770. Therefore, just because 

practices have a particularly low prevalence or a relatively large difference between the 

registers and the model, it does not necessarily mean that they are performing badly in 

any way relative to other general practices. Nevertheless, a comparison of the 

differences between the modelled prevalence and the practice list registers can act as a 

starting point for investigation. Practices with a low prevalence or a relatively large 

difference between the model and the register estimates can be examined further and 

considered in relation to patient characteristics using local knowledge. Differences 

might just reflect that the model is not a very good fit for Hull. For reference, the mean 

age of practice patients (Table 28) and mean deprivation scores (Table 49) for each 

practice may be examined. 



Using the Doncaster PCT model, the modelled and actual diagnosed numbers of 

patients who have had a stroke or TIA are given in Table 206. The model does not 

necessarily represent the actual number of people who should be diagnosed with having 

had a stroke or TIA for each practice; it is only a guide. The characteristics of each 

practice differ and need to be considered. Furthermore, it does not include undiagnosed 

cases of stroke or TIA. The numbers are probably relatively small unless the stroke or 

TIA is mild with no longer term symptoms or consequences to health. The model uses 

information from the Health Survey for England (Health Survey for England 2008) 

collected during the year 2003. The model does not adjust the estimates in any way for 

ethnicity or deprivation. 





2010. 

Table 206: Actual diagnosed and modelled stroke numbers, September 2010 

Code Practice name List size Numbers with stroke or TIA 





B81035 Dr WGT Sande & Partners 6,160 116 116 0 


B81104 Dr JK Nayar 6,553 15 23 -8 

B81635 Dr G Dave 2,979 47 61 -14 


Y01200 The Calvert Practice 1,815 37 37 0 



B81021 Faith House Surgery 7,372 165 131 34 

B81075 Dr MK Mallik 2,197 16 57 -41 


B81094 Dr AK Datta 1,790 15 28 -13 

B81095 Dr Cook 4,145 79 88 -9 

B81097 Dr RD Yagnik 1,689 25 39 -14 

B81690 Dr SK Ray 1,650 15 26 -11 



B81048 Dr SM Hussain & Partners 8,915 123 117 6 

B81049 Dr VA Rawcliffe & Partners 9,221 169 158 11 


B81072 Dr R Percival & Partners 7,574 148 110 38 


Y02786 Priory Surgery 813 17 11 6 




Code Practice name List size Numbers with stroke or TIA 







B81074 Dr AK Rej 3,534 51 61 -10 



B81646 Dr M Shaikh 1,822 21 32 -11 


B81053 Diadem Medical Practice 10,642 290 204 86 

B81054 Dr MJ Varma & Partners 10,690 185 181 4 

B81058 Dr M Foulds & Partner 8,680 206 161 45 



B81616 Dr GT Hendow 2,539 45 44 1 





B81674 Dr JC Joseph 2,246 58 35 23 

B81675 Dr Tak & Dr Stryjakiewicz 9,111 113 112 1 

B81685 Dr NA Poulose 2,394 34 30 4 

B81688 Dr KV Gopal 2,023 32 23 9 

Y02344 Northpoint 2,021 27 26 1 

B81027 St Andrews Group Practice 5,954 132 108 24 



B81089 Dr Witvliet 3,593 48 52 -4 

B81631 Dr R Raut 3,438 40 31 9 

B81683 Dr AS Raghunath & Partners 1,749 24 24 0 

Y02896 Story St Practice/Walk In 944 10 9 1 

B81017 Kingston Medical Group 6,725 135 105 30 



B81046 Dr JD Blow & Partners 9,247 160 139 21 


Y00955 Riverside Medical Centre 2,460 37 32 5 

Y02748 Haxby Orchard Park Surgery 552 8 5 3 

HULL 288,935 4,571 4,603 -32 


years who have a long-standing condition due to having had a stroke for the period 2010 

to 2025 (Table 391). 






admission rate for admissions (DSR) where the primary diagnosis was stroke (for at 

least one of the clinician episodes during the hospital stay) per 100,000 resident 

population (standardised to Hull‟s 2009 population). As previously mentioned, usage of 

services will depend on many different things, such as prevalence of risk factors and 

disease, willingness of visit GPs, referral rates within Primary Care, accessibility of 

Primary and Secondary Care services, etc. 

Table 207: Total three year admissions and annual average age-standardised stroke 



100,000 Hull residents with primary diagnosis of stroke 

2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 


Northern 98 204 (166 to 249) 80 183 (145 to 229) 


East 122 171 (142 to 205) 145 199 (168 to 234) 

Park 121 183 (151 to 218) 142 218 (184 to 258) 




West 127 192 (160 to 229) 126 188 (156 to 223) 

Wyke 72 164 (128 to 207) 116 262 (216 to 315) 


HULL 758 190 (177 to 205) 836 215 (201 to 230) 


From the Compendium, the age-specific mortality rates for stroke for 2006-2008 are 

given in Table 208 for Hull and comparator areas (see section 3.3.3 on page 44). The 

mortality rate in Hull is comparable to the Industrial Hinterlands and average of the 10 

comparators for those aged 35-64 years and 75+ years, but is higher for those aged 65- 

74 years in particular for Hull women. 



Table 208: Stroke age-specific mortality rates for 2006-2008 

Area Stroke age specific mortality rates per 100,000 for 2006-2008 

Males Females 


England 15.8 125 823 68.3 12.3 93.9 981 106 

Hull 21.1 178 869 66.7 14.4 186.1 993 105 

Y&H SHA 16.4 134 886 71.8 13.4 110.0 1,027 112 

Indust Hinterlands 19.1 155 845 74.9 15.1 116.4 999 114 

Wolverhampton 22.3 203 910 88.4 17.9 93.7 973 113 

Salford 22.3 164 1,163 86.0 19.3 102.0 1,206 129 

Derby 14.2 123 790 65.6 15.1 125.1 895 102 

Stoke-on-Trent 17.8 157 843 71.0 15.7 116.7 960 109 

Coventry 16.1 125 883 66.8 12.4 96.6 930 97 

Plymouth 14.3 100 694 54.7 14.4 60.9 1,017 109 

Sandwell 22.6 196 993 85.2 16.4 158.1 1,104 124 

Middlesbrough 24.9 192 821 72.6 13.8 142.3 1,008 105 

Sunderland 16.8 140 716 61.5 15.4 88.1 845 91 

Leicester 20.8 186 892 62.3 14.0 127.7 1,013 89 

Average above 10 19.2 158 871 71.4 15.4 111.1 995 107 

NE Lincolnshire 17.0 141 907 78.5 15.6 109.8 1,083 124 



Table 209: Stroke age-specific mortality rates for 2007-2009 by Area in Hull 

Area/Locality Stroke age specific mortality rates per 100,000 for 2007-2009 

Males Females 


North Carr 37 239 963 57 * 148 1,094 * 

Northern 37 * 670 * * * 411 33 

NORTH 37 115 766 52 * 89 646 * 

East 31 111 978 92 13 97 941 121 

Park 11 * 772 * * 147 833 * 

Riverside (East) * 244 355 * * * 878 87 

EAST 19 79 831 62 11 126 890 99 

Riverside (West) 50 136 906 65 29 210 1,295 124 

West * 111 1,046 * * 136 658 * 

Wyke * 234 956 * 18 180 1,289 119 

WEST 23 149 982 68 18 169 1,013 109 

HULL 25 115 880 62 12 134 899 90 

Over the period 2007-2009, there were a total of 249 deaths in men and 350 deaths in 

women due to stroke. The figures for Hull differ slightly from the Compendium because 

different population estimates have been used, and it is not possible to present the 

information for all areas due to small numbers (marked with an asterisk in the table). 



The total number of under 75 deaths from stroke for the period 2007-2009 and the 

directly standardised mortality rates (DSRs) are given in Table 210 by Area and 

Locality. The DSRs are standardised to the European Standard Population. The 

confidence intervals are given, and it can be seen that they are wide for the Areas and 

Localities, particularly for the former. Therefore, despite the relatively large differences 

among the Areas and Localities, the differences could well be associated with random 

variation rather than related to true differences in the mortality rates. 

Table 210: Total number of deaths and under 75 directly standardised mortality rates for 

stroke per 100,000 persons, Hull 2007-2009 

Area Total deaths over three years and under 75 DSRs for stroke 2007-2009 per 

100,000 persons (95% CI) 



North Carr 12 33.4 (17.2 to 58.5) 5 13.4 (4.3 to 31.4) 17 23.2 (13.4 to 37.2) 

Northern * * * * 10 10.7 (5.1 to 19.8) 

NORTH 20 24.0 (14.6 to 37.1) 7 7.9 (3.1 to 16.3) 27 15.9 (10.5 to 23.2) 

East 12 19.0 (9.8 to 33.2) 8 11.5 (4.9 to 22.9) 20 15.2 (9.2 to 23.5) 

Park 3 4.8 (1.0 to 14.2) 9 13.2 (6.0 to 25.1) 12 9.3 (4.8 to 16.3) 

Riverside (E) 4 22.1 (5.9 to 56.8) 3 16.0 (3.2 to 46.9) 7 18.9 (7.6 to 39.0) 

EAST 19 13.1 (7.9 to 20.5) 20 12.6 (7.6 to 19.5) 39 12.9 (9.2 to 17.7) 

Riverside (W) 17 32.6 (19.0 to 52.3) 13 28.2 (14.9 to 48.5) 30 30.9 (20.8 to 44.1) 

West 6 10.0 (3.6 to 21.9) 9 13.5 (5.9 to 26.0) 15 11.8 (6.5 to 19.6) 

Wyke 8 19.3 (8.2 to 38.1) 8 20.4 (8.7 to 40.2) 16 19.6 (11.2 to 31.9) 

WEST 31 20.4 (13.8 to 28.9) 30 19.8 (13.3 to 28.3) 61 20.1 (15.4 to 25.9) 

HULL 70 18.4 (14.4 to 23.3) 57 14.3 (10.8 to 18.6) 127 16.5 (13.7 to 19.6) 

*Numbers not given as one area has less than three deaths from stroke over the period. 

Table 211 gives under 75 SMRs for Hull and comparator areas from the Compendium 

for 2006-2008. The under 75 mortality rate for stroke is 38% and 68% higher than 

England for men and women respectively. Both men and women have a higher under 

75 years SMR for stroke compared to the Industrial Hinterlands and the average of the 

10 comparators with the rates for Hull approximately 13% higher than these 

comparators for men and approximately 40% for women. Furthermore, for women the 

under 75 SMR is higher for all 10 of these comparator PCTs. 



Table 211: Under 75 standardised mortality ratios for stroke for Hull and comparators, 

2006-2008 

Area Under 75 stroke SMR 2006-2008 (95% CI) 


England 100 (98, 102) 100 (98, 102) 100 (99, 101) 

Hull 138 (109, 171) 168 (132, 209) 151 (128, 176) 

Y&H SHA 106 (100, 112) 114 (107, 120) 109 (105, 114) 



Salford 137 (107, 172) 123 (92, 162) 131 (109, 156) 

Derby 96 (72, 126) 127 (96, 165) 110 (90, 132) 

Stoke-on-Trent 119 (92, 150) 124 (95, 160) 121 (101, 144) 

Coventry 103 (81, 131) 102 (77, 132) 103 (86, 122) 

Plymouth 83 (61, 110) 82 (59, 111) 82 (66, 101) 

Sandwell 154 (126, 186) 158 (127, 194) 156 (135, 179) 


Sunderland 107 (84, 133) 104 (80, 134) 106 (89, 125) 

Leicester 143 (113, 178) 131 (100, 168) 137 (115, 162) 

Average above 10 123 (114, 133) 119 (109, 129) 121 (115, 128) 



2001 to 2007-2009 for stroke on the Hull Atlas (www.hullpublichealth.org). 

The trends in the directly standardised mortality rates (DSRs) per 100,000 persons for 

CHD for Hull and comparator areas are given in Figure 192. This figure refers to deaths 

for those aged under 75 years as the World Class Commissioning target relates to 

under 75 (see section 10.1.3.11 on page 481). It can be seen that for 1993-1995, the 

DSR per 100,000 persons for Hull was similar but slightly lower than the comparator 

areas (Industrial Hinterlands, North East Lincolnshire and the average of the 10 

comparator areas). However, for 2006-2008, Hull‟s DSR was slightly higher than these 

comparator areas. The underlying data are given in the APPENDIX on page 908. 



Figure 192: Trends over time in under 75 directly standardised mortality rates for stroke 


persons 

40 

35 

30 

25 

20 

15 

10 

5 

0 

1993-1995 


1994-1996 

1995-1997 

1996-1998 

1997-1999 

Period 

England Hull 

1998-2000 

1999-2001 


A Stroke Health Equity Audit is currently underway across Hull and East Riding of 

Yorkshire. The equity audit examines stroke „need‟ in relation to specific groups where 

inequity may exist. Stroke „need‟ is based on the prevalence of risk factors, the 

prevalence of stroke and transient ischaemic attack on the GP disease registers, 

modelled prevalence of stroke, hospital admissions for stroke, mortality from stroke, and 

quality of care as measured by the on-going measures of care on the GP‟s Quality and 

Outcomes Framework (QOF). Whilst it is recognised that there are a number of „groups‟ 

of individuals who might experience health inequalities in relation to stroke, the equity 

audit examines groups defined on the basis of age, gender, ethnicity and deprivation as 

information is available for these groups (other groups are considered but not in detail 

due to the lack of information). The equity audit also examines programmes of care that 

might reduce inequalities, and produces a list of recommendations. 

The report is due to be published in Spring 2011, and will be available at 



2000-2002 


2001-2003 

2002-2004 

2003-2005 

2004-2006 

2005-2007 

2006-2008






population). Table 212 shows the prevalence of diagnosed stroke and TIA on the 

practice disease registers for 2009/10 grouping the practices into five groups. Figure 

193 shows the practice IMD 2007 scores and the prevalence of diagnosed stroke and 

TIA for each practice. The linear regression line is also shown and indicates that there 

is no association between the deprivation score and the prevalence of diagnosed stroke 

and TIA (p=0.63). One would expect an association to exist, so this could suggest that 

patients are more likely in the most deprived areas to have stroke and TIA which is 

undiagnosed. However, overall mortality rates in the more deprived areas are higher, 

including mortality rates from stroke, so people in the more deprived areas may be less 

likely to be „living with a previous stroke‟ and also to have lived with a stroke a shorter 

length of time (as a higher proportion of them die sooner than in more deprived areas). 

The underlying data for the figure is given in the APPENDIX on page 908. 










Table 212: Diagnosed prevalence of stroke and TIA by deprivation quintile at practice 

level, 2009/10 

Practice IMD 2007 Number of List size Stroke Stroke prevalence 

quintile 

practices* (Jan 10) numbers 

(%) 

Most deprived 10 57,367 883 1.54 

2 12 55,245 941 1.70 

3 12 66,252 1,009 1.52 

4 11 65,303 1,094 1.68 

Least deprived 11 43,851 514 1.17 




Figure 193: Diagnosed prevalence of stroke and TIA by deprivation score at practice 

level 

10.1.3.7 Inpatient Admissions in Relation to Deprivation 


inpatient admission rates which involve a primary diagnosis of stroke (any clinician 


2007/08 to 2009/10 (standardised to Hull‟s 2009 population). The 95% confidence 

intervals are shown. There is a statistically significant difference among the quintiles for 

daycase and inpatient admissions for stroke. The underlying data are given in the 



living in the most deprived areas have a higher hospital admission rate for stroke. 

However, it is difficult to ascertain if this pattern is reflecting „need‟. It could be that the 

gradient between the most and least deprived quintiles should be steeper or less steep 

than the gradient observed. 



Figure 194: Age-standardised stroke annual daycase and inpatient admission rate per 

100,000 population for all ages by local deprivation quintile for Hull 


The directly standardised mortality rate for deaths from stroke per 100,000 persons 

aged less than 75 years is given in Figure 195 for Hull (for the period 2007 to 2009). 

There is a strong association between under 75 directly standardised rates for stroke 

and local deprivation quintile with the mortality rate in the most deprived local quintile 

being 2.7 times higher than that for the least deprived local quintile. The underlying data 

are given in the APPENDIX on page 910. 

Figure 195: Standardised mortality rates for stroke for persons aged under 75 years by 

deprivation for Hull for 2007-2009 

Under 75 directly age-standardsied stroke 

mortality rate per 100,000 persons 2007- 

2009 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

Most 

deprived local 

quintile 



quintile 




















Figure 196 shows trends in under 75 standardised mortality ratios (SMRs) for stroke for 



residents. The underlying data are given in the APPENDIX on page 911. While under 75 

stroke SMRs for men in Hull decreased between 2001-2003 and 2006-2008 by 12%, 

decreases in comparators over this period ranged from 21% to 26%. Whereas under 75 

stroke SMRs in most deprived men in Hull in 20001-2003 were similar to those in 

comparator areas (although a little higher in each case) by 2006-2008 they were around 

20% higher in Hull. Amongst women under 75 stroke SMRs increased by 14% between 

2001-2003 and 2004-2006, thereby decreasing by 21% by 2006-2008, an overall 

decrease of 10% between 2001-2003 and 2006-2008, compared with decreases of 

between 16% and 20% for comparators, excluding North East Lincolnshire which saw 

SMRs increase by 60% over this period. In 2006-2008 under 75 stroke SMRs in Hull‟s 

most deprived women were between 17% and 28% higher than for comparators, an 

increase of between 50% and 100% since 2001-2003. 



Figure 196: Trends in under 75 stroke standardised mortality ratios by national 




10.1.3.10 Social Marketing 

Social marketing research was completed in Hull during September 2009 to assess 

general public knowledge and perception of stroke. Further information is included 

within the final presentation which is available on request. In conclusion: 

The majority knew someone who had suffered a stroke. 

Good awareness of a stroke but no awareness of TIA (some awareness of a „mini 

stroke‟). 

High awareness of causes and symptoms of a stroke (especially the physical 

signs). 

However, there was concern over differentiation between less severe conditions 

(with similar symptoms) especially for less obvious symptoms. 

The majority would call 999 if symptoms of a stroke or TIA were recognised. 

Some less likely to react urgently to themselves (stubborn and not wanting to 

bother others). 

Surprise that stroke is the biggest cause of disability in the UK, which could be a 

key message for communication with the general public. 

There was high recall of the FAST (Facial weakness, Arms and leg weakness, 

Speech problems, Time to call 999) campaign and a positive reaction to this 

national campaign. 

There needs to be clarity around TIA (what to do, the term and warning signs). 


The target relating to stroke within the local World Class Commissioning (WCC) Strategy 

was to reduce the under 75 year directly standardised mortality rate (DSR) per 100,000 

standard European population for stroke (ICD 10: I60-I69) between 2004-2006 and 

2011-2013 by a rate that is 20% higher than the reduction in England (observed 

between 1995-97 and 2004-06). The annual average decrease in the under 75 DSR for 

stroke was 1.40 and 0.52 per 100,000 men and women respectively between 1995-1997 

and 2006-2008. However, the change has been very variable over the last ten years. 

The target DSR is 14.1, 15.9 and 15.1 per 100,000 men, women and persons 

respectively for 2011-13 59 . For the most recent year, 2006-2008 there has been no real 

change for males, but a reduction in the DSR for females. The targets for 2006-2008 

have been achieved for both men and women. 





59 Target given for 2011-13 within WCC strategy, but annual targets calculated here with equal increase 

between 2004-06 and 2011-13 (updated WCC strategy may not include staged rather than equal size 

improvements). 











difference in the population estimates. 

There has been a considerable decrease in the under 75 mortality rate for both men and 

women. In 1996, there were 94 deaths under the age of 75 years with a primary cause 

of stroke (51 for men and 43 for women), and this has steadily decreased falling to just 

under 70 deaths per year between 2001 and 2006. However, in 2007, 2008 and 2009 

there were 38, 52 and 37 deaths respectively. Whilst the population may have 

increased slightly in the older age groups, it is not surprising that the rate has fallen 

given the relatively large reduction in the number of deaths. The decrease has been 

particularly large between 2006-2008 and for 2007-2009 as the number of deaths for 

2009 (37) was substantially lower than the number for 2006 (68). It is likely that the 

2007-2009 target will be achieved for both men and women, but it would be necessary 

to wait until the official figures from the Compendium are available for confirmation. 



under 75 mortality rate from circulatory disease, but there is no mention of a separate 

target for stroke. Therefore, it is possible that this outcome measure will no longer be a 

key outcome measure unless it is retained locally. 



Table 213: World Class Commissioning stroke mortality targets 

Year Under 75 stroke DSR per 100,000 persons 


DSR Change Target DSR Change Target DSR Change Target 

1995-97 35.0 26.0 30.2 

1996-98 36.0 0.94 25.0 –0.97 30.2 –0.06 

1997-99 35.5 –0.52 23.0 –2.03 29.1 –1.10 

1998-00 32.8 –2.66 21.3 –1.69 26.8 –2.25 

1999-01 33.9 1.14 20.5 –0.75 27.0 0.13 

2000-02 30.2 –3.70 20.2 –0.33 25.0 –1.94 

2001-03 31.1 0.82 21.6 1.37 26.2 1.15 

2002-04 27.9 –3.21 22.5 0.94 25.1 –1.05 

2003-05 26.5 –1.39 22.1 –0.36 24.2 –0.90 

2004-06 25.2 –1.28 24.0 1.84 24.5 0.31 

2005-07 21.6 –3.58 23.6 21.1 –2.83 22.8 21.4 –3.18 23.2 

2006-08 21.6 –0.01 22.0 19.4 –1.75 21.7 20.5 –0.83 21.8 

Average –1.40 –0.52 –0.93 

2007-09* 18.4 –3.16 20.4 14.3 –5.08 20.5 16.5 –4.01 20.5 

2008-10 18.9 19.4 19.1 

2009-11 17.3 18.2 17.8 

2010-12 15.7 17.1 16.4 

2011-13 14.1 15.9 15.1 




Expenditure per head for 2008/2009 in Hull on cerebrovascular disease (stroke) was 

£29.05 (ranked 7 th ) compared to £20.40 for the Industrial Hinterlands average, £21.03 

for North East Lincolnshire and £19.35 for England. Further information on expenditure 

on stroke outcomes used in the Yorkshire and the Humber Public Health Observatory 

Programme Budgeting toolkit is given in section 10.1.1.6 on page 445. 



10.1.4 Heart Failure 




The prevalence of diagnosed heart failure is given in section 10.1.1.2 on page 434 for 

each general practice in Hull for 2009/10. Table 214 presents the prevalence of 

diagnosed heart failure for 2009/10 for Hull and comparator areas (see section 3.3.3 on 

page 44), as well as for England. The prevalence in Hull is the lowest of all 

comparators. 

Table 214: Prevalence of diagnosed heart failure based on GP disease registers 


PCT 

Number on heart 

failure disease 

Heart failure 

unadjusted 



practices population register 

England 8,305 54,836,561 393,290 0.72 

Hull 60 289,210 1,760 0.61 

Sunderland 55 284,551 2,873 1.01 


Salford 54 242,922 2,243 0.92 

Derby City 33 294,438 2,357 0.80 


Coventry 65 357,743 2,463 0.69 


Sandwell 67 339,020 3,074 0.91 

Stoke-On-Trent 57 280,265 2,104 0.75 

Plymouth 43 270,338 2,235 0.83 

Average of 10 520 2,840,950 23,613 0.83 

NE Lincs 34 169,565 1,430 0.84 

The number of patients with diagnosed heart failure and the prevalence as recorded on 

the GP QOF disease registers over time is illustrated in Table 215 for 2006/07 to 

2009/10 (the registers were introduced during 2004/05 but the heart failure measure 

was introduced 2006/07). The latest list size refers to the registered population as at 1 st 

January 2010, but the number and prevalence on the disease register is as at 31 st 

March 2010 (the same definitions used in QOF), and this means that the prevalence can 

be biased if large population changes have occurred over this three month period (e.g. 

Y02747, Y02786, Y02896 and Y02748 all opened between 5 th October 2009 and 11 th 

January 2010). The latest list size for B81668 (Dr EG Stryjakiewicz) relates to 2006/07. 

Some practices were not in existence for all the years so information is not applicable 

(N/A). 



Table 215: Numbers and prevalence of diagnosed heart failure on GP QOF disease 

registers, 2006/07 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on heart failure QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81035 6,114 45 0.72 38 0.62 31 0.51 34 0.56 

B81056 13,489 78 0.64 81 0.64 81 0.62 89 0.66 

B81104 7,721 2 0.03 4 0.06 4 0.06 7 0.09 

B81635 2,967 27 0.86 27 0.89 29 0.97 22 0.74 

B81662 1,856 14 0.60 17 0.75 19 0.88 20 1.08 

Y01200 1,765 8 0.51 6 0.37 10 0.59 10 0.57 


B81020 7,512 56 0.77 49 0.67 59 0.77 59 0.79 

B81021 7,257 89 1.25 78 1.08 73 0.98 62 0.85 

B81075 2,263 7 0.28 8 0.33 8 0.34 8 0.35 

B81085 5,299 21 0.39 23 0.43 27 0.51 28 0.53 

B81094 1,925 5 0.22 1 0.04 0 0.00 2 0.10 

B81095 4,242 27 0.68 24 0.60 25 0.60 29 0.68 

B81097 1,688 4 0.25 4 0.24 5 0.30 5 0.30 

B81690 1,734 11 0.62 8 0.46 9 0.52 9 0.52 

B81001 3,358 9 0.31 9 0.30 9 0.27 11 0.33 

B81008 15,062 61 0.41 63 0.42 68 0.46 64 0.42 

B81048 9,048 49 0.54 48 0.53 42 0.45 48 0.53 

B81049 9,354 83 0.98 83 0.95 74 0.81 69 0.74 

B81052 5,740 19 0.36 18 0.32 21 0.38 27 0.47 

B81072 7,807 93 1.35 82 1.12 76 1.00 69 0.88 

B81644 2,245 8 0.36 9 0.41 10 0.45 10 0.45 



B81011 5,243 230 4.18 43 0.79 46 0.86 37 0.71 

B81038 7,732 50 0.64 55 0.71 60 0.79 45 0.58 

B81057 3,345 13 0.36 14 0.40 18 0.52 16 0.48 

B81074 3,639 52 0.81 51 0.84 35 0.92 32 0.88 

B81081 3,520 13 0.37 18 0.53 17 0.49 14 0.40 

B81645 2,128 18 0.68 18 0.68 15 0.66 16 0.75 

B81646 1,949 5 0.20 5 0.21 5 0.24 7 0.36 

B81682 3,726 20 0.54 19 0.52 16 0.43 16 0.43 

B81053 10,232 76 0.75 76 0.75 79 0.78 79 0.77 

B81054 10,851 93 0.82 85 0.76 93 0.84 99 0.91 

B81058 8,722 79 0.84 88 0.97 84 0.95 94 1.08 

B81066 2,522 13 0.54 12 0.49 15 0.59 15 0.59 

B81080 2,216 18 0.70 18 0.77 13 0.58 11 0.50 

B81616 2,571 27 0.98 20 0.74 15 0.57 17 0.66 

B81002 3,844 10 0.33 12 0.40 15 0.50 23 0.60 

B81112 3,498 20 0.54 19 0.53 23 0.64 20 0.57 

B81119 4,593 17 0.38 18 0.39 19 0.40 27 0.59 

B81634 3,044 8 0.26 8 0.26 8 0.26 6 0.20 

B81674 2,241 12 0.67 18 0.93 20 0.95 34 1.52 

B81675 9,476 19 0.40 39 0.72 40 0.42 47 0.50 

B81685 2,444 24 0.93 27 1.05 26 1.03 28 1.15 

B81688 2,009 6 0.29 3 0.14 3 0.14 2 0.10 



Code Latest 

list 

size 

Number and prevalence on heart failure QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

Y02344 1,645 N/A N/A N/A N/A 10 0.51 7 0.43 

B81027 5,976 61 1.03 61 1.02 57 0.95 58 0.97 

B81040 16,805 72 0.43 67 0.39 64 0.38 60 0.36 

B81047 7,377 48 0.66 44 0.61 35 0.48 30 0.41 

B81089 3,583 17 0.51 18 0.53 27 0.76 31 0.87 

B81631 3,425 14 0.44 14 0.43 14 0.41 12 0.35 

B81683 1,644 11 0.72 13 0.90 15 0.99 19 1.16 


B81017 6,800 66 0.91 65 0.90 56 0.82 51 0.75 

B81018 6,602 43 0.63 37 0.55 32 0.48 35 0.53 

B81032 2,478 14 0.51 16 0.59 12 0.46 9 0.36 

B81046 9,068 60 0.67 60 0.68 58 0.65 59 0.65 

B81692 1,814 1 0.05 2 0.11 1 0.06 2 0.11 

Y00955 2,556 12 0.72 14 0.63 15 0.59 15 0.59 



number of people with diagnosed heart failure (Doncaster PCT 2008). 
























The results of the modelling and the actual diagnosed numbers of patients with heart 

failure are given in Table 216. The model does not necessarily represent the actual 



number of people who should be diagnosed with heart failure for each practice; it is only 

a guide. The characteristics of each practice differ and need to be considered. 

Furthermore, it does not include undiagnosed cases of heart failure. The model uses 

information derived from a large survey examining heart failure in general practice 

between 1994 and 1998 (Ellis, Gnani et al. 2001). Their study did examine prevalence 

by deprivation, but the Doncaster model did not include this information (or adjust for 

other factors such as ethnicity). 





2010. 

Table 216: Actual diagnosed and modelled heart failure numbers, September 2010 

Code Practice name List size Numbers with heart failure 







B81104 Dr JK Nayar 6,553 7 7 0 

B81635 Dr G Dave 2,979 22 48 -26 






B81075 Dr MK Mallik 2,197 8 53 -45 


B81094 Dr AK Datta 1,790 3 21 -18 

B81095 Dr Cook 4,145 31 74 -43 

B81097 Dr RD Yagnik 1,689 13 33 -20 

B81690 Dr SK Ray 1,650 15 18 -3 












B81074 Dr AK Rej 3,534 33 50 -17 



Code Practice name List size Numbers with heart failure 







B81646 Dr M Shaikh 1,822 10 25 -15 







B81616 Dr GT Hendow 2,539 15 36 -21 





B81674 Dr JC Joseph 2,246 33 30 3 


B81685 Dr NA Poulose 2,394 26 20 6 

B81688 Dr KV Gopal 2,023 4 16 -12 

Y02344 Northpoint 2,021 7 20 -13 




B81089 Dr Witvliet 3,593 31 42 -11 

B81631 Dr R Raut 3,438 12 19 -7 










HULL 288,935 1,812 3,830 -2,018 


There were 18 deaths (11 men and 7 women) from heart failure in Hull residents aged 

under 75 years which were registered over the three year period 2007-2009, so on 

average six deaths per year for those aged under 75 years. Most of the deaths from 

heart failure occur after this age, and there were 103 deaths (45 men and 58 women) for 

all ages during the same period, averaging 34 deaths per year. 



10.1.5 Atrial Fibrillation 


The prevalence of diagnosed atrial fibrillation is given in section 10.1.1.2 on page 434 

for each general practice in Hull for 2009/10. Table 217 presents the prevalence of 

diagnosed atrial fibrillation for 2009/10 for Hull and comparator areas (see section 3.3.3 

on page 44), as well as for England. The prevalence of atrial fibrillation in Hull is lowest 

of the comparators with the exception of Leicester City. Atrial fibrillation is a risk factor 

for stroke, so if the rate of undiagnosed atrial fibrillation in Hull could be reduced and 

these patients properly treated, this could reduce the stroke mortality rate. 

Table 217: Prevalence of diagnosed atrial fibrillation based on GP disease registers 


PCT 

Number on atrial 

fibrillation 

Atrial fibrillation 

unadjusted 




England 8,305 54,836,561 761,965 1.39 

Hull 60 289,210 3,170 1.10 

Sunderland 55 284,551 4,522 1.59 


Salford 54 242,922 3,460 1.42 

Derby City 33 294,438 3,832 1.30 


Coventry 65 357,743 4,022 1.12 


Sandwell 67 339,020 4,547 1.34 

Stoke-On-Trent 57 280,265 3,952 1.41 

Plymouth 43 270,338 3,857 1.43 

Average of 10 520 2,840,950 36,759 1.29 

NE Lincs 34 169,565 2,694 1.59 

The number of patients with diagnosed atrial fibrillation and the prevalence as recorded 


2009/10 (the registers were introduced during 2004/05 but the atrial fibrillation measure 

was introduced 2006/07). The latest list size refers to the registered population as at 1 st 







(N/A). 



Table 218: Numbers and prevalence of diagnosed atrial fibrillation on GP QOF disease 

registers, 2006/07 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on atrial fibrillation QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81035 6,114 60 0.96 65 1.06 70 1.15 75 1.23 

B81056 13,489 146 1.19 149 1.18 149 1.15 177 1.31 

B81104 7,721 7 0.10 7 0.10 8 0.11 10 0.13 

B81635 2,967 32 1.02 29 0.95 35 1.16 34 1.15 

B81662 1,856 35 1.50 34 1.50 39 1.81 33 1.78 

Y01200 1,765 30 1.92 27 1.65 37 2.20 37 2.10 


B81020 7,512 72 0.99 82 1.12 89 1.17 96 1.28 

B81021 7,257 115 1.61 114 1.58 121 1.63 132 1.82 

B81075 2,263 10 0.40 11 0.45 13 0.55 13 0.57 

B81085 5,299 77 1.44 80 1.50 86 1.61 80 1.51 

B81094 1,925 16 0.69 14 0.62 12 0.56 15 0.78 

B81095 4,242 43 1.08 43 1.07 52 1.26 67 1.58 

B81097 1,688 4 0.25 4 0.24 5 0.30 15 0.89 

B81690 1,734 7 0.39 7 0.40 9 0.52 9 0.52 

B81001 3,358 70 2.43 64 2.13 64 1.94 58 1.73 

B81008 15,062 155 1.04 140 0.94 136 0.91 138 0.92 

B81048 9,048 93 1.02 92 1.01 100 1.08 95 1.05 

B81049 9,354 113 1.34 111 1.27 122 1.34 138 1.48 

B81052 5,740 27 0.51 33 0.59 39 0.70 50 0.87 

B81072 7,807 63 0.91 63 0.86 54 0.71 53 0.68 

B81644 2,245 15 0.67 14 0.64 19 0.86 15 0.67 



B81011 5,243 69 1.25 70 1.29 69 1.29 69 1.32 

B81038 7,732 84 1.07 87 1.12 104 1.37 100 1.29 

B81057 3,345 38 1.04 38 1.07 36 1.05 33 0.99 

B81074 3,639 66 1.03 63 1.03 49 1.29 49 1.35 

B81081 3,520 50 1.42 55 1.61 59 1.68 66 1.88 

B81645 2,128 20 0.76 17 0.64 17 0.75 15 0.70 

B81646 1,949 13 0.52 10 0.42 10 0.49 11 0.56 

B81682 3,726 34 0.92 30 0.82 30 0.81 38 1.02 

B81053 10,232 147 1.46 158 1.55 154 1.52 164 1.60 

B81054 10,851 128 1.14 126 1.13 141 1.27 155 1.43 

B81058 8,722 127 1.35 122 1.34 132 1.49 140 1.61 

B81066 2,522 20 0.83 25 1.02 25 0.99 26 1.03 

B81080 2,216 43 1.67 39 1.67 34 1.51 41 1.85 

B81616 2,571 29 1.05 26 0.96 26 0.99 30 1.17 

B81002 3,844 18 0.59 20 0.66 23 0.76 26 0.68 

B81112 3,498 26 0.71 28 0.78 25 0.69 24 0.69 

B81119 4,593 28 0.62 24 0.52 29 0.62 44 0.96 

B81634 3,044 9 0.29 12 0.39 13 0.42 12 0.39 

B81674 2,241 15 0.83 21 1.08 27 1.28 28 1.25 

B81675 9,476 34 0.71 76 1.41 74 0.77 83 0.88 

B81685 2,444 15 0.58 14 0.54 10 0.39 14 0.57 

B81688 2,009 5 0.24 7 0.33 7 0.33 10 0.50 

Y02344 1,645 N/A N/A N/A N/A 15 0.76 12 0.73 



Code Latest 

list 

size 

Number and prevalence on atrial fibrillation QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81027 5,976 90 1.52 95 1.59 87 1.45 87 1.46 

B81040 16,805 123 0.73 121 0.71 134 0.79 140 0.83 

B81047 7,377 77 1.05 75 1.04 71 0.98 67 0.91 

B81089 3,583 25 0.75 25 0.74 25 0.70 30 0.84 

B81631 3,425 11 0.35 11 0.34 10 0.29 12 0.35 

B81683 1,644 8 0.52 9 0.62 16 1.06 21 1.28 


B81017 6,800 88 1.22 83 1.15 89 1.31 82 1.21 

B81018 6,602 52 0.77 50 0.74 41 0.61 51 0.77 

B81032 2,478 19 0.69 18 0.66 21 0.80 14 0.56 

B81046 9,068 65 0.72 69 0.79 79 0.88 91 1.00 

B81692 1,814 1 0.05 1 0.06 3 0.17 1 0.06 

Y00955 2,556 18 1.09 23 1.03 21 0.83 30 1.17 



number of people with diagnosed atrial fibrillation (Doncaster PCT 2008). In general 




in a particular PCT area. Therefore, the accuracy of the estimates depend on the quality 

of the initial research and the modelling itself. If the original research did not include 

very deprived areas, it is very difficult to generalise and apply the model to very deprived 

areas like Hull. Furthermore, there are many reasons why the prevalence could differ 

among practices (see section 12.13 on page 782 for more information). Further 

information about problems associated with models can be found in the Association of 

Public Health Observatories Technical Briefing (Association of Public Health 

Observatories 2011) and in section 12.1 on page 770. Therefore, just because 











Doncaster PCT used prevalence rates for atrial fibrillation available from the Office for 

National Statistics (Office for National Statistics 2005). The model used age-genderspecific 

prevalence estimates for seven age groups (0-34, 35-44, 45-54, 55-64, 65-74, 

75-84 and 85+ years) and did not adjust for ethnicity or deprivation in any way. The 

results of the modelling and the actual diagnosed numbers of patients with atrial 

fibrillation are given in Table 219. The model does not necessarily represent the actual 

number of people who should be diagnosed with atrial fibrillation for each practice; it is 



only a guide. The characteristics of each practice differ and need to be considered. 

Furthermore, it does not include undiagnosed cases of atrial fibrillation as the 

prevalence rates are estimated from prescribing rates for atrial fibrillation. 





2010. 

Table 219: Actual diagnosed and modelled atrial fibrillation numbers, September 2010 

Code Practice name List size Numbers with atrial fibrillation 







B81104 Dr JK Nayar 6,553 11 7 4 

B81635 Dr G Dave 2,979 40 55 -15 






B81075 Dr MK Mallik 2,197 13 60 -47 


B81094 Dr AK Datta 1,790 17 23 -6 

B81095 Dr Cook 4,145 76 87 -11 

B81097 Dr RD Yagnik 1,689 24 38 -14 

B81690 Dr SK Ray 1,650 10 22 -12 

B81001 Dr Ali & Partners 3,333 55 54 1 











B81074 Dr AK Rej 3,534 49 58 -9 

B81081 Dr KM Tang & Partner 3,556 69 63 6 


B81646 Dr M Shaikh 1,822 23 29 -6 




Code Practice name List size Numbers with atrial fibrillation 










B81616 Dr GT Hendow 2,539 32 43 -11 





B81674 Dr JC Joseph 2,246 29 33 -4 


B81685 Dr NA Poulose 2,394 12 24 -12 

B81688 Dr KV Gopal 2,023 13 19 -6 

Y02344 Northpoint 2,021 13 23 -10 




B81089 Dr Witvliet 3,593 30 47 -17 

B81631 Dr R Raut 3,438 14 21 -7 










HULL 288,935 3,319 4,328 -1,009 


Expenditure per head for 2008/2009 in Hull on problems of rhythm which will include 

atrial fibrillation (the most common rhythm problem) was £9.41 (ranked 40 th ) compared 

to £9.47 for the Industrial Hinterlands average, £7.69 for North East Lincolnshire and 

£8.43 for England. Further information on circulatory disease outcomes used in the 

Yorkshire and the Humber Public Health Observatory Programme Budgeting toolkit is 

given in section 10.1.1.6 on page 445. 



10.1.6 Hypertension 


The prevalence of diagnosed hypertension is given in section 10.1.1.2 on page 434 for 

each general practice in Hull for 2009/10. Table 220 presents the prevalence of 

diagnosed hypertension for 2009/10 for Hull and comparator areas (see section 3.3.3 

on page 44), as well as for England. The rate in Hull is one of the lowest of the 

comparators with only Leicester City having a lower prevalence. 

Table 220: Prevalence of hypertension based on GP disease registers 2009/10, Hull 


PCT 

Number on 

hypertension 

Hypertension 

unadjusted 




England 8,305 54,836,561 7,321,472 13.4 

Hull 60 289,210 37,559 13.0 

Sunderland 55 284,551 46,275 16.3 


Salford 54 242,922 34,822 14.3 

Derby City 33 294,438 40,421 13.7 


Coventry 65 357,743 48,130 13.5 


Sandwell 67 339,020 51,700 15.2 

Stoke-On-Trent 57 280,265 45,868 16.4 

Plymouth 43 270,338 37,535 13.9 

Average of 10 520 2,840,950 405,262 14.3 

NE Lincs 34 169,565 26,458 15.6 

The number of patients with diagnosed hypertension and the prevalence as recorded on 

the GP QOF disease registers over time is illustrated in Table 221 for 2004/05 to 











Table 221: Numbers and prevalence of diagnosed hypertension on GP QOF disease 

registers, 2004/05 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on hypertension QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81035 6,114 1,444 18.1 729 11.4 708 11.3 689 11.3 705 11.6 719 11.8 

B81056 13,489 1,226 10.8 1,472 12.5 1,778 14.5 1,870 14.8 1,930 14.9 1,980 14.7 

B81104 7,721 117 1.8 131 1.6 143 2.0 156 2.2 149 2.1 149 1.9 

B81635 2,967 327 10.0 354 11.1 492 15.6 526 17.3 562 18.7 576 19.4 

B81662 1,856 221 9.4 314 13.1 346 14.8 362 16.0 364 16.9 352 19.0 


Y01200 1,765 N/A N/A 120 9.8 239 15.3 275 16.8 311 18.5 351 19.9 


B81020 7,512 638 9.3 692 9.5 740 10.2 759 10.3 927 12.2 934 12.4 

B81021 7,257 819 11.5 891 12.4 903 12.6 917 12.7 971 13.1 985 13.6 

B81075 2,263 171 6.2 224 8.3 234 9.3 241 9.9 250 10.6 257 11.4 

B81085 5,299 769 14.2 800 14.7 837 15.6 849 15.9 862 16.2 866 16.3 

B81094 1,925 218 9.8 242 10.6 248 10.7 239 10.6 230 10.7 226 11.7 

B81095 4,242 331 8.2 396 10.0 523 13.1 619 15.4 675 16.3 731 17.2 

B81097 1,688 168 10.1 191 11.7 215 13.3 214 13.0 216 12.9 316 18.7 

B81690 1,734 248 13.6 243 14.3 261 14.7 269 15.4 295 16.9 339 19.6 

B81001 3,358 285 9.4 293 10.0 316 11.0 355 11.8 393 11.9 407 12.1 

B81008 15,062 1,506 10.5 1,622 11.1 1,698 11.4 1,668 11.2 1,712 11.5 1,748 11.6 

B81048 9,048 691 7.7 786 8.5 813 8.9 822 9.0 877 9.4 894 9.9 

B81049 9,354 847 10.6 914 11.3 955 11.3 993 11.4 1,051 11.5 1,080 11.5 

B81052 5,740 422 8.1 480 8.6 531 10.1 560 10.1 591 10.6 610 10.6 

B81072 7,807 681 9.5 740 10.8 790 11.5 825 11.3 816 10.8 810 10.4 

B81644 2,245 170 7.5 179 8.0 235 10.5 266 12.1 302 13.7 306 13.6 



B81011 5,243 547 9.9 608 10.8 655 11.9 687 12.6 741 13.8 772 14.7 

B81038 7,732 839 10.7 904 11.6 942 12.0 988 12.7 1,010 13.3 1,142 14.8 

B81057 3,345 600 16.8 601 16.6 578 15.8 538 15.2 507 14.8 477 14.3 

B81074 3,639 827 12.9 862 13.5 880 13.8 879 14.4 609 16.0 672 18.5 

B81081 3,520 225 5.9 387 10.6 550 15.6 567 16.6 656 18.7 667 18.9 

B81645 2,128 316 12.1 303 11.4 294 11.1 278 10.5 268 11.8 288 13.5 

B81646 1,949 210 8.1 268 10.5 279 11.2 260 10.9 226 11.0 248 12.7 

B81682 3,726 431 11.8 419 11.3 436 11.8 419 11.4 433 11.8 545 14.6 

B81053 10,232 1,436 14.5 1,451 14.5 1,455 14.4 1,485 14.6 1,512 14.9 1,595 15.6 

B81054 10,851 1,063 9.4 1,370 12.2 1,402 12.4 1,412 12.7 1,430 12.9 1,541 14.2 

B81058 8,722 1,147 12.1 1,168 12.1 1,209 12.8 1,229 13.5 1,252 14.2 1,317 15.1 

B81066 2,522 254 10.0 257 10.4 255 10.6 266 10.9 270 10.7 298 11.8 

B81080 2,216 357 13.1 387 14.1 352 13.6 330 14.2 318 14.1 311 14.0 

B81616 2,571 299 10.9 348 12.9 349 12.7 334 12.3 324 12.4 391 15.2 

B81002 3,844 229 7.9 267 9.0 317 10.4 371 12.3 386 12.7 532 13.8 

B81112 3,498 262 6.6 265 6.9 261 7.1 281 7.8 280 7.7 281 8.0 

B81119 4,593 609 10.0 525 9.0 590 13.1 615 13.4 652 13.9 662 14.4 

B81634 3,044 242 7.8 256 8.2 263 8.4 262 8.5 295 9.6 310 10.2 

B81674 2,241 272 15.8 276 15.8 279 15.5 332 17.1 364 17.3 407 18.2 

B81675 9,476 319 7.3 486 11.3 534 11.1 964 17.9 1,028 10.7 1,086 11.5 

B81685 2,444 222 8.7 244 9.3 247 9.6 265 10.3 268 10.6 275 11.3 

B81688 2,009 182 9.0 184 9.0 179 8.6 195 9.3 203 9.6 218 10.9 


B81027 5,976 782 12.4 782 13.0 820 13.8 864 14.5 889 14.8 897 15.0 

B81040 16,805 1,418 8.6 1,523 9.2 1,700 10.1 1,776 10.5 1,858 11.0 1,925 11.5 

B81047 7,377 931 12.4 802 10.9 814 11.1 717 9.9 718 9.9 751 10.2 



Code Latest 

list 

size 

Number and prevalence on hypertension QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81089 3,583 375 11.7 373 11.5 392 11.8 424 12.5 434 12.2 449 12.5 

B81631 3,425 240 7.4 344 11.0 436 13.7 471 14.5 512 15.0 535 15.6 

B81683 1,644 93 6.0 128 8.1 127 8.3 146 10.1 168 11.1 198 12.0 


B81017 6,800 1,258 17.1 1,154 16.4 1,166 16.1 1,145 15.8 1,094 16.0 1,032 15.2 

B81018 6,602 700 10.7 712 10.9 747 11.0 741 11.0 753 11.3 804 12.2 

B81032 2,478 133 4.4 148 5.0 141 5.1 154 5.7 153 5.8 232 9.4 

B81046 9,068 997 11.7 1,072 12.7 1,135 12.6 1,166 13.3 1,200 13.4 1,259 13.9 

B81692 1,814 30 1.6 37 1.9 36 1.9 42 2.4 41 2.3 61 3.4 

Y00955 2,556 N/A N/A 93 13.9 220 13.3 263 11.8 301 11.8 354 13.8 


There is a model to estimate the number of people with hypertension produced by the 

Eastern Region Public Health Observatory. This model previously only produced 

estimates at PCT level, but has been updated to produce practice level estimates. 

There is a further model produced by Doncaster PCT (Doncaster PCT 2008) which is 

slightly less sophisticated and this has been used here, updated from Release 2 of the 

JSNA Foundation Profile. The Doncaster PCT produces estimates of the number of 

people with high blood pressure defined on the basis of systolic blood pressure above 

140mmHg and/or diastolic blood pressure above 90mmHg, or taking medication 

specifically prescribed for high blood pressure. 






















The Doncaster model just uses estimated prevalence for men and women for different 

age groups (


of the total number of people with hypertension. No adjustments were made for 

ethnicity, deprivation or other factors. 

The results of the modelling and the actual diagnosed numbers of patients with 

hypertension are given in Table 222. The model does not necessarily represent the 

actual number of people who should be diagnosed with hypertension for each practice; it 


The Doncaster model used the gender-age-specific prevalence estimates obtained from 

the Health Survey for England (Health Survey for England 2008) which was conducted 

during the year 2003. The survey involved an interview and a subsequent nurse visit 

where blood pressure was recorded. Hypertension was defined as a systolic blood 

pressure of 140mmHg or more or a diastolic blood pressure of 90mmHg or more, or 

taking medication prescribed for high blood pressure. Therefore, from the way this 

information was collected it should include diagnosed hypertension (those taking the 

medication) and an estimate of those with undiagnosed hypertension (as blood pressure 

measurements were taken). This provides some explanation as to why the model 

estimates are so much higher than the numbers on the practice registers. 





2010. 

Table 222: Actual diagnosed and modelled hypertension numbers, September 2010 

Code Practice name List size Numbers with hypertension 





B81035 Dr WGT Sande & Partners 6,160 730 1,605 -875 

B81056 Springhead Medical Centre 13,813 1,987 3,354 -1,367 

B81104 Dr JK Nayar 6,553 149 572 -423 

B81635 Dr G Dave 2,979 575 850 -275 




B81020 Dr PC Mitchell & Partners 7,436 955 1,838 -883 

B81021 Faith House Surgery 7,372 1,013 1,818 -805 

B81075 Dr MK Mallik 2,197 257 721 -464 

B81085 Dr JW Richardson & Ptnrs 5,302 874 1,466 -592 

B81094 Dr AK Datta 1,790 225 441 -216 

B81095 Dr Cook 4,145 730 1,157 -427 

B81097 Dr RD Yagnik 1,689 357 508 -151 

B81690 Dr SK Ray 1,650 359 400 -41 


B81008 Dr JS Parker & Partners 14,936 1,738 3,376 -1,638 



Code Practice name List size Numbers with hypertension 





B81048 Dr SM Hussain & Partners 8,915 862 1,775 -913 

B81049 Dr VA Rawcliffe & Partners 9,221 1,092 2,142 -1,050 

B81052 Dr J Musil And PJ Queenan 5,736 629 1,179 -550 

B81072 Dr R Percival & Partners 7,574 842 1,626 -784 



B81011 Wheeler Street Healthcare 5,212 793 1,310 -517 

B81038 Dr AA Mather & Partners 7,690 1,180 2,065 -885 


B81074 Dr AK Rej 3,534 656 870 -214 



B81646 Dr M Shaikh 1,822 278 458 -180 


B81053 Diadem Medical Practice 10,642 1,656 2,662 -1,006 

B81054 Dr MJ Varma & Partners 10,690 1,550 2,610 -1,060 

B81058 Dr M Foulds & Partner 8,680 1,317 2,266 -949 



B81616 Dr GT Hendow 2,539 438 605 -167 





B81674 Dr JC Joseph 2,246 402 472 -70 

B81675 Dr Tak & Dr Stryjakiewicz 9,111 1,093 1,743 -650 

B81685 Dr NA Poulose 2,394 280 462 -182 

B81688 Dr KV Gopal 2,023 221 381 -160 

Y02344 Northpoint 2,021 247 396 -149 

B81027 St Andrews Group Practice 5,954 900 1,468 -568 

B81040 Dr PF Newman & Partners 16,721 1,942 3,746 -1,804 

B81047 Dr JN Singh & Partners 7,505 786 1,660 -874 

B81089 Dr Witvliet 3,593 449 775 -326 

B81631 Dr R Raut 3,438 536 565 -29 



B81017 Kingston Medical Group 6,725 1,032 1,551 -519 

B81018 Dr RK Awan & Partners 6,518 827 1,351 -524 


B81046 Dr JD Blow & Partners 9,247 1,291 1,980 -689 




HULL 288,935 38,347 65,878 -27,531 




A short health equity audit was conducted during 2011 for Hull and East Riding of 

Yorkshire, and the following key findings were noted. The full report will be available at 


Rates of hypertension increase with age, so practices with older populations have 

higher rates. Once age differences in the population of practices in Hull and East 

Riding of Yorkshire were allowed for, more deprived practices had slightly higher 

levels of diagnosed hypertension. The estimated change in diagnosed 

hypertension prevalence levels between the least deprived tenth of practices and 

the most deprived tenth of practice is 5%, from 15.3% to 20.3%. 

The overall indirect age standardised diagnosed hypertension prevalence was 

calculated as 18% and 16% for Hull and East Riding respectively. The overall 

diagnosed prevalence for hypertension is 13% and 15% for Hull and East Riding 

respectively, as although East Riding is less deprived it generally has an older 

population. 

There is no apparent association between practice deprivation score and 

diagnosed prevalence as a percentage of the Eastern Region Public Health 

Observatory modelled prevalence. It is suggested that the diagnosis of 

hypertension is equitable, despite higher levels of hypertension with deprivation. 

Examining QOF measures of ongoing care by practice deprivation score and 

mean patient age uncovered no significant associations. Management of 

hypertension in primary care appears therefore to be equitable with respect to 

deprivation and age. 

Due to the nature of the data and models utilised within this report, certain 

caveats should be acknowledged with its interpretation. Firstly, the use of models 

within this report are based upon certain assumptions and therefore findings 

resulting from such models are tentative. The nature of the data used within this 

report only facilitates the examination of equity with respect to levels of mean 

practice deprivation and age and it should be appreciated that there may be other 

factors that may affect the prevalence or equity in the management of 

hypertension which are beyond the scope of this report. There are numerous 

drugs used in the management of hypertension care, many of which are used for 

other indications. It was therefore deemed that the analysis of the equity of drug 

prescribing for hypertension would be unfeasible. 



10.1.7 Abdominal Aortic Aneurysm 


Smoking is a risk factor for abdominal aortic aneurysms as noted in Table 96 with 61% 

and 52% of deaths from abdominal aortic aneurysm directly attributable to smoking for 

men and women respectively. 


There were 20 deaths (15 men and 5 women) from aortic aneurysm in Hull residents 

aged under 75 years which were registered over the three year period 2007-2009, the 

majority from abdominal aortic aneurysm, so on average around 7 deaths per year for 

those aged under 75 years. There were a further 57 deaths (32 men and 25 women) in 

those aged 75+ years. 

10.1.7.3 Screening 

For more information on screening, see page 433. 



10.2 Cancer 

10.2.1 All Cancers 


There are many postulated risk factors for cancer. Some risk factors, such as cigarette 

smoking are well-documented with much supporting evidence, particularly in relation to 

cancers such as lung cancer. For some other potential risk factors there is less certainty 

about the their effect, with some studies suggesting an association and other studies not 

suggesting or failing to find an association. Individual genetic makeup is an important 

risk factor for colorectal cancer, breast cancer, cervical cancer, and many other types of 

cancer. There are other occupational and environmental potential risk factors, such as 

air pollution, exposure to electromagnetic fields, radon exposure, etc which may be 

associated with an increased risk of cancer. Stainless steel welding and radon 

exposure have been found by some to have an association with lung cancer, and 

oestrogen may be linked with breast cancer. The human papilloma virus is suspected to 

be responsible for approximately 95% of all cases of cervical cancer. This virus is 

passed on through sexual intercourse and as a result a high number of sexual partners, 

age at first sexual intercourse and low condom use will increase the risk of obtaining the 

virus. Table 223 details some of the risk factors and potential risk factors that have 

been linked to some of the main different types of cancer (Cancer Research UK 2004). 

Table 223: Risk factors and potential risk factors for cancer 

Risk factor or potential risk All 

Specific cancers 

factor 

cancer Lung Colorectal Breast Cervical Skin 

Genetics Y Y Y Y 

Asbestos Y 

Environmental Y Y Y 

Occupational Y Y 

Smoking Y Y Y 

Diet Y Y 

Exercise Y 

Obesity Y Y 

Human papilloma virus Y 

Number of sexual partners Y 

Decreased condom use Y 

Age at first sexual intercourse Y 

Parity Y 

Hormone replacement therapy Y 

Alcohol Y Y 

Oral contraceptive pill Y 

Ultraviolet light (sun) Y 



10.2.1.2 Incidence 

Due to cancer registration, incidence estimates are available for cancer. The latest 

information available on the Compendium is for 2004-2006 but only for a limited number 

of cancer sites. 

Local cancer incidence information is publicly available from the Northern and Yorkshire 

Cancer Registry and Information Service (NYCRIS) for the period 2003-2007 (Northern 

and Yorkshire Cancer Registry and Information Service, 2008). NYCRIS has produced 

„Factsheets‟ for each PCT within their geographical area (23 PCTs across Yorkshire and 

the North East of England) which give information on incidence and mortality for 

different cancers. Each PCT is compared with the relevant cancer network, which in the 

case of Hull PCT is the Humber and Yorkshire Coast Cancer Network. The four page 

factsheet for Hull can be downloaded directly from the NYCRIS website at 

www.nycris.nhs.uk/reports/pct_factsheets/. More up to date cancer information can be 

accessed through the National Cancer Information Service, an online service that is 

populated with cancer incidence, mortality and survival information from the United 

Kingdom regional cancer registries. A password for NCIS can be requested through 

NYCRIS. Currently the NCIS is populated with cancer incidence data up to 2008. 

However, as data is not available at the ONS area classification level, Table 224, Table 

226 and Table 228 have been retained in order for comparisons with the Industrial 

Hinterland group to be made. 

Table 224 and Table 226 give the directly age-standardised rates (DSR) for incidence 

for men and women respectively over the period 2004-2006 from the Compendium for 

the main cancer sites comparing Hull with England, the ONS Industrial Hinterlands 

group and the average of the 10 comparator areas (see section 3.3.3 on page 44), 

while Table 225 and Table 227 give the directly age-standardised rates (DSR) for 

incidence for men and women respectively over the period 2006-2008 using data 

extracted from the NCIS for the main cancer sites comparing Hull with the Yorkshire and 

Humber region, England and the average of the 10 comparator areas. The 95% 

confidence intervals are given except for the average of the 10 comparators (as 

individual data is not available to calculate this, but the confidence interval will be 

narrower than the confidence interval for Hull as the number of cancer cases will be 

around ten times larger and the confidence interval for the 10 comparators will be 

slightly wider than that of the ONS Industrial Hinterlands group). For International 

Classification of Diseases (ICD) version 10 coding see section 13.4.5 on page 811. 



Table 224: Incidence of cancer for men in Hull and comparator areas for 2004-2006 

Cancer site (ICD 10) Age-standardised incidence rate per 100,000 men (all ages), 

2004-2006 (95% CI) 

Hull 

Industrial 

Hinterlands 


England 

Average of 10 

comparators* 

All sites (C00-C97 excl C44) 465 (444, 586) 441 (436, 447) 408 (407, 409) 435 

Oesophageal (C15) 17.8 (13.5, 22.0) 15.3 (14.3, 16.2) 13.8 (13.6, 14.1) 14.9 

Stomach (C16) 16.2 (12.2, 20.2) 18.0 (16.9, 19.0) 13.7 (13.4, 13.9) 17.5 

Colorectal (C17-C21) 59.6 (52.1, 67.1) 63.2 (61.2, 65.2) 56.6 (56.1, 57.1) 59.0 

Lung (C33-C34) 97.7 (87.9, 107) 82.1 (80.0, 84.3) 60.1 (59.5, 60.5) 80.0 

Skin (C43-C44) 119 (108, 129) 145 (143, 149) 128 (127, 129) 136 

Skin excl MM* (C44) 110 (100, 121) 136 (133, 138) 115 (114, 115) 125 

Prostate (C61) 97.1 (87.5, 107) 92.6 (90.2, 94.9) 99.0 (98.3, 99.6) 95.8 

Bladder cancer (C67) 20.9 (16.4, 25.5) 20.4 (19.3, 21.5) 19.2 (18.9, 19.5) 20.1 

*Malignant melanoma. 

Table 225: Incidence of cancer for men in Hull and comparators 2006-2008 

Cancer site (ICD 10) Age-standardised incidence rate per 100,000 men 

(all ages), 2006-2008 (95% CI) 

Hull 

Yorkshire 

and Humber 

England 

Average 10 

comparators 


Oesophageal (C15) 14.6 (14.1, 15.0) 14.2 (12.8, 15.5) 25.4 (16.8, 33.9) 15.6 

Stomach (C16) 18.2 (14.1, 22.2) 14.2 (13.4, 15) 12.9 (12.6, 13.1) 17.9 

Colorectal (C18-C21) 63.8 (56.1, 71.6) 58.1 (56.5, 59.6) 56.6 (56.1, 57.1) 62.3 

Lung (C33-C34) 106 (95.9, 116) 69.7 (68, 71.4) 59.3 (58.8, 59.8) 77.4 

Malignant melanoma (C43) 11.9 (8.4, 15.4) 13.8 (13, 14.6) 15.2 (14.9, 15.4) 11.3 

Prostate (C61) 100 (90, 109) 101 (99, 103) 101 (100, 101) 93.8 

Bladder cancer (C67) 21.3 (16.9, 25.8) 20.6 (19.6, 21.5) 19.4 (19.1, 19.7) 20.1


Table 226: Incidence of cancer for women in Hull and comparator areas for 2004-2006 

Cancer site (ICD 10) Age-standardised incidence rate per 100,000 women 

(all ages), 2004-2006 (95% CI) 

England 


Hull 

Industrial 

Hinterlands 

Average 10 

comparators 


Oesophageal (C15) 7.4 (5.0, 9.9) 6.0 (5.5, 6.6) 5.5 (5.3, 5.6) 6.7 

Stomach (C16) 6.3 (4.2, 8.4) 8.1 (7.5, 8.7) 5.4 (5.3, 5.6) 6.9 

Colorectal (C17-C21) 40.1 (34.2, 46.0) 37.2 (35.8, 38.6) 36.6 (36.2, 36.9) 35.1 

Lung (C33-C34) 59.0 (51.8, 66.3) 50.9 (49.3, 52.5) 35.0 (34.6, 35.4) 45.5 

Skin (C43-C44) 86 (78, 95) 107 (105, 109) 91 (91, 92) 103 

Skin excl MM* (C44) 78 (69, 86) 95 (92, 97) 77 (76, 77) 91 

Breast (C50) 123 (112, 135) 123 (120, 126) 123 (122, 124) 120 

Cervical (C53) 18.3 (14.0, 22.6) 10.3 (9.6, 11.0) 8.0 (7.9, 8.2) 10.4 



Table 227: Incidence of cancer for women in Hull and comparators 2006-2008 

Cancer site (ICD 10) Age-standardised incidence rate per 100,000 women 

(all ages), 2006-2008 (95% CI) 

Hull 

Yorkshire 

and Humber 

England 

Average 10 

comparators 


Oesophageal (C15) 5.3 (5.1, 5.5) 5.8 (5.1, 6.6) 6.4 (3.0, 9.9) 6.1 

Stomach (C16) 7.3 (4.9, 9.6) 6.1 (5.7, 6.6) 5.2 (5.1, 5.3) 6.8 

Colorectal (C18-C21) 38.5 (32.8, 44.2) 35.9 (34.7, 37.0) 37.1 (36.8, 37.5) 37.8 

Lung (C33-C34) 65.6 (58.0, 73.1) 45.9 (44.5, 47.2) 37.0 (36.6, 37.4) 50.0 

Malignant melanoma (C43) 14.1 (10.4, 17.8) 16.1 (15.3, 17.0) 16.0 (15.7, 16.3) 12.7 

Breast (C50) 121 (110, 132) 122 (120, 125) 124 (123, 125) 122 

Cervical (C53) 18.2 (14, 22.5) 10.3 (9.6, 11.0) 8.4 (8.2, 8.6) 11.4 

Ovary (C56-C574) 15.0 (14.7, 15.3) 14.5 (13.6, 15.3) 15.0 (10.9, 19.0) 18.7 


It is also useful to examine the incidence of cancers occurring in the under 75. This 

information is also available on the Compendium and the NCIS for the above sites. Due


to small numbers, the directly standardised incidence rates are given in Table 228 for all 

sites, lung cancer, colorectal cancer, skin cancer excluding malignant melanoma, breast 

cancer and prostate cancer only for 2004-2006, and in Table 229 for 2006-2008. Skin 

cancer is not included for 2006-2008 as non-melanoma skin cancers (C44) are no 

longer consistently recorded by regional cancer registries. For ICD 10 coding see Table 

224 and Table 226 above. 

Table 228: Under 75 incidence of cancer in Hull and comparators for 2004-2006 

Gender Cancer site Age-standardised incidence rate per 100,000 population 

(under 75), 2004-2006 (95% CI) 

Men 

Hull 

Industrial 

Hinterlands 


England 

Average 10 

comparators 

All sites 335 (317, 354) 320 (315, 325) 298 (297, 299) 319 

Colorectal 38.8 (32.4, 45.3) 44.5 (42.8, 46.2) 39.9 (39.4, 40.3) 42.2 

Lung 67.3 (58.8, 75.9) 56.6 (54.6, 58.5) 40.9 (40.4, 41.3) 56.0 

Skin excl MM* 71.4 (62.6, 80.2) 94.8 (92.2, 97.3) 77.4 (76.8, 78.0) 84.0 

Prostate 72.7 (63.9, 81.6) 65.6 (63.5, 67.7) 70.6 (70.0, 71.2) 67.0 

All sites 326 (307, 345) 309 (305, 314) 291 (290, 293) 304 

Colorectal 29.4 (23.8, 35.0) 26.3 (25.0, 27.6) 26.0 (25.6, 26.3) 25.4 

Women Lung 45.7 (38.7, 52.7) 38.7 (37.1, 40.2) 26.2 (25.9, 26.6) 34.9 

Skin excl MM* 56.3 (48.4, 64.1) 70.9 (68.8, 73.1) 56.9 (56.4, 57.4) 67.6 

Breast 115 (104, 126) 112 (109, 115) 112 (111, 113) 108 


Table 229:Under 75 incidence of cancer for Hull and comparators for 2006-2008 

Gender Cancer site Age-standardised incidence rate per 100,000 population 

(under 75), 2006-2008 (95% CI) 

Men 

Women 

Hull 

Yorkshire 

and Humber 

England 

Average 10 

comparators 

All sites 358 (339, 377) 316 (312, 320) 307 (306, 309) 327 

Colorectal 46.0 (39.1, 53.0) 41.1 (39.7, 42.5) 40.5 (40, 40.9) 44.8 

Lung 72.2 (63.4, 80.9) 46.6 (45.1, 48.1) 40.1 (39.6, 40.5) 53.5 

Prostate 74.2 (65.3, 83.0) 73.3 (71.4, 75.1) 72.9 (72.3, 73.5) 65.6 

All sites 339 (320, 358) 312 (308, 316) 301 (300, 303) 318 

Colorectal 27.0 (21.7, 32.4) 25.7 (24.6, 26.8) 26.5 (26.2, 26.9) 27.3 

Lung 47.4 (40.3, 54.5) 34 (32.8, 35.3) 27.4 (27.1, 27.8) 37.9 

Breast 112 (101, 123) 111 (109, 113) 113 (112, 114) 110


10.2.1.3 Diagnosed Cases Since April 2003 








have a higher level of disease, as a result practices have been grouped into groups with 

similar age and deprivation profiles (see section 3.3.3.3 on page 47). See section 

12.13 on page 782 for more information on QOF and issues associated with presenting 

the this type of information at practice level. Also see Table 28 and Table 49 for mean 

age of patients and mean deprivation scores for each practice (which will influence the 

prevalence on the disease registers). One such register is for cancer, and relates to 

patients who have been diagnosed with cancer since 1 st April 2003. 

Table 230 presents the percentage of patients on the cancer disease register for all the 

general practices in Hull for 2009/10. This refers to all patients who have been 

diagnosed with cancer since 1 st April 2003. The latest list size refers to the registered 

population as at 1 st January 2010, but the number and prevalence on the disease 

register is as at 31 st March 2010 (the same definitions used in QOF), and this means 

that the prevalence can be biased if large population changes have occurred over this 

three month period (e.g. Y02747, Y02786, Y02896 and Y02748 all opened between 5 th 

October 2009 and 11 th January 2010). 

Table 230: Percentage of patients who have been diagnosed cancer since 1 st April 2003 

as at 2009/10 

Practice 

code 


population 

(Jan 10) 

Number (%) of patients 

diagnosed with cancer since 1 st 

April 2003 as at 2009/10 


B81035 Dr Sande & Partners 6,114 136 2.22 

B81056 Springhead Med Centr 13,489 199 1.48 

B81104 Dr J K Nayar 7,721 18 0.23 

B81635 Dr G Dave 2,967 31 1.04 

B81662 Mizzen Road Surgery 1,856 25 1.35 

Y01200 The Calvert Practice 1,765 16 0.91 

Y02747 Kingswood Surgery 902 2 0.22 

B81020 Dr Mitchell & Partners 7,512 119 1.58 

B81021 Faith House Surgery 7,257 75 1.03 

B81075 Dr M K Mallik 2,263 23 1.02 

B81085 Dr Richardson & Partrs 5,299 76 1.43 

B81094 Dr A K Datta 1,925 27 1.40 

B81095 Dr Cook 4,242 80 1.89 

B81097 Dr R D Yagnik 1,688 14 0.83 



Practice 

code 


population 

(Jan 10) 



April 2003 as at 2009/10 


B81690 Dr S K Ray 1,734 11 0.63 

B81001 Dr Ali & Partners 3,358 29 0.86 

B81008 Dr Parker & Partners 15,062 83 0.55 

B81048 Dr SM Hussain & Ptrs 9,048 76 0.84 

B81049 Dr Rawcliffe & Partners 9,354 178 1.90 

B81052 Dr Musil & Queenan 5,740 72 1.25 

B81072 Dr Percival & Partners 7,807 100 1.28 

B81644 Dr K K Mahendra 2,245 31 1.38 

Y02786 Priory Surgery 141 2 1.42 

B81011 Wheeler St Healthcare 5,243 84 1.60 

B81038 Dr Mather & Partners 7,732 165 2.13 

B81057 Dr S MacPhie & Koul 3,345 35 1.05 

B81074 Dr A K Rej 3,639 34 0.93 

B81081 Dr K M Tang & Partner 3,520 42 1.19 

B81645 East Park Practice 2,128 15 0.70 

B81646 Dr M Shaikh 1,949 16 0.82 

B81682 Dr M Shaikh & Partners 3,726 32 0.86 

B81053 Diadem Med Practice 10,232 81 0.79 

B81054 Dr Varma & Partners 10,851 99 0.91 

B81058 Dr M Foulds & Partner 8,722 97 1.11 

B81066 Dr G M Chowdhury 2,522 31 1.23 

B81080 Dr G S Malczewski 2,216 49 2.21 

B81616 Dr G T Hendow 2,571 59 2.29 

B81002 Dr A Kumar-Choudhary 3,844 33 0.86 

B81112 Dr Ghosh Raghunath & Ptnrs 3,498 33 0.94 

B81119 Dr Palooran & Partners 4,593 43 0.94 

B81634 Dr J Venugopal 3,044 23 0.76 

B81674 Dr J C Joseph 2,241 16 0.71 

B81675 Drs Tak & Stryjakiewicz 9,476 62 0.65 

B81685 Dr N A Poulose 2,444 22 0.90 

B81688 Dr K V Gopal 2,009 17 0.85 

Y02344 Northpoint 1,645 15 0.91 

B81027 St Andrews Grp Practic 5,976 95 1.59 

B81040 Dr Newman & Partners 16,805 236 1.40 

B81047 Dr Singh & Partners 7,377 36 0.49 

B81089 Dr Witvliet 3,583 35 0.98 

B81631 Dr R Raut 3,425 37 1.08 

B81683 Dr Raghunath & Ptnrs 1,644 14 0.85 

Y02896 Story St Pract & WalkIn 343 1 0.29 

B81017 Kingston Medical Grp 6,800 104 1.53 

B81018 Dr Awan & Partners 6,602 81 1.23 

B81032 Dr AW Hussain & Ptnrs 2,478 21 0.85 

B81046 Dr J D Blow & Partners 9,068 55 0.61 

B81692 Quays Medical Centre 1,814 2 0.11 

Y00955 Riverside Med Centre 2,556 12 0.47 



Practice 

code 


population 

(Jan 10) 



April 2003 as at 2009/10 


Y02748 Haxby Orchard Pk Surg 60 1 1.67 

North Locality 68,517 881 1.29 

North Locality* 67,555 878 1.30 

East Locality 83,180 851 1.02 

West Locality 137,513 1,524 1.11 

West Locality* 137,029 1,521 1.11 

HULL 289,210 3,256 1.13 

HULL* 287,764 3,250 1.13 





Table 231 presents the prevalence of patients who have been diagnosed with cancer 

since the 1 st April 2003 for 2009/10 for Hull and comparator areas (see section 3.3.3 on 

page 44), as well as for England. The prevalence in Hull is one of the lowest with only 

Leicester City lower. 

Table 231: Percentage of patients who have been diagnosed with cancer since 1 st April 

2003 as at 2009/10, Hull versus comparator areas 

PCT 

Number on 

cancer disease 

Unadjusted 

percentage on 

cancer register 



England 8,305 54,836,561 775,623 1.41 

Hull 60 289,210 3,256 1.13 

Sunderland 55 284,551 4,305 1.51 


Salford 54 242,922 3,288 1.35 

Derby City 33 294,438 3,486 1.18 


Coventry 65 357,743 4,321 1.21 


Sandwell 67 339,020 3,974 1.17 

Stoke-On-Trent 57 280,265 3,905 1.39 

Plymouth 43 270,338 4,370 1.62 

Average of 10 520 2,840,950 36,216 1.27 

NE Lincs 34 169,565 2,239 1.32 

The number of patients diagnosed with cancer since the 1 st April 2003 and the 

prevalence as recorded on the GP QOF disease registers over time is illustrated in 

Table 232 for 2004/05 to 2009/10. The latest list size refers to the registered population 

as at 1 st January 2010, but the number and prevalence on the disease register is as at 



31 st March 2010 (the same definitions used in QOF), and this means that the prevalence 

can be biased if large population changes have occurred over this three month period 

(e.g. Y02747, Y02786, Y02896 and Y02748 all opened between 5 th October 2009 and 

11 th January 2010). The latest list size for B81676 (Dr PN Jones) relates to 2004/05 and 

the latest list size for B81668 (Dr EG Stryjakiewicz) relates to 2006/07. Some practices 

were not in existence for all the years so information is not applicable (N/A). 

Table 232: Numbers and prevalence of cancer diagnosed since 1 st April 2003 on GP 

QOF disease registers, 2004/05 to 2009/10 

Code Latest 

list 

size 

Number and prevalence of cancer diagnosed since 1 st April 2003 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81035 6,114 84 1.05 89 1.40 91 1.45 82 1.34 78 1.29 136 2.22 

B81056 13,489 65 0.57 90 0.76 119 0.97 138 1.09 163 1.26 199 1.48 

B81104 7,721 5 0.08 9 0.11 16 0.22 18 0.25 18 0.25 18 0.23 

B81635 2,967 27 0.83 37 1.16 31 0.99 35 1.15 27 0.90 31 1.04 

B81662 1,856 24 1.02 28 1.17 26 1.11 26 1.15 27 1.25 25 1.35 


Y01200 1,765 N/A N/A 3 0.24 6 0.38 9 0.55 9 0.54 16 0.91 


B81020 7,512 21 0.30 23 0.32 36 0.50 55 0.75 91 1.19 119 1.58 

B81021 7,257 61 0.86 70 0.97 76 1.06 64 0.89 70 0.94 75 1.03 

B81075 2,263 8 0.29 11 0.41 17 0.67 24 0.99 23 0.97 23 1.02 

B81085 5,299 21 0.39 37 0.68 36 0.67 54 1.01 60 1.12 76 1.43 

B81094 1,925 16 0.72 34 1.49 28 1.21 20 0.89 28 1.30 27 1.40 

B81095 4,242 32 0.80 38 0.96 49 1.23 65 1.61 78 1.89 80 1.89 

B81097 1,688 12 0.72 14 0.86 12 0.74 10 0.61 11 0.66 14 0.83 

B81690 1,734 13 0.71 12 0.70 9 0.51 9 0.52 5 0.29 11 0.63 

B81001 3,358 20 0.66 23 0.78 32 1.11 27 0.90 32 0.97 29 0.86 

B81008 15,062 73 0.51 110 0.75 79 0.53 84 0.57 85 0.57 83 0.55 

B81048 9,048 50 0.56 62 0.67 67 0.73 69 0.76 74 0.80 76 0.84 

B81049 9,354 65 0.81 72 0.89 105 1.25 123 1.41 149 1.63 178 1.90 

B81052 5,740 36 0.69 35 0.63 34 0.64 32 0.58 69 1.24 72 1.25 

B81072 7,807 30 0.42 44 0.64 73 1.06 75 1.03 87 1.15 100 1.28 

B81644 2,245 13 0.57 13 0.58 20 0.89 23 1.04 30 1.36 31 1.38 



B81011 5,243 36 0.65 53 0.95 66 1.20 70 1.29 82 1.53 84 1.60 

B81038 7,732 46 0.59 70 0.90 102 1.30 132 1.70 151 1.99 165 2.13 

B81057 3,345 19 0.53 25 0.69 34 0.93 41 1.16 42 1.22 35 1.05 

B81074 3,639 26 0.41 49 0.77 53 0.83 53 0.87 29 0.76 34 0.93 

B81081 3,520 16 0.42 22 0.60 26 0.74 32 0.94 35 1.00 42 1.19 

B81645 2,128 24 0.92 29 1.09 8 0.30 8 0.30 11 0.49 15 0.70 

B81646 1,949 12 0.46 14 0.55 11 0.44 17 0.71 12 0.58 16 0.82 

B81682 3,726 32 0.88 30 0.81 28 0.76 26 0.71 34 0.92 32 0.86 

B81053 10,232 54 0.54 92 0.92 68 0.67 70 0.69 77 0.76 81 0.79 

B81054 10,851 63 0.56 87 0.78 106 0.94 106 0.95 98 0.88 99 0.91 

B81058 8,722 64 0.67 105 1.09 92 0.98 101 1.11 96 1.09 97 1.11 

B81066 2,522 15 0.59 20 0.81 28 1.16 30 1.23 30 1.18 31 1.23 

B81080 2,216 24 0.88 32 1.16 39 1.51 46 1.97 50 2.22 49 2.21 

B81616 2,571 26 0.95 36 1.33 34 1.23 38 1.40 48 1.83 59 2.29 



Code Latest 

list 

size 

Number and prevalence of cancer diagnosed since 1 st April 2003 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81002 3,844 12 0.41 20 0.67 20 0.66 21 0.69 25 0.83 33 0.86 

B81112 3,498 19 0.48 24 0.63 30 0.82 29 0.81 31 0.86 33 0.94 

B81119 4,593 23 0.38 25 0.43 31 0.69 26 0.57 35 0.74 43 0.94 

B81634 3,044 14 0.45 14 0.45 18 0.58 18 0.58 22 0.72 23 0.76 

B81674 2,241 9 0.52 9 0.52 9 0.50 7 0.36 8 0.38 16 0.71 

B81675 9,476 0 0.00 12 0.28 10 0.21 58 1.08 54 0.56 62 0.65 

B81685 2,444 16 0.63 23 0.87 25 0.97 29 1.13 27 1.07 22 0.90 

B81688 2,009 9 0.45 11 0.54 10 0.48 11 0.52 20 0.95 17 0.85 


B81027 5,976 48 0.76 66 1.10 66 1.11 75 1.26 90 1.50 95 1.59 

B81040 16,805 66 0.40 102 0.62 134 0.80 174 1.02 214 1.27 236 1.40 

B81047 7,377 34 0.45 46 0.62 40 0.55 35 0.48 37 0.51 36 0.49 

B81089 3,583 21 0.66 20 0.62 32 0.96 33 0.97 35 0.99 35 0.98 

B81631 3,425 10 0.31 12 0.38 15 0.47 22 0.68 28 0.82 37 1.08 

B81683 1,644 3 0.20 7 0.44 4 0.26 5 0.34 9 0.59 14 0.85 


B81017 6,800 53 0.72 83 1.18 76 1.05 92 1.27 102 1.50 104 1.53 

B81018 6,602 31 0.47 37 0.57 52 0.77 50 0.74 66 0.99 81 1.23 

B81032 2,478 12 0.39 6 0.20 11 0.40 17 0.63 22 0.84 21 0.85 

B81046 9,068 31 0.36 64 0.76 49 0.54 64 0.73 53 0.59 55 0.61 

B81692 1,814 6 0.32 6 0.30 2 0.11 1 0.06 1 0.06 2 0.11 

Y00955 2,556 N/A N/A 4 0.60 4 0.24 5 0.22 9 0.35 12 0.47 



number of people with cancer (Doncaster PCT 2008). As the disease register refers to 

“producing a register of patients with a diagnosis of cancer excluding non-melanoma 

skin cancer from 1 st April 2003”, the model uses annual survivor-incidence rates to 

estimate the expected number of patients on the cancer disease register. The agegender-specific 

incidence rates for all years to 2004 and the age-gender specific 

mortality rates for 1999 were used in calculating the survivor-incidence rates. When 

calculating (previously within the earlier release of these profiles – Release 2) the 

modelled numbers using October 2008 population and comparing the result to the actual 

disease registers for March 2009, the methodology is complicated by the length of time 

(six years) as survival rates have changed between the period 1999 and 2009. The 

model only adjusts for age and gender, not for any other factors such as ethnicity or 

deprivation. It is possible, and indeed likely that those diagnosed with cancer during the 

earlier years, say at the beginning of the financial year 2003/2004, are in remission, but 

based on the definition used for the general practice disease registers, patients will still 

be included on the cancer disease register. For these reasons, the number of people 

with cancer has not been estimated using the model. 




12.12 on page 781), with 22,225 (8.2%) of them having a primary diagnosis of cancer. 



Overall, 13.8% of all clinician episodes for cancer were for malignant neoplasm related 

to the lymphoid, haematopoietic and related tissue which includes leukaemia, a further 

13.4% for lung cancer, 11.9% for breast cancer, 11.2% for bladder cancer, and 10.3% 

for colorectal cancer (Table 233). 







diagnosis of cancer over three year period 2007/08 to 2009/10 

ICD 10 code Cancer type Total cancer clinician 

episodes 2007/08 to 

2009/10 


C00-C14 Lip, oral cavity & pharynx cancer 407 1.8 

C15 Oesophagus cancer 609 2.7 

C16 Stomach cancer 509 2.3 

C17-C21 Colorectal cancer 2,293 10.3 

C25 Pancreas cancer 573 2.6 

C22-C24, C26 Other digestive system cancers 266 1.2 

C32 Larynx cancer 204 0.9 

C33-C34 Lung cancer 2,989 13.4 

C40-C41 Bone and articular cartilage 41 0.2 

C43 Malignant melanoma 139 0.6 

C44 Other malignant neoplasms of the skin 809 3.6 

C45 Mesothelioma cancer 84 0.4 

C46-C49 Soft tissue 193 0.9 

C50 Breast cancer 2,640 11.9 

C53 Cervical cancer 244 1.1 

C56 Ovary cancer 494 2.2 

C61 Prostate cancer 435 2.0 

C51-63 excl C53,C56&C61 Other reproductive system cancers 448 2.0 

C64 Kidney cancer 255 1.1 

C67 Bladder cancer 2,465 11.1 

C65-C66, C68 Other urinary tract organs 65 0.3 

C71 Brain cancer 282 1.3 

C76-C80 Ill-defined, secondary or unspecified sites 2480 11.2 

C91-C95 Leukaemia 1,108 5.0 

C81-C90, C96 Other lymphoid/haematopoietic/related 1,954 8.8 

C00-C97 excl above Other cancers 239 1.1 

Total cancer clinician episodes 22,225 100.0 





admission rate for admissions (DSR) where the primary diagnosis was cancer (for at 

least one of the clinician episodes during the hospital stay) per 1,000 resident population 

(standardised to Hull‟s 2009 population). As previously mentioned, usage of services 

will depend on many different things, such as prevalence of risk factors and disease, 

willingness of visit GPs, referral rates within Primary Care, accessibility of Primary and 

Secondary Care services, etc. 

Table 234: Total three year admissions and annual average age-standardised cancer 



per 1,000 Hull residents with a primary diagnosis of 

cancer, 2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 




Area: North Carr 1,063 31.2 (29.3 to 33.2) 932 24.9 (23.3 to 26.6) 

Beverley 384 22.4 (20.2 to 24.8) 492 32.2 (29.4 to 35.3) 



Area: Northern 1,305 26.0 (24.6 to 27.4) 1,347 27.5 (26.0 to 29.0) 


Ings 574 23.1 (21.2 to 25.1) 745 30.0 (27.9 to 32.3) 

Longhill 644 30.8 (28.4 to 33.3) 571 29.0 (26.6 to 31.5) 

Sutton 417 19.5 (17.7 to 21.5) 578 27.6 (25.4 to 30.1) 

Area: East 1,635 24.3 (23.1 to 25.5) 1,894 28.7 (27.4 to 30.0) 


Marfleet 619 32.4 (29.9 to 35.1) 484 24.0 (21.9 to 26.3) 



Area: Park 1,794 27.2 (25.9 to 28.5) 1,632 24.7 (23.5 to 25.9) 

Drypool 337 18.4 (16.4 to 20.4) 604 33.1 (30.5 to 35.9) 



Myton 550 22.7 (20.8 to 24.7) 544 29.5 (27.0 to 32.1) 



Area: Riverside (West) 1,502 27.7 (26.3 to 29.2) 1,265 28.1 (26.6 to 29.7) 







per 1,000 Hull residents with a primary diagnosis of 

cancer, 2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 

Area: West 1,633 26.3 (25.0 to 27.6) 1,861 29.3 (28.0 to 30.7) 

Avenue 369 22.8 (20.5 to 25.4) 386 22.0 (19.8 to 24.3) 


Newland 263 24.6 (21.6 to 27.9) 251 25.4 (22.3 to 28.8) 

Area: Wyke 946 22.3 (20.9 to 23.7) 1,012 24.0 (22.5 to 25.5) 


HULL 10,215 25.7 (25.2 to 26.2) 10,548 27.3 (26.8 to 27.8) 


From the Compendium, the age-specific mortality rates for cancer for 2006-2008 are 

given in Table 235 for Hull and comparator areas (see section 3.3.3 on page 44). 

Table 235: Cancer age-specific mortality rates for 2006-2008 

Area Cancer age specific mortality rates per 100,000 for 2006-2008 

Males Females 


England 145 906 2,153 269 138 624 1,344 238 

Hull 168 1,214 2,631 292 172 856 1,661 274 

Y&H SHA 155 951 2,265 280 148 667 1,394 251 

Indust Hinterlands 178 1,141 2,509 333 160 751 1,549 288 

Wolverhampton 163 1,016 2,294 310 145 659 1,386 259 

Salford 216 1,121 2,544 311 176 849 1,589 287 

Derby 146 1,001 2,213 275 145 619 1,199 223 

Stoke-on-Trent 191 1,240 2,501 329 181 713 1,621 291 

Coventry 153 918 2,146 250 155 582 1,328 226 

Plymouth 177 872 2,299 274 148 566 1,439 246 

Sandwell 190 1,039 2,340 303 148 706 1,434 254 

Middlesbrough 179 1,288 2,582 320 160 843 1,654 278 

Sunderland 185 1,218 2,656 342 159 766 1,615 285 

Leicester 122 890 2,247 211 144 628 1,425 197 

Average above 10 172 1,060 2,382 293 156 693 1,469 254 

NE Lincolnshire 155 1,136 2,149 308 137 720 1,416 266 





Table 236: Cancer age-specific mortality rates for 2007-2009 by Area in Hull 

Area/Locality Cancer age specific mortality rates per 100,000 for 2007-2009 

Males Females 


North Carr 212 1,437 2,408 237 134 703 1,824 177 

Northern 164 1,001 1,970 230 234 967 1,643 274 

NORTH 186 1,180 2,114 233 187 861 1,706 230 

East 188 1,065 2,568 350 192 877 1,548 329 

Park 166 1,313 2,880 305 160 736 2,100 292 

Riverside (East) 162 1,137 3,783 312 111 568 1,554 212 

EAST 174 1,182 2,819 324 167 782 1,773 297 

Riverside (West) 176 1,526 2,635 276 205 1,290 1,559 275 

West 151 1,084 2,145 305 130 778 1,435 282 

Wyke 125 975 3,396 238 92 683 1,504 193 

WEST 152 1,209 2,606 273 143 906 1,489 252 

HULL 168 1,192 2,601 282 162 848 1,644 263 

Over the three year period 2007-2009, there were 1,126 cancer deaths in men and 

1,020 cancer deaths in women in Hull. The age-specific mortality rates for Hull differ 

slightly from the Compendium because different population estimates have been used. 

The total number of deaths from cancer in men and women aged under 75 years as well 

as the directly standardised mortality rates (DSRs) for all cancers are given in Table 237 

for the most recent period 2007-2009. The DSRs are standardised to the European 

Standard Population. The confidence intervals are given, and it can be seen that they 

are wide for the Areas and Localities, particularly for the former. Therefore, despite the 

relatively large differences among the Areas and Localities, the differences could well be 

associated with random variation rather than related to true underlying differences. 

Table 237: Total deaths and under 75 directly standardised mortality rates for all 

cancers per 100,000 persons, Hull 2007-2009 

Area Total deaths over three years and under 75 DSRs for cancer 2007-2009 per 

100,000 persons (95% CI) 





NORTH 138 166 (139 to 196) 120 137 (114 to 164) 258 151 (133 to 170) 

East 93 155 (125 to 190) 88 139 (111 to 171) 181 147 (126 to 170) 

Park 105 170 (139 to 206) 77 121 (95 to 152) 182 145 (125 to 168) 


EAST 226 161 (140 to 183) 181 125 (107 to 145) 407 142 (129 to 157) 


West 82 139 (110 to 173) 69 110 (85 to 140) 151 124 (104 to 145) 

Wyke 50 129 (95 to 170) 35 90 (62 to 125) 85 109 (87 to 135) 

WEST 233 155 (135 to 176) 183 126 (108 to 146) 416 140 (127 to 154) 

HULL 597 159 (147 to 173) 484 128 (117 to 140) 1,081 143 (135 to 152) 



Table 238 gives under 75 SMRs for cancer for Hull and comparators for 2006-2008. 

The premature cancer mortality rate is 29% higher in Hull compared to England, which 

is one of the highest of the comparator areas. There are relatively small differences in 

the SMRs between men and women in Hull. So whilst the age-specific mortality rates 

as illustrated in Table 235 are higher for men aged 65-74 years and 75+ years 

compared to women, both men and women fair equally poorly in relation to England. 

Furthermore, the mortality rates for men and women in Hull are higher than the 

Industrial Hinterlands and the average of the 10 comparators. 

Table 238: Under 75 standardised mortality ratios for all cancers for Hull and 


Area Under 75 cancer SMR 2006-2008 (95% CI) 


England 100 (99, 101) 100 (99, 101) 100 (100, 100) 

Hull 128 (118, 138) 131 (120, 143) 129 (122, 137) 

Y&H SHA 105 (103, 107) 107 (105, 109) 106 (104, 107) 



Salford 135 (124, 147) 131 (119, 143) 133 (125, 141) 

Derby 106 (97, 116) 104 (94, 115) 105 (98, 112) 

Stoke-on-Trent 131 (121, 142) 122 (111, 133) 127 (120, 135) 

Coventry 106 (98, 115) 105 (96, 115) 106 (99, 112) 

Plymouth 106 (97, 116) 98 (88, 108) 102 (96, 109) 

Sandwell 124 (115, 134) 112 (103, 122) 119 (112, 126) 


Sunderland 131 (122, 140) 118 (109, 128) 125 (118, 132) 

Leicester 97 (88, 107) 105 (95, 115) 101 (94, 108) 

Average above 10 118 (115, 121) 112 (109, 115) 115 (113, 118) 

North East Lincolnshire 116 (105, 128) 108 (96, 120) 112 (104, 121) 


2001 to 2007-2009 for cancer on the Hull Atlas (which can be found at 



cancer for Hull and comparator areas is given in Figure 197. This figure refers to 

deaths for persons aged under 75 years as the LAA target relates to under 75 years 

(see section 10.2.1.15 on page 530). Hull has (relatively consistently) had higher 

premature mortality rates for cancer than its comparators between 1993-95 and 2006- 

08. The underlying data are given in the APPENDIX on page 912. 



Figure 197: Trends over time in under 75 directly standardised mortality rates for cancer 


persons 

200 

180 

160 

140 

120 

100 

80 

60 

40 

20 

0 

1993-1995 

1994-1996 

1995-1997 

10.2.1.6 Cancer Mortality by Tumour Site 

1996-1998 

1997-1999 

1998-2000 

1999-2001 

For male cancer deaths registered during 2006 and 2008, the tumour sites of cancer are 

illustrated in Figure 198 for England and Figure 199 for Hull (with comparison between 

England and Hull illustrated in Figure 200). The data comes from the Compendium 

(based on total number of deaths for all the cancer causes listed on the Compendium), 

and the total number of deaths over the three year period are given (for all ages). The 

underlying data are given in the APPENDIX on page 912. Further information on the 

cause of death also given in Table 80. 


2000-2002 

Period 

England Hull 



Spearheads 

2001-2003 

2002-2004 

2003-2005 

2004-2006 

2005-2007 

2006-2008


Figure 198: Cancer mortality in men – tumour site, England for 2006-2008 

Other, 67,497, 33% 

Stomach, 7,922, 4% 

Skin incl malignant 

melanoma, 3,474, 2% 

Prostate, 25,762, 

13% 

Bladder, 8,202, 4% 

Colorectal, 21,474, 

11% 

Oesophagus, 11,979, 

6% 

Leukaemia, 6,239, 3% 

Lung, 47,676, 24% 

Figure 199: Cancer mortality in men – tumour site, Hull for 2006-2008 

Other, 339, 30% 

Stomach, 57, 5% 

Skin incl malignant 

melanoma, 13, 1% 

Prostate, 114, 10% 

Bladder, 44, 4% 

Oesophagus, 56, 5% 

Colorectal, 104, 10% 

Leukaemia, 22, 2% 

Lung, 372, 33% 



Figure 200 compares the percentages of cancer deaths for men by tumour site of 

cancer between England and Hull for the period 2006-2008. Skin cancer includes 

malignant melanomas. The biggest differences between England and Hull, also 

illustrated in the pie charts, are for lung cancer. One quarter of all cancer deaths in 

England are due to lung cancer, but one-third in Hull. Men in Hull have slightly lower 

percentages of cancer deaths due to prostate cancer. 

Figure 200: Comparison of cancer mortality by tumour site between England and Hull for 

men for 2006-2008 

Male cancer deaths 2006-2008 (%) 

40 

35 

30 

25 

20 

15 

10 

5 

0 

England Hull 

Bladder Colorectal Leukaemia Lung Oesophagus Prostate Skin* Stomach Other 

Cancer site 

The three main sites of cancer from which men from Hull die are lung, colorectal and 

prostate. Age-specific rates for these three cancer sites are given in section 10.2.2.4, 

section 10.2.3.4 and section 10.2.4.4 respectively. For all other tumour sites, mortality 

is less than 25 men per year in Hull and it is not possible to examine these cancers in 

more detail. 

For female cancer deaths registered between 2006 and 2008, the tumour sites are 

illustrated in Figure 201 for England and Figure 202 for Hull (with comparison between 

England and Hull illustrated in Figure 203). The data comes from the Compendium 

(based on total number of deaths for all the cancer causes listed on the Compendium), 

and the total number of deaths over the three year period are given (for all ages). The 




Figure 201: Cancer mortality in women – tumour site, England for 2006-2008 

Other, 73,487, 40% 

Stomach, 4,775, 3% 

Skin excl malignant 

melanoma, 2,760, 2% 

Bladder, 4,157, 2% 

Oesophagus, 6,171, 

3% 

Breast, 30,294, 17% 

Lung, 35,612, 19% 

Cervical, 2,284, 1% 

Colorectal, 18,825, 

10% 

Leukaemia, 4,710, 3% 

Figure 202: Cancer mortality in women – tumour site, Hull for 2006-2008 

Other, 348, 34% 

Stomach, 39, 4% 

Skin excl malignant 

melanoma, 6, 1% 

Oesophagus, 30, 3% 

Bladder, 31, 3% 

Breast, 165, 16% 

Lung, 280, 27% 

Cervical, 21, 2% 

Colorectal, 88, 8% 

Leukaemia, 25, 2% 



Figure 203 compares the percentages of cancer deaths in women by tumour site 

between England and Hull for the period 2006-2008. Skin cancer which includes 

malignant melanomas. Similar to men, the biggest differences between England and 

Hull, also illustrated in the pie charts, are for lung cancer. One in five of all cancer 

deaths in England are due to lung cancer, but more than one-quarter in Hull. 

Figure 203: Comparison of cancer mortality by tumour site between England and Hull for 

women for 2006-2008 

Female cancer deaths 2006-2008 (%) 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

England Hull 

Bladder Breast Cervical Colorectal Leukaemia Lung Oesophagus Skin* Stomach Other 

Cancer site 

The three main sites of cancer from which women in Hull die are lung, breast and 

colorectal. Age-specific rates for these three types of cancers are given in section 

10.2.2.4, section 10.2.5.4 and section 10.2.3.4 respectively. For all other tumour sites, 

mortality is less than 25 women per year in Hull and it is not possible to examine these 

cancers in more detail. 



10.2.1.7 Survival Rates in Humber and Yorkshire Coast Cancer Network 

The Northern and Yorkshire Cancer Registry and Information Service (NYCRIS), in 

common with the other regional cancer registries, provides information on survival from 

cancer for its constituent cancer networks. The one-year and five-year survival rates are 

presented in Table 239 and Table 240 respectively for the Humber and Yorkshire Coast 

Cancer Network. Data were extracted from the National Cancer Information Service 

using a password provided by NYCRIS. One-year relative survival rates are presented 

for those cancer cases diagnosed during 2003-2007 and five-year relative survival rates 

for cases diagnosed 1999-2003, these being the most recent five-year periods for which 

survival data were available at the time of publication. The relative survival rates are 

presented which are adjusted for the background mortality experienced by the general 

population. 

Table 239: One Year Cancer Relative Survival Rates in Humber and Yorkshire Coast 

Cancer Network 

One-year relative survival rates in Humber and Yorkshire Coast 

Network (cases diagnosed 2003-2007) 

Cancer type and ICD 10 coding 

Males Females 

Cohort Deaths 

Surviving % 

(95% CI) 

Cohort Deaths 

Surviving % 

(95% CI) 

All cancers (C00-C97)* 12,696 4,819 65 (64, 66) 12,078 3,997 69 (68, 70) 

Lip, oral, pharynx (C00-C14) 322 66 82 (77, 86) 154 29 84 (78, 91) 

Head & neck (C00-C14, C30-C32, C73) 560 116 82 (78, 85) 295 44 87 (83, 92) 

Oesophagus (C15) 451 298 35 (31, 40) 240 168 32 (25, 38) 

Stomach (C16) 466 298 38 (33, 43) 239 176 28 (22, 34) 

Colorectal (C18-C21) 1,703 537 72 (69, 74) 1,371 456 70 (67, 73) 

Pancreas (C25) 280 233 18 (13, 22) 336 291 14 (10, 18) 

Larynx (C32) 179 35 83 (77, 89)


Table 240: Five Year Cancer Relative Survival Rates in Humber and Yorkshire Coast 

Cancer Network 

Five-year relative survival rates in Humber and Yorkshire Coast 

Network (cases diagnosed 1999-2003) 

Cancer type and ICD 10 coding 

Males Females 

Cohort Deaths 

Surviving % 

(95% CI) 

Cohort Deaths 

Surviving % 

(95% CI) 

All cancers (C00-C97)* 11,785 7,901 42 (41, 43) 11,460 6,377 53 (52, 54) 

Lip, oral, pharynx (C00-C14) 285 138 61 (54, 68) 153 75 60 (51, 70) 

Head & neck (C00-C14, C30-C32, C73) 496 248 59 (54, 65) 277 112 69 (62, 76) 

Oesophagus (C15) 411 381 9 (6, 12) 238 223 8 (4, 13) 

Stomach (C16) 511 462 13 (9, 16) 276 240 18 (12, 23) 

Colorectal (C18-C21) 1,647 1,032 48 (45, 51) 1,263 745 53 (49, 56) 

Pancreas (C25) N/A N/A 

Larynx (C32) 173 95 54 (45, 63) 35 11 77 (60, 95) 

Lung (C33-C34) 2,148 2,033 7 (6, 8) 1,353 1,265 8 (6, 10) 

Malignant melanoma of skin (C43) 

Mesothelioma (C45)** 

204 61 80 (73, 88) 304 56 91 (86, 96) 

Breast (C50) 23 10 75 (48, 103) 3,444 969 82 (80, 84) 

Cervix uteri (C53) N/A 328 91 77 (71, 82) 

Corpus uteri (C54) N/A 453 146 78 (73, 83) 

Ovary (C56-C574) N/A 598 386 41 (36, 45) 

Prostate (C61) 2,521 1,091 77 (74, 79) N/A 

Testis (C62) 159 18 90 (85, 95) N/A 

Kidney/urinary (C64-C66, C68) 329 186 53 (46, 59) 225 138 46 (39, 54) 

Bladder (C67) 621 361 58 (52, 63) 267 187 41 (33, 49) 

Brain (C71) 210 186 13 (8, 18) 160 141 13 (8, 19) 

Hodgkin's disease (C81) 80 21 77 (67, 88) 51 14 77 (63, 90) 

Non-Hodgkin's lymphoma (C82-C85, C96) 447 238 57 (51, 63) 331 148 65 (59, 72) 

Lymphoid leukaemia (C91) 291 111 76 (69, 83) 174 65 78 (69, 87) 

Myeloid leukaemia (C92) 140 111 26 (18, 35) 137 102 33 (23, 42) 

Leukaemia (C91-C95) 437 228 59 (53, 65) 315 171 58 (51, 65) 

Other haematological (C88-C90) 191 135 38 (29, 46) 187 135 34 (26, 43) 

*Excluding non-melanoma skin (C44). 

**5-year survival data were not available at time of publication 

Survival rates at PCT level are not routinely produced, but are available on request from 

NYCRIS provided the numbers of cases are large enough so that confidentiality is not 

an issue and the number of deaths is sufficient for meaningful estimates to be produced. 

Five year relative survival rates for cases diagnosed during 1998-2002 and 2000-2002 

are available for Hull for lung cancer (within section 10.2.2.5 on page 540), colorectal 

cancer (within section 10.2.3.5 on page 552) and breast cancer (within section 

10.2.5.5 on page 561). 

10.2.1.8 Screening 

See specific section on screening above on page 416. 




The cancer equity audit was completed during 2005/2006. This document is available at 

www.hullpublichealth.org and includes information on risk factors, incidence, inpatient 

admissions and mortality for all cancers and for each of the main cancer sites. This 

information is examined in relation to age, gender and deprivation (Index of Multiple 

Deprivation) to assess potential inequalities that might exist among these groups. The 

document also examined breast and cervical screening rates, and potential programmes 

that could reduce health inequalities. 

Essentially, the main findings in relation to potential inequalities are summarised in the 

next few paragraphs. 

Whilst the intention was to examine health equity for many different groups of 

individuals, the data is often not available. For example, there is no readily-available 

accurate information on ethnicity for incidence or mortality. Therefore, it was only 

possible to examine whether inequity may exist based on gender, age and deprivation. 

The incidence rates vary between males and females and between different age groups 

differs reflecting both the different types of cancers as well as differences in the 

underlying determinants of cancer. 

Up until the age of 60 men had a lower inpatient admission rate for cancer compared to 

women, and within the 30-49 year age group approximately half as many men were 

admitted to hospital for cancer over the five year period compared to women. In the 

older age groups, there was an increasing trend with more men being admitted as 

inpatients with cancer than women. The number of men aged 60-64 admitted as an 

inpatient for cancer was 9% higher than females, and this gradually increased as age 

increased with twice as many men aged 85+ years being admitted compared to women. 

These differences could reflect the different types of cancer, the age at which these 

cancers generally occur, types of treatment available as well as other factors influencing 

admission such as the presence of co-morbidities. 

Cancer mortality rates differ considerably between men and women and across different 

age groups. However, again this could be because of a number of factors such as type 

of cancer, age at diagnosis, the prevalence of risk factors and co-morbidities, survival 

rates, types of treatments. It does not necessarily mean that inequity is present. 

Due to the strong association between smoking and deprivation, and between smoking 

and the risk of lung cancer, there is a strong association between deprivation and lung 

cancer incidence. The relative risk of developing other types of cancer due to different 

types of risk factors is smaller, so even if there is an association between deprivation 

and the prevalence of the risk factor, the resulting association between deprivation and 

incidence will be weaker. For colorectal cancer and breast cancer in women there is not 

a strong association between incidence and deprivation. For skin cancer and prostate 

cancer in men, there is a higher incidence in the least deprived groups. For all cancers 



combined, those in the most deprived national quintile have a higher inpatient admission 

rate compared to those in the least deprived national quintile. 

It is not possible to examine cancer mortality rates for most types of cancer as the 

number of deaths is too small. For those cancers where it is possible, there is strong 

evidence of an association between deprivation and mortality for all cancers, lung 

cancer, all cancers excluding lung cancer, and colorectal cancer. There is no evidence 

locally of an association between deprivation and breast cancer mortality. 

For specific types of cancer, one would expect that the incidence would be related to 

mortality through survival, and if no inequalities were present one would expect that the 

relationship would be relatively constant over the different deprivation quintiles. The 

relationship is relatively constant for lung cancer as the mortality rate is high regardless 

of deprivation group. However, for most other types of cancer there appears to be 

inequity present as there is a higher mortality rate relative to the incidence rate for the 

most deprived quintiles compared to the least deprived quintiles. This is the case for all 

cancers combined, colorectal cancer, breast cancer and prostate cancer. Again, it is not 

possible to examine incidence relative to mortality for the majority of cancer types due to 

the small number of deaths. It is not know why there is a difference in the incidence to 

mortality ratio across the deprivation quintiles, and whether this reflects excess mortality 

in the most deprived group relative to incidence or under-diagnosis in the most deprived 

groups (a similar figure has been reproduced but using more up-to-date information; see 

Figure 208). It is likely that there are many complex reasons for this difference, and the 

reasons may include differences in risk factors, stage at diagnosis, co-morbidity, 

treatment options, type of cancer, survival or other factors. 





population). Table 241 shows the prevalence of diagnosed cancer on the practice 

disease registers for 2009/10; grouping the practices into five groups. Figure 204 

shows the practice IMD 2007 scores and the prevalence of diagnosed cancer for each 

practice. It can be seen from the figure that there is an association between the 

diagnosed prevalence of cancer and deprivation measured at practice level (p=0.034). 

However, the relationship is the reverse to what might be expected with a lower 

prevalence in more deprived areas. Furthermore, among the quintiles the relationship is 

not consistent with the most deprived quintile having a higher prevalence compared to 

the second least deprived and middle deprivation categories. One would expect that 

cancer was more prevalent in the more deprived groups. There are a number of 

possible reasons why there is a lack of a relationship such as survival rates are lower in 

the more deprived groups which could be related to the type of cancers (such as lung 

cancer being more prevalent with its low survival rate), poor recording in relation to 

cancer for certain types of patients or within certain practices which could mean that the 

patients are not included on the register or that people are not removed from the register 



if they enter remission or there is a different time lag removing patients among the 

practices. Breast cancer does tend show nationally an association between deprivation 

and prevalence with the higher prevalence for the least deprived groups, and this may 

be influencing the pattern observed in the figure, especially as the survival rate for 

breast cancer is relatively high so women diagnosed since 2003 may still be included on 

the disease registers. The underlying data for the figure is given in the APPENDIX on 

page 913. 










Table 241: Diagnosed prevalence of cancer by deprivation quintile at practice level, 

2009/10 

Practice IMD 2007 

quintile 

Number of 

practices* 

List size 

(Jan 10) 

Numbers diagnosed with cancer 

since 1 st April 2003 


Most deprived 10 57,367 655 1.14 

2 12 55,245 455 0.82 

3 12 66,252 747 1.13 

4 11 65,303 862 1.32 





Figure 204: Diagnosed prevalence of cancer by deprivation score at practice level 



inpatient admission rates which involve a primary diagnosis of cancer (any clinician 




daycase and inpatient admissions for cancer. The standardised admission rate in the 

most deprived quintile is 28.4 admissions per 1,000 persons compared to 26.2 per 1,000 

persons in the least deprived quintiles, and whilst this does not appear to be a large 

difference, the 95% confidence intervals do not overlap for the most deprived quintile 

(27.5 to 29.3) and the least deprived quintile (25.4 to 27.0). The underlying data are 



living in the most deprived areas have a higher hospital admission rate for cancer. 






Figure 205: Age-standardised cancer annual daycase and inpatient admission rate per 



The directly standardised mortality rates for deaths from all cancers for those persons 


There is a relationship between under 75 DSRs and deprivation quintile, with people 

living in the most deprived 20% of areas of Hull having a premature mortality rate for 

cancer which is 88% higher than that for the people living in the least deprived 20% of 

areas of Hull (although the second least deprived quintile had a slightly lower DSR). 

This relationship will be influenced by the strong association between deprivation and 

lung cancer mortality. The underlying data are given in the APPENDIX on page 915. 

Figure 206: Standardised mortality rates for cancer for 100,000 persons aged under 75 

years by deprivation for Hull for 2007-2009 

Under 75 directly age-standardsied 

cancer mortality rate per 100,000 

persons 2007-2009 

250 

200 

150 

100 

50 

0 

Most 

deprived 



deprived 





















Figure 207 shows trends in under 75 standardised mortality ratios (SMRs) for cancer for 



residents. The underlying data are given in the APPENDIX on page 916. Under 75 

cancer SMRs for men in Hull were higher for each year than for all comparators 

excluding North East Lincolnshire. The only substantial changes in under 75 cancer 

SMRs for Hull were a 9% decrease in 2003-2005 and an 8% increase in 2006-2008 to 

end the period just 2.5% lower than in 2001-2003, and higher than all the comparator 

areas. For women in Hull under 75 cancer SMRs increased for each year, ending the 

period 22% higher than in 2001-2003, and between 16% and 20% higher than for 

comparator areas, statistically significantly higher than for each comparator, excluding 

North East Lincolnshire. Under 75 cancer SMRs remained largely unchanged over the 

period for comparator areas. 



Figure 207: Trends in under 75 cancer standardised mortality ratios by national 


10.2.1.14 Survival in Relation to Deprivation 

The local Cancer Equity Audit conducted during the financial year 2005/2006 revealed 

that whilst premature cancer mortality was strongly associated with deprivation, 

incidence was less strongly associated and the relationship between incidence and 

mortality was not consistent among the deprivation quintiles (Figure 208). The Cancer 

Equity Audit was conducted in Hull and East Riding of Yorkshire so the data are for both 

local authorities combined and use incidence and mortality data for the period 2001 to 

2003, and deprivation defined on the basis of the Index of Multiple Deprivation 2004 

national quintiles. It can be seen that there is no substantial difference in cancer 

incidence among the national deprivation quintiles. However, there is a trend in cancer 

mortality with those in the most deprived quintiles having the highest mortality rates. 

This suggests that survival rates are lower in the most deprived national quintile. There 

are many potential reasons why this might be the case, and this relationship could 

reflect differences in risk factors, stage of cancer at diagnosis, referral rates to 

secondary care, co-morbidity, treatment options, type of cancer, and many other factors. 



There is an increased incidence and mortality rate for lung cancer in the most deprived 

areas, and as this cancer has a very high mortality rate it might be thought that this 

could be a reason for this relationship. However, further research revealed that this 

relationship is present for all remaining cancers even when lung cancer is excluded from 

the standardisation calculations. The underlying data are given in the APPENDIX on 

page 917. Note that it would be possible to update the mortality information to that for the 

period 2005-2007, but it is not possible to update the incidence data without obtaining 

more recent data from Northern and Yorkshire Cancer Registry and Information Service 

(NYCRIS provided this information on request specifically for the Cancer Equity Audit). 

Figure 208: Annual age-standardised incidence rate and mortality rate during 2001 to 

2003 with a primary diagnosis of cancer by deprivation for those aged under 75 years 

Cancer age-gender standardised 

incidence/mortality rate per 100,000 

persons aged under 75 years 

500 

450 

400 

350 

300 

250 

200 

150 

100 

50 

0 



Index of Multiple Deprivation 2004 national quintile 

Incidence Mortality 

The Local Area Agreement (LAA) 2 target is to reduce the directly standardised mortality 

rate from cancer for those aged under 75 years (standardised to European standard 

population). Reduction in this measure was also a Public Service Agreement target for 

2004 (MH Treasury, 2004) with a target of at least a 20% reduction in the cancer 

mortality rate for people aged under 75 years between 1995-1997 and 2009-2011. The 

LAA2 single year targets are given in Table 242 together with the actual values for the 

period 1995-2007 and the change in the mortality rate between successive years. The 

average reduction was 3.1 deaths per 100,000 persons between the period 1995-2008, 

but in order to achieve the target by 2011, it would be necessary to have an average 

annual reduction of 3.65 deaths per 100,000 each year. If the previously observed rate 

of reduction continues (3.1), then the mortality rate would not fall to the target. 















difference in the population estimates, therefore, it would appear that Hull has failed to 

achieve its target for 2007-09. 



under 75 mortality rate from cancer. Therefore, it is possible that this outcome measure 

will be retained. 

Table 242: Under 75 year cancer disease mortality targets 

Year Under 75 year cancer mortality rate per 100,000 population 

Target Actual Difference 

1995 186.2 –4.7 

1996 183.2 –3.0 

1997 156.1 –27.1 

1998 172.3 16.3 

1999 159.2 –13.2 

2000 157.1 –2.1 

2001 154.7 –2.4 

2002 155.0 0.4 

2003 141.8 –13.2 

2004 154.0 12.2 

2005 136.9 –17.1 

2006 149.8 12.9 

2007 141.0 145.8 –4.0 

2008 138.5 145.7 –0.1 

Average –3.1 

2009 136.0 *142.7 –3.0 

2010 133.6 

2011 131.2 





The target relating to cancer within the local World Class Commissioning (WCC) 

Strategy was to increase the proportion of women aged 53-64 years offered screening 

for breast cancer. Following the change in the government in May 2010, new outcomes 

are now under consultation (see section 3.3.6.2 on page 52). One of the outcomes 

proposed is related to uptake of national screening programmes so it is wider than the 

WCC target relating to screening for breast, cervical and colorectal cancer (as well as 

other non-cancer screening programmes). Therefore, it is possible that this outcome 

measure could be retained. Information is given in section 9.3.1 on page 416 relating 

to breast screening and in section 9.3.1.2 on page 420 relating to targets set for breast 

screening. 


As illustrated in Figure 1, expenditure on cancer and tumours per head for 2008/2009 in 

Hull was £87.15 compared to £94.07 for the Industrial Hinterlands average, £153.99 for 

North East Lincolnshire and £94.55 for England. Therefore, expenditure was slightly 

lower in Hull compared to the Industrial Hinterlands average and compared to England 

(ranked 107 th highest out of 152 PCTs). 

Expenditure per head for 2008/2009 in Hull on lung cancer was £9.14 (ranked 2 nd ) 

compared to £5.55 for the Industrial Hinterlands average, £7.73 for North East 

Lincolnshire and £4.48 for England. For breast cancer, the expenditures per head were 

£7.90, £7.53, £9.72 and £9.34 for Hull, Industrial Hinterlands, North East Lincolnshire 

and England respectively, with Hull ranked 99 th . 

Information on seven cancer outcomes are also available within the information 

produced by the Yorkshire and Humber Public Health Observatory (Y&H PHO) 

programme budgeting tool for each PCT, Industrial Hinterlands and England. The 

outcomes measures are given in Table 243 for Hull and comparator areas (see section 

3.3.3 on page 44 for more on comparators). The under 75 directly standardised 

mortality rates (DSR) for all cancers, lung cancer and breast for 2006-2008 are all 

considerably higher in Hull compared to the Industrial Hinterlands and England. The 

under 75 DSRs are ranked 146 th , 149 th and 150 th out of 152 PCTs for all cancers, lung 

cancer and breast cancer respectively, so at most there are only seven PCTs with 

higher mortality rates for these cancers. The percentage of patients receiving their first 

definitive treatment within two months of GP urgent referral for suspected cancer during 

2008/2009 is marginally lower in Hull (96.6%) compared to England (97.1%), but higher 

than the Industrial Hinterlands (96.5%). The percentage of women aged 53-70 years 

screened for breast cancer in the previous three years as at March 2008, was lower in 

Hull (72.4%) in relation to both the target of 80% and in relation to England (73.8%) and 

the Industrial Hinterlands (76.3%). Further information on breast screening is presented 

in section 9.3.1 on page 416, which gives screening rates by general practice and 

overall rates for Hull for women aged 53-70 years. For this age group, the percentage 

screened is only slightly lower than England. Only two of the outcomes are better in Hull 

than the national average. The under 75 DSR for colorectal is lower than England, and 

the self-reported four-week quit rate for smokers per 100,000 for 2008/2009 is higher in 



Hull compared to England (more detailed information on the quit rates for the stop 

smoking service are given in section 8.4.8 on page 260). 

So overall, total spend on cancer is lower than England and the Industrial Hinterlands 

average, although spend on lung cancer is considerably higher in Hull. Outcomes are 

generally worse in Hull compared to England and comparator areas. 

Table 243: Cancer disease outcomes in Y&H PHO programme budgeting tool 

Area U75 cancer 

DSR 

2006-08 

Urgent 

referral 

patients 

receiving 

treatment 

within 2 

months, 

2008/09 

U75 

colorectal 

cancer 

DSR 

2006-08 

Selfreported4week 

quit 

rate per 

100,000, 

2008/09 

U75 lung 

cancer 

DSR 

2006-08 

U75 breast 

cancer 

DSR 

2006-08 


Women 53- 

70 yrs 

screened 

for breast 

cancer, 

2008/09 

DSR Rnk % Rnk DSR Rnk % Rnk DSR Rnk DSR Rnk % Rnk 

England 114 97 10.8 813 26.5 20.6 74 

Industrial Hint 136 96 12.3 1125 39.2 19.7 76 

Hull* 147 146 97 106 11.6 105 1277 8 47.5 149 25.9 150 72 104 

North Tyneside* 138 137 96 113 13.3 139 1190 11 40.1 141 16.1 8 78 56 

Hartlepool* 164 152 94 145 12.6 130 1561 2 46.9 148 25.2 148 78 64 

Plymouth 118 82 96 127 8.8 9 1011 40 28.7 79 16.5 12 81 17 

Salford 152 148 99 12 13.8 147 911 63 45.9 146 22.6 129 72 111 

Knowsley* 152 149 97 102 12.8 135 1556 3 48.0 150 16.1 9 69 125 

Darlington* 120 92 98 68 10.8 77 1056 33 30.9 100 23.5 139 78 65 

Gateshead* 128 117 94 146 11.8 108 829 82 38.0 135 18.0 29 79 52 

South Tyneside* 144 143 98 65 13.3 140 1086 27 39.1 138 23.3 136 77 66 

Sunderland* 141 140 97 89 12.4 126 1134 16 43.6 144 18.7 42 79 42 

Middlesbrough* 149 147 99 28 14.3 149 1083 29 51.0 152 22.8 130 72 107 

Tamesd&Glossp* 136 134 97 75 13.5 141 920 62 33.8 117 21.5 99 75 87 

Coventry 121 99 97 97 10.9 81 580 136 29.6 89 22.3 121 73 98 

Wolverhampton 128 118 99 18 11.9 114 976 45 29.7 91 24.4 146 72 103 

Derby 120 91 96 124 11.2 92 1159 12 29.9 92 18.7 39 81 25 

County Durham* 131 124 97 71 10.4 56 1204 10 39.8 140 18.7 40 80 31 

Sefton* 120 90 97 95 12.5 128 1115 20 31.7 105 15.6 5 74 88 

Wirral* 135 131 96 126 11.4 99 941 54 36.5 130 20.6 80 79 49 

Halton&St Hlens* 134 129 96 115 12.4 127 1105 23 34.4 121 20.3 70 76 80 

Leicester 115 66 95 132 10.7 66 1097 24 29.1 83 22.8 131 75 86 

Sandwell 135 133 100 7 15.7 152 858 73 33.6 115 16.7 16 68 127 

Stoke on Trent* 143 142 95 136 14.4 150 923 60 38.2 136 20.5 75 77 74 

Redcar&Clevel‟d* 129 122 97 73 13.7 146 1017 38 36.3 127 16.2 11 78 60 

NE Lincolnshire 127 115 95 137 11.5 101 801 93 32.4 109 17.1 20 57 143 

*Within Industrial Hinterlands group.


10.2.2 Lung Cancer 


Cancer Research UK gives information on the risk factors for lung cancer (Cancer 

Research UK 2009) as detailed in this paragraph. After smoking, radon exposure is 

considered to the second most important cause of lung cancer after tobacco, and 

several industrial carcinogens, for example, arsenic, polycyclic hydrocarbons, asbestos, 

some herbicides and insecticides, silica, etc. Some occupations including non-ferrous 

metal production and painting have also been linked to lung cancer. Family history has 

been found to be a risk factor. Exercise and high intake of fruit and vegetables have 

been shown in some studies to reduce the risk of lung cancer, but it is likely that the 

effect is limited for smokers. However, the main risk factor and preventable risk factor 

for lung cancer is smoking. Based on the information presented in Table 96, Action on 

Smoking and Health estimate that 86% of all lung cancer deaths are directly attributable 

to smoking. The strength of the association locally is clearly illustrated in the Figure 209 

which shows, by local deprivation quintile, the under 75 directly standardised mortality 

rate (DSR) for lung cancer per 100,000 persons for 2005-2007 in relation to the 

prevalence of daily and occasional smoking from the local Health and Lifestyle Survey 

conducted during 2007. The underlying data are given in the APPENDIX on page 917. 

Figure 209: Association between prevalence of daily and occasional smoking and 

premature mortality from lung cancer 

Under 75 average annual DSR for 

lung cancer 2005-2007 per 100,000 

persons with 95% CI (bars on chart) 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Most deprived 

quintile 

Lung cancer DSR 

Smoking prevalence 

Quintile 2 Quintile 3 Quintile 4 Least deprived 

quintile 



50 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

Smoking prevalence in 2007 Health 

and Lifestyle Survey (line on chart)



Information relating to the incidence of lung cancer is given in section 10.2.1.2 on page 

502. 




admission rate for admissions (DSR) where the primary diagnosis was lung cancer (for 

at least one of the clinician episodes during the hospital stay) per 100,000 resident 





Table 244: Total three year admissions and annual average age-standardised lung 

cancer inpatient admission rate in Hull, financial years 2007/08 to 2009/10 


100,000 Hull residents with primary diagnosis of lung 

cancer 2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 


Northern 209 411 (357 to 471) 200 394 (341 to 453) 


East 179 266 (228 to 308) 253 361 (317 to 408) 

Park 256 387 (341 to 437) 196 300 (260 to 345) 




West 221 356 (310 to 406) 147 223 (189 to 263) 

Wyke 114 285 (235 to 343) 65 164 (126 to 209) 


HULL 1,457 366 (347 to 385) 1,241 321 (303 to 339) 




From the Compendium, the age-specific mortality rates for lung cancer for 2006-2008 

are given in Table 245 for Hull and comparator areas (see section 3.3.3 on page 44). 

The mortality rates are substantially higher in Hull compared to the Industrial Hinterlands 

and the average of the 10 comparators in particular for those aged 65+ years. Using the 

PHMF and GP registration file (October 2007, 2008 and 2009), the age-specific mortality 

rates have been calculated for each Area and Locality (Table 246). 

Table 245: Lung cancer age-specific mortality rates for 2006-2008 

Area Lung cancer age specific mortality rates per 100,000 for 2006-2008 

Males Females 


England 35.3 245 478 64.1 26.2 148 244 46.2 

Hull 53.9 472 809 96.9 46.2 271 422 74.1 

Y&H SHA 40.9 286 555 73.6 33.3 178 304 57.5 

Indust Hinterlands 52.5 363 660 94.9 40.1 230 363 73.0 

Wolverhampton 47.6 265 537 77.4 23.9 150 202 43.6 

Salford 53.4 367 732 89.4 54.6 306 473 90.2 

Derby 29.9 290 452 62.5 37.0 156 251 50.8 

Stoke-on-Trent 57.6 391 657 94.1 42.1 180 309 61.6 

Coventry 34.5 286 462 59.8 31.5 156 217 43.6 

Plymouth 52.2 228 414 62.1 30.1 128 223 44.3 

Sandwell 57.3 288 574 80.7 29.8 150 281 50.7 

Middlesbrough 73.3 429 677 99.9 43.8 319 466 84.2 

Sunderland 56.3 397 787 104.2 48.6 259 386 79.0 

Leicester 29.9 289 540 54.3 33.3 142 269 40.7 

Average above 10 49.2 323 583 78.4 37.5 195 308 58.9 

NE Lincolnshire 43.5 327 558 83.3 31.3 185 240 53.7 

Table 246: Lung cancer age-specific mortality rates for 2007-2009 by Area in Hull 

Area/Locality Lung cancer age specific mortality rates per 100,000 for 2007-2009 

Males Females 


North Carr 62 718 803 90 32 333 677 64 

Northern 37 445 552 72 46 298 548 78 

North Locality 49 557 634 80 39 312 592 72 

East 52 266 783 99 58 273 379 90 

Park 57 430 1,010 103 48 210 489 74 

Riverside(E) 58 406 1,773 130 * 325 338 * 

East Locality 55 355 976 105 49 252 419 79 

Riverside(W) 54 654 535 84 97 600 396 104 

West 55 420 831 117 19 194 388 68 

Wyke 30 429 909 71 * 180 349 * 

West Locality 47 502 764 90 42 311 380 72 

Hull 50 459 826 93 44 289 433 74 



For the three year period 2007-2009 in Hull, there were 372 deaths in men and 288 

deaths in women in total. The figures for Hull differ slightly from the Compendium 

because different population estimates have been used, and it is not possible to present 

the information for all areas due to small numbers (marked with an asterisk in the table). 

The total number of deaths from lung cancer for men and women aged under 75 years 

as well as the directly standardised mortality rates (DSRs) are given in Table 247 for the 

most recent period 2007-2009. The DSRs are standardised to the European Standard 

Population. The confidence intervals are given, and it can be seen that they are wide for 

the Areas and Localities, particularly for the former. Therefore, despite the relatively 

large differences among the Areas and Localities, the majority of the differences could 

well be associated with random variation rather than related to true differences in the 

mortality rates. 


lung cancer per 100,000 persons, Hull 2007-2009 

Area Total deaths over three years and under 75 DSRs for lung cancer 2007- 

2009 per 100,000 persons (95% CI) 





NORTH 51 61 (45 to 80) 34 38 (26 to 53) 85 49 (39 to 61) 

East 24 40 (25 to 59) 27 41 (27 to 60) 51 41 (30 to 54) 

Park 34 56 (39 to 78) 22 35 (22 to 54) 56 45 (34 to 59) 


EAST 68 49 (38 to 62) 55 38 (29 to 50) 123 43 (36 to 52) 


West 31 52 (35 to 75) 14 22 (12 to 38) 45 37 (27 to 49) 

Wyke 17 46 (26 to 73) 7 18 (7 to 38) 24 32 (20 to 48) 

WEST 85 57 (45 to 70) 58 40 (30 to 52) 143 48 (41 to 57) 

HULL 204 55 (48 to 63) 147 39 (33 to 46) 351 47 (42 to 52) 

Table 248 gives under 75 SMRs for lung cancer for Hull and comparators relating to 

deaths which were registered during the period 2006-2008. The under 75 mortality rate 

from lung cancer is 79% higher in men and 82% higher in women compared to England. 

The SMR is one of the highest of the comparator areas. Middlesbrough has a higher 

SMR for both men and women and Salford for women. Middlesbrough is the only local 

authority that has a higher Index of Multiple Deprivation 2007 score (9 th versus Hull‟s 

11 th ranking over all 354 local authorities). Sandwell (14 th ), Salford (15 th ) and Stoke-on- 

Trent (16 th ) are the three other local authorities with the most similar IMD 2007 score to 

Hull. So the premature mortality rates from lung cancer are not consistently high for the 

more deprived areas below; it is possible that there are differential rates of smoking 

across the country independent of deprivation. The prevalence of smoking may be 

higher in the North compared to the South. 



Table 248: Under 75 standardised mortality ratios for lung cancer for Hull and 


Area Under 75 lung cancer SMR 2006-2008 (95% CI) 


England 100 (99, 101) 100 (99, 101) 100 (99, 101) 

Hull 179 (156, 205) 182 (154, 214) 180 (162, 200) 

Y&H SHA 115 (111, 119) 123 (118, 128) 118 (115, 122) 



Salford 153 (130, 178) 207 (176, 244) 175 (156, 196) 

Derby 105 (87, 125) 123 (100, 151) 112 (98, 129) 

Stoke-on-Trent 158 (136, 182) 137 (113, 165) 149 (133, 167) 

Coventry 111 (94, 130) 113 (93, 136) 112 (99, 126) 

Plymouth 114 (96, 135) 98 (79, 121) 107 (94, 122) 

Sandwell 139 (120, 160) 109 (89, 131) 126 (112, 141) 


Sunderland 160 (140, 182) 179 (154, 206) 168 (152, 184) 

Leicester 108 (89, 129) 116 (93, 142) 111 (97, 127) 

Average above 10 134 (127, 140) 135 (127, 143) 134 (129, 139) 



2001 to 2007-2009 for lung cancer on the Hull Atlas (which can be found at 


The trends in the directly standardised mortality rates (DSRs) for lung cancer for Hull 

and comparator areas are given per 100,000 men and women in Figure 210 and Figure 

211. These figures refer to deaths for all ages as over 80% of lung cancer deaths are 

preventable in that this is the estimated number directly caused by cancer (regardless of 

whether the death is premature (under 75 years) or not). The underlying data are given 

in the APPENDIX on page 918 and page 918. 

For men, the all age lung cancer mortality rate is higher than the Industrial Hinterlands 

average and the average of the 10 comparators, and the highest for 2006-2008, 

although only just above Middlesbrough and Sunderland. The mortality rate fell by 32% 

for England between 1993-95 and 2006-08, but for Hull the decrease was only 16%. 

The mortality rates in Middlesbrough and Sunderland fell by 26% and 21% over the 

same period, so if these trends continue, Hull will have by far the highest mortality rate 

in relation to these comparators. For the period 2006-2008, the all age lung cancer 

mortality rate is the highest of all 152 PCTs, and together with Manchester, 

Middlesbrough, Liverpool, Sunderland and Newcastle has a DSR or more than 80 per 

100,000 males. 



For women, the mortality rate has increased for most of the comparators, in particular for 

Hull. Hull has one of the highest all age lung cancer mortality rates of all comparators 

with only Salford and Middlesbrough having higher rates for 2006-2008. Hull has the 8 th 

highest mortality rate for lung cancer for 2006-2008 out of 152 PCTs. Knowsley has the 

highest (77 per 100,000 women) mortality rate, followed by Hartlepool, Salford, 

Middlesbrough, Liverpool, Manchester, Newcastle, and these together with Sunderland 

all have a DSR above 50 per 100,000 women. The lung cancer mortality rate for 

England has increased by 3% between 1993-95 and 2006-08, but the rate in Hull has 

increased by 14% over the same period. As around 84% of all lung cancer deaths are 

directly attributable to smoking (see Table 96), and smoking prevalence in women has 

not decreased as much as it has in men over the last few decades, it is not surprising 

that the rates in women have not decreased. 

Figure 210: Trends over time in all age directly standardised mortality rates for lung 

cancer for men 


males 

120 

100 

80 

60 

40 

20 

0 

1993-1995 

1994-1996 

1995-1997 

1996-1998 

1997-1999 

1998-2000 

1999-2001 


2000-2002 

Period 

England Hull 



2001-2003 

2002-2004 

2003-2005 

2004-2006 

2005-2007 

2006-2008


Figure 211: Trends over time in all age directly standardised mortality rates for lung 

cancer for women 


females 

60 

50 

40 

30 

20 

10 

0 

1993-1995 

1994-1996 

10.2.2.5 Five Year Survival Rates 

1995-1997 

1996-1998 

1997-1999 

1998-2000 

1999-2001 

Survival rates are not readily available in a national dataset at PCT level due to the 

relatively small numbers. However, the Northern and Yorkshire Cancer Registry and 

Information Service has provided this information for Hull. Table 249 gives the five-year 

crude survival and relative survival rates for lung cancer for the diagnosed cases within 

the periods 1998-2002 and 2000-2002. The crude rate is simply the percentage of 

people who were diagnosed with lung cancer who survived to five years. The relative 

survival rates are adjusted to take into account that in a cohort of people of similar age 

some people would have died of other causes over a five year period, so it reflects the 

relative survival rate for people diagnosed with lung cancer relative to the general 

population. The relative survival rate for the Humber and Yorkshire Coast Network 

given in Table 240 is 9% (95% CI 7% to 10%) for males and 8% (95% CI 6% to 9%) for 

females for lung cancer that was diagnosed during 1995-1999. Therefore, the survival 

rates for Hull males was lower for cases diagnosed during 1998-2002 and comparable 

for cases diagnosed 2000-2002. However, in the meantime, it is likely that survival rates 

across the Humber and Yorkshire Coast Network have increased, i.e. if information was 

available for cases diagnosed 2000-2002. Therefore, it is possible that current relative 

lung cancer five-year survival rates for Hull males are lower in relation to the Network 


2000-2002 

Period 

England Hull 



2001-2003 

2002-2004 

2003-2005 

2004-2006 

2005-2007 

2006-2008


average. However, whilst lower it is unlikely that they would be statistically significantly 

lower given the overlap in the confidence intervals for Hull with the Network. A similar 

pattern emerges for Hull females, but not as pronounced as for Hull males, as the 

survival rate for lung cancer cases diagnosed 1998-2002 is comparable to the Network 

rate for cases diagnosed 1995-1999 (and it is expected that the Network rate would 

have improved between 1995-1999 and 1998-2002). Whilst lower for Hull females, it is 

unlikely that the difference from the Network would be statistically significant given the 

overlap in the two sets of confidence intervals. It is possible that people in Hull are 

diagnosed at a later stage as they do not visit their GP when they first develop 

symptoms, and they may have other co-morbidities which could affect their survival. 

Table 249: Five Year Lung Cancer Survival Rates for Hull 

Gender Five year lung cancer survival rates in Hull 

Diagnosed 1998-2002 Diagnosed 2000-2002 

Cohort Deaths Relative Survival Cohort Deaths Relative Survival 

(95% CI) 

(95% CI) 

Males 665 628 7.1 (4.9, 9.4) 374 349 8.6 (5.3, 12.0) 

Females 424 397 7.9 (4.9, 10.8) 259 239 9.5 (5.4, 13.6) 

Persons 1,089 1,025 7.4 (5.6, 9.2) 663 588 9.0 (6.4, 11.6) 



inpatient admission rates which involve a primary diagnosis of lung cancer (any clinician 




daycase and inpatient admissions for lung cancer. The standardised admission rate in 

the most deprived quintile is twice as high (479 admissions per 100,000 persons) 

compared to those in the least deprived quintiles (218 per 100,000 persons). The 



living in the most deprived areas have a higher hospital admission rate for cancer. 






Figure 212: Age-standardised lung cancer annual daycase and inpatient admission rate 

per 100,000 population for all ages by local deprivation quintile for Hull 

Directly standardised hospital 

admission rate per 100,000 population, 

2007/08 to 2009/10 

600 

500 

400 

300 

200 

100 

0 

Most deprived 

quintile 


quintile 


The directly standardised mortality rates for deaths from lung cancer for those persons 


The under 75 lung cancer DSR for people living in the most deprived quintile areas of 

Hull is 77.5 per 100,000 persons almost three times as high as in the least deprived 

quintile areas (26.3 per 100,000 persons), although the DSR in the second least 

deprived quintile is slightly lower. The underlying data are given in the APPENDIX on 

page 919. 

Figure 213: Standardised mortality rate for lung cancer per 100,000 persons aged under 

75 years by deprivation for Hull for 2007-2009 

Under 75 directly age-standardsied lung 

cancer mortality rate per 100,000 

persons 2007-2009 

100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Most 

deprived 




deprived 





















Figure 214 shows trends in under 75 standardised mortality ratios (SMRs) for lung 

cancer for Hull and comparator areas for those residents living in areas that lie within the 

most deprived 20% of areas in England, which for Hull amounts to more than half of all 

residents. The underlying data are given in the APPENDIX on page 920. Under 75 lung 

cancer SMRs for men in Hull, although decreasing in 2003-2005 and 2005-2007, 

remained largely unchanged in 2006-2008 compared with 2001-2003. This compares 

with decreases in Spearhead PCTs of 5% and the 20 most deprived PCTs of 9%. The 

under 75 lung cancer SMR in most deprived men in Hull was statistically significantly 

higher than for all comparator areas except North East Lincolnshire in 2001-2003 and 

remained so in 2006-2008, being between 21% and 42% higher than each comparator 

area in 2006-2008. Amongst most deprived women lung cancer SMRs increased 

between 2001-2003 and 2006-2008 for Hull and each comparator, although the 24% 

increase for Hull was higher than for each comparator excluding North East Lincolnshire 

(increases ranging from 6% to 14%). The Hull under 75 lung cancer SMR was higher 

than for each comparator area for each year, and in 2006-2008 it was statistically 

significantly higher than for each comparator excluding North East Lincolnshire. 



Figure 214: Trends in under 75 lung cancer standardised mortality ratios by national 



Expenditure per head for 2008/2009 in Hull on lung cancer was £9.14 (ranked 2 nd ) 

compared to £5.55 for the Industrial Hinterlands average, £7.73 for North East 

Lincolnshire and £4.48 for England. Further information on expenditure on cancer 

outcomes used in the Yorkshire and the Humber Public Health Observatory Programme 

Budgeting toolkit is given in section 10.2.1.16 on page 532. 



10.2.2.10 Risk Stratification in Relation to Lung Cancer Mortality in Most Deprived 

Wards in Hull 

An analysis was completed in three of the most deprived wards in Hull (Bransholme 

East, Bransholme West, and Orchard Park and Greenwood) where the prevalence of 

smoking is high. Based on the Index of Multiple Deprivation 2007 (see section 6.9.1 on 

page 131), Bransholme East and Bransholme West are the 6 th and 8 th most deprived 

ward in Hull respectively (both in bottom 2% nationally) and Orchard Park and 

Greenwood is the 2 nd most deprived ward in Hull (in the bottom 1% nationally). 

The smoking prevalence from the local Health and Lifestyle Survey 2007 (see section 

13.2.1.2 on page 791), was 44% in Bransholme East (relatively small numbers with only 

25 completed questionnaires), 48% in Bransholme West, and 56% in Orchard Park and 

Greenwood. 

Age-specific mortality rates were examined for lung cancer for 2004-2008 (due to the 

small numbers per year in the wards five years‟ of data needed to be combined for 

analysis) and compared with the rest of Hull (Table 250). 

Table 250: Age-specific lung cancer mortality rates in Bransholme and Orchard Park 

and Greenwood wards, 2004-2008 

Area Lung cancer mortality rates per 100,000, 2004-2008 

Males Females 

< 65 65-74 75+ < 65 65-74 75+ 

Bransholme 29.9 597 1,087 16.6 267 664 

Orchard Pk & Greenwood 35.7 481 622 9.5 417 560 

Rest of Hull 22.8 456 800 19.8 257 352 

For 2004-2008, the all age standardised mortality ratios (SMRs) for lung cancer were 

higher in Bransholme and Orchard Park and Greenwood wards (229 and 185 for men 

respectively and 216 and 219 for women respectively) compared to the rest of Hull (165 

for men and 162 for women). 

Table 251 shows the percentages of the October 2008 populations of Bransholme, and 

Orchard Park and Greenwood wards that are within each ACORN type, group and 

category, based on the dominant ACORN type, group and category at output area level. 

Only types and groups are shown where the percentages are greater than zero (with the 

exception of the categories so the complete list of five categories is noted). 

Only 5% of Bransholme residents are in the “Wealthy Achievers” ACORN category (in 

type “Well-Off Working Families with Mortgages”), with the remainder of Bransholme 

residents in the Hard Pressed category, 90% in the ACORN group “Struggling Families” 

(of which most are within the “Low Income Families, Terraced Estates” type). All the 

residents of Orchard Park and Greenwood live in output areas with the dominant 



ACORN category Hard Pressed; 82% in “Struggling Families” group, 12% in “Burdened 

Singles” group and the remaining in 6% are within the “High Rise Hardship” group. 

Table 251: Percentage of the population (October 2008) of Bransholme, and Orchard 

Park and Greenwood wards that is in each ACORN type, group and category (dominant 

ACORN at output area level) 

Acorn type, group and category Bransholme Orchard 

Park & 

Greenwood 

1.C.10 Well-Off Working Families with Mortgages 4.8 0.0 

1.C Flourishing Families 4.8 0.0 

1. Wealthy Achievers 4.8 0.0 

2. Urban Prosperity 0.0 0.0 

3. Comfortably Off 0.0 0.0 

4. Moderate Means 0.0 0.0 

5.N.45 Low Income, Older people, Smaller Semis 1.4 0.0 

5.N.47 Low Income Families, Terraced Estates 52.1 28.1 

5.N.48 Families & Single Parents, Semis & Terraces 10.3 36.5 

5.N.49 Large Families & Single Parents, Many Children 25.9 17.8 

5.N Struggling Families 89.7 82.3 

5.O.51 Single Parents & Pensioners, Council Terraces 4.4 11.9 

5.O Burdened Singles 4.4 11.9 

5.P.53 Old People, Many High Rise Flats 1.1 2.4 

5.P.54 Singles and Single Parents, High Rise Estates 0.0 3.4 

5.P High Rise Hardship 1.1 5.8 

5. Hard Pressed 95.2 100.0 

The analysis was completed for these three wards in Hull as well as two deprived areas 

in East Riding of Yorkshire (Goole and South East Holderness). Table 252 gives the all 

age and under 75 SMRs for Hull and East Riding combined by ACORN type, group and 

category (for only the selected types in Table 251 for Bransholme and Orchard Park and 

Greenwood). The SMRs are not presented if the total number of lung cancer deaths 

over the five year period is fewer than 10. 

All the ACORN types within the “Hard Pressed” category had statistically significant high 

SMRs, both all age and under 75. Therefore, 95% of Bransholme‟s population and all of 

Orchard Park and Greenwood‟s population fall within areas where the dominant ACORN 

category had an SMR for lung cancer that was statistically significantly high compared to 

England (represented by SMR value of 100). 



Table 252: Lung cancer standardised mortality ratios by ACORN group and category, 

2004-2008 Hull and East Riding of Yorkshire combined 

ACORN group and category SMR (95% confidence interval) 


1.C.10 Well-Off Working Families with Mortgages 37.3 (17.0, 70.8) * 

1.C Flourishing Families 61.8 (49.3, 76.5) 57.8 (42.4, 76.8) 

1. Wealthy Achievers 65.9 (58.5, 74.0) 59.0 (49.7, 69.4) 

5.N.45 Low Income, Older people, Smaller Semis 154.0 (121.9, 191.9) 160.8 (112.0, 223.7) 

5.N.47 Low Income Families, Terraced Estates 174.0 (150.5, 200.2) 210.2 (175.6, 249.6) 

5.N.48 Families/Single Parents, Semis and Terraces 204.7 (161.5, 255.8) 198.3 (143.5, 267.1) 

5.N.49 Large Families/Single Parents, Many Children 215.0 (154.3, 291.7) 231.6 (157.3, 328.7) 

5.N Struggling Families 178.9 (162.3, 196.8) 202.8 (179.0, 229.0) 

5.O.51 Single Parents/Pensioners, Council Terraces 199.9 (173.9, 228.7) 232.0 (191.4, 278.7) 

5.O Burdened Singles 190.1 (169.3, 212.8) 233.0 (198.6, 271.6) 

5.P.53 Old People, Many High Rise Flats 178.3 (139.5, 224.5) 185.6 (120.1, 274.0) 

5.P.54 Singles/Single Parents, High Rise Estates 233.5 (120.5, 407.9) * 

5.P High Rise Hardship 184.5 (147.2, 228.4) 203.3 (139.9, 285.5) 

5. Hard Pressed 183.5 (171.1, 196.6) 212.7 (193.6, 233.1) 

*Less than 10 deaths during 2004-2008. 

A similar analysis was undertaken using the Health ACORN categories. The 

percentages of the October 2008 populations of Bransholme, and Orchard Park and 

Greenwood wards that are within each Health ACORN type, group are shown in Table 

253. Approximately one-quarter of residents in Bransholme lived in an area where the 

dominant category was “Existing Problems”, 71% with “Future Problems” and the 

remaining 5% as “Healthy”. Fourteen percent of Orchard Park and Greenwood 

residents lived in an area where the dominant category was “Existing Problems”, 84% 

with “Future Problems” and the remaining 2% as “Possible Future Concerns”. 

Table 254 gives the all age and under 75 SMRs for Hull and East Riding combined by 

Health ACORN type, group and category (for only the selected types in Table 253 for 

Bransholme and Orchard Park and Greenwood). The majority of the residents of 

Bransholme (95.8%) and Orchard Park and Greenwood (100%) lived within areas where 

the dominant Health ACORN type had a statistically significant SMR for lung cancer (for 

both under 75 years and all ages). 



Table 253: Percentage of the population (October 2008) of Bransholme and Orchard 

Park and Greenwood wards that is in each Health ACORN type, group and category 

Health ACORN type 


Bransholme 

Orchard Pk & 

Greenwd 

1.1 - Older couples, traditional diets, cardiac issues 1.4 0.0 

1.2 - Disadvantaged elderly, poor diet, chronic health 0.0 0.6 

1.3 - Vulnerable disadvantaged, smokers/ with high levels of obesity 1.1 6.4 

1.4 - Post industrial pensioners with long term illness 2.7 0.0 

1.5 - Deprived neighbourhoods with poor diet, smokers 5.1 7.4 

1.8 - Disadvantaged neighbourhoods with poor diet & severe health issues 13.9 0.0 

Existing Problems 24.3 14.4 

2.9 - Poor single parent families with lifestyle related illnesses 26.9 36.1 

2.10 - Multi-ethnic, high smoking, high fast food consumption 19.6 0.9 

2.11 - Urban estates with sedentary lifestyle and low fruit & veg consumption 24.5 46.7 

Future Problems 71.0 83.7 

3.14 - Less affluent neighbourhoods, high fast food, sedentary lifestyles 0.0 1.9 

Possible Future Concerns 0.0 1.9 

4.20 - Young mobile population with good health and diet 4.8 0.0 

Healthy 4.8 0.0 

Table 254: Lung cancer standardised mortality ratios by Health ACORN group and type, 

2004-2008 

Health ACORN group and type SMR (95% CI) 


1.1 - Older couples, traditional diets, cardiac issues 132 (96, 178) 136 (76, 224) 

1.2 - Disadvantaged elderly, poor diet, chronic health 236 (179, 304) 329 (215, 481) 

1.3 - Vulnerable disadvantaged, smokers with high levels of obesity 259 (185, 353) 319 (202, 479) 

1.4 - Post industrial pensioners with long term illness 178 (147, 213) 200 (149, 262) 

1.5 - Deprived neighbourhoods with poor diet, smokers 203 (166, 247) 258 (198, 330) 

1.8 - Disadvantaged neighbourhoods/poor diet & severe health issues 162 (135, 193) 177 (139, 224) 

Existing Problems 158 (147, 171) 177 (158, 198) 

2.9 - Poor single parent families with lifestyle related illnesses 254 (192, 329) 227 (159, 315) 

2.10 - Multi-ethnic, high smoking, high fast food consumption 227 (168, 300) 242 (168, 338) 

2.11 - Urban estates with sedentary lifestyle/low fruit & veg consump 207 (177, 240) 242 (200, 290) 

Future Problems 215 (195, 237) 238 (211, 267) 

3.14 - Less affluent neighbourhoods, fast food, sedentary lifestyles 154 (126, 188) 150 (112, 198) 

Possible Future Concerns 90 (82, 99) 83 (73, 95) 

4.20 - Young mobile population with good health and diet 82 (57, 113) 72 (43, 112) 

Healthy 95 (88, 104) 90 (80, 101)


10.2.3 Colorectal Cancer 


Cancer Research UK gives information on the risk factors for colorectal cancer (Cancer 

Research UK 2008) as detailed in this paragraph. Colorectal cancer incidence is 

generally higher in populations with „westernised‟ diets and these populations also tend 

to have a higher proportion of overweight and obese people and lower levels of 

exercise. Risk factors include increased consumption of red and processed meat, low 

fibre intake, obesity (effect stronger in men and effect may be influenced by oestrogen), 

and increased alcohol consumption. There is a reduction in the risk of colorectal cancer 

with higher intake of fish, and there is some evidence to suggest that the risk is also 

lowered with higher fibre intake, higher intake of fruit and vegetables and higher levels of 

calcium and some vitamins. The higher intake of fruit and vegetables may be linked to 

folate which has shown to reduce the risk of colorectal cancer but the synthetic form of 

folate (folic acid) shows no reduction in risk. Individuals, particularly men, with high 

levels of physical activity throughout their lives are at lower risk for colon cancer but it is 

uncertain whether physical activity modifies rectal cancer risk. Some medications may 

decrease the risk such as regular used of aspirin, use of hormone replacement therapy 

and use of the oral contraceptive pill may reduce the risk of colorectal cancer. 


Information relating to the incidence of colorectal cancer is given in section 10.2.1.2 on 

page 502. 




admission rate for admissions (DSR) where the primary diagnosis was colorectal cancer 

(for at least one of the clinician episodes during the hospital stay) per 100,000 resident 







Table 255: Total three year admissions and annual average age-standardised colorectal 


Locality Total three year admissions and annual average DSR per 

100,000 Hull residents with primary diagnosis of 

colorectal cancer 2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 

North 200 237 (205 to 272) 212 252 (219 to 289) 

East 513 337 (309 to 368) 326 213 (191 to 238) 

West 607 379 (350 to 411) 235 153 (134 to 174) 

HULL 1,320 332 (314 to 350) 773 200 (186 to 215) 


From the Compendium, the age-specific mortality rates for colorectal cancer for 2006- 

2008 are given in Table 256 for Hull and comparators (see section 3.3.3 on page 44). 

The rates are not presented if the number of deaths are less than three due to 

confidential reasons (marked with an asterisk). The mortality rates in Hull are lower than 

the Industrial Hinterlands and the average of the 10 comparator areas for men, but 

slightly higher for women aged 65+ years. 

Table 256: Colorectal cancer age-specific mortality rates for 2006-2008 

Area Colorectal cancer age specific mortality rates per 100,000 for 2006-08 

Males Females 


England 15.4 98.4 232 28.9 10.6 55.9 162 24.4 

Hull 16.4 101.8 258 27.1 8.7 77.8 165 23.3 

Y&H SHA 16.9 94.6 244 29.4 10.7 55.3 153 23.5 

Indust Hinterlands 17.8 119.5 263 34.4 12.3 60.5 160 26.2 

Wolverhampton 14.1 136.1 281 36.4 9.7 * 157 24.6 

Salford 23.1 111.7 285 33.8 11.8 69.2 155 24.7 

Derby 20.9 93.0 239 30.7 7.6 52.1 128 19.5 

Stoke-on-Trent 23.4 139.0 281 37.8 10.0 85.1 202 30.7 

Coventry 17.8 77.8 282 28.7 10.5 53.7 166 23.8 

Plymouth 17.9 74.7 253 27.9 6.8 36.5 190 24.1 

Sandwell 26.2 127.6 283 37.8 14.6 73.8 164 27.3 

Middlesbrough 9.2 198.2 246 32.8 17.5 45.6 93 19.1 

Sunderland 16.8 117.2 242 31.4 13.1 60.4 158 25.6 

Leicester 9.8 110.7 203 20.5 10.0 62.1 170 20.1 

Average above 10 17.9 118.6 259 31.8 11.2 58.9 158 24.0 

NE Lincolnshire 15.9 * 235 29.6 11.5 74.7 156 27.1 

*Less than three deaths. 




mortality rates have been calculated for each Locality (Table 257). The total 

number of deaths in Hull over the three year period 2007-2009 was 108 in men and 85 

in women. 

Table 257: Colorectal cancer age-specific mortality rates for 2007-2009 by Locality in 

Hull 

Locality Colorectal cancer age specific mortality rates per 100,000 for 2007-09 

Males Females 


North 23 66 264 24 15 * 162 * 

East 19 118 229 30 11 99 199 31 

West 17 102 267 27 5 53 119 16 

HULL 19 100 251 27 10 65 160 22 



due to small numbers (marked with an asterisk in the table). 

The total number of deaths from colorectal cancer for men and women aged under 75 

years as well as the directly standardised mortality rates (DSRs) are given in Table 258 



are wide for Hull, and even wider for the Localities. For women, there are relatively 

minor differences among the Localities. For men, the differences are larger with North 

appearing to have a lower DSR compared to East and West. However, as the 

confidence intervals are wide, it could well be that any differences observed are 

associated with random variation rather than related to true differences in the mortality 

rates (there is considerable overlap in the confidence intervals). 


colorectal cancer per 100,000 persons, Hull 2007-2009 

Area Total deaths over three years and under 75 DSRs for colorectal cancer 

2007-2009 per 100,000 persons (95% CI) 



North 12 14.8 (7.6 to 25.9) 7 7.8 (3.1 to 16.2) 19 11.3 (6.7 to 17.6) 

East 23 16.2 (10.2 to 24.3) 17 10.8 (6.2 to 17.3) 40 13.5 (9.6 to 18.4) 

West 22 15.1 (9.4 to 22.9) 9 6.0 (2.7 to 11.4) 31 10.7 (7.2 to 15.2) 

HULL 57 15.4 (11.6 to 19.9) 33 8.3 (5.7 to 11.7) 90 11.9 (9.5 to 14.6) 







crude survival and relative survival rates for colorectal cancer for the diagnosed cases 

within the periods 1998-2002 and 2000-2002. The crude rate is simply the percentage 

of people who were diagnosed with colorectal cancer who survived to five years. The 

relative survival rates are adjusted to take into account that in a cohort of people of 

similar age some people would have died of other causes over a five year period, so it 

reflects the relative survival rate for people diagnosed with colorectal cancer relative to 

the general population. The relative survival rate for the Humber and Yorkshire Coast 

Network given in Table 240 is 47% (95% CI 44% to 51%) for males and 50% (95% CI 

46% to 53%) for females for colorectal cancer that was diagnosed during 1995-1999. 

Therefore, the survival rates for Hull males is lower for cases diagnosed during 1998- 

2002 and diagnosed during 2000-2002 and for females for cases diagnosed during 

2000-2002. However, in the meantime, it is likely that survival rates across the Humber 

and Yorkshire Coast Network have increased, i.e. if information was available for cases 

diagnosed 2000-2002. Therefore, it is possible that current relative colorectal cancer 

five-year survival rates for Hull males are lower in relation to the Network average. 

However, whilst lower it is unlikely that they would be statistically significantly lower 

given the overlap in the confidence intervals for Hull and the Network. It is possible that 

people in Hull are diagnosed at a later stage as they do not visit their GP when they first 

develop symptoms, and they may have other co-morbidities which could affect their 

survival. 

Table 259: Five Year Colorectal Cancer Survival Rates for Hull 

Gender Five year colorectal cancer survival rates in Hull 


Cohort Deaths Relative Survival Cohort Deaths Relative Survival 

(95% CI) 

(95% CI) 

Males 368 243 45.1 (38.5, 51.6) 221 143 46.8 (38.3, 55.3) 

Females 272 168 50.6 (42.8, 58.4) 158 100 48.9 (38.7, 59.1) 

Persons 640 411 47.4 (42.4, 52.5) 379 243 47.7 (41.1, 54.2) 




The directly standardised mortality rates for deaths from colorectal cancer for those 

persons aged less than 75 years is given in Figure 215 for Hull (for the period 2005 to 

2007). The underlying data are given in the APPENDIX on page 921. The total number 

of deaths over the three year period is relatively small, hence the wide confidence intervals. 

For 2007-2009, the total number of deaths which occurred to people aged under 75 years 

was 13 for the most deprived quintile, 22 for the second most deprived quintile, 17 for the 

middle quintile, 13 for the second least deprived quintile and 25 for the least deprived 

quintile. 

Figure 215: Standardised mortality rate for colorectal cancer per 100,000 persons aged 

under 75 years by deprivation for Hull for 2007-2009 


colorectal cancer mortality rate per 

100,000 persons 2007-2009 

30 

25 

20 

15 

10 

5 

0 

Most deprived 







10.2.4 Prostate Cancer 


Cancer Research UK provide more information on the risk factors for prostate cancer 

(Cancer Research UK 2008) as detailed in this paragraph. Age, family history and 

ethnicity are established risk factors, but no modifiable risk factors have been identified. 

Many other factors have been studied but the evidence is inconclusive. These potential 

factors include diet, alcohol consumption, smoking, bodyweight, physical activity, 

medications, previous medical procedures and infections, endogenous hormones and 

diabetes. 


Information relating to the incidence of prostate cancer is given in section 10.2.1.2 on 

page 502. 




admission rate for admissions (DSR) for men where the primary diagnosis was prostate 

cancer (for at least one of the clinician episodes during the hospital stay) per 100,000 

resident population (standardised to Hull‟s 2009 population). As previously mentioned, 

usage of services will depend on many different things, such as prevalence of risk 

factors and disease, willingness of visit GPs, referral rates within Primary Care, 

accessibility of Primary and Secondary Care services, etc. 

Table 260: Total three year admissions and annual average age-standardised prostate 



100,000 Hull men with primary diagnosis of prostate cancer 

2007/08 to 2009/10 (95% CI) 

N DSR 

North 94 109 (88 to 134) 

East 180 116 (99 to 134) 

West 136 85 (71 to 101) 

HULL 410 103 (93 to 113) 




From the Compendium, the age-specific mortality rates for prostate cancer for 2006- 


Table 261: Prostate cancer age-specific mortality rates for 2006-2008 

Area Prostate cancer age specific mortality rates per 100,000 for 2006-08 

65-74 75+ all ages 

England 88.6 401 34.6 

Hull 90.9 387 29.7 

Y&H SHA 92.3 385 33.4 

Indust Hinterlands 94.3 391 35.7 

Wolverhampton 122.2 440 41.9 

Salford 75.8 380 28.3 

Derby 81.8 348 31.2 

Stoke-on-Trent 84.1 391 31.5 

Coventry 74.7 346 26.9 

Plymouth 71.1 419 32.8 

Sandwell 151.4 446 41.9 

Middlesbrough 79.3 398 32.3 

Sunderland 117.2 325 32.3 

Leicester 35.6 304 18.6 

Average above 10 89.3 380 31.8 

NE Lincolnshire 121.9 403 40.1 


mortality rates have been calculated for each Locality (Table 262). 

Table 262: Prostate cancer age-specific mortality rates for 2007-2009 by Locality in Hull 

Locality Prostate cancer age specific mortality rates per 100,000 for 

2007-09 

65-74 75+ all ages 

North 82 370 25 

East 69 349 28 

West 65 339 23 

HULL 70 349 25 


estimates have been used. The total number of deaths from prostate cancer over the 

three year period 2007-2009 was 100. 

As the majority of the prostate cancer deaths are occur over the age of 75 years, Table 

263 gives the total number of deaths from prostate cancer for all ages for the three year 

period 2007-2009. The all age directly standardised mortality rates (DSRs) are also 



given, standardised to the European Standard Population. The confidence intervals are 

given, and it can be seen that they are wide for the Localities, and the DSRs are all 

similar. 

Table 263: Total number of deaths and directly standardised mortality rates for prostate 

cancer per 100,000 men, Hull 2007-2009 

Locality Total deaths over three years and DSRs for prostate cancer 

2007-2009 per 100,000 men (95% CI) 

N DSR 

North 23 26.8 (16.7 to 40.6) 

East 40 21.3 (15.1 to 29.2) 

West 37 19.1 (13.4 to 26.5) 

HULL 100 21.5 (17.5 to 26.2) 


The directly standardised mortality rates for deaths from prostate cancer for men aged 

less than 75 years is given in Figure 216 for Hull (for the period 2007 to 2009). The 

underlying data are given in the APPENDIX on page 921. The total number of deaths to 

men aged under 75 years over the three year period 2007-2009 is small (5, 3, 4, 10 and 7 

for least deprived to most deprived quintiles respectively), hence the wide confidence 

intervals. 

Figure 216: Standardised mortality rate for prostate cancer per 100,000 men aged under 



prostate cancer mortality rate per 

100,000 men 2007-2009 

30 

25 

20 

15 

10 

5 

0 

Most deprived 







10.2.5 Breast Cancer 


Cancer Research UK provide more information on the risk factors for breast cancer 

(Cancer Research UK 2008) as detailed in this paragraph. A substantial proportion of 

the breast cancer cases experienced in developed countries can be explained by factors 

which influence exposure to oestrogen, including reproductive and hormonal factors, 

obesity, alcohol and physical activity. Age is a strong risk factor for developing breast 

cancer in women. Women in developed countries are at increased risk of breast cancer 

compared with women from less developed countries. Much of this variation can be 

explained by the fact that women in developed countries have fewer children and a 

limited duration of breastfeeding. Reproductive factors also influence the risk of 

developing breast cancer. Early age at menarche, having children at a later age, not 

having children, and late menopause all increase the risk of breast cancer. Use of oral 

contraceptives also increases the risk although there is no significant risk ten or more 

years after stopping use. Hormone replacement therapy increases the risk of breast 

cancer and also reduces the sensitivity of mammography. Overweight and obesity 

moderately increases the risk of postmenopausal breast cancer and is one of the few 

modifiable risk factors for breast cancer. Increased physical activity may lower the risk 

of breast cancer, but this may be an indirect effect though its influence on overweight 

and obesity. Increased alcohol consumption has shown to increase the risk of breast 

cancer and a diet high in fat may increase the risk. Taller women have also been shown 

to have an increased risk of breast cancer. Exposure to ionising radiation may also 

increase the risk. Breast cancer tends to have a higher incidence in the more affluent 

social classes, although this effect has not been seen when analysing local data. Family 

history and previous breast cancer are also risk factors. 


Information relating to the incidence of breast cancer is given in section 10.2.1.2 on 

page 502. 




admission rate for admissions (DSR) for women where the primary diagnosis was breast 

cancer (for at least one of the clinician episodes during the hospital stay) per 100,000 







Table 264: Total three year admissions and annual average age-standardised breast 

cancer inpatient admission rate for women in Hull, financial years 2007/08 to 2009/10 

Total three year admissions and annual average DSR 

per 100,000 Hull women with primary diagnosis of 

breast cancer 2007/08 to 2009/10 (95% CI) 

N DSR 

North Carr 213 532 (462 to 609) 

Northern 310 642 (572 to 718) 

NORTH LOCALITY 523 598 (548 to 652) 

East 448 707 (643 to 776) 

Park 326 487 (436 to 543) 

Riverside (East) 164 910 (775 to 1,060) 

EAST LOCALITY 938 630 (591 to 672) 

Riverside (West) 255 558 (492 to 631) 

West 503 853 (780 to 931) 

Wyke 354 817 (734 to 907) 

WEST LOCALITY 1,112 746 (703 to 791) 

HULL 2,573 668 (642 to 694) 


From the Compendium, the female age-specific breast cancer mortality rates for 2006- 


The mortality rates in Hull are considerably higher than the Industrial Hinterlands and 

the average of the 10 comparators. 

Table 265: Breast cancer female age-specific mortality rates for 2006-2008 

Area Breast cancer age specific mortality rates per 100,000 for 2006-08 

35-64 65-74 75+ all ages 

England 34.2 88.8 188 39.3 

Hull 39.0 138.7 217 43.7 

Y&H SHA 34.1 90.5 181 38.7 

Indust Hinterlands 32.5 88.4 203 41.4 

Wolverhampton 40.3 99.9 216 47.0 

Salford 37.0 105.6 119 33.7 

Derby 31.7 73.0 187 36.1 

Stoke-on-Trent 36.4 75.7 234 43.4 

Coventry 35.2 96.6 161 35.5 

Plymouth 28.0 70.0 179 34.2 

Sandwell 22.5 100.1 191 35.3 

Middlesbrough 35.0 113.9 225 42.6 

Sunderland 34.3 65.5 239 42.0 

Leicester 35.9 100.1 167 31.3 

Average above 10 33.6 90.0 192 38.1 

NE Lincolnshire 22.9 114.2 202 40.0 







due to small numbers (marked with an asterisk in the table). There were a total of 141 

deaths in women in Hull over the three year period 2007-2009. 

Table 266: Breast cancer age-specific mortality rates for 2007-2009 by Area in Hull 

Locality Breast cancer age specific mortality rates per 100,000 for 2007-09 

35-64 65-74 75+ all ages 

North Carr 32 * * 19 

Northern 46 198 * * 

NORTH 39 149 54 28 

East 36 97 182 43 

Park 32 126 344 50 

Riverside (East) * * * 22 

EAST 31 108 243 44 

Riverside (West) 29 180 132 32 

West 33 97 219 46 

Wyke 24 180 81 25 

WEST 29 142 156 35 

HULL 32 131 175 36 

The total number of deaths from breast cancer for women aged under 75 years as well 

as the directly standardised mortality rates (DSRs) are given in Table 267 for the most 

recent period 2007-2009. The DSRs are standardised to the European Standard 

Population. The confidence intervals are given, and it can be seen that they are wide for 

the Localities. There is considerable overlap for all the confidence intervals which 

suggests that there is no significant difference among the Localities. 


breast cancer per 100,000 women, Hull 2007-2009 

Locality Total deaths over three years and under 75 DSRs for breast 

cancer 2007-2009 per 100,000 women (95% CI) 

N DSR 

North 23 27.5 (17.4 to 41.4) 

East 29 20.3 (13.5 to 29.2) 

West 32 21.9 (14.9 to 31.0) 

HULL 84 22.5 (17.9 to 27.9) 



Table 268 gives under 75 SMRs for breast cancer for Hull and comparators relating to 

deaths which were registered during the period 2006-2008. Hull has the highest 

premature breast cancer mortality rate of all the comparators, 29% higher than England. 

Furthermore, it is the only area where the rate, despite the wide confidence intervals, 

that is statistically significantly higher than England. The under 75 SMR for the 

Industrial Hinterlands and the average of the 10 comparators are both slightly lower than 

England (lower than 100). 

Table 268: Under 75 standardised mortality ratios for breast cancer for Hull and 

comparators for women, 2006-2008 

Area Under 75 breast cancer SMR 

2006-2008 (95% CI) for women 

England 100 (98, 102) 

Hull 129 (104, 157) 

Y&H SHA 100 (95, 105) 

Indust Hinterlands 96 (91, 102) 

Wolverhampton 119 (96, 147) 

Salford 111 (87, 139) 

Derby 91 (70, 116) 

Stoke-on-Trent 98 (77, 123) 

Coventry 107 (87, 131) 

Plymouth 80 (61, 102) 

Sandwell 85 (67, 106) 

Middlesbrough 111 (82, 148) 

Sunderland 90 (72, 111) 

Leicester 110 (87, 136) 

Average above 10 99 (92, 106) 

North East Lincolnshire 89 (66, 118) 

The trends in the directly standardised mortality rates (DSRs) for breast cancer for Hull 

and comparator areas are given per 100,000 women in Figure 217. The underlying 

data are given in the APPENDIX on page 922. The mortality rate for breast cancer has 

consistently decreased for most of the comparator areas over the period 1993-95 and 

2006-08 with the exception of Hull. The mortality rate in Hull decreased by 40% from 

41.3 to 24.6 per 100,000 women between 1993-95 and 2001-03, but since 2001-03 and 

2006-08 the rate has increased by 35%, so that the current rate is 20% lower than 1993- 

95. The mortality rate in Hull is the highest of all 152 PCTs, and 24% and 22% higher 

than the Industrial Hinterlands and the average of the 10 comparators respectively. If 

the increasing trend from 2001-03 continues then the all age breast cancer mortality rate 

will be higher for 2011-13 than it was for 1993-95. 



Figure 217: Trends over time in all age directly standardised mortality rates for breast 

cancer for women 


females 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

1993-1995 

1994-1996 


1995-1997 

1996-1998 

1997-1999 

Period 

England Hull 

1998-2000 


1999-2001 





crude survival and relative survival rates for breast cancer for the diagnosed cases 

within the periods 1998-2002 and 2000-2002. The crude rate is simply the percentage 

of women who were diagnosed with breast cancer who survived to five years. The 

relative survival rates are adjusted to take into account that in a cohort of women of 

similar age some women would have died of other causes over a five year period, so it 

reflects the relative survival rate for women diagnosed with breast cancer relative to the 

general population. The relative survival rate for the Humber and Yorkshire Coast 

Network given in Table 240 is 80% (95% CI 78% to 82%) for breast cancer that was 

diagnosed during 1995-1999. Therefore, the survival rates for Hull females is higher for 

cases diagnosed during 1998-2002 and diagnosed during 2000-2002. As a number of 

new drug treatments are currently available for breast cancer and changes in treatment 

may have occurred between 1995-1999 and 1998-2002 / 2000-2002, it is difficult to 

ascertain any difference in breast cancer five-year survival rates between Hull and the 

Network. 


2000-2002 

2001-2003 

2002-2004 

2003-2005 

2004-2006 

2005-2007 

2006-2008


Table 269: Five Year Breast Cancer Survival Rates for Hull Females 

Measure Five year breast cancer survival rates for Hull females 


Number in cohort 652 382 

Number of deaths 184 105 

Relative Survival (95% CI) 82.3 (78.3, 86.4) 83.2 (77.9, 88.4) 



inpatient admission rates which involve a primary diagnosis of breast cancer (any 

clinician episode within that hospital stay) by local deprivation quintile over three 

financial years 2007/08 to 2009/10 (standardised to Hull‟s 2009 population). The 95% 

confidence intervals are shown. There is a statistically significant difference among the 

quintiles for daycase and inpatient admissions for breast cancer. The standardised 

admission rate in the most deprived quintile is 471 per 100,000 women compared to 780 

per 100,000 women in the least deprived quintile. The underlying data are given in the 


There tends to be an association between breast cancer and deprivation, but with the most 

deprived having the lower prevalence of breast cancer. This patterns is reflected in the 

figure. However, it is difficult to ascertain if this pattern is reflecting „need‟. It could be that 

the gradient between the most and least deprived quintiles should be steeper or less steep 


Figure 218: Age-standardised breast cancer annual daycase and inpatient admission 

rate per 100,000 women for all ages by local deprivation quintile for Hull 




The directly standardised mortality rates for deaths from breast cancer for women aged 

less than 75 years are given in Figure 219 for Hull (for the period 2007 to 2009). The 

underlying data are given in the APPENDIX on page 923. It can be seen that the under 

75 mortality rate in the most deprived quintiles is higher than in each other quintile, but that 

the confidence intervals are wide. So overall, there are no significant differences in the 

mortality rates among the deprivation quintiles. Nationally, it is recognised that there is a 

general trend in the incidence rate with the risk of developing breast cancer being higher in 

the least deprived quintiles (which is contrary to most diseases). Incidence data for 2001- 

2003 was provided by Northern Yorkshire Cancer Registry and Information Service 

(NYCRIS) specifically for the Cancer Equity Audit for Hull and East Riding of Yorkshire and 

no trend was found between incidence and Index of Multiple Deprivation 2004 national 

quintile. Recent incidence data is not available so it is neither possible to examine this 

relationship using more recent data nor just for Hull residents. The Cancer Equity Audit 

report is available at www.hullpublichealth.org. 

Figure 219: Standardised mortality rate for breast cancer per 100,000 women aged 

under 75 years by deprivation for Hull for 2007-2009 


breast cancer mortality rate per 100,000 

women 2007-2009 

60 

50 

40 

30 

20 

10 

0 

Most deprived 






For breast cancer, the expenditures per head was £7.90, £7.53, £9.72 and £9.34 for 

Hull, Industrial Hinterlands, North East Lincolnshire and England respectively with Hull 

ranked 99 th . Further information on expenditure on cancer outcomes used in the 

Yorkshire and the Humber Public Health Observatory Programme Budgeting toolkit is 

given in section 10.2.1.16 on page 532. 



10.3 Diabetes 

10.3.1 Risk Factors 

There are some postulated risk factors for diabetes. For type 1 diabetes, less is known 

about the risk factors than for type 2 diabetes, but family history can play a part. For 

type 2 diabetes, obesity is a key risk factor and family history is important. With the 

prevalence of obesity increasing nationally it is anticipated that the prevalence of 

diabetes will increase. Indeed in some areas of the country it is reported that the 

prevalence of type 2 diabetes is increasing by 15% per year (Roberts 2007). 

Being overweight increases the risk of diabetes considerably (Wild and Byrne 2006). In 

a 14 year follow-up period, the risk of developing diabetes in nurses aged 30-55 years at 

baseline was 49 times higher among women whose baseline body mass index (BMI) 

was more than 35 compared to women whose baseline BMI was less than 22. A BMI of 

22.0-22.9 also increased the risk of developing diabetes compared to women with a BMI 

of less than 22. Similar findings have been reported for men from a United States 

cohort of 51,529 male health professionals aged 40-75 years in 1986 who were followed 

up until 1992. 

However, other risk factors which have been reported for diabetes include: family 

history, impaired glucose tolerance, low activity level, poor diet, being overweight, 

having excess body weight particularly around the waist area, ethnicity, high blood 

pressure, high levels of triglycerides in the blood, and a high level of high density 

lipoprotein (HDL) cholesterol. In addition for women: polycystic ovary syndrome, 

diabetes during a previous pregnancy or having given birth to a heavy (9lb+) baby. It is 

also possible that alcohol can increase the risk of developing diabetes due to the 

damage alcohol can cause to the pancreas. Most of these risk factors are discussed on 

diabetes.co.uk (Diabetes.co.uk 2009). 

10.3.2 Diagnosed and Modelled Prevalence 









disease). See section 12.13 on page 782 for more information on QOF and issues 

associated with presenting the prevalence at practice level. Also see Table 28 and 

Table 49 for mean age of patients and mean deprivation scores for each practice (which 

will influence the prevalence on the disease registers). One such register is for 

diabetes, which covers patients with diagnosed type 1 or type 2 diabetes who are aged 

17+ years. 



Table 270 presents the information for diabetes for all the general practices in Hull for 

2009/10 based on these disease registers. The latest list size refers to the registered 






Table 270: Prevalence of diagnosed diabetes for those aged 17+ years based on GP 

disease registers 2009/10 

Practice 

code 


population 

(Jan 10) 

Registered 

population 

17+ 

Prevalence on 

diabetes registers 

2009/10 

N % 



B81104 Dr J K Nayar 7,721 6,022 55 0.91 

B81635 Dr G Dave 2,967 2,433 137 5.63 






B81075 Dr M K Mallik 2,263 1,946 81 4.16 


B81094 Dr A K Datta 1,925 1,579 60 3.80 

B81095 Dr Cook 4,242 3,436 188 5.47 

B81097 Dr R D Yagnik 1,688 1,435 69 4.81 

B81690 Dr S K Ray 1,734 1,387 61 4.40 








Y02786 Priory Surgery 3,326 93 5 5.37 




B81074 Dr A K Rej 3,639 2,875 171 5.95 



B81646 Dr M Shaikh 1,949 1,520 101 6.64 





Practice 

code 


population 

(Jan 10) 

Registered 

population 

17+ 

Prevalence on 

diabetes registers 

2009/10 

N % 





B81616 Dr G T Hendow 2,571 1,980 121 6.11 





B81674 Dr J C Joseph 2,241 1,614 91 5.64 


B81685 Dr N A Poulose 2,444 1,760 89 5.06 

B81688 Dr K V Gopal 2,009 1,467 83 5.66 

Y02344 Northpoint 1,645 1,234 76 6.16 

B81027 St Andrews Grp Practic 5,976 4,721 327 6.93 



B81089 Dr Witvliet 3,583 2,651 146 5.51 

B81631 Dr R Raut 3,425 2,398 143 5.96 










North Locality 68,517 52,111 2,767 5.31 

North Locality* 67,555 51,395 2,747 5.34 

East Locality 83,180 64,893 3,701 5.70 

West Locality 137,513 109,089 5,298 4.86 

West Locality* 137,029 108,725 5,285 4.86 

HULL 289,210 226,093 11,766 5.20 

HULL* 287,764 225,012 11,733 5.21 





Table 271 presents the prevalence of diabetes for patients aged 17+ years for 2009/10 

for Hull and comparator areas (see section 3.3.3 on page 44), as well as for England. 

The prevalence of diabetes will be influenced by ethnicity, and the percentage of non- 

White British population is particularly high in Coventry (25%), Derby (18%), Leicester 

(42%), Sandwell (25%) and Wolverhampton (27%) compared to Hull (9%) as illustrated 



on page 814. This could partially explain why the prevalence of diabetes is low in Hull 

compared to the majority of the comparators. 

Table 271: Prevalence of diagnosed diabetes for those aged 17+ years based on GP 

disease registers 2009/10, Hull versus comparator areas 

PCT Number of 

practices 

Practice 

population 

aged 17+ 

For those aged 17+ years 

Number on 

diabetes disease 

register 

Diabetes 

unadjusted 


England 8,305 43,329,604 2,338,813 5.40 

Hull 60 226,093 11,766 5.20 

Sunderland 55 227,193 12,788 5.63 


Salford 54 189,723 10,744 5.66 

Derby City 33 229,187 14,310 6.24 


Coventry 65 277,536 15,157 5.46 


Sandwell 67 261,730 17,499 6.69 

Stoke-On-Trent 57 219,489 14,531 6.62 

Plymouth 43 214,164 10,891 5.09 

Average of 10 520 2,213,372 135,051 6.10 

NE Lincs 34 133,993 7,884 5.88 

The number of patients aged 17+ years with diagnosed diabetes and the prevalence as 

recorded on the GP QOF disease registers over time is illustrated in Table 272 for 

2004/05 to 2009/10. For 2004/05 and 2005/06, the definition was for all patients with 

diabetes to be included on the register, and for later years it was changed to all patients 

aged 17 years or older who had either type 1 or type 2 diabetes. Thus as well as the 

change in the age range, there was a slight change in that the practice needed to be 

able to identify whether the patients with diabetes had either type 1 diabetes or type 2 

diabetes. In order to estimate the number of patients aged 17 years and older for 

2004/05 and 2005/06, the number of patients at each practice with diabetes aged under 

17 years has been estimated and subtracted from the total register. The prevalence for 

those aged under 17 years was estimated to be 0.19% (from Diabetes Equity Audit 

available at www.hullpublichealth.org). The latest list size refers to the registered 





October 2009 and 11 th January 2010). The latest list size for B81676 (Dr PN Jones) 

relates to 2004/05 and the latest list size for B81668 (Dr EG Stryjakiewicz) relates to 

2006/07. Some practices were not in existence for all the years so information is not 

applicable (N/A). 



Table 272: Numbers and prevalence of diagnosed diabetes (aged 17+) on GP QOF 

disease registers, 2004/05 to 2009/10 

Code Latest 

pop 

17+ 

Number and prevalence on diabetes QOF register over time (aged 17+) 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N* % N* % N % N % N % N % 

B81035 4,952 225 3.46 170 2.74 166 2.64 186 3.71 190 3.80 202 4.08 

B81056 10,521 306 3.55 346 3.76 403 3.28 442 4.44 465 4.51 535 5.08 

B81104 6,022 38 0.64 56 0.73 49 0.68 53 0.89 47 0.79 55 0.91 

B81635 2,433 93 3.42 110 4.14 116 3.69 125 4.93 134 5.34 137 5.63 

B81662 1,559 65 3.35 85 4.30 98 4.20 115 6.03 107 5.91 99 6.35 


Y01200 1,377 N/A N/A N/A N/A 63 4.03 57 4.27 69 5.15 80 5.81 


B81020 5,934 186 3.29 196 3.36 194 2.67 208 3.52 245 4.01 256 4.31 

B81021 5,733 219 3.85 225 3.89 258 3.61 273 4.71 301 5.04 309 5.39 

B81075 1,946 43 1.84 50 2.20 60 2.37 67 3.21 77 3.77 81 4.16 

B81085 4,345 141 3.18 155 3.46 167 3.12 180 4.09 192 4.34 209 4.81 

B81094 1,579 42 2.39 46 2.50 40 1.73 58 3.12 61 3.42 60 3.80 

B81095 3,436 133 3.95 137 4.12 152 3.80 175 5.23 183 5.35 188 5.47 

B81097 1,435 48 3.29 48 3.33 53 3.27 52 3.65 61 4.22 69 4.81 

B81690 1,387 45 3.14 40 3.02 45 2.53 47 3.37 57 4.08 61 4.40 

B81001 2,586 108 4.63 117 5.04 123 4.28 134 5.68 138 5.33 127 4.91 

B81008 11,748 427 3.80 459 3.99 481 3.23 514 4.41 527 4.46 554 4.72 

B81048 7,057 211 2.90 233 3.10 232 2.54 242 3.30 268 3.57 281 3.98 

B81049 7,203 201 3.19 243 3.82 283 3.36 296 4.32 335 4.67 366 5.08 

B81052 4,592 136 3.28 145 3.18 150 2.84 159 3.52 165 3.67 170 3.70 

B81072 6,168 180 3.25 197 3.61 155 2.25 181 3.13 198 3.28 210 3.40 

B81644 1,729 41 2.40 42 2.47 51 2.28 52 3.05 56 3.24 53 3.07 



B81011 4,142 173 3.94 196 4.44 211 3.83 209 4.80 216 5.02 227 5.48 

B81038 6,186 291 4.43 298 4.52 335 4.26 367 5.79 398 6.42 411 6.64 

B81057 2,709 110 3.76 130 4.38 146 4.00 152 5.22 148 5.25 151 5.57 

B81074 2,875 198 3.96 217 4.38 211 3.31 247 5.14 168 5.49 171 5.95 

B81081 2,781 125 4.27 129 4.54 133 3.77 149 5.48 161 5.74 165 5.93 

B81645 1,745 88 4.16 88 4.12 95 3.59 97 4.43 93 4.91 99 5.67 

B81646 1,520 61 2.99 67 3.31 66 2.64 80 4.21 94 5.74 101 6.64 

B81682 2,869 119 4.36 132 4.72 128 3.46 136 4.81 149 5.18 160 5.58 

B81053 7,981 427 5.50 453 5.83 476 4.71 510 6.36 524 6.55 549 6.88 

B81054 8,789 357 3.79 391 4.26 411 3.65 437 4.73 489 5.30 525 5.97 

B81058 7,152 268 3.46 284 3.58 248 2.63 270 3.59 346 4.70 382 5.34 

B81066 1,992 94 4.70 92 4.69 99 4.10 108 5.50 116 5.69 109 5.47 

B81080 1,817 101 4.49 102 4.46 101 3.91 110 5.67 125 6.71 143 7.87 

B81616 1,980 90 4.34 94 4.51 111 4.03 111 5.27 117 5.72 121 6.11 

B81002 2,768 70 3.46 80 3.82 96 3.16 105 4.76 117 5.22 171 6.18 

B81112 2,519 114 4.02 112 3.97 111 3.02 113 4.29 115 4.32 117 4.65 

B81119 3,399 182 4.11 176 4.06 169 3.76 175 5.07 189 5.34 202 5.94 

B81634 2,222 59 2.62 70 3.09 90 2.89 115 4.95 116 5.06 119 5.36 

B81674 1,614 61 4.89 64 5.01 68 3.78 81 5.55 83 5.30 91 5.64 

B81675 7,202 129 3.69 144 4.25 136 2.83 239 5.73 276 3.72 306 4.25 

B81685 1,760 60 3.25 68 3.60 71 2.75 84 4.51 91 4.92 89 5.06 



Code Latest 

pop 

17+ 

Number and prevalence on diabetes QOF register over time (aged 17+) 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N* % N* % N % N % N % N % 

B81688 1,467 53 3.69 60 4.10 67 3.23 72 4.70 78 5.02 83 5.66 


B81027 4,721 252 5.09 254 5.29 270 4.56 288 6.01 320 6.62 327 6.93 

B81040 12,772 582 4.61 636 5.01 650 3.87 703 5.34 796 6.07 818 6.40 

B81047 5,975 212 3.48 239 3.92 261 3.57 273 4.64 299 5.06 338 5.66 

B81089 2,651 94 3.92 99 4.07 104 3.13 122 4.78 124 4.69 146 5.51 

B81631 2,398 101 4.38 102 4.45 117 3.69 125 5.36 134 5.53 143 5.96 

B81683 1,249 75 6.82 77 6.50 69 4.52 66 5.94 70 6.00 77 6.16 


B81017 5,508 262 4.19 285 4.93 282 3.90 298 5.03 313 5.56 315 5.72 

B81018 4,819 199 4.07 211 4.27 205 3.02 212 4.19 272 5.44 287 5.96 

B81032 2,057 91 3.71 98 4.01 93 3.36 100 4.44 112 5.11 101 4.91 

B81046 6,801 231 3.60 260 4.05 282 3.13 314 4.71 334 4.92 385 5.66 

B81692 1,578 25 1.51 29 1.65 20 1.08 24 1.56 22 1.38 30 1.90 

Y00955 2,019 N/A N/A N/A N/A 47 2.83 57 3.21 71 3.50 96 4.75 


*Adjusted number on register (subtracted 0.19% of those aged under 17 years) from original total number 

on register (of all ages). So the adjusted number is an estimate of those patients with diabetes who are 

aged 17 years or older. 

As part of Yorkshire and Humber (Y&H) Public Health Observatory (PHO) work to create 

a Diabetes Commissioning Toolkit, the prevalence of diabetes was estimated for all 

PCTs in England (Merrick 2006) in different phases. The work was undertaken in 

conjunction with the (Y&H) PHO, Brent PCT and School of Health and Related 

Research (ScHARR) and the model is referred to as the PBS model (taking the first 

letter of each of these organisations). 

In Phase 1, the PBS model calculated age-gender-ethnic group specific estimates of 

diagnosed and undiagnosed diabetes prevalence derived from epidemiological 

population studies and applied these estimates to local resident populations based on 

the 2001 Census. In Phase 2, an adjustment was made for deprivation. The model is 

based on research undertaken elsewhere in the UK examining the prevalence of 

diagnosed and undiagnosed diabetes in the community, which has then been modelled 

and applied to different populations such as those living in a particular PCT area. 

Therefore, the accuracy of the estimates depends on the quality of the initial research 

and the modelling itself. The model required the population estimates for each practice 

based on age, gender and ethnicity. As ethnicity information was not available, 

estimates were used. More detailed information on the development of the model and 

the assumptions about local data used within the model are given in section 12.14 on 

page 784. The Phase 2 model was used in the Diabetes Equity Audit (full report is 

available at www.hullpublichealth.org). Phase 3 was released since modelled estimate 

were derived in the Diabetes Equity Audit. However, it is not know what version is 

currently available on the Yorkshire and Humber Public Health Observatory website as 

no version number is quoted. However, the current model does not allow the user to 

specify the distribution of the national deprivation quintiles for each geographical area or 

population the user wishes to examine (this could be specified in the Phase 2 model). In 



the Diabetes Equity Audit, the percentage of the registered population living in the most 

deprived quintile areas (with quintiles defined on a national basis) ranged from 10% to 

92% for the general practices in Hull. It is likely that this could affect the results of the 

modelling. However, whilst more up-to-date data could be entered into the Phase 2 

model, the model produces estimates for 2001 which are considerably lower (between 

40% and 60% lower) than the current model estimates which relate to estimates for the 

year 2010. 

In the current model (downloaded January 2011), it is necessary to specify the number 

of people in each age, gender and ethnicity group for the geographical area or 

population the user wishes to examine. The current model uses 10 year age bands (16- 

24, 25-34, ..., 65-74 and 75+) with Black and Minority Ethnic (BME) groups defined on 

the basis of three groups (White, Mixed and Other combined, Black or Black British, and 

Asian or Asian British). The numbers by BME group are not known at practice level, but 

can be estimated using the same methodology used in the Diabetes Equity Audit. 

Further information about the PBS model and estimating ethnicity at practice level is 

available in section 12.14 on page 784. 

The results of the modelling and the actual diagnosed numbers of patients with diabetes 

are given in Table 273 for the current model. The current model provides estimates for 

those aged 16+ years, but the QOF relates to those aged 17+ years. However, there 

will be very few patients aged 17 years with diabetes for each practice so it is unlikely to 

influence the calculations, and the fact that the population ages differ has been ignored 

for simplicity. The model does not necessarily represent the actual total (undiagnosed 

and diagnosed) number of people who should have diabetes for each practice; it is only 

a guide. The characteristics of each practice differ and need to be considered. 

Using the current PBS model, it is estimate that there are 16,645 patients with diabetes 

registered with Hull practices as at 2010. However, the number on the GP disease 

registers is 12,279. If the model is a good estimate of the prevalence of diagnosed and 

undiagnosed diabetes then this would mean there are 4,366 patients with undiagnosed 

diabetes. The current prevalence is 5.29% whereas the prevalence estimated by the 

model is 7.17%. 

As the current model does not adjust for deprivation at practice level, but only overall 

(assuming the distribution of the national deprivation quintiles for Hull applies to all 

practices), the model is likely to give less influence to deprivation in the most deprived 

practices and more influence to deprivation in least deprived practices. 





2010. 



Table 273: Actual diagnosed and modelled undiagnosed and diagnosed diabetes 

numbers for those aged 17+ years, 2010 

Code Practice name List size Numbers with diabetes 

aged QMAS Sept Modelled Difference 

17+ (Oct 2010 estimate 

2010) (actual (guide only 

diagnosed 

aged 17+) 

aged 16+) 



B81104 Dr JK Nayar 6,107 57 142 -85 

B81635 Dr G Dave 2,506 145 217 -72 






B81075 Dr MK Mallik 1,916 81 189 -108 


B81094 Dr AK Datta 1,518 55 109 -54 

B81095 Dr Cook 3,438 191 296 -105 

B81097 Dr RD Yagnik 1,455 72 132 -60 

B81690 Dr SK Ray 1,342 70 104 -34 












B81074 Dr AK Rej 2,850 177 221 -44 



B81646 Dr M Shaikh 1,463 101 116 -15 







B81616 Dr GT Hendow 1,987 124 155 -31 





Code Practice name List size Numbers with diabetes 

aged QMAS Sept Modelled Difference 

17+ (Oct 2010 estimate 

2010) (actual (guide only 

diagnosed 

aged 17+) 

aged 16+) 



B81674 Dr JC Joseph 1,652 95 120 -25 


B81685 Dr NA Poulose 1,773 91 117 -26 

B81688 Dr KV Gopal 1,516 86 95 -9 

Y02344 Northpoint 1,522 84 100 -16 




B81089 Dr Witvliet 2,725 146 196 -50 

B81631 Dr R Raut 2,486 149 138 11 










HULL 232,178 12,279 16,645 -4,366 






admission rate for admissions (DSR) where the primary diagnosis was diabetes (for at 






Table 274: Total three year admissions and annual average age-standardised diabetes 



100,000 Hull residents with primary diagnosis of diabetes 

2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 


Northern 70 136 (106 to 172) 52 103 (77 to 135) 


East 92 152 (122 to 187) 44 67 (48 to 90) 

Park 92 138 (111 to 169) 92 138 (111 to 169) 




West 62 105 (80 to 135) 64 119 (91 to 153) 

Wyke 36 81 (56 to 112) 69 153 (119 to 195) 


HULL 559 140 (129 to 152) 461 119 (108 to 130) 




From the Compendium, the age-specific mortality rates for diabetes for 2006-2008 are 

available for Hull and comparator PCTs (see section 3.3.3 on page 44). However, it is 

not possible to present the data for those aged under 65 years or for women aged 65-74 

years due to confidential reasons as most PCTs have fewer than three deaths. The 

diabetes age-specific mortality rates in Hull are similar to the Industrial Hinterlands and 

the average of the 10 comparators for women, but higher for men. However, the total 

number of deaths is relatively small so differences could be due to random variation. 

Table 275: Diabetes age-specific mortality rates for 2006-2008 

Area Diabetes age specific mortality rates per 100,000 for 2006-08 

Males Females 

65-74 75+ all ages 75+ all ages 

England 25.4 97.0 9.7 85.7 10.5 

Hull 32.7 109.2 9.9 77.6 9.8 

Y&H SHA 27.2 98.8 9.8 84.7 10.4 

Indust Hinterl’ds 25.6 97.1 10.1 86.3 11.2 

Wolverhampton 52.4 142.6 16.5 151.8 19.5 

Salford 35.9 111.8 10.8 72.7 10.5 

Derby * 112.9 10.3 93.3 12.1 

Stoke-on-Trent 32.9 109.6 11.3 92.3 12.4 

Coventry * 150.3 13.6 80.5 14.1 

Plymouth * 87.4 9.0 77.2 9.0 

Sandwell 53.4 123.6 14.2 173.8 22.0 

Middlesbrough 39.6 84.6 9.4 82.2 * 

Sunderland * 66.6 7.7 98.5 12.0 

Leicester 59.3 96.4 11.1 105.3 10.3 

Average above 10 35.6 108.6 11.4 102.8 13.2 

NE Lincolnshire 53.6 127.6 15.7 109.6 15.0 





estimates have been used, and it is not possible to present the information for men and 

women separately or for Areas due to small numbers (marked with an asterisk in the 

table). 



Table 276: Diabetes age-specific mortality rates for 2007-2009 by Area in Hull 

Locality Diabetes age specific mortality rates per 100,000 persons for 2007-2009 

35-64 65-74 75+ all ages 

North 4.4 * 64.1 * 

East * 32.9 73.1 * 

West 4.1 * 83.0 * 

HULL 3.0 17.8 75.6 7.5 

*Number of deaths less than three. 

The total number of deaths in Hull with a primary cause of death of diabetes over the 

three year period 2007-2009 were 31 in men and 28 in women. The total number of 

under 75 deaths over the three year period 2007-2009 and the under 75 directly 

standardised mortality rates (DSRs) for diabetes is given in Table 277 by Locality. The 

DSRs are standardised to the European Standard Population. The confidence 

intervals are given, and are quite wide due to the small number of deaths. 

Table 277: Total deaths and under 75 directly standardised mortality rates for diabetes 

per 100,000 persons, Hull 2007-2009 

Area Total deaths over three years and under 75 DSRs for diabetes 2007- 

2009 per 100,000 persons (95% CI) 



North * * * * 4 2.4 (0.6 to 6.1) 

East * * * * 8 2.6 (1.1 to 5.2) 

West * * * * 7 2.4 (0.9 to 4.9) 

HULL 13 3.5 (1.8 to 5.9) 6 1.4 (0.5 to 3.1) 19 2.5 (1.5 to 3.8) 

*Suppressed due to small numbers of deaths. 

Table 278 gives all age SMRs for mortality from diabetes for Hull and comparators for 

2006-2008. The number of deaths, in particular the number of premature (under 75 

years) deaths are small, so the figures are presented for all ages. The mortality rate in 

Hull is higher than England for men, but similar to areas with similar ethnicity rates. For 

women, the mortality rate is only slightly higher than England. However, the confidence 

intervals are very wide ranging from 84 (16% lower than England) to 164 (64% higher 

than England) for men, and ranging from 74 (26% lower than England) to 146 (46% 

higher than England) for women. 



Table 278: All age standardised mortality ratios for diabetes disease for Hull and 


Area All age diabetes SMR 2006-2008 (95% CI) 


England 100 (98, 102) 100 (98, 102) 100 (98, 102) 

Hull 119 (84, 164) 106 (74, 146) 112 (88, 141) 

Y&H SHA 103 (96, 111) 99 (93, 106) 101 (96, 106) 



Salford 122 (85, 170) 100 (69, 140) 110 (86, 140) 

Derby 106 (74, 147) 116 (84, 156) 111 (88, 138) 

Stoke-on-Trent 120 (85, 163) 119 (87, 159) 119 (95, 148) 

Coventry 151 (115, 193) 139 (107, 178) 145 (120, 172) 

Plymouth 97 (67, 137) 83 (58, 116) 90 (69, 114) 

Sandwell 151 (115, 195) 214 (173, 261) 185 (157, 216) 


Sunderland 83 (56, 117) 122 (91, 161) 103 (82, 128) 

Leicester 143 (105, 190) 124 (91, 166) 133 (107, 163) 

Average above 10 125 (114, 138) 133 (122, 145) 129 (121, 138) 



diabetes for Hull and comparator areas is given in Figure 220. As the approximately 

two-thirds of all deaths with a primary cause of death of diabetes occur after the age of 

75 years and the number of deaths under 75 with a primary cause of death of diabetes 

are very small, the DSRs are presented for all ages. The underlying data are given in 

the APPENDIX on page 923. The mortality rate in Hull decreased between 1993-95 

and 2003-05, but rose relatively sharply between 2003-05 and 2004-06. The rate has 

then decreased between 2004-06 and 2006-08. The increase for this single period 

could be due to random variation as the total number of deaths are relatively small. For 

men, the total number of deaths between 1993 and 2008 ranged from 5 (for 1997) to 16 

(for 1996 and 2006) with an average of 11deaths per year. For women, the number of 

deaths ranged from 8 (in 2000) to 27 (1993) with 10 of the 16 years having between 9 

and 15 deaths with an overall mean of 14 deaths per year between 1993 and 2008. 

During 2003, there were 9 male and 9 female deaths which was the lowest over the 

period 1993 to 2008. During 2006 there were 16 male and 18 female deaths, which is 

one of the highest (except for 1993). Thus it is not surprising that the DSR mortality rate 

increased between 2003-05 and 2004-06 as the year 2003 which few deaths was 

excluded and the year 2006 which had many deaths was introduced. As the number of 

deaths in 2006 was so high compared to all the years since the mid-1990s, it is likely 

that there will be a relatively large decreased in the mortality rate for the period 2007- 

2009 when the year 2006 is excluded. The DSRs for 2007 and 2008 were 6.0 and 5.2 

per 100,000 persons respectively, compared to 10.7 for 2006. If the DSR was around 6 

per 100,000 persons for 2009 (which is similar to that for 2007 and 2008, but slightly 



lower than the overall average over the entire period 1993-2008), then the average DSR 

for 2007-2009 would be 5.7 per 100,000 persons. 

Figure 220: Trends over time in all age directly standardised mortality rates for diabetes 

Directly standardised mortality rate per 100,000 persons 

14 

12 

10 

8 

6 

4 

2 

0 

1993-1995 

There will be considerably more deaths with diabetes as a secondary cause of death 

rather than a primary cause of death. Information on the number of deaths and mortality 

rates relating to secondary cause of death is not available on the Compendium and 

PHMF. However, secondary cause of death is available on the Primary Care Mortality 

Database (PCMD) and information from this source has been examined in more detail 

within the Diabetes Equity Audit (for full report see www.hullpublichealth.org). 

10.3.5 Quality of Care 

1994-1996 

1995-1997 

1996-1998 

1997-1999 

1998-2000 

1999-2001 

Period 

England Hull 


As part of the Quality and Outcomes Framework (QOF) as well as general practices 

compiling disease and medical condition registers as mentioned above, the practices 

also record information relating to the quality of care of patients on those disease 

registers. It is not possible to examine this information in detail within this document, but 

further information is available for diabetes specifically in the Diabetes Equity Audit. The 

5 th and 95 th percentiles and the five practices with the lowest and highest exclusions 


2000-2002 


2001-2003 

2002-2004 

2003-2005 

2004-2006 

2005-2007 

2006-2008


(see equity audit document for more information about „exclusions‟) and outcomes are 

presented for all outcome measures for diabetes, and the four measures of HbA1c, 

retinal screening, micro-albumin and cholesterol were examined in more detail within the 

equity audit. 

A national survey of people with diabetes was conducted in 2006 by the Healthcare 

Commission, and some information relating to the findings was examined within the 

Diabetes Equity Audit. 

For more information about the QOF quality of care measures and the national survey of 

people with diabetes, see the Diabetes Equity Audit report at www.hullpublichealth.org. 

10.3.6 Health Equity Audit 

A health equity audit was conducted during 2008/2009 for diabetes for Hull and East 

Riding of Yorkshire. The full document is available at www.hullpublichealth.org. The 

main findings were noted as follows: 

It is estimated that there are relatively large rate of undiagnosed diabetes 

particularly in Hull residents. 

There were relatively large differences in prevalence as measured by the primary 

care diabetes disease registers and the indicators measuring on-going care of 

diabetes for Hull and East Riding general practices (Quality and Outcomes 

Framework – QOF). 

Men with diabetes may be more readily admitted as daycases or inpatients 

compared to women with diabetes. 

Around 10% of people with diabetes in Hull and 5% of people in East Riding had 

attended an educational course, with more men attending than women, and a 

strong relationship with age with fewer older people attending courses. 

Prevalence was highest in the middle deprivation local quintiles followed by the 

most deprived quintile with the least deprived quintiles having the lowest 

prevalence. However, hospital admission rates and mortality rates were highest 

in the most deprived quintile which suggests excess hospital admissions and 

mortality in this group relative to their prevalence. The differences were relatively 

large and it is unlikely that these differences could be explained by underdiagnosis 

of diabetes alone. Furthermore, the most deprived quintile had the 

highest prevalence of risk factors for diabetes in terms of obesity, lack of exercise 

and diet. 

Those living in the most deprived areas of Hull tended to have slightly poorer 

outcomes in relation to the primary care on-going measures of care (QOF) 

compared to the least deprived areas, but this pattern was less apparent in East 

Riding. 

It is difficult to examine potential inequity in other groups such as groups defined 

by ethnicity, physical health, mental health, etc owing to lack of information. 



Twenty recommendations were noted within the diabetes equity audit. It was possible to 

incorporate some of these recommendations into the PCT‟s World Class Commissioning 

Strategy. The recommendations were as follows: 

1. Better information is obtained on other groups with respect to inequalities in 

diabetes. 

2. Improvements in the coding of ethnicity and diabetes should occur. 

3. Consistent, good quality educational information in a suitable format is 

provided to patients regarding healthy lifestyles and diabetes for patients at an 

increased risk. 

4. Staff training is undertaken, where necessary, so that consistent educational 

information about healthy lifestyles is provided to patients and staff have 

sufficient knowledge about the risk factors for diabetes and about the disease 

itself. 

5. Networks are utilised to maximise information flow and raise awareness, for 

example, by using the South Asian GPs‟ network and community groups. 

6. Existing weight-loss and exercise programmes continue, with a single point of 

contact for those requiring information, advice and referral for obesity. People 

with glucose intolerance should be targeted specifically with respect to 

existing services. 

7. Further work is completed within primary care, pharmacies and with others in 

an attempt to identify patients with undiagnosed diabetes. 

8. Further work is undertaken within primary care to assess the disease registers 

and measures of on-going care with the aim of helping practices to improve 

their disease registers and the ways in which patients on the disease registers 

are managed more effectively. The findings of this report should be used to 

prioritise practices which may require additional help to achieve this aim. 

9. Further work is completed on oral glucose tolerance testing to ensure that all 

general practices have access to glucose tolerance testing by staff accredited 

to administer the test. Further work is conducted on glucose test results with 

the aim of identifying undiagnosed cases of diabetes. 

10. The provision of structured patient educational programmes continue with 

modifications, where necessary, to improve access to such courses and 

decrease waiting times. 

11. Ensuring that National Institute for Health and Clinical Excellence (NICE) 

prescribing guidelines for patients with type 2 diabetes are met, with the cost 

implications considered when initiating insulin therapy, and conduct a primary 

care audit which includes prescribing. 

12. The number of paediatric diabetes specialist nurses posts is increased to 

meet national standards. 

13. Plans are put in place to reduce the high DNA (“did not attend”) rates in 

transitional and young adult diabetes clinics. 

14. Young people in the transitional and young adult clinics have their feet 

examined. 

15. Work is undertaken at Locality level to provide support for those in primary 

care to improve the care of patients with diabetes and reduce the prevalence 

of risk factors associated with diabetes in their practice populations. This 



should be particularly the case for practices with high list sizes and/or 

practices with a single GP. 

16. Reducing excess hospital admissions and mortality in the most deprived 

groups will require a multi-faceted approach involving improving patient selfcare, 

reducing risk factors such as smoking, lack of exercise, poor diet, etc, 

raising health aspirations, improving on-going care at primary care level in 

practices with a high proportion of patients living in deprived areas, etc. 

Extension of the telephone helpline coverage may also help as this could 

reduce hospital admissions if out-of-hours advice is available. 

17. To reduce hospital admissions and length of stay, improve awareness of 

diabetes through staff training and increase the number of inpatient diabetes 

specialist nurses posts to improve hospital care. 

18. To improve footcare, provide accreditation of the podiatry team with a post 

created to co-ordinate all accreditation, and review footcare within primary 

care. 

19. Put plans in place to reduce the DNA (“did not attend”) rate for retinal 

screening. 

20. Give consideration to nerve damage and nerve pain within primary care, and 

assess the estimated Glomerular Filtration Rate (eGFR) and chronic kidney 

disease primary care QOF indicators in more detail. 

10.3.7 Diagnosed Prevalence in Relation to Deprivation 




population). Table 279 shows the prevalence of diagnosed diabetes on the practice 

disease registers for 2009/10 grouping the practices into five groups. Figure 221 shows 

the practice IMD 2007 scores and the prevalence of diagnosed diabetes for each 

practice. It can be seen from both the figure that there appears to be a slight 

association between the diagnosed prevalence of diabetes and deprivation measured at 

practice level, but the association is quite not statistically significant (p=0.085). One 

would expect diabetes to be more prevalent in the more deprived groups. Mortality 

rates are higher for the more deprived areas including premature mortality, so it is 

possible that more people are dying from diseases such as cardiovascular disease, so 

fewer people in the most deprived quintile are included on the disease registers (and/or 

for a shorter period of time). The underlying data for the figure is given in the 













Table 279: Diagnosed prevalence of diabetes by deprivation quintile at practice level, 

2009/10 

Practice IMD 2007 Number of List size aged Diabetes (ages 17+) 2009/10 

quintile 

practices* 17+ (Jan 10) Number Percentage 

Most deprived 10 45,395 2,582 5.69 

2 12 43,094 2,503 5.81 

3 12 53,194 2,836 5.33 

4 11 53,165 2,380 4.48 

Least deprived 11 36,737 1,432 3.90 


Figure 221: Diagnosed prevalence of diabetes by deprivation score at practice level 



10.3.8 Inpatient Admissions in Relation to Deprivation 


inpatient admission rates which involve a primary diagnosis of diabetes (any clinician 



intervals are shown. There is a statistically significant difference among the deprivation 

quintiles, with the most deprived areas of Hull having a higher standardised admission 

rate compared to the least deprived areas of Hull. The standardised admission rate per 

100,000 persons is 130 for Hull overall, but 171 and 193 in the most deprived and 

second most deprived quintiles respectively compared to 85 and 86 in the second least 

deprived and least deprived quintiles. The underlying data are given in the APPENDIX 

on page 925. 

It is not surprising that the rate of hospital admissions is higher for people living in the most 

deprived areas, but it is difficult to ascertain if this pattern is reflecting „need‟. It could be 

that the gradient between the most and least deprived quintiles should be steeper or less 

steep than the gradient observed. 

Figure 222: Age-standardised diabetes annual daycase and inpatient admission rate per 


Annual average DSR per 100,000 per 

persons for diabetes 

250 

200 

150 

100 

50 

0 

Most deprived 

quintile 


quintile 




10.3.9 Mortality in Relation to Deprivation 

The directly standardised mortality rates for deaths from diabetes for those persons 

aged less than 75 years is given in Figure 223 for Hull (for the period 2007 to 2009). It 

can be seen that the width of the confidence intervals is wide due to the small number of 

deaths that occur under the age of 75 years where the primary cause of death is 

diabetes. The underlying data are given in the APPENDIX on page 926. 

Figure 223: Standardised mortality rates for diabetes for 100,000 persons aged under 



diabetes mortality rate per 100,000 

persons 2007-2009 

12 

10 

8 

6 

4 

2 

0 

Most 

deprived 



deprived 



10.3.10 Prevalence, Inpatient Admissions and Mortality in Relation to 

Deprivation 

Table 270 gave the prevalence of diabetes on the practice registers and Table 273 

compared the number of people on these registers with the PBS modelled number at 

practice level, and Figure 222 and Figure 223 have compared inpatient admissions and 

mortality relating to diabetes across the deprivation quintiles. This information has been 

presented for Hull using the local deprivation quintiles and for mortality where diabetes 

was the primary cause of death. A comparison of prevalence, inpatient admissions and 

mortality could be undertaken. Combining the most and second most deprived quintiles 

and the least deprived and second least deprived quintiles together, the prevalence was 

approximately 27% higher for the most deprived areas, inpatient admissions were 

approximately 127% higher and mortality was approximately double (100% higher). 

This suggests that there is inequalities present, i.e. whilst the prevalence is higher, the 



inpatient admission rate and mortality rates appear to be considerably higher relative to 

the prevalence rate for the most deprived areas compared to the least deprived areas. 

Within the Diabetes Equity Audit conducted for Hull and East Riding of Yorkshire, a 

similar pattern was observed (Table 280). In addition, mortality with a secondary cause 

of death as diabetes was examined. The information presented is not the latest 

available information as the equity audit was completed during 2007/2008. 

Furthermore, the equity audit covered Hull and East Riding of Yorkshire so the 

prevalence, hospital admissions and resident mortality rates are presented in relation to 

national deprivation quintiles, and as the mortality rates where diabetes was a (primary 

or) secondary cause of death are only available for Hull GPs, the final two columns are 

presented in relation to local Hull deprivation quintiles. As the prevalence, hospital 

admission rates and mortality rates are all provided using different scales, e.g. 

percentages and rates per 100,000 population, an index is provided which relates all 

other deprivation quintiles to the most deprived quintile which has a fixed index of 100. 

Thus, where the index is higher than 100 it implies that the figure is higher than the most 

deprived quintile group. It can be seen that the prevalence on the GP registers and the 

modelled prevalence based on the population as at October 2006 are both higher for the 

second most deprived and middle quintile groups and for the second least deprived 

quintile group for the register prevalence compared to the most deprive quintile (as the 

index is higher than 100). However, the inpatient and daycase admission rate and the 

mortality rates for the most deprived quintile is the highest and the relationship between 

deprivation quintile and both inpatient admissions and mortality is relatively strong. This 

suggests that: (i) there is inequalities present such that for the same level of „need‟ (as 

defined by the prevalence), there is a much higher inpatient admission rate and a higher 

mortality rate; and/or (ii) the prevalence on the GP registers and the modelled 

prevalence do not accurately reflect the actual prevalence or „need‟, in that there are 

more patients with undiagnosed diabetes in the more deprived quintile and the model 

may be a poor fit for more deprived areas (see Diabetes Equity Audit for more 

discussion and section 10.3.2 on page 564 above for briefer discussion of this point). It 

is likely that both of these points are reasons for the discrepancy between prevalence, 

inpatient admissions and mortality. People living in the most deprived areas will be 

more likely to have additional co-morbidities and risk factors (such as smoking) which 

will increase their risk of hospital admission and mortality. There was also a suggestion 

that general practices in the most deprived areas tended to have higher rates of 

undiagnosed diabetes. The Diabetes Equity Audit report is available at 




Table 280: Relationship between prevalence, hospital admission rate and mortality rate 

among deprivation quintiles (from Diabetes Equity Audit 2007/2008) 

Deprivation Prevalence PBS Age-gender standardised rates per 100,000 pop 

quintile on GP modelled Hospital Mortality rate from diabetes (index) 

(IMD 2004) registers prevalence admission Residents GP deaths (Hull) 

2006/2007, Oct 2006, rate 2004-2005 2005-2006 

% (index)* % (index)* 2005/06 to Primary Primary 2 

2006/07 

(index)* 

cause* cause 

ndary 

cause 

Most dep‟d 4.48 (100) 5.73 (100) 2,137 (100) 11.49 (100) 14.42 (100) 50.9 (100) 

2 4.52 (101) 6.28 (110) 1,502 (70) 10.40 (91) 11.33 (79) 46.2 (91) 

3 4.72 (105) 6.26 (109) 1,294 (61) 9.34 (86) 13.71 (95) 41.6 (82) 

4 4.86 (108) 5.57 (97) 1,036 (48) 6.75 (59) 8.63 (60) 38.9 (76) 

Least dep‟d 4.05 (90) 4.92 (86) 1,015 (47) 8.25 (72) 4.74 (33) 32.1 (63) 

*Hull and East Riding of Yorkshire combined (from Diabetes Equity Audit). 


The target relating to diabetes within the local World Class Commissioning (WCC) 

Strategy was to increase the percentage of patients with diabetes who have an HbA1c 

of 7.5 or less (indicator DM20). Information at practice level is given the Diabetes Equity 

Audit for HbA1c for 2006/2007 available at www.hullpublichealth.org. However, the 

indicators for the Quality and Outcomes Framework (QOF) have changed for 2009/2010 

and the DM23 indicator relates to having an HbA1c of 7.0 or less (although there are 

indicators for 8.0 or less and for 9.0 or less). 

Table 281 gives the percentages with the indicator with HbA1c of 7.0 or less (“overall 

outcome”) for Hull practices for 2009/2010 with practices grouped based on the mean 

deprivation scores and mean age of their patients (see section 3.3.3.3 on page 47 for 

more about the groupings). The table gives the number on the diabetes disease register 

and the numerators and denominators for the DM23 outcome which refers to having a 

HbA1c of 7.0 or less recorded in the last 15 months. From this information, the number 

and percentage of exceptions (see section 12.13 for more information on exceptions) 

have been calculated. It can be seen that there is considerable variability in the 

percentage of exceptions among the practices (excluding the new practices opened 

after October 2009 60 , the percentage of exceptions range from 1.2% to 35.7% of those 

on the disease register). See section 12.13 for more information, but this could be 

because the patients are frail, have other co-morbidities, are terminally ill or measuring 

their HbA1c levels would be inappropriate for some medical reasons, or because the 

patient (was not invited or) did not attend to review appointments on three separate 

occasions. The practices opened since October 2009 have a higher prevalence of 

exceptions as they would have had less opportunity to undertake the reviews within the 

60 Practices Y02747, Y02748, Y02786 and Y02896. 



time period. Of those who did have their HbA1c measured within the last 15 months 61 , 

between 46% and 80% had a HbA1c level of 7.0. If the percentage with a HbA1c level 

of 7.0 or less was counted out of the total number of people on the diabetes register 

(rather than out of those included for the measure, i.e. denominator), then the 

percentage fell to between 61% for Hull and ranged between 35% and 68%. 

The WCC target was to reduce the overall percentage of people with diabetes with a 

HbA1c level of 7.5 or less out of all the patients on the diabetes disease register. The 

targets for HbA1c 7.5 or less were 60.3%, 61.2%, 62.1%, 63.0% and 63.9% for 2008/09, 

2009/10, 2010/11, 2011/12 and 2012/13 respectively. However, as mentioned, the 

information relating to HbA1c 7.5 or less will no longer be available, and it is likely that 

the targets would have been reworked to give targets for HbA1c 7.0 or less. However, 

following the change in the government in May 2010, new outcomes are now under 


prevalence of diabetes (see Table 271 for current prevalence estimate), but there is no 

mention of a separate target relating to HbA1c. Therefore, it is possible that this 

outcome measure will no longer be a key outcome measure unless it is retained locally. 

Table 281: HbA1c of 7.0 or less for each practice in Hull, 2009/2010 

Code Practice name 

Numbers on register 

DM23: HbA1c of 7.0 or less 


Numerator 

Denominator 

Exceptions N 

Exceptions % 

Overall outcome % 

Overall number out of 

those on register % 

B81035 Dr Sande & Ptrns 202 105 188 14 6.9 55.9 52.0 

B81056 Springhead Med Cn 535 292 443 92 17.2 65.9 54.6 

B81104 Dr Nayar 55 19 38 17 30.9 50.0 34.5 

B81635 Dr Dave 137 90 128 9 6.6 70.3 65.7 

B81662 Mizzen Rd Surgery 99 56 90 9 9.1 62.2 56.6 

Y01200 The Calvert Practice 80 43 74 6 7.5 58.1 53.8 

Y02747 Kingswood Surgery 14 6 6 8 57.1 100.0 42.9 

B81020 Dr Mitchell & Ptrns 256 134 202 54 21.1 66.3 52.3 

B81021 Faith Hse Surgery 309 153 297 12 3.9 51.5 49.5 

B81075 Dr Mallik 81 42 80 1 1.2 52.5 51.9 

B81085 Dr Richardson & Pts 209 97 177 32 15.3 54.8 46.4 

B81094 Dr AK Datta 60 30 48 12 20.0 62.5 50.0 

61 There is another indicator which examines the outcome of measuring HbA1c rather than the outcome of 

the HbA1c value itself, but this information is not included in the table. It is assumed that the numerator 

for this other measure is the same as the denominator for DM23, but it is known that there are slight 

discrepancies between these two measures and the reason for this is unknown.






Numerator 

Denominator 

Exceptions N 

Exceptions % 




B81095 Dr Cook 188 89 178 10 5.3 50.0 47.3 

B81097 Dr Yagnik 69 35 60 9 13.0 58.3 50.7 

B81690 Dr Ray 61 25 49 12 19.7 51.0 41.0 

B81001 Dr Ali & Partners 127 68 122 5 3.9 55.7 53.5 

B81008 Dr Parker & Partnrs 554 249 473 81 14.6 52.6 44.9 

B81048 Dr SM Hussain &Pts 281 140 236 45 16.0 59.3 49.8 

B81049 Dr Rawcliffe & Ptnrs 366 160 307 59 16.1 52.1 43.7 

B81052 Dr Musil & Queenan 170 74 155 15 8.8 47.7 43.5 

B81072 Dr Percival & Prtnrs 210 99 173 37 17.6 57.2 47.1 

B81644 Dr Mahendra 53 25 48 5 9.4 52.1 47.2 

Y02786 Priory Surgery 5 1 1 4 80.0 100.0 20.0 

B81011 Wheeler St Healthcr 227 118 210 17 7.5 56.2 52.0 

B81038 Dr Mather & Partnrs 411 175 324 87 21.2 54.0 42.6 

B81057 Dr MacPhie & Koul 151 79 141 10 6.6 56.0 52.3 

B81074 Dr Rej 171 99 166 5 2.9 59.6 57.9 

B81081 Dr Tang & Partner 165 86 158 7 4.2 54.4 52.1 

B81645 East Park Practice 99 57 95 4 4.0 60.0 57.6 

B81646 Dr Shaikh 101 60 81 20 19.8 74.1 59.4 

B81682 Dr Shaikh & Partnrs 160 76 131 29 18.1 58.0 47.5 

B81053 Diadem Med Pract 549 318 505 44 8.0 63.0 57.9 

B81054 Dr Varma & Partnrs 525 270 474 51 9.7 57.0 51.4 

B81058 Dr Foulds & Partner 382 196 291 91 23.8 67.4 51.3 

B81066 Dr Chowdhury 109 45 89 20 18.3 50.6 41.3 

B81080 Dr Malczewski 143 97 122 21 14.7 79.5 67.8 

B81616 Dr Hendow 121 62 105 16 13.2 59.0 51.2 

B81002 Dr Kumar-Choudhary 171 92 151 20 11.7 60.9 53.8 

B81112 Dr GhoshRaghunath&Pts 117 54 101 16 13.7 53.5 46.2 

B81119 Dr Palooran & Ptnrs 202 85 186 16 7.9 45.7 42.1 

B81634 Dr Venugopal 119 54 104 15 12.6 51.9 45.4 

B81674 Dr Joseph 91 53 84 7 7.7 63.1 58.2 

B81675 Dr Tak & Stryjakiewicz 306 124 268 38 12.4 46.3 40.5 

B81685 Dr Poulose 89 43 71 18 20.2 60.6 48.3 

B81688 Dr Gopal 83 41 79 4 4.8 51.9 49.4 

Y02344 Northpoint 76 35 59 17 22.4 59.3 46.1 

B81027 St Andrews Gp Pract 327 179 311 16 4.9 57.6 54.7 

B81040 Dr Newman & Ptnrs 818 370 633 185 22.6 58.5 45.2 

B81047 Dr Singh & Partners 338 157 264 74 21.9 59.5 46.4 

B81089 Dr Witvliet 146 78 132 14 9.6 59.1 53.4






Numerator 

Denominator 

Exceptions N 

Exceptions % 




B81631 Dr Raut 143 63 92 51 35.7 68.5 44.1 

B81683 Dr Raghunath & Pts 77 38 69 8 10.4 55.1 49.4 

Y02896 Story St Pract & Walk In 8 1 1 7 87.5 100.0 12.5 

B81017 Kingston Med Grp 315 153 271 44 14.0 56.5 48.6 

B81018 Dr Awan & Partners 287 152 264 23 8.0 57.6 53.0 

B81032 Dr AW Hussain & Pts 101 42 84 17 16.8 50.0 41.6 

B81046 Dr Blow & Partners 385 163 355 30 7.8 45.9 42.3 

B81692 Quays Med Centre 30 13 21 9 30.0 61.9 43.3 

Y00955 Riverside Med Centre 96 59 81 15 15.6 72.8 61.5 

Y02748 Haxby Orchard Pk Surg 6 2 2 4 66.7 100.0 33.3 

Table 282 gives the equivalent information for Hull and comparator PCTs (see section 

3.3.3 on page 44). The outcome measure as recorded by QOF 2009/2010 and the 

overall number with HbA1c 7.0 or less out of all those patients on the diabetes register 

are both slightly higher than England and the average of the 10 comparators.


Table 282: HbA1c of 7.0 or less, 2009/2010, Hull versus Comparators 

PCT On 

diabetes 

disease 

register 

Numerator 



Denominator 

Exceptions N 

Exceptions % 

Overall 

outcome % 

Overall number 

out of those on 

register % 

England 2,338,813 1,094,853 2,036,913 301,900 12.9 53.8 46.8 

Hull 11,766 5,821 10,148 1,618 13.8 57.4 49.5 

Middlesbrough 6,247 2,907 5,402 845 13.5 53.8 46.5 

Sunderland 12,788 6,960 11,514 1,274 10.0 60.4 54.4 

Salford 10,744 5,808 9,361 1,383 12.9 62.0 54.1 

Derby City 14,310 6,041 12,000 2,310 16.1 50.3 42.2 

Leicester City 18,998 7,658 15,994 3,004 15.8 47.9 40.3 

Coventry 15,157 7,624 13,647 1,510 10.0 55.9 50.3 

Sandwell 17,499 9,109 15,624 1,875 10.7 58.3 52.1 

Stoke-on-Trent 14,531 7,521 12,887 1,644 11.3 58.4 51.8 

Wolverhampton 13,886 6,374 12,622 1,264 9.1 50.5 45.9 

Plymouth 10,891 5,346 9,732 1,159 10.6 54.9 49.1 

Average of 10 146,817 71,169 128,931 17,886 12.2 55.2 48.5 

NE Lincolnshire 7,884 3,685 7,179 705 8.9 51.3 46.7 

10.3.12 Programme Budgeting and Outcomes 

As illustrated in Figure 1, expenditure on Endocrine, Nutritional and Metabolic 

programmes per head for 2008/2009 in Hull was £36.92 compared to £46.75 for the 

Industrial Hinterlands average, £46.34 for North East Lincolnshire and £43.38 for 

England. Therefore, expenditure in Hull was lower than most comparator areas (ranked 

128 th out of 152 PCTs). 

Information on five diabetes outcomes are also available within the information produced 

by the Yorkshire and Humber Public Health Observatory (Y&H PHO) programme 

budgeting tool for each PCT, Industrial Hinterlands and England. The outcomes 

measures are given in Table 283 for Hull and comparator areas (see section 3.3.3 on 

page 44 for more on comparators). The percentage of patients with diabetes with 

HbA1c 7.5 or less is higher compared to England and lower compared to the Industrial 

Hinterlands. Blood pressure 145/85mmHg or less is higher in Hull compared to the 

Industrial Hinterlands and England. The percentage with cholesterol 5mmol/l or less was 

higher in Hull compared to England, but lower than the Industrial Hinterlands. The 

directly standardised rate (DSR) per 100,000 population for patients with diabetes with 

lower limb amputations for 2007/2008 is considerably larger for Hull compared to the 

Industrial Hinterlands and England (22.1 per 100,000 in Hull compared to 10.8 for


Industrial Hinterlands per 100,000 and 10.2 per 100,000 in England). The DSR for 

emergency admissions for diabetic ketoacidosis and hypoglycaemia is also higher in 

Hull compared to England but lower than the Industrial Hinterlands. 

Overall, diabetes outcomes are worse in Hull compared to the Industrial Hinterlands and 

England. Spend for 2008/2009 on Endocrine, Nutritional and Metabolic programmes 

lower in Hull compared to England and comparator areas. 

Table 283: Diabetes outcomes in Y&H PHO programme budgeting tool 

Area Patients 

with 

diabetes 

with 

HbA1c≤7.5, 

2008/09 

Patients with 

diabetes with 

lower limb 

amputations, 

2007/08 

Patients 

with 

diabetes 

with blood 

pressure 

≤145/85, 

2008/09 

Patients 

with 

diabetes 

with 

cholesterol 

≤5mmol/l, 

2008/09 

Emergency 

admissions for 

diabetic 

ketoacidosis & 

hypoglycaemia 

2007/08 

% Rnk DSR Rnk % Rnk % Rnk DSR Rnk 

England 66.3 10.2 79.9 82.6 26.7 

Ind Hint 69.6 10.8 80.1 83.9 32.5 

Hull* 69.3 30 22.1 151 81.1 37 82.9 76 28.7 97 

North Tyneside* 67.0 68 10.4 83 78.0 128 81.6 101 41.4 139 

Hartlepool* 68.2 49 5.3 7 78.1 126 84.6 39 17.4 16 

Plymouth 67.1 66 9.3 58 77.2 141 85.0 23 16.1 11 

Salford 70.5 19 15.3 137 81.5 25 85.0 24 36.2 130 

Knowsley* 71.3 16 13.3 123 82.4 15 83.6 62 63.5 152 

Darlington* 73.2 7 11.3 98 81.2 34 85.8 11 49.8 149 

Gateshead* 67.4 59 5.8 11 80.5 57 86.4 7 35.4 122 

South Tyneside* 73.7 6 5.5 8 81.3 33 85.1 20 16.4 12 

Sunderland* 72.1 11 9.7 67 80.9 42 87.2 2 39.3 136 

Middlesbrough* 62.6 130 8.4 42 81.1 38 83.6 63 42.4 141 

Tameside&Glossop* 71.7 14 10.3 81 80.3 62 85.4 15 23.7 53 

Coventry 64.8 103 8.2 41 77.9 133 80.7 117 25.8 66 

Wolverhampton 63.1 123 9.1 56 75.4 151 77.3 148 28.5 96 

Derby 69.3 32 17.6 144 80.8 44 87.2 1 29.1 100 

County Durham* 69.3 31 11.0 95 78.4 121 81.4 105 26.4 77 

Sefton* 68.6 43 6.5 19 79.1 108 84.8 31 28.0 91 

Wirral* 74.1 5 9.5 61 83.0 9 84.3 44 30.0 102 

Halton&St Helens* 68.2 48 13.3 125 80.0 72 82.1 93 35.1 119 

Leicester 65.9 87 12.5 118 79.6 88 80.1 125 32.5 110 

Sandwell 68.3 47 18.5 147 81.7 20 84.9 25 26.6 78 

Stoke on Trent* 68.4 46 9.5 61 79.4 93 84.9 27 20.5 29 

Redcar&Cleveland* 66.1 84 12.1 112 78.9 112 83.9 53 28.1 94 

NE Lincolnshire 64.8 100 18.2 146 78.9 111 82.0 96 19.8 27 




10.4 Chronic Kidney Disease 















There is one such register for chronic kidney disease (CKD) for those aged 18+ years. 

Table 284 presents the information for CKD for all the general practices in Hull for 

2009/10 based on these disease registers. The latest list size refers to the registered 






Table 284: Prevalence of diagnosed CKD for those aged 18+ years based on GP 


Practice 

code 


population 

(Jan 10) 

Registered 

population 

18+ 

Prevalence on 

CKD registers 

2009/10 

N % 



B81104 Dr J K Nayar 7,721 5,559 1 0.02 

B81635 Dr G Dave 2,967 2,403 202 8.41 






B81075 Dr M K Mallik 2,263 1,924 5 0.26 


B81094 Dr A K Datta 1,925 1,540 3 0.19 

B81095 Dr Cook 4,242 3,394 208 6.13 



Practice 

code 


population 

(Jan 10) 

Registered 

population 

18+ 

Prevalence on 

CKD registers 

2009/10 

N % 

B81097 Dr R D Yagnik 1,688 1,418 13 0.92 

B81690 Dr S K Ray 1,734 1,353 43 3.18 












B81074 Dr A K Rej 3,639 2,838 152 5.36 



B81646 Dr M Shaikh 1,949 1,501 3 0.20 







B81616 Dr G T Hendow 2,571 1,954 138 7.06 





B81674 Dr J C Joseph 2,241 1,591 83 5.22 


B81685 Dr N A Poulose 2,444 1,735 49 2.82 

B81688 Dr K V Gopal 2,009 1,446 49 3.39 

Y02344 Northpoint 1,645 1,201 39 3.25 

B81027 St Andrews Grp Practice 5,976 4,661 260 5.58 



B81089 Dr Witvliet 3,583 2,580 112 4.34 

B81631 Dr R Raut 3,425 2,329 66 2.83 










Practice 

code 


population 

(Jan 10) 

Registered 

population 

18+ 

Prevalence on 

CKD registers 

2009/10 

N % 



North Locality 68,517 51,160 1,846 3.61 

North Locality* 67,555 50,454 1,837 3.64 

East Locality 83,180 63,772 2,423 3.80 

West Locality 137,513 106,775 3,859 3.61 

West Locality* 137,029 106,417 3,835 3.60 

HULL 289,210 221,707 8,128 3.67 

HULL* 287,764 220,643 8,095 3.67 





Table 285 presents the prevalence of CKD for patients aged 18+ years for 2009/10 for 

Hull and comparator areas (see section 3.3.3 on page 44), as well as for England. Hull 

has one of the lowest prevalence rates with Coventry having the same prevalence and 

only Leicester City having a lower prevalence. 

Table 285: Prevalence of diagnosed CKD for those aged 18+ years based on GP 


PCT Number of 

practices 

Practice 

population 


Number on CKD CKD unadjusted 

aged 18+ disease register prevalence (%) 

England* 8,305 42,613,280 1,817,871 4.27 

Hull 60 221,707 8,128 3.67 

Sunderland 55 223,324 8,943 4.00 


Salford 54 186,193 7,585 4.07 

Derby City 33 225,334 10,415 4.62 


Coventry 65 271,656 9,964 3.67 


Sandwell 67 257,006 12,112 4.71 

Stoke-On-Trent 57 215,633 9,591 4.45 

Plymouth 43 209,693 10,596 5.05 

Average of 10 520 2,170,855 90,561 4.17 

NE Lincs 34 131,676 6,954 5.28 

*Population estimated from (rounded) prevalence and number on disease register (so 

there will be rounding errors). 



The number of patients with diagnosed CKD and the prevalence as recorded on the GP 

QOF disease registers (aged 18+ years) is illustrated over time in Table 286 for 2006/07 

to 2009/10 (the disease registers commenced 2004/05, but the CKD was a new 

measure introduced 2006/07). The latest list size refers to the registered population as 

at 1 st January 2010, but the number and prevalence on the disease register is as at 31 st 






(N/A). 

Table 286: Numbers and prevalence of diagnosed CKD (aged 18+ years) on GP QOF 


Code Latest 

pop 

18+ 

Number and prevalence on CKD QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81035 4,891 159 2.53 174 3.53 185 3.76 208 4.25 

B81056 10,387 305 2.48 393 4.01 388 3.83 400 3.85 

B81104 5,559 2 0.03 1 0.02 2 0.04 1 0.02 

B81635 2,403 86 2.73 112 4.49 238 9.62 202 8.41 

B81662 1,540 24 1.03 78 4.14 79 4.42 67 4.35 

Y01200 1,359 10 0.64 10 0.76 46 3.48 50 3.68 


B81020 5,859 161 2.22 177 3.04 207 3.44 237 4.04 

B81021 5,660 249 3.49 269 4.71 292 4.97 311 5.49 

B81075 1,924 7 0.28 7 0.34 5 0.25 5 0.26 

B81085 4,292 66 1.23 191 4.41 249 5.72 186 4.33 

B81094 1,540 3 0.13 4 0.22 3 0.17 3 0.19 

B81095 3,394 68 1.70 159 4.82 186 5.51 208 6.13 

B81097 1,418 2 0.12 3 0.21 6 0.42 13 0.92 

B81690 1,353 31 1.74 35 2.55 38 2.76 43 3.18 

B81001 2,552 157 5.46 199 8.58 200 7.87 187 7.33 

B81008 11,598 234 1.57 226 1.97 214 1.85 275 2.37 

B81048 6,876 126 1.38 148 2.07 226 3.10 244 3.55 

B81049 7,016 67 0.79 166 2.48 177 2.53 256 3.65 

B81052 4,477 100 1.90 113 2.55 115 2.60 139 3.10 

B81072 6,011 113 1.64 216 3.81 263 4.45 251 4.18 

B81644 1,684 11 0.49 16 0.96 21 1.24 20 1.19 



B81011 4,090 97 1.76 122 2.85 131 3.10 143 3.50 

B81038 6,108 239 3.04 327 5.24 335 5.48 319 5.22 

B81057 2,676 48 1.32 73 2.55 91 3.28 91 3.40 

B81074 2,838 129 2.02 151 3.20 138 4.59 152 5.36 

B81081 2,746 144 4.09 146 5.46 154 5.59 145 5.28 

B81645 1,724 35 1.32 32 1.49 28 1.50 21 1.22 

B81646 1,501 1 0.04 2 0.11 2 0.12 3 0.20 

B81682 2,795 4 0.11 11 0.40 86 3.04 85 3.04 

B81053 7,879 240 2.38 327 4.15 366 4.66 404 5.13 



Code Latest 

pop 

18+ 

Number and prevalence on CKD QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81054 8,681 276 2.45 390 4.29 440 4.86 466 5.37 

B81058 7,065 106 1.13 167 2.26 192 2.65 227 3.21 

B81066 1,942 65 2.69 96 4.99 118 5.90 127 6.54 

B81080 1,795 47 1.82 89 4.65 96 5.22 107 5.96 

B81616 1,954 1 0.04 1 0.05 148 7.37 138 7.06 

B81002 2,691 56 1.84 65 3.02 74 3.38 127 4.72 

B81112 2,484 68 1.85 64 2.49 69 2.65 68 2.74 

B81119 3,307 34 0.76 32 0.95 34 0.98 35 1.06 

B81634 2,192 74 2.37 88 3.87 79 3.52 69 3.15 

B81674 1,591 46 2.55 53 3.71 53 3.45 83 5.22 

B81675 7,012 69 1.44 156 3.82 166 2.28 313 4.46 

B81685 1,735 38 1.47 48 2.63 48 2.65 49 2.82 

B81688 1,446 16 0.77 32 2.14 40 2.64 49 3.39 

Y02344 1,201 N/A N/A N/A N/A 67 4.45 39 3.25 

B81027 4,661 150 2.53 214 4.55 243 5.12 260 5.58 

B81040 12,436 48 0.29 66 0.51 308 2.40 301 2.42 

B81047 5,828 58 0.79 94 1.62 104 1.79 160 2.75 

B81089 2,580 59 1.77 85 3.39 124 4.78 112 4.34 

B81631 2,329 47 1.48 55 2.41 59 2.49 66 2.83 

B81683 1,217 55 3.61 58 5.34 67 5.88 69 5.67 


B81017 5,440 96 1.33 170 2.92 176 3.18 173 3.18 

B81018 4,753 86 1.27 59 1.20 53 1.09 72 1.51 

B81032 2,007 11 0.40 29 1.31 35 1.62 40 1.99 

B81046 6,620 196 2.18 196 3.01 187 2.82 217 3.28 

B81692 1,560 2 0.11 2 0.13 4 0.26 12 0.77 

Y00955 1,968 29 1.75 34 1.97 42 2.12 47 2.39 



number of people with diagnosed CKD (Doncaster PCT 2008). In general when such 

models have been produced, the model is based on research undertaken elsewhere in 

the UK examining the prevalence of diagnosed disease in the community, which has 

then been modelled and applied to different populations such as those living in a 

particular PCT area. Therefore, the accuracy of the estimates depend on the quality of 

the initial research and the modelling itself. If the original research did not include very 

deprived areas, it is very difficult to generalise and apply the model to very deprived 


















The Doncaster model uses estimated prevalence for men and women combined for 

different age groups (18-39, 40-59, 60-69 and 70+ years) which are applied to estimated 

age-specific population figures for each practice to obtain an estimate of the total 

number of people with CKD aged over 18 years. No adjustments were made for 

ethnicity, deprivation or other factors. The original research used to estimate the 

prevalence was from a US study undertaken by Coresh (Coresh, Astor et al. 2003) 

involved a nationally representative sample of over 15,000 adults. Serum creatinine 

assay provided a basis for estimating the prevalence of CKD using standardised criteria 

based on estimating glomerular filtration rate. Kidney function (GFR), kidney damage 

(albuminuria) and CKD (GFR and albuminuria) were estimated from calibrated serum 

creatinine level, spot urine albumin level, age, sex, and race. GFR was estimated using 

the simplified Modification of Diet in Renal Disease Study equation and compared with 

the Cockcroft-Gault equation for creatinine clearance. Therefore, the estimated 

prevalence is based on a model, and furthermore on the US population where obesity 

levels, and hence type 2 diabetes prevalence, are relatively high. The National Services 

Framework for Renal Services (Department of Health 2005) claims the US study will 

slightly over-estimate prevalence. As the model is based on serum creatinine levels, 

and albeit modelled data, it appears that the prevalence estimates may include 

undiagnosed case of CKD as well as diagnosed CKD. Table 287 gives the results of 

the modelling and the actual diagnosed numbers of patients with CKD. Due to the 

limitations mentioned above, the model does not necessarily represent the actual 

number of people who should be diagnosed with CKD for each practice; it is only a 

guide. Furthermore, the characteristics of each practice differ and need to be 

considered. 





2010. 



Table 287: Actual diagnosed and modelled CKD numbers for those aged 18+ years, 

September 2010 


Numbers with CKD 







B81104 Dr JK Nayar 6,553 3 40 -37 

B81635 Dr G Dave 2,979 187 155 32 






B81075 Dr MK Mallik 2,197 5 153 -148 


B81094 Dr AK Datta 1,790 3 69 -66 

B81095 Dr Cook 4,145 208 236 -28 

B81097 Dr RD Yagnik 1,689 55 104 -49 

B81690 Dr SK Ray 1,650 55 66 -11 












B81074 Dr AK Rej 3,534 145 161 -16 



B81646 Dr M Shaikh 1,822 3 80 -77 





B81066 Dr GM Chowdhury 2,460 133 110 23 


B81616 Dr GT Hendow 2,539 135 123 12 







Numbers with CKD 






B81674 Dr JC Joseph 2,246 81 89 -8 


B81685 Dr NA Poulose 2,394 51 73 -22 

B81688 Dr KV Gopal 2,023 52 56 -4 

Y02344 Northpoint 2,021 43 67 -24 




B81089 Dr Witvliet 3,593 112 132 -20 

B81631 Dr R Raut 3,438 65 70 -5 










HULL 288,935 8,610 11,952 -3,342 



10.5 Respiratory Disease 

10.5.1 All Respiratory Disease 

10.5.1.1 Prevalence 














There are registers which covers asthma and chronic obstructive pulmonary disease 

(COPD). 

Table 288 presents the information for asthma and COPD for all the general practices in 

Hull for 2009/10. The latest list size refers to the registered population as at 1 st January 

2010, but the number and prevalence on the disease register is as at 31 st March 2010 

(the same definitions used in QOF), and this means that the prevalence can be biased if 



2010). 

Table 288: Prevalence of diagnosed asthma and COPD based on GP disease registers 

2009/10 

Practice 

code 


population 

Prevalence on disease 


Asthma COPD 

N % N % 

B81035 Dr W G T Sande & Partners 6,114 343 5.61 86 1.41 

B81056 The Springhead Medical Centre 13,489 880 6.52 206 1.53 

B81104 Dr J K Nayar 7,721 262 3.39 22 0.28 

B81635 Dr G Dave 2,967 232 7.82 75 2.53 

B81662 Mizzen Road Surgery 1,856 84 4.53 34 1.83 

Y01200 The Calvert Practice 1,765 118 6.69 30 1.70 

Y02747 Kingswood Surgery 902 55 6.10 4 0.44 

B81020 Dr P C Mitchell & Partners 7,512 406 5.40 100 1.33 



Practice 

code 


population 



Asthma COPD 

N % N % 

B81021 Faith House Surgery 7,257 562 7.74 141 1.94 

B81075 Dr M K Mallik 2,263 66 2.92 20 0.88 

B81085 Dr J W Richardson & Partners 5,299 333 6.28 77 1.45 

B81094 Dr A K Datta 1,925 113 5.87 19 0.99 

B81095 Dr Cook 4,242 103 2.43 99 2.33 

B81097 Dr R D Yagnik 1,688 144 8.53 32 1.90 

B81690 Dr S K Ray 1,734 92 5.31 29 1.67 

B81001 Dr Ali & Partners 3,358 208 6.19 62 1.85 

B81008 Dr J S Parker & Partners 15,062 916 6.08 213 1.41 

B81048 Dr S M Hussain & Partners 9,048 480 5.31 143 1.58 

B81049 Dr V A Rawcliffe & Partners 9,354 637 6.81 231 2.47 

B81052 Dr J Musil & P J Queenan 5,740 292 5.09 81 1.41 

B81072 Dr R Percival & Partners 7,807 422 5.41 117 1.50 

B81644 Dr K K Mahendra 2,245 78 3.47 30 1.34 

Y02786 Priory Surgery 141 17 12.16 7 4.96 

B81011 Wheeler Street Healthcare 5,243 444 8.47 97 1.85 

B81038 Dr A A Mather & Partners 7,732 453 5.86 177 2.29 

B81057 Dr S MacPhie & Koul 3,345 168 5.02 47 1.41 

B81074 Dr A K Rej 3,639 295 8.11 115 3.16 

B81081 Dr K M Tang & Partner 3,520 217 6.16 73 2.07 

B81645 East Park Practice 2,128 161 7.57 47 2.21 

B81646 Dr M Shaikh 1,949 138 7.08 40 2.05 

B81682 Dr M Shaikh & Partners 3,726 341 9.15 79 2.12 

B81053 Diadem Medical Practice 10,232 711 6.95 299 2.92 

B81054 Dr M J Varma & Partners 10,851 752 6.93 210 1.94 

B81058 Dr M Foulds & Partner 8,722 584 6.70 262 3.00 

B81066 Dr G M Chowdhury 2,522 132 5.23 32 1.27 

B81080 Dr G S Malczewski 2,216 113 5.10 44 1.99 

B81616 Dr G T Hendow 2,571 131 5.10 62 2.41 

B81002 Dr A Kumar-Choudhary 3,844 226 5.88 84 2.19 

B81112 Dr Ghosh Raghunath & Prtners 3,498 203 5.80 73 2.09 

B81119 Dr G Palooran & Partners 4,593 286 6.23 72 1.57 

B81634 Dr J Venugopal 3,044 193 6.34 38 1.25 

B81674 Dr J C Joseph 2,241 185 8.26 93 4.15 

B81675 Dr Tak & Dr Stryjakiewicz 9,476 632 6.67 224 2.36 

B81685 Dr N A Poulose 2,444 163 6.67 73 2.99 

B81688 Dr K V Gopal 2,009 146 7.27 72 3.58 

Y02344 Northpoint 1,645 83 5.05 39 2.37 

B81027 St Andrews Group Practice 5,976 398 6.66 209 3.50 

B81040 Dr P F Newman & Partners 16,805 891 5.30 314 1.87 

B81047 Dr J N Singh & Partners 7,377 520 7.05 136 1.84 

B81089 Dr Witvliet 3,583 176 4.91 65 1.81 

B81631 Dr R Raut 3,425 189 5.52 138 4.03 

B81683 Dr A S Raghunath & Partners 1,644 126 7.66 44 2.68 

Y02896 Story St Pract & Walk In Centr 343 23 6.71 5 1.46 



Practice 

code 


population 



Asthma COPD 

N % N % 

B81017 Kingston Medical Group 6,800 420 6.18 219 3.22 

B81018 Dr R K Awan & Partners 6,602 493 7.47 232 3.51 

B81032 Dr A W Hussain & Partners 2,478 120 4.84 39 1.57 

B81046 Dr J D Blow And Partners 9,068 638 7.04 199 2.19 

B81692 The Quays Medical Centre 1,814 126 6.95 35 1.93 

Y00955 Riverside Medical Centre 2,556 185 7.24 99 3.87 

Y02748 Haxby Orchard Park Surgery 60 19 31.67 3 5.00 

North Locality 68,517 4,184 6.11 1,543 2.25 

North Locality* 67,555 4,110 6.08 1,536 2.27 

East Locality 83,180 5,271 6.34 1,690 2.03 

West Locality 137,513 8,469 6.16 2,714 1.97 

West Locality* 137,029 8,429 6.15 2,702 1.97 

HULL 289,210 17,924 6.20 5,947 2.06 

HULL* 287,764 17,810 6.19 5,928 2.06 





Population projections of the number of people in Hull aged 65+ years who have a longstanding 

condition due to bronchitis and emphysema is given in Table 392. 




admission rate for admissions (DSR) where the primary diagnosis was respiratory 

disease (for at least one of the clinician episodes during the hospital stay) per 1,000 







Table 289: Total three year admissions and annual average age-standardised 

respiratory disease inpatient admission rate in Hull, financial years 2007/08 to 2009/10 


DSR per 1,000 Hull residents (respiratory disease), 

2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 





Beverley 203 15.4 (13.3 to 17.8) 166 13.8 (11.7 to 16.1) 



Area: Northern 914 18.0 (16.9 to 19.3) 926 18.8 (17.6 to 20.0) 


Ings 389 17.0 (15.2 to 18.8) 491 20.3 (18.4 to 22.3) 

Longhill 362 17.3 (15.6 to 19.3) 334 15.8 (14.1 to 17.6) 

Sutton 350 18.3 (16.4 to 20.4) 278 14.9 (13.1 to 16.8) 

Area: East 1,101 17.4 (16.4 to 18.5) 1,103 17.1 (16.1 to 18.1) 


Marfleet 418 20.3 (18.3 to 22.3) 416 20.1 (18.1 to 22.1) 



Area: Park 1,237 18.4 (17.4 to 19.4) 1,234 18.6 (17.6 to 19.7) 

Drypool 311 16.8 (15.0 to 18.8) 390 21.9 (19.7 to 24.1) 



Myton 617 25.8 (23.7 to 27.9) 462 24.0 (21.8 to 26.3) 



Area: Riverside (West) 1,303 23.1 (21.9 to 24.4) 1,116 22.9 (21.6 to 24.3) 




Area: West 973 16.5 (15.5 to 17.6) 893 14.9 (13.9 to 15.9) 

Avenue 282 15.9 (14.0 to 17.9) 263 15.6 (13.7 to 17.6) 


Newland 274 20.7 (18.1 to 23.5) 199 16.6 (14.2 to 19.2) 

Area: Wyke 764 16.7 (15.5 to 18.0) 641 14.5 (13.3 to 15.6) 


HULL 7,374 18.5 (18.0 to 18.9) 6,959 17.9 (17.5 to 18.4) 




Mortality rates are not available on the Compendium for all respiratory disease 

combined. Information is given for pneumonia and for bronchitis, emphysema and 

chronic obstructive pulmonary disease (COPD) combined (see section 10.5.3.5 on 

page 621 for mortality from latter). 



Table 290: Respiratory disease age-specific mortality rates for 2007-2009 by Area 

Area/Locality Respiratory age specific mortality rates per 100,000 for 2007-2009 

Males Females 


North Carr 37 439 1,846 99 32 111 2,084 113 

Northern 53 362 1,379 113 34 372 1,178 125 

NORTH 46 393 1,533 107 33 267 1,490 120 

East 70 488 2,006 212 45 331 1,457 218 

Park 53 294 1,900 140 16 420 1,593 169 

Riverside (East) 35 812 2,009 156 42 * 1,216 119 

EAST 57 443 1,963 171 31 342 1,486 183 

Riverside (West) 42 572 2,800 167 63 390 2,246 219 

West 23 199 1,689 145 33 136 1,047 139 

Wyke 30 585 1,865 118 * 324 1,799 163 

WEST 32 418 2,061 145 34 258 1,593 173 

HULL 44 422 1,923 145 33 292 1,531 164 

Over the three year period 2007-2009, there were a total of 100, 243 and 237 deaths in 

men in North, East and West Localities respectively (580 among men in Hull in total), 

and 112, 260 and 263 deaths in women in North, East and West Localities respectively 

(635 among women in Hull in total). Thus, respiratory disease represents a significant 

cause of death overall. For instance, more people die of respiratory disease than CHD 

(1,145 in total), and almost as many die from respiratory disease as from stroke (599 in 

total) and lung cancer (660 in total) combined. 

The total number of deaths from respiratory disease for men and women aged under 75 

years as well as the directly standardised mortality rates (DSRs) are given in Table 291 



are wide for the Areas and Localities, particularly for the former. Therefore, despite the 

relatively large differences among the Areas and Localities, the majority of the 

differences could well be associated with random variation rather than related to true 

differences in the mortality rates. Given the width of the confidence intervals, no 

particular Area or Locality appears particularly high or low in relation to the DSR. 




2001 to 2007-2009 for respiratory disease on the Hull Atlas (which can be found at 



respiratory disease per 100,000 persons, Hull 2007-2009 

Area Total deaths over three years and under 75 DSRs for respiratory disease 

2007-2009 per 100,000 persons (95% CI) 





NORTH 42 48 (35 to 65) 29 31 (21 to 45) 71 40 (31 to 50) 

East 38 61 (43 to 84) 30 44 (29 to 64) 68 53 (41 to 67) 

Park 29 47 (31 to 67) 24 36 (23 to 54) 53 42 (31 to 55) 


EAST 80 56 (45 to 70) 58 38 (29 to 49) 138 47 (40 to 56) 


West 14 24 (13 to 40) 14 23 (12 to 39) 28 23 (15 to 34) 

Wyke 21 55 (34 to 84) 10 25 (12 to 46) 31 40 (27 to 57) 

WEST 67 45 (35 to 57) 49 33 (25 to 44) 116 39 (32 to 47) 

HULL 189 50 (43 to 57) 136 35 (29 to 41) 325 42 (38 to 47) 


Currently there are no specific targets relating to respiratory disease as a whole, but 

there are targets relating to chronic obstructive pulmonary disease (COPD). Following 

the change in the government in May 2010, new outcomes are now under consultation 

(see section 3.3.6.2 on page 52). One of the outcomes proposed is the under 75 

mortality rate from chronic respiratory disease. If this becomes a new measure, it is not 

clear whether it will relate to COPD alone or whether it might include asthma. More 

information about the local targets relating to COPD are given in section 10.5.3.12 on 

page 631. 




As illustrated in Figure 1, expenditure on problems of the respiratory system per head 

for 2008/2009 in Hull was £114.50 compared to £92.71 for the Industrial Hinterlands 

average, £95.47 for North East Lincolnshire and £77.97 for England. Hull‟s expenditure 

on respiratory disease was the 2 nd highest of all 152 PCTs. 

Expenditure per head for 2008/2009 in Hull on obstructive airways disease was £36.98 

(ranked 1 st ) compared to £18.76 for the Industrial Hinterlands average, £17.44 for North 

East Lincolnshire and £12.70 for England. For asthma, the expenditures per head were 

£19.12, £20.18, £18.14 and £16.99 for Hull, Industrial Hinterlands, North East 

Lincolnshire and England respectively with Hull ranked 36 th . 

Information on three respiratory disease outcomes are also available within the 

information produced by the Yorkshire and Humber Public Health Observatory (Y&H 

PHO) programme budgeting tool for each PCT and England (but not for Industrial 

Hinterlands). The outcomes measures are given in Table 292 for Hull and comparator 

areas (see section 3.3.3 on page 44 for more on comparators). The under 75 directly 

standardised mortality rate (DSR per 100,000 European Standard Population) for 

bronchitis, emphysema and COPD combined, for bronchitis and emphysema, and for 

asthma are all higher in Hull compared to the Industrial Hinterlands and England. 

So overall, respiratory disease outcomes were worse for Hull compared to England, 

although not substantially different from other comparators. However, spend was 

considerably higher in Hull with the total expenditure on respiratory disease being the 

2 nd highest of all 152 PCTs. Given the high prevalence of smoking, the higher mortality 

rates in relation to England are not surprising. 



Table 292: Respiratory disease outcomes in Y&H PHO programme budgeting tool 

Area U75 DSR 

bronchitis and 

emphysema and 

COPD, 2006-08 

U75 DSR bronchitis 

and emphysema, 

2006-08 

U75 DSR asthma, 

2006-08 

DSR Rank DSR Rank DSR Rank 

England 12.09 0.83 1.30 

Ind Hint 17.63 0.73 1.43 

Hull* 21.17 143 1.81 140 2.29 143 

North Tyneside* 11.10 59 0.28 16 0.81 12 

Hartlepool* 16.88 114 0.70 71 2.59 150 

Plymouth 13.46 83 1.10 108 1.28 71 

Salford 24.17 148 2.63 150 1.73 118 

Knowsley* 25.45 151 0.27 15 1.20 59 

Darlington* 16.60 109 1.16 113 2.49 148 

Gateshead* 16.97 116 0.96 100 0.60 4 

South Tyneside* 19.73 138 2.31 148 1.00 36 

Sunderland* 17.67 122 0.50 40 0.99 33 

Middlesbrough* 22.47 144 0.64 60 1.11 46 

Tameside&Glossop* 20.59 141 0.64 60 1.47 91 

Coventry 19.48 134 1.48 128 2.77 152 

Wolverhampton 14.72 91 0.38 22 1.79 124 

Derby 12.35 71 0.69 67 0.90 21 

County Durham* 17.93 124 0.13 6 1.37 83 

Sefton* 13.85 84 0.59 49 1.84 125 

Wirral* 16.33 106 0.54 43 0.86 16 

Halton&St Helens* 16.71 111 0.01 1 0.82 14 

Leicester 18.51 130 0.32 18 2.17 141 

Sandwell 18.86 131 1.12 110 1.93 132 

Stoke on Trent* 16.48 108 1.72 138 2.37 145 

Redcar&Cleveland* 16.63 110 0.19 9 1.09 45 

NE Lincolnshire 21.16 142 0.95 98 2.11 137 




10.5.2 Asthma 


The prevalence of diagnosed asthma is given in section 10.5.1.1 on page 599 for each 

general practice in Hull for 2009/10. Table 293 presents the prevalence of asthma for 

2009/10 for Hull and comparator areas (see section 3.3.3 on page 44), as well as for 

England. Hull‟s prevalence estimate for asthma is comparable to other areas and higher 

than the average of the 10 comparators. 

Table 293: Prevalence of diagnosed asthma based on GP disease registers 2009/10, 


PCT 

Number on 

asthma disease 

Asthma 

unadjusted 




England 8,305 54,836,561 3,254,562 5.94 

Hull 60 289,210 17,924 6.20 

Sunderland 55 284,551 17,345 6.10 


Salford 54 242,922 15,642 6.44 

Derby City 33 294,438 18,037 6.13 


Coventry 65 357,743 21,419 5.99 


Sandwell 67 339,020 21,386 6.31 

Stoke-On-Trent 57 280,265 17,535 6.26 

Plymouth 43 270,338 18,217 6.74 

Average of 10 520 2,840,950 172,258 6.06 

NE Lincs 34 169,565 10,296 6.07 

The number of patients with diagnosed asthma and the prevalence as recorded on the 

GP QOF disease registers over time is illustrated in Table 294 for 2004/05 to 2009/10. 





Y02896 and Y02748 all opened between 5 th October 2009 and 11 th January 2010). The 

latest list size for B81676 (Dr PN Jones) relates to 2004/05 and the latest list size for 

B81668 (Dr EG Stryjakiewicz) relates to 2006/07. Some practices were not in existence 

for all the years so information is not applicable (N/A). 



Table 294: Numbers and prevalence of diagnosed asthma on GP QOF disease 

registers, 2004/05 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on asthma QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81035 6,114 457 5.71 343 5.38 335 5.33 341 5.57 341 5.62 343 5.61 

B81056 13,489 671 5.93 726 6.15 780 6.35 768 6.09 828 6.38 880 6.52 

B81104 7,721 204 3.16 223 2.78 227 3.13 247 3.46 243 3.37 262 3.39 

B81635 2,967 226 6.94 228 7.12 251 7.98 237 7.80 230 7.65 232 7.82 

B81662 1,856 85 3.61 99 4.13 101 4.33 102 4.50 85 3.94 84 4.53 


Y01200 1,765 N/A N/A 54 4.40 106 6.78 120 7.35 112 6.66 118 6.69 


B81020 7,512 317 4.60 299 4.12 304 4.19 371 5.06 437 5.74 406 5.40 

B81021 7,257 534 7.52 527 7.34 551 7.72 553 7.66 597 8.04 562 7.74 

B81075 2,263 68 2.47 74 2.74 79 3.13 76 3.13 70 2.97 66 2.92 

B81085 5,299 290 5.34 286 5.24 268 5.01 260 4.88 290 5.43 333 6.28 

B81094 1,925 157 7.06 151 6.60 145 6.26 149 6.62 147 6.81 113 5.87 

B81095 4,242 140 3.49 127 3.21 95 2.38 100 2.48 105 2.54 103 2.43 

B81097 1,688 137 8.21 131 8.03 134 8.26 127 7.71 128 7.66 144 8.53 

B81690 1,734 112 6.12 107 6.28 98 5.51 97 5.56 97 5.56 92 5.31 

B81001 3,358 211 6.97 191 6.49 189 6.57 187 6.22 213 6.47 208 6.19 

B81008 15,062 1,014 7.04 959 6.53 933 6.27 847 5.71 902 6.05 916 6.08 

B81048 9,048 491 5.50 508 5.52 501 5.49 509 5.59 499 5.37 480 5.31 

B81049 9,354 645 8.07 674 8.31 711 8.44 656 7.53 670 7.34 637 6.81 

B81052 5,740 226 4.35 287 5.13 289 5.48 283 5.09 306 5.51 292 5.09 

B81072 7,807 526 7.38 454 6.63 434 6.30 435 5.95 446 5.88 422 5.41 

B81644 2,245 100 4.42 83 3.70 88 3.93 80 3.63 89 4.03 78 3.47 



B81011 5,243 418 7.56 419 7.48 430 7.81 430 7.91 443 8.27 444 8.47 

B81038 7,732 439 5.60 447 5.74 448 5.69 453 5.83 450 5.92 453 5.86 

B81057 3,345 158 4.41 162 4.49 178 4.88 167 4.72 171 4.98 168 5.02 

B81074 3,639 366 5.73 364 5.72 362 5.67 363 5.95 280 7.36 295 8.11 

B81081 3,520 196 5.17 192 5.27 184 5.22 177 5.17 206 5.88 217 6.16 

B81645 2,128 189 7.22 177 6.68 165 6.23 165 6.22 148 6.53 161 7.57 

B81646 1,949 187 7.20 189 7.40 173 6.93 171 7.16 151 7.33 138 7.08 

B81682 3,726 351 9.60 310 8.38 316 8.55 318 8.69 314 8.52 341 9.15 

B81053 10,232 697 7.03 690 6.91 679 6.72 660 6.47 674 6.64 711 6.95 

B81054 10,851 576 5.11 682 6.08 655 5.81 646 5.79 652 5.86 752 6.93 

B81058 8,722 653 6.88 626 6.50 600 6.37 561 6.18 542 6.13 584 6.70 

B81066 2,522 115 4.52 130 5.27 125 5.18 136 5.57 142 5.61 132 5.23 

B81080 2,216 122 4.48 125 4.55 115 4.46 117 5.02 112 4.97 113 5.10 

B81616 2,571 176 6.42 172 6.36 158 5.73 154 5.69 135 5.16 131 5.10 

B81002 3,844 209 7.20 227 7.61 208 6.85 213 7.05 191 6.31 226 5.88 

B81112 3,498 275 6.94 262 6.86 235 6.40 207 5.75 214 5.92 203 5.80 

B81119 4,593 283 4.67 241 4.12 269 5.99 264 5.77 291 6.19 286 6.23 

B81634 3,044 237 7.61 235 7.57 214 6.87 202 6.53 182 5.95 193 6.34 

B81674 2,241 124 7.20 116 6.64 110 6.11 122 6.28 139 6.61 185 8.26 

B81675 9,476 314 7.14 300 6.98 295 6.14 517 9.60 620 6.47 632 6.67 

B81685 2,444 203 7.93 180 6.84 174 6.73 182 7.08 180 7.11 163 6.67 

B81688 2,009 194 9.62 200 9.81 163 7.85 161 7.67 165 7.81 146 7.27 



Code Latest 

list 

size 

Number and prevalence on asthma QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 


B81027 5,976 514 8.16 455 7.58 404 6.82 403 6.74 385 6.40 398 6.66 

B81040 16,805 791 4.82 804 4.88 835 4.98 864 5.09 907 5.37 891 5.30 

B81047 7,377 441 5.87 425 5.75 420 5.74 447 6.18 474 6.55 520 7.05 

B81089 3,583 174 5.43 172 5.30 158 4.75 174 5.13 168 4.74 176 4.91 

B81631 3,425 191 5.91 141 4.50 162 5.11 163 5.02 182 5.32 189 5.52 

B81683 1,644 118 7.67 115 7.25 101 6.62 103 7.10 122 8.05 126 7.66 


B81017 6,800 440 5.99 418 5.96 448 6.20 431 5.95 436 6.39 420 6.18 

B81018 6,602 437 6.67 474 7.24 592 8.72 490 7.28 478 7.17 493 7.47 

B81032 2,478 155 5.09 144 4.84 138 4.99 136 5.01 144 5.47 120 4.84 

B81046 9,068 634 7.45 621 7.34 635 7.06 631 7.19 642 7.19 638 7.04 

B81692 1,814 98 5.22 73 3.67 84 4.53 99 5.57 116 6.45 126 6.95 

Y00955 2,556 N/A N/A 34 5.07 91 5.49 123 5.53 146 5.74 185 7.24 



number of people with diagnosed asthma (Doncaster PCT 2008). In general when such 

models have been produced, the model is based on research undertaken elsewhere in 

the UK examining the prevalence of diagnosed disease in the community, which has 




















The model estimates the prevalence of people who have been treated for asthma from 

age-gender-specific prevalence rates from Key Health Statistics from General Practice 

1998 (Office for National Statistics 1998) with the average prevalence used across 

Townsend‟s deprivation scores. The model is not adjusted for deprivation or ethnicity or 

other factors. The results of the modelling and the actual diagnosed numbers of 

patients with asthma are given in Table 295. The model does not necessarily represent 



the actual number of people who should be diagnosed with asthma for each practice; it 


Furthermore, it does not include undiagnosed cases of asthma. The estimates from the 

model are substantially higher than those on the disease register. This may be 

associated with the definitions used. For instance, the model estimates the number 

“who have been treated for asthma” and presumably there will be some patients with 

mild asthma who have been treated more as a one-off rather than requiring continuous 

care and these patients may not be on the practice registers. 





2010. 

Table 295: Actual diagnosed and modelled asthma numbers, September 2010 


Numbers with asthma 






B81056 Springhead Medical Centre 13,813 731 1,271 -540 

B81104 Dr JK Nayar 6,553 245 605 -360 

B81635 Dr G Dave 2,979 215 273 -58 






B81075 Dr MK Mallik 2,197 66 199 -133 


B81094 Dr AK Datta 1,790 109 161 -52 

B81095 Dr Cook 4,145 110 379 -269 

B81097 Dr RD Yagnik 1,689 144 153 -9 

B81690 Dr SK Ray 1,650 92 150 -58 


B81008 Dr JS Parker & Partners 14,936 891 1,355 -464 













Numbers with asthma 





B81074 Dr AK Rej 3,534 284 323 -39 



B81646 Dr M Shaikh 1,822 145 167 -22 







B81616 Dr GT Hendow 2,539 158 236 -78 





B81674 Dr JC Joseph 2,246 188 210 -22 


B81685 Dr NA Poulose 2,394 153 224 -71 

B81688 Dr KV Gopal 2,023 155 187 -32 

Y02344 Northpoint 2,021 101 186 -85 


B81040 Dr PF Newman & Partners 16,721 758 1,534 -776 


B81089 Dr Witvliet 3,593 176 329 -153 

B81631 Dr R Raut 3,438 182 314 -132 







B81692 The Quays Medical Centre 1,677 140 132 8 



HULL 288,935 17,749 26,326 -8,577 


Expenditure per head for 2008/2009 in Hull on asthma is £19.12 (ranked 36 th highest out 

of 152 PCTs) compared to £20.18 for the Industrial Hinterlands average, £18.14 for 

North East Lincolnshire and £16.99 for England. Further information on expenditure on 

respiratory disease outcomes used in the Yorkshire and the Humber Public Health 

Observatory Programme Budgeting toolkit is given in section 10.5.1.5 on page 605. 



10.5.3 Chronic Obstructive Pulmonary Disease 

10.5.3.1 Definition 

Chronic obstructive pulmonary disease (COPD) is the general name for a collection of 

diseases which affect the lungs, including chronic bronchitis, emphysema and chronic 

obstructive airways disease (NHS Choices 2008). This corresponds broadly to the 

codes used to define COPD for the general practice registers as well as the International 

Classification of Diseases Version 10 (ICD 10) codes and mortality information provided 

by the Compendium. Unless otherwise stated this section examines bronchitis, 

emphysema and other chronic obstructive pulmonary disease combined (see section 

13.4.5 on page 811 for ICD codes). 


NHS Choices provide some background information on COPD as follows: “COPD is the 

general name for a collection of diseases which affect the lungs, including chronic 

bronchitis, emphysema and chronic obstructive airways disease. Often people with 

COPD have both emphysema and chronic bronchitis. People with COPD have trouble 

breathing in and out (airflow obstruction) and their lungs become inflamed due to 

irritation (usually by cigarette smoke). 

Over many years the inflammation leads to permanent changes in the lung. These 

changes cause airflow obstruction, where the flow of air into and out of the body is 

impaired. The airflow is reduced because the walls of the airways get thicker in 

response to the inflammation and more mucus is produced. Damage to the delicate 

walls of the air sacs in the lungs means the lungs lose their normal elasticity, and it 

becomes much harder work to breathe, especially on exertion. These changes in the 

lungs lead to the symptoms of COPD: breathlessness, cough and phlegm. 

Although any damage that has already occurred to the lungs cannot be reversed, it is 

possible to prevent COPD from developing or getting worse by making lifestyle 

changes.” (NHS Choices 2008) 

The following list of risk factors is taken from this same web page from NHS Choices 

which also provides information on some of the risk factors for COPD (NHS Choices, 

2008). People who smoke are much more likely to develop COPD with smoking 

causing four out of every five cases of COPD. It is estimated that between 10% and 

25% of smokers develop COPD with about three in every 20 people who smoke 20 

cigarettes a day developing COPD if they continue to smoke and this rises to one in four 

smokers for those who smoke 40 or more cigarettes a day. Passive smoking can also 

increase the risk of COPD. Exposure to certain types of dust and chemicals at work 

(such as grains, isocyanates, cadmium and coal) have also been implicated in the 

development of COPD even in people who don‟t smoke. The risk of COPD is increased 



even more if someone breathes in dust or fumes in the workplace and they also smoke. 

Air pollution may also be an additional risk factor, but the association is not clear and 

further research is continuing into this potential risk factor. Genetics can also play a role 

in the development of COPD. 

Based on the information presented in Table 96, Action on Smoking and Health 

estimate that 84% of all COPD deaths are directly attributable to smoking. The strength 

of the association locally is clearly illustrated in the Figure 224 which shows, by local 

deprivation quintile, the under 75 directly standardised mortality rate (DSR) for COPD 

per 100,000 persons for 2005-2007 in relation to the prevalence of daily and occasional 

smoking from the local Health and Lifestyle Survey conducted during 2007. The 


Figure 224: Association between prevalence of daily and occasional smoking and 

premature mortality from COPD 

Under 75 average annual DSR for 

COPD 2005-2007 per 100,000 

persons with 95% CI (bars on chart) 

50 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

Most deprived 

quintile 


COPD DSR 

Smoking prevalence 


quintile 


The prevalence of diagnosed COPD is given in section 10.5.1.1 on page 599 for each 

general practice in Hull for 2009/10. Table 296 presents the prevalence of COPD for 


England. Within the World Class Commissioning Strategy for the PCT, reducing the 

prevalence of undiagnosed COPD was set as a specific target, so given the high 

prevalence of smoking in Hull and this target, it is not unexpected that the prevalence of 

diagnosed COPD is higher than England and the average of the 10 comparators. 


50 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

Smoking prevalence in 2007 Health 

and Lifestyle Survey (line on chart)


Table 296: Prevalence of diagnosed COPD based on GP disease registers 2009/10, 


PCT 

Number on 

COPD disease 

COPD 

unadjusted 




England 8,305 54,836,561 861,341 1.57 

Hull 60 289,210 5,947 2.06 

Sunderland 55 284,551 8,217 2.89 


Salford 54 242,922 6,748 2.78 

Derby City 33 294,438 4,633 1.57 


Coventry 65 357,743 5,623 1.57 


Sandwell 67 339,020 5,872 1.73 

Stoke-On-Trent 57 280,265 5,629 2.01 

Plymouth 43 270,338 4,905 1.81 

Average of 10 520 2,840,950 53,766 1.89 

NE Lincs 34 169,565 3,441 2.03 

The number of patients with diagnosed COPD and the prevalence as recorded on the 

GP QOF disease registers over time is illustrated in Table 297 for 2004/05 to 2009/10. 





Y02896 and Y02748 all opened between 5 th October 2009 and 11 th January 2010). The 

latest list size for B81676 (Dr PN Jones) relates to 2004/05 and the latest list size for 





Table 297: Numbers and prevalence of diagnosed COPD on GP QOF disease registers, 

2004/05 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on COPD QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81035 6,114 93 1.16 61 0.96 64 1.02 70 1.14 77 1.27 86 1.41 

B81056 13,489 147 1.30 146 1.24 160 1.30 157 1.24 176 1.36 206 1.53 

B81104 7,721 14 0.22 17 0.21 20 0.28 23 0.32 25 0.35 22 0.28 

B81635 2,967 68 2.09 70 2.19 68 2.16 67 2.20 72 2.40 75 2.53 

B81662 1,856 14 0.59 21 0.88 24 1.03 27 1.19 33 1.53 34 1.83 


Y01200 1,765 N/A N/A 19 1.55 27 1.73 29 1.78 26 1.55 30 1.70 


B81020 7,512 81 1.18 78 1.08 64 0.88 68 0.93 86 1.13 100 1.33 

B81021 7,257 102 1.44 111 1.55 122 1.71 123 1.70 125 1.68 141 1.94 

B81075 2,263 4 0.15 5 0.19 16 0.63 19 0.78 16 0.68 20 0.88 

B81085 5,299 64 1.18 62 1.14 62 1.16 63 1.18 73 1.37 77 1.45 

B81094 1,925 17 0.76 18 0.79 21 0.91 23 1.02 23 1.07 19 0.99 

B81095 4,242 34 0.85 47 1.19 56 1.40 63 1.56 79 1.91 99 2.33 

B81097 1,688 41 2.46 34 2.08 33 2.03 34 2.06 34 2.03 32 1.90 

B81690 1,734 19 1.04 19 1.12 20 1.12 21 1.20 22 1.26 29 1.67 

B81001 3,358 31 1.02 41 1.39 38 1.32 46 1.53 48 1.46 62 1.85 

B81008 15,062 211 1.46 200 1.36 198 1.33 186 1.25 185 1.24 213 1.41 

B81048 9,048 104 1.16 123 1.34 127 1.39 132 1.45 133 1.43 143 1.58 

B81049 9,354 160 2.00 189 2.33 213 2.53 230 2.64 230 2.52 231 2.47 

B81052 5,740 35 0.67 51 0.91 59 1.12 67 1.20 73 1.32 81 1.41 

B81072 7,807 182 2.55 125 1.83 120 1.74 122 1.67 119 1.57 117 1.50 

B81644 2,245 25 1.10 23 1.03 26 1.16 28 1.27 35 1.58 30 1.34 



B81011 5,243 77 1.39 77 1.37 89 1.62 85 1.56 93 1.74 97 1.85 

B81038 7,732 112 1.43 116 1.49 117 1.49 124 1.60 146 1.92 177 2.29 

B81057 3,345 30 0.84 33 0.91 36 0.99 36 1.02 34 0.99 47 1.41 

B81074 3,639 106 1.66 111 1.74 102 1.60 106 1.74 78 2.05 115 3.16 

B81081 3,520 53 1.40 52 1.43 50 1.42 48 1.40 57 1.63 73 2.07 

B81645 2,128 31 1.18 24 0.91 33 1.25 34 1.28 41 1.81 47 2.21 

B81646 1,949 21 0.81 29 1.14 34 1.36 35 1.47 36 1.75 40 2.05 

B81682 3,726 63 1.72 66 1.78 66 1.79 64 1.75 74 2.01 79 2.12 

B81053 10,232 293 2.96 278 2.78 266 2.63 281 2.76 273 2.69 299 2.92 

B81054 10,851 168 1.49 182 1.62 177 1.57 175 1.57 180 1.62 210 1.94 

B81058 8,722 230 2.42 231 2.40 224 2.38 239 2.63 260 2.94 262 3.00 

B81066 2,522 27 1.06 24 0.97 28 1.16 34 1.39 35 1.38 32 1.27 

B81080 2,216 43 1.58 42 1.53 38 1.47 41 1.76 49 2.17 44 1.99 

B81616 2,571 55 2.01 47 1.74 61 2.21 56 2.07 55 2.10 62 2.41 

B81002 3,844 24 0.83 42 1.41 48 1.58 51 1.69 65 2.15 84 2.19 

B81112 3,498 77 1.94 76 1.99 81 2.20 88 2.44 77 2.13 73 2.09 

B81119 4,593 55 0.91 49 0.84 60 1.34 63 1.38 69 1.47 72 1.57 

B81634 3,044 48 1.54 51 1.64 53 1.70 46 1.49 40 1.31 38 1.25 

B81674 2,241 96 5.57 119 6.82 125 6.94 117 6.02 83 3.94 93 4.15 

B81675 9,476 53 1.20 53 1.23 57 1.19 113 2.10 168 1.75 224 2.36 

B81685 2,444 61 2.38 53 2.01 52 2.01 57 2.22 64 2.53 73 2.99 



Code Latest 

list 

size 

Number and prevalence on COPD QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81688 2,009 47 2.33 41 2.01 47 2.26 57 2.71 64 3.03 72 3.58 


B81027 5,976 255 4.05 228 3.80 211 3.56 202 3.38 194 3.22 209 3.50 

B81040 16,805 271 1.65 232 1.41 270 1.61 283 1.67 295 1.75 314 1.87 

B81047 7,377 115 1.53 123 1.67 129 1.76 121 1.67 123 1.70 136 1.84 

B81089 3,583 37 1.16 37 1.14 42 1.26 45 1.33 57 1.61 65 1.81 

B81631 3,425 65 2.01 93 2.97 107 3.37 110 3.38 122 3.57 138 4.03 

B81683 1,644 33 2.15 34 2.14 34 2.23 39 2.69 39 2.57 44 2.68 


B81017 6,800 230 3.13 214 3.05 220 3.04 211 2.91 189 2.77 219 3.22 

B81018 6,602 217 3.31 212 3.24 210 3.09 199 2.96 200 3.00 232 3.51 

B81032 2,478 35 1.15 31 1.04 29 1.05 36 1.33 49 1.86 39 1.57 

B81046 9,068 134 1.57 141 1.67 150 1.67 171 1.95 192 2.15 199 2.19 

B81692 1,814 7 0.37 13 0.65 17 0.92 25 1.41 28 1.56 35 1.93 

Y00955 2,556 N/A N/A 15 2.24 36 2.17 46 2.07 54 2.12 99 3.87 


The Association of Public Health Observatories has produced estimates of the number 

of people in each PCT with have diagnosed COPD. Whist this is useful, it is probably 

more useful to examine this at practice level. Doncaster PCT has created a model 

which can be used to produce the estimated number of people with diagnosed COPD 

(Doncaster PCT 2008). 


























This model estimates the number of people with COPD by assuming the prevalence of 

COPD for each gender and age band based on estimates produced by systematic 

reviews and examination of the General Practice Research Database (step 1), adjusting 

the resulting estimates by the all age COPD mortality ratio (e.g. Hull‟s COPD 2005-2007 

SMR was 159 so the stage 1 numbers would be increased by 59% (step 2) and by then 

adjusting the resulting estimates by a deprivation score (UV67 derived from 2001 

Census information) produced at practice level (step 3). This practice deprivation score 

(from step 3) is first divided by the „expected‟ (UV67) score for Hull to avoid „doublecounting‟ 

the effect of deprivation (step 2 and step 3 both adjusted for deprivation). 

Halbert et al (Halbert, Isonaka et al. 2003) undertook a systematic review of COPD 

prevalence from 32 studies from across the world mainly based in the US or Europe. 

The prevalence estimates varied widely from 1% to 18%. Soriano et al (Soriano, Maier 

et al. 2000) have also produced some estimated prevalence figures from the General 

Practice Research Database, which were 1.7% for males and 1.4% for females (so at 

the lower end of the scale in relation to Halbert‟s estimates), Soriano considers that they 

are a reasonably good indicator of levels of physician diagnosed COPD in the UK. 

Soriano provided prevalence rates for men and women but not by age group, although it 

is suggested that the age distribution is broadly in range in relation to 1991-1992 data 

from the Morbidity Statistics from General Practice, i.e. consultancy rates (Office for 

Population Censuses and Surveys 1995). The prevalence estimates used in the model 

uses the age-specific rates from the Morbidity Statistics but increased them in-line with 

Soriano‟s reported overall prevalence rates. 

The results of the modelling and the actual diagnosed numbers of patients with COPD 

are given in Table 298. The model does not necessarily represent the actual number of 

people who should be diagnosed with COPD for each practice; it is only a guide. The 

characteristics of each practice differ and need to be considered. Furthermore, it does 

not include undiagnosed cases of COPD. 





2010. 



Table 298: Actual diagnosed and modelled COPD numbers, September 2010 


Numbers with COPD 







B81104 Dr JK Nayar 6,553 19 38 -19 

B81635 Dr G Dave 2,979 73 70 3 



Y02747 Kingswood Surgery 1,380 6 6 0 



B81075 Dr MK Mallik 2,197 20 71 -51 


B81094 Dr AK Datta 1,790 17 33 -16 

B81095 Dr Cook 4,145 101 106 -5 

B81097 Dr RD Yagnik 1,689 38 46 -8 

B81690 Dr SK Ray 1,650 27 31 -4 












B81074 Dr AK Rej 3,534 114 93 21 


B81645 East Park Practice 2,176 64 58 6 

B81646 Dr M Shaikh 1,822 44 48 -4 







B81616 Dr GT Hendow 2,539 83 62 21 








Numbers with COPD 





B81674 Dr JC Joseph 2,246 98 65 33 


B81685 Dr NA Poulose 2,394 71 48 23 

B81688 Dr KV Gopal 2,023 85 39 46 

Y02344 Northpoint 2,021 40 42 -2 




B81089 Dr Witvliet 3,593 65 97 -32 

B81631 Dr R Raut 3,438 149 58 91 




B81018 Dr RK Awan & Partners 6,518 251 192 59 






HULL 288,935 6,332 6,889 -557 


years who have a long-standing condition due to having bronchitis and emphysema for 

the period 2010 to 2025 (Table 392). 




admission rate for admissions (DSR) where the primary diagnosis was COPD (for at 








Table 299: Total three year admissions and annual average age-standardised COPD 



DSR per 100,000 Hull residents with a primary 

diagnosis of COPD, 2007/08 to 2009/10 (95% CI) 

Men Women 

N DSR N DSR 

Bransholme East 53 601 (440 to 799) 38 451 (312 to 627) 

Bransholme West 55 409 (306 to 534) 80 594 (470 to 741) 

Kings Park 25 393 (245 to 592) 23 390 (236 to 601) 

Area: North Carr 133 444 (369 to 530) 141 474 (396 to 562) 

Beverley 37 233 (163 to 321) 27 169 (110 to 246) 

Orchard Park & Greenwood 117 612 (505 to 734) 152 823 (696 to 968) 

University 35 264 (183 to 368) 79 551 (436 to 687) 

Area: Northern 189 387 (334 to 447) 258 523 (461 to 592) 

Locality: North 322 400 (357 to 447) 399 494 (446 to 545) 

Ings 74 263 (205 to 332) 146 515 (433 to 607) 

Longhill 77 338 (265 to 425) 74 319 (249 to 403) 

Sutton 71 360 (279 to 458) 54 260 (194 to 341) 

Area: East 222 313 (273 to 357) 274 387 (343 to 436) 

Holderness 48 248 (182 to 330) 55 283 (212 to 371) 

Marfleet 110 578 (473 to 698) 131 640 (533 to 761) 

Southcoates East 71 559 (436 to 705) 88 675 (541 to 832) 

Southcoates West 61 497 (379 to 638) 54 450 (337 to 588) 

Area: Park 290 441 (392 to 495) 328 502 (449 to 559) 

Drypool 79 453 (358 to 565) 123 697 (579 to 832) 

Area: Riverside (East) 79 453 (358 to 565) 123 697 (579 to 832) 

Locality: East 591 380 (350 to 412) 725 469 (435 to 504) 

Myton 178 735 (631 to 851) 106 565 (462 to 684) 

Newington 73 445 (348 to 560) 79 548 (433 to 685) 

St Andrew's 93 740 (596 to 907) 74 652 (511 to 820) 

Area: Riverside (West) 344 644 (577 to 716) 259 585 (515 to 661) 

Boothferry 73 336 (263 to 423) 60 275 (210 to 354) 

Derringham 71 328 (256 to 414) 83 373 (297 to 463) 

Pickering 118 493 (407 to 592) 95 399 (322 to 489) 

Area: West 262 390 (344 to 440) 238 349 (306 to 397) 

Avenue 53 331 (245 to 436) 40 278 (198 to 380) 

Bricknell 43 291 (210 to 393) 30 177 (119 to 254) 

Newland 36 358 (249 to 498) 41 436 (312 to 594) 

Area: Wyke 132 316 (264 to 375) 111 273 (224 to 329) 

Locality: West 738 459 (427 to 494) 608 396 (365 to 429) 

HULL 1,652 415 (395 to 435) 1,732 447 (426 to 468) 




From the Compendium, the age-specific mortality rates for COPD for 2006-2008 are 

given in Table 300 for Hull and comparator areas (see section 3.3.3 on page 44). In 

general, the mortality rates in Hull are higher than comparator areas. Using the PHMF 

and GP registration file (October 2007, 2008 and 2009), the age-specific mortality rates 

have been calculated for each Area and Locality (Table 301). 

Table 300: COPD age-specific mortality rates for 2006-2008 

Area COPD age specific mortality rates per 100,000 for 2006-2008 

Males Females 


England 12.2 129 513 47.5 8.8 95 315 41.4 

Hull 21.1 214 640 57.0 16.6 176 534 65.4 

Y&H SHA 15.2 147 560 52.1 10.8 114 391 51.0 

Indust Hinterlands 17.8 167 703 66.1 14.7 154 473 66.3 

Wolverhampton 19.3 168 554 59.5 9.7 81 354 46.7 

Salford 20.7 207 621 58.1 14.3 266 489 73.5 

Derby 10.5 115 470 42.7 9.8 111 333 44.8 

Stoke-on-Trent 21.3 146 872 73.0 16.4 132 395 55.8 

Coventry 18.4 202 560 53.6 18.5 123 376 51.1 

Plymouth * 135 423 39.1 11.6 125 298 44.0 

Sandwell 21.4 193 761 70.3 15.2 111 384 51.4 

Middlesbrough 24.9 192 686 64.1 20.0 177 526 68.4 

Sunderland 18.6 154 774 66.9 10.9 181 526 68.9 

Leicester 22.1 202 608 49.9 11.3 107 291 32.7 

Average above 10 18.7 171 633 57.7 13.8 141 397 53.7 

NE Lincolnshire 34.0 200 571 68.9 * 132 447 62.5 


Table 301: COPD disease age-specific mortality rates for 2007-2009 by Area 

Area/Locality COPD age specific mortality rates per 100,000 for 2007-2009 

Males Females 


North Carr 19 200 562 35 19 * 730 * 

Northern 32 250 630 60 28 248 383 57 

NORTH 26 229 608 49 24 178 503 51 

East 39 222 709 85 22 234 531 90 

Park 30 158 742 60 12 294 525 70 

Riverside (East) * 325 1,182 * * * 338 43 

EAST 29 207 771 72 18 243 508 75 

Riverside (West) 13 436 741 62 34 240 819 90 

West 18 155 697 70 * 97 405 * 

Wyke * 234 622 * * 252 376 * 

WEST 14 270 691 58 13 178 514 63 

HULL 22 237 708 61 17 203 509 65 



Over the three year period 2007-2009, there were a total of 243 deaths in men and 250 

deaths in women from COPD. The age-specific mortality rates for Hull differ slightly 

from the Compendium because different population estimates have been used, and it is 

not possible to present the information for all areas due to small numbers (marked with 

an asterisk in the table). 

The total number of deaths from COPD for men and women aged under 75 years as 

well as the directly standardised mortality rates (DSRs) are given in Table 302 for the 

most recent period 2007-2009. The DSRs are standardised to the European Standard 

Population. Given the relatively wide confidence intervals, no particular Locality appears 

particularly high or low in relation to the DSR. 


COPD per 100,000 persons, Hull 2007-2009 

Locality Total deaths over three years and under 75 DSRs for COPD 2007-2009 per 

100,000 persons (95% CI) 



North 23 26.5 (16.8 to 39.8) 20 21.1 (12.8 to 32.6) 43 23.7 (17.1 to 31.9) 

East 38 26.5 (18.7 to 36.4) 37 23.3 (16.3 to 32.2) 75 25.1 (19.7 to 31.4) 

West 38 24.9 (17.6 to 34.3) 27 18.1 (11.9 to 26.4) 65 21.5 (16.5 to 27.4) 

HULL 99 25.9 (21.1 to 31.6) 84 20.9 (16.7 to 26.0) 183 23.4 (20.1 to 27.1) 

Table 303 gives under 75 SMRs for cancer for Hull and comparators for 2006-2008. 

For men, the premature COPD mortality rate is 70% higher in Hull compared to England 

(and statistically significantly higher), which has increased substantially from 2005-2007 

when it was 27% higher than England. It is possible that the increase is due to random 

variation including slightly difference in the age the people living in Hull died from COPD 

(i.e. a few more died before 75 years rather than at 75+ years). For 2005-2007, the 

under 75 COPD SMR in Hull was lower than the Industrial Hinterlands and the average 

of the 10 comparators, but for 2006-2008, it is substantially higher than England, and 

one of the highest of the comparators (only Leicester is higher). For women, the 

premature SMR for COPD was 88% higher than England and statistically significant 

higher than England. Despite being so much higher than England for women, the SMR 

for Hull is not the highest of the comparators with Salford and Middlesbrough having 

premature mortality rates that are twice England‟s. These areas have similar levels of 

deprivation compared to Hull, and the SMRs for lung cancer were also high for these 

areas, which suggests, as expected, the smoking prevalence is high in these areas. 

Given the prevalence of smoking in Hull, it is not surprising that the premature mortality 

rate for COPD is so high, with an estimated 84% of COPD deaths directly attributable to 

smoking (see Table 96 and Figure 224). 



Table 303: Under 75 standardised mortality ratios for COPD for Hull and comparators, 

2006-2008 

Area Under 75 COPD SMR 2006-2008 (95% CI) 


England 100 (98, 102) 100 (98, 102) 100 (99, 101) 

Hull 170 (137, 209) 188 (148, 235) 178 (152, 207) 

Y&H SHA 116 (110, 122) 120 (113, 128) 118 (113, 123) 



Salford 164 (129, 204) 246 (198, 303) 199 (170, 232) 

Derby 88 (64, 118) 116 (85, 156) 100 (81, 123) 

Stoke-on-Trent 131 (102, 166) 152 (117, 194) 141 (118, 166) 

Coventry 157 (127, 192) 159 (126, 198) 158 (135, 183) 

Plymouth 94 (70, 124) 131 (100, 169) 111 (91, 134) 

Sandwell 162 (132, 197) 134 (104, 170) 149 (128, 174) 


Sunderland 128 (103, 159) 171 (138, 210) 147 (126, 171) 

Leicester 174 (140, 215) 125 (93, 165) 153 (128, 181) 

Average above 10 139 (129, 150) 150 (138, 162) 144 (136, 152) 


The trends in the directly standardised mortality rates (DSRs) for COPD for Hull and 

comparator areas are given per 100,000 men and women in Figure 225 and Figure 

226. This figure refers to deaths for all ages as 84% of COPD deaths are preventable in 

that this is the estimated number directly caused by smoking (see Table 96). The 

underlying data are given in the APPENDIX on page 927 and page 927. 

For males, the mortality rate for COPD was slightly higher for the most recent period 

2006-2008 compared to the Industrial Hinterlands and the average of the 10 

comparators. The mortality rate had decreased by 29% between 1993-95 and 2006-08 

which is similar or slightly lower than that for the Industrial Hinterlands (31%) and the 

average of the 10 comparators (35%). The rate decreased by 37% for England over the 

same period. 

For women for 2006-2008, Hull had the 6 th highest mortality rate for COPD with 

Tameside & Glossop (39.5), Middlesbrough (40.3), Salford (42.6), Liverpool (45.6) and 

Knowsley (50.0) having higher mortality rates per 100,000 women. Between 1993-95 

and 2006-08, the mortality rate in Hull decreased by 8% compared to 3% for England 

and an increase of 4% for the Industrial Hinterlands and 3% for the average of the 10 

comparators. However, despite an overall reduction since 1993-95 in the last four 

periods the mortality rate in Hull has increased. The mortality rate was highest in the 

mid-1990s being 45.0 per 100,000 women for 1995-1997 decreasing to a minimum of 

31.8 per 100,000 women for 2002-2004, but has since increased to 38.9 per 100,000 

women for 2006-2008 which is slightly lower than the rate in 2005-2007 (40.1 per 



100,000 women). The mean reduction between 1993-95 and 2002-04 was 1.2 per 

100,000 women whereas the mean increase between 2003-05 and 2006-08 was 1.8 per 

100,000 women. If the recent trends (of increasing by an average of 1.8 per 100,000 

women per annum) continues then in two years‟ time (i.e. 2008-10) the mortality rate 

would be the same as for 1993-95. Therefore, despite the overall reduction of the entire 

period from 1993-95, there is a concern that there is a current increasing trend, which 

would not be particularly surprising given the slower decrease in the prevalence of 

smoking in women over the last few decades. A similar pattern was observed for lung 

cancer, where a very similar percentage of deaths are directly attributable to smoking 

(see Figure 211). 

Figure 225: Trends over time in all age directly standardised mortality rates for COPD in 

men 


males 

80 

70 

60 

50 

40 

30 

20 

10 

0 

1993-1995 

1994-1996 

1995-1997 

1996-1998 

1997-1999 

1998-2000 

1999-2001 


2000-2002 

Period 

England Hull 



2001-2003 

2002-2004 

2003-2005 

2004-2006 

2005-2007 

2006-2008


Figure 226: Trends over time in all age directly standardised mortality rates for COPD in 

women 


females 

50 

45 

40 

35 

30 

25 

20 

15 

10 

5 

0 

1993-1995 


1994-1996 

1995-1997 

1996-1998 

A health equity audit for COPD has been almost completed. A draft report is available 

at www.hullpublichealth.org. Recommendations are due to be added to the draft 

document prior to completion. 


1997-1999 

1998-2000 

1999-2001 




population). Table 304 shows the prevalence of diagnosed COPD on the practice 


the practice IMD 2007 scores and the prevalence of diagnosed COPD for each practice. 

Both the table and the figure show an association between the prevalence of diagnosed 

COPD and the deprivation, and this relationship is statistically significant (p


the more deprived areas. However, mortality rates could be higher in the more deprived 

areas which could reduce the number on the disease registers. The underlying data for 

the figure is given in the APPENDIX on page 927. 










Table 304: Diagnosed prevalence of COPD by deprivation quintile at practice level 

Practice IMD 2007 Number of List size 

COPD 2009/10 

quintile 

practices* (Jan 10) Number Percentage 

Most deprived 10 57,367 1,455 2.54 

2 12 55,245 1,327 2.40 

3 12 66,252 1,392 2.10 

4 11 65,303 1,171 1.79 





Figure 227: Diagnosed prevalence of COPD by deprivation score at practice level 



inpatient admission rates which involve a primary diagnosis of COPD (any clinician 




daycase and inpatient admissions for COPD. The difference in the inpatient admission 

rates is dramatic with 1,023 admissions for people living in the most deprived quintile 

areas of Hull with a rate of 713 admissions per 100,000 population (95% CI 670 to 758) 

compared to 356 admissions for people living in the least deprived quintile areas of Hull 

with a rate of 228 admissions per 100,000 population (95% CI 205 to 253). The 



living in the most deprived areas have a higher hospital admission rate for COPD. 






Figure 228: Age-standardised COPD annual daycase and inpatient admission rate per 



persons for COPD 

800 

700 

600 

500 

400 

300 

200 

100 

0 

Most deprived 

quintile 



quintile 


The directly standardised mortality rates for deaths from COPD for those aged less than 

75 years is given in Figure 229 for Hull (for the period 2007 to 2009). The underlying 

data are given in the APPENDIX on page 930. The trend is statistically significant, with 

the number of premature deaths from COPD decreasing from 63 for those living in the 

most deprived quintile to 16 for those in the least deprived areas of Hull. The under 75 

directly standardised mortality rate decreased from 45.7 deaths (95% CI 35.0 to 58.6) for 

the most deprived to 9.0 deaths (95% CI 5.2 to 14.7) for the least deprived quintile per 

100,000 persons; that is a five-fold difference in DSR between the most deprived and least 

deprived areas of Hull. 



Figure 229: Standardised mortality rate for COPD per 100,000 persons aged under 75 

years by deprivation for Hull for 2007-2009 


COPD mortality rate per 100,000 

persons 2007-2009 

70 

60 

50 

40 

30 

20 

10 

0 

Most 


quintile 



quintile 


















Figure 230 shows trends in under 75 standardised mortality ratios (SMRs) for COPD for 



residents. The underlying data are given in the APPENDIX on page 931. Under 75 

COPD SMRs for men in Hull were lower than for each comparator area, decreased 



slightly between 2001-2003 and 2005-2007, thereafter increasing by one third in 2006- 

2008, giving an overall increase between 2001-2003 and 2006-2008 of 24%. While this 

was lower than the 45% increase seen for North East Lincolnshire, each other 

comparator saw small decreases of between 1% and 6% over this period. Amongst 

women under 75 COPD SMRs increased for Hull and comparators between 2001-2003 

and 2006-2008, although the 26% increase in Hull was 2.5 to 4 times higher than for all 

comparators excluding North East Lincolnshire which saw under 75 COPD SMRs 

increase by 42%. Under 75 COPD SMRs in most deprived women in Hull remained 

higher than for each comparator throughout this period, with the gap between Hull and 

comparators, excluding North East Lincolnshire, increasing. 

Figure 230: Trends in under 75 COPD standardised mortality ratios by national 




10.5.3.11 Social Marketing 

Social marketing research was completed in Hull during September 2009 to assess 

general public knowledge and perception of COPD. Further information is included 

within the final presentation which is available on request. In conclusion, there was: 

A perceived health danger relating to quitting smoking “quit and you‟ll die!”. 

A “prove it” attitude with a lack of trust in the link between COPD and smoking. 

Denial with a “it‟s not related to me” attitude. 

Low awareness of COPD (what it is, causes, symptoms or treatment) with greater 

awareness of bronchitis and emphysema. 

No awareness of a connection between COPD and bronchitis or emphysema. 

A need to communicate with the general public (the term COPD, causes, 

symptoms, long term effects and proof). 

A need to address the main barriers to seeking help which were victimisation as a 

smoker and COPD being incurable (“what‟s the point?” attitude). 

A need to overcome the barriers by listening, not preaching and explaining things 

clearly. 

A high awareness of stop smoking services (all had attempted to quit). 

Ideas put forward to encourage smokers to quit such as financial incentive, free 

prescriptions and encouragement “well done”. 


The target relating to COPD within the local World Class Commissioning (WCC) 

Strategy was to increase the prevalence of patients on the COPD GP disease register 

(Quality and Outcomes Framework) so that the prevalence of undiagnosed COPD is 

reduced. By 2013, the aim is to increase the number of patients on the COPD disease 

register by 30% (Table 305). From 2006/07, the baseline year, when 4,893 patients 

were included on the COPD disease register, there has been a large percentage 

increase during 2009/10, with a total of 5,947 on the COPD disease register 

representing an increase of over 20% over the baseline numbers. The numbers on the 

register for 2009/10 is higher than the target for 2010/11. Therefore, the targets have 

been achieved for 2008/09, 2009/10 and 2010/11. 



under 75 mortality rate from chronic respiratory disease, but there is no mention of a 

separate target for the prevalence of COPD. Therefore, it is possible that this outcome 

measure will no longer be a key outcome measure unless it is retained locally. If the 

new measure relating to chronic respiratory disease becomes a new outcome measure, 

it is not clear whether it will just include COPD or whether it will include COPD and 

asthma. 



Table 305: World Class Commissioning target for COPD 

Financial year Patients on COPD QOF disease register 

Target Actual 

Number % increase from Number % increase from 

baseline 

baseline 

2006/07 (baseline) 4,893 4,893 

2007/08 5,036 2.9 

2008/09 5,137 5 5,320 8.7 

2009/10 5,382 10 5,947 21.5 

2010/11 5,871 20 

2011/12 6,116 25 

2012/13 6,360 30 


Expenditure per head for 2008/2009 in Hull on obstructive airway disease is £36.98 

(ranked 1 st out of 152 PCTs) compared to £18.76 for the Industrial Hinterlands average, 

£17.44 for North East Lincolnshire and £12.70 for England. Further information on 

expenditure on respiratory disease outcomes used in the Yorkshire and the Humber 

Public Health Observatory Programme Budgeting toolkit is given in section 10.5.1.5 on 

page 605. 



10.6 Epilepsy 









have a higher prevalence of many diseases (and generally a higher prevalence of 

undiagnosed disease). See section 12.13 on page 782 for more information on QOF 

and issues associated with presenting the prevalence at practice level. Also see Table 

28 and Table 49 for mean age of patients and mean deprivation scores for each 

practice (which will influence the prevalence on the disease registers). One such 

register is for epilepsy for those aged 18+ years. 

Table 306 presents the information for epilepsy for all the general practices in Hull for 

2009/10 based on these disease registers. Frequently the QOF „prevalence‟ figures are 

presented out of the total registered population, but this is not an accurate measure of 

prevalence in the population if it differs from the numerator. The numerator for epilepsy 

is the number of people aged 18+ years who have epilepsy, so the denominator also 

uses the population aged 18+ years. The latest list size refers to the registered 


register is as at 31 st March 2010 (QOF definitions), and this means that the prevalence 

can be biased if large population changes have occurred over this three month period 

(e.g. for newly opened practices: Y02747, Y02786, Y02896 and Y02748). 

Table 306: Prevalence of diagnosed epilepsy for those aged 18+ years based on GP 


Practice 

code 


population 

Registered 

population 

aged 18+ 

years 

Prevalence on 

epilepsy disease 

register 2009/10 

N % 

B81035 Dr W G T Sande & Partners 6,114 4,891 46 0.94 

B81056 The Springhead Medical Centre 13,489 10,387 99 0.95 

B81104 Dr J K Nayar 7,721 5,559 16 0.29 

B81635 Dr G Dave 2,967 2,403 17 0.71 




B81020 Dr P C Mitchell & Partners 7,512 5,859 54 0.92 


B81075 Dr M K Mallik 2,263 1,924 10 0.52 

B81085 Dr J W Richardson & Partners 5,299 4,292 32 0.75 



Practice 

code 


population 

Registered 

population 

aged 18+ 

years 

Prevalence on 



N % 

B81094 Dr A K Datta 1,925 1,540 6 0.39 

B81095 Dr Cook 4,242 3,394 17 0.50 

B81097 Dr R D Yagnik 1,688 1,418 15 1.06 

B81690 Dr S K Ray 1,734 1,353 10 0.74 


B81008 Dr J S Parker & Partners 15,062 11,598 135 1.16 

B81048 Dr S M Hussain & Partners 9,048 6,876 57 0.83 

B81049 Dr V A Rawcliffe & Partners 9,354 7,016 75 1.07 

B81052 Dr J Musil & P J Queenan 5,740 4,477 30 0.67 

B81072 Dr R Percival & Partners 7,807 6,011 56 0.93 



B81011 Wheeler Street Healthcare 5,243 4,090 44 1.08 

B81038 Dr A A Mather & Partners 7,732 6,108 68 1.11 


B81074 Dr A K Rej 3,639 2,838 21 0.74 



B81646 Dr M Shaikh 1,949 1,501 16 1.07 


B81053 Diadem Medical Practice 10,232 7,879 109 1.38 

B81054 Dr M J Varma & Partners 10,851 8,681 86 0.99 




B81616 Dr G T Hendow 2,571 1,954 23 1.18 


B81112 Dr Ghosh Raghunath & Prtners 3,498 2,484 45 1.81 

B81119 Dr G Palooran & Partners 4,593 3,307 31 0.94 


B81674 Dr J C Joseph 2,241 1,591 18 1.13 

B81675 Dr Tak & Dr Stryjakiewicz 9,476 7,012 43 0.61 

B81685 Dr N A Poulose 2,444 1,735 28 1.61 

B81688 Dr K V Gopal 2,009 1,446 20 1.38 

Y02344 Northpoint 1,645 1,201 16 1.33 

B81027 St Andrews Group Practice 5,976 4,661 45 0.97 

B81040 Dr P F Newman & Partners 16,805 12,436 163 1.31 

B81047 Dr J N Singh & Partners 7,377 5,828 41 0.70 

B81089 Dr Witvliet 3,583 2,580 23 0.89 

B81631 Dr R Raut 3,425 2,329 20 0.86 

B81683 Dr A S Raghunath & Partners 1,644 1,217 9 0.74 

Y02896 Story St Pract & Walk In Centr 343 267 3 0.89 

B81017 Kingston Medical Group 6,800 5,440 68 1.25 

B81018 Dr R K Awan & Partners 6,602 4,753 63 1.33 

B81032 Dr A W Hussain & Partners 2,478 2,007 26 1.30 



Practice 

code 


population 

Registered 

population 

aged 18+ 

years 

Prevalence on 



N % 

B81046 Dr J D Blow And Partners 9,068 6,620 89 1.34 

B81692 The Quays Medical Centre 1,814 1,560 20 1.28 

Y00955 Riverside Medical Centre 2,556 1,968 28 1.42 

Y02748 Haxby Orchard Park Surgery 60 39 2 5.13 

North Locality 68,517 51,160 553 1.08 

North Locality* 67,555 50,454 545 1.08 

East Locality 83,180 63,772 707 1.11 

West Locality 137,513 106,775 1,011 0.95 

West Locality* 137,029 106,417 1,006 0.95 

HULL 289,210 221,707 2,271 1.02 

HULL* 287,764 220,643 2,258 1.02 





Table 307 presents the prevalence of epilepsy for those aged 18+ years for 2009/10 for 

Hull and comparator areas (see section 3.3.3 on page 44), as well as for England. The 

prevalence of epilepsy in Hull is comparable or slightly higher than most comparators. 

Table 307: Prevalence of diagnosed epilepsy for those aged 18+ years based on GP 


PCT Number of 

practices 

Practice 

population 

aged 18+* 


Number on 


register 

Epilepsy 

unadjusted 


England 8,305 42,613,280 332,001 0.78 

Hull 60 221,707 2,271 1.02 

Sunderland 55 223,324 2,226 1.00 


Salford 54 186,193 1,867 1.00 

Derby City 33 225,334 1,873 0.83 


Coventry 65 271,656 2,151 0.79 


Sandwell 67 257,006 2,138 0.83 

Stoke-On-Trent 57 215,633 2,312 1.07 

Plymouth 43 209,693 2,001 0.95 

Average of 10 520 2,170,855 19,606 0.90 

NE Lincs 34 131,676 1,365 1.04 

*Population estimated from (rounded) prevalence and number on disease register (so there will 

be rounding errors). 



The number of patients with diagnosed epilepsy and the prevalence for those aged 18+ 

years as recorded on the GP QOF disease registers over time is illustrated in Table 308 

for 2004/05 to 2008/09. The latest list size refers to the registered population as at 1 st 





January 2010). The latest list size for B81676 (Dr PN Jones) relates to 2004/05 and the 

latest list size for B81668 (Dr EG Stryjakiewicz) relates to 2006/07. Some practices 


Table 308: Numbers and prevalence of diagnosed epilepsy (aged 18+) on GP QOF 


Code Latest 

pop 

18+ 

Number and prevalence on epilepsy QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81035 4,891 58 0.91 49 0.81 46 0.91 44 0.89 40 0.81 46 0.94 

B81056 10,387 86 1.01 82 0.91 88 0.91 84 0.86 92 0.91 99 0.95 

B81104 5,559 15 0.25 19 0.25 13 0.23 15 0.27 16 0.29 16 0.29 

B81635 2,403 23 0.86 19 0.73 19 0.74 16 0.64 15 0.61 17 0.71 

B81662 1,540 4 0.21 5 0.26 8 0.42 11 0.58 9 0.50 7 0.45 


Y01200 1,359 N/A N/A 7 N/A 10 0.77 10 0.76 10 0.76 8 0.59 


B81020 5,859 46 0.83 53 0.92 52 0.89 53 0.91 56 0.93 54 0.92 

B81021 5,660 46 0.82 45 0.79 47 0.83 47 0.82 58 0.99 54 0.95 

B81075 1,924 9 0.39 12 0.53 12 0.57 13 0.63 11 0.54 10 0.52 

B81085 4,292 42 0.96 39 0.88 36 0.83 36 0.83 37 0.85 32 0.75 

B81094 1,540 12 0.69 11 0.61 10 0.54 8 0.44 7 0.40 6 0.39 

B81095 3,394 22 0.66 21 0.64 20 0.61 19 0.58 22 0.65 17 0.50 

B81097 1,418 8 0.56 12 0.85 12 0.87 12 0.85 13 0.91 15 1.06 

B81690 1,353 10 0.70 11 0.84 10 0.73 8 0.58 7 0.51 10 0.74 

B81001 2,552 29 1.27 27 1.19 27 1.23 25 1.08 28 1.10 28 1.10 

B81008 11,598 91 0.82 121 1.07 120 1.04 126 1.10 134 1.16 135 1.16 

B81048 6,876 69 0.96 66 0.89 56 0.77 53 0.74 49 0.67 57 0.83 

B81049 7,016 69 1.12 69 1.11 72 1.10 73 1.09 76 1.08 75 1.07 

B81052 4,477 32 0.78 30 0.66 27 0.62 26 0.59 30 0.68 30 0.67 

B81072 6,011 59 1.08 56 1.05 55 1.01 54 0.95 56 0.95 56 0.93 

B81644 1,684 13 0.78 14 0.85 16 0.96 16 0.96 18 1.06 16 0.95 



B81011 4,090 46 1.07 51 1.18 45 1.04 45 1.05 44 1.04 44 1.08 

B81038 6,108 67 1.04 71 1.09 76 1.21 80 1.28 73 1.19 68 1.11 

B81057 2,676 28 0.98 22 0.75 22 0.75 22 0.77 23 0.83 20 0.75 

B81074 2,838 47 0.96 48 0.98 48 0.99 45 0.95 20 0.66 21 0.74 

B81081 2,746 27 0.94 23 0.82 22 0.81 23 0.86 24 0.87 29 1.06 

B81645 1,724 13 0.63 12 0.57 14 0.66 12 0.56 12 0.64 12 0.70 

B81646 1,501 12 0.60 12 0.61 15 0.78 18 0.96 16 0.99 16 1.07 

B81682 2,795 27 1.00 26 0.94 25 0.89 22 0.79 27 0.96 31 1.11 



Code Latest 

pop 

18+ 

Number and prevalence on epilepsy QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81053 7,879 80 1.05 84 1.10 90 1.15 92 1.17 96 1.22 109 1.38 

B81054 8,681 104 1.12 104 1.15 108 1.18 99 1.09 86 0.95 86 0.99 

B81058 7,065 103 1.35 102 1.31 103 1.36 103 1.39 96 1.32 97 1.37 

B81066 1,942 17 0.87 16 0.83 16 0.85 17 0.88 23 1.15 23 1.18 

B81080 1,795 18 0.81 22 0.97 22 1.07 17 0.89 19 1.03 19 1.06 

B81616 1,954 33 1.63 29 1.43 24 1.15 21 1.01 22 1.10 23 1.18 

B81002 2,691 38 1.93 50 2.44 48 2.25 45 2.09 39 1.78 50 1.86 

B81112 2,484 45 1.64 46 1.67 43 1.66 40 1.56 44 1.69 45 1.81 

B81119 3,307 32 0.74 33 0.78 37 1.12 34 1.01 33 0.96 31 0.94 

B81634 2,192 26 1.17 26 1.17 25 1.11 25 1.10 26 1.16 26 1.19 

B81674 1,591 12 0.98 15 1.19 14 1.05 15 1.05 17 1.11 18 1.13 

B81675 7,012 38 1.10 33 0.99 29 0.78 49 1.20 48 0.66 43 0.61 

B81685 1,735 27 1.51 28 1.53 27 1.48 30 1.65 30 1.66 28 1.61 

B81688 1,446 16 1.14 13 0.91 16 1.09 14 0.93 19 1.25 20 1.38 


B81027 4,661 51 1.05 46 0.98 50 1.07 49 1.04 49 1.03 45 0.97 

B81040 12,436 151 1.23 161 1.30 165 1.29 158 1.23 160 1.25 163 1.31 

B81047 5,828 53 0.88 49 0.82 43 0.73 42 0.73 43 0.74 41 0.70 

B81089 2,580 27 1.14 26 1.08 21 0.85 18 0.72 21 0.81 23 0.89 

B81631 2,329 28 1.24 25 1.11 29 1.28 23 1.01 26 1.10 20 0.86 

B81683 1,217 13 1.20 15 1.29 11 0.98 11 1.01 8 0.70 9 0.74 


B81017 5,440 61 0.99 72 1.27 73 1.24 65 1.12 71 1.28 68 1.25 

B81018 4,753 65 1.36 60 1.24 70 1.40 68 1.38 70 1.43 63 1.33 

B81032 2,007 28 1.16 26 1.08 25 1.11 23 1.04 25 1.16 26 1.30 

B81046 6,620 79 1.26 77 1.23 71 1.08 74 1.13 76 1.14 89 1.34 

B81692 1,560 14 0.87 22 1.28 18 1.17 21 1.39 23 1.47 20 1.28 

Y00955 1,968 N/A N/A 13 N/A 20 1.37 28 1.62 27 1.36 28 1.42 



number of people with diagnosed epilepsy (Doncaster PCT 2008). 
























The results of the modelling and the actual diagnosed numbers of patients aged 18+ 

years with epilepsy are given in Table 309. The model does not necessarily represent 

the actual number of people who should be diagnosed with epilepsy for each practice; it 


The model uses age-gender-specific prevalence estimates derived from work 

undertaken which examined the prevalence of epilepsy and prescribing patterns in 

primary care (Purcell, Gaitatzis et al. 2002), and the total model estimate and the total 

number on the disease register is very similar. 




QMAS system. Table 309 gives this information as at September 2010. 

Table 309: Actual diagnosed and modelled epilepsy numbers of those aged 18+ years, 

September 2010 

Code Practice name List size Numbers with epilepsy 






B81056 Springhead Medical Centre* 13,813 99 107 -8 

B81104 Dr JK Nayar 6,553 13 46 -33 

B81635 Dr G Dave 2,979 18 24 -6 




B81020 Dr PC Mitchell & Partners* 7,436 54 58 -4 


B81075 Dr MK Mallik 2,197 10 19 -9 


B81094 Dr AK Datta 1,790 6 14 -8 

B81095 Dr Cook 4,145 19 33 -14 

B81097 Dr RD Yagnik 1,689 17 14 3 

B81690 Dr SK Ray 1,650 10 13 -3 


B81008 Dr JS Parker & Partners 14,936 141 113 28 





Code Practice name List size Numbers with epilepsy 









B81011 Wheeler Street Healthcare 5,212 43 41 2 

B81038 Dr AA Mather & Partners 7,690 72 61 11 

B81057 Dr S MacPhie & Koul* 3,185 20 25 -5 

B81074 Dr AK Rej 3,534 19 27 -8 



B81646 Dr M Shaikh 1,822 20 14 6 






B81080 Dr GS Malczewski 2,168 17 17 0 

B81616 Dr GT Hendow 2,539 26 19 7 





B81674 Dr JC Joseph 2,246 20 16 4 


B81685 Dr NA Poulose 2,394 27 17 10 

B81688 Dr KV Gopal 2,023 19 15 4 

Y02344 Northpoint 2,021 15 15 0 


B81040 Dr PF Newman & Partners* 16,721 163 126 37 


B81089 Dr Witvliet 3,593 23 27 -4 

B81631 Dr R Raut 3,438 26 24 2 





B81032 Dr AW Hussain & Partners 2,328 28 18 10 





HULL 288,935 2,306 2,203 103 

*The number of patients with epilepsy was zero in the QMAS extract taken in Septmeber 2010, 

so the number from the QOF figures for March 2010 have been used. 



10.7 Hypothyroidism 













will influence the prevalence on the disease registers). One such register is for 

hypothyroidism. 

Table 310 presents the prevalence of hypothyroidism for all the general practices in Hull 

for 2009/10 based on these disease registers. The latest list size refers to the registered 






Table 310: Prevalence of diagnosed hypothyroidism based on GP disease registers 

2009/10 

Practice 

code 


population 

Prevalence of hypothyroidism 

on disease registers 2009/10 

N % 

B81035 Dr W G T Sande & Partners 6,114 172 2.81 

B81056 The Springhead Medical Centre 13,489 540 4.00 

B81104 Dr J K Nayar 7,721 48 0.62 

B81635 Dr G Dave 2,967 130 4.38 




B81020 Dr P C Mitchell & Partners 7,512 218 2.90 


B81075 Dr M K Mallik 2,263 61 2.70 

B81085 Dr J W Richardson & Partners 5,299 188 3.55 

B81094 Dr A K Datta 1,925 63 3.27 

B81095 Dr Cook 4,242 141 3.32 

B81097 Dr R D Yagnik 1,688 87 5.15 

B81690 Dr S K Ray 1,734 40 2.31 



Practice 

code 


population 



N % 


B81008 Dr J S Parker & Partners 15,062 422 2.80 

B81048 Dr S M Hussain & Partners 9,048 268 2.96 

B81049 Dr V A Rawcliffe & Partners 9,354 289 3.09 

B81052 Dr J Musil & P J Queenan 5,740 165 2.87 

B81072 Dr R Percival & Partners 7,807 178 2.28 



B81011 Wheeler Street Healthcare 5,243 179 3.41 

B81038 Dr A A Mather & Partners 7,732 258 3.34 


B81074 Dr A K Rej 3,639 101 2.78 



B81646 Dr M Shaikh 1,949 53 2.72 


B81053 Diadem Medical Practice 10,232 442 4.32 

B81054 Dr M J Varma & Partners 10,851 332 3.06 




B81616 Dr G T Hendow 2,571 81 3.15 


B81112 Dr Ghosh Raghunath & Prtners 3,498 85 2.43 

B81119 Dr G Palooran & Partners 4,593 129 2.81 


B81674 Dr J C Joseph 2,241 94 4.19 

B81675 Dr Tak & Dr Stryjakiewicz 9,476 181 1.91 

B81685 Dr N A Poulose 2,444 72 2.95 

B81688 Dr K V Gopal 2,009 62 3.09 

Y02344 Northpoint 1,645 36 2.19 

B81027 St Andrews Group Practice 5,976 195 3.26 

B81040 Dr P F Newman & Partners 16,805 386 2.30 

B81047 Dr J N Singh & Partners 7,377 174 2.36 

B81089 Dr Witvliet 3,583 93 2.60 

B81631 Dr R Raut 3,425 95 2.77 

B81683 Dr A S Raghunath & Partners 1,644 32 1.95 

Y02896 Story St Pract & Walk In Centr 343 9 2.62 

B81017 Kingston Medical Group 6,800 184 2.71 

B81018 Dr R K Awan & Partners 6,602 177 2.68 

B81032 Dr A W Hussain & Partners 2,478 50 2.02 

B81046 Dr J D Blow And Partners 9,068 269 2.97 

B81692 The Quays Medical Centre 1,814 21 1.16 

Y00955 Riverside Medical Centre 2,556 55 2.15 

Y02748 Haxby Orchard Park Surgery 60 9 15.00 

North Locality 68,517 2,011 2.94 



Practice 

code 


population 



N % 

North Locality* 67,555 1,987 2.94 

East Locality 83,180 2,633 3.17 

West Locality 137,513 3,827 2.78 

West Locality* 137,029 3,811 2.78 

HULL 289,210 8,471 2.93 

HULL* 287,764 8,431 2.93 





Table 311 presents the prevalence of hypothyroidism for 2009/10 for Hull and 

comparator areas (see section 3.3.3 on page 44), as well as for England. 

Table 311: Prevalence of diagnosed hypothyroidism based on GP disease registers 


PCT 

Number on 

hypothyroidism 

Hypothyroidism 

unadjusted 




England 8,305 54,836,561 1,603,670 2.92 

Hull 60 289,210 8,471 2.93 

Sunderland 55 284,551 11,556 4.06 


Salford 54 242,922 6,933 2.85 

Derby City 33 294,438 7,247 2.46 


Coventry 65 357,743 8,722 2.44 


Sandwell 67 339,020 11,919 3.52 

Stoke-On-Trent 57 280,265 7,901 2.82 

Plymouth 43 270,338 9,681 3.58 

Average of 10 520 2,840,950 86,020 3.03 

NE Lincs 34 169,565 5,679 3.35 

The number of patients with diagnosed hypothyroidism and the prevalence as recorded 












Table 312: Numbers and prevalence of diagnosed hypothyroidism on GP QOF disease 

registers, 2004/05 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on hypothyroidism QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81035 6,114 237 2.96 176 2.76 164 2.61 157 2.56 165 2.72 172 2.81 

B81056 13,489 371 3.28 392 3.32 433 3.53 493 3.91 519 4.00 540 4.00 

B81104 7,721 22 0.34 27 0.34 31 0.43 39 0.55 44 0.61 48 0.62 

B81635 2,967 103 3.16 112 3.50 122 3.88 122 4.01 129 4.29 130 4.38 

B81662 1,856 20 0.85 54 2.25 74 3.17 98 4.32 92 4.27 87 4.69 


Y01200 1,765 N/A N/A 23 1.88 39 2.49 40 2.45 61 3.63 62 3.51 


B81020 7,512 132 1.92 155 2.14 164 2.26 190 2.59 213 2.80 218 2.90 

B81021 7,257 206 2.90 208 2.90 212 2.97 225 3.12 239 3.22 239 3.29 

B81075 2,263 37 1.34 39 1.44 42 1.66 65 2.68 65 2.75 61 2.70 

B81085 5,299 152 2.80 159 2.91 163 3.05 173 3.25 181 3.39 188 3.55 

B81094 1,925 58 2.61 75 3.28 79 3.41 75 3.33 69 3.20 63 3.27 

B81095 4,242 60 1.49 98 2.48 118 2.95 123 3.06 135 3.26 141 3.32 

B81097 1,688 32 1.92 32 1.96 42 2.59 45 2.73 45 2.69 87 5.15 

B81690 1,734 32 1.75 30 1.76 37 2.08 34 1.95 37 2.12 40 2.31 

B81001 3,358 87 2.87 89 3.02 83 2.89 87 2.89 96 2.92 91 2.71 

B81008 15,062 204 1.42 343 2.34 359 2.41 375 2.53 388 2.60 422 2.80 

B81048 9,048 241 2.70 251 2.73 252 2.76 252 2.77 273 2.94 268 2.96 

B81049 9,354 177 2.22 202 2.49 245 2.91 247 2.84 267 2.93 289 3.09 

B81052 5,740 98 1.89 124 2.22 142 2.69 163 2.93 160 2.88 165 2.87 

B81072 7,807 148 2.08 158 2.31 163 2.36 170 2.33 177 2.33 178 2.28 

B81644 2,245 51 2.25 57 2.54 68 3.04 69 3.13 80 3.62 77 3.43 



B81011 5,243 147 2.66 159 2.84 157 2.85 165 3.03 172 3.21 179 3.41 

B81038 7,732 191 2.44 185 2.37 198 2.52 229 2.95 251 3.30 258 3.34 

B81057 3,345 84 2.35 86 2.38 88 2.41 78 2.21 78 2.27 78 2.33 

B81074 3,639 107 1.67 106 1.66 102 1.60 150 2.46 93 2.44 101 2.78 

B81081 3,520 91 2.40 86 2.36 91 2.58 108 3.16 121 3.45 125 3.55 

B81645 2,128 44 1.68 43 1.62 39 1.47 39 1.47 42 1.85 50 2.35 

B81646 1,949 50 1.93 52 2.04 52 2.08 54 2.26 47 2.28 53 2.72 

B81682 3,726 125 3.42 122 3.30 127 3.44 124 3.39 127 3.45 158 4.24 

B81053 10,232 331 3.34 352 3.53 380 3.76 410 4.02 406 4.00 442 4.32 

B81054 10,851 239 2.12 251 2.24 258 2.29 291 2.61 312 2.80 332 3.06 

B81058 8,722 212 2.23 242 2.51 250 2.66 295 3.25 294 3.32 309 3.54 

B81066 2,522 16 0.63 17 0.69 18 0.75 58 2.38 61 2.41 66 2.62 

B81080 2,216 57 2.09 71 2.58 65 2.52 58 2.49 60 2.66 70 3.16 

B81616 2,571 75 2.74 75 2.77 86 3.12 82 3.03 73 2.79 81 3.15 

B81002 3,844 52 1.79 61 2.05 64 2.11 67 2.22 74 2.44 105 2.73 

B81112 3,498 88 2.22 83 2.17 76 2.07 80 2.22 82 2.27 85 2.43 

B81119 4,593 115 1.90 97 1.66 108 2.40 107 2.34 119 2.53 129 2.81 

B81634 3,044 44 1.41 48 1.55 55 1.76 70 2.26 67 2.19 68 2.23 

B81674 2,241 59 3.43 69 3.95 71 3.94 77 3.96 87 4.13 94 4.19 



Code Latest 

list 

size 

Number and prevalence on hypothyroidism QOF register over time 

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81675 9,476 78 1.77 83 1.93 83 1.73 171 3.18 178 1.86 181 1.91 

B81685 2,444 47 1.84 52 1.98 52 2.01 69 2.69 71 2.80 72 2.95 

B81688 2,009 52 2.58 49 2.40 57 2.75 56 2.67 62 2.94 62 3.09 


B81027 5,976 189 3.00 180 3.00 176 2.97 189 3.16 190 3.16 195 3.26 

B81040 16,805 173 1.05 202 1.23 260 1.55 303 1.78 359 2.12 386 2.30 

B81047 7,377 164 2.18 184 2.49 181 2.48 175 2.42 166 2.29 174 2.36 

B81089 3,583 60 1.87 68 2.09 78 2.34 80 2.36 82 2.31 93 2.60 

B81631 3,425 73 2.26 70 2.23 81 2.55 87 2.68 91 2.66 95 2.77 

B81683 1,644 34 2.21 28 1.76 27 1.77 29 2.00 31 2.04 32 1.95 


B81017 6,800 109 1.48 130 1.85 137 1.90 151 2.08 204 2.99 184 2.71 

B81018 6,602 83 1.27 109 1.66 124 1.83 140 2.08 136 2.04 177 2.68 

B81032 2,478 49 1.61 46 1.54 39 1.41 53 1.95 47 1.79 50 2.02 

B81046 9,068 206 2.42 213 2.52 228 2.53 247 2.81 257 2.88 269 2.97 

B81692 1,814 4 0.21 8 0.40 9 0.49 12 0.67 18 1.00 21 1.16 

Y00955 2,556 N/A N/A 20 2.98 29 1.75 51 2.29 52 2.05 55 2.15 



number of people with diagnosed hypothyroidism (Doncaster PCT 2008). In general 




in a particular PCT area. Therefore, the accuracy of the estimates depend on the quality 

of the initial research and the modelling itself. If the original research did not include 

very deprived areas, it is very difficult to generalise and apply the model to very deprived 
















The model uses age-gender-specific prevalence estimates to calculate the number of 

people with hypothyroidism. No adjustments were made for other factors such as 



ethnicity or deprivation. The initial prevalence estimates were obtained from morbidity 

statistics from general practice relating to 1991-1992 (Office for Population Censuses 

and Surveys 1995). These figures were then adjusted in the light of overall community 

prevalence rates taken from the Whickham studies (Vanderpump, Tunbridge et al. 1995; 

Vanderpump and Tunbridge 2002). This original study documented the prevalence of 

thyroid disorders in a randomly selected sample of 2,779 adults which was matched to 

the Great Britain population in terms of age, sex and social class. As part of the 20 year 

follow-up, subjects were traced (825 patients had died), and of the 1,877 known 

survivors, 96% participated in the follow-up study and 91% were tested for clinical, 

biochemical and immunological evidence of thyroid dysfunction. Levels of „spontaneous 

hypothyroidism‟ were estimated from the information collected. The model may slightly 

underestimate the prevalence rates as it does not include patients with hypothyroidism 

due to other causes. As the survey examined clinical, biochemical and immunological 

evidence in a community-based population, the estimate appears to include 

undiagnosed cases of hypothyroidism as well as diagnosed cases. 

The results of the modelling and the actual diagnosed numbers of patients with 

hypothyroidism are given in Table 313. The model does not necessarily represent the 

actual number of people who should be diagnosed with hypothyroidism for each 

practice; it is only a guide. The characteristics of each practice differ and need to be 

considered. Overall for Hull, there is a considerable discrepancy between the numbers 

on the disease register and the estimated numbers from the model, with more patients 

diagnosed with hypothyroidism locally compared to that predicted by the model. 





2010. 

Table 313: Actual diagnosed and modelled hypothyroidism numbers, September 2010 

Code Practice name List size Numbers with hypothyroidism 






B81056 Springhead Medical Centre* 13,813 540 285 255 

B81104 Dr JK Nayar 6,553 49 48 1 

B81635 Dr G Dave 2,979 141 68 73 

B81662 Mizzen Road Surgery 1,720 89 41 48 


Y02747 Kingswood Surgery 1,380 19 17 2 

B81020 Dr PC Mitchell & Partners* 7,436 218 150 68 


B81075 Dr MK Mallik 2,197 61 53 8 








B81085 Dr JW Richardson & Ptnrs 5,302 195 120 75 

B81094 Dr AK Datta 1,790 59 35 24 

B81095 Dr Cook 4,145 139 93 46 

B81097 Dr RD Yagnik 1,689 97 38 59 

B81690 Dr SK Ray 1,650 46 29 17 





B81052 Dr J Musil And PJ Queenan 5,736 161 95 66 


B81644 Dr KK Mahendra 2,229 77 38 39 




B81057 Dr S MacPhie & Koul* 3,185 78 64 14 

B81074 Dr AK Rej 3,534 102 70 32 



B81646 Dr M Shaikh 1,822 54 36 18 

B81682 Dr M Shaikh & Partners 3,780 156 75 81 






B81616 Dr GT Hendow 2,539 81 51 30 





B81674 Dr JC Joseph 2,246 97 41 56 


B81685 Dr NA Poulose 2,394 75 39 36 

B81688 Dr KV Gopal 2,023 63 32 31 

Y02344 Northpoint 2,021 40 33 7 


B81040 Dr PF Newman & Partners* 16,721 386 312 74 

B81047 Dr JN Singh & Partners 7,505 183 124 59 

B81089 Dr Witvliet 3,593 93 60 33 

B81631 Dr R Raut 3,438 97 46 51 

















HULL 288,935 8,581 5,348 3,233 

*The number of patients with hypothyroidism was zero in the QMAS extract taken in Septmeber 

2010, so the number from the QOF figures for March 2010 have been used. 



10.8 Palliative Care 

10.8.1 Actual and Modelled Prevalence 



various conditions can be estimated. One such register is for those requiring palliative 

care. However, there may be a high proportion of patients who might benefit from 

palliative care but do not formally receive it (and might have been excluded from the 

register). Furthermore, the figures are unadjusted for influencing factors, such as the 

age of the patients and deprivation. Practices with a high proportion of elderly patients 

and practices in the most deprived areas will tend to have a higher need for palliative 

care, and possibly more likely not to be included on the register. See section 12.13 on 

page 782 for more information on QOF and issues associated with presenting the 

prevalence at practice level. Also see Table 28 and Table 49 for mean age of patients 

and mean deprivation scores for each practice (which will influence the prevalence on 

the disease registers). 

Table 314 presents the prevalence of palliative care for all the general practices in Hull 

for 2009/10 based on these disease registers. The latest list size refers to the registered 






Table 314: Prevalence of palliative care based on GP disease registers 2009/10 

Practice 

code 


population 

Prevalence of palliative care on 


N % 

B81035 Dr W G T Sande & Partners 6,114 6 0.10 

B81056 The Springhead Medical Centre 13,489 6 0.04 

B81104 Dr J K Nayar 7,721 0 0.00 

B81635 Dr G Dave 2,967 9 0.30 




B81020 Dr P C Mitchell & Partners 7,512 12 0.16 


B81075 Dr M K Mallik 2,263 1 0.04 

B81085 Dr J W Richardson & Partners 5,299 10 0.19 

B81094 Dr A K Datta 1,925 2 0.10 

B81095 Dr Cook 4,242 12 0.28 

B81097 Dr R D Yagnik 1,688 2 0.12 

B81690 Dr S K Ray 1,734 11 0.63 



Practice 

code 


population 



N % 


B81008 Dr J S Parker & Partners 15,062 9 0.06 

B81048 Dr S M Hussain & Partners 9,048 6 0.07 

B81049 Dr V A Rawcliffe & Partners 9,354 13 0.14 

B81052 Dr J Musil & P J Queenan 5,740 3 0.05 

B81072 Dr R Percival & Partners 7,807 14 0.18 



B81011 Wheeler Street Healthcare 5,243 11 0.21 

B81038 Dr A A Mather & Partners 7,732 14 0.18 


B81074 Dr A K Rej 3,639 5 0.14 



B81646 Dr M Shaikh 1,949 2 0.10 


B81053 Diadem Medical Practice 10,232 3 0.03 

B81054 Dr M J Varma & Partners 10,851 13 0.12 




B81616 Dr G T Hendow 2,571 34 1.32 


B81112 Dr Ghosh Raghunath & Prtners 3,498 26 0.74 

B81119 Dr G Palooran & Partners 4,593 27 0.59 


B81674 Dr J C Joseph 2,241 2 0.09 

B81675 Dr Tak & Dr Stryjakiewicz 9,476 17 0.18 

B81685 Dr N A Poulose 2,444 9 0.37 

B81688 Dr K V Gopal 2,009 9 0.45 

Y02344 Northpoint 1,645 4 0.24 

B81027 St Andrews Group Practice 5,976 5 0.08 

B81040 Dr P F Newman & Partners 16,805 20 0.12 

B81047 Dr J N Singh & Partners 7,377 10 0.14 

B81089 Dr Witvliet 3,583 6 0.17 

B81631 Dr R Raut 3,425 6 0.18 

B81683 Dr A S Raghunath & Partners 1,644 2 0.12 

Y02896 Story St Pract & Walk In Centr 343 0 0.00 

B81017 Kingston Medical Group 6,800 18 0.26 

B81018 Dr R K Awan & Partners 6,602 1 0.02 

B81032 Dr A W Hussain & Partners 2,478 4 0.16 

B81046 Dr J D Blow And Partners 9,068 15 0.17 

B81692 The Quays Medical Centre 1,814 2 0.11 

Y00955 Riverside Medical Centre 2,556 6 0.23 


North Locality 68,517 219 0.32 



Practice 

code 


population 



N % 

North Locality* 67,555 219 0.32 

East Locality 83,180 108 0.13 

West Locality 137,513 176 0.13 

West Locality* 137,029 176 0.13 

HULL 289,210 503 0.17 

HULL* 287,764 503 0.17 





Table 315 presents the prevalence of palliative care for 2009/10 for Hull and 

comparator areas (see section 3.3.3 on page 44), as well as for England. 

Table 315: Prevalence of palliative care based on GP disease registers 2009/10, Hull 


PCT 

Number on 

palliative care 

Palliative care 

unadjusted 




England 8,305 54,836,561 74,907 0.14 

Hull 60 289,210 503 0.17 

Sunderland 55 284,551 576 0.20 

Middlesbrough 25 153,187 184 0.12 

Salford 54 242,922 474 0.20 

Derby City 33 294,438 377 0.13 

Leicester City 66 360,251 247 0.07 

Coventry 65 357,743 326 0.09 

Wolverhampton 55 258,235 414 0.16 

Sandwell 67 339,020 487 0.14 

Stoke-On-Trent 57 280,265 403 0.14 

Plymouth 43 270,338 279 0.10 

Average of 10 520 2,840,950 3,767 0.13 

NE Lincs 34 169,565 300 0.18 

The number and prevalence of patients on the palliative care GP QOF register is 

illustrated over time in Table 316 for 2006/07 to 2009/10 (the registers were introduced 

during 2004/05 but the palliative care measure was introduced 2006/07). The latest list 

size refers to the registered population as at 1 st January 2010, but the number and 

prevalence on the disease register is as at 31 st March 2010 (the same definitions used 

in QOF), and this means that the prevalence can be biased if large population changes 

have occurred over this three month period (e.g. Y02747, Y02786, Y02896 and Y02748 

all opened between 5 th October 2009 and 11 th January 2010). The latest list size for 





Table 316: Numbers and prevalence of actual palliative care on GP QOF registers, 

2004/05 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on palliative care QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81035 6,114 10 0.16 9 0.15 6 0.10 6 0.10 

B81056 13,489 10 0.08 9 0.07 7 0.05 6 0.04 

B81104 7,721 0 0.00 0 0.00 0 0.00 0 0.00 

B81635 2,967 6 0.19 12 0.39 12 0.40 9 0.30 

B81662 1,856 1 0.04 3 0.13 5 0.23 2 0.11 

Y01200 1,765 1 0.06 1 0.06 2 0.12 3 0.17 


B81020 7,512 8 0.11 16 0.22 8 0.11 12 0.16 

B81021 7,257 4 0.06 6 0.08 5 0.07 6 0.08 

B81075 2,263 2 0.08 1 0.04 1 0.04 1 0.04 

B81085 5,299 6 0.11 8 0.15 3 0.06 10 0.19 

B81094 1,925 1 0.04 1 0.04 2 0.09 2 0.10 

B81095 4,242 1 0.03 1 0.02 6 0.15 12 0.28 

B81097 1,688 1 0.06 7 0.42 5 0.30 2 0.12 

B81690 1,734 0 0.00 0 0.00 2 0.11 11 0.63 

B81001 3,358 3 0.10 5 0.17 7 0.21 6 0.18 

B81008 15,062 22 0.15 19 0.13 19 0.13 9 0.06 

B81048 9,048 7 0.08 7 0.08 9 0.10 6 0.07 

B81049 9,354 2 0.02 4 0.05 5 0.05 13 0.14 

B81052 5,740 0 0.00 1 0.02 2 0.04 3 0.05 

B81072 7,807 14 0.20 15 0.21 14 0.18 14 0.18 

B81644 2,245 0 0.00 1 0.05 0 0.00 1 0.04 



B81011 5,243 10 0.18 8 0.15 10 0.19 11 0.21 

B81038 7,732 5 0.06 8 0.10 18 0.24 14 0.18 

B81057 3,345 2 0.05 3 0.08 1 0.03 1 0.03 

B81074 3,639 4 0.06 6 0.10 7 0.18 5 0.14 

B81081 3,520 3 0.09 1 0.03 7 0.20 4 0.11 

B81645 2,128 3 0.11 5 0.19 7 0.31 9 0.42 

B81646 1,949 0 0.00 2 0.08 1 0.05 2 0.10 

B81682 3,726 4 0.11 6 0.16 14 0.38 5 0.13 

B81053 10,232 9 0.09 9 0.09 8 0.08 3 0.03 

B81054 10,851 4 0.04 3 0.03 9 0.08 13 0.12 

B81058 8,722 1 0.01 10 0.11 6 0.07 19 0.22 

B81066 2,522 7 0.29 7 0.29 5 0.20 3 0.12 

B81080 2,216 8 0.31 7 0.30 7 0.31 12 0.54 

B81616 2,571 6 0.22 3 0.11 5 0.19 34 1.32 

B81002 3,844 1 0.03 2 0.07 11 0.36 18 0.47 

B81112 3,498 0 0.00 3 0.08 18 0.50 26 0.74 

B81119 4,593 2 0.04 1 0.02 7 0.15 27 0.59 

B81634 3,044 2 0.06 2 0.06 5 0.16 27 0.89 

B81674 2,241 0 0.00 3 0.15 7 0.33 2 0.09 

B81675 9,476 5 0.10 5 0.09 2 0.02 17 0.18 



Code Latest 

list 

size 

Number and prevalence on palliative care QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81685 2,444 1 0.04 3 0.12 3 0.12 9 0.37 

B81688 2,009 6 0.29 6 0.29 14 0.66 9 0.45 

Y02344 1,645 N/A N/A N/A N/A 2 0.10 4 0.24 

B81027 5,976 8 0.14 5 0.08 3 0.05 5 0.08 

B81040 16,805 27 0.16 16 0.09 1 0.01 20 0.12 

B81047 7,377 12 0.16 7 0.10 4 0.06 10 0.14 

B81089 3,583 10 0.30 9 0.27 3 0.08 6 0.17 

B81631 3,425 2 0.06 4 0.12 4 0.12 6 0.18 

B81683 1,644 0 0.00 2 0.14 2 0.13 2 0.12 


B81017 6,800 1 0.01 11 0.15 12 0.18 18 0.26 

B81018 6,602 10 0.15 4 0.06 2 0.03 1 0.02 

B81032 2,478 2 0.07 5 0.18 4 0.15 4 0.16 

B81046 9,068 9 0.10 8 0.09 8 0.09 15 0.17 

B81692 1,814 0 0.00 1 0.06 1 0.06 2 0.11 

Y00955 2,556 3 0.18 2 0.09 4 0.16 6 0.23 



number of people requiring palliative care (Doncaster PCT 2008). 


undertaken elsewhere in the UK examining the prevalence in the community, which has 




















The model for palliative care uses information from the Office for National Statistics 

(Office for National Statistics 2006), to estimate the percentage of people within their last 



year of life. The model rates were adjusted so that they were zero for those aged under 

18 years (the rates for those aged 15-19 years was multiplied by two-fifths to account for 

those aged 18-19 years). The overall rates were then multiplied by eleven-twelfths to 

account for the fact that “about a twelfth of the population will die suddenly with little or 

no warning” (The Gold Standards Framework 2006) as palliative care will not be 

required. In a similar method to that described for CHD (page 447) and COPD (page 

613), the model estimates the number of people requiring palliative care by assuming 

these prevalence estimates for each age-gender group (step 1), adjusting these 

resulting estimates by the all age all cause standardised mortality ratio (e.g. Hull‟s all 

age all cause 2005-2007 SMR was 123 so the stage 1 numbers would be increased by 

23% (step 2) and by then adjusting the resulting estimates by a deprivation score (UV67 

derived from 2001 Census information) produced at practice level (step 3). This practice 

deprivation score (from step 3) is first divided by the „expected‟ (UV67) score for Hull to 

avoid „double-counting‟ the effect of deprivation (step 2 and step 3 both adjusted for 

deprivation). 

The results of the modelling and the actual numbers of patients requiring palliative care 


people requiring palliative care for each practice; it is only a guide. The characteristics 

of each practice differ and need to be considered. It can be seen that there is a large 

discrepancy between the estimated numbers on the register and the model. It is 

possible that the register is too low and more patients should be on the palliative care 

register. It is not known if the model over-estimates the number who should be on the 

register or not. 





2010. 

Table 317: Actual requiring and modelled palliative care numbers, September 2010 

Code Practice name List size Numbers requiring palliative care 







B81104 Dr JK Nayar 6,553 2 8 -6 

B81635 Dr G Dave 2,979 16 35 -19 













B81075 Dr MK Mallik 2,197 0 42 -42 


B81094 Dr AK Datta 1,790 2 15 -13 

B81095 Dr Cook 4,145 16 55 -39 

B81097 Dr RD Yagnik 1,689 3 25 -22 

B81690 Dr SK Ray 1,650 10 12 -2 












B81074 Dr AK Rej 3,534 4 41 -37 



B81646 Dr M Shaikh 1,822 6 20 -14 







B81616 Dr GT Hendow 2,539 39 27 12 





B81674 Dr JC Joseph 2,246 2 28 -26 


B81685 Dr NA Poulose 2,394 8 16 -8 

B81688 Dr KV Gopal 2,023 40 13 27 

Y02344 Northpoint 2,021 7 17 -10 




B81089 Dr Witvliet 3,593 6 37 -31 

B81631 Dr R Raut 3,438 11 16 -5 

















HULL 288,935 586 3,151 -2,565 



10.9 Mental Health 

10.9.1 Introduction 

It is relatively difficult to assess the impact of poor mental health. Information relating to 

the prevalence of mental health is limited with generally only information on the 

prevalence of serious mental health conditions such as schizophrenia etc. The numbers 

of people requiring hospital admission or who die from mental health conditions is small 

and therefore it is not straightforward to present the information. As well as there being 

limited information on the prevalence and impact of less serious mental health 

conditions, the assessment of mental health is made more difficult as people may 

choose not to seek help and it is possible that a large proportion of mental ill-health is 

undiagnosed. 

There are some measures of mental health and well-being that can be examined locally. 

A survey examining aspects of social capital in relation to health was conducted during 

2004 in Hull (Hunter, Lee et al. 2005). A further survey specifically on social capital has 

been completed during 2009, and the findings from this survey are presented below. 

The Health and Lifestyle Survey conducted during 2007 also collected information on 

social capital as well as the Black and Minority Ethnic (BME) Health and Lifestyle Survey 

2007 and the Gypsy and Traveller Health and Lifestyle Survey 2007 which all used the 

same questionnaire. The Young People Health and Lifestyle Survey 2008-09 also 

collected information on feelings of safety and the frequency of being happy and sad. 

See section 13.2 on page 790 for more information about the local surveys. The full 

reports from these surveys are all available at www.hullpublichealth.org. Social capital 

examines feelings of safety when walking around after dark in the community, civic 

engagement, neighbourliness, social networks and social support. It is argued that 

improved social capital can have a positive influence on the mental health and wellbeing 

of the people living in the community. However, it should also be noted that there 

can sometimes be a negative effect with improved social capital such as social networks 

which, for example, lead to easier access to smuggled tobacco or drugs, peer-pressure 

to continue smoking or eating a poor diet. These surveys also included questions 

relating to mental health which form the Mental Health Index, and the Health and 

Lifestyle Survey included the Health Utility Index which included an emotional health 

component. The Social Capital Surveys of 2004 and 2009 also measured perceived 

levels of stress and pressure over the last year. 

To assess „need‟ for mental health services, it is also possible to examine the number 

and percentage of Incapacity Benefit and Severe Disablement Allowance claimants 

where the main reason for the claim was mental health. 

There are GP registers for dementia and serious mental health as part of the Quality 

and Outcomes Framework (QOF), and the prevalence of these conditions can be 

examined for each practice in Hull. 



The estimated number of people and projected population estimates for Hull residents 

aged 65+ years who have depression are given in Table 388. 

10.9.2 Measures of Social Capital 

The information presented below is from the Social Capital Survey 2009. More details 

are available in the full survey report at www.hullpublichealth.org. 

10.9.2.1 Feeling Safe in the Community 

The overwhelming majority of survey respondents felt very safe or fairly safe when 

walking alone in their area during the daytime, with generally around 1-2% of each 

subgroup feeling very unsafe. A little over half of respondents felt very safe or fairly safe 

walking alone in their area after dark, 68% of men and 36% of women (Figure 231), 

while 20% never go out after dark. Although the young were the most likely group to 

feel very unsafe or a bit unsafe (35% aged 16-24 years), the old were more likely to 

never go out (60% aged 75+ years) than the young (6% aged 16-24 years). Feelings of 

safety after dark increased as deprivation decreased. The underlying data are given in 


Figure 231: Feeling very safe or fairly safe walking alone in area after dark 

Percent 

75% 

50% 

25% 

0% 

Males 

Females 

16-24 

25-34 

35-44 

45-54 

55-64 

65-74 

75+ 

Gender Age band Locality Deprivation quintile 


North 

East 

West 

Most 

2 

3 

4 

Least


10.9.2.2 Civic Engagement 

Civic engagement is a measure of the degree to which people participate in community 

life, and the extent to which they feel empowered to change their society. Figure 232 

examines the percentages of residents who feel that they are well-informed about things 

which affect their local area and who feel that they can influence local decisions that 

affect their area. There was little difference between men and women in relation to 

being well informed or feelings about ability to influence local decisions being made, but 

there were quite large differences among the age groups. The youngest age group felt 

the least informed and fewer of them felt they could influence local decisions, and whilst 

the percentage who felt well informed increased with age so that the eldest felt the most 

informed, this pattern was not the same in relation to influencing decisions. The middle 

age group (45-54) had the highest percentage who felt they could influence decisions 

(41%), with the youngest and oldest age groups having the lowest percentages (26% 

and 32% respectively). Feeling informed or able to influence decisions increased as 

deprivation decreased. The underlying data are given in the APPENDIX on page 932. 

Figure 232: Degree of civic engagement 

Percent 

80% 

60% 

40% 

20% 

0% 

Males 

Females 

16-24 

25-34 

35-44 

45-54 

55-64 

65-74 

75+ 


Well informed about local issues Ability of influence local decisions 


North 

East 

West 

Most 

2 

3 

4 

Least


10.9.2.3 Neighbourliness 

Neighbourliness examines the extent of interaction, trust and reciprocity between 

neighbours. Table 318 gives the percentages of responders who trust their neighbours. 

The level of trust increase with age, and with lower levels of deprivation. 

Table 318: Level of trust in neighbourhood 

Group Number 

answering 

question 

How many neighbours trusted (%) 

Most Many A few None Don’t 

know 

Males 1,950 50.2 15.9 24.9 6.0 3.0 

Females 2,098 48.8 16.3 26.9 4.7 3.3 

Aged 16-24 686 36.3 16.6 35.3 7.4 4.4 

Aged 25-34 664 37.0 20.9 30.3 7.1 4.7 

Aged 35-44 711 46.3 15.8 27.4 7.3 3.2 

Aged 45-54 657 52.4 15.5 24.5 4.6 3.0 

Aged 55-64 538 56.9 15.6 23.4 2.4 1.7 

Aged 65-74 422 65.9 11.8 18.0 2.8 1.4 

Aged 75+ 365 67.7 14.2 13.4 2.5 2.2 

North Locality resident 918 47.3 14.9 30.8 4.8 2.2 

East Locality resident 1,498 52.2 16.4 23.4 4.9 3.1 

West Locality resident 1,632 48.2 16.5 25.5 6.1 3.7 

Most deprived local quintile 695 38.3 14.5 35.1 9.4 2.7 

Quintile 2 737 37.2 12.8 39.6 7.3 3.1 

Quintile 3 910 48.4 15.8 26.2 5.6 4.1 

Quintile 4 751 53.0 20.6 19.6 3.5 3.3 

Least deprived local quintile 955 65.3 16.6 13.5 2.1 2.4 

Overall 4,048 49.5 16.1 25.9 5.3 3.1 



Table 319 gives the percentages who feel that their neighbours „look out for each other‟. 

The findings are similar to those reported for trust of neighbours suggesting that people 

who trust their neighbours also feel that their neighbours „look out for each other‟. 

Table 319: Feel neighbours „look out for each other‟ 

Group Number 

answering 

question 

Neighbours ‘look out for each other’ 

(%) 


Males 1,955 74.0 19.1 6.9 

Females 2,099 73.6 19.4 7.0 

Aged 16-24 685 64.8 26.3 8.9 

Aged 25-34 665 73.4 17.4 9.2 

Aged 35-44 711 75.7 17.9 6.5 

Aged 45-54 659 77.2 17.0 5.8 

Aged 55-64 539 73.1 21.0 5.9 

Aged 65-74 423 76.6 17.3 6.1 

Aged 75+ 367 79.3 16.3 4.4 

North Locality resident 921 72.3 21.5 6.2 

East Locality resident 1,501 77.7 16.0 6.3 

West Locality resident 1,632 71.0 21.1 8.0 

Most deprived local quintile 695 65.3 26.8 7.9 

Quintile 2 739 70.6 22.7 6.6 

Quintile 3 911 71.5 19.9 8.7 

Quintile 4 753 76.8 17.4 5.8 

Least deprived local quintile 956 82.2 12.1 5.6 

Overall 4,054 73.8 19.3 6.9 



10.9.2.4 Social Networks 

Social networks were also examined as part of the Health and Lifestyle Survey. Figure 

233 illustrates the frequency of speaking to non-household family members. Over half 

of survey respondents spoke to family members (other than those they lived with) on 

most days, with many more women (68.0%) than men (51.4%) doing so. There is 

relatively little difference among age groups and deprivation quintiles. Around 90% 

speak to non-household family most days or weekly. The underlying data are given in 


Figure 233: Frequency of speaking to non-household family 

Percent 

100% 

80% 

60% 

40% 

20% 

0% 

Males 

Females 

16-24 

25-34 

35-44 

45-54 

55-64 

65-74 

75+ 


Weekly Most days 


North 

East 

West 

Most 

2 

3 

4 

Least


Figure 234 illustrates the frequency of speaking to friends who are not family members 

or neighbours. Compared to the frequency of speaking to family, it can be seen that 

there is a larger difference among the age groups. Around four-fifths of those aged 16- 

24 years speak to friends most days, whereas in the 75+ year age group this falls to less 

than 50%. The underlying data are given in the APPENDIX on page 933. 

Figure 234: Frequency of speaking to friends who are not family or neighbours 

Percent 

100% 

80% 

60% 

40% 

20% 

0% 

Males 

Females 

16-24 

25-34 

35-44 

45-54 

55-64 

65-74 

75+ 




North 

East 

West 

Most 

2 

3 

4 

Least


Figure 235 illustrates the frequency of speaking to neighbours who are not family or 

friends. Communication with neighbours is less frequent than with family or friends. In 

a similar manner to Figure 234, there are only small differences among the groups with 

the exception of age with shows the reverse relationship to that observed for friends in 

Figure 234. Around 30% of those aged 16-24 years speak to neighbours most days, 

but this increases with age to 63% of those aged 65-74 years and 55% of those aged 

75+ speaking to neighbours most days. The underlying data are given in the 


Figure 235: Frequency of speaking to neighbours who are not family or friends 

Percent 

100% 

80% 

60% 

40% 

20% 

0% 

Males 

Females 

16-24 

25-34 

35-44 

45-54 

55-64 

65-74 

75+ 




North 

East 

West 

Most 

2 

3 

4 

Least


Table 320 gives the frequency of speaking to family, friends or neighbours. Overall, 

85% of respondents speak to family, friends or neighbours most days and virtually all 

respondents people speak to one or more of these groups of people at least weekly. 

0.5% speak to family, friends or neighbours monthly or bi-monthly and a further 0.2% 

speak to these people annually or have not spoken to these people within the last year. 

So whilst the percentage who could be socially isolated 62 are small, they could add up to 

a small but significant total number across all of Hull. 

Table 320: Frequency of speaking to family, friends or neighbours 

Group Number Frequency of speaking to family, 

answering friends or neighbours (%) 

question 

63 

Most 

days 

Weekly Monthly Rarely 

Males 1,954 81.5 17.6 0.6 0.3 

Females 2,099 87.9 11.6 0.4 0.0 

Aged 16-24 685 91.2 8.5 0.1 0.1 

Aged 25-34 665 86.2 13.1 0.6 0.2 

Aged 35-44 711 82.3 17.4 0.1 0.1 

Aged 45-54 658 82.8 16.7 0.3 0.2 

Aged 55-64 539 80.5 18.6 0.6 0.4 

Aged 65-74 423 88.4 10.4 0.9 0.2 

Aged 75+ 367 81.2 17.7 1.1 0.0 

North Locality resident 921 84.9 14.8 0.2 0.1 

East Locality resident 1,501 85.7 13.9 0.3 0.1 

West Locality resident 1,631 84.1 15.0 0.7 0.2 

Most deprived local quintile 695 86.9 12.4 0.7 0.0 

Quintile 2 739 84.4 14.6 0.7 0.3 

Quintile 3 912 85.4 13.8 0.5 0.2 

Quintile 4 752 83.0 16.5 0.3 0.3 

Least deprived local quintile 955 84.6 15.1 0.2 0.1 

Overall 4,053 84.9 14.5 0.5 0.2 

62 These questions don‟t include contact with people within the same household and it is possible that 

some or many of these people who don‟t speak frequently to family, friends or neighbours could share a 

home with other family members to whom they speak frequently. 

63 Most days=daily or 4-6 days per week; Weekly=1-4 days per week; Monthly=1-2 times per month or bi- 

monthly; Rarely=1-2 times per year or less 



10.9.2.5 Social Support 

The Social Capital Survey also asked about the social support available. Overall, a 

large majority of respondents had someone they could contact if they were ill in bed and 

needed help at home (Table 321), although there were differences between deprivation 

quintiles and age bands with fewer older respondents and fewer respondents in the 

more deprived quintiles having people to help them. 

Table 321: Anybody to help if ill in bed and needed help at home 

Group Survey 

responders 

(N) 

Anybody to help if ill in bed and 

needed help at home (%) 

Yes No Don’t 

know 

Males 1,947 94.5 4.4 1.1 

Females 2,097 93.5 5.7 0.9 

Aged 16-24 682 96.3 3.1 0.6 

Aged 25-34 664 93.8 5.3 0.9 

Aged 35-44 710 94.4 4.6 1.0 

Aged 45-54 657 94.4 4.7 0.9 

Aged 55-64 538 93.1 5.4 1.5 

Aged 65-74 423 92.9 6.4 0.7 

Aged 75+ 365 90.7 7.9 1.4 

North Locality resident 918 95.1 4.2 0.7 

East Locality resident 1,498 94.0 5.1 0.9 

West Locality resident 1,628 93.3 5.5 1.2 

Most deprived local quintile 694 91.2 7.9 0.9 

Quintile 2 737 91.7 6.2 2.0 

Quintile 3 910 93.2 6.4 0.4 

Quintile 4 751 96.9 2.0 1.1 

Least deprived local quintile 952 96.1 3.3 0.6 

Overall 4,044 94.0 5.1 1.0 



The majority of people also had someone to turn to for comfort and support in a serious 

crisis (Table 322) with only 1.4% of the population who have no-one to turn to in a 

serious crisis. 

Table 322: Number of people to turn to for comfort and support in a serious crisis 

Group Survey 

responders 

(N) 

Number of people to turn to in 

serious crisis (%) 

0 1-3 4-6 7-10 >10 

Males 1,946 1.7 14.6 29.9 21.9 31.9 

Females 2,096 1.1 18.7 27.3 23.3 29.6 

Aged 16-24 685 0.6 11.2 25.7 26.1 36.4 

Aged 25-34 663 1.2 16.4 26.1 24.1 32.1 

Aged 35-44 711 1.1 13.4 30.4 24.5 30.7 

Aged 45-54 655 1.4 14.5 26.9 24.1 33.1 

Aged 55-64 536 2.2 21.1 27.6 22.0 27.1 

Aged 65-74 422 1.9 18.0 34.8 17.3 28.0 

Aged 75+ 365 2.2 30.4 31.8 14.2 21.4 

North Locality resident 918 1.3 15.3 28.1 23.9 31.5 

East Locality resident 1,497 1.4 15.8 27.1 23.6 32.1 

West Locality resident 1,627 1.5 18.4 30.2 21.1 28.9 

Most deprived local quintile 693 2.0 20.9 29.0 19.2 28.9 

Quintile 2 739 2.3 20.4 26.9 19.4 31.0 

Quintile 3 911 1.5 16.7 26.5 24.3 31.1 

Quintile 4 747 0.7 13.7 30.1 24.5 31.1 

Least deprived local quintile 952 0.7 13.2 30.3 24.7 31.1 

Overall 4,042 1.4 16.7 28.6 22.6 30.7 



The majority of people also had at least one relative or friend that they felt close to who 

lived within a 15-20 minute walk or 5-10 minute drive away (Table 323), but 17% had 

no-one close by who lived nearby. 

Table 323: Number of close relatives or friends living nearby 

Group Survey Number of close relatives or 

responders friends who live nearby 

(N) None One Three Five or 

or two or four more 

Males 1,951 18.4 23.7 19.0 38.9 

Females 2,097 15.9 28.3 20.0 35.8 

Aged 16-24 685 13.1 20.9 20.1 45.8 

Aged 25-34 664 14.9 24.1 18.7 42.3 

Aged 35-44 710 21.1 25.8 17.5 35.6 

Aged 45-54 657 14.9 27.1 19.8 38.2 

Aged 55-64 539 18.4 26.5 21.2 34.0 

Aged 65-74 423 20.1 27.4 18.4 34.0 

Aged 75+ 365 19.5 36.2 22.5 21.9 





Quintile 2 740 17.7 25.5 20.0 36.8 

Quintile 3 910 17.0 26.9 17.8 38.2 

Quintile 4 751 18.1 24.2 20.2 37.4 


Overall 4,048 17.1 26.1 19.5 37.3 

10.9.3 All Mental Health 

Information is presented on the prevalence of mental health and mental illness in the 

community, inpatient admissions and mortality. It is generally difficult to obtain this type 

of information as not all those who suffer from mental illnesses will consult at Primary 

Care level, and those suffering from mild forms of mental illness are not necessary 

recorded as such to due to potential problems associated with stigma, and this should 

be borne in mind when interpreting the findings. 

10.9.3.1 Diagnosed Prevalence of Serious Mental Health and Dementia 














will influence the prevalence on the disease registers). There are registers for dementia 

and serious mental health conditions (schizophrenia, bipolar disorder and other 

psychosis). 

Table 324 presents the information for dementia and serious mental health for all the 

general practices in Hull for 2009/10. The prevalence of learning disabilities from the 

QOF is presented in section 7.3 on page 158. The latest list size refers to the 

registered population as at 1 st January 2010, but the number and prevalence on the 

disease register is as at 31 st March 2010 (the same definitions used in QOF), and this 

means that the prevalence can be biased if large population changes have occurred 

over this three month period (e.g. Y02747, Y02786, Y02896 and Y02748 all opened 

between 5 th October 2009 and 11 th January 2010). 

Table 324: Prevalence of diagnosed dementia and serious mental health based on GP 


Practice Practice name Registered Prevalence on disease 

code 

population registers 2009/10 

Serious 

Dementia mental health 

N % N % 

B81035 Dr W G T Sande & Partners 6,114 23 0.38 43 0.70 

B81056 The Springhead Medical Centre 13,489 38 0.28 72 0.53 

B81104 Dr J K Nayar 7,721 2 0.03 31 0.40 

B81635 Dr G Dave 2,967 4 0.13 8 0.27 

B81662 Mizzen Road Surgery 1,856 3 0.16 11 0.59 

Y01200 The Calvert Practice 1,765 5 0.28 15 0.85 

Y02747 Kingswood Surgery 902 1 0.11 5 0.55 

B81020 Dr P C Mitchell & Partners 7,512 32 0.43 33 0.44 

B81021 Faith House Surgery 7,257 39 0.54 75 1.03 

B81075 Dr M K Mallik 2,263 1 0.04 4 0.18 

B81085 Dr J W Richardson & Partners 5,299 34 0.64 22 0.42 

B81094 Dr A K Datta 1,925 3 0.16 4 0.21 

B81095 Dr Cook 4,242 9 0.21 22 0.52 

B81097 Dr R D Yagnik 1,688 2 0.12 6 0.36 

B81690 Dr S K Ray 1,734 2 0.12 6 0.35 

B81001 Dr Ali & Partners 3,358 10 0.30 18 0.54 

B81008 Dr J S Parker & Partners 15,062 57 0.38 100 0.66 

B81048 Dr S M Hussain & Partners 9,048 23 0.25 61 0.67 

B81049 Dr V A Rawcliffe & Partners 9,354 25 0.27 77 0.82 

B81052 Dr J Musil & P J Queenan 5,740 14 0.24 84 1.46 




code 


Serious 


N % N % 

B81072 Dr R Percival & Partners 7,807 27 0.35 74 0.95 

B81644 Dr K K Mahendra 2,245 7 0.31 5 0.22 

Y02786 Priory Surgery 141 1 0.71 0 0.00 

B81011 Wheeler Street Healthcare 5,243 16 0.31 30 0.57 

B81038 Dr A A Mather & Partners 7,732 38 0.49 43 0.56 

B81057 Dr S MacPhie & Koul 3,345 12 0.36 31 0.93 

B81074 Dr A K Rej 3,639 10 0.27 22 0.60 

B81081 Dr K M Tang & Partner 3,520 10 0.28 14 0.40 

B81645 East Park Practice 2,128 11 0.52 19 0.89 

B81646 Dr M Shaikh 1,949 3 0.15 3 0.15 

B81682 Dr M Shaikh & Partners 3,726 8 0.21 18 0.48 

B81053 Diadem Medical Practice 10,232 60 0.59 67 0.65 

B81054 Dr M J Varma & Partners 10,851 28 0.26 125 1.15 

B81058 Dr M Foulds & Partner 8,722 66 0.76 75 0.86 

B81066 Dr G M Chowdhury 2,522 6 0.24 13 0.52 

B81080 Dr G S Malczewski 2,216 18 0.81 12 0.54 

B81616 Dr G T Hendow 2,571 11 0.43 20 0.78 

B81002 Dr A Kumar-Choudhary 3,844 4 0.10 26 0.68 

B81112 Dr Ghosh Raghunath & Prtners 3,498 18 0.51 43 1.23 

B81119 Dr G Palooran & Partners 4,593 19 0.41 32 0.70 

B81634 Dr J Venugopal 3,044 3 0.10 14 0.46 

B81674 Dr J C Joseph 2,241 11 0.49 19 0.85 

B81675 Dr Tak & Dr Stryjakiewicz 9,476 30 0.32 67 0.71 

B81685 Dr N A Poulose 2,444 2 0.08 11 0.45 

B81688 Dr K V Gopal 2,009 4 0.20 13 0.65 

Y02344 Northpoint 1,645 4 0.24 14 0.85 

B81027 St Andrews Group Practice 5,976 26 0.44 75 1.26 

B81040 Dr P F Newman & Partners 16,805 48 0.29 64 0.38 

B81047 Dr J N Singh & Partners 7,377 8 0.11 96 1.30 

B81089 Dr Witvliet 3,583 23 0.64 20 0.56 

B81631 Dr R Raut 3,425 5 0.15 23 0.67 

B81683 Dr A S Raghunath & Partners 1,644 6 0.36 10 0.61 

Y02896 Story St Pract & Walk In Centr 343 0 0.00 8 2.33 

B81017 Kingston Medical Group 6,800 12 0.18 104 1.53 

B81018 Dr R K Awan & Partners 6,602 3 0.05 43 0.65 

B81032 Dr A W Hussain & Partners 2,478 8 0.32 52 2.10 

B81046 Dr J D Blow And Partners 9,068 29 0.32 80 0.88 

B81692 The Quays Medical Centre 1,814 2 0.11 76 4.19 

Y00955 Riverside Medical Centre 2,556 4 0.16 51 2.00 

Y02748 Haxby Orchard Park Surgery 60 1 1.67 1 1.67 

North Locality 68,517 188 0.27 473 0.69 

North Locality* 67,555 186 0.28 467 0.69 

East Locality 83,180 322 0.39 430 0.52 

West Locality 137,513 419 0.30 1,307 0.95 




code 


Serious 


N % N % 

West Locality* 137,029 418 0.31 1,299 0.95 

HULL 289,210 929 0.32 2,210 0.76 

HULL* 287,764 926 0.32 2,196 0.76 





10.9.3.2 Frequency of Being Happy or Sad in Young People 

The Young People Health and Lifestyle Survey 2008-09 asked pupils how frequently 

they felt happy or sad. The majority stated that they were happy all, most or some of the 

time (Figure 236) with a small percentage stating that they were frequently sad (Figure 

237). The underlying data are given in the APPENDIX on page 935. 

Figure 236: Frequency of feeling happy in young people, 2008-09 

100% 

80% 

60% 

40% 

20% 

0% 

Year 7 Year 8 Year 9 Year 10 Year 11 Males Females 

School year Gender 

Rarely or 

never 

Not much 

of the time 

Some of 

the time 

Most if the 

time 

All of the 

time 



Figure 237: Frequency of feeling sad in young people, 2008-09 

100% 

80% 

60% 

40% 

20% 

0% 

Year 7 Year 8 Year 9 Year 10 Year 11 Males Females 

School year Gender 

All of the 

time 

Most if the 

time 

Some of 

the time 

Not much 

of the time 

Rarely or 

never 

10.9.3.3 Mental Health Index and Health Utility Index Emotional Health Score 

The Social Capital Surveys conducted during 2004 and 2009 and the adult Health and 

Lifestyle Survey undertaken during 2007 collected information on the Mental Health 

Index (MHI). The Mental Health Index is derived from five questions from the SF-36 

questionnaire (a frequently used questionnaire to assess physical and mental health: 

„short-form‟ with 36 questions). The five questions assessing mental health form a score 

which ranges from 5 to 30 with a higher score denoting better mental health. A 

transformed score can also be calculated with the difference being a change to the scale 

(0-100). Further information can be found in the reports produced for the Social Capital 

Surveys and the Health and Lifestyle Survey reports 2007 (main survey report involving 

4,086 residents of Hull who were representative of Hull‟s population in terms of age, 

gender and geography and the Black and Minority Ethnic group survey report involving 

1,163 residents of Hull). All these reports are available on our website 


From the 2009 Social Capital Survey, the median mental health transformed score was 

80 (denoting that half of survey responders had a score of 80 or more and half had a 

score of 80 or lower), although higher in men (85). Four in ten (42.0%) of men had a 

score of 86-100, compared with 30.6% of women, and just over one-quarter (26.0%) of 

women scored 0-60 compared with 18.1% of men. Older respondents scored more 

highly than the young, with a median value of 85 in those aged 65 years and over (and 

with 43.7% scoring 86-100) compared with a median score of 80 in those aged below 65 

years (with 36.2% of those aged 16-24 scoring 86-100). Medians were the same (80) 



for each deprivation quintile with the exception of the least deprived quintile, where the 

median score was 85 (with 41.5% scoring 86-100). 

The percentage of men and women with MHI scores 0-60, 61-75, 76-85 and 86-100 are 

given in Figure 238. The underlying data are given in the APPENDIX on page 936. 

Figure 238: Mental Health Index scores, 2009 

However, there were more substantial differences observed within the Black and 

Minority Ethnic group (BME) Health and Lifestyle Survey 2007. The survey responders 

for this survey are not necessarily representative of Hull‟s BME populations, so it is not 

known how generalisable these findings are to the entire BME population of Hull. 

Nevertheless, there is concern in relation to specific groups such as the asylum seekers 

where mental health appears to be poor. Figure 239 illustrates the percentage of 

people with MHI scores of 0-60, 61-75, 76-85 and 86-100 for all the 4,086 main survey 

responders and all the 1,163 BME survey responders based on their status in the UK 

(less a small proportion who failed to answer the questions). The underlying data are 




Figure 239: Mental Health Index scores from Health and Lifestyle Survey 2007 (main 

survey and BME survey combined) 

Mental Health Index score (%) 

100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

British Student Granted 

asylum 

Failed 

asylum 

seeker 

Refugee Working in 

UK 

temporarily 

Status in UK (main and BME surveys combined) 

86-100 (best) 76-85 61-75 0-60 (poorest) 

Working in 

UK longterm 

Other 

The Health and Lifestyle Survey 2007 also included questions from the Health Utility 

Index (HUI) which include a range of questions to measure physical and mental health 

including a question on emotional health. Further information is given in the full survey 

reports (main survey and BME survey) at www.hullpublichealth.org. The emotional 

health question from the HUI set of questions showed a similar pattern of poor mental 

health among groups depending on their status in the UK as denoted in Table 325. 

Almost one-third of failed asylum seekers stated that they were „so unhappy that life is 

not worthwhile‟ compared to 13% of those whose asylum had been granted and less 

than 4% for all other groups. 



Table 325: Emotional health based on Health Utility Index by status in UK, 2007 

Status in UK Number 

answering 

question 

Emotional health based on Health Utility Index (%) 

Happy and 

interested in 

life 

Somewhat 

happy 

Somewhat 

unhappy 

Very 

unhappy 

So unhappy 

that life is not 

worthwhile 

British 3,784 68.6 23.2 5.4 2.0 0.9 

Student 153 69.9 21.6 5.2 2.0 1.3 

Granted asylum 116 37.9 25.0 14.7 9.5 12.9 

Failed asylum seeker 188 17.0 14.9 13.3 22.9 31.9 

Refugee 157 60.5 22.9 5.7 7.0 3.8 

Working (temporarily) 244 87.3 10.2 1.6 0.4 0.4 

Working (long-term) 148 74.3 23.0 2.0 0.7 0.0 

Other 65 75.4 10.8 9.2 1.5 3.1 

10.9.3.4 Prevalence of Stress and Pressure 

The Social Capital Surveys 2004 and 2009 asked survey responders the amount of 

stress or pressure they had experienced over the past 12 months. Further more 

detailed information is available in the 2009 Social Capital Survey report available at 


Less than 10% of men and women aged 65-74 years and less than 6% of men and 

women aged 75+ year feel that they have experienced a large amount of stress or 

pressure in the last year, but this is higher in the younger age groups and highest in the 

middle age groups (Table 326). For those aged under 34 years, slightly higher 

percentages of women experience large amounts of stress or pressure compared to 

men, but for those aged 35-64 years, more men compared to women have experienced 

large amounts of stress and pressure over the last year. 



Table 326: Stress and pressure reported by age and gender, Social Capital Survey 2009 

Gender Age 

(yrs) 

Males 

Females 

Number 

answering 

question 

Stress and pressure within last 12 months (%) 

I have been completely 

free of stress or 

pressure 

I have experienced a 

small amount of stress 

or pressure 


moderate amount of 

stress or pressure 


large amount of stress 

or pressure 

18-24 337 22.8 17.8 15.9 10.2 

25-34 312 15.6 15.1 17.4 15.9 

35-44 362 14.2 15.5 21.3 27.0 

45-54 339 12.9 17.9 18.8 20.6 

55-64 258 11.0 13.8 13.4 15.2 

65-74 201 13.1 11.1 8.3 7.6 

75+ 142 10.4 8.8 4.8 3.5 

18-24 353 23.1 15.3 16.4 14.8 

25-34 349 12.8 16.7 18.0 18.3 

35-44 350 11.7 15.9 18.7 19.5 

45-54 318 10.1 14.4 15.5 20.7 

55-64 275 9.5 13.1 15.5 12.9 

65-74 217 12.5 13.0 8.0 8.1 

75+ 226 20.4 11.6 7.9 5.7 

10.9.3.5 Incapacity Benefit and Severe Disablement Allowance for Mental Health 

Reasons 

Information on claimant rates for incapacity benefit and severe disablement allowance 

claimants where the main reason for the claim is mental health reasons has already 

been presented in Table 42 for May 2009. Mental health is the commonest disease 

group given for claimants (39% of claimants). Myton ward in particular has the highest 

claimant rate with mental illness as the reason given for the claim (Figure 240). The 

claimant rate is strongly associated with deprivation. Therefore, it is not surprising that 

Myton has a high claimant rate as it is the third most deprived ward in Hull. However, 

the type of accommodation and the city centre location might have an additional 

influence. Cheaper accommodation and more supported housing and hostels are in the 

city centre ward of Myton compared to other wards in Hull. The underlying data are 

given in Table 42. 



Figure 240: Incapacity Benefit and Severe Disablement Allowance claimants with mental 

illness given as the reason for the claim for May 2009 (rate per 100 working-age 

population) 

Working population claiming IB/SDA for mental health 

reasons, May 2009 (%) 

8 

7 

6 

5 

4 

3 

2 

1 

0 



Kings Park 

Beverley 

Orchard Pk & Greenwood 

University 

Ings 

Longhill 

Sutton 

Holderness 


Marfleet 


Ward 


Drypool 

Myton 

Newington 

St Andrew's 

Boothferry 

Derringham 

Pickering 

Avenue 

Bricknell 

Newland


10.9.3.6 General Practitioner Consultations for Mental Health 

This section uses information given within the Mental Health Equity Audit (for full report 

see www.hullpublichealth.org). Whilst the information could have been updated for 

more recent population estimates, the majority of the prevalence estimates are national 

surveys have not been updated, so this will make relatively little difference to the 

estimates of the number of people within Hull with different mental illnesses. 

The fourth national study carried out by the Royal College of General Practitioners, the 

Office of Population Censuses and Surveys, and the Department of Health examined 

morbidity statistics in General Practice (McCormick, Fleming et al. 1995). This survey 

was conducted during 1991-1992 and provides the most up-to-date reasons why people 

consult their GP. The survey found that over 7% of people consulted for a mental illness 

which was 649 per 10,000 people. The prevalence was lowest among older children 

and increased with age. Among every age group in adults, the rate was higher for 

women than men. It is not stated specifically what conditions are classified as mental 

illness. However, from the tables and appendices it appears that mental illness was 

classified as organic psychotic conditions (ICD 9: 290-294), other psychoses (295-299), 

neurotic disorders, personality disorders and other non-psychotic mental disorders (300- 

316) and mental retardation (317-319). However, an acute reaction to stress or an 

adjustment reaction may be recorded by another doctor as a neurotic disorder or 

depression. Depression not elsewhere classified had a prevalence rate of 110 per 

10,000 persons, and special syndromes or syndromes not elsewhere classified a rate of 

97 per 10,000 persons. These were mainly disorders of sleep, and pains of mental 

origin (psychalgia). In addition, 26 per 10,000 consulted for acute reaction to stress, and 

36 for adjustment reaction. It is not entirely clear if these are classifications are included 

in the mental illness definition or whether they are additional conditions. However, it 

appears they are additional and the total consultation rate would increase from 649 to 

908 per 100,000 (40% increase). This would increase the consultation rate from 7% to 

9.8%. However, this is considerably lower than the 25% figure quoted by others for 

consultations related to mental health problems (Goldberg and Bridges 1987). It is likely 

that this is due to differing definitions and that reports indicate that only about 30% to 

50% of depression in primary care is recognised by GPs (Goldberg and Bridges 1987; 

Doherty 1997; Vazquez-Barquero and al 1997; Dixon, Raymond et al. 2006). 

Based on the prevalence calculated from the number of consultations from the 1991- 

1992 Survey, the estimated number of people in different geographical areas can be 

estimated in Hull (using resident population estimates for October 2005 64 ) assuming that 

the prevalence estimated above applies to the area for the current year. This 

assumption may be incorrect as there might have been an increase in the prevalence for 

various reasons, more people may be willing to see their GP about such problems as 

acceptance and attitudes towards mental illness may have changed over time, the 

64 It would be possible to update this using a more recent population file, but with the potential problems 

with the prevalence estimates, the tables only provide a guide only, and for this reason, the population 

figures for October 2005 will be sufficient, i.e. the estimates should be treated with caution. 



prevalence may be different as the rates do not apply to the local area for various 

reasons for example different levels of acceptance and stoicism, and there may have 

been changes in substance abuse, for example, drug dependence. Nevertheless, Table 

327 and Table 328 give the estimated number and percentage of people in the area 

with the conditions listed respectively, and give an indication of the degree of the 

problem but it is likely to be an underestimate. Further evidence since the early 1990s 

from the Sainsbury Centre (Boardman and Parsonage 2005) has consultation rates 

much higher (Boardman, Sillmott et al. 2004), with the gap between males and females 

much reduced. Therefore, the estimates in Table 327 should be treated with caution. 

Table 327: Estimated number of people within Hull with different mental illness (based 

on 1991-1992 GP consultation data for England and Wales and using October 2005 

population estimates for Hull) 

Condition (ICD 9 coding) Estimated number of people with the condition 

by age (years) and gender 

Males Males Females Females Total 

0-64 65+ 0-64 65+ 

Neurotic disorders (300) 2,320 396 5,088 1,121 8,925 

Unspecified anxiety states (300.0) 1,559 259 3,024 712 5,554 

Neurotic depression (300.4) 351 80 986 214 1,631 

Neurasthenia (300.5) 421 64 1,129 208 1,822 

(Other) depressive disorder (311) 650 170 1,633 396 2,849 

Drug dependence (304) 238 17 180 67 502 

Affective psychoses (296) 381 100 762 273 1,517 

Senile dementia (290.0) - 98 - 221 319 

Acute confusional state (293.0) - 69 - 117 186 

Manic depressive psychosis (296.0, 296.1) - 97 - 265 362 

Unspecified anxiety states (300.0) - 259 - 338 598 



It can be seen that whilst there is a relatively large number of people with different 

mental illnesses within Hull, this represents a small percentage of the overall population, 

but as mentioned above this is likely to be an underestimate particularly for men. 

Table 328: Estimated percentage of people within Hull with different mental illness 

(based on 1991-1992 GP consultation data for England and Wales and using October 

2005 population estimates for Hull) 

Condition (ICD 9 coding) Estimated percentage of people with the 

condition by age (years) and gender 

Males Males Females Females Total 

0-64 65+ 0-64 65+ 

Neurotic disorders (300) 2.0 2.5 4.8 5.3 3.4 

Unspecified anxiety states (300.0) 1.3 1.6 2.8 3.4 2.1 

Neurotic depression (300.4) 0.3 0.5 0.9 1.0 0.6 

Neurasthenia (300.5) 0.4 0.4 1.1 1.0 0.7 

(Other) depressive disorder (311) 0.6 1.1 1.5 1.9 1.1 

Drug dependence (304) 0.2 0.1 0.2 0.3 0.2 

Affective psychoses (296) 0.3 0.6 0.7 1.3 0.6 

Senile dementia (290.0) - 0.6 - 1.0 0.9 

Acute confusional state (293.0) - 0.4 - 0.6 0.5 

Manic depressive psychosis (296.0, 296.1) - 0.6 - 1.2 1.0 

Unspecified anxiety states (300.0) - 1.6 - 1.6 1.6 

The above percentages have not been applied to the population at Area level. As seen 

from Figure 240, there are large differences in the prevalence among the wards based 

on the claimant rate for Incapacity Benefit and Severe Disablement Allowance. 

Therefore, it would not be appropriate to estimate the number at Area level as the 

estimate depends on more than just age and gender, for example, deprivation and 

perhaps other factors such as accommodation type. 

10.9.3.7 Estimated Prevalence of Mental Health in Young People 

Table 329 gives the percentage of children with mental disorders by age and gender for 

2004 (Green, McGinnity et al. 2005). The sample for the survey was drawn from the 

Child Benefit Records held by the Child Benefit Centre. A total 12,298 opt out letters 

were dispatched, and 10,497 addresses were allocated to ONS interviewers after those 

who opted out or ineligible addresses were removed. Information was collected on 76% 

of the children. The issue of terminology is discussed and the survey deliberately uses 

the term “mental disorder” as distinct from psychiatric disorders or mental health 

problems. The questionnaires used in the survey were based on ICD10 diagnostic 

research criteria, and therefore mental disorders are defined to imply a clinically 

recognisable set of symptoms or behaviour associated in most cases with considerable 

distress and substantial interference with personal functions. If these figures were 



applied to the Hull population (as at October 2005 65 ), then there would be approximately 

3,800 children in Hull with these mental disorders (Table 330). 

Table 329: Percentage of mental disorders in children by age and gender (based on 

prevalence estimates from a national survey conducted during 2004) 

Type of mental disorder Mental disorders by age and gender, 2004 (%) 

Aged 5-10 years Aged 11-16 years 

Boys Girls Boys Girls 

Emotional disorders 2.2 2.5 4.0 6.1 

Anxiety disorders 2.1 2.4 3.6 5.2 

Depression 0.2 0.3 1.0 1.9 

Conduct disorders 6.9 2.8 8.1 6.6 

Hyperkinetic disorder 2.7 0.4 2.4 0.4 

Less common disorders* 2.2 0.4 1.6 1.1 

Any disorder 10.2 5.1 12.6 10.3 

Number of children (weighted) 2,010 1,916 2,101 1,950 

*Such as autistic spectrum disorder, tic disorders, eating disorders and mutism. 

Table 330: Estimated number of children with mental disorders in Hull (based on 

prevalence estimates from a national survey conducted during 2004 and using October 

2005 population estimates for Hull) 

Type of mental disorder Estimated number of children with mental disorders in 

Hull 

Aged 5-10 years Aged 11-16 years 

Boys Girls Boys Girls 

Emotional disorders 210 221 432 631 

Anxiety disorders 200 212 389 538 

Depression 19 27 108 197 

Conduct disorders 658 248 875 683 

Hyperkinetic disorder 257 35 259 41 

Less common disorders* 210 35 173 114 

Any disorder 972 451 1,362 1,066 

*Such as autistic spectrum disorder, tic disorders, eating disorders and mutism. 

65 It would be possible to update this using a more recent population file, but with the potential problems 

with the prevalence estimates, the tables only provide a guide only, and for this reason, the population 

figures for October 2005 will be sufficient, i.e. the estimates should be treated with caution. 



10.9.3.8 Prevalence of Mental Health in Prisoners 

From the Mental Health Equity Audit 2006/07 for Hull and East Riding of Yorkshire 

(available from www.hullpublichealth.org), the number of prisoners with mental illness 

across Hull and East Riding of Yorkshire was estimated from national prevalence 

figures. 

There are four prisons in Hull and East Riding of Yorkshire all holding male prisoners 

only. Details are given below on the type of prison and the operational capacity 66 from 

the Her Majesty‟s Prison Service website 67 . 

Everthorpe is a category C training prison which opened in 1958 as a borstal. It 

was converted to its present role in 1991 and now holds convicted male prisoners. 

In 2005 Everthorpe underwent a significant expansion programme, and now has 

operational capacity for 689 prisoners. 

Wolds was opened in 1992 as a remand prison and in 1993 was re-roled to a local 

category B prison holding sentenced prisoners, but Wolds is now for mid-term 

category C male prisoners including second stage lifers. There is an operational 

capacity of 350 prisoners. It is also a privately-run prison and as such has not 

gone through the transfer of healthcare services from the Home Office to the 

Department of Health. 

Hull is a Victorian Prison with extensive security work in 1969 and expansion in 

2002 to become a male local prison/remand centre with an operational capacity of 

1,000 and holds remand, sentenced and convicted adult males (except Category 

A) and young offenders. 

Full Sutton in East Riding of Yorkshire is a modern, purpose-build, maximum 

security prison for men in category A and category B with an operational capacity 

of 608 prisoners. The prison's primary function is to hold, in conditions of high 

security, some of the most difficult and dangerous criminals in the country. 

A review of 23,000 prisoners from 62 surveys from 12 countries found that prisoners 

were several times more likely to have psychosis and major depression, and about ten 

times more likely to have antisocial personality disorder than the general population 

(Fazel and Danesh, 2002). The prevalence of psychotic illness, major depression and 

personality disorder is estimated to be 3.7% and 4.0% for men and women respectively 

for psychotic illnesses, 10% and 12% for men and women respectively for major 

depression, and 65% and 52% for men and women respectively for personality disorder 

for the 18,530 men and 4,260 women who participated in the Fazel‟s research. Almost 

66 

Operational capacity (OC) is the maximum safe capacity of the prison population which is higher than 

the certified normal accommodation (CNA). 

67 

http://www.hmprisonservice.gov.uk/ It is not known if the capacity figures and other information from 

the website are entirely up-to-date. 



three-quarters (47% of the 65%) of men and half (21% of the 42%) of women with 

personality disorders had antisocial personality disorder. 

A smaller national survey conducted in the UK in 1997 (Singleton et al. 1997) involving 

1,250 male remand, 1,254 male sentenced, 218 female remand and 676 female 

sentenced prisoners found a higher prevalence of personality disorder and psychosis. 

The prevalence of personality disorder in men was found to be 78% in remand prisoners 

and 64% in sentenced prisoners and in women the prevalence was found to be 50%. 

The prevalence of psychosis was 7% in male sentenced, 10% in male remand and 14% 

in female prisoners. Neurotic disorders was also examined and it was found that the 

prevalence was 59%, 40%, 76% and 63% in male remand, male sentenced, female 

remand and female sentenced prisoners respectively. 

The studies reported in this review involving 23,000 prisoners were from different 

countries 68 , but the country with the second highest percentage – one quarter of all 

prisoners – was the UK. So from this, Singleton‟s study, and from anecdotal evidence it 

is likely that these findings apply to local prisons. Nevertheless, even if the prevalence 

of mental illness in local prisoners is different from that reported in these studies, it will 

still mean that there is a high number of local prisoners in need of mental health care. 

Assuming that the local prisons are full to capacity and that the prevalence of psychotic 

illnesses, major depression and personality disorder obtained from the international 

review apply to the population of all three prisons, then Table 331 gives the estimated 

number of male prisoners in each prison. It is likely that the prevalence of mental illness 

in Full Sutton is higher than Wolds, Everthorpe or Hull as Full Sutton only holds category 

A and B prisoners, whereas Wolds and Everthorpe only holds category C prisoners and 

Hull is a local prison also holding remand prisoners and does not hold any category A 

prisoners. The figures have been rounded to the nearest 5. 

Table 331: Estimated number of male prisoners with psychotic illness, major depression 

and personality disorder in Hull and East Riding of Yorkshire 

Condition Estimated number of male prisoners with condition 

assuming prison full to operational capacity 

Everthope Wolds Full Sutton Hull 

Psychotic illnesses 25 15 20 35 

Major depression 70 35 60 100 

Personality disorder 450 230 395 650 

There is a policy in the Hull prison to move acute mentally prisoners out within 14 days 

to specialist mental health services. Therefore, this will have an influence on the 

prevalence of some mental health conditions in that prison. This policy only applies to 

68 Studies were from Australia (598 prisoners), Canada (3,196), Denmark (583), Finland (1,317), Ireland 

(280), Netherlands (450), New Zealand (1,431), Norway (41), Spain (99), Sweden (103), UK (5,548) and 

the USA (9,144). 



acute cases and not to chronic cases. However, this policy had only been running a few 

weeks at the time of finalising the writing the equity audit and the immediate impact had 

not been assessed formally. 

As the four prisons for Hull and East Riding of Yorkshire only hold male prisoners, there 

is no easily available information on female residents of Hull and East Riding of 

Yorkshire who become remand and sentenced prisoners elsewhere. This could be 

viewed as an equity issue. As the number of female prisoners is small, they tend to be 

held further from their place of residence compared to male prisoners. Therefore it is 

more difficult for relatives and friends to visit, and more likely that the female prisoners 

will lose contact with family and friends. Continuity of care is also more difficult to 

achieve. These things would seem to be detrimental to mental health. This is not an 

issue that applies specifically to the Hull and East Riding PCTs, but is more of a national 

issue. 


A Mental Health Equity Audit was completed for Hull and East Riding of Yorkshire during 

2006/2007 (available from www.hullpublichealth.org). The equity audit examined 

prevalence, referrals to specialist services, hospital admissions and mortality relating to 

mental health by age, gender and deprivation quintile. Some other groups where 

potential inequalities may have been present were examined such as for different Black 

and Minority Ethnic (BME) groups, for prisoners, for Gypsy and Travellers and carers, 

etc, but examination of these groups was more limited owing to lack of data. The equity 

audit also examined potential programmes for reducing inequalities. 

The main findings are summarised as follows: 

There is a lack of information, particularly on prevalence of mental health and 

different types of mental health. Furthermore, there is a lack of local information 

for different ethnic groups with respect to mental health prevalence and service 

usage. 

For prevalence in relation to age and gender, there is a lack of local information. 

The exception is for benefit claimant rates where the main reason for the claim is 

mental health problems. The percentage of claimants is similar for men and 

women, and tends to increase as age increases. The claimant rate is 

approximately 1% for those aged 16-24 years increasing to just over 4% for those 

aged 50-59 years (per working age population). 

Examining national prevalence information, boys tend to have a higher 

prevalence of mental disorders compared to girls, with older children having a 

higher prevalence than the younger children. Men and women had similar rates 

of symptoms of poor mental health, but females tended to have higher rates of 

neurotic disorders whereas young men tended to have higher rates of personality 



disorder than young women. Men and women had a similar prevalence for 

psychotic disorders. For many of the symptoms of poor mental health the 

prevalence tended to be lowest at the youngest and oldest age groups, with 

peaks in the late 20s, late 30s and late 40s. The trend was similar for neurotic 

disorders with the highest prevalence in the late 40s and early 50s, but with the 

prevalence being much higher in young females compared to young males with 

the gap gradually reducing in the early 60s but then increasing again with older 

women having much a higher prevalence than older men. The prevalence of 

obsessions, phobias, compulsions and panic tended to be highest in the 

youngest age group and gradually decreased with age. The prevalence of 

personality disorders was similar in men over the three age groups considered. 

Men and women had a similar prevalence in the 55-74 year age group, but the 

prevalence for men was three times higher than women for those aged 16-34 

years and twice as higher for those aged 35-54 years. The national prevalence 

of psychotic disorders was based on very small numbers of individuals so it is 

difficult to compare age groups. 

With respect to differences in referrals to local specialist mental health services, 

women tended to have much higher referral rates for men being approximately 

25% higher for all age groups except those aged 0-19 years where the referral 

rate is slightly lower in women. The referral rates are highest in the 20s and 30s 

for both men and women. For men, the referral rates are 25% higher in these 

age groups compared to those aged 0-19 years, and almost twice as high for 

women aged 20-39 compared to those aged 0-19 years. The referral rates to the 

Hull Primary Care Health Workers are much higher in women being 

approximately three times higher. However, this only includes certain selected 

practices in Hull so the estimates may not be as robust. 

With respect to differences in inpatient admissions among the age groups and 

genders, the number of patients admitted for dementia increased dramatically 

with age with men tending to have a higher number of men being admitted 

compared to women. Inpatient admissions for mental and behavioural disorders 

due to psychoactive substance abuse was two or three times higher for men 

compared to women (depending on age), and considerably higher in the younger 

age groups compared to the older age groups. A similar pattern with age was 

observed for schizophrenia, schizotypal and delusional disorders, but whilst men 

under 60 were admitted more often than women the reverse was true for those 

aged 60+ years. Women were more likely to be admitted than men for mood 

disorders (half as likely again to twice as likely depending on age group) and this 

increased with age for both genders. Women were more likely to be admitted for 

neurotic, stress-related and somotoform disorders compared to men. 

Relative to prevalence, women tended to be more likely to be admitted as 

inpatients compared to men for neurotic disorders, depressive episodes, 

personality disorders and psychosis. There were exceptions over the age groups 

particularly for depressive episodes where men aged 25-44 years and 65-74 



years were more likely to be admitted relative to the prevalence. There was no 

clear pattern of inpatient admissions to prevalence for neurotic disorders and 

depressive disorders. For personality disorder, relative to prevalence, the 

admission rate was much higher for those aged 16-34 years compared to those 

aged 55-74 years, with around 1 in 100 of the women and 1 in 400 of the men 

with a personality disorder being admitted in the 16-34 year age group compared 

to 1 in over 2,000 people with a personality disorder being admitted in the 55-74 

year age group. 

With respect to differences in mortality among the age groups and genders, men 

had higher mortality rates for substance abuse (80% of all such deaths) and 

suicide and undetermined injury (75% of all such deaths). For Hull and East 

Riding of Yorkshire combined, the average annual number of deaths was 

approximately 20 for substance abuse, and 45 for men and 15 for women for 

suicide and undetermined injury. There was also a strong relationship with age 

with the young having a much higher mortality rate compared to the older age 

groups. There were over 100 deaths to Hull and East Riding of Yorkshire 

residents from dementia annually mainly in the 75+ year age group, with almost 

three-quarters of all dementia deaths in the 75+ year age group occurring to 

women. If there is a problem with the diagnosis or coding on death certificates, it 

is not just a local problem; locally the percentage of deaths with a primary cause 

of death as dementia is slightly lower than that observed nationally. 

With respect to differences among different deprivation groups, prevalence 

information is limited at both a national and local level. The only local information 

which is available is the number of claimants of Incapacity Benefit and Severe 

Disablement Allowance where the main reason for the claim was mental illness. 

There are various reasons why the number of such benefit claimants may not 

reflect prevalence. Nevertheless, this data was examined and it was found that 

there was a strong association between deprivation and the percentage of the 

working population claiming these benefits for poor mental health and mental 

illness. As the measure of deprivation was geographically based, it is possible 

that this relationship could be partially explained by the type of accommodation 

available in more deprived areas which would attract people with poor mental 

health, such as supported accommodation, hostels and in general cheaper 

accommodation. The referral pattern to Hull‟s Primary Care Mental Health 

Workers and to specialist mental health services across Hull and East Riding of 

Yorkshire followed a similar pattern. For both, the referral rate was more than 

twice as high in the most deprived national quintile compared to the least 

deprived national quintile. 

There is a strong association between increased deprivation and inpatient 

admissions which have a primary diagnosis related to mental health. This is 

particularly the case for substance abuse and schizophrenia; the latter is more 

likely to due to people with schizophrenia moving to more deprived areas where 

there are more hostels, supported accommodation and cheaper accommodation. 



The admission rate was over five times higher in the most deprived national 

quintile compared to the least deprived national quintile. There is also a relatively 

strong relationship for other types of mental health. 

It is encouraging that a similar relationship is present for referrals and inpatient 

admissions among the deprivation quintiles. This suggests that people in 

different deprivation quintiles are equally likely to be referred to a specialist 

mental health organisation as admitted as inpatients. However, given this 

relationship, it is still possible that the patients in the most deprived quintile are 

less likely to be referred and less likely to be admitted (or more likely) for both of 

these compared to the least deprived quintile relative to equivalent „need‟. 

There was a relatively small difference in the prevalence to inpatient admission 

ratio using the number of local benefit claimants where the main reason for the 

claim was mental health as a proxy for prevalence. One patient was admitted for 

every 13 people claiming benefits for the most deprived group, compared to 

approximately one in 10 for the middle three deprivation quintiles and one in 13 

for the least deprived quintile. Therefore, there was not a large difference among 

the deprivation quintiles. 

The mortality rate from mental and behavioural disorders due to psychoactive 

substance abuse was eight times higher in the most deprived compared to the 

least deprived national quintile. Using the same comparison groups, the mortality 

rate from suicide and undetermined injury was twice as high. There was less of a 

difference in the mortality rate from dementia among the deprivation quintiles with 

the highest mortality rate occurring in the most deprived followed by the least 

deprived national quintile. 

There are likely to be differences in need for mental health services for other 

groups such as for different ethnic groups, prisoners, Gypsy and Travellers, the 

homeless, single mothers, but the evidence is only available at a national level or 

anecdotal evidence. Further information is required to assess the needs and 

potential inequalities of these groups further. 

The following recommendations were put forward from the Mental Health Equity Audit: 

Improvements in data and information availability 

o In order to evaluate inequalities and changes over time, it is necessary to 

have better information. 

o Local up-to-date information on the prevalence of different types of mental 

health is not readily available. The prevalence information from the Quality 

and Outcomes Framework (QOF) GP disease registers is incomplete and 

not age adjusted (but it is hoped and expected that it will be more 

complete over time). The information included in the equity audit (with the 

exception of benefit claimants) is not available at a local level. The 



estimated number of people with mental health problems has been 

calculated using an estimate of national prevalence and applied to local 

population estimates. This is only valid if it can be assumed that the 

prevalence locally is similar to the national prevalence. It is unlikely that 

this assumption holds. Hull is, in fact, likely to have a higher prevalence of 

mental ill health associated with increased deprivation. 

o Information on certain groups where health inequalities may occur such as 

for different ethnic groups, homeless people, people who have learning or 

physical disabilities and other potential groups is not available or only 

available at a national level. Therefore, it is very difficult to assess whether 

inequity is present and if so to what degree. It also makes it difficult to 

devise action plans to address these inequalities. 

o There is a need to engage with the Mental Health Trust and others 

including those in Primary Care to improve data recording and quality. It 

would be hoped to explore some initial issues raised by the analysis of the 

extract of the data provided by Children and Adolescent Mental Health 

Services (CAMHS). This process has already been discussed with Senior 

Management at the Mental Health Trust. 

Improvements for People Living in the Most Deprived Areas 

o There is a clear association between deprivation and mental ill health, 

regardless of whether prevalence, referrals, inpatient admissions or 

mortality is examined. However, since the relationship is complex with 

people living in more deprived areas being more likely to have mental 

health problems, and people with mental health problems more likely to 

move to more deprived areas due to the location of assisted housing and 

cheap accommodation, it is difficult to fully assess the potential causal 

relationship. Nevertheless, there is a strong association, and further work 

is required to examine this in more detail and obtain information on 

programmes that can reduce mental health prevalence in these more 

deprived areas. 

Improvements for Gypsy and Travellers. 

o A study in Leeds (Tavares and Travellers Health Partnership 2001) which 

examined health for Gypsy and Travellers provided some 

recommendations, and stated that many of the health issues were 

associated with access to health care, and housing and environmental 

issues, rather than specific health problems or needs despite Travellers 

generally having a poorer level of health compared to the general 

population. However, the study acknowledges that there are many 

different types of Travellers, and their health needs and health problems 

may not necessarily be the same. Therefore, their study results may not 

be generalisable to other geographical areas. The study included the 

following recommendations: develop and evaluate on-site primary care 

services such as a health bus; fund a health visitor post which would 



concentrate on the health care of Travellers; develop health education 

services for Travellers in the most appropriate and accessible format; set 

up an operational forum where issues can be discussed; acknowledge the 

expertise of health professionals who have worked with Travellers over a 

number of years; collaborate in joint strategic planning; improve 

communication between Travellers and statutory bodies. 

o For more detailed recommendations see the report itself (Tavares and 

Travellers Health Partnership 2001) and the national study report (Parry, 

Van Clemmput et al. 2004). 

o However, as noted in the Leeds study (Tavares and Travellers Health 

Partnership 2001) the needs of different Gypsy and Travellers may be 

different. [Since the Mental Health Equity Audit was completed a local 

survey has been completed with 100 Gypsy and Travellers – see section 

8.2.2 on page 242]. 

Improvements in Access to Targeted and Intensive Services for Children and 

Young People in Hull. For improvements in access to targeted and intensive 

services (CAMHS Tiers 2, 3 and 4 for children and young people in Hull, it is 

recommended that: - 

o The Common Assessment Framework (CAF) should be recognised as the 

gateway from Universal (Primary) provision to Targeted (Secondary) 

services for children & young people who are experiencing emotional wellbeing 

difficulties. The CAF process should complement other statutory 

services including, Looked-After Children, Youth Offending populations 

and children and young people receiving services within a Safeguarding 

environment. Once fully implemented (March 2008) the CAF will provide 

quantitative and qualitative data on the needs of children and young 

people in Hull. This will assist with the identification of service user needs 

and subsequent service provision. This information should be used to 

complement service commissioning. 

o The Primary Mental Health Worker process (Gale, Hassett et al. 2005) 

should be made operational to provide a single point of access for 

Targeted and Intensive services for children and young people in Hull by 

September 2007. 

o Provider services should continue with their implementation of the CAMHS 

Outcome Research Consortium (CORC) evaluation measures. This 

process should directly evaluate service user views on provision and set 

the findings into a national context. The findings should be used to 

complement service commissioning. In addition advocacy and participation 

workers should be made available. 

o Promoting emotional well being should be seen as a core health area and 

training should be provided to raise awareness and up-skill staff including 

GPs, Practice Nurses, Health Visitors and others.. 

o Improving access to services for children in special circumstances should 

be a key aim and there should be a focus on Children and young people 



with a learning disability, looked after children, young offenders and 

minority ethnic groups. 

Improvements for People with Sensory Impairment. For improvements for people 

with sensory impairment, it is recommended that: 

o Consideration should be given to conducting local Needs Assessments of 

the mental health of Deaf people and Deafblind people, and other groups 

with sensory impairment. 

o Local Implementation Teams and Children and Adolescent Mental Health 

Service (CAMHS) development teams should make arrangements to 

access the data held by local authorities on Deafblind people as a starting 

point in considering how they might meet the needs of this group. 

o The specialist services should consider how they wish to manage referrals 

of Deafblind individuals in future and what additional expertise or 

specialisation is required. 

o Consideration should be given to conducting a needs assessment of 

Deafblind people alongside any undertaken for Deaf people. 

Improvements in Access to Primary Care for People with Learning Disabilities 

and Mental Health Problems 

o The Disability Rights Commission report (Samele, Seymour et al. 2006) 

recommended that GP practices should consider developing a protocol for 

supporting people with learning disabilities and people with mental health 

problems to get the most from their GP practice. They recommended that 

practice staff, including reception staff, GPs and nurses should receive 

learning difficulty and mental health awareness training, ideally from 

trainers who have learning difficulties themselves, mental health service 

user trainers and carer trainers. Staff should be made aware that the 

physical health problems are often overshadowed by their learning 

difficulty or mental health diagnosis. Practices should consider more 

effective health promotion advice and referral to specialist services. 

o It is recommended that these issues are considered locally to improve 

access to Primary Care for those with learning disabilities and mental 

health problems. 

Audit into Dementia Deaths 

o There is no clear explanation of the deaths where the primary cause of 

death has been coded as dementia. Whilst the percentage of people 

dying of dementia locally is in line with that observed nationally, it has 

been a surprise to observe even to clinicians. There is an obvious need to 

clarify this finding. It is recommended that an audit is conducted locally to 

examine the deaths where the primary cause of death has been noted as 

dementia. 



o Furthermore, it would be useful to explore the process by which causes of 

death are assigned, for example, by meeting with the local Registrar. 

Continue to Develop Strategies 

o One of the most important recommendations is to continue to develop 

current and new innovative strategies and continue to develop this agenda 

by engaging with others to reduce inequalities. 

o It is recommended that there should be an implementation phase for Hull 

and East Riding of Yorkshire in which a group is formed to oversee 

implementation of these recommendations. Existing members of the 

equity audit group have expressed willingness to engage in this process. 

o The next years will see resounding changes to the commissioning and 

provision of mental health services throughout the UK, and in Hull and 

East Yorkshire. The implementation group should be willing to consider 

radical solutions in order to make much needed improvements to Mental 

Health Service Provision in the area. 

Collaboration with Providers 

o This Equity Audit recognises the growing need for strong partnership 

arrangements as we move into a new and more demanding period of 

health care provision, where inequalities are recognised as a priority in the 

commissioning and provision of Mental Health Services. 




mortality rate from suicide and undetermined injury, and a number of targets relating to 

people with learning disabilities or mental health problems, such as the percentage of 

people with mental illness and/or disability in employment, the percentage of people with 

serious mental illness who smoke and the mortality rate of people with mental illness. 

The mortality rate from suicide and undetermined injury is available nationally, but is a 

narrow indicator to measure mental health and is subject to year-on-year variability due 

to the relatively small numbers. However, other measures relating to people with mental 

illness etc, depend on knowing who has mental illness, and there are problems with 

these types of indicators if there is a high prevalence of undiagnosed mental illness. It is 

not clear how accurate information for these measures can be collected. The mortality 

rate from suicide and undetermined injury is given in section 10.9.8 on page 706. 

Prior to the reorganisation which is currently underway within the NHS, the World Class 

Commissioning (WCC) target chosen for mental health was to provide a choice of 

appropriate, comprehensive, integrated mental health services within a maximum of 14 

days from referral to intervention over the next five years. A single point of access 

telephone number was been set up which enabled health professionals to refer patients 



to this single point of access. Later on, during 2009, the single access telephone 

number was made available for patients to self-refer, with the aim of enabling faster 

access to appropriate care for mental health. 

For year 2 of WCC, it was necessary to change this ‟14 day access‟ target as the 

Department of Health / SHA require that the WCC outcomes are benchmarked against 

other geographical areas. The original WCC metric outcomes for mental health were 

narrow in their focus (suicide and undetermined injury mortality, drug treatment waiting 

times, drug users in effective treatment and hospital admissions for alcohol-related 

harm), so this year 1 measure was one specifically used by NHS Hull. However, as a 

result, there is very little or no comparison information with other PCTs for 

benchmarking. Furthermore, new metric outcome measures are being considered in 

year 2 and these are more general and focus less on single aspects of mental health. 

Therefore, it is likely that „satisfaction with mental health services‟ will be chosen for the 

WCC metric outcome for year 2, so that benchmarking can be undertaken with other 

geographical areas. However, following the major reorganisation of the NHS (see 

section 3.3.6 on page 51), the way in which services are commissioned may change, 

and it is possible that key outcome measures could be changed. 

In a national survey assessing satisfaction with acute mental health inpatient services in 

which 107 local service users were consulted (37% response rate compared to national 

response rate of 28%), the local Humber Mental Health Teaching NHS Trust performed 

in the top 20% of all Trusts surveyed in half of the topic areas covered and in the middle 

60% of all Trusts for the remaining topic areas (Care Quality Commission, 2009). The 

47 questions covered topics such as care and treatment, rights, medication and talking 

therapies. The highest scores were for privacy and dignity, physical health checks and 

being treated with respect and dignity by a psychiatrist. Overall, in rating care received, 

104 local service users who answered the question scored Humber Mental Health 

Teaching NHS Trust as 64 which is in the top 20% of Trusts (20% scored lower than 53, 

60% scored between 53 and 63, and 20% scored above 63 with the highest score being 

73). However, this survey covers only one small aspect of mental health care, and 

satisfaction with primary care services and with voluntary and community services 

should be additionally assessed as well as other services provided by the Trust such as 

outpatient services. 




As illustrated in Figure 1, expenditure on problems of mental health disorders per head 

for 2008/2009 in Hull was £176.64 compared to £192.74 for the Industrial Hinterlands 

average, £192.14 for North East Lincolnshire and £191.21 for England. Therefore, 

expenditure in Hull was considerably lower than England (ranked 94 th out of 152 PCTs) 

and other comparators. 

Expenditure per head for 2008/2009 in Hull on substance misuse was £19.58 (ranked 

57 th ) compared to £23.25 for the Industrial Hinterlands average, £38.78 for North East 

Lincolnshire and £17.81 for England. For organic mental disorders, the expenditures 

per head were £2.14, £15.02, £4.40 and £17.39 for Hull, Industrial Hinterlands, North 

East Lincolnshire and England respectively with Hull ranked 142 nd . For psychotic 

disorders, the expenditures per head were £9.29, £28.90, £71.57 and £33.69 for Hull, 

Industrial Hinterlands, North East Lincolnshire and England respectively with Hull ranked 

100 th . For child and adolescent mental health disorders, the expenditures per head 

were £13.20, £11.86, £9.37 and £13.33 for Hull, Industrial Hinterlands, North East 

Lincolnshire and England respectively with Hull ranked 72 nd . 

Information on two mental health disorder outcomes are also available within the 

information produced by the Yorkshire and Humber Public Health Observatory (Y&H 

PHO) programme budgeting tool for each PCT and England (but not for Industrial 

Hinterlands). The outcomes measures are given in Table 332 for Hull and comparator 

areas (see section 3.3.3 on page 44 for more on comparators). The percentage of 

patients on the enhanced Care Programme Approach (CPA) receiving face-to-face or 

telephone follow-up within seven days of discharge during 2007/2008 was lower than 

the Industrial Hinterlands and England. Hull has a higher directly standardised mortality 

rate (DSR per 100,000 European Standard Population) from suicide and undetermined 

injury compared to the Industrial Hinterlands and England (ranked 135 th out of 152 

PCTs). 

So overall, mental health outcomes were worse for Hull compared to England and 

comparators, and spend for 2008/2009 was considerably lower in Hull compared to 

England and comparator areas. 



Table 332: Mental health outcomes in Y&H PHO programme budgeting tool 

Area % of patients on enhanced CPA 

receiving follow up (face to face 

or telephone) within 7 days of 

discharge 2007/08 

DSR mortality rate from 

suicide and injury 

undetermined, 

2006-08 

% Rank DSR Rank 

England 93.4 7.8 

Ind Hint 96.8 8.8 

Hull* 92.7 110 10.3 135 

North Tyneside* 99.9 1 10.9 142 

Hartlepool* 99.9 1 4.7 2 

Plymouth 98.2 45 8.9 106 

Salford 99.3 27 9.0 111 

Knowsley* 99.2 31 5.4 8 

Darlington* 98.3 43 7.8 78 

Gateshead* 95.0 89 6.7 40 

South Tyneside* 97.9 53 5.2 6 

Sunderland* 95.1 88 9.0 112 

Middlesbrough* 98.1 46 10.4 137 

Tameside&Glossop* 98.4 40 10.5 138 

Coventry 98.8 36 8.7 102 

Wolverhampton 82.0 145 10.0 133 

Derby 91.8 119 10.4 136 

County Durham* 99.3 29 8.7 103 

Sefton* 99.3 28 6.1 25 

Wirral* 99.5 25 12.3 150 

Halton&St Helens* 96.5 77 9.1 115 

Leicester 83.4 142 9.9 129 

Sandwell 90.7 124 9.3 121 

Stoke on Trent* 86.7 139 8.2 91 

Redcar&Cleveland* 98.1 50 9.2 119 

NE Lincolnshire 92.1 117 7.2 54 




10.9.4 Dementia 


The prevalence of dementia is given in section 10.9.3.1 on page 667 for each general 

practice in Hull for 2009/10. Table 333 presents the prevalence of dementia for 


England. Hull is relatively more deprived than England and most of the comparators, 

and with higher premature mortality rates and the younger population in Hull compared 

to the national distribution, it is perhaps not surprising that Hull‟s prevalence of dementia 

is lower than England as the highest prevalence will occur in the oldest age groups (e.g. 

85+ years). However, if the prevalence of dementia was associated with deprivation, 

then this would counter-balance this argument to some extent. 

Table 333: Prevalence of diagnosed dementia based on GP disease registers 2009/10, 


PCT 

Number on 

dementia 

Dementia 

unadjusted 




England 8,305 54,836,561 249,463 0.45 

Hull 60 289,210 929 0.32 

Sunderland 55 284,551 1,472 0.52 

Middlesbrough 25 153,187 643 0.42 

Salford 54 242,922 1,055 0.43 

Derby City 33 294,438 1,202 0.41 


Coventry 65 357,743 1,495 0.42 


Sandwell 67 339,020 1,521 0.45 

Stoke-On-Trent 57 280,265 1,216 0.43 

Plymouth 43 270,338 1,118 0.41 

Average of 10 520 2,840,950 12,227 0.43 

NE Lincs 34 169,565 788 0.46 

The number of patients with diagnosed dementia and the prevalence as recorded on the 

GP QOF disease registers over time is illustrated in Table 334 for 2006/07 to 2009/10 

(the registers were introduced during 2004/05 but the dementia measure was introduced 

2006/07). The latest list size refers to the registered population as at 1 st January 2010, 





2010). The latest list size for B81668 (Dr EG Stryjakiewicz) relates to 2006/07. Some 

practices were not in existence for all the years so information is not applicable (N/A). 



Table 334: Numbers and prevalence of diagnosed dementia on GP QOF disease 

registers, 2004/05 to 2009/10 

Code Latest 

list 

size 

Number and prevalence on dementia QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

B81035 6,114 17 0.27 16 0.26 14 0.23 23 0.38 

B81056 13,489 39 0.32 35 0.28 40 0.31 38 0.28 

B81104 7,721 1 0.01 0 0.00 1 0.01 2 0.03 

B81635 2,967 5 0.16 7 0.23 7 0.23 4 0.13 

B81662 1,856 2 0.09 4 0.18 3 0.14 3 0.16 

Y01200 1,765 4 0.26 2 0.12 7 0.42 5 0.28 


B81020 7,512 31 0.43 32 0.44 32 0.42 32 0.43 

B81021 7,257 39 0.55 28 0.39 27 0.36 39 0.54 

B81075 2,263 3 0.12 4 0.16 3 0.13 1 0.04 

B81085 5,299 13 0.24 19 0.36 28 0.52 34 0.64 

B81094 1,925 6 0.26 5 0.22 4 0.19 3 0.16 

B81095 4,242 8 0.20 7 0.17 9 0.22 9 0.21 

B81097 1,688 1 0.06 1 0.06 1 0.06 2 0.12 

B81690 1,734 2 0.11 3 0.17 1 0.06 2 0.12 

B81001 3,358 9 0.31 7 0.23 8 0.24 10 0.30 

B81008 15,062 45 0.30 53 0.36 44 0.30 57 0.38 

B81048 9,048 18 0.20 19 0.21 20 0.22 23 0.25 

B81049 9,354 41 0.49 29 0.33 27 0.30 25 0.27 

B81052 5,740 4 0.08 6 0.11 7 0.13 14 0.24 

B81072 7,807 23 0.33 20 0.27 25 0.33 27 0.35 

B81644 2,245 6 0.27 5 0.23 6 0.27 7 0.31 



B81011 5,243 18 0.33 11 0.20 16 0.30 16 0.31 

B81038 7,732 36 0.46 30 0.39 34 0.45 38 0.49 

B81057 3,345 11 0.30 10 0.28 11 0.32 12 0.36 

B81074 3,639 21 0.33 21 0.34 11 0.29 10 0.27 

B81081 3,520 5 0.14 6 0.18 8 0.23 10 0.28 

B81645 2,128 6 0.23 5 0.19 7 0.31 11 0.52 

B81646 1,949 2 0.08 2 0.08 6 0.29 3 0.15 

B81682 3,726 9 0.24 9 0.25 6 0.16 8 0.21 

B81053 10,232 35 0.35 41 0.40 49 0.48 60 0.59 

B81054 10,851 27 0.24 34 0.30 29 0.26 28 0.26 

B81058 8,722 47 0.50 45 0.50 59 0.67 66 0.76 

B81066 2,522 3 0.12 2 0.08 5 0.20 6 0.24 

B81080 2,216 24 0.93 19 0.82 18 0.80 18 0.81 

B81616 2,571 7 0.25 6 0.22 11 0.42 11 0.43 

B81002 3,844 8 0.26 8 0.26 5 0.17 4 0.10 

B81112 3,498 21 0.57 21 0.58 23 0.64 18 0.51 

B81119 4,593 7 0.16 10 0.22 13 0.28 19 0.41 

B81634 3,044 8 0.26 8 0.26 6 0.20 3 0.10 

B81674 2,241 6 0.33 11 0.57 12 0.57 11 0.49 

B81675 9,476 7 0.15 21 0.39 25 0.26 30 0.32 

B81685 2,444 2 0.08 4 0.16 2 0.08 2 0.08 

B81688 2,009 1 0.05 2 0.10 1 0.05 4 0.20 



Code Latest 

list 

size 

Number and prevalence on dementia QOF register over time 

2006/07 2007/08 2008/09 2009/10 

N % N % N % N % 

Y02344 1,645 N/A N/A N/A N/A 8 0.41 4 0.24 

B81027 5,976 24 0.41 27 0.45 23 0.38 26 0.44 

B81040 16,805 44 0.26 38 0.22 41 0.24 48 0.29 

B81047 7,377 17 0.23 15 0.21 12 0.17 8 0.11 

B81089 3,583 6 0.18 14 0.41 28 0.79 23 0.64 

B81631 3,425 4 0.13 2 0.06 4 0.12 5 0.15 

B81683 1,644 8 0.52 6 0.41 4 0.26 6 0.36 


B81017 6,800 11 0.15 13 0.18 15 0.22 12 0.18 

B81018 6,602 5 0.07 4 0.06 5 0.07 3 0.05 

B81032 2,478 4 0.14 8 0.29 9 0.34 8 0.32 

B81046 9,068 13 0.14 16 0.18 23 0.26 29 0.32 

B81692 1,814 1 0.05 2 0.11 2 0.11 2 0.11 

Y00955 2,556 3 0.18 5 0.22 3 0.12 4 0.16 



number of people with diagnosed dementia (Doncaster PCT 2008). Projecting Older 

People Population Information (POPPI) System has also produced local and national 

estimates and projections for people with dementia. This information is presented within 

Table 389. 





















practice. 


age groups (0-29, 30-64, 65-69, 70-74, …, 90-94 and 95+ years) which are applied to 



estimated age-gender specific population figures for each practice to obtain an estimate 

of the total number of people with dementia. No adjustments were made for ethnicity, 

deprivation or other factors. The model was based on two research surveys that aimed 

to estimate the prevalence of dementia (Hofman, Rocca et al. 1991; Harvey 1998). 

The results of the modelling and the actual diagnosed number of patients with dementia 


people who should be diagnosed with dementia for each practice; it is only a guide. The 

characteristics of each practice differ and need to be considered. The modelled 

estimates are considerably higher than the general practice registers. The reason for 

this is unknown. 





2010. 

Table 335: Actual diagnosed and modelled dementia numbers, September 2010 

Code Practice name List size Numbers with dementia 







B81104 Dr JK Nayar 6,553 3 4 -1 

B81635 Dr G Dave 2,979 7 38 -31 






B81075 Dr MK Mallik 2,197 1 47 -46 


B81094 Dr AK Datta 1,790 2 17 -15 

B81095 Dr Cook 4,145 17 65 -48 

B81097 Dr RD Yagnik 1,689 7 28 -21 

B81690 Dr SK Ray 1,650 4 13 -9 











Code Practice name List size Numbers with dementia 








B81074 Dr AK Rej 3,534 9 42 -33 



B81646 Dr M Shaikh 1,822 3 21 -18 







B81616 Dr GT Hendow 2,539 12 30 -18 





B81674 Dr JC Joseph 2,246 11 28 -17 


B81685 Dr NA Poulose 2,394 2 15 -13 

B81688 Dr KV Gopal 2,023 8 11 -3 

Y02344 Northpoint 2,021 6 17 -11 




B81089 Dr Witvliet 3,593 23 34 -11 

B81631 Dr R Raut 3,438 3 13 -10 










HULL 288,935 998 3,321 -2,323 



10.9.5 Serious Mental Ill Health 


The prevalence of serious mental ill health (schizophrenia, bipolar disorder and other 

psychosis) is given in section 10.9.3.1 on page 667 for each general practice in Hull for 

2009/10. Table 336 presents the prevalence of serious mental ill health for 2009/10 for 

Hull and comparator areas (see section 3.3.3 on page 44), as well as for England. The 

prevalence of serious mental ill health in Hull is low in relation to the majority of the 

comparators. 

Table 336: Prevalence of diagnosed serious mental ill health based on GP disease 

registers 2008/09, Hull versus comparator areas 

PCT 

Number on 

mental ill health 

Mental ill health 

unadjusted 




England 8,305 54,836,561 424,223 0.77 

Hull 60 289,210 2,210 0.76 

Sunderland 55 284,551 2,038 0.72 


Salford 54 242,922 2,253 0.93 

Derby City 33 294,438 2,156 0.73 


Coventry 65 357,743 2,888 0.81 


Sandwell 67 339,020 2,566 0.76 

Stoke-On-Trent 57 280,265 2,151 0.77 

Plymouth 43 270,338 2,015 0.75 

Average of 10 520 2,840,950 22,823 0.80 

NE Lincs 34 169,565 1,268 0.75 

The number of patients with diagnosed mental ill health and the prevalence as recorded 


2009/10. The indicator for mental health changed between 2005/06 and 2006/07, and 

therefore the prevalence for the first two years is not directly comparable with the 

prevalence for the last four years. The mental health indicator for 2004/05 and 2005/06 

was for the practice to produce a register “of people with severe long-term mental health 

problems who require and have agreed regular follow-up” whereas for the 2006/07 and 

onwards it was to produce a register “of people with schizophrenia, bipolar disorder and 

other psychoses”. The latest list size refers to the registered population as at 1 st 





January 2010). The latest list size for B81676 (Dr PN Jones) relates to 2004/05 and the 



latest list size for B81668 (Dr EG Stryjakiewicz) relates to 2006/07. Some practices 


Table 337: Numbers and prevalence of diagnosed serious mental ill health on GP QOF 


Code Latest 

list 

size 

Number and prevalence on serious mental ill health QOF register over time 

2004/05* 2005/06* 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81035 6,114 12 0.15 6 0.09 28 0.45 31 0.51 41 0.68 43 0.70 

B81056 13,489 61 0.54 55 0.47 45 0.37 47 0.37 60 0.46 72 0.53 

B81104 7,721 12 0.19 13 0.16 21 0.29 25 0.35 30 0.42 31 0.40 

B81635 2,967 7 0.22 7 0.22 8 0.25 7 0.23 7 0.23 8 0.27 

B81662 1,856 5 0.21 4 0.17 7 0.30 9 0.40 11 0.51 11 0.59 


Y01200 1,765 N/A N/A 4 0.33 6 0.38 8 0.49 13 0.77 15 0.85 


B81020 7,512 22 0.32 20 0.28 26 0.36 29 0.40 35 0.46 33 0.44 

B81021 7,257 60 0.84 58 0.81 66 0.92 63 0.87 67 0.90 75 1.03 

B81075 2,263 7 0.25 5 0.19 8 0.32 8 0.33 8 0.34 4 0.18 

B81085 5,299 13 0.24 16 0.29 16 0.30 19 0.36 23 0.43 22 0.42 

B81094 1,925 8 0.36 14 0.61 10 0.43 9 0.40 7 0.32 4 0.21 

B81095 4,242 15 0.37 15 0.38 28 0.70 24 0.60 26 0.63 22 0.52 

B81097 1,688 1 0.06 6 0.37 3 0.18 3 0.18 2 0.12 6 0.36 

B81690 1,734 9 0.49 5 0.29 6 0.34 5 0.29 7 0.40 6 0.35 

B81001 3,358 24 0.79 20 0.68 18 0.63 11 0.37 14 0.43 18 0.54 

B81008 15,062 60 0.42 81 0.55 81 0.54 77 0.52 89 0.60 100 0.66 

B81048 9,048 80 0.90 67 0.73 64 0.70 58 0.64 53 0.57 61 0.67 

B81049 9,354 58 0.73 59 0.73 67 0.79 77 0.88 78 0.85 77 0.82 

B81052 5,740 69 1.33 61 1.09 71 1.35 86 1.55 88 1.59 84 1.46 

B81072 7,807 68 0.95 31 0.45 69 1.00 69 0.94 76 1.00 74 0.95 

B81644 2,245 4 0.18 4 0.18 4 0.18 5 0.23 6 0.27 5 0.22 



B81011 5,243 10 0.18 21 0.37 26 0.47 29 0.53 30 0.56 30 0.57 

B81038 7,732 83 1.06 63 0.81 23 0.29 28 0.36 37 0.49 43 0.56 

B81057 3,345 45 1.26 43 1.19 49 1.34 36 1.02 36 1.05 31 0.93 

B81074 3,639 50 0.78 30 0.47 36 0.56 35 0.57 17 0.45 22 0.60 

B81081 3,520 17 0.45 13 0.36 11 0.31 9 0.26 13 0.37 14 0.40 

B81645 2,128 19 0.73 8 0.30 13 0.49 14 0.53 17 0.75 19 0.89 

B81646 1,949 17 0.65 16 0.63 10 0.40 9 0.38 2 0.10 3 0.15 

B81682 3,726 10 0.27 17 0.46 19 0.51 17 0.46 17 0.46 18 0.48 

B81053 10,232 36 0.36 35 0.35 50 0.50 59 0.58 60 0.59 67 0.65 

B81054 10,851 102 0.90 105 0.94 117 1.04 113 1.01 111 1.00 125 1.15 

B81058 8,722 73 0.77 72 0.75 81 0.86 85 0.94 80 0.90 75 0.86 

B81066 2,522 12 0.47 14 0.57 15 0.62 14 0.57 15 0.59 13 0.52 

B81080 2,216 16 0.59 18 0.65 17 0.66 15 0.64 14 0.62 12 0.54 

B81616 2,571 20 0.73 19 0.70 19 0.69 16 0.59 16 0.61 20 0.78 

B81002 3,844 18 0.62 17 0.57 19 0.63 20 0.66 20 0.66 26 0.68 

B81112 3,498 35 0.88 34 0.89 37 1.01 43 1.19 46 1.27 43 1.23 

B81119 4,593 39 0.64 38 0.65 18 0.40 25 0.55 29 0.62 32 0.70 

B81634 3,044 15 0.48 15 0.48 12 0.38 13 0.42 13 0.42 14 0.46 

B81674 2,241 20 1.16 18 1.03 13 0.72 15 0.77 14 0.67 19 0.85 



Code Latest 

list 

size 

Number and prevalence on serious mental ill health QOF register over time 

2004/05* 2005/06* 2006/07 2007/08 2008/09 2009/10 

N % N % N % N % N % N % 

B81675 9,476 45 1.02 42 0.98 41 0.85 49 0.91 53 0.55 67 0.71 

B81685 2,444 12 0.47 14 0.53 14 0.54 13 0.51 11 0.43 11 0.45 

B81688 2,009 10 0.50 10 0.49 11 0.53 12 0.57 13 0.62 13 0.65 


B81027 5,976 41 0.65 33 0.55 101 1.71 72 1.20 74 1.23 75 1.26 

B81040 16,805 29 0.18 34 0.21 74 0.44 64 0.38 65 0.38 64 0.38 

B81047 7,377 106 1.41 103 1.39 108 1.48 109 1.51 99 1.37 96 1.30 

B81089 3,583 19 0.59 16 0.49 12 0.36 14 0.41 19 0.54 20 0.56 

B81631 3,425 1 0.03 3 0.10 17 0.54 17 0.52 21 0.61 23 0.67 

B81683 1,644 11 0.72 12 0.76 13 0.85 9 0.62 9 0.59 10 0.61 


B81017 6,800 26 0.35 23 0.33 75 1.04 94 1.30 97 1.42 104 1.53 

B81018 6,602 7 0.11 25 0.38 38 0.56 37 0.55 29 0.43 43 0.65 

B81032 2,478 12 0.39 13 0.44 38 1.37 43 1.58 51 1.94 52 2.10 

B81046 9,068 54 0.63 52 0.61 67 0.74 70 0.80 77 0.86 80 0.88 

B81692 1,814 112 5.96 105 5.27 73 3.94 84 4.72 77 4.28 76 4.19 

Y00955 2,556 N/A N/A 9 1.34 21 1.27 41 1.84 54 2.12 51 2.00 


*Note that definition of indicator changed between 2005/06 and 2006/07 so that the prevalence estimates 

are not directly comparable between the first two years and the last four years. 


number of people with diagnosed severe mental health problems (Doncaster PCT 

2008). 





















practice. 




age groups (


Table 338: Actual diagnosed and modelled diagnosed and undiagnosed serious mental 

ill health numbers, September 2010 

Code Practice name List size Numbers with serious mental ill health 






B81056 Springhead Medical Centre 13,813 69 56 13 

B81104 Dr JK Nayar 6,553 27 21 6 

B81635 Dr G Dave 2,979 7 12 -5 

B81662 Mizzen Road Surgery 1,720 9 7 2 



B81020 Dr PC Mitchell & Partners 7,436 36 30 6 


B81075 Dr MK Mallik 2,197 4 9 -5 

B81085 Dr JW Richardson & Ptnrs 5,302 24 22 2 

B81094 Dr AK Datta 1,790 3 8 -5 

B81095 Dr Cook 4,145 22 17 5 

B81097 Dr RD Yagnik 1,689 8 7 1 

B81690 Dr SK Ray 1,650 5 7 -2 





B81052 Dr J Musil And PJ Queenan 5,736 82 24 58 






B81057 Dr S MacPhie & Koul 3,185 30 13 17 

B81074 Dr AK Rej 3,534 24 14 10 



B81646 Dr M Shaikh 1,822 3 7 -4 

B81682 Dr M Shaikh & Partners 3,780 18 14 4 






B81616 Dr GT Hendow 2,539 19 10 9 






Code Practice name List size Numbers with serious mental ill health 






B81674 Dr JC Joseph 2,246 19 8 11 


B81685 Dr NA Poulose 2,394 11 9 2 

B81688 Dr KV Gopal 2,023 20 8 12 

Y02344 Northpoint 2,021 14 7 7 



B81047 Dr JN Singh & Partners 7,505 96 33 63 

B81089 Dr Witvliet 3,593 20 14 6 

B81631 Dr R Raut 3,438 23 13 10 










HULL 288,935 2,247 1,148 1,099 

10.9.6 Suicide and Undetermined Injury 

See section 10.9.8 on page 706 which gives the numbers of deaths and mortality rates 

from suicide and undetermined injury. 






12.12 on page 781), with 3,245 (1.2%) of them having a primary diagnosis of mental 

and behavioural disorders. Almost half of all clinician episodes for mental and 

behavioural disorders were for mental and behavioural disorders due to psychoactive 

substance abuse with a further 13% for schizophrenia, schizotypal and delusional 

disorders, 10% for dementia and 10% for mood disorders (Table 339). Almost all 

(1,484; 92.2%) of the 1,609 mental and behavioural disorders due to psychoactive 

substance abuse were due to alcohol with a small number from opioids (61; 3.8%). The 

other substances (cannabinoids, sedatives or hypnotics, cocaine, other stimulants 

including caffeine, tobacco, volatile solvents) each had fewer than ten clinician episodes 

over the three year period (19 clinician episodes in total over the three years for all of 

these substances combined), with the „other or multiple substance‟ category having 45 

clinician episodes over the three year period. 







diagnosis of mental and behavioural disorders over three year period 2007/08 to 

2009/10 

ICD 10 

code 

Mental and behavioural disorder Total mental health 

clinician episodes 

2007/08 to 2009/10 


F00-F03 Dementia 307 9.5 

F04-F09 Other organic, including symptomatic, mental disorders 94 2.9 

F10-F19 Psychoactive substance abuse 1,609 49.6 

F20-F29 Schizophrenia, schizotypal & delusional disorders 426 13.1 

F30-F39 Mood disorders 320 9.9 

F40-F48 Neurotic, stress-related & somotoform disorders 285 8.8 

F50-F59 Behavioural syndromes 50 1.5 

F60-F69 Disorders of adult personality & behaviour 92 2.8 

F70-F79 Mental retardation 15 0.5 

F80-F89 Disorders of psychological development 23 0.7 

F90-F98 Behavioural/emotional disorders – usual child/teen onset 24 0.7 

TOTAL 3,245 100.0 




As illustrated in Table 340, in Hull during the period 2007-2009, there were twelve 

deaths in persons aged under 75 years and 195 deaths in persons aged 75+ years with 

the primary cause of death coded as dementia (F00-F03). Over the three year period, 

there were over 40 deaths due to mental and behaviour disorders due to psychoactive 

substance abuse (F10-F19). These were mainly in the younger age groups. In total, 15 

of the deaths were due to alcohol, 11 due to opioids and most of the remaining due to 

multiple substances. There were very few deaths from other mental and behavioural 

disorders (F20-F99). There were three times the number of substance abuse deaths in 

men than women over the three year period, whereas in women there were more than 

twice as many deaths from dementia (n=143) than men (n=64). 

Table 340: Total number of deaths 2007-2009 in Hull due to mental and behavioural 

disorders 

Cause of death Total number of deaths 2007- 

2009 by age at death (years) 

ICD 10 Description 15-34 35-64 65-74 75+ 

F00-F03 Dementia 12 195 

F10-F19 Mental and behaviour disorders due to 

17 24 * 

psychoactive substance abuse 

F20-F99 Other mental and behavioural disorders * 

*Fewer than three deaths in total over the three year period. 

The total number of deaths from dementia for men and women as well as the directly 

standardised mortality rates (DSRs) are given in Table 341 for the most recent period 

2007-2009. The DSRs are standardised to the European Standard Population. Given 

the relatively wide confidence intervals, no particular Locality appears particularly high or 

low in relation to the DSR. 

Table 341: Total number of deaths and directly standardised mortality rates for dementia 

per 100,000 persons, Hull 2007-2009 

Area Total deaths over three years and DSR for mortality from dementia 2007-2009 

per 100,000 persons (95% CI) 



North 6 7.1 (2.4 to 15.7) 26 18.6 (12.1 to 27.3) 32 15.1 (10.3 to 21.3) 

East 35 17.3 (12.0 to 24.2) 63 17.9 (13.6 to 23.1) 98 17.8 (14.4 to 21.8) 

West 23 11.4 (7.2 to 17.2) 54 14.2 (10.5 to 18.8) 77 13.7 (10.7 to 17.1) 

HULL 64 13.1 (10.0 to 16.8) 143 16.3 (13.7 to 19.2) 207 15.5 (13.4 to 17.7) 

For men, the all ages directly standardised mortality rates (DSR) for substance abuse 

were more than twice as high for West Locality (8.8 deaths per 100,000 European 

Standard Population; 95% CI 10.7 to 23.1) than for the other localities. Across Hull the 

substance abuse all ages DSR for men was 7.7 (95% CI 5.2 to 10.8) compared to 2.5 



(95% CI 1.1 to 4.6) for women. As mentioned within section 10.9.3.5 on page 675, 

Myton ward with its city centre location has relatively cheap accommodation and 

housing and more supported housing, so it is not surprising that West Locality has the 

highest mortality rate for substance abuse. People with mental health and substance 

abuse issues will be more likely to live in areas with cheaper housing. 

The age-specific death rates per 100,000 population for 2006 to 2008 for intentional selfharm 

or an event of undetermined intent are given in Table 342 for Hull and comparator 

areas. Hull has the one of the highest mortality rates for women aged 15-34 and 35-64 

years compared to England, the Yorkshire and the Humber SHA, Industrial Hinterlands 

group and the ten comparator areas. 

Table 342: Mortality rates from intentional self-harm or an event of undetermined intent, 

2006-2008 

Area Mortality for intentional self-harm or an event of undetermined 

intent, rate per 100,000 people for 2006-2008 

Men Women 

15-34 35-64 All ages 15-34 35-64 All ages 

England 12.6 18.3 12.7 3.4 5.6 3.9 

Hull 16.7 20.5 15.4 5.9 6.5 6.1 

Y&H SHA 13.5 18.8 13.3 2.8 5.3 3.6 

Industrial Hinterlds 15.1 20.5 14.3 4.5 6.4 4.4 

Wolverhampton 17.5 24.5 16.5 3.2 7.5 4.2 

Salford 15.5 23.9 15.7 4.1 2.5 2.8 

Derby 10.6 30.6 16.6 * 7.6 4.5 

Stoke-on-Trent 13.3 19.9 13.6 3.1 5.0 3.0 

Coventry 9.3 22.0 13.1 4.3 6.8 4.2 

Plymouth 12.7 25.8 14.8 3.8 4.8 4.2 

Sandwell 21.1 23.2 16.4 5.2 1.8 2.3 

Middlesbrough 16.3 23.6 16.4 * 11.3 5.7 

Sunderland 20.5 24.0 16.3 * 4.0 2.6 

Leicester 18.6 22.1 15.5 5.3 6.7 5.3 

Average of 10 15.5 24.0 15.5 3.6 5.8 3.9 

NE Lincs 15.4 15.9 12.2 * 3.1 2.5 

*Rates too low to present (N


Table 343: Total number of deaths and directly standardised mortality rates for suicide 

and undetermined injury per 100,000 persons, Hull 2007-2009 

Area Total deaths over three years and DSR for suicide and undetermined injury 

mortality 2007-2009 per 100,000 persons (95% CI) 



North 15 16.9 (9.4 to 27.9) 4 4.0 (1.0 to 10.4) 19 10.7 (6.4 to 16.8) 

East 18 12.1 (7.1 to 19.1) 5 3.7 (1.2 to 8.6) 23 7.9 (5.0 to 11.9) 

West 35 19.0 (13.2 to 26.5) 14 9.3 (5.0 to 15.8) 49 14.3 (10.5 to 19.0) 

HULL 68 16.1 (12.5 to 20.4) 23 5.8 (3.6 to 8.8) 91 11.1 (8.9 to 13.7) 

10.9.9 Perceived Impact of Stress on Health 


responders about their perceived impact on health of reducing stress levels. The 





10.9.10 Attitudes Towards Drugs and Substance Misuse 

Information about people‟s attitudes to drugs were collected as part of Reflector Groups 

following the 2008-09 Young Person Health and Lifestyle Survey (see section 13.2.2.3 

on page 796). The full report is available at www.hullpublichealth.org. 

10.9.11 Diagnosed Prevalence in Relation to Deprivation 




population). Table 344 shows the prevalence of diagnosed dementia on the practice 


the practice IMD 2007 scores and the prevalence of diagnosed dementia for each 

practice. There is no association between the prevalence of diagnosed dementia and 

deprivation (p=0.93). The underlying data for the figure is given in the APPENDIX on 

page 937. 












Table 344: Diagnosed prevalence of dementia by deprivation quintile at practice level 

Practice IMD 2007 Number of List size 

Dementia 2009/10 

quintile 

practices* (Jan 10) Number Percentage 

Most deprived 10 57,367 161 0.28 

2 12 55,245 166 0.30 

3 12 66,252 275 0.42 

4 11 65,303 234 0.36 



Figure 241: Diagnosed prevalence of dementia by deprivation score at practice level 

Table 345 and Figure 242 give the prevalence of serious mental health from the GP 

registers in relation to deprivation local quintiles and deprivation scores. It can be seen 



that there is an association between the prevalence of diagnosed serious mental health 

on the GP disease registers and deprivation (p


10.9.12 Mortality in Relation to Deprivation 

The all-age directly standardised mortality rates (DSR) for dementia, substance abuse 

and suicide and undetermined injury were all higher in the most deprived local quintile 

compared to the two least deprived local quintiles (Figure 243), although confidence 

intervals are wide due to relatively low numbers of deaths. The DSR for dementia was 

more twice as high in the most deprived local quintile compared to the least deprived 

quintile. For suicide and undetermined injury, the DSR was 2.6 times higher in the more 

deprived quintile areas compared to the least deprived quintile with the middle quintile 

group and the second most deprived quintile having the highest mortality rates. For 

substance abuse the DSR in the most deprived quintile was double that in the second 

least deprived quintile (DSR not produced for the least deprived quintile as fewer than 3 

deaths). The underlying data are given in the APPENDIX on page 940. 

Figure 243: Standardised mortality rate for dementia, substance abuse and suicide and 

undetermined injury per 100,000 persons all ages by deprivation for Hull for 2007-2009 

All age directly age-standardsied 

mortality rate per 100,000 persons 2007- 

2009 

35 

30 

25 

20 

15 

10 

5 

0 

Most 

deprived 



deprived 



Dementia Substance abuse Suicide and undetermined injury 



10.10 Sexual Health 

The total period fertility rate and number of births are given in section 5 on page 100 

and page 102 respectively. 

10.10.1 Abortions 

The number and crude abortion rate per 1,000 female population aged 15-44 years is 

given in Table 346 for Hull and comparators for 2008. The crude abortion rate in Hull is 

significantly lower than England. 

Table 346: Crude abortion rate per 1,000 female population aged 15-44 years, 2008 

Area Estimated 

resident 

population 

Crude abortion rate per 1,000 women aged 

15-44 yrs, 2008 

Number Rate (95% CI) 

England 10,532,490 186,218 17.7 (17.6, 17.8) 

Hull 57,560 945 16.4 (15.4, 17.5) 

Y&H SHA 1,068,666 16,699 15.6 (15.4 , 15.9) 

Wolverhampton 48,201 1,166 24.2 (22.9, 25.6) 

Salford 47,816 1,029 21.5 (20.3, 22.9) 

Derby 51,407 865 16.8 (15.7, 18.0) 

Stoke-on-Trent 50,973 887 17.4 (16.3, 18.6) 

Coventry 67,516 1,941 28.7 (27.5, 30.0) 

Plymouth 54,220 829 15.3 (14.3, 16.4) 

Sandwell 60,941 1,297 21.3 (20.2, 22.5) 


Sunderland 57,232 884 15.4 (14.5, 16.5) 

Leicester 69,938 1,426 20.4 (19.4, 21.5) 

Average of 10 537,167 10,833 20.2 (19.8, 20.5) 

NE Lincs 31,167 568 18.2 (16.8, 19.8) 

The number of abortions by age of mother is given in Table 347 for Hull for 2008, and 

for comparison purposes the crude abortion rate for 2008 by age of mother are given in 

Table 348 by age of mother for Hull and comparators. The abortion rate in Hull is 

similar to comparator areas for the younger age groups, and generally lower than 

comparator areas for the older age groups. 



Table 347: Number and rate of abortions by age of mother, 2008 

Age of mother Women in Hull 

Estimated 

resident 

population 

Crude abortion rate per 1,000 women aged 

15-44 yrs, 2008 

Number Rate (95% CI) 


Table 349: Number and percentage of abortions by estimated gestation age, 2008 

Area Total 

stated 

gestation 

Number and percentage of abortions by gestational age 

0-9 weeks 10-12 weeks 13+ weeks 

N % N % N % 

England 186,218 136,473 73.3 31,636 17.0 18,109 9.7 

Hull 945 440 46.6 416 44.0 89 9.4 

Y&H SHA 16,699 11,468 68.7 3,629 21.7 1,602 9.6 

Wolverhampton 1,166 807 69.2 225 19.3 134 11.5 

Salford 1,029 617 60.0 298 29.0 114 11.1 

Derby 865 575 66.5 231 26.7 59 6.8 

Stoke-on-Trent 887 640 72.2 126 14.2 121 13.6 

Coventry 1,941 1,493 76.9 263 13.5 185 9.5 

Plymouth 829 570 68.8 181 21.8 78 9.4 

Sandwell 1,297 968 74.6 209 16.1 120 9.3 

Middlesbrough 509 308 60.5 123 24.2 78 15.3 

Sunderland 884 494 55.9 272 30.8 118 13.3 

Leicester 1,426 880 61.7 394 27.6 152 10.7 

Average of 10 10,833 7,352 67.9 2,322 21.4 1,159 10.7 

NE Lincs 568 364 64.1 146 25.7 58 10.2 

10.10.2 Sexual Transmitted Infections 


Hull and East Riding produced a Sexual Health Strategy and Action Plan for 2005. 

Within this document, it states that the rising tide of sexually transmitted infections (STIs) 

and HIV evidenced nationally, is mirrored at the local level. Hull is experiencing a rise in 

the number of STIs together with a rise of newly diagnosed human immuno-deficiency 

virus (HIV) infections and an increasing number of visits to Departments of 

Genitourinary Medicine (GUM) with subsequent demands on service provision. 

The document also provides information on the number of cases of specific STIs from 

Conifer House for 2002-2003. 

Genital Chlamydia infection is currently the most common STI diagnosed in GUM clinics 

across the UK. In 2004, within England, rates in both males (208 per 100,000 

population) and females (243 per 100,000 population) were highest in Yorkshire and 

Humber region after London (279 and 282 per 100,000 population for males and 

females respectively). Gonorrhoea is the second most common bacterial STI in the UK, 

concentrated in urban, deprived areas and in specific population subgroups (those aged 

under 25 years, men who have sex with men and black ethnic groups). Outside 

London, diagnostic rates in males (58 per 100,000 population) and females (31 per 



100,000 population) were highest in the Yorkshire and Humber region. Incidence 

increased sharply between 2002 and 2003. 

The number of uncomplicated cases of Chlamydia and gonorrhoea seen at Conifer 

House during 2002-2003 and the number of cases of HIV in Hull are given in Table 350. 

Table 350: Number of uncomplicated cases of Chlamydia and gonorrhoea seen at 

Conifer House during 2002-2003 and number of cases of HIV in Hull 

STI Period Number of cases in Hull by gender 

Males Females 

Chlamydia 

2002 

2003 

377 

380 

452 

445 

Gonorrhoea 

2002 

2003 

61 

113 

40 

49 

HIV Total cases 67 43 

It is difficult to obtain up-to-date information on STIs, and as far as we are aware, the 

information in Table 350 has not been updated. 

Information is available in the World Class Commissioning datapacks provided by the 

Information Centre on HIV prevalence. The datapacks were published in September 

2009 (Information Centre for Health and Social Care 2009). 

The HIV figures quoted in the datapacks for Hull are less than one per 100,000 

population. This is clearly incorrect if the total numbers in Hull were approximately 100 

for 2002-2003, even if the information is supposed to be incidence (number of new 

cases), it would appear to be incorrect as according to the Health Protection Agency, 16 

male and 16 female new cases were diagnosed during 2007 (so incidence would be 

around 12 per 100,000 for 2007). Therefore, it is not clear what information is being 

presented on HIV within the datapacks. The local Health Protection Agency provided 

information on the number of patients by year of first HIV/AIDS positive result by gender 

for Hull for the Joint Strategic Needs Assessment (see www.jsnaonline.org/). Using the 

information provided by the local Health Protection Agency, the number of HIV/AIDS 

positive patients by year of diagnosis is given in Table 351. Some categories have 

been combined due to the small numbers and confidentiality reasons. The diagnosed 

prevalence of HIV/AIDS among Hull residents is approximately 60 per 100,000 

population. A further 10 people who were diagnosed between 2003-2007 and have 

since died are not included Table 351. 



Table 351: Number of diagnosed HIV/AIDS positive patients alive in Hull 

Year of diagnosis Number of HIV/AIDS positive 

patients alive in Hull 

Men Women 

1996-1999 7 

2000-2001 6 

6 

2002 4 

2003 16 15 

2004 16 13 

2005 15 12 

2006 8 11 

2007 16 16 

Total 88 73 

10.10.2.2 Chlamydia Testing and Screening 

Information is available from the National Chlamydia Screening Programme (NCSP) on 

the percentage of people aged 15-24 years screened or tested for Chlamydia. The 

datapacks were published in September 2009. Table 352 presents the information 

taken from the programme with regard the number of tests (as a proxy for the number of 

people tested) carried out on people aged 15-24 years who have been screened or 

tested for Chlamydia over four periods during 2008/2009 and 2009/2010 for Hull and 

comparators (see section 3.3.3 on page 44 for more about comparator areas). Hull, 

like most of its comparators has seen an increase in the proportion screened from 2008- 

09 to 2009-10. Hull‟s rate in 2009-10 is better than the England rate (22.1%), the 

Yorkshire and Humber rate (23.1%) and the average rate of 10 comparators (21.8%). 

Table 352: Percentage of those aged 15-24 years screened or tested for Chlamydia for 

Hull and comparators, 2008/2009 and 2009/2010 

PCT Aged 15-24 years screened or tested for Chlamydia (%) 

2008/09 2009/10 

Hull 22.4 27.1 

Plymouth 15.5 14.5 

Salford 17.7 27.4 

Sunderland 18.6 27.7 

Middlesbrough 17.1 22.8 

Coventry 12.9 21.5 

Wolverhampton 16.0 22.0 

Derby 13.1 16.8 

Leicester 15.5 26.1 

Sandwell 8.9 17.5 

Stoke-on-Trent 18.6 22.0 

North East Lincolnshire 17.1 26.0 




consultation (see section 3.3.6.2 on page 52). One of the outcomes proposed is 

Chlamydia diagnosis rates per 100,000 aged 15-24 years, but it is not yet known if this 

will become an outcome measure. 

10.10.2.3 Genito-Urinary Medicine Access Within 48 Hours 

Information is available in the World Class Commissioning datapacks provided by the 

Information Centre (Information Centre for Health and Social Care 2009) on genitourinary 

medicine (GUM) access within 48 hours for 2006/2007 and 2007/2008. The 

datapacks were published in September 2009. This indicator is also part of the Care 

Quality Commission‟s national annual performance framework for PCTs (Care Quality 

Commission 2010), and the latest figures for 2008/2009 and 2009/2010 are available 

from the Care Quality Commission. Table 353 presents the information taken from the 

datapacks with regard to GUM access within 48 hours for Hull and comparator areas 

(see section 3.3.3 on page 44 for more about comparator areas. Hull‟s rate was 100% 

for the past two financial years in line with the majority of comparators. 

Table 353: GUM access within 48 hours for Hull and comparators, 2006/2007 and 

2007/2008 

PCT GUM access within 48 hours (%) 

2006/2007 2007/2008 2008/09 2009/10 

Hull 58.7 91.3 100.0 100.0 

Plymouth 64.3 93.6 100.0 100.0 

Salford 43.5 94.4 99.8 100.0 

Sunderland 68.6 96.4 100.0 100.0 

Middlesbrough 68.2 95.8 99.9 100.0 

Coventry 39.5 99.0 99.8 100.0 

Wolverhampton * 91.0 99.9 100.0 

Derby 41.6 92.9 100.0 100.0 

Leicester 78.2 93.4 99.9 100.0 

Sandwell 44.2 83.2 99.0 99.8 

Stoke-on-Trent 38.6 77.1 100.0 99.3 

North East Lincolnshire 86.8 91.5 100.0 99.8 

*Figure not available. 


consultation (see section 3.3.6.2 on page 52). One of the outcomes proposed is GUM 

access, but it is not yet known if this will become an outcome measure. 



10.10.3 Teenage Pregnancy Rate 


From the Office for National Statistics (ONS), the conception rates for females aged 15- 

17 years are given in Figure 244 for Hull and England. The rate includes all 

conceptions (in the numerator) for females under 18 years, but the population 

(denominator) used to determine the rate only includes females aged 15-17 years as the 

majority of the conceptions will be in the older ages and there are few conceptions for 

those aged under 15 years. The majority of the conceptions will be for those aged 17 

years. It can be seen that the rates remained relatively unchanged between 2001 and 

2008 for both Hull and England with a slight decrease for the most recent year, but there 

was more year-on-year variability in Hull. However, taking the whole period from 1998 

to 2009, there has been a fall in the rate for both Hull and England. The underlying data 

are given in the APPENDIX on page 940. 

Figure 244: Conception rate for females aged 15-17 years for Hull, 2001 to 2009 

Under 18 conception rate per 1,000 women 

aged 15-17 years 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 

Year 

England Hull 

Table 354 gives the under 18 conception rates per 1,000 females aged 15-17 years for 

2009 for Hull and comparator areas from ONS. Hull has this highest rate of the 10 

comparators, and North East Lincolnshire. 



Table 354: Under 18 conception rate for Hull and comparators, 2009 

Area Under 18 conceptions, 2009 

Number Rate per 1,000 female pop aged 15-17 

England 35,966 38.2 

Hull 316 64.0 

Middlesbrough 174 60.4 

Sunderland 288 52.8 

Salford 221 54.1 

Derby 233 51.0 

Leicester 251 47.1 

Stoke-on-Trent 258 61.1 

Coventry 335 59.7 

Sandwell 304 52.7 

Wolverhampton 242 52.6 

Plymouth 194 44.3 

NE Lincolnshire 192 59.7 

From the Compendium, under 16 conception rates are available (related to the female 

population aged 13-15 years) for 2004-2006 (Table 355). For Hull, the under 16 

conception rate, whilst higher than England, is lower than the majority of the 

comparators. The latest rate (for 2007) is only available for some of the comparators 

(Table 356). 

Table 355: Under 16s conception rate for Hull and comparators, 2004-2006 

Area Under 16 conceptions, 2004-2006 

Population Number of under Rate per 1,000 female 

aged 13-15 yrs 16 conceptions pop aged 13-15 (95% CI) 

England 2,863,277 21,984 7.7 (7.6, 7.8) 

Hull 15,307 140 9.1 (7.8, 10.8) 

Industrial Hinterl‟ds 215,869 2,190 10.1 (9.7, 10.6) 


Sunderland 16,542 176 10.6 (9.2, 12.3) 

Salford 12,562 132 10.5 (8.9, 12.4) 

Derby 13,943 123 8.8 (7.4, 10.5) 

Leicester&Rutland* 16,234 175 10.8 (9.3, 12.5) 

Stoke-on-Trent 13,849 203 14.7 (12.8, 16.8) 

Coventry 17,281 189 10.9 (9.5, 12.6) 

Sandwell 17,519 224 12.8 (11.2, 14.6) 


Plymouth 13,437 126 9.4 (7.9, 11.2) 

Average above 10 144,177 1,625 11.3 (10.7, 11.8) 


*Figures are not available for Leicester alone. 



Table 356: Under 16s conception rate for Hull and comparators, 2007 

Area Under 16 conceptions, 2007 

Population Number of under Rate per 1,000 female 

aged 13-15 yrs 16 conceptions pop aged 13-15 (95% CI) 

England 931,259 7,718 8.3 (8.1, 8.5) 

Hull 4,896 67 13.7 (10.8, 17.4) 

Y&H SHA 96,409 967 10.0 (9.4, 10.7) 


Derby 4,545 51 11.2 (8.5, 14.7) 

Leicester&Rutland* 5,256 46 8.8 (6.6, 11.7) 

Stoke-on-Trent 4,240 48 11.3 (8.5, 15.0) 

Plymouth 4,343 39 9.0 (6.6, 12.3) 


*Figures are not available for Leicester alone. 

Local information is available on the number of under 18 conceptions through hospital 

records information (birth and abortion information) for conceptions occurring during the 

calendar year 2008. The number of conceptions are relatively low for some wards, and 

information is not presented for Beverley ward due to small numbers. Figure 245, 

Figure 246 and Figure 247 give the under 18 conception rates at ward level per 1,000 

females aged 15-17 years for North, East and West Locality wards respectively. The 

overall rate for Hull will differ slightly from any quoted in national data due to slightly 

different estimates of resident population used. The 95% confidence intervals are 

presented, and due to the small numbers, there is uncertainty about the underlying rates 

as the confidence intervals are relatively wide (see section 12 on page 770 for more 

information about small numbers and confidence intervals). Due to the width of the 

confidence intervals, there are no particular wards in North Locality that have a 

particularly high or low conception rate when compared to other wards in the Locality. 

For East Locality, the only exception is for Holderness which is significantly lower than 

Marfleet. For West Locality, there is a significant difference in the under 18 conception 

rates among the wards. Boothferry has a significantly lower rate compared to Myton, 

Newington, St Andrew‟s, Pickering and Newland. Avenue is also significantly lower than 

Myton, St Andrew‟s, Pickering and Newland. The underlying data are given in the 




Figure 245: Under 18 conception rates per 1,000 females aged 15-17 years during the 

calendar year 2008 for North Locality 


aged 15-17 years, 2008 

200 

180 

160 

140 

120 

100 

80 

60 

40 

20 

0 



Kings Park 

Area: North Carr 

Beverley 


calendar year 2008 for East Locality 


aged 15-17 years, 2008 

200 

180 

160 

140 

120 

100 

80 

60 

40 

20 

0 

Ings 

Longhill 

Sutton 

Area: East 

Holderness 

Ward, Area and Locality 

Marfleet 






University 

Area: Park 

Drypool 

Area: Northern 

Area: Riverside (East) 

Locality: North 

Locality: East 

HULL 

HULL



calendar year 2008 for West Locality 


aged 15-17 years, 2008 

200 

180 

160 

140 

120 

100 

80 

60 

40 

20 

0 

Myton 

Newington 


St Andrew's 

Area: Riverside (West) 

Boothferry 

Derringham 

Pickering 




under 18s conception rate, but it is not yet known if this will become a new outcome 

measure. 


Area: West 

Avenue 

Bricknell 

Newland 

Area: Wyke 

Locality: West 

HULL


10.11 Accidents 

10.11.1 Children and Young People 


From Hospital Episode Statistics, the annual age-gender-standardised rate of hospital 


having a primary or secondary diagnosis relating to an accident for the three financial 

years 2007/08 to 2009/10 for residents of Hull aged under 19 years is given in Table 

357 per 1,000 residents (see Table 416 for definitions). 


admission rate with a primary or secondary diagnosis relating to an accident for the 

three financial years 2007/08 to 2009/10 combined for Hull residents aged under 19 

years 


DSR per 1,000 Hull residents (under 19s accidents), 

2007/08 to 2009/10 (95% CI) 

Males under 19 yrs Females under 19 yrs 

N DSR N DSR 





Beverley 41 17.7 (12.7 to 24.1) 12 5.4 (2.8 to 9.5) 



Area: Northern 253 18.5 (16.3 to 20.9) 105 8.2 (6.7 to 9.9) 

Locality: North 464 17.3 (15.8 to 19.0) 204 8.1 (7.0 to 9.3) 

Ings 51 11.5 (8.6 to 15.2) 21 5.6 (3.4 to 8.5) 

Longhill 88 18.0 (14.4 to 22.1) 35 7.6 (5.3 to 10.6) 

Sutton 83 16.3 (13.0 to 20.3) 47 10.5 (7.7 to 13.9) 

Area: East 222 15.4 (13.4 to 17.6) 103 8.0 (6.5 to 9.7) 


Marfleet 90 14.9 (12.0 to 18.3) 57 9.6 (7.3 to 12.5) 



Area: Park 260 14.1 (12.4 to 15.9) 147 8.5 (7.2 to 10.0) 

Drypool 68 17.1 (13.3 to 21.7) 29 7.1 (4.7 to 10.1) 


Locality: East 550 14.9 (13.7 to 16.2) 279 8.1 (7.2 to 9.2) 

Myton 67 15.0 (11.6 to 19.1) 45 10.6 (7.7 to 14.2) 





DSR per 1,000 Hull residents (under 19s accidents), 

2007/08 to 2009/10 (95% CI) 

Males under 19 yrs Females under 19 yrs 

N DSR N DSR 


Area: Riverside (West) 216 16.5 (14.3 to 18.8) 112 8.9 (7.3 to 10.7) 




Area: West 209 16.4 (14.3 to 18.8) 114 9.8 (8.1 to 11.8) 

Avenue 52 12.5 (9.4 to 16.5) 36 9.1 (6.3 to 12.6) 


Newland 53 18.5 (13.8 to 24.3) 29 9.6 (6.4 to 13.8) 

Area: Wyke 139 13.8 (11.6 to 16.3) 78 8.1 (6.4 to 10.2) 

Locality: West 564 15.7 (14.4 to 17.0) 304 9.0 (8.0 to 10.1) 

HULL 1,578 15.9 (15.1 to 16.7) 787 8.4 (7.9 to 9.1) 



hospital admission rate caused by unintentional and deliberate injuries to those under 5 

and 5-18 years, but it is not yet known if these will become new outcome measures. 


From the Compendium, the number of accidental deaths to children and young people 

aged 1-14 years is very small for most PCTs (generally less than three) and due to 

confidentiality reasons cannot be presented. For Hull, there were fewer than three 

deaths registered during 2008 where the cause of death was listed as accidental 

(International Classification of Disease codes V01-X59). 



inpatient admission rates which involve a primary or secondary diagnosis of accidents 

(any clinician episode within that hospital stay) by local deprivation quintile over three 

financial years 2007/08 to 2009/10 (standardised to Hull‟s 2009 population). The 95% 

confidence intervals are shown. The standardised admission rate in the most deprived 

quintile is 13.5 and is 14.3 admissions per 1,000 young people in the second most 

deprived quintiles compared to 11.0 and 10.0 per 1,000 young people in the second 

least and least deprived quintiles. Whilst the differences do not appear large, there is a 

statistically significant difference among the quintiles (the 95% CIs do not overlap). The 




As expected, there is a higher admission rate for accidents for those aged under 19 years 

living in the most deprived areas. 

Figure 248: Age-standardised accident annual daycase and inpatient admission rate per 

1,000 population for those aged under 19 years by local deprivation quintile for Hull 

10.11.2 Road Traffic Accidents 

From the Department for Transport (Department for Transport 2009; Department for 

Transport 2010), the numbers killed or seriously injured on the roads for 1994-1998, 

2006 and 2007 are given in Table 358. Accidents included involve personal injury 

occurring on a public highway (including footpath) in which at least one road vehicle or a 

vehicle in collision with a pedestrian is involved and which becomes known to the police 

within 30 days of its occurrence. The vehicle need not be moving and accidents 

involving stationary vehicles and pedestrians or users are included. One accident may 

give rise to several casualties. Damage-only accidents are not included. Seriously 

injured is defined as where the patient is detained in hospital as an inpatient or any of 

the following injuries whether or not they are detained in hospital: fractures; concussion; 

internal injuries; crushings; burns (excluding friction burns); severe cuts; severe general 

shock requiring medical treatment; and injuries causing death 30 or more days after the 

accident. An injured casualty is recorded as seriously or slightly injured by the police on 

the basis of information available within a short time after the accident. This generally 

will not reflect the results of a medical examination, but may be influenced by whether 

the casualty is hospitalised or not. Hospitalisation procedures will vary regionally. 



As can be seen the actual numbers killed or seriously injured have decreased 

considerably for most areas between 1994-98 and 2009 for all ages and young people 

aged under 16 years. It is likely that most accidents which result in deaths or serious 

injuries will be reported to the police within 30 days, so most casualties should be 

included. 

Table 358: Numbers killed or seriously injured on the road, 1994-1998, 2006 and 2007 

Area Numbers killed or seriously injured on the roads 

All ages Children (under 16 years) 

1994-98 2008 2009 Change 1994-98 2008 2009 Change 

average 

(%) average 

(%) 

England 40,815 24,369 23,206 -43.1 5,729 2,402 2,278 -60.2 

Hull 207 118 113 -45.4 49 20 23 -53.1 

Salford 126 92 71 -43.7 25 13 10 -60.0 

Sunderland 162 93 100 -38.3 46 13 23 -50.0 

Coventry 322 106 118 -63.4 69 20 26 -62.3 

Sandwell 224 104 112 -50.0 44 20 14 -68.2 

Wolverhampton 200 79 64 -68.0 44 17 6 -86.4 

Middlesbrough 65 47 38 -41.5 22 13 13 -40.9 

Derby 153 113 117 -23.5 30 13 11 -63.3 

Plymouth 145 62 45 -69.0 30 9 6 -80.0 

Leicester 126 97 87 -31.0 27 18 18 -33.3 

Stoke-on-Trent 126 35 53 -57.9 24 4 4 -83.3 

NE Lincolnshire 140 102 92 -34.3 34 16 17 -50.0 

From the Department for Transport, the casualty rate (killed, seriously injured or slightly 

injured) and the killed and seriously injured casualty rate per billion vehicle miles is given 

in Table 359 for Hull and comparator areas. Hull has one of the highest casualty rates 

of comparators. This is likely to be due to the tight geographical boundaries of the city 

with the suburban areas mainly falling outside the Hull boundaries and within 

neighbouring East Riding of Yorkshire. Most other comparator areas will probably 

include some of their quieter suburban areas within their geographical boundaries. 



Table 359: Road traffic accident casualty rate per billion vehicle kilometres, 1994-1998, 

2008 and 2009 

Area Casualty rate per billion vehicle kilometres 

All casualties Killed or seriously injured 

1994-98 2008 2009 Change 1994-98 2008 2009 Change 

average 

(%) average 

(%) 

England 1,187 757 733 -38.2 171 90 86 -49.7 

Hull 1,961 1,317 1,231 -37.2 283 155 148 -47.7 

Salford 1,321 620 612 -53.7 92 62 47 -48.9 

Sunderland 1,317 822 826 -37.3 158 76 84 -46.8 

Coventry 1,242 909 795 -36.0 308 91 101 -67.2 

Sandwell 1,255 1,047 1,006 -19.8 193 82 88 -54.4 

Wolverhampton 1,661 1,062 1,116 -32.8 275 101 83 -69.8 

Middlesbrough 1,013 563 502 -50.4 88 57 46 -47.7 

Derby 1,068 952 1,038 -2.8 143 107 112 -21.7 

Plymouth 1,689 1,037 1,046 -38.1 189 72 53 -72.0 

Leicester 1,841 1,559 1,546 -16.0 153 111 100 -34.6 

Stoke-on-Trent 1,962 1,071 1,166 -40.6 165 40 59 -64.2 

NE Lincolnshire 1,544 1,426 1,391 -9.9 246 165 151 -38.6 

From the Department for Transport, Table 360 gives the number of road traffic accident 

casualties for Hull by road user type for 2009. The numbers for comparator areas are 

not provided as it is difficult to compare across areas as the actual numbers of 

casualties will depend on the population, number of vehicles and the number of vehicles 

on the roads, etc. Other includes ambulances, fire engines, trams, refuse vehicles, road 

rollers, agricultural vehicles, excavators, mobile cranes, tower wagons, army tanks, 

pedestrian-controlled vehicles with a motor, etc. Other non-motor vehicles include those 

drawn by an animal, ridden horses, invalid carriages without a motor, street barrows, 

etc. 

Table 360: Number of road traffic accident casualties by road user type, 2009 

Road user type Number of Hull casualties, 2009 

Pedestrian – all 149 

Pedestrian – child 42 

Pedal cycle – all 169 

Pedal cycle – child 27 

Motorcycle 79 

Car 463 

Bus 52 

Light goods vehicle 15 

Heavy goods vehicle 1 

Other 10 

All 938 



From the Department for Transport, Table 361 gives the rate of road traffic accident 

casualties by road user type per 1,000,000 population for 2009. The pedestrian 

casualty rate is similar to other comparator areas, but the pedal cycle casualty rate is 

considerably higher than all comparators. The reasons for this are unclear, but it is 

possible that the number of cyclists is higher than many other cities as the city is 

relatively flat (anecdotal evidence). 

Table 361: Road traffic accident casualties by road user per 1,000,000 population, 2009 

Area Road traffic accident casualties per 1,000,000 population, 2009 

Pedestrian 

Pedal cycle 

Motor cycle 

Car 


Bus 

Light goods 

vehicle 

Heavy goods 

vehicle 

England 455 306 367 2,431 108 82 25 24 3,798 

Hull 568 644 301 1,764 198 57 4 38 3,574 

Salford 471 329 182 2,946 67 44 31 13 4,083 

Sunderland 454 213 181 2,276 263 110 4 11 3,511 

Coventry 585 262 221 1,813 29 51 6 6 2,973 

Sandwell 622 168 292 2,938 182 151 31 14 4,399 

Wolverhampton 558 285 243 2,290 172 38 17 13 3,615 

Middlesbrough 484 285 128 1,900 121 7 7 7 2,940 

Derby 627 463 389 2,736 115 74 20 29 4,453 

Plymouth 479 214 436 2,080 218 16 4 0 3,448 

Leicester 719 413 240 2,786 194 43 7 3 4,404 

Stoke-on-Trent 557 243 314 3,010 96 54 33 54 4,362 

NE Lincolnshire 471 496 445 3,487 267 185 19 32 5,403 

From the Compendium, the directly standardised mortality rate (DSR) for land traffic 

accidents (ICD10: V01-V89) for 2006-2008 (Table 362) for Hull is lower than England 

for males and females. In relation to comparator areas, Hull‟s mortality rate from land 

traffic accidents is slightly higher for males, but the mortality rate for females in Hull is 

the lowest of all comparator areas. The number of female deaths is small so it is 

possible that this is due to random variation. 

Other 

All


Table 362: Total number over three years and directly standardised mortality rate from 

land traffic accidents per 100,000 persons, 2006-2008 

Area Total 3yr number of land traffic accident deaths and DSR (95% CI), 2006-2008 



England 5,844 7.46 (7.27, 7.66) 1,941 2.18 (2.07, 2.28) 7,785 4.80 (4.69, 4.91) 

Hull 26 6.58 (4.03, 9.13) 4 0.86 (0.00, 1.73) 30 3.72 (2.37, 5.07) 

Y&H HA 680 8.54 (7.89, 9.19) 221 2.43 (2.09, 2.77) 901 5.47 (5.11, 5.84) 

Indust Hint 348 6.53 (5.84, 7.23) 105 1.69 (1.34, 2.03) 453 4.06 (3.67, 4.44) 

Wolverhampton 30 8.37 (5.35, 11.39) 11 2.59 (0.96, 4.23) 41 5.56 (3.82, 7.29) 

Salford 28 7.82 (4.88, 10.76) 11 3.16 (1.22, 5.10) 39 5.50 (3.73, 7.26) 

Derby 18 4.93 (2.63, 7.23) 6 1.21 (0.18, 2.23) 24 3.09 (1.83, 4.36) 

Stoke-on-Trent 37 9.47 (6.38, 12.56) 5 1.06 (0.08, 2.03) 42 5.21 (3.59, 6.82) 

Coventry 30 6.13 (3.91, 8.36) 14 2.24 (0.95, 3.52) 44 4.30 (2.99, 5.61) 

Plymouth 20 5.09 (2.82, 7.37) 8 1.71 (0.44, 2.99) 28 3.40 (2.11, 4.69) 

Sandwell 26 6.10 (3.73, 8.47) 8 1.71 (0.49, 2.93) 34 3.90 (2.56, 5.23) 

Middlesbrough 10 4.98 (1.87, 8.09) 7 2.93 (0.67, 5.19) 17 4.02 (2.08, 5.96) 

Sunderland 22 5.19 (3.01, 7.38) 7 1.36 (0.29, 2.43) 29 3.29 (2.08, 4.51) 

Leicester 29 6.23 (3.93, 8.53) 11 2.22 (0.86, 3.58) 40 4.17 (2.85, 5.50) 

Average 10 above 25 6.43* 9 2.02* 34 4.24* 

NE Lincolnshire 24 9.97 (5.91, 14.04) 14 4.72 (2.05, 7.40) 38 7.28 (4.87, 9.69) 

*Confidence intervals not available. 

10.11.3 Falls 

For information relating to falls resulting in fractured neck of femurs for those aged 65+ 

years, see section 10.13.2 on page 756. For the estimated number of people aged 65+ 

years who are expected to fracture their neck of femurs given the ageing population, see 

section 10.13.1.8 on page 746. 



10.12 Children and Young People 

10.12.1 Low Birth Weight 

From the Compendium, the percentages of births under 1500g and under 2500g out of 

all live births and stillbirths are given in Table 363 for 2008 for Hull and comparators. 

The percentage of low birth-weight babies is slightly higher in Hull than England, but 

similar to comparator areas. 

Table 363: Percentage of low birth-weight babies in Hull, 2008 

Area Total Weight


10.12.3 Childhood Incidence of Disease 

10.12.3.1 Incidence of Measles in Hull and Comparator Areas 

From the Compendium, the incidence rate of measles in those under one year of age 

and those under 15 years of age is given in Table 364 for the years 2005 to 2008 for 

Hull and comparator areas. It can be seen that the rates of measles are considerably 

higher in Hull than England. Due to the small number of cases locally (just over 100 

cases over four years), the confidence intervals are very wide suggesting uncertainty 

about the rate. However, the lower limits of the confidence intervals for Hull (175.4 and 

60.6 for those aged


10.12.3.2 Incidence of Whooping Cough in Hull and Comparator Areas 

From the Compendium, the directly age-standardised incidence rate of whooping cough 

in those under one year of age and those under 15 years of age is given in Table 365 

for the years 2005 to 2008 for Hull and comparator areas. It can be seen that there are 

few cases of whooping cough throughout England, and that Hull has one of the lowest 

rates of its comparators areas. 

Table 365: Incidence rate of whooping cough per 100,000 children for 2005 to 2008 for 

Hull 

Geographical 

Cases and incidence rate for whooping cough 2005-2008 

area 

Children aged under 1 year Children aged under 15 years 

Total Annual standardised Total Annual standardised 

cases rate per 100,000 cases rate per 100,000 

over 4 yrs (95% CI) over 4 yrs (95% CI) 

England 717 28.2 (26.2, 30.3) 2188 6.1 (5.9, 6.4) 

Hull * * 3 1.6 (0.0, 3.5) 

Y&H SHA 89 35.5 (28.1, 42.9) 180 5.1 (4.4, 5.9) 

Industr Hint’lnds 63 37.0 (27.8, 46.1) 172 7.0 (6.0, 8.1) 

Wolverhampton 3 23.4 (0.0, 50.0) 4 2.3 (0.0, 4.6) 

Salford * * 6 4.0 (0.7, 7.2) 

Derby City 8 62.3 (19.1, 105.6) 16 9.2 (4.7, 13.7) 

Stoke on Trent** 5 36.5 (4.5, 68.6) 8 4.4 (1.3, 7.4) 

Coventry * * 6 2.7 (0.5, 4.9) 

Plymouth 12 100.9 (43.8, 157.9) 22 13.7 (7.9, 19.4) 

Sandwell 15 88.1 (43.5, 132.6) 24 10.5 (6.3, 14.8) 

Middlesbrough 4 52.9 (1.0, 104.8) 5 4.8 (0.6, 9.0) 

Sunderland 10 78.8 (29.9, 127.6) 17 9.9 (5.2, 14.6) 

Leicester City 10 52.9 (20.1, 85.8) 22 9.2 (5.3, 13.0) 

*Cases and rates are not presented as the number of cases is less than three (in order to 

preserve confidentiality). 

** Data refers to Local Authority as it is not available for the PCT. The geographical boundary is 

slightly different between the local authority and the PCT for Stoke on Trent so the figures 

presented above will not be the same for Stoke on Trent PCT. 

10.12.4 Childhood Vaccinations 

For childhood vaccination uptake rates for Hull children at ward and practice level, and 

by ethnicity, as well as comparisons for Hull overall with comparator areas for measles, 

mumps and rubella (MMR) vaccinations and whooping cough vaccinations, see section 

9.1 on page 388. 



10.12.5 Breastfeeding 

Breastfeeding status is generally measured at three periods of time: initiation and at 

discharge (generally at hospital) and at 6-8 weeks (by midwives). 


Information on the prevalence of breastfeeding initiation, measured at the time of birth, 

is given in Figure 249 which has been provided by the Department of Health using 

quarterly data (Department of Health 2010). The breastfeeding initiation rates in Hull 

(56.2%) are similar to the average for the Industrial Hinterlands (54.4%) and North East 

Lincolnshire (57.9%; not shown in figure) which is deemed by ONS to be Hull‟s nearest 

comparator, but lower than the average of the ten comparators (64.0%), the Yorkshire 

and Humber region (68.0%) and England (72.7%). The underlying data are given in the 


Figure 249: Breastfeeding initiation, 2009/2010 

Percentage of women known to initiate 

breastfeeding, 2009/10 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Hull PCT 

Plymouth 

Salford 

Sunderland 

Middlesbrough 

Coventry 

PCT England Industrial Hinterlands Yorkshire & Humber SHA Average of 10 comparators 


Wolverhampton City 

Derby City 

Leicester City 

Sandwell 

Stoke-on-Trent 

NE Lincolnshire


10.12.5.2 Social Marketing and Factors Influencing Breastfeeding 

Social marketing research is being undertaken in Hull (commencing September 2009) 

which aims to examine factors which influence breastfeeding. Some initial analysis has 

been undertaken with the aim of informing the social market research. The initial work 

involved examining ACORN classifications of those who do and do not breastfeed 

(based on their postcode). 

From this initial work, considerable geographical variability in the percentages of babies 

in Hull born 19 th February 2009 to 19 th May 2009 inclusive that were recorded on the 

Child Health System as still being breast-fed at 6 weeks was found, as shown in Table 

366. 

The numbers of babies born over this four month period was relatively small at ward 

level (varying from 17 to 64), nevertheless considerable variability was found. The 

percentages of babies who were exclusively breast-fed at 6 weeks ranged from 9.4% in 

Bransholme West, 11.1% in Ings, 12.2% in Newington, 12.5% in Orchard Park and 

Greenwood and 13.6% in Marfleet to 42.2% in Derringham, 43.2% in Boothferry, 46.0% 

in Myton and 46.2% in Avenue. The percentage of babies that were partially breast-fed 

at 6 weeks ranged from 0% to 18%. Under half of babies were exclusively bottle-fed at 

6 weeks in Myton, Avenue, Bricknell and Newland, whereas 80% or higher for 

Bransholme East, Bransholme West, Orchard Park and Greenwood, Ings, Marfleet, 

Southcoates East, Southcoates West and Newington. 

Table 366: Breast feeding status at 6 weeks by area and locality for babies resident in 

Hull and born 19 th February 2009 to 19 th May 2009 inclusive 

Breast feeding status at 6 weeks 

Area/Locality 

Exclusively Partially Exclusively All 

breast-fed breast-fed bottle-fed 

N % N % N % N 

North Carr 32 23.5 6 4.4 98 72.1 136 

Northern 25 21.4 2 1.7 90 76.9 117 

North Locality 57 22.5 8 3.2 188 74.3 253 

East 19 20.2 7 7.4 68 72.3 94 

Park 31 21.4 3 2.1 111 76.6 145 

Riverside (East) 6 17.1 5 14.3 24 68.6 35 

East Locality 56 20.4 15 5.5 203 74.1 274 

Riverside (West) 38 29.7 6 4.7 84 65.6 128 

West 42 35.6 3 2.5 73 61.9 118 

Wyke 44 41.5 15 14.2 47 44.3 106 

West Locality 124 35.2 24 6.8 204 58.0 352 

Hull 237 27.0 47 5.3 595 67.7 879 



As expected, there was a trend associated with deprivation (Table 367). Around one in 

five babies born over the four month period who lived in the most deprived and second 

most deprived quintile areas of Hull were totally breast-fed at 6 weeks, whereas in the 

least deprived and second least deprived quintile areas this was around one in three or 

higher. Three-quarters of babies were exclusively bottle-fed in the most deprived areas 

compared to around 60% in the least deprived areas. 

Table 367: Breast feeding status at 6 weeks by local deprivation quintile for babies 

resident in Hull and born 19 th February 2009 to 19 th May 2009 inclusive 

Local IMD 

Breast feeding status at 6 weeks 

2007 quintiles Exclusively Partially Exclusively All 


N % N % N % N 

Most deprived 45 21.1 7 3.3 161 75.6 213 

2 36 20.5 9 5.1 131 74.4 176 

3 43 25.0 15 8.7 114 66.3 172 

4 60 38.0 4 2.5 94 59.5 158 

Least deprived 53 33.1 12 7.5 95 59.4 160 

Hull 237 27.0 47 5.3 595 67.7 879 

There was also a strong association with ethnic group (Table 368). The percentage 

exclusively breast-fed at 6 weeks was highest in the Non-British White group (64%), 

Black or Black British (55%) and Asian or Asian British (52%) and lowest in White British 

(23%). 

Table 368: Breast feeding status at 6 weeks by broad ethnic group for babies resident in 

Hull and born 19 th February 2009 to 19 th May 2009 inclusive 

Broad ethnic group Breast feeding status at 6 weeks 



N % N % N % N 

White British 171 23.0 31 4.2 542 72.8 744 

Other White 25 64.1 6 15.4 8 20.5 39 

Mixed 17 38.6 3 6.8 24 54.5 44 

Asian or Asian British 14 51.9 7 25.9 6 22.2 27 

Black or Black British 6 54.5 0 0.0 5 45.5 11 

Chinese or other 2 40.0 0 0.0 3 60.0 5 

Missing 2 22.2 0 0.0 7 77.8 9 

Hull 237 27.0 47 5.3 595 67.7 879 

There were also differences in breast-feeding among the dominant ACORN groups (see 

section 6.10 on page 138 for more information about the ACORN classifications based 

on postcode). Four in ten babies in the Wealthy Achievers classification were 



exclusively breast-fed at 6 weeks, five in ten in the Urban Prosperity classification, 

almost four in ten in the Comfortably Off classification, 27% in the Moderate Means 

classification and less than two in ten babies in the Hard Pressed classification (Table 

369). 

Table 369: Breast feeding status at 6 weeks by dominant ACORN classification for 

babies resident in Hull and born 19 th February 2009 to 19 th May 2009 inclusive 

Dominant ACORN 

Breast-fed at 6 weeks 

Classification 



N % N % N % N 

1. Wealthy Achievers 13 41.9 0 0.0 18 58.1 31 

2. Urban Prosperity 21 50.0 5 11.9 16 38.1 42 

3. Comfortably Off 52 38.5 10 7.4 73 54.1 135 

4. Moderate Means 73 26.6 19 6.9 182 66.4 274 

5. Hard Pressed 78 19.7 12 3.0 306 77.3 396 



consultation (see section 3.3.6.2 on page 52). One of the outcomes proposed is 

related to low birth weight, but it is not yet known if this will become an outcome 

measure. 

10.12.6 Health Needs Assessments 

Two formal Health Needs Assessments have recently or are currently being conducted 

by the local authority in partnership with NHS Hull and other key stakeholders. The first 

is a general Health Needs Assessment for Children and Young People and will 

document “What it is like growing up in Hull” and involves both quantitative and 

qualitative analyses of existing and new data. The second linked Health Needs 

Assessment is specifically on alcohol and substance misuse. The aim for both needs 

assessments is to detail existing health needs, identify potential gaps and unmet health 

needs for children and young people, and find out what it is like to grow up in Hull from 

young peoples‟ perspectives. 



10.13 Older People 

10.13.1 Predictions of Future Need to 2030 for Those Aged 65+ Years 

The Projecting Older People Population Information (POPPI) System which is available 

at www.poppi.org.uk provides population projections for people aged 65+ years for 

2010, 2015, 2020, 2025 and 2030. The model also produces predictions of the people 

within these age groups who are expected to have certain care requirements and have 

certain conditions, such as limiting long-term illness, dementia, etc. All the predictions 

within this section (10.13.1) are from the POPPI system, and the population estimates 

are from the Office for National Statistics (ONS) based on the 2008 mid-year population 

estimates projected forward. The figures have been updated on POPPI for the new 

ONS population projections (the previous estimates in Release 2 of these profiles had 

fewer older people). 

10.13.1.1 Population Changes 

Table 370 gives the population projections for those aged 65+ years in Hull for 2010, 

2015, 2020, 2025 and 2030 from ONS. The percentage aged 65+ years in Hull out of 

the total population is currently estimated to be around 14% but is expected to increase 

to 17% by 2030, and the percentage aged 85+ years is currently around 1.7% in Hull 

and is expected to increase to 2.5% by 2030. The number of residents based on the GP 

registration file is given for 2010 (and these figures are similar to POPPI‟s estimates for 

2010). 

Table 370: POPPI – population projections to 2030 for those aged 65+ years in Hull 

Age (years) Hull’s population estimates and Residents estimates 

projections 

from GP registration 

2010 2015 2020 2025 2030 file, 2010 

65-69 9,500 12,500 11,800 13,000 14,800 9,610 

70-74 9,000 8,500 11,300 10,700 11,800 8,910 

75-79 7,700 7,600 7,300 9,900 9,400 7,532 

80-84 5,400 5,800 6,100 6,000 8,100 5,597 

85+ 4,600 5,100 5,900 6,900 7,800 4,699 

Total 65+ 36,200 39,500 42,400 46,500 51,900 36,348 

% 65+/total pop 13.6 14.2 14.6 15.5 16.6 13.7 

% 85+/total pop 1.7 1.8 2.0 2.3 2.5 1.8 

The estimated population and population projections are not substantially different for 

Hull between the genders for those aged 65-79 years, but differ substantially for those 

aged 85+ years (Table 371). The percentages of males and females within the specific 

age groups out of those aged 65+ years are also given. In 2030, it is estimated that of 

all those people aged 65+ years, 6.5% will be men aged 85+ years and a further 8.5% 

will be women aged 85+ years. 



Table 371: POPPI – population projections to 2030 for those aged 65+ years in Hull by 

gender 

Gender Age (years) Hull’s population estimates and projections 

2010 2015 2020 2025 2030 

65-69 4,600 6,300 5,900 6,600 7,500 

70-74 4,400 4,100 5,600 5,400 6,000 

75-79 3,500 3,600 3,500 4,800 4,600 

80-84 2,100 2,500 2,800 2,800 3,800 

Males 

85+ 

Total 65+ 

1,500 

16,100 

1,800 

18,300 

2,400 

20,200 

2,900 

22,500 

3,400 

25,300 

65-74 (% of 65+ tot) 24.9 26.3 27.0 25.8 26.0 

75-84 (% of 65+ tot) 15.5 15.4 14.8 16.3 16.2 

85+ (% of 65+ tot) 4.2 4.5 5.6 6.2 6.5 

65+ (% of 65+ tot) 44.6 46.2 47.4 48.3 48.7 

65-69 4,800 6,300 5,900 6,400 7,300 

70-74 4,700 4,400 5,700 5,400 5,900 

75-79 4,100 4,000 3,900 5,100 4,800 

80-84 3,300 3,300 3,300 3,200 4,300 

Females 

85+ 

Total 65+ 

3,100 

20,000 

3,300 

21,300 

3,600 

22,400 

4,000 

24,100 

4,400 

26,700 

65-74 (% of 65+ tot) 26.3 27.0 27.2 25.3 25.4 

75-84 (% of 65+ tot) 20.5 18.4 16.9 17.8 17.5 

85+ (% of 65+ tot) 8.6 8.3 8.5 8.6 8.5 

65+ (% of 65+ tot) 55.4 53.8 52.6 51.7 51.3 

10.13.1.2 Pensioners Claiming State Pension and Other State Benefits 

Table 372 gives the number of people of pensionable age (60+ for women and 65+ for 

men) who are claiming incapacity benefit, carer‟s benefit, income related benefits, 

disability benefits and bereavement benefits (it does not include housing benefit) for 

November 2008. The information is based on Department of Works and Pensions data. 

Table 372: POPPI – population estimates claiming state pension and other state 

benefits, November 2008 

Benefit Pensioners 

Total population of pensionable age (65+ for men and 60+ for women) 41,810 

Total receiving state pension only 19,850 

Proportion receiving state pension plus at least one other state benefit* 52.5% 

Proportion receiving state pension only 47.5% 

*Incapacity benefit, carer‟s benefit, income related benefits, disability benefits and bereavement benefits 

(it does not include housing benefit). 



10.13.1.3 Predicted Numbers by Tenure, Numbers Without Central Heating and 

Numbers Without Transport 

Table 373 gives the percentage of residents aged 65+ years who own and rent their 

property based on estimates from the 2001 Census. The percentage of people owning 

their own property decreases with age, and the percentage renting from social 

companies or private companies increases with age. 

Table 373: POPPI – population estimates for those aged 65+ years in Hull by tenure 

2001 

Age 

(years) 

Tenure from 2001 Census (%) 

Owned Rented 

Council Other social renting Private (or rent free) 

65-74 53.8 32.7 7.1 6.4 

75-84 42.1 34.8 11.0 12.1 

85+ 35.8 31.0 13.5 19.7 

Table 374 gives the numbers of people in Hull from the 2001 Census aged 65+ years 

with no central heating. The numbers have not been predicted forward as it is 

anticipated that this would be unreliable. 

Table 374: POPPI – population estimates for those aged 65+ years in Hull who have no 

central heating 2001 

Age (years) Total aged 65+ Aged 65+ with no central heating (2001) 

years 


65-74 20,268 4,876 13.1 

75-84 12,916 3,178 8.5 

85+ 4,153 910 2.4 

Total 37,337 8,964 24.0 

Based on the prevalence estimates from the 2001 Census, Table 375 gives the number 

of people who do or do not live alone who have or don‟t have transport. Overall, 13,000 

pensioner households are single person households with no transport and a further 

3,600 households where the pensioner does not live alone do not have transport. 

Table 375: POPPI – household estimates for those aged 65+ years in Hull by whether 

they live alone or not and have transport or not 

Living alone or not and with or Pensioner households 

without transport 

(number 2001) 

Living alone with transport 2,887 

Living alone without transport 13,062 

Not living alone with transport 4,786 

Not living alone without transport 3,631 



10.13.1.4 Predicted Numbers of Households by Age of Residents 

Table 376 gives the number of households by age of resident as at 2006, and the 

number and percentage increase in the number of households over the period 2006- 

2031. The information comes from figures published in the report “Components of 

household growth (2006-2013)” (Communities and Local Government 2009). Based on 

figures for 2006, there are currently around 114,000 households in Hull. Age of 

household is based on the household representative. This is the individual that 

represents that household and is usually taken as the eldest male within the household. 

It is estimated that 26,000 of these are households with the household representative 

being 65+ years (23%). It is projected that there will be an increase of 35% in the 

number of households over the period 2006-2031 resulting in a further 40,000 

households giving a total of 154,000 households. It is predicted that 12,000 of these 

households will be households with the household representative who is aged 65+ years 

which represents an increase from 26,000 to 32,000 or 23%, and 31% of all the increase 

in the households will be due to increases in the number of households with the 

household representative being 65+ years. 

Table 376: POPPI – population projections to 2006-2030 of number of Hull households 

by age of residents 

Total number in 2006 and projected increase by age (years) Households 

Total in 2006 aged under 65 88,000 

Total in 2006 aged 65 and over 26,000 

Total in 2006 all ages 114,000 

Projected increase 2006-2031 all ages 40,000 

Projected increase 2006-2031 age 65 and over 12,000 

Projected increase 2006-2031 age 75 and over 6,000 

Projected increase (all ages) as proportion of households in 2006 35 

Projected increase (65+) as proportion of increase in households (all ages) 31 

Projected increase (75+) as proportion of increase in households (all ages) 15 

10.13.1.5 Predicted Numbers Living Alone or in Care Homes 

Table 377 gives the population projections for people in Hull aged 65+ years who are 

expected to live alone. Figures are taken from the General Household Survey 

conducted during the year 2007 (Economic and Social Data Service 2008). 



Table 377: POPPI – population projections to 2030 for those aged 65+ years in Hull of 

those expected to live alone 

Age and gender Hull’s population estimates and projections of people 

expected to live alone 

2010 2015 2020 2025 2030 

Males 65-74 1,800 2,080 2,300 2,400 2,700 

Males 75+ 2,414 2,686 2,958 3,570 4,012 

Females 65-74 2,850 3,210 3,480 3,540 3,960 

Females 75+ 6,405 6,466 6,588 7,503 8,235 

Total 65-74 4,650 5,290 5,780 5,940 6,660 

Total 75+ 8,819 9,152 9,546 11,073 12,247 

Table 378 gives the numbers of people expected to live in a local authority or non-local 

authority care home with or without nursing. The information is derived from the number 

of people in care homes from the 2001 Census (Office for National Statistics 2009), 

which have been applied to ONS population projections. Currently, it is estimated that 

there are under 1,500 people aged 65+ years in local authority or non-local authority 

care homes, but this is expected to increase in Hull to almost 2,300 by 2030. 

Table 378: POPPI – population projections to 2030 for those aged 65+ years in Hull of 

those expected to live in a local authority or non-local authority care home 

Age (years) and 

local authority 

care home or not 

Hull’s population estimates and projections of people living in 

a (local authority or non-local authority) care home with or 

without nursing 

2010 2015 2020 2025 2030 

65-74 (LA) 16 18 19 20 22 

75-84 (LA) 59 60 60 71 79 

85+ (LA) 72 80 92 108 122 

65-74 (non-LA) 175 199 219 225 252 

75-84 (non-LA) 484 495 495 587 646 

85+ (non-LA) 690 765 885 1,035 1,170 

Total 65+ 1,495 1,616 1,771 2,046 2,291 

10.13.1.6 Predicted Numbers in Relation to Caring Needs 

Table 379 gives the estimated current number and projected numbers of people aged 

65+ years who are expected to be providing unpaid care to a partner, family member of 

other person. The information is derived from the number of people providing unpaid 

care from the 2001 Census (Office for National Statistics 2009), which have been 

applied to ONS population projections. It is currently estimated that around 3,700 

people aged 65+ years are providing care for someone of whom over 150 are aged over 

85+ years, and that this total is expected to increase to more than 5,000 by 2030. 




providing unpaid care 

Age (years) Hull’s population estimates and projections of people 

providing unpaid care to a partner, family member of other 

person 

2010 2015 2020 2025 2030 

65-74 2,440 2,770 3,046 3,126 3,508 

75-84 1,126 1,152 1,152 1,366 1,504 

85+ 162 179 207 243 274 

Total 65+ 3,727 4,100 4,406 4,735 5,286 

Table 380 gives the estimated number and projections to 2030 of people in Hull who are 

caring for someone else based on the number of hours they spend caring for that 

person or persons. The information comes from the 2001 Census. 


providing care by number of hours of care 

Level of 

caring 

(hours) 

None 

1-19 hours 

per week 

20-49 hours 

per week 

50+ hours 

per week 

Age 

(years) 

Hull’s population estimates and projections of people 

caring for others by number of hours of caring 

2010 2015 2020 2025 2030 

65-74 15,786 17,920 19,712 20,224 22,698 

75-84 11,298 11,556 11,556 13,712 15,092 

85+ 3,455 3,830 4,431 5,182 5,858 

65-74 1,064 1,208 1,329 1,363 1,530 

75-84 405 414 414 491 541 

85+ 45 50 58 68 77 

65-74 287 325 358 367 412 

75-84 136 139 139 165 182 

85+ 19 21 24 28 32 

65-74 1,089 1,236 1,360 1,395 1,566 

75-84 585 599 599 710 782 

85+ 97 108 125 146 165 

Table 381 gives the projected numbers of people in Hull who are in either good/fairly 

good health or in poor health who are providing care for another person. The 

prevalence estimates are from the 2001 Census. Overall, it is estimated that there will 

be over 1,300 residents of Hull by 2030 who aged 65+ years and are providing care for 

another person and they themselves are in poor health. Another almost 4,000 residents 

aged 65+ years are projected to be providing care for another person by 2030, but they 

are at least in relatively good health themselves. 



Table 381: POPPI – population projections to 2030 for those aged 65+ years in Hull who 

have good or poor health who are providing unpaid care 

Providing 

care to 

another 

No 

Yes 

Health status and age (years) Hull’s population estimates and 

projections 

2010 2015 2020 2025 2030 

Good/fairly good health/aged 65-74 11,861 13,463 14,810 15,194 17,053 

Poor health/aged 65-74 3,926 4,456 4,902 5,029 5,645 


Poor health/aged 75-84 3,651 3,735 3,735 4,432 4,878 

Good/fairly good health/aged 85+ 2,051 2,274 2,631 3,077 3,478 

Poor health/aged 85+ 1,403 1,556 1,800 2,105 2,380 


Poor health/aged 65-74 566 642 707 725 814 

Good/fairly good health/aged 75-84 780 798 798 947 1,042 

Poor health/aged 75-84 346 354 354 420 462 

Good/fairly good health/aged 85+ 111 123 142 166 188 

Poor health/aged 85+ 51 56 65 76 86 

Table 382 gives the estimated and projected numbers of people unable to manage at 

least one domestic task on their own by age group. The tasks include household 

shopping, washing and drying dishes, cleaning the inside of windows, jobs involving 

climbing, the use a vacuum cleaner to clean floors, washing clothing by hand, opening 

screw tops and dealing with personal affairs. The estimated numbers unable to manage 

at least one domestic task are derived from the Living in Britain report from the General 

Household Survey 2001 (Economic and Social Data Service 2001) applied to ONS 

population estimates and projections. It is anticipated that the number of people in Hull 

who are unable to mange at least one domestic task on their own will increase by 43% 

to over 21,000 by 2030. 


unable to mange at least one domestic task on their own 

Gender and age 

(years) 

Hull’s population estimates and projections of people unable 

to manage at least one domestic tasks on their own 

2010 2015 2020 2025 2030 

Males 65-69 736 1,008 944 1,056 1,200 

Males 70-74 924 861 1,176 1,134 1,260 

Males 75-79 1,260 1,296 1,260 1,728 1,656 

Males 80-84 861 1,025 1,148 1,148 1,558 

Males 85+ 1,020 1,224 1,632 1,972 2,312 

Females 65-69 1,344 1,764 1,652 1,792 2,044 

Females 70-74 1,880 1,760 2,280 2,160 2,360 

Females 75-79 2,132 2,080 2,028 2,652 2,496 

Females 80-84 2,211 2,211 2,211 2,144 2,881 

Females 85+ 2,542 2,706 2,952 3,280 3,608 

Total 14,910 15,935 17,283 19,066 21,375 



Table 383 gives the estimated and projected number of people unable to manage at 

least one self-care activity on their own by age group. The self-care activities include 

bathing and showering or washing all over, dressing and undressing, washing their face 

and hands, feeding and cutting their toenails. The estimated numbers unable to 

manage at least one self-care activity are derived from the Living in Britain report from 

the General Household Survey 2001 (Economic and Social Data Service 2001) applied 

to ONS population estimates and projections. It is likely that there will be considerable 

overlap in the numbers of people who cannot manage at least one domestic task (Table 

382) and cannot manage at least one self-care activity (Table 383). It is currently 

estimated that around 12,000 residents are unable to manage at least self-care activity, 

that that this will increase by 44% to around 17,500 residents of Hull. 


unable to manage at least one self-care activity on their own 


(years) 

Hull’s population estimates and projections of people unable 

to manage at least one self-care activity on their own 

2010 2015 2020 2025 2030 

Males 65-69 828 1,134 1,062 1,188 1,350 

Males 70-74 836 779 1,064 1,026 1,140 

Males 75-79 1,015 1,044 1,015 1,392 1,334 

Males 80-84 693 825 924 924 1,254 

Males 85+ 765 918 1,224 1,479 1,734 

Females 65-69 1,008 1,323 1,239 1,344 1,533 

Females 70-74 1,410 1,320 1,710 1,620 1,770 

Females 75-79 1,599 1,560 1,521 1,989 1,872 

Females 80-84 1,749 1,749 1,749 1,696 2,279 

Females 85+ 2,294 2,442 2,664 2,960 3,256 

Total 12,197 13,094 14,172 15,618 17,522 

Table 384 gives the population projections for Hull for people who are unable to manage 

at least one mobility activity on their own. The activities include going out of doors and 

walking down the road, getting up and down the stairs, getting around the house on the 

level, getting to the toilet and getting in and out of bed. The estimated numbers unable 

to manage at least one self-care activity are derived from the Living in Britain report from 

the General Household Survey 2001 (Economic and Social Data Service 2001) applied 

to ONS population estimates and projections. It is likely that there will be some overlap 

in the numbers of people who cannot manage at least one domestic task (Table 382), 

cannot manage at least one self-care activity (Table 383) and cannot manage at least 

one mobility activity (Table 384). 




unable to manage at least one mobility activity on their own 

Age (years) Hull’s population estimates and projections of people unable 

to manage at least one mobility activity on their own 

2010 2015 2020 2025 2030 

Males 65-69 368 504 472 528 600 

Males 70-74 440 410 560 540 600 

Males 75-79 420 432 420 576 552 

Males 80-84 378 450 504 504 684 

Males 85+ 525 630 840 1,015 1,190 

Total males 2,131 2,426 2,796 3,163 3,626 

Females 65-69 432 567 531 576 657 

Females 70-74 752 704 912 864 944 

Females 75-79 861 840 819 1,071 1,008 

Females 80-84 957 957 957 928 1,247 

Females 85+ 1,550 1,650 1,800 2,000 2,200 

Total females 4,552 4,718 5,019 5,439 6,056 

10.13.1.7 Predicted Numbers With Limiting Long Term Illness and Disability 

The number of people predicted to have limiting long-term illness or disability is given in 

Table 385 for Hull. The information is derived from the 2001 Census (Office for National 

Statistics 2009), which have been applied to ONS population projections. It is currently 

estimated that almost 20,000 people aged 65+ years in Hull have a limiting long-term 

illness or disability, and it is expected that this will increase to over 27,000 by 2030. 

Table 385: POPPI – population projections to 2030 for those aged 65+ years in Hull with 

a limiting long-term illness or disability 

Age (years) Hull’s population estimates and projections of people with a 

limiting long-term illness or disability 

2010 2015 2020 2025 2030 

65-74 8,842 10,037 11,041 11,327 12,713 

75-84 7,701 7,878 7,878 9,347 10,288 

85+ 2,689 2,982 3,449 4,034 4,560 

Total 65+ 19,233 20,896 22,367 24,709 27,561 

The number of people predicted to have limiting long-term illness or disability who also 

live alone is given in Table 386 for Hull. The information is also derived from the 2001 

Census. 




a limiting long-term illness or disability 

Age (years) Hull’s population estimates and projections of people with a 

limiting long-term illness or disability who live alone 

2010 2015 2020 2025 2030 

65-69 1,200 1,579 1,490 1,642 1,869 

70-74 1,665 1,573 2,091 1,980 2,183 

75-79 2,025 1,999 1,920 2,604 2,472 

80-84 1,781 1,913 2,012 1,979 2,671 

85+ 1,819 2,017 2,333 2,728 3,084 

Total 65-74 years 2,865 3,152 3,581 3,622 4,052 

Total 75+ years 5,625 5,929 6,265 7,311 8,227 

10.13.1.8 Predicted Numbers with Various Health Needs 

Table 387 gives the estimated number and population projections for those aged 65+ 

years in Hull who are expected to have learning disabilities. 

These predictions are based on prevalence rates in a report by Emerson and Hatton 

(Emerson and Hatton 2004). The authors take the prevalence base rates and adjust 

these rates to take account of ethnicity (i.e. the increased prevalence of learning 

disabilities in South Asian communities) and of mortality (i.e. both increased survival 

rates of young people with severe and complex disabilities and reduced mortality among 

older adults with learning disabilities). Therefore, figures are based on an estimate of 

prevalence across the national population; locally this will produce an over-estimate in 

communities with a low South Asian community, and an under-estimate in communities 

with a high South Asian community. 


learning disabilities 


(years) 

Hull’s population estimates and projections of people with 

learning disabilities 

2010 2015 2020 2025 2030 

65-69 402 450 502 512 574 

70-74 261 268 269 323 356 

75+ 87 97 114 134 153 

Total 65+ 749 816 885 969 1,083 

Table 388 gives the estimated number and population projections for those aged 65+ 

years in Hull who are expected to have depression. McDougall et al (McDougall, Kvaal 

et al. 2007) estimates that between 5% and 10% of men and between 9% and 11% of 

women aged 65+ years have depression and that 2.5%, 1.6%, 3.5%, 3.0% and 3.9% of 



all men and women aged 65-69, 70-74, 75-79, 80-84 and 85+ years respectively have 

severe depression. These estimates have been used to provide estimates for the total 

number of people aged 65+ years with any type of depression and severe depression 

using the ONS population projections. It is likely that these estimates are applied from 

national estimates without adjusting for deprivation, therefore, Hull‟s prevalence and 

resulting estimates could be higher than those presented in Table 388. 


depression 

Severity of 

depression 

Any 

Severe 

Gender and 

age (years) 

Hull’s population estimates and projections of 

people with a depression 

2010 2015 2020 2025 2030 

Males 65-69 267 365 342 383 435 

Males 70-74 304 283 386 373 414 

Males 75-79 207 212 207 283 271 

Males 80-84 204 243 272 272 369 

Males 85+ 77 92 122 148 173 

Total males 1,057 1,195 1,329 1,458 1,662 

Females 65-69 523 687 643 698 796 

Females 70-74 447 418 542 513 561 

Females 75-79 439 428 417 546 514 

Females 80-84 304 304 304 294 396 

Females 85+ 344 366 400 444 488 

Total females 2,056 2,203 2,305 2,495 2,754 

Persons 65-69 238 313 295 325 370 

Persons 70-74 144 136 181 171 189 

Persons 75-79 270 266 256 347 329 

Persons 80-84 162 174 183 180 243 

Persons 85+ 179 199 230 269 304 

Total persons 992 1,087 1,144 1,292 1,435 

From a recent report examining the prevalence of dementia (Dementia UK 2007), the 

estimated numbers of people and projected numbers of people with dementia in Hull is 

given in Table 389. Based on this report, the prevalence is less than 2% for those aged 

65-69 years, but increases to 2-3% (depending on gender) for those aged 70-74 years, 

5-7% for those aged 75-79 years, 10-13% for those aged 80-84 years and 20-25% for 

those aged 85+ years (with the higher prevalence for men aged under 80 years but the 

higher prevalence for women aged 80+ years). In Hull, there was a higher mortality rate 

from dementia for people living in the most deprived areas (Figure 243) although there 

was no association between diagnosed dementia from GP registers and deprivation 

(Figure 241). It is not known if the rate of undiagnosed dementia for people living in the 

most deprived areas is higher with more people undiagnosed, or if there is a coding 

issue with regards to the cause of death. However, if an association does exist between 

deprivation and the prevalence of dementia, it is likely that the numbers predicted to 

have dementia will be higher for Hull than those presented in Table 389 due to Hull‟s 



increased deprivation relative to England from which these average prevalence figures 

were derived. 


dementia 


(years) 

Hull’s population estimates and projections of people with 

dementia 

2010 2015 2020 2025 2030 

Males 65-69 69 95 89 99 113 

Males 70-74 136 127 174 167 186 

Males 75-79 179 184 179 245 235 

Males 80-84 214 255 286 286 388 

Males 85+ 296 355 473 571 670 

Total males 894 1,015 1,199 1,368 1,591 

Females 65-69 48 63 59 64 73 

Females 70-74 113 106 137 130 142 

Females 75-79 267 260 254 332 312 

Females 80-84 439 439 439 426 572 

Females 85+ 781 832 907 1,008 1,109 

Total females 1,647 1,699 1,795 1,959 2,207 

Total persons 2,541 2,714 2,994 3,327 3,798 

The numbers of people predicted to have a long-standing condition as a result of having 

had a heart attack or stroke are given in Table 390 and Table 391 respectively for Hull 

residents. The prevalence estimates used to calculate the numbers were obtained from 

the General Household Survey conducted during 2007 (Economic and Social Data 

Service 2008). Further information about the calculation and the numbers by gender are 

given at www.poppi.org.uk. The incidence of heart attacks and stroke will be higher in 

Hull due to its higher deprivation, however, this may be counter-balanced by the higher 

mortality rates following heart attack or stroke. 


a long-standing condition associated with having had a heart attack 


(years) 

Hull’s population estimates and projections of people to have 

a long-standing condition associated with a heart attack 

2010 2015 2020 2025 2030 

Males 65-74 585 676 748 780 878 

Males 75+ 405 450 496 599 673 

Females 65-74 247 278 302 307 343 

Females 75+ 536 541 551 627 689 

Total 65+ 1,772 1,945 2,096 2,313 2,582 




a long-standing condition associated with having had a stroke 


(years) 


a long-standing condition associated with a stroke 

2010 2015 2020 2025 2030 

Males 65-74 252 291 322 336 378 

Males 75+ 270 300 331 399 448 

Total males 65+ 522 591 653 735 826 

Females 65-74 114 128 139 142 158 

Females 75+ 199 201 205 234 256 

Total females 65+ 314 330 344 375 415 

The numbers of people predicted to have a long-standing condition as a result of having 

bronchitis and emphysema are given in Table 392 for Hull residents. The prevalence 

estimates used to calculate the numbers were obtained from the General Household 

Survey conducted during 2007 (Economic and Social Data Service 2008). Further 

information about the calculation and the numbers by gender are given at 

www.poppi.org.uk. The incidence of respiratory disease will be higher in Hull given 

Hull‟s higher prevalence of smoking, however, this may be counter-balanced by Hull‟s 

higher mortality rate. There will be substantial numbers who have other respiratory 

disease and a relatively high proportion will be aged 65 years or older. There are almost 

6,000 registered patients on the chronic obstructive pulmonary disease (COPD) GP 

registers for 2009/2010 in Hull (Table 297) and it is likely that a relatively high proportion 

of these patients will be aged 65+ years. 


a long-standing condition associated with having bronchitis and emphysema 


(years) 


a long-standing condition due to bronchitis and emphysema 

2010 2015 2020 2025 2030 

Males 65-74 216 250 276 288 324 

Males 75+ 149 166 183 221 248 

Females 65-74 95 107 116 118 132 

Females 75+ 147 148 151 172 189 

Total 65+ 607 671 726 799 893 

The numbers of people predicted to have Type 1 or Type 2 diabetes are given in Table 

393. The prevalence estimates are derived from the Health Survey for England 2006 

(Health Survey for England 2008). There are almost 11,800 registered patients aged 

17+ years on the diabetes GP registers for 2009/2010 in Hull (Table 272), but it is not 

known how many of these patients will be aged 65+ years. 




a long-standing condition associated with having Type 1 or Type 2 diabetes 


(years) 


Type 1 or Type 2 diabetes 

2010 2015 2020 2025 2030 

Males 65-74 1,413 1,633 1,805 1,884 2,119 

Males 75+ 959 1,067 1,175 1,418 1,593 

Total males 65+ 2,371 2,699 2,980 3,301 3,712 

Females 65-74 988 1,113 1,206 1,227 1,373 

Females 75+ 1,113 1,124 1,145 1,304 1,431 

Total females 65+ 2,101 2,236 2,351 2,531 2,804 

The number of people aged 65+ years predicted to attend accident and emergency 

departments as a result of a fall or predicted to be admitted as an inpatient as a result of 

a fall are given in Table 394 and Table 395 respectively. The predicted numbers are 

based on ONS population projections and the prevalence of having at least one fall 

within the previous 12 months from the Health Survey for England 2005 (Health Survey 

for England 2008) and hospital admission rates relating to falls from research 

undertaken by Scuffham (Scuffham, Chaplin et al. 2003). 


are predicted to have at least one fall within a 12 month period 


(years) 

Hull’s population estimates and projections of people who are 

predicted to have at least one fall within a 12 month period 

2010 2015 2020 2025 2030 

Males 65-69 828 1,134 1,062 1,188 1,350 

Males 70-74 880 820 1,120 1,080 1,200 

Males 75-79 665 684 665 912 874 

Males 80-84 651 775 868 868 1,178 

Males 85+ 645 774 1,032 1,247 1,462 

Total males 3,669 4,187 4,747 5,295 6,064 

Females 65-69 1,104 1,449 1,357 1,472 1,679 

Females 70-74 1,269 1,188 1,539 1,458 1,593 

Females 75-79 1,107 1,080 1,053 1,377 1,296 

Females 80-84 1,122 1,122 1,122 1,088 1,462 

Females 85+ 1,333 1,419 1,548 1,720 1,892 

Total females 5,935 6,258 6,619 7,115 7,922 




being admitted to hospital as a result of a fall 

Age (years) Hull’s population estimates and projections of people being 

admitted to hospital as a result of a fall 

2008 2010 2015 2020 2025 

65-69 49 65 61 68 77 

70-74 83 78 104 98 109 

75+ 651 681 710 839 931 

Total 65+ 784 824 876 1,005 1,117 

The numbers of people predicted to have problems with their bladder is given in Table 

396. The prevalence and frequency estimates are from the Health Survey for England 

2005 (Health Survey for England 2008). 


having a bladder problem 

Frequency 

of problem 

Less than 

once a 

week 

At least 

once a 

week 

Gender and 

age (years) 


people with bladder problems 

2010 2015 2020 2025 2030 

Males 65-69 230 315 295 330 375 

Males 70-74 220 205 280 270 300 

Males 75-79 175 180 175 240 230 

Males 80-84 126 150 168 168 228 

Males 85+ 195 234 312 377 442 

Total males 946 1,084 1,230 1,385 1,575 

Females 65-69 240 315 295 320 365 

Females 70-74 282 264 342 324 354 

Females 75-79 328 320 312 408 384 

Females 80-84 264 264 264 256 344 

Females 85+ 186 198 216 240 264 

Total females 1,300 1,361 1,429 1,548 1,711 

Males 65-69 552 756 708 792 900 

Males 70-74 660 615 840 810 900 

Males 75-79 630 648 630 864 828 

Males 80-84 441 525 588 588 798 

Males 85+ 285 342 456 551 646 

Total males 2,568 2,886 3,222 3,605 4,072 

Females 65-69 672 882 826 896 1,022 

Females 70-74 564 528 684 648 708 

Females 75-79 697 680 663 867 816 

Females 80-84 561 561 561 544 731 

Females 85+ 868 924 1,008 1,120 1,232 

Total females 3,362 3,575 3,742 4,075 4,509 



Table 397 gives the projected numbers of people in Hull with moderate or severe visual 

impairment who are aged 65+ years or who have a registerable sight loss and are 75+ 

years. The underlying prevalence estimates used are from Charles (Charles 2006). All 

causes of visual impairment are included with moderate or severe visual impairment 

defined as visual acuity of less than 6/18 which is largely used as the point which 

approximates to the statutory threshold for qualifying as registered severely sight 

impaired (blind) or registered sight impaired (partially sighted). Of those aged 75+ 

years, approximately half have cataracts or reflective error (i.e. correctable sight loss) 

and Table 397 also provides estimates of the projected population aged 75+ years 

excluding those with correctable sight loss. Age-related macular degeneration is the 

most common cause of registerable sight loss in older people. 


have a moderate or severe visual impairment or registerable eye condition 

Condition Age 

(yrs) 


people with a visual impairment 

2010 2015 2020 2025 2030 

Moderate or severe visual 65-74 1,036 1,176 1,294 1,327 1,490 

impairment 

75+ 2,195 2,294 2,393 2,827 3,137 

Registerable eye condition 75+ 1,133 1,184 1,235 1,459 1,619 

Table 398 gives the projected numbers of people in Hull with moderate or severe 

hearing impairment or with profound hearing impairment who are aged 65+ years. The 

prevalence estimates are based on two studies (Davis 1995; Davis 2007). 

Hearing loss and deafness is usually measured by finding the quietest sounds someone 

can hear using tones with different frequencies - which are heard as different pitches. 

The person being tested is asked to respond - usually by pressing a button - when they 

can hear a tone and the level of the tone is adjusted until they can just hear it. This level 

is called the threshold. Thresholds are measured in units called dBHL - dB stands for 

'decibels' and HL stands for 'hearing level'. Anyone with thresholds between 0 and 20 

dBHL across all the frequencies is considered to have 'normal' hearing. The greater the 

threshold level is - in dBHL - the worse the hearing loss. People with moderate 

deafness have difficulty in following speech without a hearing aid. The quietest sounds 

they can hear in their better ear average between 35 and 49 decibels. People with 

severe deafness rely a lot on lip-reading, even with a hearing aid. British Sign Language 

(BSL) may be their first or preferred language. The quietest sounds they can hear in 

their better ear average between 50 and 94 decibels. People who are profoundly deaf 

communicate by lip-reading. BSL may be their first or preferred language. The quietest 

sounds they can hear in their better ear average 95 decibels or more. 




having hearing impairment 

Severity of 

hearing 

impairment 

Moderate or 

severe 

hearing 

impairment 

Profound 

hearing 

impairment 

Gender and 

age (years) 


people with hearing impairment 

2010 2015 2020 2025 2030 

Males 65-74 2,042 2,360 2,609 2,723 3,063 

Males 75-84 3,395 3,698 3,820 4,608 5,093 

Males 85+ 1,276 1,531 2,041 2,466 2,892 

Total males 6,713 7,589 8,470 9,797 11,048 

Males 65-74 1,500 1,690 1,832 1,863 2,084 

Males 75-84 4,694 4,630 4,567 5,265 5,772 

Males 85+ 2,629 2,798 3,053 3,392 3,731 

Total females 8,823 9,118 9,451 10,520 11,588 

Males 75-79 39 45 49 52 58 

Males 80-84 23 25 26 31 34 

Males 85+ 52 62 83 100 117 

Total males 113 132 158 183 210 

Females 65-74 74 83 90 92 103 

Females 75-84 59 58 58 66 73 

Females 85+ 147 156 170 189 208 

Total females 280 298 318 348 384 

Table 399 gives the population projections for Hull for people who are expected to have 

a body mass index (BMI) of 30 or more and be classified as obese estimated from the 

Health Survey for England 2005 (Health Survey for England 2008). 


defined as obese 


(years) 

Hull’s population estimates and projections of people defined 

as obese (BMI 30+) 

2010 2015 2020 2025 2030 

Males 65-69 1,380 1,890 1,770 1,980 2,250 

Males 70-74 1,188 1,107 1,512 1,458 1,620 

Males 75-79 735 756 735 1,008 966 

Males 80-84 357 425 476 476 646 

Males 85+ 150 180 240 290 340 

Total males 3,810 4,358 4,733 5,212 5,822 

Females 65-69 1,584 2,079 1,947 2,112 2,409 

Females 70-74 1,410 1,320 1,710 1,620 1,770 

Females 75-79 1,189 1,160 1,131 1,479 1,392 

Females 80-84 792 792 792 768 1,032 

Females 85+ 589 627 684 760 836 

Total females 5,564 5,978 6,264 6,739 7,439 



10.13.1.9 Predicted Numbers Requiring Various Services 

The number of people aged 65+ years helped to live independently, projected to 2030, 

is given in Table 400. The information is taken from the National Adult Social Care 

Intelligence Service (NASCIS), Social Care data for the year 2008/2009 “Social Care 

Indicators from the National Indicator Set 2008-09” NI136. National Indicator NI136 

gives information on the number of adults aged 65 and over that are assisted directly 

through social services assessed/care planned, funded support to live independently, 

plus those supported through organisations that receive social services grant funded 

services. The information is broken down by primary client type (adults with a learning 

disability, a physical disability, a mental health problem, a substance misuse problem 

and vulnerable people) and by age group (adults aged 18-64 and older people aged 65 

and over). 

Table 400: POPPI – population projections to 2030 for those aged 65+ years helped to 

live independently 

Hull’s population estimates and projections of people helped 

to live independently 

2010 2015 2020 2025 2030 

3,165 3,453 3,707 4,065 4,537 

The number of carers receiving different types of services provided as an outcome of an 

assessment or review for carers aged 65+ years, projected to 2030, is given in Table 

401. The information is taken from the National Adult Social Care Intelligence Service 

(NASCIS), Referrals, Assessments and Packages of Care (RAP) data for 2008/2009. 

Table 401: POPPI – population projections to 2030 for those aged 65+ years who are 

carers who also receive a service 

Hull’s population estimates and projections of carers 

receiving a service 

2010 2015 2020 2025 2030 

2,281 2,489 2,671 2,930 3,270 

The number of people aged 65+ years receiving community-based services provided or 

commissioned by the Council with Social Services Responsibility (CSSR), projected to 

2030, is given in Table 402. The information is taken from the National Adult Social 

Care Intelligence Service (NASCIS), Referrals, Assessments and Packages of Care 

(RAP) data for 2008/2009. 



Table 402: POPPI – population projections to 2030 for those aged 65+ years receiving 

community-based services provided or commissioned by the Council with Social 

Services Responsibility 


receiving community-based services provided or 

commissioned by the CSSR 

2010 2015 2020 2025 2030 

5,797 6,325 6,790 7,446 8,311 

The number of people aged 18+ years receiving intensive home care (10 hours or more, 

6 or more visits per week), projected to 2030, is given in Table 403. The information is 

taken from the NASCIS, Referrals, Assessments and Packages of Care (RAP) data. 

Table 403: POPPI – household projections to 2030 for those aged 18+ years receiving 

intensive home care 

Hull’s household estimates and projections of people 

receiving intensive home care for those aged 18+ years 

2010 2015 2020 2025 2030 

426 449 464 481 502 

Hull‟s population estimates and projections of people in local authority residential care, 

independent sector residential care or nursing care during the year, purchased or 

provided by the Council with Social Services Responsibility (CSSR) are given in Table 

404. The information is taken from the NASCIS, Referrals, Assessments and Packages 

of Care (RAP) data. 

Table 404: POPPI – population projections to 2030 for those aged 65+ years in local 

authority residential care, independent sector residential care, and nursing care during 

the year, purchased or provided by the Council with Social Services Responsibilities 

Hull’s population estimates and projections of people in local 

authority residential care, independent sector residential care 

or nursing care during the year, purchased or provided by the 

Council with Social Services Responsibility (CSSR) 

2010 2015 2020 2025 2030 

2,087 2,277 2,444 2,680 2,991 

The number of people aged 65+ years admitted to permanent residential and nursing 

care during the year, and financially supported by the council, projected to 2030, is given 

in Table 405. The information is taken from the National Adult Social Care Intelligence 

Service (NASCIS), Social Care data for the year 2008/2009. 



Table 405: POPPI – population projections to 2030 for those aged 65+ years admitted to 

permanent residential and nursing care during the year and financially supported by the 

Council 


admitted to permanent residential and nursing care during the 

year and financially supported by the Council 

2010 2015 2020 2025 2030 

422 461 495 543 606 

10.13.2 Fractured Neck of Femurs 

The numbers of people aged 65+ years predicted to attend accident and emergency 

departments as a result of a fall or predicted to be admitted as an inpatient as a result of 

a fall for 2010, 2015, 2020 and 2025 are given in Table 394 and Table 395 respectively. 

10.13.2.1 Hospital Admissions 

From Hospital Episode Statistics, the annual age-gender-standardised rate of hospital 


includes a primary diagnosis for fractured neck of femur for the three financial years 

2006/07 to 2008/09 for residents of Hull aged 65+ years is given in Table 406 per 

100,000 residents (see Table 416 for definitions). 


admission rate with a primary diagnosis for fractured neck of femur for the three financial 

years 2006/07 to 2008/09 combined for Hull residents aged 65+ years 


100,000 Hull residents (65+ FNF), 2006/07-2008/09 (95% CI) 

Males 65+ years Females 65+ years 

N DSR N DSR 

North Carr 15 463 (256 to 768) 47 1,208 (884 to 1,611) 

Northern 26 455 (295 to 670) 57 893 (673 to 1,161) 

NORTH LOCALITY 41 457 (326 to 622) 104 991 (807 to 1,203) 

East 34 369 (255 to 515) 144 1,197 (1,010 to 1,410) 

Park 31 396 (269 to 562) 109 1,063 (872 to 1,282) 

Riverside (East) 11 540 (268 to 969) 32 1,141 (780 to 1,611) 

EAST LOCALITY 76 395 (311 to 494) 285 1,139 (1,010 to 1,279) 

Riverside (West) 48 806 (594 to 1,070) 81 1,081 (856 to 1,346) 

West 41 486 (349 to 660) 96 867 (702 to 1,058) 

Wyke 19 371 (222 to 582) 87 1,182 (944 to 1,461) 

WEST LOCALITY 108 557 (457 to 672) 264 1,020 (900 to 1,151) 

HULL 225 477 (417 to 544) 654 1,063 (983 to 1,148) 





inpatient admission rates which involve a primary diagnosis of fractured neck of femur 

(any clinician episode within that hospital stay) by local deprivation quintile over three 

financial years 2006/07 to 2008/09 (standardised to European Standard Population) for 

those aged 65+ years. The admissions do not necessarily relate to those caused by 

falls, but it is likely that many of the fractured neck of femurs in those aged 65+ years 

results from falls with the other main cause probably being car accidents. The 95% 

confidence intervals are shown. There is a statistically significant difference among the 

quintiles for daycase and inpatient admissions for fractured neck of femurs for those 

aged 65+ years. The standardised admission rate in the most deprived quintile is 986 

admissions per 100,000 people aged 65+ years compared to 743 per 100,000 people 

aged 65+ years in the least deprived quintiles. So whilst there is a higher admission rate 

in the most deprived areas, the trend across the five quintiles is not consistent with the 

second most derived quintile having the lowest admission rates. However, it is difficult to 

ascertain if this trend across the quintiles is reflecting „need‟. The underlying data are 

given in the APPENDIX on page 943. People living in the most deprived areas will tend to 

have higher levels of poor health generally and morbidity which could influence mobility 

and the likelihood of falls. There could also be different levels of carer and support 

available, as well as the installation of mobility aids. All these factors could influence the 

likelihood of falls in those aged 65+ years. There may also be a difference in the 

prevalence of osteoporosis among the deprivation quintiles which will be a strong predictor 

of whether a falls results in a fractured neck of the femur. 

Figure 250: Age-gender standardised inpatient hospital admission rate for fracture neck 

of the femur in those persons aged 65+ years by local deprivation quintile 


persons aged 65+ for fractured neck 

of the femur 

1200 

1000 

800 

600 

400 

200 

0 

Most 

deprived 

quintile 


deprived 

quintile 




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12 GLOSSARY AND EXPLANATION OF STATISTICAL 

TERMS, DATA SOURCES AND METHODS 

12.1 Synthetic or Modelled Estimates 

The Association of Public Health Observatories (APHO) has produced a technical 

briefing on prevalence modelling (Association of Public Health Observatories 2011). 

This discusses some of the problems associated with producing a modelled or synthetic 

estimate. The following was produced independently of the APHO but covers a number 

of the same points: 

Research and modelling methodology: The accuracy of any synthetic estimates 

depends on the quality of the initial research and the modelling itself. If the model is too 

simple, for example, just containing age and sex as predictors, this means that the 

resulting estimates will be poor for geographical areas with particularly low or particularly 

high levels of other factors that influence the estimates, such as deprivation. If the 

model is complex and contains a high number of predictive factors, it is very possible 

that the model would be “over-fitted”. This is a statistical term meaning that the model is 

(artificially) a good model using the initial research, but a much poorer model when 

applied elsewhere. 

Testing: Even if the modelling has been undertaken by qualified statisticians who 

understand the numerous problems associated with generating models, it needs to be 

„tested‟ and any modelling is still based on initial research. It is very rare for models to 

be „tested‟, so generally the accuracy to which the model predicts the true situation is 

largely unknown. 

Validity and generalisability: The quality of the original epidemiological studies could 

differ substantially, and it is possible that these studies, for any number of reasons, may 

not be appropriate or of sufficiently high quality to use in modelling. Furthermore, it is 

possible that a number of different epidemiological studies have been used to generate 

the model and this has its own complications; combining data from different studies that 

have used different methodology and definitions, and undertaken at different points in 

time. It is likely that the initial research was not originally intended to generate such a 

model, and if different studies have been used it is possible that the factors / variables in 

the model differ. This means that assumptions need to be made or changes need to be 

made to the original data to generate a model. For example, it is possible that different 

measures of deprivation have been used in the original research, but one measure 

needs to be used in the final model. The time lapse between the original research and 

the period to which the modelling refers may be long enough to render the model 

inaccurate under more recent circumstances. It is very possible that the initial research 

was undertaken in a very specific geographical area, and if this was the case, then there 

might be very little or no data at the extremes of a highly influential factor, which would 

result in a very poor model when applied to geographical areas which are substantially 

different from the geographical area of the initial research. For example, if the original 



research was undertaken in a geographical area with “average” deprivation and 

relatively few very or no deprived areas, then there would be little or no data from the 

original research to provide good predictions for more deprived areas. The model would 

generate predictions for much more deprived areas, but it is likely that the predictions 

could be very poor as the model is generating a prediction outside the range of the 

original data. This is particularly the case for Hull due to its high level of deprivation. 

Even where the model is constructed from data drawn from a wide range of situations 

(e.g. high/low deprivation), the linear assumptions made by most models may break 

down at the extremes, and all too often Hull is at the extreme end of either explanatory 

or observed variables. This will lead to inappropriate extrapolation and inaccurate and 

systematically biased estimates. 

Lack of transparency in relation to synthetic estimates: Most of the time, the details of 

the model used to create the synthetic estimates are not available. Therefore, it is 

difficult to assess the quality of the estimate or the quality of the original research used 

to derive the model. Furthermore, synthetic estimates are sometimes provided without 

stating where the estimate comes from or even that it is a modelled / synthetic estimate. 

Problems with updating synthetic estimates: Without knowing the details of the model, it 

is very difficult to assess how and when the model will change in the future (when new 

data included in the model becomes available). For example, the Index of Multiple 

Deprivation score was created in 2001 and updated in 2004 and 2007, and if the model 

included this then it is not likely to change until 2010 or even later (if at all). Some 

models will use data from the Census, which is updated every ten years with the last 

Census conducted during 2001. So information from the Census is relatively out of 

date, and new Census data will not be available until around 2012-2013 once the 2011 

Census data is analysed and published. 

Examples. Synthetic estimates have been derived by the Public Health Observatories 

(PHO), and „factsheets‟ are available for each Primary Care Trust / Local Authority from 

the Yorkshire and the Humber PHO (YHPHO) 69 . Historically the synthetic estimates for 

smoking prevalence in Hull have been considerably higher than local Health and 

Lifestyle Survey estimates (almost one third higher). The PHO estimate for 2006-2008 

is 32.5% for smoking prevalence which is similar to the local surveys conducted in Hull. 

However, the estimate prior to this (included in the profiles published during 2009) was 

41.9%. The table below gives the synthetic estimates and estimates from the local 

surveys 70 conducted in Hull. 

69 Health Intelligence Practice Profiles and PCT Level Profiles on http://www.yhpho.org.uk/ 

70 All the local surveys in Hull have used quota sampling so are representative of Hull‟s population in 

terms of age, gender and geography (and employment status). 



Table 407: Public Health Observatory synthetic lifestyle prevalence estimates for Hull 

compared to estimates from local health and lifestyle surveys 

Estimate 

type 

Time period / survey Prevalence estimate in Hull (%)* 

Smoking Binge 

drink 

Healthy 

eating 

Physically 

active 

Obese 

2003-2005 (used in 

40.9 26.2 20.0 12.2 27.3 

Synthetic 2009 profiles) 

2006-2008 (latest) 32.5 28.1 ** ** ** 

Health & Lifestyle 

31.7 21.9 23.0 26.3 20.8 

Survey 2007 

From 

Prevalence Survey 

local 

35.1 19.9 26.1 30.8 24.4 

2009 

surveys 

Social Capital Survey 

32.7 ** 28.1 39.2 26.3 

2009 

*These „terms‟ are not defined, so it is difficult to know exactly what is meant by „physically 

active‟ or „healthy eating‟. Locally, „healthy eating‟ is defined as eating 5-A-DAY, and exercise 

was defined based on fulfilling the national exercise recommendations. So definitions may not 

be comparable. 

**Not published or not asked in local survey. 

12.2 Confounding and Effect Modification 

Confounding occurs when another factor (or factors) influences the association of 

interest. This occurs when this other factor is associated with both the risk factor of 

interest and the outcome of interest. For example, if examining the association between 

alcohol consumption and lung cancer mortality, it might be that an association is found. 

However, smoking is a confounder. There is an association between smoking and 

alcohol consumption (see Alcohol report from local adult Health and Lifestyle Survey at 

www.hullpublichealth.org). There is also an association between smoking and lung 

cancer mortality. Therefore, it is possible that there is no real association between 

alcohol consumption and lung cancer mortality. Smoking is acting as a confounder. 

Failure to take into account or consider smoking when examining this association can 

lead to confounding bias, and reporting an association or relationship between two 

factors which are not really related (or related to a lesser extent), but only indirectly 

through a third factor which was not considered in the analysis. 

Age, gender and deprivation are frequently related to the prevalence of behavioural risk 

factors, and poor health and mortality are also associated with age, gender and 

deprivation. Therefore, any of these factors can act as confounders when examining the 

relationship between risk factors and poor health. 

It is also possible that one factor modifies the effect of one factor on another (effect 

modification). For example, it could be that there is a strong association between two 

factors at younger ages, but at older ages the association could disappear. Age is 

modifying the association between the two factors of interest. 



Interaction between two different factors can also occur which influence the relationship 

with another factor. For example, there could be twice the risk of developing a disease 

for a smoker compared to a non-smoker, and twice the risk of developing the same 

disease if the person is overweight compared to someone who is within the „desirable‟ 

weight category, but for an overweight smoker the risk of developing the disease may be 

ten times greater than a person who is a non-smoker and not overweight. 

Therefore, examining the relationship between two factors is not straightforward. In 

some cases, a relationship can seem to occur when there is no real relationship present 

and it is just influenced by a confounding variable. In other cases, a relationship may 

not seem to be present, but it is being masked by a confounder. Therefore, it is 

important when assessing the relationship or association between two factors, to 

consider potential confounding factors. In particular, as mentioned, age, gender and 

different measures of deprivation are frequent confounders in relation to risk factors and 

poor health. 

12.3 Standardisation 

The prevalence of ill-health, risk factors and disease and mortality within a particular 

population will depend on the age and gender structure of that population (as well as 

many other factors such as deprivation). 

In terms of the provision of resources in relation to the prevalence of ill-health, disease 

and risk factors in the population, it is most helpful to report on the prevalence without 

taking into account the age and gender distribution of the population. This is because it 

is necessary to treat and have the provision to treat the existing population, regardless 

of the age and gender structure. However, if one wishes to assess whether one 

population has an excess rate of disease or if there is a difference in the prevalence of 

disease among different levels of deprivation, it is necessary to take the age and gender 

structure into consideration. Otherwise any differences found may be simply due to 

differences in the age and gender structure of the different populations, and not due to 

the factor of interest, e.g. deprivation. The age and gender structure can be taken into 

consideration by using standardisation. Generally, standardised rates are agestandardised 

or age-gender-standardised, but rates can also be standardised to other 

differences within the populations. 

Direct standardisation involves applying the rates of disease (or prevalence of a risk 

factor) observed in the study group of people to a „standard‟ population. Indirect 

standardisation involves applying the rates of disease (or prevalence of a risk factor) in a 

„standard‟ population to the study group of people. The rates or prevalence are 

calculated for each gender and age group, for example, males aged 0-9, 10-19, 20-29 

years etc and females aged 0-9, 10-19, 20-29 years etc. The standard population can 

be an English population, the European Standard Population or a local population for a 



specific time period. Direct standardisation results in an age-gender standardised rate 

of disease (often per 10,000 or 100,000 population). 

Indirect standardisation generally 71 results in a standardised mortality (or morbidity) ratio 

(SMR). The SMR will take the value of 100 if the sample group has the same mortality 

(or morbidity) rate as the „standard‟ population, and an SMR greater (less) than 100 if 

the sample group has a greater (lower) mortality rate relative to the standard population. 

An SMR of 130 means that there is a 30% higher mortality rate for people in the local 

area compared to England even after taking into account the gender and age structure 

of the two geographical areas. An SMR of 80 means that the mortality rate locally is 

80% of that observed nationally after allowing for differences in the gender and age 

structure of the two areas (or equivalently 20% lower locally compared to the standard 

population). 

12.4 Significance Testing 

It is often useful to compare a particular summary parameter (for instance, mean, 

median, measure of risk) among different groups. Since there is natural variation 

associated with virtually all measurements and since we generally only have a sample 

and have not measured the entire population, it is necessary to distinguish between 

differences which are close enough together to be explained by chance and differences 

which are „unlikely‟ to be explained by chance. Such a comparison can be undertaken 

using a statistical test which takes into the account chance variation. When undertaking 

a statistical test, we assume that there is no difference in the summary measure among 

the groups and then calculate the probability of obtaining the difference we observe in 

our sample (i.e. in the data we have). If the calculated probability, or so-called p-value, 

is small then this means that there is a small chance of obtaining such a result under the 

assumption that there is no difference. Therefore, if the probability is small enough 

(generally, less than one in twenty or less than 0.05) then we assume that the original 

assumption must be incorrect and that there really is a difference. Since this is based 

on probabilities and assumptions, just because a small p-value is observed, it does not 

necessarily mean that the original assumption of no difference between the groups is 

untrue. However, clearly the smaller the p-value, the more likely it is that the original 

assumption is untrue. Similarly, just because you obtain a large p-value and therefore 

have no evidence to reject the original assumption, it does not mean that it is actually 

true, it could be that there is simply insufficient evidence to show otherwise (for example, 

a small number of people or small number of people with a particular event). If a small 

p-value is obtained (p


important and the fact that both areas report high levels of poor health may be more 

important. One such test is the 2 test which compares the percentages between different 

groups (with the original assumption that the percentages are the same for all groups). 

The 

2 test for trend compares the percentages across different groups with ordered 

categories, such as deprivation, and assesses whether there is an increasing or 

decreasing trend in the percentages across the ordered categories. McNemar‟s test can 

be used to compare paired percentages. Paired data occurs when responses from the 

same individual are compared, paired analyses generally occur when the aim is 

compare changes over time (see evaluation of Community Physical Activity Survey in 

section 8.6.9 on page 319). 

Another test is the t-test which compares the mean or average of a parameter between two 

groups. A paired test is used 

12.5 Confidence Intervals 

A confidence interval (CI), calculated using statistical methods, gives a range of likely 

values for the parameter of interest. Since one cannot generally survey all people for all 

years within all geographical areas of interest, it is common practice to obtain necessary 

data from a sample of the population. However, different samples will result in different 

estimates for the measure of interest due to natural variation of measurement data 

(assuming all other influences remain constant). Therefore, it is useful to have a range 

of values for the measure of interest (e.g. percentage or mean, difference between two 

means or measure of risk, etc) rather than a single value to get an idea of the range of 

likely values. The usual CI calculated is the 95% CI, in which we are 95% confident that 

the interval obtained (from the sample) will contain the true underlying measure of 

interest. Having a range of values for which the population statistic/measure lies is 

much more useful than having a single value. The interval also takes into consideration 

the number of people on which the estimate is based, so that if there are many people 

surveyed the interval tends to be narrower (and therefore more useful). The 95% CI for 

a difference in a percentage or mean between two groups that does not include the 

value zero (i.e. the percentage or mean is not the same for both groups) will have a pvalue 

less than 0.05 72 (see section 12.4 on page 774). If the CI is wide then this 

suggests uncertainty regarding the underlying statistic. 

For example, if the standardised mortality ratio is 140 then it implies there is an increase 

of 40% in the mortality rate locally compared to that in the standard population (which 

may be national population). This raises immediate concern. However, if the 95% CI 

ranges from 50 to 230 then it implies that the true underlying ratio lies between 50 and 

230, i.e. half the mortality locally compared to nationally through to more than twice the 

mortality rate locally compared to that observed nationally. Since this is a wide range, 

we are less confident in saying that there is an increased mortality rate locally as it could 

very easily have occurred by natural variation of measurements rather than representing 

72 In rare cases this is not the case depending on the way in which the statistical test is undertaken and 

the assumptions made, however, if it is not true then the p-value will be close to 0.05. 



an underlying increase. Whereas if the 95% CI ranged from 132 to 148 then we would 

be more confident in stating there was a higher mortality rate locally as the lower 

estimate of the SMR is still more than 30% higher than the mortality rate nationally. 

When dealing with small numbers of events (see section 12.7 on page 776), it is very 

important to consider the implications of this and present and assess the width of CIs to 

determine how much confidence there is in the estimate presented. 

12.6 Moving Average 

A moving average is an average or mean value over a number of years, with the years 

„moving‟ over time. A three-year moving average is very common (where the value 

presented is the mean value over three years). A moving average is very useful in 

summarising data where the number of events are small on an annual basis and there 

are potentially large fluctuations in the rate of events (see section 12.7 on page 776). 

Calculating the moving average smoothes out the fluctuations and makes interpretation 

easier so that the overall trend can be better seen. For instance, if we had the mortality 

rate for each of the eleven years from 1994 to 2004 and the annual number of deaths is 

small resulting in large fluctuations over the years, then it would be better to calculate 

and present nine three-year moving averages rather than the mortality rates for the 

individual years. The first three-year moving average mortality rate would be the mean 

or average mortality rate for the years 1994, 1995 and 1996. The second three-year 

moving average value would be the mean mortality rate for 1995, 1996 and 1997, and 

so on, with the final three-year moving average being the mean mortality rate for the 

years 2002, 2003 and 2004. 

Nevertheless, this does not guarantee a smooth „trend‟ line. For women in Hull, there 

was a particularly high number of deaths in 1998 and a particularly low number in 2001. 

As these were three years apart, this dramatically influenced the life expectancy trend in 

Hull for women over time (there was also a slightly increase in 2004). Life expectancy 

increased dramatically between 1998-2000 and 1999-2001 as the high mortality rate 

year (1998) was removed and the low mortality rate (2001) was added. 

12.7 Small Number of Events 

When comparing the mortality rates for specific relatively rare cancers, for example, skin 

cancer, differences in the mortality rates can occur which appear to be large, but are 

actually only based on a very small number of deaths. 

For example, if there are two geographical areas both with populations of 1,200 people 

and one death in area A giving a standardised mortality rate (see section 12.3 on page 

773) of 83 per 100,000 persons and two deaths in the area B giving a mortality rate of 

167 per 100,000 persons, then the number of deaths and the mortality rate is twice as 

high in area B compared to area A. However, if the mortality rates only are compared 

the difference looks dramatic, but it is misleading as the differences in the total number 



of deaths is very small, in fact, there is only one extra death in area B. Even if these two 

areas had exactly the same underlying mortality rate, one would not expect that exactly 

the same number of deaths to occur every single year in each area; there will be some 

natural variation over time and between the two areas. So it is reasonable to expect the 

number of deaths to vary over time in the two areas, and be zero, one or two in the 

areas for most years. Presenting confidence intervals (CIs) (see section 12.5 on page 

775) are useful in virtually all cases, but CIs are even more useful when there is a 

problem with small numbers. In this example, one would find that the CIs are wide, and 

this would indicate that the numbers are too small to provide a good estimate of the 

underlying statistic. In the above case the 95% confidence intervals are 1 to 464 deaths 

per 100,000 persons for area A and 19 to 602 deaths per 100,000 persons for area B. 

This represents a very wide confidence interval, and means that the estimate is not 

useful (it is likely that one would have guessed that the estimate fell between 1 and 464 

deaths per 100,000 persons in area A before any analysis of the data was completed). 

Therefore, even if a mortality rate appears to be substantially higher in one area 

compared to another, the number of deaths should be considered (and the width of the 

95% confidence interval if presented). If the numbers of deaths are relatively small, then 

the results should be interpreted very cautiously. 

12.8 Percentiles, Quartiles, Quintiles and Medians 

Percentiles divide a distribution of ordered numerical values into groups. The 10 th 

percentile is the value of a numerical variable for which 10% of the people or sample of 

values fall below. For example, if from a survey of employees at a particular company 

the 10 th percentile for annual income is £10,000, then this would mean that 10% of the 

employees for this particular company were earning £10,000 or less. Quintiles and 

quartiles are alternative names for specific percentiles. The quintiles divide the sample 

or observations or people into five groups whereas the quartiles divide the observations 

into four groups. The Index of Multiple Deprivation is frequently divided into quintiles 

usually based on the national distribution of all the IMD scores across the entire lower 

layer super output areas (LLSOAs; geographical areas – with a mean of 1,500 residents 

– on which the IMD scores are calculated). As Hull is much more deprived than 

England with none of the 163 LLSOAs within the least deprived national quintile and 

very few in the second least deprived national quintile, the IMD scores are often divided 

into local quintiles for Hull. Thus, the most deprived quintile of areas represents the 

20% most deprived areas. The quartiles divide the observations into four groups, and 

the cut-offs are generally referred to as the lower quartile, median and upper quartile. 

Thus 25% of all the observations have a value equal to the lower quartile or less, 25% 

between the lower quartile and the median, etc, and half of the observations have a 

value of the median or less (or the median or more). The median is frequently used to 

illustrate the „typical‟ or „middle‟ value if the observations have a skewed distribution 

where there are a small number of observations that have a particularly high value. The 

mean (arithmetic average) is not the best measure of the „typical‟ value if the 



distributions have a skewed distribution as it is influenced by this, whereas the median is 

not. Income is a good example of a variable that has a skewed distribution. 

12.9 Deaths and Mortality Rates: Occurrence Versus Registration 

Deaths and mortality rates produced by the Compendium are based on year of 

registration of the death rather than year of death. The Public Health Mortality File 

(PHMF) obtained from the Office for National Statistics (ONS) by Public Health Sciences 

prior to 2007, for each calendar year, was based on the year in which the death 

occurred. That is, the 2006 PHMF included deaths which occurred during 2006. This 

information was used in Release 1 of the Public Health Profiles for Hull. ONS no longer 

produces this information based on year of death, but on year of registration of the 

death. Public Health Sciences preferred using the „occurrence‟ file based on year of 

death as this was not influenced by delays in registering the death. However, as this file 

is no longer available, Public Health Sciences will, in general, analyse the „registration‟ 

file based on year of registration of the death. This change will affect the comparability 

of information between Release 1 (which used the „occurrence‟ file) and this and 

subsequent releases of the profile (which use the „registration‟ file). The historic files (for 

deaths registered during 1996 to 2006) were obtained from ONS so that analyses in this 

profile and future analyses could be based on year of registration of the death. The 

information produced will be more consistent with the nationally produced information on 

the Compendium. However, it could be biased if there are delays in the registration 

process for some reason. It is extremely unlikely that there would be delays for most 

deaths, but there could be delays in deaths which involve a Coroner‟s Inquest if there is 

a delay in the inquests, perhaps due to staffing problems at the Coroner‟s office. 

Deaths should be registered within five days of the death. However, delays can occur if 

the death needs to be investigated by the local coroner. In these cases, which involve 

unexplained or suspicious deaths including suicides, the registration date of the death 

can be several months after the date of the death. As most deaths are registered within 

a week, for the majority of deaths the year of the death and the year of the registration of 

the death will be within the same calendar year. The deaths which occur within the last 

few days of one calendar year could well be registered during the next calendar year. 

So the „registration‟ file, in relation to the „occurrence‟ file, will include „extra‟ deaths 

which occurred during December of the previous year which were registered at the 

beginning of January, and „exclude‟ deaths which occurred during December which 

were registered in January in the next year‟s registration file. Furthermore, the 

registration file will include deaths from the previous year(s) which were subject to 

registration delays predominantly those which involved Coroner‟s Inquests. For 

example, the majority of suicide and undetermined injury deaths are registered within 

nine months of the actual date of the death, but for some deaths the delay could be 

longer. Therefore, by analysing deaths based on year of registration, particular causes 

of death will be influenced to a greater extent; deaths which involved a Coroner‟s 

Inquest. Table 408 shows the difference between year of death and year of registration. 

For example, 8 of the 2,571 deaths registered during the year 2001 occurred during 



1999 and a further 76 of the deaths occurred during 2000, with the majority (2,487; 

96.7%) occurring in 2001. Due to confidentiality reasons, asterisks replace figures 

which are less than three (and the totals are not provided for the same reason). 

Table 408: Difference between year of death and year of registration of the death: all 

deaths 

Year of 

Year of registration of death 

death 2001 2002 2003 2004 2005 2006 2007 

1999 8 0 0 0 * 0 0 

2000 76 4 * 0 * 0 0 

2001 2,487 69 4 0 * 0 0 

2002 2,555 89 6 3 0 0 

2003 2,636 90 14 0 0 

2004 2,440 108 * 0 

2005 2,450 67 0 

2006 2,513 65 

2007 2,490 

As mentioned, the cause of death will influence the difference between the date of death 

and the date of the registration of the death, with suicide and undetermined injury deaths 

having a longer delay as a Coroner‟s Inquest will be required. Other causes of death 

will also result in delays, but Table 409 gives the delay for just suicide and 

undetermined injury, so it is possible to get an idea of the effect of the difference in 

registration delay. Asterisks replace the actual number of deaths if the number is less 

than three, and cannot be reported due to confidentiality reasons. 

Table 409: Difference between year of death and year of registration of the death: 

suicide and undetermined injury deaths 

Year of 

Year of registration of death 

death 2001 2002 2003 2004 2005 2006 2007 

1999 * 0 0 0 0 0 0 

2000 12 0 * 0 0 0 0 

2001 16 13 0 0 0 0 0 

2002 13 20 * 0 0 0 

2003 6 27 4 0 0 

2004 9 18 0 0 

2005 11 6 0 

2006 16 10 

2007 24 



12.10 Life Expectancy at Birth 

Life expectancy at birth is a commonly used method of assessing health, improvements 

in health over time, and differences in health between different groups (defined on the 

basis of geography, deprivation, social class, smoking status, etc). A common 

misconception is that life expectancy at birth measures the expected or average 

duration of life of a newborn; it does not. It is a measure of life expectancy assuming 

that the current age-specific mortality rates continue throughout an entire lifetime. This 

is an unrealistic assumption as mortality rates are likely to change over time. The 

current mortality rates at each age (for example, at age 50) are used in the calculation of 

life expectancy at birth for a newborn infant, but the mortality rates will not be the same 

as the mortality rates in future (for example, in 50 years‟ time when that person is 50 

years of age). Advances in healthcare, changes in political and social circumstances, 

changes in the prevalence of risk factors and changes in diseases and medical 

conditions (such as acquired immunodeficiency syndrome (AIDS), bird „flu, diseases 

resistant to antibiotics, etc) and many other factors which influence health and life 

expectancy cannot be anticipated, so it is not possible to predict mortality rates at each 

single year of age in the future. Therefore, life expectancy at birth (despite its name) is 

more generally a measure of current health rather than an expectation of life (i.e. 

predicting how long an infant will live). 

Life expectancy at birth is frequently used, but it is possible to calculate life expectancy 

at any age. For example, life expectancy at age 65 years could be calculated. This will 

tend to be closer to the true or actual duration of life than life expectancy at birth would 

be for a newborn. This is because trends in mortality rates will tend to be reasonably 

gradual, so that the current rates of mortality (on which life expectancy calculation is 

based) might be a reasonable prediction of mortality rates in the next 20 years or so (but 

not of the next 80 years or so, which is the assumption required for life expectancy at 

birth). 

Life expectancy at birth is calculated for an arbitrary 100,000 males or females and is 

the average of how long they will live based on current age-specific mortality rates (in 

the calculations for Hull the mortality rate was obtained directly from local mortality and 

population data files). 

The calculation involves applying the one year mortality rate to 100,000 males (say 5 

deaths per 1,000 live births). On average, 500 of the 100,000 boy infants would die in 

their first year of life (their contribution to life expectancy would be calculated 73 ). This 

would leave 99,500 boys aged one year who contribute in total 99,500 years to the life 

expectancy total (in their first year). Applying the mortality rate to these 99,5000 boys 

(say 40 deaths per 100,000 in second year) would mean, on average, 40 would die 

within their second year of life. Their contribution for this year would be approximately 

73 Many of the infants who die within their first year of life die within the first seven days of life, therefore, 

most will contribute only a short period of time (the mean age at death within the first year is used to 

estimate their average contribution). 



half a year (20 years in total) and the 99,460 who survive their second year would 

contribute a whole year. So 99,480 years would be contributed in total (in the second 

year). The calculation is undertaken for each single year of age 74 (separately for males 

and females). The „contributions‟ at each single year of age are summed and divided by 

100,000 (the starting number of individuals) to obtain the average life expectancy at 

birth. 

12.11 Total Period Fertility or Abortion Rate 

Since there are differences in the number of births amongst women of different ages, 

one measure of fertility is the number of births per 1,000 women for a specific agegroup. 

For example, 203 births per 1,000 women aged 25-29 years. However, this 

results in a different fertility estimate for each age group, and the overall fertility rate 

among different geographical areas cannot be easily compared. This is particularly the 

case, if there is a difference in the age women tend to have their children among 

different geographical areas or countries. The total period fertility rate (TPFR) is a 

convenient summary measure of the fertility. It is an hypothetical estimate of completed 

fertility. It indicates how many births a woman would have by the end of her 

reproductive life, if, for all of her childbearing years, she was to experience the agespecific 

birth rates for a given year (e.g. current fertility rates as at 2009). It takes into 

account the differences in the fertility rates within different reproductive age groups, and 

enables comparisons to be made between different geographical areas and between 

different time periods, because it is not affected by the age distribution of the women in 

the reproductive age-groups. The total period abortion rate (TPAR) is a similar measure 

of abortions rather than births over all age groups. 

12.12 Hospital Episode Statistics 

Hospital Episode Statistics (HES) refers to the data generate during a stay in hospital. 

Inpatient admission rates provide useful information about the general level of illness 

and the use of hospital services within geographical areas. Patients admitted to a bed 

for elective surgery, but discharged the same day are classed as daycases, and these 

are included within inpatients in this document, unless otherwise stated. However, it is 

very important to note that admission rates depend on how willing people are to make 

use of medical services, the location and accessibility of services, as well as differences 

in referral patterns and practices within primary and secondary care. These factors may 

differ between geographical areas, and may explain different levels of hospital activity 

rather than differences in the prevalence of disease. For example, in general, people 

who live in more deprived areas are less likely to visit their GP than people with similar 

levels of symptoms who live in more affluent areas. Referral rates can vary dramatically 

74 It is necessary to adjust the method slightly at the oldest ages. The Government Actuarial Department 

do not provide information on how mortality rates are applied to those over 100. Locally calculated 

mortality rates examined the age distribution in men and women separately and mortality rates were 

assumed for the oldest ages. 



among different GPs which can influence admission rates. Therefore, findings should 

be interpreted cautiously with regard to assessing the general level of illness. 

Nevertheless, analysis of inpatient admission rates will give an indication of the usage of 

hospital services by patients or residents of different geographical areas. 

When a patient is admitted to hospital a “clinician episode” is generated. If the patient is 

transferred to the care of another clinician during their hospital stay, another clinician 

episode is generated. Thus, there could be one or many clinician episodes during a 

patient‟s hospital stay. It is not necessarily the case that the primary and secondary 

diagnoses codes remain the same. A patient could be admitted for cancer treatment 

with this as the primary diagnosis, but they may develop respiratory problems during 

their stay and be transferred under the care of another clinician (generating another 

clinician episode) and their primary diagnosis may change. Therefore, when examining 

hospital episode statistics with a specific primary or secondary diagnosis, or assessing 

the number of procedures or operations that have occurred, different results will be 

obtained depending on which clinician episode is examined. If all clinician episodes are 

examined then this will mean that all relevant diagnoses or procedures are included, but 

reporting on the number of clinician episodes is not as useful as reporting on the number 

of hospital stays/admissions or the number of patients. 

12.13 Quality and Outcomes Framework 

As part of the General Medical Services contract implemented in April 2004, the Quality 

Outcomes and Framework (QOF) was set out as a means for practices to measure 

achievement against a set of clinical and other indicators that reflected the quality of 

care provided to their patients. GP practices have been submitting QOF data since this 

time via the Quality Management and Analysis System (QMAS), the national system 

established to support the calculation of GP practice payments according to the 

achievements against QOF. 


is given from the Quality Outcomes and Framework (QOF). The Excel data tables can 

be downloaded from the Information Centre (Information Centre for Health and Social 

Care 2010). Patients can be on more than one disease register. Further information is 

available related to the quality of care received by patients on the specific disease 

registers. For instance, the number of people on the diabetes register who have had 

retinal screening during the previous 15 months, or the number of people on the 

coronary heart disease register in whom the last blood pressure reading (measured in 

the last 15 months) was 150/90 or less, etc. However, within this report it is not possible 

to examine these additional indicators. Some key indicators have been examined in 

more detail at practice level for diabetes specifically in the Diabetes Equity Audit 

(available at www.hullpublichealth.org). 

In general, one would expect that Hull would have a higher prevalence of these 

conditions relative to England as a whole and other less deprived areas, as the 



prevalence of the risk factors is generally higher in Hull. However, this is not necessarily 

the case, patients in more deprived areas may be less likely to present with symptoms 

or their concerns and may as a result be more likely to be undiagnosed. Note that the 

prevalence is not adjusted in any way for the patient population, and practices with a 

relatively high percentage of elderly patients, patients in nursing homes and patients 

who live in more deprived areas (who will have a higher prevalence of risk factors such 

as smoking and poor diet and may be less likely to present if they develop symptoms). 

However, as well as differences among the practices which will be due to the patient 

population, there will also be differences in the prevalence due to differences in how well 

the practices diagnose and record cases of each disease and medical condition. A 

more detailed document has been produced which discusses these and other issues 

(available on request). However, in summary the following factors can influence the 

prevalence of diagnosed disease on the practice registers: 

Differences in age and gender structure among practices; 

Differences in deprivation among practices (influenced by poor housing, 

unemployment and lower paid jobs, increased stress, higher prevalence of risk 

factors for poor health such as smoking, obesity, poor diet, lack of exercise, etc); 

Differences in patient profiles among practices, such as practices predominately 

serving student populations, a high proportion of nursing or care homes, or high 

risk groups such as the homeless, drug addicts and asylum seekers, or other 

choices made by the patient based on ethnicity or ease of travelling to the 

practice which can influence the structure of the practice population; 

Differences in resources and skills base among practices with larger practices, in 

general, being able to produce more accurate and complete disease registers; 

Different GPs specialising in different diseases and medical conditions, so 

registers in those practices may be more accurate and complete compared to 

other practices as patients with those specific diseases as patients within those 

practices have been targeted by the GP(s) over a long period of time; 

Differences in the knowledge and attitudes to health among the patients will affect 

the completeness of the register, with patients who tend to be more 

knowledgeable about their health more likely to consult their GP about a 

particular problem and therefore more likely to be subsequently placed on a 

disease register compared to patients who accept poor health at a younger age 

due to their family history and low expectations of health; 

Differences in list size errors among practices can influence the disease 

prevalence as practices with an inflated list size will have a higher true 

prevalence of the condition compared to their calculated prevalence (based on 

the incorrect list size). 

Therefore, when comparing the prevalence and achievement figures among practices, it 

is important to consider potential biases and circumstances for those particular 

practices. In order to give an indication of the age of patients and deprivation levels for 

each practice, Table 28 gives the mean age of practice patients (as at October 2008) 

and Table 49 gives the mean Index of Multiple Deprivation (IMD) 2007 score (weighted 



by number of patients 75 – see section 6.9 on page 131 for more information on the 

IMD). Therefore, these two tables should be considered when interpreting any 

prevalence figures at practice level, and caution should be used when comparing 

practices. 

12.14 PBS Diabetes Model 

As part of Yorkshire and Humber (Y&H) Public Health Observatory (PHO) work to create 

a Diabetes Commissioning Toolkit, the prevalence of diabetes was estimated for all 

PCTs in England (Merrick 2006) in different phases. The work was undertaken in 

conjunction with the (Y&H) PHO, Brent PCT and School of Health and Related 

Research (ScHARR) and the model is referred to as the PBS model (taking the first 

letter of each of these organisations). 

For more information about the modelled and synthetic estimates, see section 12.1 on 

page 770. 

In Phase 1, the PBS model applied age-gender-ethnic group specific estimates of 

diagnosed and undiagnosed diabetes prevalence derived from epidemiological 

population studies and applied these estimates to local resident populations based on 

the 2001 Census. No single epidemiological study gave the age-gender specific 

prevalence of type 1 and type 2 diabetes for all ethnic groups. The following UK studies 

were used: 

The White and Asian type 2 age-gender-ethnic specific prevalence rates from a 

Coventry study which including those with previously known and newly diagnosed 

(by oral glucose tolerance test) type 2 diabetes (Simmons, Williams et al. 1991; 

Simmons and Williams 1993). 

The Black type 2 age-sex-ethnic specific prevalence rates used in the PBS model 

were those observed in European white population in the Coventry diabetes 

study, multiplied by age-gender specific excess diabetes risk ratios derived from 

a comparison of Black African-Caribbean and European white populations in a 

London (Brent) study (Chaturvedi, McKeigue et al. 1993). 

Type 1 age-gender specific prevalence rates from a study of 418,200 people in 

Wales using a capture-recapture technique with the same prevalence rates 

applied to all ethnic groups (Harvey, Craney et al. 2002). 

75 The IMD 2007 score is used for each patient (based on their postcode and assigning the score relating 

to the lower layer super output area – geographical area containing on average 1,500 residents – which 

includes their postcode). The mean score for each practice is weighted by the population (i.e. number of 

patients with that specific IMD 2007 score). 



The PHO then applied two separate adjustments to type 2 prevalence rates to reflect 

differences in „time‟ and „place‟ between the 1986-1989 Coventry study and England 

2001. 

For the „time‟ adjustment, type 2 prevalence rates were upwardly adjusted to reflect 

presumed increases in the national type 2 diabetes rate since the Coventry study was 

conducted, using prevalence of obesity and overweight as a marker of increasing 

diabetes prevalence. A Diabetes Index was calculated for each gender for each year 

using the estimated percentage of population within different BMI classification 

categories (normal weight, overweight and obese) multiplied by the relative risk of type 2 

diabetes (Must, Spadano et al. 1999) for the different BMI categories and then summed. 

For each gender separately, the Diabetes Indices were then plotted for each year 1991 

to 2002 and extrapolated backwards using linear regression to estimate the value of the 

index from 1986 to 1990. The adjustment factor was then the ratio of the Diabetes 

Index for 2001 and the average of the Diabetes Index for 1986-1989. The adjustment 

ratio for „time‟ was +29.9% for men and +20.6% for women. 

For the „place‟ adjustment, type 2 diabetes prevalence rates were downwardly adjusted 

to reflect the fact that there were higher levels of obesity and overweight and therefore 

presumably of diabetes in Coventry (Foleshill electoral ward) than in England in 1991. A 

similar method to the one used to adjust for „time‟ was used to adjust for „place‟. The 

adjustment ratio for „place‟ was –7.0% for men and –13.4% for women. 

Phase 2 of the modelling involved an adjustment for deprivation. Numerous UK studies 

(Unwin, Watson et al. 1995; Eachus, Williams et al. 1996; Ismail and al 1999; Connolly, 

Unwin et al. 2000; Evans, Newton et al. 2000; Office for National Statistics 2000; Riste 

and al 2001; Abbas 2003) have demonstrated a strong positive association between 

increasing socio-economic deprivation and the prevalence of type 2 diabetes. The type 

2 registered diabetes prevalence from a study undertaken by the National Clinical Audit 

Support Programme (NCASP) team (now the National Diabetes Audit (NDA) team) was 

examined by deprivation quintiles (using Townsend‟s deprivation). The NCASP/NDA 

study was selected for a number of reasons: (i) the diabetes prevalence rates are 

adjusted for age, sex and ethnicity to be representative of the whole of England 

population structure for 2001; (ii) the sample size of 57,800 persons with registered 

diabetes is very large compared to most other studies; (iii) it was conducted in the same 

year (2001) for which the PBS model estimates diabetes prevalence; and (iv) the 

registers on which the study is based cover areas with diverse demography. The type 2 

registered diabetes prevalence from the NCASP/NDA study were 1.67%, 1.76%, 2.12%, 

2.43% and 2.95% in the five (Townsend) deprivation quintiles with the prevalence 

increasing as deprivation increased. These figures were weighted by the population 

distribution within the deprivation quintiles (based on IMD 2004 deprivation 76 ) giving a 

76 It was assumed that the Townsend deprivation quintiles and the Index of Multiple Deprivation 2004 

quintiles had the same relative risks of Type 2 diabetes. The IMD 2004 is a better measure of deprivation 

within London as the Townsend scores were originally derived for northern England and in particular used 

car ownership as a measure of affluence. This resulted in some very affluent areas of central London 

being recorded as deprived using the Townsend scores. 



population-weighted prevalence of 2.19% for England. Similarly, a population-weighted 

prevalence was calculated for each geographical area. The figure for Yorkshire and 

Humber Government Office Region was 2.32% giving a deprivation adjustment ratio of 

1.059 (2.32 2.19). This model also assumes that the total diabetes prevalence 

(diagnosed and undiagnosed) has the same relative risk ratio across the deprivation 

quintiles. It is recognised by the PHO that diagnosis rates were likely to be lower in 

more deprived areas, and therefore the adjustment for deprivation is an under-estimate 

of the gradient of the total (diagnosed and undiagnosed) type 2 diabetes across 

deprivation quintiles and as a result the prevalence is likely to be a conservative 

estimate. 

The estimated number of people with diabetes and the prevalence has been calculated 

at PCT level. However, a template (in Excel) has been set up by Y&H PHO so that data 

can be entered for any population, and estimates of the number of people with diabetes 

produced for these specified populations. At the time of writing the Diabetes Equity 

Audit, there were two versions available depending on the data that is available. 

Version 1 of the PBS phase 2 diabetes model requires: 

Ward where most of population lies (deprivation score is generated). 

Percentage of population Black and percentage of population Asian. 

Age and gender structure of population with age bands defined as 0-4, 5-14, 15- 

24, 25-34, 35-44, 45-54, 55-64, 65-74 and 75+. 

Version 2 of the PBS phase 2 diabetes model requires: 

Percentage of population within each deprivation quintile (IMD 2004) 

Age, gender and ethnic group structure of population with 5-year age bands from 

0-4 to 25-29 and 10-year age bands from 30-39 to 70-79 and 80+ and ethnic 

group defined as White, Black, Asian and Other. 

A new Phase 3 model was available after the Diabetes Equity Audit was almost finished, 

but the current model on the Yorkshire and Humber Public Health Observatory website 

(www.yhpho.org.uk) is a new model (and the „phase‟ number is not specified). 

Phase 2 was more sophisticated especially in terms of deprivation so this model was 

used in the Diabetes Equity Audit, although it requires more assumptions to estimate 

ethnicity at practice level. The current model, which has been used in this JSNA 

Foundation Profile, also requires ethnicity data at practice level and a similar method 

has been used to obtain this information as was used for the Diabetes Equity Audit. 

From the GP registration file (latest file October 2010), it is known which ward each 

patient registered with each practice lives, and an estimate can be derived on their 

ethnicity. The distribution by ethnic group by ward is given in Table 34 from the 2001 

Census. However, it is known that the percentage of residents from Black and Minority 

Ethnic (BME) groups has increased in Hull. It is possible to assume that the same 



percentage increases have occurred from 2001 to 2007 (from Table 36) for each ward 

by broad BME group 77 . For instance, the percentage of residents who were Asian or 

British Asian was 0.78% from the 2001 Census (Table 34), but had increased to an 

estimated 2.18% by 2007 (Table 36). Therefore, it is estimated that the percentage of 

Asians or British Asians increased by 178% between 2001 and 2007 in Hull. From 

Table 34, it was estimated at the time of the 2001 Census that 0.3% of residents in 

Bransholme East were Asians or British Asians, so it is estimated that this increased by 

178% to 0.5% for 2007. It was further assumed that if a patient who was registered with 

a specific general practice lived in Bransholme East, then they have a 0.5% chance of 

being Asian or British Asian. The ward level calculation was undertaken for both Hull 

and East Riding of Yorkshire as around 10% of patients registered with Hull GPs live in 

East Riding of Yorkshire 78 . This calculation was completed for each of the BME groups 

used in the model for all practice patients to obtain the ethnicity distribution at practice 

level. 

It was further assumed that the distribution of BME groups was the same over the 

different age groups and genders. This assumption is unlikely to be the case (given the 

findings of the BME Health and Lifestyle Survey 2007 – summary and full reports 

available at www.hullpublichealth.org), but it is unlikely to make a great deal of 

difference to the model, because the overall numbers of the different BME groups in Hull 

are relatively low. 

From this information, it was possible to provide an estimate of the number of men and 

women for each age group who were White, Mixed or Other BME groups combined, 

Asian or British Asian, and Black or Black British for each general practice in Hull as at 

October 2010. 

The resulting estimates from the model are given in Table 273. 

77 

The modelling undertaken in the Diabetes Equity Audit (www.hullpublichealth.org) used ONS BME 

estimates for mid-year 2004. 

78 

Patients whose postcode fell outside these areas were excluded from the BME weighted average 

calculation, but the numbers would have been very small and it is unlikely that their BME status is different 

to those within Hull and East Riding of Yorkshire so it is anticipated that the weighted estimates would not 

have change very much at all with their inclusion. Patients living outside Hull and East Riding of Yorkshire 

were still included in the overall numbers of patients at the practice though. 



13 APPENDIX 

13.1 Data Sources 

The data sources for each table and figure included within this report are listed in 

section 13.7 on page 944. 

Local and national data is available from the Compendium (of Clinical and Health 

Indicators) from http://www.nchod.nhs.uk. The information provided is quite varied, such 

as resident population estimates, information from the Quality and Outcomes 

Framework (see below), age-specific and indirectly and directly standardised mortality 

rates for the main causes of death, cancer incidence, screening uptake rates, number of 

births, fertility rates, hospital episode statistics standardised admission or procedural 

rates for a limited number of diseases or procedures, etc. The Compendium provides 

information for different geographical areas, such as England, SHAs, PCTs, Office for 

National Statistics (ONS) Area Classifications, local authorities, etc. Information is 

usually provided for males and females separately and combined, and for different age 

groups. The standardised mortality rates are generally provided for all ages and for 

those aged under 75 years, with (indirectly) standardised mortality ratios (SMRs) 

standardised to the English population and the directly standardised mortality rates 

standardised to the European Standard Population. This report generally uses the 

mortality rates from the Compendium when presenting information for Hull overall, 

because these are the nationally recognised figures and it is also useful to have the 

equivalent comparison information for England, the local SHA and comparator areas. 

Information from the 2001 Census is available for different geographical areas from 

http://neighbourhood.statistics.gov.uk. 

The prevalence from the Quality and Outcomes Framework (QOF) GP disease registers 

(see section 12.13 on page 782 for more information) have been taken from Excel files 

downloaded from the Information Centre (Information Centre for Health and Social Care 

2010). More recent information for Hull was downloaded from the local Quality 

Management and Analysis System (the data extracted from QMAS at the end of March 

is equivalent to the nationally produced QOF figures). 

The Public Health Mortality Files (PHMF) and the Public Health Birth Files (PHBF) are 

both available to PCTs from the Office for National Statistics. These files contain 

individual records for all deaths and births respectively in Hull. The age, gender and 

postcode of each individual are included in the file. The PHMF includes the date of 

death, primary cause of death and place of death. The PHMF has been used for 

analyses involving the calculation of the number of deaths from specific causes as well 

as the calculation of standardised rates when mortality information has been provided 

for wards, Areas or Localities, or by deprivation quintiles. For these analyses, resident 

population estimates were derived from the GP registration file (Connecting for Health, 

2009). In some cases, the estimate for Hull has been presented, but this will not be the 



same as the figure produced in the Compendium due to the differing population 

estimates. In these circumstances, the figure from the Compendium should be used in 

preference to any locally derived figures. Using the resident population estimate from 

the GP registration file tends to produce a slightly higher life expectancy estimates and a 

slightly lower directly standardised mortality rate compared to the Compendium, 

because the local population estimate is slightly higher than ONS‟s estimate. 

Patient level data for daycase and inpatient admissions was obtained from local Hospital 

Episode Statistics (Office for National Statistics 2009; The Information Centre for Health 

and Social Care 2009). The file includes patient‟s gender, date of birth, dates of 

admission and discharge, primary and secondary causes of admission and information 

on any surgical procedures undertaken as well as the type of admission (daycase, 

elective or emergency). For more information about Hospital Episode Statistics data, 

see section 12.12 on page 781. 

Projected population estimates were obtained from the Office for National Statistics 

(ONS) from http://www.statistics.gov.uk. 

Information on benefit claimants was downloaded from the Department for Work and 

Pensions (Department for Work and Pensions 2009). 

Data from the Stop Smoking Service was downloaded from the Information Centre 

(Information Centre for Health and Social Care 2010). 

Rates of childhood immunisation for Hull and comparator areas was obtained from the 

Information Centre (Information Centre for Health and Social Care 2010), and local 

childhood immunisation data was obtained from the local Child Health System 

SystmOne. Local data on breastfeeding status at 6 weeks and child height and weight 

data (to measure obesity) were also obtained from the local Child Health System 

SystmOne. 

Cervical and breast screening information at General Practitioner level was obtained 

from the Primary Care Information System (Open Exeter). 

Older information on influenza uptake rates and pneumococcal vaccinations were 

obtained from the Health Protection Agency‟s Annual Report (Humber Health Protection 

Unit 2006), and more recent information was obtained from the World Class 

Commissioning data packs (Information Centre for Health and Social Care 2009), from 

the Information Centre (Information Centre for Health and Social Care 2010) and from a 

joint Department of Health and Health Protection Agency report (Begum and Pebody 

2008) respectively. 

The estimated number of persons injured in road accidents has been obtained from the 

Department for Transport from http://www.dft.gov.uk (Department for Transport 2009). 

Crime information has been kindly provided from Hull Citysafe. 



13.2 Local Surveys 

13.2.1 Health and Lifestyle Surveys 

In order to have an impact on reducing inequity in health and preventing disease rather 

than just treating disease, it is necessary to influence people‟s attitudes and behaviours 

towards health, and in order to accomplish this it is necessary to have knowledge about 

health-related attitudes and behaviours and people‟s perceptions towards their health, 

as well as the prevalence of risk factors, such as smoking, and prevalence of diseases 

and medical conditions. 

National data are available for some health and lifestyle issues from surveys such as the 

Health Survey for England, but since this covers the whole of England, relatively few 

people within the local area participate in the survey. However, such data can be used 

to compare local data with national data, although in many cases different questions and 

responses categories, and differences in the survey designs mean that it is not 

straightforward to compare the results directly. 

A number of local surveys have been conducted and are detailed below. Reports 

resulting from these local surveys can be found at www.hullpublichealth.org. 

13.2.1.1 Adult Survey Conducted in 2003 

A local adult Health and Lifestyle Survey conducted in Hull by the Public Health 

Development Team 79 during 2003 provides more detail at the local level (Public Health 

Development Team 2005). The aim of the survey was to provide information which 

could be used in the planning and evaluation of current and future services within the 

area, particularly those services aimed at improving public health. The survey also 

provided information to a much wider range of organisations and individuals who have 

an interest in the health and health-related lifestyle activities of the population. A 

random sample of people aged between 16 and 84 years who were registered with a 

General Practitioner (GP) within the Hull and East Riding of Yorkshire were sent a selfcompletion 

questionnaire. As this represents a GP practice-based sample, it means that 

some individuals who live beyond the boundary were included in the sample. However, 

as postcode of the individual was collected, it is possible to examine only residents of 

Hull. A self-completed questionnaire was returned by 1,716 Eastern Hull PCT and 

1,560 West Hull PCT residents (out of 6,500) giving an overall response rate of 50% 

which compares favourably to other general population surveys, especially in urban 

areas. 

Local people participating in the Health and Lifestyle Survey were asked questions 

about specific risk factors, including questions relating to obesity, smoking, exercise and 

alcohol, and were also asked about their usage of local health services. 

79 Now Public Health Science section of Hull Teaching Primary Care Trust. 



13.2.1.2 Adult Survey Conducted in 2007 

Another adult Health and Lifestyle Survey was completed in Hull during early 2007 

(Sheikh Iddenden, Porter et al. 2008). This provided more up-to-date information and 

allows changes over time to be examined. A number of questions remained the same 

so that comparisons could be made, but it was necessary to add or change some of the 

existing questions. A different methodology was used (quota sampling), which aimed to 

provide a final sample of survey responders who were more representative of the overall 

population of Hull in terms of age, gender, area of residence and employment status. 

As the questionnaire took approximately 20 minutes to complete, most people when 

approached on their doorstep by the interviewer preferred to complete it at their leisure. 

So the majority of the completed questionnaires were self-completed rather than 

completed by interview. The questionnaires were collected by the interviewer at a 

mutually agreed time to ensure a higher completion/return rate. A total of 4,086 

residents of Hull completed the questionnaire. As this survey resulted in a sample that 

was broadly similar to Hull‟s overall population, an estimate of the number of people 

from different Black and Minority Ethnic (BME) groups can be obtained. Three specific 

reports on obesity and exercise, alcohol and smoking have been written. Reflector 

groups were also held following the survey (see section 13.2.2.2 on page 795). 

13.2.1.3 Adult Black and Minority Ethnic Survey Conducted in 2007 

As well as a Health and Lifestyle Survey completed which was broadly representative of 

the Hull population, another adult survey was completed entirely for Black and Minority 

Ethnic (BME) groups (Porter, Sheikh Iddenden et al. 2008). A further survey was 

completed for Gypsy and Travellers (Sheikh Iddenden, Porter et al. 2008). The surveys 

used the same questionnaire as the main survey. However, it was not possible to use 

the same methodology, and potential BME Survey responders were approached 

through community groups and the Gypsy and Travellers were approached using 

existing contacts and networks. A total of 1,163 residents of Hull who were from 

different BME groups, and a further 100 Gypsy and Travellers completed the 

questionnaire. A BME reflector group was held following the survey (see section 

13.2.2.2 on page 795). A summary of the findings from the BME Survey is given in 

section 8.2.1 on page 239, and a summary of the findings from the Gypsy and Traveller 

Survey is given in section 8.2.2 on page 242. 

13.2.1.4 Adult Prevalence Survey Conducted in 2009 

A smaller „Prevalence Survey‟ was completed during late 2009. The questionnaire 

included questions to examine the prevalence of the main risk factors to update the 

information collected in the 2007 Health and Lifestyle Survey. As well as questions on 

smoking, exercise, 5-A-DAY, alcohol and height and weight to measure overweight and 

obesity, the survey included a small number of questions to examine the survey 

population (general health status, limiting long-term illness or disability, mental health 

index, age, gender, ethnicity, and employment status). Quota sampling was used with 

the target to interview 1,750 residents of Hull. Interviewers approached individuals at 

their homes. 



13.2.1.5 Young People Survey Conducted in 2002 

A Health and Lifestyle Survey (McTighe 2003) was completed among young people 

aged 11-15 years (school years 7-10). All 36 schools within Hull and East Riding of 

Yorkshire were asked to take part in the survey, and 21 agreed. In the majority of 

participating schools, a request was made for two classes of each of the years 7-10 to 

be surveyed; where schools wished to select only specific age groups this was 

respected. The sample was therefore not directly random as the schools and pupils 

taking part were volunteers, few pupils refused to participate. Based on the postcode of 

the school, a total of 1,432 young people participated in Hull (759 in West Hull PCT and 

673 in Eastern Hull PCT). 

13.2.1.6 Young People Survey Conducted in 2008-09 

Another Health and Lifestyle Survey was completed among young people aged 11-16 

years (school years 7-11) within Hull during the period November 2008 to February 

2009. Thirteen of the fourteen schools agreed to participate as well as a further three 

Pupil Referral Units (PRUs). St Mary‟s school did not agree to take part, which takes 

pupils from across the city. As the intake is not geographically focused, it is hoped that 

there will not be a bias in the survey responders due to the exclusion of this school. All 

pupils from the PRUs were asked to participate and quota sampling was used for the 

schools based on the school census conducted in January 2008. Schools were asked 

to select the number of classes within each school year to survey so that at least as 

many questionnaires were completed as stated on the quota (minimum). Within the 

school year, the school chose which classes participated. On the whole, the survey was 

undertaken during Personal, Social and Health Education (PSHE) classes which are 

generally not selected in relation to ability and future educational attainment. Therefore, 

the classes should represent a mix of pupils based on socio-economic status, etc. In 

some schools, the quotas for different school years or overall were not achieved, and 

some schools were approached to ask if they would be willing to complete further 

questionnaires. The target of 3,000 completed questionnaires was not quite achieved 

as 2,928 completed questionnaires were obtained. Reflector groups were also held. 

Two groups were conducted in two schools across all school years, and four further 

groups were held with those aged 16-18 years (see section 13.2.2.3 on page 796). 

13.2.1.7 Veterans‟ Survey Conducted in 2009 

The fieldwork for a Veterans‟ Health and Lifestyle Survey occurred during Autumn 2009 

for Veterans who lived in Hull and had served in the British Armed forces since 1970. 

As well as a questionnaire, around 20 Veterans completed an in-depth interview. Due to 

the difficulty in knowing which residents in Hull were Veterans, different organisations 

who deal with Veterans and other local sources of information were used to approach 

Veterans directly by post asking the Veterans if they would be willing to participate in the 

survey. A press release was also issued encouraging Veterans to come forward to 

participate in the survey. Due to the methodology used to approach Veterans, those 

who participate in the survey will not necessarily be representative of all Veterans living 



in Hull who have served in the Armed Forces since 1970 (as Veterans with health 

problems are likely to volunteer for the survey more readily or be involved with 

organisations helping Veterans). 

From information provided by the 53 Veterans who completed questionnaires between 

August and October 2009 and had served in and left Armed Services in 1970 or 

afterwards, a summary of the main findings were: 

Only a half of Veterans (48%) knew about the „fast-track‟ service. 

Overall, 43% felt they did not have access to all the services they needed and 

14% stated that they were reasons why they might not want to engage with local 

health services mainly as civilians did not understand (although the total numbers 

not wanting to engage were very small). There were comments about the delays 

in receiving care, and a hope that action would result rather than this being „just 

another survey‟. 

Just under a half stated that they had depression or anxiety and the majority 

(87%) of these stated that this was related to their service. 

Around one in four stated they suffered from post traumatic stress disorder 

(PTSD) and all thought this was related to their service. 

One-quarter had problems controlling violence with the majority (83%) of these 

stating it was related to their service. 

One-third had difficulty obtaining or maintaining a job and the majority (63%) of 

these stated that this was related to their service. 

One in six stated they smoked too much, drank too much alcohol or ate 

unhealthily to help deal with stress and the majority of these felt that this was 

related to their service 

Two-thirds had physical health problems (but this could be associated with age 

for many), and 79% of these with health problems stated that they felt these 

problems were related to their time in the Armed Services. 

Overall, of the 51 Veterans answering these questions, 10 (20%) stated that they 

did not have any of the above health or lifestyle issues and 11 (22%) stated that 

they had “physical health problems” but none of the other health or lifestyle 

issues (depression or anxiety, PTSD, problems controlling violence, difficulty 

obtaining or maintaining a job, or smoking or drinking too much, eating 

unhealthily or taking drugs). 

Similar percentages attributed these health and lifestyle issues to other people 

(depression or anxiety, PTSD, problems controlling violence, difficulty obtaining 

or maintaining a job) they knew who used to be in the Armed Services with the 

exception of lifestyle issues (smoking or drinking too much, eating unhealthily or 

taking drugs) where a much higher percentage attributed these factors to others. 

All were registered with a GP and many had used local health services within the 

last year; 94% had seen a GP, 62% a practice nurse, 23% a community 

psychiatric nurse, 26% had attended physiotherapy, 38% had attended 

counselling, 31% had attended a psychologist appointment, 71% had attended a 

dental appointment, 19% had been to A&E, 53% had had an outpatient 

appointment, 39% a daycase appointment and 19% had been an inpatient. 



Veterans were asked if they had sought help or advice from a professional within 

the last year (or more than a year ago) with regard to the various health and 

lifestyle issues above. Within the last year, 61% had sought help or advice for 

physical health problems, 36% for depression or anxiety, 33% for PTSD, 23% for 

problems controlling violence, 13% for employment problems, 23% for problems 

with family relationships and few had sought help or advice for lifestyle issues. 

53 completed questionnaires for post-1970 Veterans with wide age range (23 to 

88) with mean age of 54 years, serving between 1-38 years (mean 16 years). 

Compared to similarly-aged local Health and Lifestyle Survey responders, there 

was much poorer physical and mental health for Veterans, but similar prevalence 

for 5-A-DAY and alcohol although 17% of Veterans stated that a relative or friend, 

or a doctor or other health professional has been concerned about their drinking 

or suggested they cut down. Fewer Veterans smoked and a higher percentage of 

Veterans exercised to national guidelines compared to the Health and Lifestyle 

Survey responders. 

The final report is available at www.hullpublichealth.org which includes findings and 

learning points from the in-depth interviews. 

13.2.2 Qualitative and Social Marketing Research 

13.2.2.1 Attitudes to Health Focus Groups 2007 

Twelve focus groups were held in Hull during 2007 to ask about opinions and attitudes 

to health which included a theme on diet and nutrition. Eleven groups were held with 

residents of Hull aged 40-60 years (8 mixed sex, 1 all female group, 1 all male group 

and one Black and Minority Ethnic (BME) group). A reflector group was also held 

involving community volunteers. Various other interviews, follow-up and discussion 

groups were also held. 

Focus group participants were able to identify a range of preventable diseases and 

conditions that they believed were attributable to lifestyle and behaviours which were 

consistent with those identified by community professionals. The main factors identified 

by the groups which affected health were: smoking; alcohol; stress; poor environment; 

employment; unemployment; lack of money; poor diet; lack of exercise; lack of 

knowledge; lack of support and illegal drug use. The main personal situations and 

behaviours believed to constitute a risk to health included: where individuals lived and 

worked; alcohol intake and excessive drinking; smoking and inhaling the smoke of 

others; eating a poor diet and over-eating; failing to take exercise; long-working hours; 

taking illegal drugs and social isolation. In terms of attitudes to diet and poor nutrition, 

though participants in all groups identified good nutrition as an important factor in 

remaining healthy and fit in middle age, discussion revealed a huge variance in attitude 

and behaviour. There was a broad recognition of healthy and unhealthy food groups 

and an anxiety that related to an increasing lack of knowledge about food purchase and 

basic cookery skills, which have been lost because of the availability of processed 

foods, change in family lifestyle and lack of education in school. Blame for the post-war 



change and deterioration in diet was levelled at the supermarkets, food manufacturers, 

advertising, low incomes and low availability of good food shops in some areas. 

13.2.2.2 Reflector Groups Following 2007 Health and Lifestyle Survey 

The findings from the 2007 Health and Lifestyle Survey for some subject areas 

demonstrated that there were reasons for public health concern in respect of a number 

of health and lifestyle topic areas. The objectives of the reflector groups following the 

quantitative survey were to gain additional insight into the varying attitudes, opinions and 

feelings of a number of target groups and improve understanding of the statistical 

differences identified between men and women, old and young, those living in different 

areas of the city, and between different ethnic groups for the main health and lifestyle 

topics of concern, namely, smoking; alcohol consumption; diet; overweight and obesity; 

and exercise. 

The groups were recruited by telephone and on a face-to-face basis with a target of 12 

attendees for each group. The groups recruited were: (i) all female – mixed age and 

living in the most deprived areas of Hull (18–64 years); (ii) all male – mixed age and 

living in the most deprived areas of Hull (18–64 years); (iii) male and female – mixed 

age and living in the least deprived areas of Hull (18–64 years); (iv) male and female 

aged 18–24 years; (v) male and female aged 60+ years; and (vi) male and female ethnic 

minority/immigrant 80 (18–64 years). The full report (Oldroyd et al. 2008) is available at 


The key findings noted in the main report were: 

“Smoking rates were high in all groups with a variety of explanations given for the 

higher frequency of smoking among men and women in Hull and mixed levels of 

success for those who had tried to quit. Psychological and economic pressures 

were cited most frequently as reasons for continued smoking and these were 

often related to unemployment and social deprivation. Good levels of health 

service support were recognised by most people but some men said that there 

was insufficient guidance in the area and there was a shared belief that high 

impact advertising was an effective way of driving messages home. Though 

smoking while pregnant was considered to be unacceptable by most people the 

majority did not regard the health impacts of smoking particularly seriously. 

There was broad understanding of the components of healthy and unhealthy 

diets and agreement that the cost of a healthy diet barred some people from 

eating the right food. The poor access to fresh fruit and vegetables in some 

areas, and the availability and the convenience of junk food were major factors, 

particularly for young people who were also most likely to ignore messages about 

80 As the survey found Africans and Asians tended to have the worst health as a relatively high proportion 

were asylum seekers, failed asylum seekers or refugees, the Black and Minority Ethnic (BME) reflector 

group focused on these BME groups. 



consumption of good food. A lack of knowledge about shopping and cooking was 

identified as a serious issue for young families and there were suggestions from 

several people about how healthy eating education and advertising could be 

improved and made more effective. Only in the young people‟s group was there 

an obvious lack of knowledge and disinterest about the long-term effects of eating 

badly and the health implications of a persistently bad diet were well understood 

by most participants. 

On the whole, women were more likely to be taking regular exercise and conform 

to national exercise guidelines than men. Though many walked regularly, most 

were unenthusiastic about exercise and targets were considered to be unrealistic. 

Things that prevented people from exercising were related to finance, which 

prevented many from taking gym memberships; insufficient local facilities that 

caused queuing and discouragement; and reduced access to public spaces, 

where family and retirement leisure and activity had been curtailed by the abuse 

of parks and open spaces. 

Opinions about weight were mixed and there was little consensus in either male 

or female groups about at what stage a clothing size was associated with obesity. 

Most people did not regard obesity as a big problem though some young people 

were making an effort to prevent obesity in their children. 

Perceptions about health risks associated with alcohol were mixed with young 

people disregarding the seriousness of their drinking habits. Though most over 

25s thought that alcohol was more harmful than tobacco the anti-smoking ban 

had convinced younger people that smoking was more harmful and less socially 

acceptable. Health and social risks were well recognised across the other groups 

but the social impact of binge drinking was trivialised by the younger group. 

Binge drinking was accepted as a social norm by most people despite an 

understanding of its negative impacts, which included danger to the individual 

and the community. The BME group expressed the highest levels of fear about 

alcohol-induced bad behaviour.” 

13.2.2.3 Reflector Groups Following 2008-09 Young People Health and Lifestyle 

Survey 

Two reflector groups were conducted in two schools across all school years, and further 

four groups were held with those aged 16-18 years following the Young People Health 

and Lifestyle Survey 2008-09. A report was completed by SMSR who undertook the 

Survey on behalf of NHS Hull (Jackson and Vann-Plevey 2009), and is available at 

www.hullpublichealth.org. The findings are summarised as follows: 

“Diet and exercise 

o The majority of young people aged both 11-16 and 16-18 tended to think that 

they had an unhealthy diet. The ease, convenience and low cost of take-aways 



and „junk food‟ tended to factor in their choice of diet. Although parents in both 

sets of age groups did encourage a healthy diet and prepared healthy meals for 

their children, many „did not like the taste‟ of healthy food and preferred to 

choose convenience over health value. 

o Females also admitted to „not eating very much‟ to maintain a thinner figure and 

tended to use celebrities such as Victoria Beckham and Cheryl Cole as role 

models. It was also felt by the females that males preferred thinner figures on 

women and so tended to eat as little as possible to impress the opposite sex. 

o In terms of exercise, males were much more likely than females to both enjoy 

and participate in any form of sport or exercise. A lack of confidence and worry 

about image in physical education in schools tended to prevent females from 

taking part, as well as lack of facilities, lack of variation in sporting activities and 

lack of „girls only‟ teams. Males tended to enjoy and take part in football and 

rugby, with many being involved in teams in and around Hull. 

o Diet and exercise, or lack of it, were not seen as something that should be 

worried about at a young age, as with alcohol, smoking and taking drugs; young 

people of all ages tended to think that health was something to worry about 

„when you are older‟ and to „live life to the full‟ while at a young age. 

o The impact of an unhealthy diet, lack of exercise and indulging in drugs, alcohol 

and smoking on young person‟s body and how it can affect them in the future 

needs to be addressed with the young age groups and awareness raised of how 

it will affect them and their lifestyles in the future. 

Smoking 

o Smoking was something that tended to be started at an early age, with many of 

the 16-18 participants smoking from the age of 13 or 14; however within the 

school groups, just two of the participants had tried smoking – but had not 

continued. Image, stress and influence of peers were the main reasons for 

starting smoking, with the number of cigarettes smoked increasing with stress. 

o Respondents aged 11-16 tended to be much more negative about smoking with 

personal experiences being a major factor. 

Alcohol 

o All participants had tried alcohol, with the 11-16 year olds most likely to have 

tried alcohol in the presence of family members, with the older participants of 

this age group drinking socially at friends‟ houses once a week. Year 9 (aged 13 

or 14 years) was thought to be the year that young persons tended to start 

drinking alcohol, due to influence of older friends, more socialising outside of 

school and an increase in confidence that alcohol gives them. 

o Participants of the 16-18 year old groups tended to drink large amounts of 

alcohol on a regular basis, with vodka and lager being the preferred options due 

to low cost and speed of which it gets them drunk. Access to alcohol was not an 

issue as many – even at the age of 14 – could buy alcohol in local shops without 

having to give ID. 



Drugs 

o Worryingly, access to drugs was seen as incredibly easy, with children in school 

witnessing drugs being bought within the school grounds. The relative 

cheapness of them, along with ease of access were thought to be contributing 

factors in young people trying them. While the majority of participants of the 16- 

18 year old groups had tried and were currently taking drugs, just one of the 11- 

16 year olds had in fact tried drugs and was currently still using them. 

o Along with access and low cost, boredom and the influence of older peers – 

especially with females – were seen as reasons for the use of drugs. Cannabis 

was the most commonly used drug as it was not seen as harmful and simply 

used to „relax‟, however „harder‟ drugs such as cocaine and Ecstasy were taken 

by participants on an occasional basis. 

o The glamorisation of drugs in the media, in television shows and films such as 

„Skins‟, „Shameless‟ and „Trainspotting‟, were seen to be a sign of acceptance 

that people take drugs and it isn‟t „that much of a big deal‟. 

o All participants recognised the health risks involved with taking drugs and 

tended to feel that taking drugs was more harmful to health than alcohol and 

smoking; however despite this recognition, older participants felt that nothing 

would influence them to stop taking drugs as „young people will try things 

regardless of what they are told‟. Younger participants agreed that young people 

will try drugs, alcohol and smoking even if they are told not to, however felt that 

graphic, hard hitting, real life education at a young age – for example taking an 

addict into schools to show children what can happen if you take drugs and how 

it can ruin lives – would perhaps have an influence and stop young people trying 

them at a young age.” 

13.2.3 Social Capital Surveys 

13.2.3.1 Survey Conducted in 2004 

In Hull, a survey was undertaken during 2004 to assess the levels of Social Capital 

(features of social organisation such as trust, norms and reciprocity that can improve the 

efficiency of society by coordinating action) and potential associations between this and 

health (Hunter, Lee et al. 2005). The survey included questions on health-related 

behaviour and attitudes, and perceptions of health. A total of 4,002 people aged 16 

years and over were interviewed for the survey (quota sampling was used so that the 

participants were representative of the overall population of Hull in relation to gender, 

age, employment status and area of residence). People were approached by knocking 

on their doors and asking if they would be willing to take part in the survey. 

13.2.3.2 Survey Conducted in 2009 

Another Social Capital Survey was completed during 2009. The survey included most of 

the questions from the questionnaire used in 2004, but also additional questions relating 

to knowledge of alcohol units and perceived impact of changes to lifestyle on health 



status to assess whether people were taking on board and using national guidelines and 

messages relating to health and lifestyle. The survey involved the same methodology 

as the 2004 survey, and there were a total of 4,057 survey responders. 

13.2.4 Other Surveys 

Following a successful pilot survey in 2006, between 2006 and 2009 at six-monthly 

intervals, information was collected, through a specifically-designed questionnaire, on 

physical activity levels, obesity and diet for members of community managed 

programmes led by community groups which had an element on physical activity. The 

key aims were to assess physical activity levels and mental health status of the 

participants, and examine trends over time. There were a 621 completed 

questionnaires from 360 individuals who participated in the survey over the four survey 

rounds (see section 8.6.9 on page 319 for more information). 

During 2004, there was a survey examining 5-A-DAY which involved a mapping 

exercise of availability of fresh fruit and vegetables (Public Health Development Team 

2005). This survey was completed in the most deprived areas of Hull so the findings 

were not representative, but provided some useful insight into availability of fruit and 

vegetables locally, problems with trying to and reasons for not eating 5-A-DAY, etc. 

13.2.5 Patient and Public Involvement Projects 

Two main projects have been undertaking by the Patient and Public Involvement 

directorate. The Listening Exercise involved obtaining information on the aspirations 

and expectations for health and healthcare from Hull residents, and the Membership 

project allowed Hull residents to become members of NHS Hull. 

13.2.5.1 Membership 

NHS Hull was one of the first organisations to introduce a Membership Model. People 

can become members of NHS Hull with varying degrees of involvement (currently 

7,000+ members). Membership offers many benefits for local people, including the 

development of a greater, more influential voice for the public when it comes to deciding 

what local health service‟s money is spent on and where. There are benefits for NHS 

Hull including the establishment of better links with the community, and the ability to 

seek input and opinions on projects, services and consulting issues much more directly. 

13.2.5.2 Listening Exercise “We‟re All Ears” 

Another large project which aimed to seek the views of the public on health was the 

NHS Hull Listening Exercise “We‟re All Ears”. Stage one involved telephone interviews 

with 1,500 residents to obtain their views on their local needs and their health 

aspirations. As well as the interviews, there are three large community events and 

around 20 small focus groups from different „more hard to reach‟ groups such as young 



people, blind people, deaf people, Eastern European migrant workers, Gypsies and 

Travellers, people who work with people with mental health problems, Black and 

Minority Ethnic (BME) groups and people from the voluntary and community sector. 

From this initial information, as part of stage two, a short questionnaire was designed 

and 10,000 interviews are to be conducted. Fieldwork for this second phase occurred 

during early 2009, and the results analysed over summer 2009. Initial findings from 

stage one, revealed problems with access to primary care, and as this is being 

addressed through various measures, it was not included in stage two. In stage two, 

people were asked to state how important they felt various project and programmes 

were both in general and specifically in relation to them (“would you use these 

services?”). The list included having a health „MOT‟, having activities to improve fitness, 

information on achieving a cheap healthy diet, programmes to reduce weight, training to 

improve employment prospects, etc. This research provides information on the 

importance of various programmes that can be introduced. If it is necessary to obtain 

more specific information, it may be possible to obtain views from NHS Hull Members. 

The top three priorities for the community as a whole were: (i) services to support older 

people to stay in their own homes; (ii) training to help people gain skills they need for 

work; and (iii) a regular, free health and well-being „MOT‟. Having access to a health 

and well-being „MOT‟ had the highest percentage stating they would definitely use this 

type of services within the next five years, followed by activities to help people improve 

their fitness and information on how to achieve a cheap, healthy diet. 

A number of the findings from the Listening Exercise had previously being highlighted 

and work was already underway to improve or change services, such as access to GP 

appointments. However, there are a number of areas where the findings from the 

Listening Exercise could be implemented with new services being introduced, changes 

to existing services, or further advertising about existing services. Details of an 

information leaflet and work being undertaken on top three community priorities are 

given below. 

A 24 page colour leaflet, “When Should I Call the Doctor”, was produced and was 

delivered to every household in Hull during late May and early June 2009. The leaflet 

was complied in response to findings from the Listening Exercise. Many of the issues 

raised during the first stage of the consultation focused on access to GPs and more 

convenient appointments, helping people to stay fit and healthy and manage their own 

illnesses, and how to get advice and information. The leaflet covered these issues in 

one handy, user-friendly leaflet which could be retained as a reference guide, covering 

how to make the best use of services, particularly GP services, and contained a useful 

self-care guide for many common illnesses and ailments which could be treated at 

home. It also signposted people to other sources of help such as minor injury units, 

emergency dental care, the quit smoking service and the weight loss services. It was 

hoped that the leaflet would help people choose the right treatment when they needed it 

and feel more confident about treating themselves and their family for minor illnesses 

and injuries. 



A huge amount of work to support people to stay living in their homes, working with local 

voluntary organisations has already been completed. A new community rehabilitation 

services has been set up so that people are discharged from hospital earlier but have 

the support they need to stay living at home. Telehealth has also been piloted to 

monitor people following hospital admission for heart failure. This means that patient‟s 

vital signs can be actively monitored while they are living at home and a community 

specialist nurse can identify any problems and arrange treatment before hospital 

admission becomes necessary. There are plans in place to extend this to patients who 

have had a stroke. NHS Hull are also offering free Caring with Confidence sessions to 

carers aged 18 years and over to help support carers. 

NHS Hull have increased the capacity in work experience opportunities in the NHS, and 

created a Health Award, so that young people can have evidence of working on health 

and social care projects while learning simultaneously about the NHS and its roles and 

functions. A mentoring programme is also underway to give young people guidance, 

support and advice on how to achieve their aims of working in the NHS. NHS Hull is 

also helping with apprenticeships in health and have a job shop set up jointly with NHS 

Hull and Hull City Council to give information, advice and guidance on NHS careers. 

GPs, as well as 30 pharmacies across Hull, offerred free „Healthy Heart‟ checks to Hull 

residents aged between 40 and 64 years as long as they are not already being treated 

for cardiovascular disease. There were further checks taking place in the community 

such as at local shopping centres. From April 2010, this initiative became the NHS 

Health Check and the upper age limit raised to 74 years. 

NHS Hull is also currently looking into other options, such as using special state-of-theart, 

health kiosks, allowing individuals to measure their weight, body mass index, body 

fat content, blood pressure and heart rate. One such health kiosk has been installed at 

Health Central (a drop-in centre for health). 

Other actions are taking place on other key findings from the Listening Exercise, and a 

comprehensive action plan has been produced, which is being fed into the World Class 

Commissioning (WCC) Strategy via the goal groups. A working group was also set up 

which planeed to highlight any gaps found in the findings from the listening exercise and 

implementation of changes. Following the change of government in May 2010, and the 

major NHS reorganisation (see section 3.3.6 on page 51), a number of these services 

could change. 



13.3 Partnership Working 

13.3.1 Joint Strategic Needs Assessment 

An initial Joint Strategic Needs Assessment (JSNA) was conducted during 2008/2009 by 

NHS Hull and Hull City Council through a consultation process that involved asking Hull 

people and service providers what they want from their local service. It is the most 

comprehensive assessment of both the short and longer-term needs of the people of 

Hull that has ever been carried out. The assessment considered health needs, care 

needs and well-being needs and is now being used to inform the planning of services 

and to decide how resources should be shared between services. The initial JSNA 

provided the opportunity to review and build on all the needs assessment work that has 

already been done and will help to develop and join up health and social care services. 

This document incorporates data provided by Hull City Council and other partners and 

forms a foundation for the updated JSNA. The initial and updated JSNA documents for 

Hull are available at www.jsnaonline.org as well as at www.hullpublichealth.org 

13.3.2 Children and Young People Health Needs Assessments 

Health needs assessments have been undertaken on various ad-hoc small projects 

examining the basic health needs in relation to specific groups and individuals. Two 

more formal and in-depth Health Needs Assessments have been recently completed or 

are currently (February 2011) which are being conducted by the local authority in 

partnership with NHS Hull and other key stakeholders for young people. The first is a 

general Health Needs Assessment for Children and Young People and documents 

“What it is like growing up in Hull” and involves both quantitative and qualitative 

analyses of existing and new data. The second linked Health Needs Assessment is 

specifically on alcohol and substance misuse, and is updated annually. The aim for both 

needs assessments is to detail existing health needs, identify potential gaps and unmet 

health needs for children and young people, and find out what it is like to grow up in Hull 

from young peoples‟ perspective. 

13.3.3 Health Impact Assessments 

Health Impact Assessments were undertaken by the local authority in partnership with 

NHS Hull and other key stakeholders in three distinct areas of housing, regeneration 

and education. 

13.3.4 Joint Appointments Between NHS Hull and Hull City Council 

The Director of Public Health for Hull is a joint appointment between NHS Hull and Hull 

City Council. Several other appointments in Children and Young People‟s Services and 

Adult Social Care are similarly funded to improve value for money and partnership 

working. Many of the lifestyle factors that impact upon health inequalities in the City can 

only be addressed in partnership with those responsible for housing, planning, transport, 



leisure, education, employment and crime. One example of this is NHS Hull funding a 

range of initiatives aimed at helping young people to improve their health and wellbeing 

by raising their aspirations and employment skills, in conjunction with a range of 

partners including the local football club. 

However, with the forthcoming major reorganisation of the NHS, the structure of the 

NHS and public health will change (see section 3.3.6 on page 51). 

13.3.5 Local Strategic Partnership 

Prior to the change in government (May 2010), the Local Strategic Partnership through 

Local Area Agreement 2 (LAA2), a performance management framework and regular 

Meetings of the Chairs of the Strategic Delivery Partnerships, had helped the City to 

realise the benefits of working together for the city across the boundaries of different 

organisations. The Health and Wellbeing Strategic Delivery Partnership had Task 

Groups reported into it from Adults and Older People, Joint Strategic Needs 

Assessment, Communities for Health, Physical Activity Strategy Steering Group and 

Affordable Warmth. 

13.3.6 Locality Boards 

Each of the three NHS Hull Locality Boards (East, West and North) has a number of lay 

representatives on them. Lay representatives are also a key feature of Health and 

Wellbeing Locality Board sub-committees. At the end of 2009, each Locality Board 

undertook a public launch of the Board to local communities with the aim of encouraging 

increased community awareness of the Board, and local people aware of how to access 

their lay representatives. 

Following major restructuring changes to the NHS, these Boards have been replaced. 

13.3.7 Health and Wellbeing Strategic Delivery Partnership 

The Health and Wellbeing Strategic Delivery Partnership (SDP) was chaired by the 

Director of Public Health for Hull and the Safe Strategic Delivery Partnership by the 

Chief Executive of NHS Hull. 

The Government Office for Yorkshire and the Humber (GOYH) in late 2009 said the 

Health and Well Being SDP is newly constituted with much stronger representation than 

previously. It has a clearer sense of purpose, target ownership, and clear reporting lines 

and accountability in relation to delivery of LAA targets. There are positive signs that the 

SDP is operating effectively, under the chairmanship of the Director of Public Health for 

Hull, and that it will have a positive impact on improved delivery as it further embeds. 

Following the major restructuring changes to the NHS and public health, a new Health 

and Wellbeing group will be established. 



13.3.8 Communities for Health Programme 

The Communities for Health Programme is designed to promote action across local 

organisations – voluntary sector, NHS, local authorities, business and industry – on a 

locally-chosen priority for health, to celebrate achievements, and build momentum for 

future change. In 2008-2009 it was agreed that Hull City Council and NHS Hull would 

jointly organise, deliver and evaluate 7 community health and lifestyle events with one 

event taking place in each of the 7 Hull City Council Areas. Each of the 7 Areas were 

allocated £10,000 to spend on locally identified community-based health-improvement 

activities. The main purpose of the events was to engage people in generating ideas 

and informing the decision-making process for spending the local allocation. Following 

the Events an exercise has been undertaken to reflect upon the „process‟ of partnership 

working between the City Council and NHS Hull looking at structures and 

communication channels, to identify what worked well and where improvements could 

be made. Communities for Health funding has been used by the City Council and NHS 

Hull through the Locality Health and Wellbeing sub committees to consult with residents 

in each of the 7 Areas and, following these Events, to identify barriers to a healthy 

lifestyle, pilot new health initiatives or jointly market existing services at a local level, with 

the aim of reducing health inequalities. 

13.3.9 Partnership Working on Specific Projects 

There are a number of specific projects in partnership with the Hull City Council, local 

sports clubs, voluntary organisations, etc. Details of these projects fall outside the 

scope of this JSNA Foundation Profile, although a number of these projects which fall 

within a goal area will be detailed within the World Class Commissioning Strategic Plan. 

A small number of these projects have been mentioned in passing within this document 

such as Fit Fans (section 8.5.9 on page 297) and supporting people to stay in their own 

homes (section 13.2.5.2 on page 799). However, there are numerous projects that 

have been undertaken in conjunction with NHS Hull and other organisations, from the 

high profile „training vessel‟ project to very local small projects undertaken within the 

community. The Wilberforce Sailing Academy project is being jointly funded and run by 

NHS Hull and Hull City Council. It aims to give young people who are not in education, 

employment or training (NEET) and are aged 17 to 19 years, training to learn a range of 

skills such as plumbing, electronics and carpentry, as well as time on a boat which will 

help with confidence, interpersonal skills and learning about team work. Training will 

also include CV writing, interview skills and job applications. The entire programme 

lasts almost one year, and has had very positive results since it started. 

The health equity audits completed across Hull and East Riding of Yorkshire have been 

undertaken in conjunction with a range of other stakeholders such as colleagues from 

within the PCT (commissioning, public health, performance, primary care, etc) as well as 

colleagues from Hull City Council, Humber Mental Health Teaching Trust, Hull Royal 

Infirmary, Cancer Network, service providers, etc. 



13.4 Definitions and Classifications 

13.4.1 Definition of Overweight and Obesity 

13.4.1.1 Adults 

Height and weight were collected as part of the local Health and Lifestyle Surveys. 

However, it is well known that self-reported height tends to be overestimated and selfreported 

weight tends to be underestimated compared to measured height and weight. 

A survey of 4,808 British men and women aged 35-76 which compared self-reported 

and measured height and weight (Spencer, Appleby et al. 2002), found that height was 

overestimated by on average 1.23cm for men and 0.60cm for women, but the extent of 

the overestimation was greater in older men and women, shorter men and heavier 

women. They also found that weight was underestimated by on average 1.85kg for men 

and 1.40kg for women and the extent of the underestimation was greater in heavier men 

and women, but did not vary with age or height (although other studies in the other parts 

of the world have found that the elderly particularly underestimate their weight 

(Jalkanen, Tuomilehto et al. 1987; Kuczmarski, Kuczmarski et al. 2001)). These 

differences were added or subtracted to the self-reported height and weight to try to 

obtain a more realistic estimate of actual height and weight. For more details, including 

the effects on the prevalence, are available in the Obesity and Exercise report resulting 

from the Health and Lifestyle Survey 2007 at www.hullpublichealth.org. 

Definitions of underweight, desirable or healthy weight, overweight and obesity are 

defined on the basis of the body mass index (BMI) which is a measure of the weight to 

height ratio. It was calculated by taking the adjusted weight (in kilograms) and dividing it 

by the square of adjusted height (in metres). In adults, the cut-off values for BMI vary 

for defining underweight and desirable weight, with some defining underweight as 

having a BMI of less than 18.5 whereas others define underweight as having a BMI of 

less than 20. For the purposes of the analysis below the local data uses underweight 

defined as having a BMI of less than 20. In practice, differences in the definitions of 

underweight are not of particular concern within this report as the focus is on presenting 

information on overweight and obesity. Desirable weight is defined as having a BMI 

more than (18.5 or) 20 but less than 25, overweight as having a BMI of 25 or more but 

less than 30, and obesity is defined as having a BMI of 30 or more. Within this latter 

category, morbidly obese is defined as having a BMI of 40 or more. 

13.4.1.2 Children 

There is little consensus on the “best” definition of childhood obesity in terms of BMI 

owing to the marked changes of BMI profile in populations of children across time and 

countries as well as over age. However, BMI remains the measure of choice in 

assessing obesity in children. Approximations to the definitions of overweight and 

obese children used by the Department of Health to produce Local Delivery Plan (LDP) 

target figures for the childhood obesity indicator (Public Service Agreement: PSA10a) 



will be used throughout this report (MH Treasury 2004). This means the figures 

presented here may differ slightly from those for Hull quoted in forthcoming reports from 

the NHS Information Centre and Public Health Observatories. Children are defined as 

obese if their BMI is above the 95 th centile of the reference curve for their age and sex 

according to the UK BMI centile classification (Cole, Freeman et al. 1995). Similarly 

children are classified as overweight if their BMI is above the 85 th centile. Since 

expected BMI measurements vary over the ages 4½ years to 6 years, and 10 to 12 

years, BMI thresholds for weight categories were defined at 6 monthly intervals and 

used to classify underweight, desirable/healthy weight, overweight and obese, as 

illustrated in Table 410. This classification is different from the technically superior one 

that was used in earlier local childhood obesity reports (Chinn and Rona 2004), so 

prevalence within BMI categories will not be directly comparable. 

Table 410: Body mass index thresholds and categories UK 1990, 95 th and 85 th centiles 

Underweight Healthy Weight Overweight Obese 

Adults less than 18.5 to 25.0 to 30.0 and above 

Boys aged 

4¼ to 4¾ less than 13.5 to 17.01 to 17.97 and above 

4¾ to 5¼ less than 13.5 to 16.96 to 17.95 and above 


5¾ to 6 less than 13.5 to 17.01 to 18.10 and above 

Girls aged 





Boys aged 

10 to 10¾ less than 14.0 to 18.94 to 20.79 and above 




Girls aged 

10 to 10¾ less than 14.0 to 19.85 to 21.94 and above 






13.4.2 Definitions Used to Measure Alcohol Consumption 

The local Health and Lifestyle Surveys collected information on the total number of 

drinks consumed over the previous week by category of drink, e.g. the number of pints 

of ordinary-strength and strong beer, lager, cider and stout, number of glasses of wine, 

number of pub measures of spirits, etc. The questionnaires used in the local surveys 

can be found at www.hullpublichealth.org. From this information the estimated number 

of alcohol units were derived. Table 411 gives the number of alcohol units for each type 

of drink from the 2009 Prevalence Survey (adapted from the units used in the local 2007 

Health and Lifestyle Survey). From this, the total number of alcohol units drunk during 

the previous week was calculated. 

Table 411: Calculating alcohol units consumed during the previous week based on types 

of drinks consumed 

Type of drink Measure Units 

Ordinary beer, lager 

or cider 

Strong beer, lager or 

cider 

Wine 

Whisky, gin, sherry 

etc 

Pint (586ml) or large bottle/can (500ml) 2.0 

Standard can (440ml) 1.5 

Small can/bottle (330ml) 1.1 

Pint (586ml) or large bottle/can (500ml) 4.0 

Standard can (440ml) 3.0 

Small can/bottle (330ml) 2.3 

Pub measure glass 2.0 

Large glass 3.0 

Bottle 9.0 

Pub measure glass 1.0 

Home measure glass 1.4 

Alcopops Standard bottle 1.5 

Survey responders were also asked how frequently they drank 8 or more units (for men) 

or 6 or more units (for women) with examples of what constituted an alcoholic unit. It is 

recommended that men do not exceed 4 units daily and that women do not exceed 3 

units daily. Therefore, this question asks about the frequency of consuming twice the 

daily recommended limit and this is generally the definition used for binge drinking 

(although the General Lifestyle Survey uses “exceeding 8 units” for men and “exceeding 

6 units” for women, i.e. drinking exactly 8 and 6 units respectively is not classified as 

binge drinking). Table 412 gives the definitions used to define excessive alcohol 

consumption and binge drinking in the local Health and Lifestyle Surveys. Further 

information can also be found in the Alcohol report resulting from analysis of the 2007 

Health and Lifestyle Survey data which is available at www.hullpublichealth.org. 



Table 412: Definitions of excessive alcohol consumption and binge drinking 

Risk 

factor 

Alcohol 

(weekly) 

Alcohol 

(binge 

drinking) 

Problem 

drinking 

Question Response/Calculation Risk factor present 

Number of alcohol drinks 

in last seven days for 

different types of drinks for 

different types, e.g. 

ordinary and strong beer, 

lager or cider, wine, sherry, 

spirits, alcopops, etc 

How often do you drink 8/6 

or more units of alcohol on 

a single day? (asked 

separately for men/women 

with unit examples given) 

Calculated number of 

weekly alcohol units based 

on number of pints/glasses 

of alcohol stated with some 

assumptions about number 

of units per pint/glass 

(Porter et al. 2008b). 

„Everyday‟, ‟4-6 days a 

week‟, „1-3 days a week‟, „1- 

3 days a month‟, „less than 

once a month‟, or „never‟. 

Male: >21 units 

Female: >14 units 

(more than the 

recommended 

weekly amount) 

„1-3 days a week‟ or 

more frequently 

Excessive alcohol 

consumption and/or 

binge drinking 

There are no national recommendations relating to young people for alcohol. It is illegal 

to sell alcohol to anyone under the age of 18 years, and whilst it is not illegal to drink 

alcohol under this age, young people clearly should not be drinking very much alcohol at 

all. However, as there are no recommended alcohol units for young people, the alcohol 

unit limits for adults were applied to young people to estimate excessive alcohol 

consumption for the Young People Health and Lifestyle Survey 2008-09. The effects of 

exceeding the alcohol limits for adults is clearly much worse for young people aged 11- 

16 years. 

13.4.3 Definitions Used to Measure Levels of Exercise 

It is recommended that adults undertake 30 minutes or more of vigorous or moderate 

exercise at least five times per week. The 2007 Health and Lifestyle Survey and the 

2009 Prevalence Survey asked about the frequency of vigorous, moderate and light 

exercise, and from this information it was possible to assess if individuals were 

undertaking exercise to the recommended guidelines (Table 413). As an assumption 

was made regarding the number of times per week for the 2007 survey when a survey 

responder ticked the 3-4 or 1-2 times per week, the questionnaire was changed for the 

2009 survey to ask survey responders the specific number of times per week. However, 

there is the possibility that the question could have been interpreted differently which 

could influence comparability. 



Table 413: Definitions of exercise levels 

Survey Question Response/Calculation Risk factor 

present 

2007 In a usual week, how 5+ times per week, 3-4 times per Less than 5 times 

many times do you week, 1-2 times per week or weekly, but this 

undertake exercising never. Values of 3.5 and 1.5 was divided into 

lasting 30 minutes or were assigned to the middle three different 

more? Separately for categories respectively and the categories (


13.4.4 Defining Risk of a Cardiovascular Event Within Ten Years in the Healthy 

Heart Study 

Table 414 gives the points assigned based on the following six risk factors for men and 

women to give a total score (summed over the six risk factors) of a cardiovascular event 

within the next ten years. The total scores in combination with family history were 

related to 10-year risk as given in Table 415 (see example below table). 

Table 414: Points for scoring each risk factor 

Risk factor Category Men Women 

Age (years) 30-34 –1 –9 

35-39 0 –4 

40-44 1 0 

45-49 2 3 

50-54 3 6 

55-59 4 7 

60-64 5 8 

65-69 6 8 

Total cholesterol 

(mmol/L) 

High density 

lipoprotein (HDL) 

cholesterol (mmol/L) 

Blood pressure 

(SBP/DBP mmHg)* 

70-74 7 8 

4.14 –3 –2 

4.15 to 5.17 0 0 

5.18 to 6.21 1 1 

6.22 to 7.24 2 1 

7.25 3 3 

0.90 2 5 

0.91 to 1.16 1 2 

1.17 to 1.29 0 1 

1.20 to 1.55 0 0 

1.56 –2 –3 


Table 415: Overall score relating to 10-year risk of a cardiovascular event 

Total 

points # 

Probability of cardiovascular risk in next 10 years (based on total 

points scored for six risk factors) with and without family history 

Men Women 

Without family With family Without family With family 

history 

history 

history 

history 

–2 2 3.0 1 1.5 

–1 2 3.0 2 3.0 

0 3 4.5 2 3.0 

1 3 4.5 2 3.0 

2 4 6.0 3 4.5 

3 5 7.5 3 4.5 

4 7 10.5 4 6.0 

5 8 12.0 4 6.0 

6 10 15.0 5 7.5 

7 13 19.5 6 9.0 

8 16 24.0 7 10.5 

9 20 30.0 8 12.0 

10 25 37.5 10 15.0 

11 31 46.5 11 16.5 

12 37 55.5 13 19.5 

13 45 67.5 15 22.5 

14 53 79.5 18 27.0 

15 53 79.5 20 30.0 

16 53 79.5 24 36.0 

17 53 79.5 27 40.5 

*Risk is multiplied by 1.5 if there is family history of premature CVD death. 

# 

The total points is the sum of the individual points for each of the six risk factors. 

For instance, a man of 52 years with total cholesterol of 7mmol/L, HDL cholesterol of 

1.2mmol/L, blood pressure 131/82mmHg, who does not have diabetes but who smokes 

would have individual scores of 3, 2, 0, 1, 0 and 2 for each of the risk factors 

respectively, giving a total score of 8, which relates to a 16% chance/probabaility of a 

cardiovascular event in the next 10 years provided he does not have family history of 

premature cardiovascular disease (or 24% chance with family history). 

13.4.5 Disease Definitions Using International Classification of Diseases 

The International Classification of Disease (ICD) is the international standard method 

used to diagnose and define disease status. The version currently being used is version 

10 (since 2001). Table 416 gives the ICD codes for the different diseases used in this 

document. Prior to 2001, ICD version 9 was used, but versions 9 and 10 are not easily 

cross-linked for all diseases and medical conditions. Therefore, for these tables and 

figures, there has been some adjustments so that trends over time are more comparable 



so the information being presented is comparing like-with-like. These adjustments have 

been made by the Office for National Statistics and the details of such adjustments are 

not given within this report. 

Table 416: International Classification of Diseases: classifications used 

Disease or medical condition ICD 10 

Accidents V01 to X59 

Alcohol-related F10, G62.1, I42.6, K29.2, K70, K86.0, O35.4, 

P04.3, Q86.0, T51, X45, X65, Y15, Z50.2, 

Z71.4, Z72.1 (see Table 417) 

Dementia F00 to F03 

Diabetes E10 to E14 

Cancer C00 to C97 

Bladder cancer C67 

Brain cancer C71 

Breast cancer C50 

Cervical cancer C53 

Colorectal cancer C17 to C21* 

Haematological cancers C81 to C96 

Kidney cancer C64 

Lung cancer C33 to C34** 

Oesophagus cancer C15 

Ovary C56 

Prostate cancer C61 

Pancreatic cancer C25 

Skin cancer C43 to C44*** 

Stomach C16 

Uterus C54**** 

Cardiovascular disease I00 to I99 

Coronary heart disease I20 to I25 

Stroke I60 to I69# 

Chronic liver disease including cirrhosis K70, K73 to K74 

Chronic obstructive pulmonary disease J40 to J44 

Fractured neck of the femur S72 

Mental/behavioural disorders (drugs) F10-F19 

Suicide or event of undetermined intent X60 to X84 and Y10 to Y34 excl Y33.9 

*Also defined as C18-C20 if otherwise stated in specific table/figure. 

**Also defined as just C34 if otherwise stated in specific table/figure. 

***Melanoma of the skin only is defined as C43 and is stated in specific table/figure. 

****Also defined as C54 and C55 if otherwise stated in specific table/figure. 

#Although the ICD10 coding for stroke differs in the Compendium depending on if mortality or 

hospital admission data are being analysed. 



Table 417 gives the locally defined descriptions for the alcohol-related medical 

conditions and diseases mentioned in Table 416. 

Table 417: Alcohol-related medical conditions and diseases 

ICD 10 coding Description 

F10 Mental and behavioural disorders due to use of alcohol 

G62.1 Alcoholic polyneuropathy 

I42.6 Alcoholic cardiomyopathy 

K29.2 Alcoholic gastritis 

K70 Alcoholic liver disease 

K86.0 Alcohol-induced chronic pancreatitis 

O35.4 Maternal care for (suspected) damage to fetus from alcohol 

P04.3 Fetus and newborn affected by maternal use of alcohol 

Q86.0 Fetal alcohol syndrome 

T51 Toxic effect of alcohol 

X45 Accidental poisoning by and exposure to alcohol 

X65 Intentional self-poisoning by and exposure to alcohol 

Y15 Poisoning by and exposure to alcohol, undetermined intent 

Z50.2 Alcohol rehabilitation 

Z71.4 Alcohol abuse counselling and surveillance 

Z72.1 Problems related to lifestyle – alcohol use 

13.4.6 Surgical Operations and Procedure Codes 

The Office of Population Censuses and Surveys (OPCS) Classification of Surgical 

Operations and Procedures was used to classify medical procedures that were 

undertaken. Table 418 provides a list of the surgical codes that were used to define the 

procedures presented in this profile. 

Table 418: Classification of Surgical Operations and Procedures: classifications used 

Surgical operation or procedure Coding used 

Angiography (cardiac) K63, K65 

Coronary artery bypass graft K40, K41, K44, K45 

Hip replacement W37, W38, W39, W46, W47, W48 

Percutaneous coronary intervention K49 

13.5 Statistical Methods and Terms 

See section 12 on page 770 for further information about particular statistical methods, 

terms and measures. 



13.6 Underlying Data for Figures 

More detailed information on comparators 

More detailed information on the Hull‟s potential comparator areas is given below. The 

information is summarised in Table 3 in terms of similarities and dissimilarities whereas 

in the table below gives the actual population estimates, ranks and percentages being 

compared. 

Characteristic from 

2001 census (unless 

otherwise stated) 

Wolverhampton 

Potential comparator area – percentage (unless otherwise stated) 

Salford 

Derby 


Population (2005, 000s) 240 216 234 238 304 246 286 138 284 288 77 249 

Aged 0-39 (2005) 53.5 54.2 54.6 52.2 56.4 52.9 54.0 54.0 51.3 60.4 51.6 55.3 

Aged 40-69 (2005) 34.3 34.5 33.6 36.1 32.7 35.5 34.4 35.1 37.5 30.4 38.2 34.0 

Aged 70+ (2005) 12.2 11.3 11.8 11.7 10.9 11.6 11.6 10.9 11.3 9.2 10.2 10.7 

Deprivat‟n score IMD04 32.2 38.2 27.7 35.3 28.2 26.2 35.4 40.7 34.3 32.8 29.4 41.1 

Deprivat‟n rank IMD04 35 12 69 18 64 76 16 10 22 31 52 9 

Terraced housing 19.6 33.0 23.2 30.4 49.7 37.7 28.6 37.0 34.1 36.9 36.1 56.1 

Detached 18.4 10.9 26.1 15.1 10.9 11.9 12.2 14.9 12.1 11.7 21.3 7.2 

Flats 10.9 12.5 6.7 5.2 9.6 15.9 10.0 6.0 6.8 10.1 7.0 7.5 

Central heating 86.6 92.9 88.5 90.7 88.0 84.5 81.9 93.0 97.4 91.7 87.2 78.7 

Mean household rooms 5.2 5.1 5.3 5.0 5.1 5.1 5.0 5.2 5.1 5.0 5.4 4.9 

Occupcy/overcrowding~ 1.10 1.11 1.22 1.12 1.07 1.11 1.07 1.13 1.07 0.96 1.33 0.97 

Non White British 2006 26.6 11.4 18.1 8.8 25.1 6.4 24.9 10.2 5.0 41.7 4.5 8.2 

Single 31.3 35.4 30.7 30.2 34.3 30.2 29.6 33.2 30.9 36.8 26.6 34.2 

Married 43.4 36.8 42.7 41.6 40.5 39.8 44.9 41.1 43.9 39.9 42.3 37.3 

Single parent househlds 7.8 8.7 7.3 7.7 8.3 7.4 8.0 9.9 8.0 8.7 8.7 8.9 

Limit long-term ill/disabl 21.2 22.8 19.3 23.7 18.6 20.6 21.7 22.3 24.0 18.8 19.0 20.7 

Not good health 11.7 12.5 9.9 12.8 10.0 10.1 11.9 11.7 12.9 10.2 9.3 11.2 

Working 54.3 55.3 57.6 54.5 55.5 57.7 55.3 48.9 53.3 53.0 57.7 53.2 

Unemployed 5.3 3.8 4.0 4.0 4.0 3.2 5.3 6.2 4.8 4.9 5.5 6.2 

Student 7.7 8.1 8.3 7.8 12.4 9.3 5.8 9.1 7.2 12.7 5.1 8.1 

Retired 14.4 13.5 14.4 14.0 12.6 13.9 14.1 14.1 14.3 10.8 15.1 13.3 

Ill/disabled no work 6.9 9.5 5.8 9.6 6.1 6.7 7.4 9.2 10.4 6.5 5.7 7.4 

No qualifications 40.7 35.5 31.4 42.9 31.4 29.0 45.6 36.8 36.9 38.5 37.1 41.2 


Coventry 

Plymouth 

Sandwell 

Middlesbrough 

Sunderland 

Leicester 

NE Lincolnshire 

HULL


Characteristic from 

2001 census (unless 

otherwise stated) 

Wolverhampton 

Potential comparator area – percentage (unless otherwise stated) 

Salford 

Derby 


Degree or higher 13.6 14.4 17.7 9.9 16.7 13.5 9.7 12.8 12.0 16.8 10.5 9.9 

No cars/vans househld* 35.2 39.2 30.6 34.6 33.1 30.2 37.5 41.0 39.9 38.3 33.2 43.8 

Mean vehicle/househld* 0.92 0.84 0.98 0.90 0.95 0.96 0.86 0.81 0.82 0.82 0.92 0.72 

Land use: buildings 14.4 9.2 12.4 11.4 12.0 11.4 14.9 9.9 8.4 14.9 3.9 14.8 

Land use: roads, rail, etc 14.1 11.9 13.2 12.2 12.3 13.3 14.7 13.0 11.2 15.3 4.6 15.4 

Land use: domest gardn 31.9 14.7 26.9 19.1 22.2 21.0 24.8 17.7 12.8 25.0 7.3 20.6 

Land use: greenspace 29.6 56.3 39.0 48.6 45.0 43.8 33.8 52.4 61.1 37.1 73.8 34.8 

Land use: water 0.7 1.8 1.2 1.0 0.6 4.0 1.5 1.9 1.7 0.8 6.5 2.3 

*This is based on registration of vehicles and assumes that people register the vehicles legally. 

~Household scored as –2, –1, 0, 1 or 2 to measure overcrowding. For example, –2 relates to having at 

least two fewer rooms than required based on an assessment of household members relationships to 

each other, their ages and their genders. 


Coventry 

Plymouth 

Sandwell 

Middlesbrough 

Sunderland 

Leicester 

NE Lincolnshire 

HULL


Expenditure by programme budget 

The underlying data for Figure 1 collated by the Yorkshire and Humber Public Health 

Observatory is given below. 

Programme Expenditure (£ per head) for 2008/09 

Y&H 

Ind’trial NE 

England SHA Hull Hint’l’ds Lincs 

1. Infectious Diseases £23.46 £18.08 £12.62 £16.56 £19.46 

2. Cancers and Tumours £94.55 £97.28 £87.15 £94.07 £153.99 

3. Disorders of Blood £19.50 £18.33 £11.91 £20.03 £13.57 

4. Endocrine, Nutritional and Metabolic £43.38 £41.88 £36.92 £46.75 £46.34 

5. Mental Health Disorders £191.21 £192.82 £176.64 £192.74 £192.14 

6. Problems of Learning Disability £56.11 £49.16 £42.62 £57.28 £105.65 

7. Neurological £67.64 £69.85 £88.80 £73.67 £60.23 

8. Problems of Vision £32.95 £34.40 £28.81 £30.91 £33.43 

9. Problems of Hearing £8.16 £9.39 £4.94 £8.54 £2.87 

10. Problems of Circulation £129.94 £144.24 £131.65 £135.72 £145.82 

11. Problems of the Respiratory System £77.97 £89.58 £114.50 £92.71 £95.47 

12. Dental Problems £62.44 £68.88 £74.27 £63.54 £64.89 

13. Problems of Gastro Intestinal System £77.89 £84.97 £103.11 £88.78 £93.37 

14. Problems of the Skin £32.34 £33.53 £31.56 £30.77 £31.31 

15. Problems of Musculo Skeletal System £79.68 £72.65 £65.56 £80.90 £67.87 

16. Problems due to Trauma and Injuries £63.54 £64.43 £62.22 £64.88 £38.32 

17. Problems of Genito Urinary System £73.78 £73.97 £72.82 £69.43 £54.72 

18. Maternity and Reproductive Health £60.44 £55.07 £62.91 £57.33 £62.62 

19. Conditions of Neonates £17.23 £16.08 £10.78 £17.13 £33.46 

20. Adverse effects and poisoning £18.31 £17.49 £26.17 £19.78 £23.03 

21. Healthy Individuals £35.74 £33.56 £56.89 £43.30 £14.23 

22. Social Care Needs £36.58 £53.98 £10.53 £28.04 £269.91 

23. Other Areas of Spend/Conditions £227.71 £265.57 £282.13 £191.65 £240.98 

TOTAL £1,531 £1,605 £1,596 £1,525 £1,864 



Outcomes by programme budget group 

The underlying data for Figure 2 and Figure 3 collated by the Yorkshire and Humber 

Public Health Observatory is given below. The numbers of the budget areas are given 

so that they can be related to the budget figures given in the table above if necessary. It 

is not possible to provide all the measures for all ONS Industrial Hinterlands PCTs and 

the figures are not presented for the Industrial Hinterlands group combined. The 

national ranks are presented out of the 152 PCTs in England and the ONS rank is 

presented out of the 16 Industrial Hinterland PCTs. The Z-score is the number of 

standard deviations that the Hull measure is away from the England mean. 

Approximately, 30% of the z-scores based on a normal distribution will be outside ±1 

and approximately 5% of the z-scores will be outside ±1.96. A low rank or negative zscore 

denotes that Hull is worse than England. 

Outcome Hull in relation to rest of PCTs/England 

Measure Rank Z- ONS rank 

Eng Hull (/152) score (/16) 

1. Infectious/parasitic diseases mortality* 8.4 10.7 110 -0.72 13 

2. Under 75 cancer mortality* 114 147 146 -1.96 13 

4. Diabetic patients last HbA1c≤7.5, 08/09 66% 69% 30 0.78 7 

5. On enhanced CPA receiving follow-up 93% 93% 110 -0.06 15 

7. Under 75 epilepsy mortality* 1.47 3.13 151 -2.02 15 

8. Total sight tests per 10,000 pop, 08/09 22,075 24,659 37 0.59 7 

10. Under 75 circulatory mortality* 74.8 104.58 133 -1.51 14 

11. Under 75 bronc/emph/COPD mort* 12.09 21.17 143 -1.53 14 

12. % decay/miss/fill teeth 5yr olds, 07/08 30.9% 42.6% 129 -1.22 13 

16. Accidents mortality* 15.9 17.1 90 -0.33 5 

17. Deaths < 30 days GU IP adm, 07/08** 2,609 2,538 72 0.16 10 

18. Low birth weight


Residence of patients who are registered with a practice in the North, East and West 

Localities (October 2010) 

The table below gives the underlying data used to produce Figure 11, Figure 12 and 

Figure 13 obtained from Primary Care Information System (Open Exeter). Practices are 

in practice code order separately for North, East and West Localities. 

Practice 

code 

Practice name Number of patients living in Hull 

Locality/Elsewhere 

North East West ERoY Other 

B81002 Dr A Kumar-Choudhary 2,716 1,016 21 84 0 

B81018 Dr R K Awan & Partners 5,878 117 384 137 2 

B81020 Dr P C Mitchell & Partners 2,550 4,391 1 494 0 

B81021 Faith House Surgery 5,025 364 1,255 724 4 

B81049 Dr V A Rawcliffe & Partners 4,618 0 2,425 2,175 3 

B81094 Dr A K Datta 891 810 37 51 1 

B81095 Dr Cook 3,011 387 387 360 0 

B81112 Dr Ghosh Raghunath & Partners 2,197 1,144 81 32 0 

B81119 Dr G Palooran & Partners 3,134 1,338 18 38 0 

B81616 Dr G T Hendow 1,465 864 79 131 0 

B81631 Dr R Raut And Partner 2,608 578 153 99 0 

B81634 Dr J Venugopal 1,934 906 111 64 3 

B81662 Mizzen Road Surgery 1,267 97 96 259 1 

B81685 Dr N A Poulose 1,448 832 64 50 0 

B81688 Dr K V Gopal 1,420 549 11 43 0 

B81690 Dr S K Ray 812 737 23 78 0 

Y02344 Northpoint 1,336 631 33 17 4 

Y02747 Kingswood Surgery 1,309 44 2 22 3 

Y02748 Haxby Orchard Park Surgery 527 5 8 12 0 

North Locality 44,146 14,810 5,189 4,870 21 

B81001 Dr A E Ogunba & Partners 171 3,058 17 87 0 

B81008 Dr J S Parker & Partners 67 14,625 101 141 2 

B81040 Dr P F Newman & Partners 644 15,873 19 175 10 

B81053 Diadem Medical Practice 56 10,276 12 297 1 

B81066 Dr G M Chowdhury 359 2,027 27 47 0 

B81074 Dr AK Rej 58 3,256 109 111 0 

B81080 Dr G S Malczewski 79 2,010 7 72 0 

B81081 Dr K M Tang & Partner 148 3,321 52 35 0 

B81085 Dr J W Richardson & Partners 21 5,264 3 14 0 

B81089 Dr Witvliet 105 3,292 66 130 0 

B81097 Dr R D Yagnik 61 1,556 29 43 0 

B81635 Dr G Dave 26 1,532 13 1,408 0 

B81644 Dr K K Mahendra 308 1,830 34 57 0 

B81645 East Park Practice 134 1,947 47 48 0 

B81646 Dr M Shaikh 63 1,441 23 295 0 

B81674 Dr J C Joseph 55 1,972 16 203 0 

B81682 Dr M Shaikh & Partners 217 3,356 33 174 0 

East Locality 2,572 76,636 608 3,337 13 

B81011 Wheeler Street Healthcare 9 0 4,513 690 0 



Practice 

code 

Practice name Number of patients living in Hull 

Locality/Elsewhere 

North East West ERoY Other 

B81017 Kingston Medical Group 1,250 421 4,979 74 1 

B81027 St Andrews Group Practice 35 39 5,296 583 1 

B81032 Dr A W Hussain & Partners 144 158 1,864 161 1 

B81035 The Avenues Medical Centre 52 0 5,146 961 1 

B81038 Dr A A Mather & Partners 0 1 6,494 1,195 0 

B81046 Dr J D Blow & Partners 4,105 81 4,453 608 0 

B81047 Dr J N Singh & Partners 811 222 5,990 478 4 

B81048 Dr S M Hussain & Partners 1,907 221 5,651 1,135 1 

B81052 Dr J Musil & P J Queenan 477 25 4,854 379 1 

B81054 Dr M J Varma & Partners 2,948 1,186 6,126 429 1 

B81056 The Springhead Medical Centre 19 1 7,012 6,779 2 

B81057 Dr S Macphie 143 17 2,641 383 1 

B81058 Dr M Foulds & Partner 151 59 6,534 1,927 9 

B81072 Dr R Percival & Partners 1,189 165 5,017 1,202 1 

B81075 Dr M K Mallik 70 43 1,520 564 0 

B81104 Dr J K Nayar 2,155 68 3,331 992 7 

B81675 Dr A H Tak & Dr E G Stryjakiewicz 218 173 7,926 793 1 

B81683 Dr A S Raghunath & Partners 56 71 1,484 137 1 

B81692 The Quays Medical Centre 149 196 1,299 33 0 

Y00955 Riverside Medical Centre 22 38 2,397 3 0 

Y01200 The Calvert Practice 7 4 1,204 600 0 

Y02786 Priory Surgery 91 5 679 36 2 

Y02896 Story St Practice & Walk In Centre 38 133 759 11 3 

West Locality 16,046 3,327 97,169 20,153 38 

Comparison of resident population structure among Localities (October 2010) 

The table below gives the underlying data used to produce Figure 14 obtained from 

Primary Care Information System (Open Exeter). 

Age (years) Number (%) of resident population by Locality 

North East West HULL 

0-9 8,530 (13.5) 11,343 (11.9) 11,673 (10.9) 31,546 (11.9) 

10-19 8,810 (13.9) 12,138 (12.8) 11,753 (11.) 32,701 (12.3) 

20-29 11,203 (17.7) 13,558 (14.2) 19,472 (18.2) 44,233 (16.7) 

30-39 8,485 (13.4) 12,401 (13.) 16,184 (15.2) 37,070 (14.) 

40-49 8,804 (13.9) 13,901 (14.6) 15,568 (14.6) 38,273 (14.4) 

50-59 6,689 (10.6) 11,882 (12.5) 12,331 (11.5) 30,902 (11.6) 

60-69 5,389 (8.5) 9,264 (9.7) 9,141 (8.6) 23,794 (9.) 

70-79 3,676 (5.8) 6,353 (6.7) 6,413 (6.) 16,442 (6.2) 

80+ 1,695 (2.7) 4,346 (4.6) 4,255 (4.) 10,296 (3.9) 



Population pyramid for Hull 

The underlying data for Figure 15 is given in Table 15 for Hull and below for England. 

Age (years) England population, 2008 

Males Females 

N % N % 

0-4 1,636,000 6.41 1,560,100 5.93 

5-9 1,464,000 5.74 1,399,100 5.32 

10-14 1,543,800 6.05 1,472,700 5.60 

15-19 1,700,900 6.67 1,610,900 6.13 

20-24 1,817,200 7.12 1,737,100 6.61 

25-29 1,788,900 7.01 1,722,700 6.55 

30-34 1,647,100 6.46 1,615,900 6.15 

35-39 1,817,100 7.12 1,840,300 7.00 

40-44 1,970,300 7.72 1,983,100 7.54 

45-49 1,838,600 7.21 1,886,800 7.18 

50-54 1,600,500 6.27 1,629,200 6.20 

55-59 1,467,900 5.75 1,518,200 5.77 

60-64 1,519,100 5.95 1,587,500 6.04 

65-69 1,132,300 4.44 1,218,100 4.63 

70-74 956,600 3.75 1,073,000 4.08 

75-79 738,900 2.90 920,400 3.50 

80+ 875,200 3.43 1,519,900 5.78 

Total 25,514,400 100.0 26,295,000 100.0 

Population pyramid for Localities 

The underlying data for Figure 16, Figure 17 and Figure 18 is given in Table 12, Table 

13 and Table 14, with the comparison Hull figures given in Table 15. 



Population pyramid for wards and areas within Hull 

The underlying data for Figure 19, Figure 20 and Figure 21 is given below (with the 

comparison data for Hull in Table 15). 

Gender Age 

(yrs) 

Male 

Females 

NORTH 

CARR 

Area / Ward population October 2010 

Bransholme 

East 

Bransholme 

West 

Kings Park 

N % N % N % N % 

0-4 1,227 8.4 511 9.3 339 7.6 377 8.0 

5-9 1,009 6.9 423 7.7 278 6.2 308 6.6 

10-14 1,014 6.9 431 7.9 308 6.9 275 5.9 

15-19 1,212 8.3 512 9.3 406 9.1 294 6.3 

20-24 1,206 8.2 517 9.4 362 8.1 327 7.0 

25-29 1,088 7.4 428 7.8 303 6.8 357 7.6 

30-34 1,001 6.8 367 6.7 262 5.9 372 7.9 

35-39 1,119 7.6 414 7.6 265 5.9 440 9.4 

40-44 1,148 7.8 395 7.2 337 7.6 416 8.9 

45-49 1,066 7.3 350 6.4 313 7.0 403 8.6 

50-54 791 5.4 244 4.5 241 5.4 306 6.5 

55-59 704 4.8 227 4.1 215 4.8 262 5.6 

60-64 721 4.9 257 4.7 237 5.3 227 4.8 

65-69 490 3.3 164 3.0 190 4.3 136 2.9 

70-74 385 2.6 117 2.1 188 4.2 80 1.7 

75-79 249 1.7 63 1.2 113 2.5 73 1.6 

80+ 206 1.4 58 1.1 103 2.3 45 1.0 

0-4 1,122 7.7 470 8.5 295 6.9 357 7.5 

5-9 949 6.5 414 7.5 244 5.7 291 6.1 

10-14 934 6.4 429 7.7 251 5.8 254 5.4 

15-19 1,136 7.8 483 8.7 363 8.5 290 6.1 

20-24 1,170 8.0 486 8.8 342 8.0 342 7.2 

25-29 1,142 7.8 434 7.8 302 7.0 406 8.6 

30-34 1,090 7.5 394 7.1 227 5.3 469 9.9 

35-39 1,051 7.2 394 7.1 263 6.1 394 8.3 

40-44 1,077 7.4 384 6.9 286 6.7 407 8.6 

45-49 1,002 6.9 361 6.5 291 6.8 350 7.4 

50-54 761 5.2 249 4.5 211 4.9 301 6.4 

55-59 745 5.1 269 4.9 227 5.3 249 5.3 

60-64 796 5.5 272 4.9 264 6.1 260 5.5 

65-69 497 3.4 166 3.0 217 5.1 114 2.4 

70-74 436 3.0 140 2.5 196 4.6 100 2.1 

75-79 296 2.0 82 1.5 142 3.3 72 1.5 

80+ 368 2.5 115 2.1 172 4.0 81 1.7 



Gender Age 

(yrs) 

Male 

Females 


NORTHERN Beverley 

Orchard Park 

& Greenwood 

University 

N % N % N % N % 

0-4 1,127 6.6 177 4.3 620 8.2 330 6.2 

5-9 1,074 6.3 180 4.3 627 8.3 267 5.0 

10-14 1,017 5.9 174 4.2 547 7.2 296 5.5 

15-19 1,293 7.6 230 5.5 657 8.6 406 7.6 

20-24 1,879 11.0 354 8.5 663 8.7 862 16.1 

25-29 1,334 7.8 256 6.2 578 7.6 500 9.4 

30-34 1,094 6.4 264 6.4 478 6.3 352 6.6 

35-39 1,116 6.5 283 6.8 489 6.4 344 6.4 

40-44 1,178 6.9 314 7.6 509 6.7 355 6.7 

45-49 1,196 7.0 299 7.2 567 7.5 330 6.2 

50-54 1,011 5.9 306 7.4 424 5.6 281 5.3 

55-59 872 5.1 263 6.3 372 4.9 237 4.4 

60-64 853 5.0 301 7.2 316 4.2 236 4.4 

65-69 555 3.2 205 4.9 201 2.6 149 2.8 

70-74 595 3.5 228 5.5 212 2.8 155 2.9 

75-79 476 2.8 177 4.3 185 2.4 114 2.1 

80+ 425 2.5 146 3.5 155 2.0 124 2.3 

0-4 1,066 6.3 189 4.5 605 8.2 272 5.0 

5-9 956 5.6 164 3.9 533 7.2 259 4.8 

10-14 920 5.4 166 4.0 506 6.8 248 4.6 

15-19 1,284 7.6 217 5.2 641 8.7 426 7.9 

20-24 2,065 12.2 382 9.2 678 9.2 1,005 18.6 

25-29 1,319 7.8 245 5.9 564 7.6 510 9.4 

30-34 986 5.8 233 5.6 437 5.9 316 5.8 

35-39 1,028 6.1 253 6.1 471 6.4 304 5.6 

40-44 1,044 6.1 255 6.1 481 6.5 308 5.7 

45-49 1,093 6.4 303 7.3 485 6.5 305 5.6 

50-54 974 5.7 298 7.2 425 5.7 251 4.6 

55-59 831 4.9 283 6.8 322 4.3 226 4.2 

60-64 833 4.9 304 7.3 298 4.0 231 4.3 

65-69 644 3.8 253 6.1 219 3.0 172 3.2 

70-74 656 3.9 221 5.3 259 3.5 176 3.3 

75-79 583 3.4 186 4.5 220 3.0 177 3.3 

80+ 696 4.1 208 5.0 264 3.6 224 4.1 



Gender Age 

(yrs) 

Male 

Females 


EAST Ings Longhill Sutton 

N % N % N % N % 

0-4 1,113 5.9 312 5.1 403 6.6 398 6.0 

5-9 1,026 5.4 311 5.1 365 6.0 350 5.3 

10-14 1,144 6.1 366 6.0 391 6.4 387 5.9 

15-19 1,364 7.2 401 6.5 457 7.5 506 7.7 

20-24 1,290 6.9 425 6.9 431 7.1 434 6.6 

25-29 1,261 6.7 374 6.1 406 6.7 481 7.3 

30-34 1,098 5.8 300 4.9 374 6.1 424 6.4 

35-39 1,191 6.3 358 5.8 397 6.5 436 6.6 

40-44 1,354 7.2 440 7.2 429 7.0 485 7.3 

45-49 1,364 7.2 504 8.2 409 6.7 451 6.8 

50-54 1,258 6.7 441 7.2 366 6.0 451 6.8 

55-59 1,223 6.5 368 6.0 377 6.2 478 7.2 

60-64 1,254 6.7 395 6.4 382 6.3 477 7.2 

65-69 791 4.2 274 4.5 232 3.8 285 4.3 

70-74 705 3.7 259 4.2 212 3.5 234 3.5 

75-79 623 3.3 272 4.4 178 2.9 173 2.6 

80+ 767 4.1 329 5.4 285 4.7 153 2.3 

0-4 1,037 5.4 287 4.5 370 5.8 380 5.8 

5-9 965 5.0 301 4.7 358 5.6 306 4.7 

10-14 1,125 5.8 339 5.3 392 6.2 394 6.0 

15-19 1,215 6.3 374 5.8 400 6.3 441 6.7 

20-24 1,307 6.8 383 6.0 457 7.2 467 7.1 

25-29 1,212 6.3 297 4.6 466 7.3 449 6.8 

30-34 1,029 5.3 318 5.0 333 5.2 378 5.8 

35-39 1,281 6.6 414 6.5 410 6.5 457 7.0 

40-44 1,254 6.5 439 6.8 392 6.2 423 6.4 

45-49 1,342 6.9 474 7.4 383 6.0 485 7.4 

50-54 1,250 6.5 424 6.6 366 5.8 460 7.0 

55-59 1,258 6.5 390 6.1 387 6.1 481 7.3 

60-64 1,205 6.2 364 5.7 356 5.6 485 7.4 

65-69 811 4.2 305 4.8 236 3.7 270 4.1 

70-74 846 4.4 360 5.6 231 3.6 255 3.9 

75-79 811 4.2 362 5.6 259 4.1 190 2.9 

80+ 1,378 7.1 580 9.0 555 8.7 243 3.7 



Gender Age 

(yrs) 

Male 

Females 


PARK Holderness Marfleet 

Southcoates 

East 

Southcoates 

West 

N % N % N % N % N % 

0-4 1,548 7.0 409 5.9 578 8.4 280 6.5 281 6.9 

5-9 1,383 6.2 370 5.3 456 6.7 322 7.5 235 5.8 

10-14 1,392 6.3 466 6.7 452 6.6 266 6.2 208 5.1 

15-19 1,668 7.5 530 7.6 560 8.2 343 8.0 235 5.8 

20-24 1,696 7.7 483 6.9 546 8.0 394 9.2 273 6.7 

25-29 1,586 7.2 449 6.4 506 7.4 312 7.3 319 7.9 

30-34 1,409 6.4 391 5.6 430 6.3 281 6.6 307 7.6 

35-39 1,534 6.9 518 7.4 455 6.6 249 5.8 312 7.7 

40-44 1,676 7.6 582 8.4 475 6.9 307 7.2 312 7.7 

45-49 1,701 7.7 570 8.2 494 7.2 289 6.8 348 8.6 

50-54 1,524 6.9 531 7.6 437 6.4 288 6.7 268 6.6 

55-59 1,232 5.6 410 5.9 356 5.2 229 5.4 237 5.8 

60-64 1,201 5.4 441 6.3 313 4.6 211 4.9 236 5.8 

65-69 772 3.5 272 3.9 188 2.7 154 3.6 158 3.9 

70-74 679 3.1 231 3.3 192 2.8 129 3.0 127 3.1 

75-79 530 2.4 155 2.2 176 2.6 105 2.5 94 2.3 

80+ 630 2.8 158 2.3 240 3.5 121 2.8 111 2.7 

0-4 1,497 6.8 357 5.3 554 8.1 318 7.1 268 6.6 

5-9 1,260 5.7 336 5.0 433 6.3 291 6.5 200 5.0 

10-14 1,394 6.3 429 6.4 469 6.8 292 6.5 204 5.0 

15-19 1,602 7.2 455 6.8 519 7.5 354 7.9 274 6.8 

20-24 1,655 7.5 411 6.1 566 8.2 375 8.4 303 7.5 

25-29 1,626 7.4 413 6.1 539 7.8 327 7.3 347 8.6 

30-34 1,277 5.8 410 6.1 374 5.4 230 5.1 263 6.5 

35-39 1,428 6.5 476 7.1 424 6.2 264 5.9 264 6.5 

40-44 1,536 6.9 566 8.4 426 6.2 291 6.5 253 6.3 

45-49 1,702 7.7 578 8.6 477 6.9 341 7.6 306 7.6 

50-54 1,411 6.4 491 7.3 382 5.6 290 6.5 248 6.1 

55-59 1,135 5.1 382 5.7 327 4.8 201 4.5 225 5.6 

60-64 1,211 5.5 443 6.6 327 4.8 215 4.8 226 5.6 

65-69 816 3.7 282 4.2 207 3.0 163 3.6 164 4.1 

70-74 740 3.3 244 3.6 219 3.2 142 3.2 135 3.3 

75-79 735 3.3 203 3.0 270 3.9 140 3.1 122 3.0 

80+ 1,089 4.9 251 3.7 367 5.3 233 5.2 238 5.9 



Gender Age 

(yrs) 

Males 

Females 


RIVERSIDE (EAST) Drypool 

N % N % 

0-4 459 7.0 459 7.0 

5-9 347 5.3 347 5.3 

10-14 295 4.5 295 4.5 

15-19 317 4.8 317 4.8 

20-24 427 6.5 427 6.5 

25-29 508 7.7 508 7.7 

30-34 549 8.3 549 8.3 

35-39 613 9.3 613 9.3 

40-44 565 8.6 565 8.6 

45-49 572 8.7 572 8.7 

50-54 450 6.8 450 6.8 

55-59 378 5.7 378 5.7 

60-64 389 5.9 389 5.9 

65-69 252 3.8 252 3.8 

70-74 185 2.8 185 2.8 

75-79 131 2.0 131 2.0 

80+ 167 2.5 167 2.5 

0-4 392 6.4 392 6.4 

5-9 316 5.1 316 5.1 

10-14 289 4.7 289 4.7 

15-19 333 5.4 333 5.4 

20-24 457 7.4 457 7.4 

25-29 533 8.7 533 8.7 

30-34 493 8.0 493 8.0 

35-39 499 8.1 499 8.1 

40-44 404 6.6 404 6.6 

45-49 431 7.0 431 7.0 

50-54 420 6.8 420 6.8 

55-59 343 5.6 343 5.6 

60-64 329 5.3 329 5.3 

65-69 233 3.8 233 3.8 

70-74 200 3.2 200 3.2 

75-79 168 2.7 168 2.7 

80+ 315 5.1 315 5.1 



Gender Age 

(yrs) 

Male 

Females 

RIVERSIDE 

(WEST) 


Myton Newington St Andrew’s 

N % N % N % N % 

0-4 1,335 6.6 497 5.5 506 7.8 332 7.2 

5-9 925 4.6 306 3.4 386 5.9 233 5.1 

10-14 944 4.7 338 3.7 387 5.9 219 4.8 

15-19 1,129 5.6 435 4.8 447 6.9 247 5.4 

20-24 1,555 7.7 701 7.7 538 8.2 316 6.9 

25-29 2,178 10.8 1,142 12.6 551 8.4 485 10.6 

30-34 1,973 9.8 1,027 11.3 478 7.3 468 10.2 

35-39 1,788 8.9 894 9.9 515 7.9 379 8.3 

40-44 1,607 8.0 691 7.6 546 8.4 370 8.1 

45-49 1,468 7.3 645 7.1 513 7.9 310 6.8 

50-54 1,233 6.1 530 5.8 427 6.5 276 6.0 

55-59 1,137 5.6 509 5.6 349 5.4 279 6.1 

60-64 935 4.6 443 4.9 296 4.5 196 4.3 

65-69 607 3.0 277 3.1 170 2.6 160 3.5 

70-74 563 2.8 263 2.9 168 2.6 132 2.9 

75-79 390 1.9 182 2.0 124 1.9 84 1.8 

80+ 415 2.1 188 2.1 122 1.9 105 2.3 

0-4 1,269 7.5 451 6.9 473 7.8 345 8.1 

5-9 934 5.5 315 4.8 389 6.4 230 5.4 

10-14 893 5.3 271 4.1 402 6.6 220 5.2 

15-19 1,113 6.6 379 5.8 459 7.5 275 6.5 

20-24 1,653 9.8 719 10.9 549 9.0 385 9.1 

25-29 1,644 9.7 747 11.4 505 8.3 392 9.3 

30-34 1,241 7.3 504 7.7 427 7.0 310 7.3 

35-39 1,112 6.6 452 6.9 400 6.6 260 6.1 

40-44 1,078 6.4 372 5.7 429 7.0 277 6.5 

45-49 1,121 6.6 373 5.7 462 7.6 286 6.8 

50-54 1,050 6.2 387 5.9 390 6.4 273 6.4 

55-59 794 4.7 324 4.9 269 4.4 201 4.7 

60-64 715 4.2 291 4.4 237 3.9 187 4.4 

65-69 568 3.4 240 3.6 192 3.1 136 3.2 

70-74 515 3.0 228 3.5 153 2.5 134 3.2 

75-79 450 2.7 197 3.0 151 2.5 102 2.4 

80+ 764 4.5 327 5.0 213 3.5 224 5.3 



Gender Age 

(yrs) 

Male 

Females 


WEST Boothferry Derringham Pickering 

N % N % N % N % 

0-4 1,014 5.7 330 5.3 342 6.0 342 5.7 

5-9 930 5.2 313 5.0 298 5.3 319 5.3 

10-14 1,033 5.8 397 6.4 287 5.1 349 5.8 

15-19 1,221 6.8 422 6.8 373 6.6 426 7.1 

20-24 1,133 6.3 383 6.1 334 5.9 416 6.9 

25-29 1,207 6.7 374 6.0 414 7.3 419 6.9 

30-34 1,118 6.2 385 6.2 375 6.6 358 5.9 

35-39 1,278 7.1 443 7.1 416 7.4 419 6.9 

40-44 1,364 7.6 479 7.7 439 7.8 446 7.4 

45-49 1,478 8.2 538 8.6 465 8.2 475 7.9 

50-54 1,241 6.9 478 7.7 347 6.1 416 6.9 

55-59 1,050 5.9 373 6.0 318 5.6 359 5.9 

60-64 1,057 5.9 387 6.2 337 6.0 333 5.5 

65-69 762 4.3 278 4.5 245 4.3 239 4.0 

70-74 737 4.1 252 4.0 258 4.6 227 3.8 

75-79 634 3.5 203 3.3 199 3.5 232 3.8 

80+ 667 3.7 198 3.2 208 3.7 261 4.3 

0-4 1,010 5.5 334 5.3 340 5.8 336 5.5 

5-9 851 4.6 308 4.9 267 4.6 276 4.5 

10-14 914 5.0 334 5.3 258 4.4 322 5.3 

15-19 1,080 5.9 404 6.4 290 4.9 386 6.3 

20-24 1,182 6.4 378 6.0 393 6.7 411 6.7 

25-29 1,195 6.5 391 6.2 434 7.4 370 6.0 

30-34 1,125 6.1 384 6.1 406 6.9 335 5.5 

35-39 1,218 6.6 424 6.7 389 6.6 405 6.6 

40-44 1,335 7.3 485 7.6 437 7.5 413 6.7 

45-49 1,414 7.7 517 8.1 438 7.5 459 7.5 

50-54 1,205 6.6 460 7.2 329 5.6 416 6.8 

55-59 1,021 5.6 356 5.6 313 5.3 352 5.7 

60-64 1,129 6.2 419 6.6 366 6.2 344 5.6 

65-69 818 4.5 286 4.5 280 4.8 252 4.1 

70-74 869 4.7 269 4.2 305 5.2 295 4.8 

75-79 765 4.2 233 3.7 243 4.1 289 4.7 

80+ 1,203 6.6 364 5.7 377 6.4 462 7.5 



Gender Age 

(yrs) 

Male 

Females 


WYKE Avenue Bricknell Newland 

N % N % N % N % 

0-4 903 5.2 388 5.5 212 5.0 303 5.1 

5-9 812 4.7 350 4.9 222 5.3 240 4.0 

10-14 807 4.7 334 4.7 276 6.5 197 3.3 

15-19 977 5.7 383 5.4 314 7.4 280 4.7 

20-24 2,099 12.2 607 8.6 294 7.0 1,198 20.1 

25-29 1,747 10.1 710 10.0 219 5.2 818 13.7 

30-34 1,535 8.9 653 9.2 231 5.5 651 10.9 

35-39 1,489 8.6 687 9.7 294 7.0 508 8.5 

40-44 1,379 8.0 624 8.8 338 8.0 417 7.0 

45-49 1,209 7.0 556 7.8 321 7.6 332 5.6 

50-54 1,035 6.0 437 6.2 325 7.7 273 4.6 

55-59 883 5.1 399 5.6 280 6.6 204 3.4 

60-64 823 4.8 364 5.1 283 6.7 176 3.0 

65-69 494 2.9 207 2.9 182 4.3 105 1.8 

70-74 375 2.2 142 2.0 143 3.4 90 1.5 

75-79 305 1.8 117 1.6 122 2.9 66 1.1 

80+ 397 2.3 135 1.9 162 3.8 100 1.7 

0-4 937 5.8 404 6.3 219 5.1 314 5.8 

5-9 753 4.7 295 4.6 223 5.2 235 4.4 

10-14 687 4.2 306 4.7 205 4.7 176 3.3 

15-19 955 5.9 355 5.5 298 6.9 302 5.6 

20-24 2,305 14.3 698 10.8 254 5.9 1,353 25.1 

25-29 1,574 9.7 675 10.5 241 5.6 658 12.2 

30-34 1,228 7.6 572 8.9 230 5.3 426 7.9 

35-39 1,079 6.7 450 7.0 293 6.8 336 6.2 

40-44 1,122 6.9 489 7.6 344 7.9 289 5.4 

45-49 993 6.1 408 6.3 324 7.5 261 4.8 

50-54 906 5.6 406 6.3 297 6.9 203 3.8 

55-59 776 4.8 322 5.0 253 5.8 201 3.7 

60-64 733 4.5 288 4.5 280 6.5 165 3.1 

65-69 500 3.1 213 3.3 186 4.3 101 1.9 

70-74 424 2.6 158 2.5 177 4.1 89 1.7 

75-79 386 2.4 147 2.3 149 3.4 90 1.7 

80+ 809 5.0 258 4.0 357 8.2 194 3.6 

Population density 2007 

There is too much information provided in map for Figure 22 showing the population 

density to present it easily within a table (163 data items). Furthermore, the references 

to the 163 lower layer super output areas will be relatively meaningless. However, the 

data is available on request. 



Comparison of registered population (patient) structure among Localities (October 2010) 

The table below gives the underlying data used to produce Figure 23 obtained from 

Primary Care Information System (Open Exeter). 

Age (years) Number (%) of registered (patient) population by Locality 

North East West HULL 

0-9 8,955 (13.0) 9,838 (11.8) 14,527 (10.6) 33,377 (11.5) 

10-19 9,339 (13.5) 10,548 (12.7) 15,950 (11.7) 35,899 (12.4) 

20-29 10,319 (14.9) 11,749 (14.1) 24,711 (18.1) 46,991 (16.2) 

30-39 9,280 (13.4) 10,483 (12.6) 19,478 (14.2) 39,393 (13.6) 

40-49 9,819 (14.2) 12,068 (14.5) 20,175 (14.8) 42,202 (14.6) 

50-59 7,992 (11.6) 10,574 (12.7) 15,774 (11.5) 34,407 (11.9) 

60-69 6,808 (9.9) 8,089 (9.7) 12,185 (8.9) 27,117 (9.4) 

70-79 4,399 (6.4) 5,729 (6.9) 8,756 (6.4) 18,900 (6.5) 

80+ 2,125 (3.1) 4,088 (4.9) 5,177 (3.8) 11,412 (3.9) 

Maternal age of live births 

The underlying data for Figure 24 from the Compendium is given in the table below. 

Area Year Number of births for each maternal age group (years) 

11-15 16-19 20-24 25-34 35-39 40+ Total 

2005 1,102 40,621 114,882 335,438 99,663 21,322 613,028 

England 

2006 

2007 

1,154 

1,064 

41,264 

40,714 

120,221 

122,968 

344,642 

355,842 

105,701 22,766 

110,424 24,345 

635,748 

655,357 

2008 1,134 40,466 127,762 366,922 111,140 25,385 672,809 

2005 15 441 944 1,479 275 49 3,203 

Hull 

2006 

2007 

12 

18 

492 

448 

1,008 

1,045 

1,610 

1,594 

317 

301 

61 

65 

3,500 

3,471 

2008 17 410 1,117 1,763 313 62 3,682 



Projected population estimates for Hull 

The table below gives the underlying data used to produce Figure 25 obtained from the 

Office for National Statistics. 

Year Estimated population (in thousands) by age group (years) 

0-4 5-9 10-14 15-19 20-29 30-39 40-49 50-59 60-69 70-79 80-84 85-89 90+ 

2008 15.9 13.0 15.2 18.9 50.1 34.3 35.9 28.9 22.3 16.8 5.5 3.1 1.3 

2009 16.4 13.1 14.7 18.9 51.5 34.2 36.2 29.0 22.7 16.7 5.4 3.1 1.4 

2010 16.8 13.4 14.1 18.6 53.0 34.8 36.1 29.4 23.2 16.7 5.4 3.2 1.4 

2011 17.3 13.8 13.5 18.1 54.4 35.5 36.0 29.9 23.7 16.4 5.5 3.2 1.5 

2012 17.6 14.3 13.0 17.6 55.3 36.4 35.7 30.8 24.1 16.2 5.6 3.2 1.6 

2013 17.7 15.0 12.7 17.2 56.1 37.3 35.3 31.4 24.5 16.1 5.7 3.2 1.7 

2014 17.8 15.4 12.8 16.7 56.4 38.6 34.6 32.1 25.0 16.1 5.7 3.2 1.7 

2015 18.0 15.8 13.1 16.1 56.4 40.2 33.9 32.8 25.3 16.1 5.8 3.3 1.8 

2016 18.1 16.2 13.4 15.6 56.1 41.8 33.4 33.3 25.6 16.2 5.9 3.4 1.8 

2017 18.3 16.5 13.9 15.1 55.8 43.6 32.6 33.9 25.3 17.1 5.9 3.5 1.9 

2018 18.3 16.6 14.6 14.8 55.4 45.2 32.2 34.1 25.3 17.8 6.0 3.6 2.0 

2019 18.4 16.7 15.0 14.8 54.7 46.5 32.1 34.4 25.5 18.2 6.0 3.7 2.0 

2020 18.4 16.8 15.3 15.0 53.8 47.5 32.3 34.4 25.8 18.6 6.1 3.8 2.1 

2021 18.4 17.0 15.7 15.4 52.7 48.4 32.6 34.4 26.4 19.1 5.9 3.9 2.2 

2022 18.4 17.1 15.9 15.9 51.9 49.2 33.2 34.0 27.1 19.5 5.8 4.0 2.4 

2023 18.4 17.2 16.0 16.5 51.2 49.7 33.9 33.7 27.6 19.9 5.9 4.0 2.5 

2024 18.3 17.2 16.1 16.9 51.0 50.0 35.0 33.0 28.2 20.3 5.9 4.2 2.6 

2025 18.3 17.3 16.2 17.3 50.9 49.9 36.1 32.4 29.0 20.6 6.0 4.2 2.7 

2026 18.2 17.3 16.3 17.7 50.9 49.7 37.6 31.9 29.5 20.8 6.3 4.1 2.9 

2027 18.2 17.2 16.5 18.0 51.1 49.6 39.0 31.3 29.9 20.6 7.0 4.1 3.0 

2028 18.2 17.2 16.5 18.0 51.6 49.2 40.5 30.8 30.2 20.6 7.5 4.2 3.2 

2029 18.2 17.2 16.6 18.1 52.1 48.7 41.5 30.6 30.4 20.8 7.9 4.2 3.3 

2030 18.2 17.1 16.6 18.2 52.8 48.1 42.5 30.7 30.5 21.2 8.1 4.3 3.5 

2031 18.2 17.1 16.7 18.3 53.6 47.3 43.2 31.0 30.4 21.7 8.2 4.5 3.5 

2032 18.2 17.1 16.6 18.4 54.3 46.7 43.9 31.5 30.2 22.3 7.9 5.1 3.6 

2033 18.3 17.0 16.6 18.5 54.9 46.2 44.4 32.1 30.0 22.8 7.8 5.5 3.8 



Highest educational qualification by locality 

The table below gives the underlying percentages used to produce Figure 26 from the 

local 20007 Health and Lifestyle Survey. The number of people in the survey with each 

qualification is also provided. 

Highest 

educational 

attainment 

Number and percentage of people by locality 


N % N % N % 

None 274 35.2 529 36.0 451 28.1 

GCSE/O-level 208 26.7 409 27.8 433 26.9 

A-level 87 11.2 120 8.2 193 12.0 

Degree/HNC 127 16.3 257 17.5 299 18.6 

Postgraduate 20 2.6 47 3.2 85 5.3 

Other 63 8.1 109 7.4 146 9.1 

Total 779 100.0 1,471 100.0 1,607 100.0 

Crime 

The underlying data for Figure 27 is given in Table 46. 

Index of Multiple Deprivation maps 

There is too much information provided in maps for Figure 28 and Figure 29 showing 

the Index of Multiple Deprivation 2007 national and local quintiles respectively to present 

it easily within a table (163 data items). Furthermore, the references to the 163 lower 

layer super output areas will be relatively meaningless. However, the data is available 

on request. 

ACORN and Health ACORN 

The underlying data for Figure 30 is given in Table 50 and the underlying data for 

Figure 32 is given in Table 52. There are too many data points to provide the 

information relating to Figure 31 or Figure 33. 



Self-rated general health by locality 

The underlying data for Figure 34 from the local Health and Lifestyle Survey 2007 is 

given in the table below. 

Area committee 

area / locality 

Number 

answering 

question 

Excellent 

Self-reported health status (%) 

Very 

good Good Fair Poor 

North Carr 167 9.0 28.1 34.7 16.2 12.0 

Northern 224 6.3 31.3 42.0 12.5 8.0 

North Locality 391 7.4 29.9 38.9 14.1 9.7 

East 254 10.2 24.8 35.8 17.7 11.4 

Park 295 12.2 22.0 36.9 18.0 10.8 

Riverside (East) 84 13.1 35.7 33.3 8.3 9.5 

East Locality 633 11.5 25.0 36.0 16.6 10.9 

Riverside (West) 243 8.6 20.6 40.7 17.3 12.8 

West 228 11.8 28.1 34.6 15.8 9.6 

Wyke 253 15.0 34.4 36.4 10.7 3.6 

West Locality 724 11.9 27.8 37.3 14.5 8.6 

Hull 1,748 10.8 27.2 37.2 15.2 9.7 

General health status by local deprivation quintile 

The underlying data for Figure 35 from the local Prevalence Survey conducted during 

2009 is given in the table below. 

IMD 2007 local Number 

Self-reported health status (%) 

quintile answering 

Very 

Don't 

question Excellent good Good Fair Poor know 

Most deprived 307 8.1 20.5 40.1 17.3 14.0 0.0 

2 331 8.5 22.4 38.4 16.3 14.2 0.3 

3 321 7.5 27.7 38.0 16.8 9.7 0.3 

4 477 14.9 28.3 36.5 14.9 5.5 0.0 

Least deprived 309 12.6 37.2 33.0 10.0 7.1 0.0 



Limiting long-term illness or disability by area 

The table below gives the underlying data for Figure 36, Figure 37 and Figure 38 from 

the Prevalence Survey 2009. 


answering 

question 

Illness or disability lasting more than 

a month which limits activities (%) 

No Yes 

Bransholme East 65 75.4 24.6 

Bransholme West 44 56.8 43.2 

Kings Park 58 82.8 17.2 

Area: North Carr 167 73.1 26.9 

Beverley 54 85.2 14.8 

Orchard Park & Greenwood 80 71.3 28.8 

University 85 77.6 22.4 

Area: Northern 219 77.2 22.8 

Locality: North 386 75.4 24.6 

Ings 90 76.7 23.3 

Longhill 81 76.5 23.5 

Sutton 84 71.4 28.6 

Area: East 255 74.9 25.1 

Holderness 89 88.8 11.2 

Marfleet 81 84.0 16.0 

Southcoates East 68 73.5 26.5 

Southcoates West 55 78.2 21.8 

Area: Park 293 81.9 18.1 

Drypool 84 82.1 17.9 

Area: Riverside (East) 84 82.1 17.9 

Locality: East 632 79.1 20.9 

Myton 95 70.5 29.5 

Newington 85 71.8 28.2 

St Andrews 62 71.0 29.0 

Area: Riverside (West) 242 71.1 28.9 

Boothferry 85 83.5 16.5 

Derringham 81 84.0 16.0 

Pickering 62 67.7 32.3 

Area: West 228 79.4 20.6 

Avenue 99 91.9 8.1 

Bricknell 55 74.5 25.5 

Newland 98 92.9 7.1 

Area: Wyke 252 88.5 11.5 

Locality: West 722 79.8 20.2 

HULL 1,740 78.6 21.4 



Limiting long-term illness or disability by local deprivation quintile 



Local deprivation Number answering Limiting long-term 

quintile 

question illness or disability (%) 

Most deprived 307 30.6 

2 331 23.3 

3 321 24.0 

4 476 14.3 

Least deprived 309 18.4 

Responsible for the long term care of someone by Locality 

The table below gives the underlying data for Figure 40 from the 2003 Health and 

Lifestyle Survey. Note that the number of survey responders by Locality differs for each 

question, and that the number with a caring responsibility is given (rather than the 

number answering the question). 

Person/group Number and percentage responsible for the long term 

care of someone by Locality, 2003 

North North East East West West 

N % N % N % 

Sick/disabled partner 38 6.2 67 5.9 51 5.0 

Sick/disabled child 11 1.9 19 1.8 15 1.5 

Sick/disabled relative 15 2.6 21 2.0 17 1.8 

Elderly relatives 20 3.5 31 2.9 28 2.9 

Sick/disabled friend 2 0.4 3 0.3 3 0.3 

Parents 32 5.5 38 3.6 43 4.4 

Someone else 11 1.9 15 1.4 12 1.2 

Anyone (summary) 111 17.3 193 16.6 140 13.5 



Caring status in young people survey 

The underlying data for Figure 41 from the Young People Health and Lifestyle Survey 

2008-09 is given in the table below. 

Gender School 

year 

Males 

Females 

Number 

answering 

question 

No-one 

Caring/helping look after (%) 

Disabled or ill 

mother 


father 


sibling 

Elderly 

grandparents 

7 264 61.4 11.7 8.3 9.1 20.8 14.0 

8 239 59.8 16.7 9.6 10.5 20.5 13.0 

9 230 70.9 8.3 4.8 4.8 14.3 10.0 

10 290 63.4 11.4 8.6 4.1 14.5 11.7 

11 163 73.6 5.5 0.6 3.7 10.4 13.5 

7 264 61.4 11.4 8.0 9.1 18.6 15.2 

8 258 65.1 8.9 5.0 5.4 12.8 13.2 

9 235 63.8 10.6 5.5 10.6 14.0 15.3 

10 298 64.4 6.7 5.4 7.4 12.1 15.4 

11 232 65.5 6.5 3.0 4.7 9.5 19.0 

Responsible for the long-term care of someone by local deprivation quintile 

The underlying data for Figure 42 from the local Health and Lifestyle Survey conducted 

during 2007 is given in the table below. 

Local deprivation Responsible for long-term 

quintile 

care of someone (%) 

Most deprived 22.0 

2 15.8 

3 13.3 

4 13.9 

Least deprived 14.6 


Someone else


Years since last dental visit for Hull adult residents at time of survey 2007 by age 

The underlying data for Figure 43 from the local Health and Lifestyle Survey conducted 

during 2007 is given in the table below. 

Age 

(yrs) 

Num 

ans Q 

Last time at dentist (%) 

Never 10+ yrs 5-10 yrs 3-5 yrs 2-3 yrs 1-2 yrs


Years since last dental visit for Hull young people 2008-09 


conducted during 2008-09 is given in the table below. 

Gender School 

year 

Males 

Females 

Number 

answering 

question 

During 

last 6 

months 

Last dental visit (%) 

7-12 

months 

ago 

1-2 

years 

ago 

>2 

years 

ago 

Never 

7 255 70.6 17.3 5.9 3.5 2.7 

8 227 81.1 10.6 3.5 3.5 1.3 

9 232 82.8 9.1 5.6 1.7 0.9 

10 275 78.2 11.3 4.7 4.4 1.5 

11 173 77.5 11 4.6 5.2 1.7 

Total 1,162 77.9 12 4.9 3.6 1.6 

7 247 76.1 12.1 4.9 1.6 5.3 

8 237 73.8 17.3 3 4.6 1.3 

9 224 81.3 9.4 3.6 1.8 4 

10 299 78.6 11 5 4 1.3 

11 234 73.9 14.1 6.8 5.1 0 

Total 1,241 76.8 12.7 4.7 3.5 2.3 



Male and female life expectancy at birth over time – Hull compared to England and SHA 

The underlying data for Figure 46 and Figure 47 for the trend in life expectancy for 

males and females for England and Hull is given in the table below. 

Period Male life expectancy 

Female life expectancy 

at birth (in years) 

at birth (in years) 

England SHA Hull England SHA Hull 

1991-1993 73.69 73.1 72.6 79.12 78.6 78.1 

1992-1994 74.02 73.5 72.9 79.37 78.9 78.1 

1993-1995 74.18 73.6 72.8 79.44 79.0 78.1 

1994-1996 74.44 73.9 72.7 79.64 79.1 78.1 

1995-1997 74.61 74.1 72.9 79.69 79.2 78.2 

1996-1998 74.84 74.2 72.7 79.84 79.3 78.1 

1997-1999 75.09 74.4 72.9 79.97 79.5 78.4 

1998-2000 75.38 74.7 73.0 80.19 79.7 78.5 

1999-2001 75.71 75.1 73.4 80.42 80.0 79.3 

2000-2002 76.00 75.4 73.7 80.66 80.2 79.3 

2001-2003 76.23 75.6 73.8 80.72 80.3 79.4 

2002-2004 76.53 75.9 74.3 80.91 80.4 79.1 

2003-2005 76.90 76.2 74.4 81.14 80.6 78.9 

2004-2006 77.32 76.6 74.7 81.55 81.0 79.0 

2005-2007 77.65 76.9 74.8 81.81 81.1 79.1 

2006-2008 77.93 77.1 75.0 82.02 81.3 79.5 



Male and female life expectancy at birth in years for 2007-2009 

The table below gives the underlying data for Figure 48 and Figure 49 for life expectancy 

calculated locally for 2007-2009 (with 95% confidence intervals) for males and females. 

Ward Life expectancy at birth (in years) with 95% CIs 

Males Females 

Bransholme East 71.3 (69.1, 73.4) 77.8 (75.8, 79.8) 

Bransholme West 76.5 (73.8, 79.2) 80.9 (79.0, 82.8) 

Kings Park 76.6 (74.3, 78.8) 81.0 (79.0, 83.1) 

Beverley 81.0 (78.8, 83.3) 83.2 (80.7, 85.8) 

Orchard Park and Greenwood 73.9 (71.9, 75.8) 78.8 (76.8, 80.7) 

University 76.8 (74.2, 79.5) 82.8 (80.6, 85.0) 

Ings 76.6 (74.9, 78.2) 80.0 (78.6, 81.4) 

Longhill 76.5 (74.7, 78.3) 82.8 (80.3, 85.3) 

Sutton 75.1 (73.3, 76.8) 78.5 (76.8, 80.3) 

Holderness 78.7 (76.8, 80.6) 83.4 (81.7, 85.1) 

Marfleet 72.9 (70.9, 74.9) 80.1 (78.5, 81.7) 

Southcoates East 74.8 (72.6, 77.1) 76.4 (73.8, 78.9) 

Southcoates West 76.5 (74.8, 78.3) 79.5 (77.4, 81.5) 

Drypool 75.0 (73.1, 76.9) 82.4 (80.7, 84.2) 

Myton 71.2 (69.1, 73.2) 76.9 (75.0, 78.8) 

Newington 73.3 (71.3, 75.3) 77.4 (75.2, 79.5) 

St Andrew's 71.0 (68.8, 73.3) 74.2 (71.6, 76.8) 

Boothferry 78.9 (76.7, 81.1) 83.5 (81.5, 85.6) 

Derringham 79.1 (76.8, 81.4) 83.7 (81.5, 85.9) 

Pickering 73.6 (71.3, 75.8) 80.4 (78.3, 82.5) 

Avenue 76.9 (75.0, 78.9) 79.9 (78.1, 81.7) 

Bricknell 76.5 (73.1, 79.8) 84.4 (82.7, 86.1) 

Newland 75.8 (73.8, 77.9) 80.1 (77.6, 82.6) 

HULL 75.4 (75.0, 75.8) 80.1 (79.7, 80.5) 



Relationship between deprivation and male and female life expectancy at birth 2006- 


The table below gives the underlying data used to produce Figure 50 and Figure 51 

from the Compendium. The life expectancy at birth is missing for two local authorities 

(City of London and Isles of Scilly) as the populations are too small for reliable estimates 

to be calculated. The IMD 2007 is available for 254 local authorities prior to boundary 

changes in April 2009, and has not been updated following boundary changes in April 

2009 as a result it is not available for all 326 of the current local authorities. As a result, 

the figure illustrates deprivation and life expectancy in 315 of the 326 local authorities. 

Hull‟s code is 00FA. 

Local 

authority 

code 

Local authority name IMD 

2007 

Male life 

expectancy 

2006-08 (years) 

Female life 

expectancy 

2006-08 (years) 

00AA City of London LB 12.84 * * 

00AB Barking and Dagenham LB 34.5 76.4 80.6 

00AC Barnet LB 21.2 79.9 84.0 

00AD Bexley LB 16.2 79.1 82.7 

00AE Brent LB 29.2 78.9 84.0 

00AF Bromley LB 14.4 79.7 83.6 

00AG Camden LB 28.6 77.8 82.6 

00AH Croydon LB 21.3 78.9 82.2 

00AJ Ealing LB 25.1 78.7 83.1 

00AK Enfield LB 26.2 78.8 82.7 

00AL Greenwich LB 33.9 75.4 81.7 

00AM Hackney LB 46.1 75.9 82.2 

00AN Hammersmith and Fulham LB 28.1 78.3 84.3 

00AP Haringey LB 35.7 76.3 83.1 

00AQ Harrow LB 15.6 80.4 84.2 

00AR Havering LB 16.1 78.5 82.5 

00AS Hillingdon LB 18.6 78.1 83.2 

00AT Hounslow LB 23.2 77.4 81.6 

00AU Islington LB 39.0 75.1 81.0 

00AW Kensington and Chelsea LB 23.5 84.3 88.9 

00AX Kingston upon Thames LB 13.1 80.0 83.3 

00AY Lambeth LB 34.9 75.7 81.0 

00AZ Lewisham LB 31.0 76.2 81.0 

00BA Merton LB 14.6 79.9 83.4 

00BB Newham LB 43.0 75.8 80.4 

00BC Redbridge LB 20.4 79.0 82.6 



Local 

authority 

code 


2007 

Male life 

expectancy 

2006-08 (years) 

Female life 

expectancy 

2006-08 (years) 

00BD Richmond upon Thames LB 9.6 80.3 84.3 

00BE Southwark LB 33.3 77.2 82.4 

00BF Sutton LB 14.0 79.0 82.6 

00BG Tower Hamlets LB 44.6 75.3 80.4 

00BH Waltham Forest LB 33.2 76.5 81.2 

00BJ Wandsworth LB 20.3 77.5 81.5 

00BK Westminster, City of LB 26.3 82.9 85.8 

00BL Bolton MCD 29.7 75.5 79.9 

00BM Bury MCD 21.4 76.6 80.9 

00BN Manchester MCD 44.5 73.8 78.9 

00BP Oldham MCD 30.8 75.4 79.4 

00BQ Rochdale MCD 33.9 75.6 79.8 

00BR Salford MCD 36.5 74.5 79.0 

00BS Stockport MCD 18.1 77.9 82.5 

00BT Tameside MCD 28.8 75.7 79.6 

00BU Trafford MCD 17.3 78.1 82.4 

00BW Wigan MCD 26.9 75.6 79.8 

00BX Knowsley MCD 43.2 75.5 79.2 

00BY Liverpool MCD 47.0 74.3 78.8 

00BZ St Helens MCD 29.8 75.8 80.3 

00CA Sefton MCD 25.1 77.0 81.5 

00CB Wirral MCD 27.9 75.9 81.0 

00CC Barnsley MCD 30.5 76.0 80.1 

00CE Doncaster MCD 30.8 76.1 80.9 

00CF Rotherham MCD 26.7 76.5 80.7 

00CG Sheffield MCD 27.8 77.5 81.5 

00CH Gateshead MCD 29.5 76.2 80.5 

00CJ Newcastle upon Tyne MCD 31.4 75.7 80.6 

00CK North Tyneside MCD 23.5 76.6 80.6 

00CL South Tyneside MCD 31.2 76.2 80.3 

00CM Sunderland MCD 31.8 75.4 80.4 

00CN Birmingham MCD 38.7 75.9 81.0 

00CQ Coventry MCD 27.9 76.5 81.1 

00CR Dudley MCD 23.7 77.2 81.9 

00CS Sandwell MCD 37.0 74.3 80.0 

00CT Solihull MCD 16.2 78.9 83.5 

00CU Walsall MCD 30.1 75.8 81.3 

00CW Wolverhampton MCD 33.0 75.7 80.5 

00CX Bradford MCD 32.0 76.1 80.1 



Local 

authority 

code 


2007 

Male life 

expectancy 

2006-08 (years) 

Female life 

expectancy 

2006-08 (years) 

00CY Calderdale MCD 23.0 77.1 81.5 

00CZ Kirklees MCD 25.2 76.5 80.7 

00DA Leeds MCD 25.1 77.2 81.9 

00DB Wakefield MCD 27.1 76.3 80.6 

00EB Hartlepool UA 34.1 75.3 79.0 

00EC Middlesbrough UA 38.9 75.4 79.8 

00EE Redcar and Cleveland UA 29.7 77.2 81.1 

00EF Stockton-on-Tees UA 23.8 76.4 80.9 

00EH Darlington UA 24.1 76.3 80.5 

00EJ County Durham UA ** 76.7 80.5 

00EM Northumberland UA ** 77.9 81.5 

00EQ Cheshire East UA ** 78.6 82.5 

00ET Halton UA 32.6 74.8 78.8 

00EU Warrington UA 17.9 76.8 80.6 

00EW Cheshire West and Chester UA ** 78.1 81.9 

00EX Blackburn with Darwen UA 35.8 74.4 79.5 

00EY Blackpool UA 37.7 73.6 78.8 

00FA Kingston upon Hull, City of UA 38.3 75.0 79.5 

00FB East Riding of Yorkshire UA 14.2 78.8 82.3 

00FC North East Lincolnshire UA 29.7 75.9 80.8 

00FD North Lincolnshire UA 20.9 77.3 81.0 

00FF York UA 13.4 79.4 83.2 

00FK Derby UA 26.6 77.2 81.5 

00FN Leicester UA 34.7 75.5 79.9 

00FP Rutland UA 7.5 80.1 84.5 

00FY Nottingham UA 37.5 75.1 80.1 

00GA Herefordshire, County of UA 17.6 78.6 83.4 

00GF Telford and Wrekin UA 22.3 77.4 81.5 

00GG Shropshire UA ** 78.6 82.7 

00GL Stoke-on-Trent UA 36.0 75.4 79.8 

00HA Bath & North East Somerset UA 11.5 80.0 83.5 

00HB Bristol UA 27.8 76.9 81.7 

00HC North Somerset UA 15.0 79.3 83.2 

00HD South Gloucestershire UA 9.6 79.8 83.6 

00HE Cornwall UA ** 78.7 82.8 

00HF Isles of Scilly UA ** * * 

00HG Plymouth UA 26.1 77.2 82.0 

00HH Torbay UA 26.4 78.1 82.4 

00HN Bournemouth UA 23.0 78.1 82.2 



Local 

authority 

code 


2007 

Male life 

expectancy 

2006-08 (years) 

Female life 

expectancy 

2006-08 (years) 

00HP Poole UA 14.9 78.9 83.1 

00HX Swindon UA 16.9 77.7 82.1 

00HY Wiltshire UA ** 79.4 83.3 

00JA Peterborough UA 24.5 76.8 81.0 

00KA Luton UA 24.7 76.7 80.4 

00KB Bedford UA ** 78.6 82.1 

00KC Central Bedfordshire UA ** 79.1 82.4 

00KF Southend-on-Sea UA 22.5 77.6 81.8 

00KG Thurrock UA 21.3 77.9 81.8 

00LC Medway Towns UA 19.5 76.8 81.2 

00MA Bracknell Forest UA 8.8 79.6 83.4 

00MB West Berkshire UA 8.2 79.7 83.1 

00MC Reading UA 19.3 77.7 82.1 

00MD Slough UA 22.3 77.7 82.6 

00ME Windsor and Maidenhead UA 8.5 79.3 82.9 

00MF Wokingham UA 5.4 81.1 83.8 

00MG Milton Keynes UA 15.3 78.1 81.8 

00ML Brighton and Hove UA 25.6 76.6 82.5 

00MR Portsmouth UA 24.2 76.8 82.0 

00MS Southampton UA 24.3 77.6 82.1 

00MW Isle of Wight UA 20.7 78.8 82.9 

11UB Aylesbury Vale CD 8.8 80.2 82.3 

11UC Chiltern CD 7.0 80.1 85.0 

11UE South Bucks CD 8.3 81.2 83.9 

11UF Wycombe CD 10.6 80.2 84.0 

12UB Cambridge CD 13.9 78.1 82.8 

12UC East Cambridgeshire CD 10.8 80.5 83.8 

12UD Fenland CD 20.5 77.3 81.3 

12UE Huntingdonshire CD 9.3 79.1 83.0 

12UG South Cambridgeshire CD 6.6 81.1 84.5 

16UB Allerdale CD 21.6 77.4 80.6 

16UC Barrow-in-Furness CD 32.7 76.4 80.8 

16UD Carlisle CD 22.7 77.1 81.4 

16UE Copeland CD 25.7 77.2 79.8 

16UF Eden CD 14.6 79.0 83.0 

16UG South Lakeland CD 11.7 79.4 82.8 

17UB Amber Valley CD 18.1 78.2 82.0 

17UC Bolsover CD 28.9 76.2 80.5 

17UD Chesterfield CD 25.7 77.2 82.1 



Local 

authority 

code 


2007 

Male life 

expectancy 

2006-08 (years) 

Female life 

expectancy 

2006-08 (years) 

17UF Derbyshire Dales CD 12.5 79.5 83.0 

17UG Erewash CD 18.0 77.5 81.6 

17UH High Peak CD 15.3 78.7 81.9 

17UJ North East Derbyshire CD 17.4 78.4 81.6 

17UK South Derbyshire CD 13.9 78.0 81.8 

18UB East Devon CD 13.7 80.6 83.6 

18UC Exeter CD 20.3 78.9 83.4 

18UD Mid Devon CD 17.3 80.4 83.3 

18UE North Devon CD 20.0 77.7 83.1 

18UG South Hams CD 14.3 79.2 83.8 

18UH Teignbridge CD 17.3 79.9 83.6 

18UK Torridge CD 21.1 79.1 83.2 

18UL West Devon CD 17.1 79.1 84.2 

19UC Christchurch CD 14.7 80.2 84.8 

19UD East Dorset CD 8.5 81.2 85.1 

19UE North Dorset CD 13.0 80.8 84.3 

19UG Purbeck CD 13.5 80.6 84.0 

19UH West Dorset CD 15.5 79.9 83.9 

19UJ Weymouth and Portland CD 21.2 78.1 82.2 

21UC Eastbourne CD 23.4 78.6 82.8 

21UD Hastings CD 32.2 76.3 80.5 

21UF Lewes CD 14.8 80.5 84.3 

21UG Rother CD 17.9 79.3 83.1 

21UH Wealden CD 10.9 80.5 83.5 

22UB Basildon CD 20.6 78.2 81.6 

22UC Braintree CD 13.6 78.9 82.8 

22UD Brentwood CD 9.2 79.7 83.6 

22UE Castle Point CD 12.9 79.7 82.1 

22UF Chelmsford CD 9.3 80.2 84.2 

22UG Colchester CD 14.6 78.7 83.3 

22UH Epping Forest CD 14.3 78.9 82.1 

22UJ Harlow CD 21.4 78.0 83.2 

22UK Maldon CD 12.3 78.6 82.8 

22UL Rochford CD 9.2 79.8 84.6 

22UN Tendring CD 23.4 78.3 82.1 

22UQ Uttlesford CD 6.9 79.5 83.7 

23UB Cheltenham CD 15.9 79.4 83.3 

23UC Cotswold CD 10.2 80.6 83.6 

23UD Forest of Dean CD 16.0 77.9 81.5 



Local 

authority 

code 


2007 

Male life 

expectancy 

2006-08 (years) 

Female life 

expectancy 

2006-08 (years) 

23UE Gloucester CD 21.6 77.9 81.9 

23UF Stroud CD 11.1 78.9 82.6 

23UG Tewkesbury CD 11.2 79.1 83.8 

24UB Basingstoke and Deane CD 9.8 79.7 82.5 

24UC East Hampshire CD 8.1 79.4 82.4 

24UD Eastleigh CD 9.2 79.4 83.2 

24UE Fareham CD 7.3 81.4 84.1 

24UF Gosport CD 17.8 78.7 81.4 

24UG Hart CD 4.1 81.3 85.4 

24UH Havant CD 21.3 79.1 82.9 

24UJ New Forest CD 10.2 80.6 84.5 

24UL Rushmoor CD 11.6 79.6 82.6 

24UN Test Valley CD 8.9 79.6 83.7 

24UP Winchester CD 7.2 80.0 83.2 

26UB Broxbourne CD 16.2 79.5 82.9 

26UC Dacorum CD 10.7 79.6 83.1 

26UD East Hertfordshire CD 7.4 79.8 83.2 

26UE Hertsmere CD 12.9 78.8 82.8 

26UF North Hertfordshire CD 10.7 78.6 82.2 

26UG St Albans CD 8.9 80.4 83.4 

26UH Stevenage CD 16.4 77.4 82.0 

26UJ Three Rivers CD 10.7 80.6 83.7 

26UK Watford CD 15.8 77.5 81.3 

26UL Welwyn Hatfield CD 14.2 79.3 82.3 

29UB Ashford CD 14.4 80.7 82.8 

29UC Canterbury CD 16.2 78.8 82.2 

29UD Dartford CD 16.7 78.9 81.4 

29UE Dover CD 19.1 78.1 81.8 

29UG Gravesham CD 20.4 78.7 82.1 

29UH Maidstone CD 13.0 78.8 82.4 

29UK Sevenoaks CD 10.3 80.9 83.7 

29UL Shepway CD 21.4 78.2 82.5 

29UM Swale CD 22.1 77.1 81.1 

29UN Thanet CD 27.6 76.8 81.5 

29UP Tonbridge and Malling CD 10.9 79.9 83.8 

29UQ Tunbridge Wells CD 11.5 79.5 83.2 

30UD Burnley CD 34.6 75.5 79.1 

30UE Chorley CD 16.6 77.2 81.3 

30UF Fylde CD 12.9 78.6 82.2 



Local 

authority 

code 


2007 

Male life 

expectancy 

2006-08 (years) 

Female life 

expectancy 

2006-08 (years) 

30UG Hyndburn CD 30.9 75.3 80.0 

30UH Lancaster CD 21.9 76.9 80.8 

30UJ Pendle CD 30.2 76.4 81.4 

30UK Preston CD 29.8 75.2 80.0 

30UL Ribble Valley CD 10.1 79.2 83.4 

30UM Rossendale CD 24.2 75.7 80.4 

30UN South Ribble CD 14.1 77.8 81.7 

30UP West Lancashire CD 20.4 77.7 80.8 

30UQ Wyre CD 17.7 77.7 81.9 

31UB Blaby CD 8.4 79.9 83.5 

31UC Charnwood CD 11.9 79.0 82.8 

31UD Harborough CD 7.1 80.1 83.7 

31UE Hinckley and Bosworth CD 10.9 79.6 82.9 

31UG Melton CD 10.4 79.2 82.5 

31UH North West Leicestershire CD 14.7 77.9 81.9 

31UJ Oadby and Wigston CD 10.5 79.9 82.5 

32UB Boston CD 22.8 76.3 81.2 

32UC East Lindsey CD 24.6 77.4 81.6 

32UD Lincoln CD 26.6 76.6 80.4 

32UE North Kesteven CD 10.3 78.8 83.1 

32UF South Holland CD 16.2 78.2 81.4 

32UG South Kesteven CD 11.5 78.5 82.1 

32UH West Lindsey CD 16.8 79.0 81.1 

33UB Breckland CD 15.3 79.4 82.8 

33UC Broadland CD 10.1 79.7 83.4 

33UD Great Yarmouth CD 28.3 77.4 81.6 

33UE Kings Lynn and West Norfolk CD 20.6 78.8 82.2 

33UF North Norfolk CD 18.1 78.7 84.3 

33UG Norwich CD 27.8 77.8 83.0 

33UH South Norfolk CD 10.8 80.0 83.3 

34UB Corby CD 26.2 74.4 80.4 

34UC Daventry CD 10.6 78.5 82.2 

34UD East Northamptonshire CD 11.8 79.3 81.6 

34UE Kettering CD 15.1 78.6 81.8 

34UF Northampton CD 21.1 77.2 81.9 

34UG South Northamptonshire CD 6.5 80.1 83.3 

34UH Wellingborough CD 17.8 77.7 83.0 

36UB Craven CD 11.6 79.7 83.7 

36UC Hambleton CD 9.8 80.2 83.3 



Local 

authority 

code 


2007 

Male life 

expectancy 

2006-08 (years) 

Female life 

expectancy 

2006-08 (years) 

36UD Harrogate CD 9.5 79.4 82.7 

36UE Richmondshire CD 10.9 78.9 82.6 

36UF Ryedale CD 14.5 79.3 82.8 

36UG Scarborough CD 24.1 77.4 81.9 

36UH Selby CD 12.2 78.4 82.6 

37UB Ashfield CD 25.3 76.5 80.7 

37UC Bassetlaw CD 24.1 77.1 81.2 

37UD Broxtowe CD 14.4 78.8 82.2 

37UE Gedling CD 15.5 78.4 82.4 

37UF Mansfield CD 31.8 76.1 80.7 

37UG Newark and Sherwood CD 18.0 77.5 81.5 

37UJ Rushcliffe CD 8.1 80.1 83.9 

38UB Cherwell CD 11.3 78.7 83.5 

38UC Oxford CD 18.8 78.0 82.8 

38UD South Oxfordshire CD 7.8 79.6 83.4 

38UE Vale of White Horse CD 7.2 79.9 84.6 

38UF West Oxfordshire CD 6.7 79.4 83.7 

40UB Mendip CD 14.8 79.4 83.2 

40UC Sedgemoor CD 17.8 78.3 83.1 

40UD South Somerset CD 13.9 79.6 83.7 

40UE Taunton Deane CD 15.7 78.9 82.9 

40UF West Somerset CD 23.2 79.3 84.3 

41UB Cannock Chase CD 20.6 76.3 80.4 

41UC East Staffordshire CD 18.4 77.0 81.2 

41UD Lichfield CD 12.1 78.7 81.5 

41UE Newcastle-under-Lyme CD 19.3 77.0 81.9 

41UF South Staffordshire CD 11.6 79.0 82.0 

41UG Stafford CD 12.7 78.2 82.3 

41UH Staffordshire Moorlands CD 16.4 78.4 82.0 

41UK Tamworth CD 19.8 78.2 81.2 

42UB Babergh CD 11.3 79.1 84.0 

42UC Forest Heath CD 11.9 79.3 83.9 

42UD Ipswich CD 23.7 77.9 82.6 

42UE Mid Suffolk CD 9.8 80.2 83.6 

42UF St Edmundsbury CD 12.1 79.7 83.8 

42UG Suffolk Coastal CD 11.3 80.6 83.8 

42UH Waveney CD 22.3 79.0 82.7 

43UB Elmbridge CD 7.1 81.3 83.4 

43UC Epsom and Ewell CD 7.4 81.2 84.3 



Local 

authority 

code 


2007 

Male life 

expectancy 

2006-08 (years) 

Female life 

expectancy 

2006-08 (years) 

43UD Guildford CD 8.2 80.4 84.6 

43UE Mole Valley CD 7.2 80.4 84.1 

43UF Reigate and Banstead CD 8.6 79.4 83.0 

43UG Runnymede CD 8.3 79.9 83.2 

43UH Spelthorne CD 12.2 79.7 83.3 

43UJ Surrey Heath CD 5.7 79.9 83.6 

43UK Tandridge CD 8.5 80.7 83.4 

43UL Waverley CD 6.9 80.8 84.3 

43UM Woking CD 8.7 79.1 83.4 

44UB North Warwickshire CD 16.2 77.7 81.2 

44UC Nuneaton and Bedworth CD 22.4 76.7 80.9 

44UD Rugby CD 13.1 79.2 81.9 

44UE Stratford-on-Avon CD 9.6 79.3 82.6 

44UF Warwick CD 12.0 79.2 83.4 

45UB Adur CD 20.5 78.4 81.6 

45UC Arun CD 16.6 78.7 82.5 

45UD Chichester CD 12.1 79.0 83.0 

45UE Crawley CD 15.6 80.2 83.6 

45UF Horsham CD 7.4 79.8 83.3 

45UG Mid Sussex CD 6.9 80.1 83.0 

45UH Worthing CD 17.5 78.1 81.9 

47UB Bromsgrove CD 10.2 79.5 81.8 

47UC Malvern Hills CD 13.6 79.2 83.2 

47UD Redditch CD 21.0 77.6 81.5 

47UE Worcester CD 18.0 77.0 82.1 

47UF Wychavon CD 12.0 79.5 83.8 

47UG Wyre Forest CD 19.1 78.2 82.5 

* Life expectancy figures not provided – population is too small and this would result in 

unreliable estimates. 

** IMD 2007 score is not available due to boundary changes (April 2009). That is, this local 

authority did not exist in 2007 when scores were calculated, and the IMD 2007 scores have not 

been updated. 



Relationship between deprivation and male life expectancy at birth in Hull 

The table below gives the underlying data used to produce Figure 52. Life expectancy 

is calculated from the local PHMF and the local GP registration file (for resident 

population estimates) for men in Hull. 

Year Hull male life expectancy in years (95% CIs) by local deprivation quintile 


1999-01 69.8 (68.8, 70.7) 71.6 (70.6, 72.7) 73.7 (72.7, 74.6) 75.5 (74.6, 76.4) 78.5 (77.6, 79.4) 

2000-02 70.3 (69.3, 71.3) 72.1 (71.0, 73.1) 74.0 (73.1, 75.0) 75.8 (74.8, 76.8) 78.4 (77.5, 79.3) 

2001-03 70.3 (69.3, 71.3) 72.1 (71.1, 73.2) 74.1 (73.1, 75.0) 76.6 (75.7, 77.6) 78.4 (77.5, 79.3) 

2002-04 70.8 (69.8, 71.8) 72.9 (71.9, 73.9) 74.2 (73.3, 75.1) 77.9 (76.9, 78.9) 78.4 (77.5, 79.4) 

2003-05 70.5 (69.5, 71.5) 73.1 (72.1, 74.0) 74.3 (73.3, 75.2) 78.0 (77.1, 78.9) 78.7 (77.8, 79.7) 

2004-06 70.6 (69.6, 71.6) 72.7 (71.7, 73.7) 74.9 (74.0, 75.8) 78.3 (77.4, 79.2) 79.3 (78.4, 80.2) 

2005-07 70.9 (69.9, 71.9) 72.9 (71.9, 73.9) 74.9 (73.9, 75.8) 78.1 (77.2, 79.0) 79.4 (78.5, 80.4) 

2006-08 71.9 (70.9, 72.9) 72.4 (71.4, 73.4) 74.7 (73.8, 75.6) 78.5 (77.5, 79.5) 79.7 (78.7, 80.7) 

2007-09 72.0 (71.1, 73.0) 72.6 (71.7, 73.6) 75.0 (74.0, 75.9) 78.5 (77.5, 79.5) 79.7 (78.8, 80.6) 

Relationship between deprivation and female life expectancy at birth in Hull 

The table below gives the underlying data used to produce Figure 53. Life expectancy 

is calculated from the local PHMF and the local GP registration file (for resident 

population estimates) for women in Hull. 

Year Hull female life expectancy in years (95% CIs) by local deprivation quintile 


1999-01 76.6 (75.6, 77.6) 78.9 (77.9, 79.9) 79.7 (78.8, 80.6) 80.8 (79.8, 81.8) 81.2 (80.3, 82.1) 

2000-02 76.8 (75.8, 77.7) 78.4 (77.4, 79.4) 79.5 (78.6, 80.4) 81.3 (80.3, 82.2) 81.8 (81.0, 82.7) 

2001-03 77.2 (76.3, 78.1) 78.7 (77.7, 79.7) 79.5 (78.6, 80.5) 80.8 (79.9, 81.8) 81.7 (80.8, 82.5) 

2002-04 76.6 (75.7, 77.6) 78.3 (77.4, 79.3) 79.0 (78.1, 80.0) 81.2 (80.2, 82.1) 80.8 (79.8, 81.8) 

2003-05 76.2 (75.2, 77.2) 78.3 (77.4, 79.3) 78.8 (77.8, 79.8) 80.7 (79.8, 81.7) 81.6 (80.6, 82.5) 

2004-06 75.8 (74.8, 76.8) 77.6 (76.6, 78.6) 79.4 (78.5, 80.3) 81.1 (80.2, 82.1) 82.1 (81.1, 83.1) 

2005-07 75.5 (74.5, 76.5) 77.7 (76.7, 78.7) 79.6 (78.7, 80.4) 80.5 (79.5, 81.5) 83.7 (82.8, 84.6) 

2006-08 76.1 (75.1, 77.1) 78.1 (77.1, 79.1) 79.9 (79.0, 80.7) 81.3 (80.4, 82.2) 83.1 (82.2, 84.1) 

2007-09 76.6 (75.7, 77.6) 78.8 (77.8, 79.7) 79.9 (79.0, 80.8) 82.4 (81.5, 83.2) 83.2 (82.2, 84.2) 

Relationship between deprivation and female life expectancy at birth in Hull and 

comparator areas 

The underlying data for Figure 54 and Figure 55 is given in Table 74 and Table 75 

respectively. 



Cause of deaths (pies) 

The underlying data for the cause of death pie charts (Figure 56, Figure 57, Figure 58, 

Figure 59, Figure 60, Figure 61, Figure 62 and Figure 63) are given in the figures 

themselves. However, the data is also presented in the tables below. 

Cause of death Number (%) deaths for males in Hull and by 

Locality 2007-2009 

Hull North East West 

Lung cancer 204 (11.3) 51 (12.6) 68 (10.3) 85 (11.5) 

Other cancers 393 (21.8) 87 (21.5) 158 (23.9) 148 (20.1) 

Coronary heart disease 329 (18.3) 77 (19.1) 119 (18.0) 133 (18.0) 

Stroke 70 (3.9) 20 (5.0) 19 (2.9) 31 (4.2) 

Other circulatory disease 94 (5.2) 16 (4.0) 37 (5.6) 41 (5.6) 

Influenza and pneumonia 42 (2.3) 7 (1.7) 18 (2.7) 17 (2.3) 

Bronchitis, emphysema & other COPD 98 (5.4) 23 (5.7) 38 (5.8) 37 (5.0) 

Other respiratory disease 49 (2.7) 12 (3.0) 24 (3.6) 13 (1.8) 

Diseases of the digestive system 143 (7.9) 36 (8.9) 49 (7.4) 58 (7.9) 

External causes of death 144 (8.0) 31 (7.7) 43 (6.5) 70 (9.5) 

Other causes of death 236 (13.1) 44 (10.9) 87 (13.2) 105 (14.2) 

TOTAL 1,802 (100) 404 (100) 660 (100) 738 (100) 

Cause of death Number (%) deaths for females in Hull and by 

Locality 2007-2009 

Hull North East West 

Lung cancer 147 (12.9) 34 (13.3) 55 (12.9) 58 (12.6) 

Other cancers 337 (29.5) 86 (33.7) 126 (29.5) 125 (27.2) 

Coronary heart disease 127 (11.1) 33 (12.9) 46 (10.8) 48 (10.5) 

Stroke 57 (5.0) 7 (2.7) 20 (4.7) 30 (6.5) 

Other circulatory disease 65 (5.7) 14 (5.5) 25 (5.9) 26 (5.7) 

Influenza and pneumonia 29 (2.5) 5 (2.0) 13 (3.0) 11 (2.4) 

Bronchitis, emphysema & other COPD 82 (7.2) 20 (7.8) 36 (8.4) 26 (5.7) 

Other respiratory disease 25 (2.2) 4 (1.6) 9 (2.1) 12 (2.6) 

Diseases of the digestive system 61 (5.3) 15 (5.9) 18 (4.2) 28 (6.1) 

External causes of death 40 (3.5) 6 (2.4) 12 (2.8) 22 (4.8) 

Other causes of death 171 (15.0) 31 (12.2) 67 (15.7) 73 (15.9) 

TOTAL 1,141 (100) 255 (100) 427 (100) 459 (100) 

Causes of death by age 

It is difficult to summarise the underlying data for Figure 64, Figure 65, Figure 66, 

Figure 67 and Figure 68 due to the quantity of information forming these figures. A 

summary of the information is available on request. 



Standardised mortality ratio for persons aged under 75 years by local deprivation 

quintile for 2007-2009 (all cause) 

The underlying data for Figure 69 derived from the PHMF (deaths) and the Primary 

Care Information System (population) using England as the standard population 

(mortality rates from Compendium) are given in the table below for premature deaths (all 

causes). The overall SMRs for Hull are also given. 

Local deprivation Standardised mortality ratio for persons aged 

quintile 

under 75 years (95% CI) for all causes 

Most deprived 192 (179, 206) 

2 167 (155, 179) 

3 135 (125, 146) 

4 92 (83, 102) 

Least deprived 79 (71, 87) 

Hull 131 (126, 136) 



Trends in under 75 all cause standardised mortality ratio for men by national deprivation quintiles of IMD 2007 

The underlying data for Figure 70 derived from the national public health mortality file and resident population estimates at 

lower layer super output area level, using England deprivation-specific reference rates. 

Area and national 

deprivation quintile 

Hull 

North East 

Lincolnshire 

Comparator 

PCTs 

Spearhead 

PCTs 

20 most 

deprived PCTs 

Yorkshire & 

Humber SHA 

Trends in under 75 all cause SMRs for men in the most deprived national quintile of IMD 2007 

(95% confidence intervals), Hull and comparator areas 

2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 

Most dep'd 113 (107, 120) 111 (105, 117) 109 (103, 115) 109 (103, 115) 107 (101, 113) 110 (104, 116) 

2 102 (92, 112) 94 (84, 104) 96 (86, 106) 92 (82, 102) 94 (84, 104) 90 (80, 100) 

3 109 (95, 125) 107 (93, 123) 103 (89, 118) 88 (75, 102) 81 (69, 94) 78 (66, 91) 

4 102 (80, 128) 87 (67, 111) 98 (77, 123) 88 (69, 112) 102 (81, 126) 92 (72, 115) 

Most dep'd 125 (115, 135) 120 (111, 131) 120 (110, 130) 118 (108, 128) 112 (103, 122) 114 (104, 124) 

2 105 (91, 121) 105 (90, 120) 108 (94, 124) 104 (90, 119) 102 (88, 118) 100 (86, 115) 

3 136 (117, 157) 123 (105, 143) 107 (91, 125) 105 (89, 123) 107 (91, 126) 112 (96, 131) 

4 110 (96, 126) 111 (96, 126) 108 (94, 124) 105 (92, 121) 114 (100, 130) 118 (103, 134) 

Most dep'd 114 (112, 117) 113 (111, 115) 110 (108, 113) 107 (105, 109) 105 (103, 108) 104 (102, 106) 

2 118 (115, 122) 113 (110, 116) 109 (106, 112) 106 (103, 110) 104 (100, 107) 103 (100, 107) 

3 115 (110, 119) 110 (105, 114) 108 (104, 113) 105 (100, 109) 103 (98, 107) 100 (96, 105) 

4 108 (103, 114) 105 (99, 111) 105 (100, 111) 104 (99, 110) 100 (95, 106) 96 (90, 101) 

Most dep'd 114 (113, 114) 111 (110, 111) 107 (106, 108) 104 (103, 105) 102 (101, 103) 101 (101, 102) 

2 117 (115, 118) 113 (111, 114) 109 (107, 110) 105 (104, 106) 103 (101, 104) 101 (100, 102) 

3 116 (114, 118) 113 (111, 115) 110 (109, 112) 107 (105, 109) 104 (103, 106) 102 (101, 104) 

4 119 (117, 121) 116 (114, 118) 113 (111, 115) 108 (106, 110) 105 (104, 107) 102 (100, 104) 

Most dep'd 113 (111, 114) 109 (108, 111) 106 (104, 107) 102 (101, 104) 100 (99, 101) 98 (97, 100) 

2 110 (107, 112) 104 (102, 107) 100 (98, 103) 98 (96, 101) 96 (93, 98) 95 (93, 98) 

3 109 (105, 113) 106 (102, 110) 103 (99, 107) 97 (94, 101) 94 (91, 98) 92 (88, 96) 

4 107 (101, 114) 105 (99, 112) 102 (96, 108) 102 (96, 108) 99 (93, 105) 91 (85, 97) 

Most dep'd 111 (109, 113) 109 (107, 111) 107 (105, 109) 105 (103, 107) 103 (101, 105) 103 (101, 105) 

2 116 (114, 119) 112 (109, 115) 108 (105, 110) 105 (102, 108) 104 (101, 107) 102 (99, 104) 

3 116 (113, 119) 114 (111, 117) 109 (106, 112) 106 (103, 108) 102 (99, 105) 103 (100, 106) 

4 118 (115, 121) 114 (111, 117) 110 (107, 113) 105 (102, 107) 102 (99, 105) 100 (97, 102) 



Trends in under 75 all cause standardised mortality ratio for women by national deprivation quintiles of IMD 2007 

The underlying data Figure 71 for derived from the national public health mortality file and resident population estimates at 

lower layer super output area level, using England deprivation-specific reference rates. 

Area and national 


Hull 

North East 

Lincolnshire 

Comparator 

PCTs, 

combined 

Spearhead 

PCTs, 

combined 

20 most 

deprived 

PCTs, 

combined 

Yorkshire & 

Humber SHA 

Trends in under 75 all cause SMRs for men in the most deprived national quintile of IMD 2007 

(95% confidence intervals), Hull and comparator areas 

2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 

Most dep'd 105 (98, 113) 111 (103, 119) 113 (105, 121) 118 (110, 126) 119 (111, 128) 119 (111, 128) 

2 97 (85, 110) 98 (86, 111) 99 (87, 112) 98 (86, 112) 96 (84, 109) 94 (82, 108) 

3 108 (91, 128) 113 (95, 133) 111 (94, 131) 113 (95, 133) 104 (87, 123) 100 (84, 119) 

4 104 (77, 136) 113 (85, 146) 112 (85, 145) 93 (69, 123) 80 (58, 108) 79 (57, 106) 

Most dep'd 98 (87, 110) 103 (92, 116) 108 (97, 121) 112 (100, 125) 112 (100, 125) 109 (97, 122) 

2 106 (89, 126) 111 (94, 130) 98 (82, 116) 98 (82, 116) 93 (77, 111) 100 (83, 118) 

3 102 (83, 125) 104 (85, 126) 114 (94, 137) 120 (100, 144) 118 (98, 142) 116 (96, 140) 

4 95 (79, 113) 89 (74, 106) 96 (80, 113) 104 (88, 122) 106 (90, 125) 92 (77, 110) 

Most dep'd 113 (110, 116) 112 (109, 114) 110 (107, 113) 106 (103, 108) 101 (99, 104) 103 (100, 106) 

2 114 (110, 119) 114 (110, 118) 109 (105, 114) 107 (103, 111) 101 (97, 105) 101 (97, 105) 

3 112 (106, 117) 108 (103, 113) 105 (100, 111) 109 (104, 114) 107 (102, 113) 106 (101, 112) 

4 103 (96, 109) 105 (98, 112) 103 (96, 110) 101 (95, 108) 102 (96, 109) 100 (94, 107) 

Most dep'd 112 (111, 113) 110 (109, 111) 108 (107, 109) 105 (104, 106) 102 (101, 104) 102 (101, 103) 

2 115 (113, 117) 113 (111, 115) 111 (109, 112) 107 (106, 109) 104 (103, 106) 103 (102, 105) 

3 117 (115, 119) 113 (111, 115) 110 (108, 112) 107 (105, 109) 106 (104, 108) 104 (103, 106) 

4 117 (114, 119) 112 (110, 114) 109 (106, 111) 106 (104, 109) 105 (103, 108) 103 (101, 105) 

Most dep'd 110 (108, 112) 108 (106, 110) 105 (104, 107) 103 (101, 104) 99 (98, 101) 99 (97, 101) 

2 107 (104, 110) 107 (103, 110) 103 (100, 106) 100 (97, 103) 95 (92, 98) 95 (92, 99) 

3 107 (102, 111) 104 (99, 109) 101 (97, 106) 100 (95, 105) 99 (95, 104) 97 (93, 102) 

4 106 (98, 113) 102 (95, 110) 100 (93, 107) 99 (92, 107) 98 (91, 105) 97 (90, 104) 

Most dep'd 110 (108, 113) 108 (105, 110) 105 (103, 108) 103 (101, 105) 104 (102, 107) 106 (103, 108) 

2 113 (110, 117) 110 (107, 113) 109 (106, 113) 107 (104, 110) 106 (103, 110) 104 (101, 108) 

3 116 (112, 119) 113 (109, 116) 107 (104, 111) 105 (101, 108) 102 (99, 105) 101 (98, 105) 

4 113 (110, 117) 109 (105, 112) 108 (104, 111) 107 (103, 110) 106 (103, 110) 103 (100, 107) 



Trend in directly standardised all-cause all-age mortality rate per 100,000 males 


Period Directly standardised all-cause all-age mortality rate per 100,000 men 

England 

Hull 

Y&H SHA 

Industrial 

Hinterlands 

(ONS group) 

Average of 10 

comparator 

areas 

North East 

Lincolnshire 

(ONS nearest 

comparator) 

1993-95 968 1,049 1,009 1,106 1,102 1,031 1,111 

1994-96 945 1,059 982 1,086 1,073 988 1,086 

1995-97 931 1,043 969 1,074 1,055 995 1,073 

1996-98 911 1,051 956 1,058 1,034 977 1,053 

1997-99 892 1,041 938 1,034 1,021 975 1,034 

1998-00 870 1,025 910 1,007 1,001 938 1,007 

1999-01 845 1,000 880 978 975 918 979 

2000-02 822 966 859 954 943 917 951 

2001-03 807 971 847 941 931 910 938 

2002-04 786 938 828 916 911 885 915 

2003-05 761 925 802 886 889 850 888 

2004-06 732 893 774 854 857 811 856 

2005-07 710 880 750 831 838 799 834 

2006-08 692 868 736 813 822 803 819 


Spearheads


Trend in directly standardised all-cause all-age mortality rate per 100,000 females 


Period Directly standardised all-cause all-age mortality rate per 100,000 women 

England 

Hull 

Y&H SHA 

Industrial 

Hinterlands 

(ONS group) 

Average of 10 

comparator 

areas 

North East 

Lincolnshire 

(ONS nearest 

comparator) 

1993-95 620 693 643 707 687 638 696 

1994-96 609 691 634 688 674 610 684 

1995-97 606 690 630 685 668 604 682 

1996-98 599 693 625 685 658 605 677 

1997-99 592 675 613 679 652 619 670 

1998-00 580 665 602 666 644 620 657 

1999-01 568 624 585 647 633 590 642 

2000-02 556 624 577 636 626 570 630 

2001-03 553 626 572 634 628 556 629 

2002-04 543 642 565 628 623 559 620 

2003-05 532 643 555 615 606 548 609 

2004-06 512 637 537 594 587 547 590 

2005-07 500 636 532 582 571 546 576 

2006-08 491 615 523 576 569 543 568 

Target for all-cause all-age mortality rates 

The underlying data for Figure 74 from the Compendium and Y&H SHA/DoH is given in 

Table 87 with the exception of the predicted trends (which are 834, 820, 806 and 792 for 

men for 2008, 2009, 2010 and 2011 respectively calculated from the 2007 value (i.e. 

848 deaths per 100,000 less 14 per 100,000 for each year) and 633, 629, 625 and 621 

for women for 2008, 2009, 2010 and 2011 respectively calculated from the 2007 value 

(i.e. 637 deaths per 100,000 less 4 per 100,000 for each year)). 


Spearheads


Excess winter mortality index for Hull and local PCTs 

The underlying data for Figure 75 from National Energy Action is given below. 

PCT Excess winter mortality 2007/08, % 

Barnsley 19.4 

Doncaster 19.4 

Rotherham 20.1 

Sheffield 11.1 

Bradford 16.6 

Calderdale 14.4 

Kirklees 12.8 

Leeds 18.0 

Wakefield 15.0 

Hull 13.8 

East Riding of Yorkshire 11.1 

North East Lincolnshire 15.2 

North Lincolnshire 12.8 

York 17.2 

Craven 35.0 

Hambleton 2.5 

Harrogate 6.6 

Richmondshire 40.2 

Ryedale 8.1 

Scarborough 17.1 

Selby 23.4 

Excess winter mortality index for Hull by local deprivation quintile 

The underlying data for Figure 76 from the Public Health Mortality File is given below. 

Period Number of deaths and excess winter mortality index by 

Index of Multiple Deprivation local quintile 

Most 2 3 4 Least 

deprived 

deprived 

Winter 1,134 1,028 1,144 807 642 

Non-Winter 1,816 1,737 1,852 1,332 1,117 

Non-Winter average 227 217 232 167 140 

Non-Winter 4 months 908 869 926 666 559 

Excess 226 160 218 141 84 

Index 24.9 18.4 23.5 21.2 15.0 



Perceived impact of change of lifestyle risk factors on health 

The underlying data for Figure 77 from the local Social Capital Survey 2009 is given 

below. 

Lifestyle change Perceived impact on health (%) 

Very big 

effect 

Fairly big 

effect 

Fairly small 

to no effect 

Reducing alcohol levels 57.9 30.2 11.9 

Achieving & maintaining a healthy weight 62.1 30.4 7.5 

More exercise 64.6 28.3 7.1 

Reducing stress levels 65.4 25.8 8.7 

Healthier diet 67.6 27.1 5.3 

Quit smoking 78.1 15.7 6.3 

National cigarette smoking prevalence for those aged 16+ years 

The underlying data for Figure 78 from the General Household Survey 2008 is given 

below. 

Gender 

Men 

Women 

Age 

(yrs) 

Prevalence of cigarette smoking (%) 

1998 2000 2001 2002 2003 2004 2005 2006 2007 2008 

16-19 30 30 25 22 27 23 23 20 22 18 

20-24 41 35 40 37 38 36 34 33 32 29 

25-34 38 39 38 36 38 35 34 33 29 30 

35-49 33 31 31 29 32 31 29 26 25 24 

50-59 28 27 26 27 26 26 25 23 22 23 

60+ 16 16 16 17 16 15 14 13 13 13 

Overall 30 29 28 27 28 26 25 23 22 22 

16-19 32 28 31 29 25 25 26 20 20 26 

20-24 39 35 35 38 34 29 30 29 30 31 

25-34 33 32 31 33 31 28 29 26 23 25 

35-49 29 27 28 27 28 28 26 25 23 23 

50-59 27 28 25 24 23 22 23 22 21 20 

60+ 16 15 17 14 14 14 13 12 12 12 

Overall 26 25 26 25 24 23 23 21 20 21 



Percentage of daily and occasional smokers by gender, age and Locality in Hull, 2007 

The underlying data for Figure 79 on the percentage of daily and occasional smokers 

from the local Prevalence Survey conducted during 2009 is given below. 

Gender Age 

(yrs) 

Men 

Women 

Percentage of daily and occasional smokers by Locality 


Daily Occasional Daily Occasional Daily Occasional 

18-24 41.9 0.0 53.7 2.4 27.0 4.8 

25-34 33.3 0.0 46.2 3.8 47.3 2.7 

35-49 31.7 5.0 38.6 1.1 45.7 2.1 

50-59 51.9 0.0 44.6 1.8 35.6 1.7 

60+ 22.0 0.0 22.5 1.3 14.1 1.3 

Overall 34.4 1.6 38.8 1.9 34.5 2.4 

18-24 13.9 0.0 39.5 5.3 33.3 1.8 

25-34 38.9 2.8 37.7 7.5 36.9 4.6 

35-49 29.8 1.8 42.0 0.0 29.9 1.1 

50-59 52.0 0.0 23.4 2.1 38.6 0.0 

60+ 15.2 0.0 24.2 0.0 17.6 2.0 

Overall 28.0 1.0 33.1 2.2 29.3 2.0 



Age-adjusted percentage of smoking daily or occasionally during 2009 for each ward 

The underlying data for Figure 80, Figure 81 and Figure 82 on the age-adjusted 

percentage of daily and occasional smokers from the 2009 Prevalence Survey and 2009 

Social Capital Survey combined is given below. 

Ward/area/locality Age-adjusted percentage of current smokers 


Bransholme East 39.3 (28.7, 53.4) 37.9 (28.7, 49.6) 39.1 (31.6, 47.7) 

Bransholme West 59.9 (41.9, 83.9) 54.0 (39.0, 73.7) 56.2 (44.6, 70.5) 

Kings Park 20.5 (13.2, 31.2) 22.5 (14.1, 34.8) 21.6 (15.7, 29.2) 

Area: North Carr 36.0 (29.5, 43.6) 37.1 (30.8, 44.5) 36.8 (32.2, 42.0) 

Beverley 19.8 (12.5, 30.6) 17.1 (9.5, 29.3) 18.3 (12.8, 25.6) 

Orchard Park and Greenwood 43.4 (32.8, 56.9) 49.1 (39.4, 60.8) 47.1 (39.7, 55.6) 

University 24.6 (16.2, 36.7) 18.9 (12.0, 29.0) 21.4 (15.9, 28.5) 

Area: Northern 31.4 (25.7, 38.2) 32.1 (26.8, 38.3) 31.7 (27.8, 36.2) 

Locality: North 33.5 (29.1, 38.4) 34.5 (30.3, 39.1) 34.1 (31.0, 37.4) 

Ings 26.6 (18.2, 38.2) 28.6 (19.4, 41.3) 27.2 (20.8, 35.1) 

Longhill 43.1 (31.8, 57.6) 43.9 (33.5, 57.2) 43.2 (35.5, 52.5) 

Sutton 33.7 (25.0, 44.8) 32.8 (25.1, 42.5) 33.2 (27.3, 40.2) 

Area: East 34.1 (28.5, 40.8) 34.9 (29.5, 41.0) 34.5 (30.6, 38.9) 

Holderness 26.7 (19.4, 36.3) 23.7 (17.2, 32.5) 24.8 (19.8, 30.8) 

Marfleet 48.3 (36.8, 62.9) 43.3 (32.0, 57.8) 45.9 (37.6, 55.8) 

Southcoates East 45.7 (31.4, 65.2) 39.0 (26.0, 56.9) 42.9 (33.0, 55.2) 

Southcoates West 34.7 (24.8, 47.9) 34.0 (24.7, 46.2) 34.1 (27.2, 42.6) 

Area: Park 36.5 (31.3, 42.5) 33.6 (28.8, 39.2) 35.0 (31.5, 39.0) 

Drypool 34.7 (26.0, 45.9) 29.0 (21.2, 39.1) 32.4 (26.2, 39.8) 

Area: Riverside (East) 34.7 (26.0, 45.9) 29.0 (21.2, 39.1) 32.4 (26.2, 39.8) 

Locality: East 35.4 (31.8, 39.3) 33.5 (30.2, 37.2) 34.4 (31.9, 37.1) 

Myton 51.4 (40.0, 65.8) 44.0 (32.5, 58.7) 48.2 (40.0, 57.8) 

Newington 44.7 (35.8, 55.6) 37.4 (29.4, 47.4) 40.9 (34.8, 48.0) 

St Andrews 49.8 (37.2, 66.2) 57.2 (41.8, 77.5) 53.1 (43.1, 65.3) 

Area: Riverside (West) 48.3 (41.9, 55.6) 43.4 (37.2, 50.4) 46.0 (41.5, 51.0) 

Boothferry 26.8 (17.7, 39.4) 29.7 (20.8, 41.4) 27.3 (21.2, 34.9) 

Derringham 27.6 (18.8, 39.9) 24.6 (17.1, 34.9) 25.0 (19.3, 32.3) 

Pickering 28.9 (16.7, 47.5) 27.8 (18.5, 41.0) 29.3 (21.4, 39.7) 

Area: West 26.6 (21.0, 33.4) 26.5 (21.6, 32.4) 26.3 (22.6, 30.6) 

Avenue 22.6 (16.6, 30.6) 32.5 (24.1, 43.5) 27.2 (21.9, 33.6) 

Bricknell 25.4 (15.6, 40.0) 24.8 (14.6, 40.0) 25.2 (17.7, 35.1) 

Newland 39.4 (29.4, 51.8) 28.6 (19.6, 40.6) 35.3 (28.0, 43.8) 

Area: Wyke 29.4 (24.7, 35.0) 27.3 (22.5, 33.1) 28.5 (25.0, 32.4) 

Locality: West 35.2 (31.9, 38.8) 32.1 (29.0, 35.5) 33.6 (31.3, 36.1) 

HULL 34.9 (32.7, 37.1) 33.1 (31.1, 35.3) 34.0 (32.5, 35.5) 



Percentage of women known to be smoking at time of delivery, 2009/2010 

The underlying data for Figure 83 on the percentage of women known to be smokers at 

the time of delivery for the financial year 2009/2010 is given below. 

Area Percentage of women known to be 

smokers at time of delivery, 2009/2010 

England 14.0 

Industrial Hinterlands 22.2 

Yorkshire & Humber SHA 17.1 

Hull 23.1 

Plymouth 18.8 

Salford 19.3 

Sunderland 22.2 

Middlesbrough 28.9 

Coventry 14.2 




Sandwell 14.7 

Stoke-on-Trent 22.7 

Average of 10 comparators 18.0 

North East Lincolnshire PCT 24.4 

Percentage of survey responders smoking by local deprivation quintile 



Smoking status Percentage of responders by deprivation quintile 


Daily 52.8 41.7 35.5 22.6 18.1 

Occasional 1.0 2.4 1.2 2.5 1.9 



Percentage of survey responders in national survey who smoke cigarettes by social 

class 

The underlying data for Figure 85 from the General Lifestyle Survey 2008 is given in the 

table below. 

Gender Social class 

Men 

Women 

Current cigarette smokers for England (%) 

2001 2002 2003 2004 2005 2006 2007 2008 

Managerial & professional 21 20 20 20 18 17 16 15 

Intermediate 29 27 28 26 24 22 21 21 

Routine and manual 34 32 34 32 32 32 28 31 

Managerial & professional 17 17 17 17 16 14 14 14 

Intermediate 26 25 24 22 22 20 18 21 

Routine and manual 31 31 30 30 29 28 24 27 

Percentage of survey responders smoking by employment status 



Employment status Number 

answering 

question 

Percentage smoking 

Daily Occasionally Daily or 

occasionally 

Working 854 31.1 2.5 33.6 

Student 101 14.9 4.0 18.8 

Retired 387 20.2 0.8 20.9 

Looking after family/home 134 45.5 0.7 46.3 

Unemployed or not working 150 61.3 2.0 63.3 

Long-term sick or disabled 98 60.2 1.0 61.2 

Smoking cessation data 

The underlying data for Figure 87, Figure 88 and Figure 89 is given in Table 102. 



Percentage of men overweight or obese from the Health Survey for England 2008 and 

local Prevalence Survey 2009 

The underlying data for Figure 90 of the percentage of men overweight or obese from 

the Health Survey for England 2008 and the local Prevalence Survey 2009 is given 

below. 

Age 

Men overweight or obese (%) 

(years) 

England Hull 

Morbidly Obese Overweight Morbidly Obese Overweight 

obese 

obese 

16/18*-24 0.5 7.8 25.0 0.0 9.8 34.1 

25-34 1.0 17.6 40.6 1.3 18.2 40.9 

35-44 1.8 26.1 46.5 1.2 25.7 44.4 

45-54 0.8 30.8 43.7 4.1 29.0 46.9 

55-64 1.7 33.9 44.3 1.6 31.1 43.4 

65-74 1.6 33.0 49.9 2.6 26.3 44.7 

75+ 0.4 22.7 49.4 0.0 15.5 48.3 

Overall 1.1 24.1 41.8 1.6 22.6 42.8 


Percentage of women overweight or obese from the Health Survey for England 2008 

and local Prevalence Survey 2009 

The underlying data for Figure 91 of the percentage of women overweight or obese 

from the Health Survey for England 2008 and the local Prevalence Survey 2009 is given 

below. 

Age 

Women overweight or obese (%) 

(years) 

England Hull 

Morbidly Obese Overweight Morbidly Obese Overweight 

obese 

obese 

16/18*-24 1.2 13.9 20.3 1.7 11.2 23.3 

25-34 2.9 18.8 26.5 2.1 22.9 32.6 

35-44 3.7 25.2 31.2 4.3 20.7 34.3 

45-54 3.4 28.9 35.1 3.2 29.6 44.8 

55-64 3.0 31.0 37.7 0.9 27.2 33.3 

65-74 3.6 33.3 38.5 5.0 30.0 40.0 

75+ 1.0 25.8 39.8 0.0 12.9 37.6 

Overall 2.8 24.9 32.0 2.5 22.1 34.8 




Age-adjusted percentage of men and women overweight or obese for each ward 

The underlying data for Figure 92, Figure 93 and Figure 94 of age-standardised 

percentages overweight or obese from the Prevalence Survey 2009 and the Social 

Capital Survey 2009 combined is given below for males, females and persons 

respectively. 

Area Age-adjusted percentage overweight or obese for men 

Overweight Obese Obese or 

overweight 



Kings Park 48.0 (35.3, 64.4) 25.7 (17.3, 37.6) 73.7 (57.9, 93.1) 


Beverley 44.6 (32.6, 60.5) 28.1 (19.0, 41.0) 72.7 (57.1, 92.2) 

Orchard Pk & Greenwood 27.6 (19.3, 38.8) 44.6 (33.3, 59.0) 72.3 (57.8, 89.8) 

University 37.6 (26.5, 52.4) 29.7 (19.8, 43.7) 67.4 (51.8, 86.7) 

Area: Northern 36.3 (30.1, 43.7) 33.9 (28.0, 41.0) 70.3 (61.5, 80.2) 


Ings 42.2 (31.4, 56.1) 29.7 (20.9, 41.5) 71.9 (57.4, 89.4) 

Longhill 33.3 (24.2, 45.3) 35.2 (25.5, 47.9) 68.5 (54.7, 85.3) 

Sutton 38.3 (29.3, 49.6) 34.2 (25.7, 45.1) 72.5 (59.8, 87.6) 

Area: East 38.0 (32.3, 44.6) 32.4 (27.2, 38.6) 70.4 (62.5, 79.2) 

Holderness 44.0 (34.6, 55.6) 22.4 (15.9, 31.0) 66.4 (54.7, 80.3) 

Marfleet 34.2 (24.1, 47.7) 32.1 (22.9, 44.2) 66.3 (52.1, 83.6) 



Area: Park 41.1 (35.6, 47.4) 28.9 (24.4, 34.2) 70.0 (62.7, 78.1) 

Drypool 37.8 (28.8, 49.3) 29.1 (21.3, 39.4) 66.9 (54.5, 81.7) 


Locality: East 39.5 (35.8, 43.6) 30.0 (26.8, 33.6) 69.6 (64.6, 74.9) 

Myton 48.0 (36.7, 62.2) 21.7 (14.7, 31.5) 69.7 (56.0, 86.3) 

Newington 43.7 (34.6, 55.1) 32.0 (24.4, 41.6) 75.8 (63.5, 90.1) 

St Andrews 42.6 (31.0, 57.9) 21.7 (13.9, 33.3) 64.3 (49.7, 82.6) 


Boothferry 58.6 (45.3, 74.9) 17.4 (11.8, 25.3) 76.1 (61.3, 93.6) 

Derringham 47.9 (36.1, 62.9) 31.3 (22.0, 44.0) 79.2 (63.6, 98.0) 

Pickering 53.2 (36.4, 75.3) 25.5 (14.0, 42.7) 78.7 (57.5, 105.4) 

Area: West 52.5 (44.7, 61.3) 24.3 (19.3, 30.4) 76.8 (67.4, 87.3) 

Avenue 38.0 (29.6, 48.6) 22.9 (16.4, 31.5) 60.9 (49.9, 74.0) 

Bricknell 32.8 (22.0, 47.9) 32.2 (21.6, 47.1) 65.0 (49.2, 85.2) 

Newland 45.2 (30.1, 64.3) 21.1 (13.6, 31.6) 66.4 (49.0, 87.4) 

Area: Wyke 38.9 (33.1, 45.6) 24.5 (19.9, 30.1) 63.4 (55.8, 71.9) 

Locality: West 44.7 (41.0, 48.8) 25.3 (22.5, 28.4) 70.0 (65.3, 75.1) 

HULL 41.9 (39.5, 44.4) 28.2 (26.3, 30.2) 70.0 (67.0, 73.2) 



Area Age-adjusted percentage overweight or obese for women 


overweight 



Kings Park 40.8 (28.0, 58.5) 18.4 (10.7, 30.5) 59.1 (43.6, 79.5) 


Beverley 42.8 (29.9, 60.3) 17.4 (10.0, 29.1) 60.2 (44.8, 80.2) 


University 34.0 (23.5, 48.1) 27.9 (18.9, 40.4) 61.9 (47.5, 79.9) 

Area: Northern 32.4 (26.8, 39.0) 29.3 (24.0, 35.6) 61.6 (53.8, 70.6) 


Ings 42.6 (31.5, 56.8) 20.2 (13.1, 30.0) 62.8 (49.2, 79.4) 

Longhill 31.3 (22.0, 43.8) 28.3 (20.1, 39.3) 59.6 (46.7, 75.5) 

Sutton 36.7 (28.5, 47.0) 29.8 (22.5, 39.1) 66.5 (55.2, 79.9) 

Area: East 35.6 (30.2, 41.8) 26.9 (22.3, 32.3) 62.5 (55.3, 70.5) 

Holderness 34.4 (25.9, 45.1) 30.4 (22.7, 40.2) 64.7 (53.0, 78.8) 

Marfleet 38.8 (27.6, 53.6) 25.8 (17.5, 37.3) 64.6 (50.1, 82.5) 



Area: Park 31.0 (26.2, 36.7) 29.8 (25.1, 35.3) 60.8 (54.0, 68.5) 

Drypool 36.8 (27.5, 48.9) 24.0 (17.2, 33.1) 60.8 (48.9, 75.3) 


Locality: East 33.6 (30.2, 37.4) 28.0 (24.9, 31.5) 61.6 (57.0, 66.7) 

Myton 26.8 (17.7, 39.6) 24.4 (14.7, 38.6) 51.2 (37.2, 69.3) 

Newington 31.0 (23.1, 41.2) 33.7 (25.7, 43.9) 64.7 (53.1, 78.6) 

St Andrews 38.2 (25.7, 55.5) 36.2 (23.7, 54.1) 74.4 (55.9, 98.0) 


Boothferry 31.2 (22.6, 42.3) 20.2 (14.1, 28.5) 51.5 (40.5, 64.8) 

Derringham 38.7 (28.8, 51.6) 24.2 (16.7, 34.6) 62.9 (50.0, 78.8) 

Pickering 38.8 (26.7, 55.5) 24.9 (15.6, 38.6) 63.8 (47.8, 84.2) 

Area: West 35.0 (29.2, 41.7) 23.4 (18.8, 28.9) 58.3 (50.8, 66.9) 

Avenue 29.8 (21.7, 40.5) 21.2 (14.5, 30.5) 51.0 (40.0, 64.5) 

Bricknell 33.4 (21.2, 50.5) 23.5 (13.3, 38.5) 56.9 (40.2, 78.4) 

Newland 32.7 (21.7, 47.7) 24.4 (15.1, 37.9) 57.1 (42.0, 76.2) 

Area: Wyke 30.9 (25.3, 37.5) 22.5 (17.9, 28.3) 53.4 (46.0, 61.9) 

Locality: West 32.2 (28.9, 35.8) 25.7 (22.8, 28.9) 57.9 (53.4, 62.7) 

HULL 33.1 (31.0, 35.3) 27.4 (25.4, 29.4) 60.4 (57.6, 63.5) 



Area Age-adjusted percentage overweight or obese for persons 


overweight 



Kings Park 45.1 (35.8, 56.4) 22.6 (16.5, 30.7) 67.7 (56.2, 81.2) 


Beverley 43.3 (34.4, 54.4) 22.5 (16.3, 30.8) 67.1 (55.8, 80.5) 


University 35.7 (27.9, 45.3) 26.7 (20.0, 35.2) 64.9 (54.1, 77.5) 

Area: Northern 34.3 (30.1, 39.1) 28.8 (25.0, 33.2) 65.8 (59.8, 72.3) 


Ings 42.9 (34.8, 52.4) 22.5 (17.1, 29.3) 67.3 (57.2, 78.9) 

Longhill 31.9 (25.3, 40.1) 27.9 (21.8, 35.4) 63.5 (54.0, 74.6) 

Sutton 37.7 (31.4, 45.0) 29.2 (23.8, 35.7) 69.6 (61.0, 79.3) 

Area: East 37.0 (33.0, 41.5) 26.9 (23.5, 30.6) 66.5 (61.1, 72.4) 

Holderness 38.7 (32.4, 46.2) 24.7 (19.7, 30.7) 65.0 (56.7, 74.5) 

Marfleet 36.6 (28.9, 46.0) 25.8 (19.9, 33.2) 65.8 (55.5, 77.6) 



Area: Park 36.1 (32.4, 40.2) 26.4 (23.3, 29.9) 65.4 (60.3, 70.8) 

Drypool 37.2 (30.6, 45.2) 24.6 (19.4, 31.1) 64.2 (55.4, 74.4) 


Locality: East 36.6 (34.0, 39.3) 26.3 (24.2, 28.7) 65.6 (62.1, 69.2) 

Myton 39.2 (31.5, 48.6) 21.4 (15.9, 28.5) 62.0 (52.1, 73.5) 

Newington 37.2 (31.0, 44.5) 28.8 (23.5, 35.2) 70.2 (61.6, 79.9) 

St Andrews 40.8 (32.1, 51.7) 25.8 (18.9, 34.8) 68.3 (56.7, 82.1) 


Boothferry 44.0 (36.3, 53.1) 18.4 (14.0, 23.8) 63.1 (54.0, 73.5) 

Derringham 43.5 (35.6, 53.0) 25.5 (19.6, 33.1) 71.6 (61.2, 83.5) 

Pickering 44.5 (34.6, 56.7) 22.7 (15.8, 31.8) 69.3 (56.6, 84.2) 

Area: West 43.4 (38.5, 48.7) 22.4 (19.0, 26.3) 67.4 (61.4, 74.0) 

Avenue 34.2 (28.1, 41.4) 19.6 (15.1, 25.3) 56.3 (48.4, 65.4) 

Bricknell 33.7 (25.3, 44.3) 23.4 (16.9, 31.8) 60.3 (49.0, 73.9) 

Newland 38.4 (30.1, 48.4) 19.3 (13.7, 26.6) 61.0 (50.4, 73.2) 

Area: Wyke 35.4 (31.2, 40.0) 21.0 (17.8, 24.6) 59.0 (53.6, 64.9) 

Locality: West 38.7 (36.2, 41.4) 23.1 (21.1, 25.2) 64.2 (60.9, 67.7) 

HULL 37.5 (35.9, 39.2) 25.3 (24.0, 26.7) 65.3 (63.2, 67.5) 



Trend in BMI categories of boys and girls, Hull 1999/2000 to 2007/2008 

The underlying data for Figure 95 and Figure 96 of the trend in the prevalence of the 

BMI categories of children aged 4-5 years of age from the Child Health System and 

SystmOne is given below. 

Gender School 

year when 

Boys 

Girls 

measured 

Number of 

children 

measured 

Percentage of year R children (aged 4-5 years) 



1999/00 879 9.0 11.6 75.2 4.2 

2000/01 1,270 9.8 11.7 75.1 3.4 

2001/02 1,482 10.7 12.0 72.9 4.3 

2002/03 1,427 10.0 12.6 75.9 1.5 

2003/04 1,326 11.8 14.0 72.3 2.0 

2004/05 1,216 13.1 15.6 69.4 1.9 

2005/06 1,294 12.0 16.4 71.1 0.5 

2006/07 1,254 13.4 14.5 71.4 0.7 

2007/08 1,172 13.4 15.7 70.1 0.8 

2008/09 1,423 10.9 16.0 72.7 0.5 

1999/00 832 8.7 9.6 79.0 2.8 

2000/01 1,271 7.8 10.3 79.5 2.4 

2001/02 1,295 9.0 10.2 78.1 2.6 

2002/03 1,369 9.9 12.0 76.3 1.8 

2003/04 1,207 8.9 12.8 76.8 1.5 

2004/05 1,118 12.5 11.9 74.1 1.5 

2005/06 1,217 10.7 14.0 74.8 0.6 

2006/07 1,082 9.6 15.4 74.5 0.5 

2007/08 1,196 10.7 13.5 75.2 0.7 

2008/09 1,271 9.7 14.2 75.5 0.6 

Trend in BMI categories of boys and girls, Hull 2005/2006 to 2007/2008 

The underlying data for Figure 97 and Figure 98 of the trend in the prevalence of the 

BMI categories of children aged 10-11 years of age from the Child Health System and 

SystmOne is given below. 

Gender School 

year when 

Boys 

Girls 

measured 

Number of 

children 

measured 

Percentage of year 6 children (aged 10-11 years) 



2005/06 1,253 22.6 16.5 59.9 1.0 

2006/07 1,059 21.1 15.6 62.2 1.1 

2007/08 1,304 24.2 15.8 58.7 1.2 

2008/09 1,330 22.9 13.5 62.7 0.8 

2005/06 1,175 22.6 15.7 60.7 1.1 

2006/07 1,117 20.9 15.3 62.5 1.3 

2007/08 1,183 20.3 13.7 64.7 1.4 

2008/09 1,264 20.6 14.4 64.0 1.0 



Body mass index at ages 4–5 and 10–11 years compared in the same children (bar 

charts) 

The underlying data for Figure 99 and Figure 100 is given in Table 118 and Table 119 

respectively. 

Body mass index at ages 4–5 and 10–11 years compared in the same children 

(scatterplot) 

It is not possible to provide the underlying data for Figure 101 and Figure 102 as there 

are too many data points. 

Percentage of responders overweight or obese by local deprivation quintile 



Local 

Percentage overweight or obese 

deprivation Overweight 

Obese 

Overweight or 

quintile 

(BMI 25-29.9) 

(BMI 30+) obese (BMI 25+) 

Most deprived 33.9 26.4 60.3 

2 41.9 27.9 69.8 

3 31.7 26.1 57.8 

4 39.6 22.5 62.1 

Least deprived 47.3 19.5 66.8 

Percentage of responders overweight or obese by employment status 



Employment status Percentage overweight or obese 

Overweight Obese Overweight or 

(BMI 25-29.9) (BMI 30+) obese (BMI 25+) 

Working 42.1 23.6 65.7 

Full-time education 24.2 9.9 34.1 

Unemployed 34.8 23.4 58.2 

Long term sickness or disability 34.0 42.6 76.6 

Retired 39.5 24.9 64.3 

Looking after the home or family 33.6 27.2 60.8 



Distribution of people referred to weight loss services via single point of access service 

It is not possible to present the data underlying Figure 105 as there are too many data 

points. 

Evaluation of Shapes Slimming Club weight loss programme in Hull 

The underlying data for Figure 106 from the evaluation of the Shapes Slimming Club 

weight loss programme in Hull using the SF-36 questionnaire is given in the table 

below. 

SF-36 component Mean change (95% CI) 

General health 8.58 (4.16, 13.00) 

Vitality 10.25 (5.67, 14.83) 

Social functioning 2.00 (–3.09, 7.09) 

Role emotional 9.67 (3.03, 16.30) 

Mental health 5.20 (1.14, 9.26) 

Bodily pain 7.32 (1.43, 13.21) 

Role physical 9.63 (3.77, 15.48) 

Physical functioning 5.10 (–3.32, 13.52) 

Health transition 10.50 (3.75, 17.25) 

Physical health summary 2.87 (0.89, 4.84) 

Mental health summary 3.50 (0.84, 6.15) 

Evaluation of Fit Fans weight loss programme in Hull 

The underlying data for Figure 107 from the evaluation of the Fit Fans weight loss 

programme in Hull using the SF-36 questionnaire is given in the table below. 

SF-36 component Mean change (95% CI) 

General health 10.95 (5.94, 15.96) 

Vitality 15.32 (9.28, 21.37) 

Social functioning 4.58 (–1.36, 10.52) 

Role emotional 0.54 (–6.52, 7.59) 

Mental health 8.39 (3.17, 13.60) 

Bodily pain 2.87 (–4.69, 10.43) 

Role physical 2.02 (–4.20, 8.24) 

Physical functioning –0.61 (–10.19, 8.97) 



Exercise levels for men in England 2008 and Hull 2009 

The underlying data for Figure 108 from the Health Survey for England 2008 and from 

the local Prevalence Survey 2009 is given in the table below. 

Age 

Moderate/vigorous exercising lasting 30+ mins: men (%) 

(years) 

England 2008 Hull 2009 

5+ times Some Low 5+ times


Age-adjusted percentage of never/light exercise during 2009 for each ward 


percentage of never exercising or undertaking light exercise only is given below. 

Ward/area/locality Age-adjusted percentages never exercising or light 

exercise only 




Kings Park 23.8 (14.7, 37.0) 43.6 (30.8, 60.7) 34.2 (26.1, 44.5) 


Beverley 19.5 (12.3, 30.3) 31.2 (20.1, 47.1) 24.8 (18.3, 33.4) 


University 26.1 (17.6, 37.8) 39.6 (29.1, 53.3) 33.3 (26.3, 41.9) 

Area: Northern 32.0 (26.5, 38.6) 43.1 (36.9, 50.3) 38.1 (33.8, 42.9) 


Ings 31.0 (22.2, 42.3) 34.6 (25.0, 47.1) 31.8 (25.3, 39.5) 

Longhill 43.2 (32.6, 56.7) 52.4 (41.3, 66.1) 48.4 (40.4, 57.7) 

Sutton 33.0 (24.8, 43.3) 51.2 (41.8, 62.4) 43.2 (36.7, 50.7) 

Area: East 35.5 (30.1, 41.7) 46.2 (40.3, 52.9) 41.2 (37.1, 45.7) 

Holderness 21.4 (15.5, 29.2) 38.3 (29.7, 49.0) 30.0 (24.6, 36.3) 

Marfleet 37.8 (26.8, 52.3) 44.7 (33.9, 58.5) 41.3 (33.6, 50.5) 



Area: Park 29.0 (24.6, 34.3) 40.2 (34.9, 46.2) 34.6 (31.1, 38.5) 

Drypool 33.0 (24.7, 43.6) 39.2 (30.5, 50.0) 36.2 (30.0, 43.5) 


Locality: East 32.2 (29.0, 35.8) 42.8 (39.1, 46.8) 37.6 (35.1, 40.3) 

Myton 37.9 (28.3, 50.2) 56.4 (43.1, 73.1) 45.9 (38.0, 55.4) 

Newington 32.3 (24.6, 42.0) 47.9 (38.4, 59.5) 40.3 (34.0, 47.6) 

St Andrews 42.7 (31.3, 57.7) 50.3 (36.4, 68.6) 46.3 (37.2, 57.2) 


Boothferry 27.4 (19.4, 37.9) 31.9 (24.2, 41.6) 29.4 (23.9, 35.9) 

Derringham 32.9 (23.4, 45.5) 45.0 (34.8, 57.8) 38.8 (31.8, 47.3) 

Pickering 39.1 (26.6, 55.8) 36.9 (26.3, 51.0) 39.7 (31.2, 50.1) 

Area: West 32.4 (26.7, 39.0) 38.3 (32.7, 44.7) 35.5 (31.5, 40.0) 

Avenue 18.7 (13.1, 26.3) 37.3 (28.1, 49.2) 27.4 (22.0, 34.0) 

Bricknell 29.6 (19.8, 43.4) 31.4 (21.6, 44.7) 30.6 (23.3, 39.7) 

Newland 34.7 (20.8, 52.9) 42.7 (30.2, 58.8) 38.1 (29.7, 48.3) 

Area: Wyke 26.9 (22.1, 32.6) 36.3 (30.5, 43.0) 31.5 (27.7, 35.8) 

Locality: West 32.2 (29.1, 35.6) 41.7 (38.2, 45.6) 36.9 (34.5, 39.4) 

HULL 32.6 (30.6, 34.7) 43.7 (41.4, 46.1) 38.2 (36.7, 39.8) 



Age-adjusted percentage fulfilling exercise guidelines during 2009 for each ward 


percentage exercising to national exercise guidelines is given below. 

Ward/area/locality Age-adjusted percentages exercising for 30 minutes 

(moderate/vigorous exercise) 5+ times a week 




Kings Park 44.0 (32.7, 58.7) 25.7 (16.4, 39.4) 35.8 (28.0, 45.5) 


Beverley 50.8 (38.0, 67.4) 32.5 (21.4, 48.2) 41.8 (33.0, 52.5) 


University 43.2 (31.3, 58.9) 35.2 (25.5, 47.8) 38.8 (31.0, 48.2) 

Area: Northern 42.5 (35.8, 50.2) 34.8 (29.2, 41.2) 38.2 (33.9, 43.1) 


Ings 39.4 (28.7, 53.5) 34.9 (25.1, 47.7) 38.0 (30.3, 47.2) 

Longhill 32.5 (22.9, 45.5) 25.5 (17.6, 36.2) 28.2 (22.0, 36.0) 

Sutton 40.6 (31.0, 52.6) 29.4 (22.3, 38.5) 34.7 (28.7, 41.8) 

Area: East 38.0 (32.0, 45.1) 30.3 (25.4, 36.1) 34.0 (30.0, 38.4) 

Holderness 46.8 (37.0, 58.8) 34.2 (26.1, 44.4) 40.6 (34.1, 48.2) 

Marfleet 37.1 (27.3, 49.9) 38.9 (27.9, 53.2) 37.6 (30.2, 46.6) 



Area: Park 43.8 (38.1, 50.3) 35.0 (30.1, 40.7) 39.4 (35.6, 43.6) 

Drypool 44.9 (35.0, 57.3) 30.7 (22.1, 42.0) 37.7 (31.0, 45.8) 


Locality: East 41.8 (37.9, 46.1) 32.4 (29.1, 36.0) 37.0 (34.4, 39.8) 

Myton 39.3 (29.4, 52.1) 22.7 (15.1, 33.2) 32.2 (25.5, 40.3) 

Newington 54.2 (44.1, 66.2) 37.2 (29.0, 47.4) 45.5 (38.9, 53.1) 

St Andrews 41.0 (29.6, 56.3) 30.9 (19.9, 46.8) 36.3 (28.1, 46.6) 


Boothferry 50.5 (38.2, 65.9) 41.7 (31.4, 54.6) 46.1 (38.1, 55.5) 

Derringham 38.3 (27.9, 52.2) 33.6 (24.9, 44.8) 36.3 (29.3, 44.8) 

Pickering 38.9 (23.8, 60.5) 36.7 (25.7, 51.7) 36.8 (27.9, 48.1) 

Area: West 42.9 (35.7, 51.3) 37.0 (31.3, 43.8) 39.8 (35.2, 45.0) 

Avenue 49.3 (39.4, 61.3) 37.7 (28.6, 49.4) 43.4 (36.5, 51.4) 

Bricknell 40.5 (27.6, 58.2) 46.5 (31.3, 67.3) 43.2 (32.9, 55.9) 

Newland 46.5 (35.5, 59.8) 34.4 (24.9, 46.5) 40.4 (33.0, 49.1) 

Area: Wyke 45.2 (39.1, 52.1) 36.7 (31.1, 43.3) 41.0 (36.8, 45.6) 

Locality: West 44.4 (40.7, 48.4) 35.0 (31.7, 38.5) 39.7 (37.2, 42.4) 

HULL 42.4 (40.0, 44.9) 32.8 (30.7, 34.9) 37.5 (35.9, 39.1) 



Exercise levels for young people in Hull 2008-09 

The underlying data for Figure 116 from the local Young People Health and Lifestyle 

Survey 2008-09 is given in the table below. 

Gender School 

Daily exercise levels in young people (%) 

year None Less than 1 1-2 hours/day More than 2 

hour/day 

hours/day 

7 0.7 50.2 32.4 16.7 

8 3.0 48.5 30.8 17.7 

Males 

9 

10 

3.8 

3.9 

46.7 

49.5 

36.3 

29.8 

13.3 

16.7 

11 9.3 45.9 26.8 18.0 

Total 3.7 48.4 31.4 16.5 

7 2.1 70.1 20.8 6.9 

8 1.1 59.9 26.5 12.5 

Females 

9 

10 

4.8 

6.0 

62.3 

63.8 

21.1 

21.6 

11.8 

8.5 

11 10.5 48.4 27.4 13.7 

Total 4.8 61.2 23.4 10.5 

Percentage of survey responders exercising to national recommendations by local 




Local 

deprivation 

quintile 

Number of 

respondents 

30 minutes 

moderate/vigorous 

exercise 5+ per 

week 

Exercise levels (%) 

30 minutes 


exercise


Percentage of responders exercising to national recommendations by employment 

status 



Working status Number of 

respondents 

30 minutes 


exercise 5+ per 

week 

Exercise levels (%) 

30 minutes 


exercise


Number of portions of fruit and vegetables daily in Hull and England 

The underlying data for Figure 119 and Figure 120 from the Health Survey for England 

2008 and the local Prevalence Survey 2009 is given in the table below. 

Gender Age 

(years) 

Males 

Females 

16/18-24* 

25-34 

35-44 

45-54 

55-64 

65-74 

75+ 

All 

16/18-24* 

25-34 

35-44 

45-54 

55-64 

65-74 

75+ 

Area Daily portions of fruit and vegetables (%) 

None One Two Three Four Five or 

more 

Hull 18.5 12.6 24.4 25.2 7.4 11.9 

England 14.8 19.6 21.3 14.4 12.3 17.6 

Hull 7.5 14.5 21.4 26.4 13.2 17.0 

England 10.0 20.1 18.1 14.2 11.9 25.8 

Hull 9.1 14.2 19.3 20.5 10.8 26.1 

England 10.2 16.4 18.5 16.6 15.0 23.4 

Hull 12.2 7.5 21.1 21.1 13.6 24.5 

England 8.6 15.9 16.4 15.8 17.3 26.0 

Hull 8.1 10.6 12.2 24.4 16.3 28.5 

England 7.3 10.9 16.9 18.4 15.0 31.6 

Hull 2.5 13.9 17.7 25.3 15.2 25.3 

England 6.1 12.6 17.0 19.5 15.0 29.8 

Hull 8.6 10.3 19.0 32.8 10.3 19.0 

England 5.8 14.1 18.5 21.0 17.5 23.2 

Hull 10.0 12.1 19.6 24.2 12.3 21.8 

England 9.4 16.1 18.1 16.6 14.6 25.1 

Hull 9.2 12.2 22.1 29.8 9.9 16.8 

England 12.9 19.0 18.2 17.0 12.3 20.6 

Hull 5.2 5.8 15.6 26.0 16.9 30.5 

England 9.3 14.3 18.0 17.5 12.6 28.3 

Hull 4.4 14.6 12.7 21.5 17.1 29.7 

England 8.7 14.6 15.7 16.8 14.4 29.8 

Hull 2.3 5.3 18.2 26.5 15.9 31.8 

England 8.1 11.3 14.1 16.8 16.8 32.8 

Hull 6.7 5.0 13.3 25.0 18.3 31.7 

England 6.4 11.4 14.2 16.4 15.3 36.3 

Hull 4.6 3.4 3.4 26.4 19.5 42.5 

England 4.6 12.7 16.9 20.3 16.1 29.5 

Hull 2.2 4.4 18.9 23.3 14.4 36.7 

England 7.1 13.3 19.6 19.1 17.1 23.8 

All 

Hull 

England 

5.0 

8.4 

7.8 

13.8 

15.3 

16.4 

25.5 

17.5 

15.9 

14.8 

30.5 

29.0 




Age-adjusted percentage of eating 5-A-DAY during 2009 for each ward 


percentage of eating 5-A-DAY from the 2009 Prevalence Survey and 2009 Social 

Capital Survey combined is given below. 

Ward/area/locality Age-adjusted percentage of eating 5-A-DAY 




Kings Park 30.6 (19.7, 45.2) 28.3 (21.1, 37.1) 25.4 (16.9, 36.6) 


Beverley 41.4 (28.2, 58.5) 29.7 (22.2, 38.8) 21.0 (12.9, 32.3) 

Orchard Park and Greenwood 22.2 (15.6, 30.6) 21.1 (16.1, 27.0) 20.5 (13.2, 30.3) 

University 39.8 (28.7, 53.6) 32.2 (25.1, 40.7) 22.4 (14.2, 33.5) 

Area: Northern 32.0 (26.6, 38.3) 27.3 (23.6, 31.4) 21.5 (16.8, 27.1) 


Ings 33.7 (24.2, 45.5) 32.7 (25.8, 40.7) 30.0 (20.9, 41.5) 

Longhill 29.6 (21.0, 40.5) 25.4 (19.6, 32.4) 19.8 (12.8, 29.1) 

Sutton 28.9 (21.8, 37.6) 27.4 (22.2, 33.6) 27.2 (19.0, 37.5) 

Area: East 30.5 (25.6, 36.0) 28.4 (24.9, 32.1) 25.8 (21.0, 31.3) 

Holderness 37.5 (29.0, 47.7) 32.9 (27.1, 39.5) 26.8 (19.6, 35.7) 

Marfleet 29.1 (19.1, 41.9) 25.2 (18.9, 32.8) 23.1 (14.1, 35.1) 



Area: Park 31.2 (26.5, 36.5) 27.1 (23.9, 30.5) 22.7 (18.6, 27.4) 

Drypool 30.2 (21.5, 41.1) 24.7 (19.2, 31.3) 20.6 (13.5, 30.0) 


Locality: East 30.6 (27.4, 34.0) 27.2 (25.0, 29.5) 23.6 (20.7, 26.7) 

Myton 23.7 (15.5, 34.5) 21.8 (16.4, 28.4) 20.0 (12.9, 29.4) 

Newington 34.6 (26.4, 44.6) 30.7 (25.1, 37.2) 26.4 (19.2, 35.4) 

St Andrews 23.4 (13.7, 36.9) 22.8 (16.2, 31.0) 21.0 (12.9, 32.4) 


Boothferry 32.8 (24.2, 43.2) 31.9 (25.6, 39.3) 29.0 (20.5, 39.6) 

Derringham 29.7 (21.4, 40.2) 30.0 (23.6, 37.6) 29.6 (20.3, 41.6) 

Pickering 34.3 (23.2, 48.5) 30.9 (23.0, 40.4) 27.4 (16.0, 42.8) 

Area: West 32.1 (26.8, 38.1) 30.9 (27.0, 35.2) 28.6 (23.1, 34.9) 

Avenue 39.3 (29.6, 51.2) 36.7 (30.3, 44.1) 34.1 (25.7, 44.2) 

Bricknell 22.2 (13.2, 34.6) 22.2 (15.8, 30.2) 22.9 (13.9, 35.3) 

Newland 24.4 (15.3, 36.3) 18.4 (13.1, 25.0) 13.1 (7.3, 21.1) 

Area: Wyke 30.5 (25.0, 36.7) 27.7 (24.1, 31.7) 25.1 (20.3, 30.7) 

Locality: West 30.6 (27.5, 33.9) 28.0 (25.9, 30.3) 25.5 (22.7, 28.5) 

HULL 30.4 (28.4, 32.4) 27.2 (25.8, 28.5) 23.7 (22.0, 25.6) 



Daily portions of fruit and vegetables by local deprivation quintile 



Local deprivation 

quintile 

Daily portions of fruit and vegetables (%) 

0, 1 or 2 3 4 5+ 

Most deprived 45.6 21.5 13.0 19.9 

2 35.6 26.6 14.2 23.6 

3 32.7 26.8 10.0 30.5 

4 30.4 25.8 14.7 29.1 

Least deprived 32.7 23.0 18.1 26.2 

Percentage of responders cooking using butter, lard or dripping and percentage not 

eating fried food by local deprivation quintile 

The underlying data for Figure 125 from the local Health and Lifestyle Survey 

conducted during 2003 is given in the table below. 

Local deprivation Use butter, lard or Do not eat fried 

quintile 

dripping (%) food (%) 

Most deprived 8.2 13.7 

2 6.3 15.8 

3 5.4 16.5 

4 4.8 18.3 

Least deprived 3.1 20.3 

Daily portions of fruit and vegetables by employment status 



Employment status Daily portions of fruit and vegetables (%) 

0, 1 or 2 3 4 5+ 

Working 34.1 24.9 14.3 26.7 

Student 42.6 28.7 12.9 15.8 

Retired 50.7 20.7 12.0 16.7 

Looking after family/home 36.7 21.4 13.3 28.6 

Unemployed* 26.9 26.4 14.7 32.0 

Long-term sick or disabled 38.1 24.6 15.7 21.6 

* Unemployed, not allowed to work or not working but no reason. 



Knowledge of daily recommended alcohol units 

The underlying data for Figure 127 from the local Social Capital Survey 2009 is given in 

the table below. 

Age 

(years) 

Percentage correctly stating maximum number of 

units for recommended daily limit 

Males (≤4 units) Females (≤3 units) 

16-24 71.9 81.2 

25-34 83.1 87.9 

35-44 84.2 85.3 

45-54 83.0 87.1 

55-64 89.5 87.6 

65-74 89.3 89.7 

75+ 84.5 93.2 

Knowledge of weekly recommended alcohol units 

The underlying data for Figure 128 from the local Social Capital Survey 2009 is given in 

the table below. 

Age 

(years) 

Percentage correctly stating maximum number of 

units for recommended weekly limit 

Males (≤21 units) Females (≤14 units) 

16-24 74.9 79.2 

25-34 83.2 84.8 

35-44 85.4 82.7 

45-54 86.2 85.6 

55-64 87.4 84.7 

65-74 83.8 88.5 

75+ 91.7 88.6 



Frequency of alcohol consumption, Hull 2003 versus 2009 

The underlying data for Figure 129 and Figure 130 from the local Health and Lifestyle 

Survey 2003 and the local Prevalence Survey 2009 is given in the table below. 

Gender Age 

(years) 

Males 

Females 

18-24 

25-44 

45-64 

65-74 

75+ 

18-24 

25-44 

45-64 

65-74 

75+ 

Survey 

year 

Frequency of alcohol consumption (%) 

(number of days (d) per week (w) or month (m)) 

7d/w 4-6d/w 1-3d/w 1-3d/m


Frequency of alcohol consumption by Locality, Hull 2003 versus 2009 


Survey 2003 and the Prevalence Survey 2009 is given in the table below. 

Gender Locality Survey 

year 

Males 

Females 

North 

East 

West 

North 

East 

West 

Frequency of alcohol consumption (%) 

(number of days (d) per week (w) or month (m)) 

7d/w 4-6d/w 1-3d/w 1-3d/m


Frequency of alcohol units the previous week, 2003 versus 2009 


Surveys conducted during 2003 and 2009 is given in the table below. 

Gender Age 

(years) 

Males 

Females 

18-24 

25-44 

45-64 

65-74 

75+ 

18-24 

25-44 

45-64 

65-74 

75+ 

Survey Number of alcohol units the previous week (%) for 

year 

males (M) and females (F) 

None 1-21 (M) 22-50 (M) 51+ (M) 

1-14 (F) 15-35 (F) 36+ (F) 

2003 34.5 44.5 13.6 7.3 

2009 45.2 30.6 17.6 6.6 

2003 27.2 48.9 19.6 4.3 

2009 45.3 33.6 16.0 5.1 

2003 29.1 53.0 15.6 2.4 

2009 40.8 39.8 13.5 6.0 

2003 41.2 49.8 8.5 0.5 

2009 40.3 52.8 6.1 0.9 

2003 48.9 48.1 3.0 0.0 

2009 49.2 45.9 3.8 1.1 

2003 33.3 51.7 13.4 1.5 

2009 58.3 30.1 10.0 1.6 

2003 43.1 50.0 5.8 1.1 

2009 59.3 31.8 7.9 1.1 

2003 49.0 43.4 7.1 0.5 

2009 51.6 41.1 6.4 0.9 

2003 70.8 27.3 1.2 0.8 

2009 62.1 36.0 2.0 0.0 

2003 78.8 21.2 0.0 0.0 

2009 73.3 24.6 2.1 0.0 



Age-adjusted percentage of drinking alcohol during 2009 for men 

The underlying data for Figure 135 on the age-adjusted percentage of never drinking 

and problem drinking from the 2007 Health and Lifestyle Survey is given below. 

Area/Locality Age-adjusted percentages for men 

Never drinks Above weekly 

limits 

Binge drinking Problem 

drinking* 

North Carr 15.2 (11.0, 20.6) 25.9 (19.6, 33.9) 36.3 (28.7, 45.6) 43.6 (35.3, 53.6) 

Northern 19.0 (12.5, 28.3) 24.2 (16.4, 35.0) 33.8 (24.1, 46.9) 44.8 (33.4, 59.4) 

NORTH 17.8 (13.9, 22.6) 25.6 (20.6, 31.8) 34.5 (28.6, 41.4) 43.3 (36.7, 51.0) 

East 13.1 (9.3, 18.2) 25.6 (19.8, 33.0) 29.0 (22.7, 36.9) 37.8 (30.5, 46.6) 

Park 22.9 (18.2, 28.7) 19.9 (15.6, 25.3) 31.4 (25.8, 38.0) 33.5 (27.7, 40.3) 

Riverside (East) 21.7 (13.9, 33.1) 19.9 (12.0, 32.0) 32.9 (22.6, 47.3) 34.2 (23.6, 48.9) 

EAST 19.4 (16.3, 23.0) 21.9 (18.6, 25.8) 30.7 (26.7, 35.3) 35.0 (30.7, 39.9) 

Riverside (West) 21.8 (16.9, 28.1) 23.2 (18.1, 29.5) 34.2 (28.0, 41.7) 38.3 (31.7, 46.2) 

West 12.0 (7.7, 17.8) 20.3 (14.9, 27.2) 22.4 (16.9, 29.2) 31.9 (25.1, 40.2) 

Wyke 13.9 (9.9, 19.4) 25.2 (19.7, 32.0) 28.9 (23.0, 36.2) 36.3 (29.6, 44.4) 

WEST 15.8 (13.2, 18.8) 23.1 (19.9, 26.7) 29.4 (25.8, 33.4) 36.0 (32.1, 40.5) 

HULL 17.4 (15.6, 19.3) 23.1 (20.9, 25.4) 30.7 (28.2, 33.4) 37.0 (34.3, 39.9) 

*Drinks more than weekly recommended alcohol units and/or binge drinks. 

Age-adjusted percentage of drinking alcohol during 2009 for women 

The underlying data for Figure 136 on the age-adjusted percentage of never drinking 

and problem drinking from the 2007 Health and Lifestyle Survey is given below. 

Area/Locality Age-adjusted percentages for women 

Never drinks Above weekly 

limits 

Binge drinking Problem 

drinking* 

North Carr 28.6 (22.9, 35.4) 8.9 (5.8, 13.3) 14.5 (10.5, 19.7) 17.8 (13.3, 23.6) 

Northern 17.9 (11.4, 27.4) 6.4 (3.1, 12.4) 18.5 (11.1, 29.4) 20.4 (12.6, 31.6) 

NORTH 26.5 (21.8, 32.1) 8.0 (5.6, 11.3) 15.2 (11.7, 19.6) 18.0 (14.1, 22.7) 

East 38.0 (30.5, 47.1) 5.6 (3.0, 9.8) 10.5 (6.8, 15.8) 12.1 (8.1, 17.7) 

Park 29.0 (23.4, 35.9) 6.4 (3.9, 10.3) 13.1 (9.3, 18.1) 15.9 (11.7, 21.4) 

Riverside (East) 33.9 (23.5, 48.1) 9.8 (5.0, 18.2) 17.3 (10.4, 27.9) 19.5 (12.1, 30.8) 

EAST 33.0 (28.7, 37.9) 6.4 (4.6, 8.7) 12.6 (10.0, 15.7) 14.8 (12.0, 18.1) 

Riverside (West) 27.2 (20.4, 35.9) 10.1 (6.4, 15.6) 16.6 (11.7, 23.4) 18.2 (12.9, 25.2) 

West 18.2 (13.6, 24.0) 10.2 (6.1, 16.2) 14.2 (9.7, 20.3) 18.6 (13.1, 25.8) 

Wyke 33.4 (27.0, 41.1) 9.7 (6.7, 13.8) 12.9 (9.3, 17.6) 16.1 (12.1, 21.4) 

WEST 26.8 (23.2, 30.8) 9.8 (7.7, 12.4) 14.5 (11.9, 17.5) 17.3 (14.5, 20.6) 

HULL 28.7 (26.3, 31.3) 8.3 (7.0, 9.8) 14.1 (12.4, 16.0) 16.7 (14.9, 18.8) 

*Drinks more than weekly recommended alcohol units and/or binge drinks. 



Frequency of drinking alcohol at specific locations 

The underlying data for Figure 137 showing the percentage drinking alcohol almost 

always, often or sometimes at three types of locations from the 2009 Social Capital 

Survey combined is given below. 

Group Drinking almost always, often or sometimes in 

these types of locations (%) 

Pubs, clubs, 

restaurants, etc 

Home or home of 

friends or family 

Elsewhere 

Gender 

Males 

Females 

67.3 

64.7 

72.9 

69.9 

13.5 

13.3 

16-24 77.1 72.5 19.7 

25-34 71.8 74.6 12.6 

35-44 63.6 75.4 13.3 

Age 45-54 66.3 72.2 13.0 

55-64 60.1 69.6 10.4 

65-74 59.7 59.6 9.3 

75+ 47.2 65.6 10.9 

North 63.3 72.4 13.1 

Locality East 68.5 69.9 12.2 

West 65.4 72.4 14.6 

Most deprived 59.5 68.7 9.9 

Local 2 63.5 68.3 10.8 

deprivation 3 67.3 71.4 16.4 

quintile 4 68.1 74.5 15.1 

Least deprived 69.2 73.0 13.3 

Ever drank alcohol by age, gender and survey 


2008-09 and the Health Survey for England 2007 is given in the table below. 

Age 

Males 

Ever had an alcoholic drink (%) 

Females All 

Hull England Hull England Hull England 

11 years 41.8 23 25.3 16 34.0 20 

12 years 42.3 31 39.0 32 40.5 32 

13 years 62.2 56 66.5 52 64.4 54 

14 years 71.3 69 78.8 72 74.8 71 

15 years 80.3 80 87.1 83 84.1 81 

11-15 years 60.2 54 61.9 54 61.0 54 



Age-standardised percentage drinking over adult weekly recommended alcohol unit 

limits by local deprivation quintile 


Survey conducted during 2008-09 is given in the table below. The maximum 

recommended alcohol unit limits for adults is 21 for men and 14 for women. 

Drinking over adult recommended weekly alcohol units 


Age-standardised % 5.3 5.3 5.6 3.3 4.2 

Frequency of getting drunk in young people 


Survey 2008-09 is given in the table below. 

Gender School 

Frequency of getting drunk (%) 

year Weekly Monthly Less than Never been Never drunk 

monthly drunk alcohol 

7 0.4 0.7 13.9 26.4 58.6 

8 2.4 1.2 13.9 25.5 57.0 

Males 9 3.4 3.0 29.1 29.1 35.4 

10 8.3 10.9 36.3 19.5 25.1 

11 21.6 14.4 34.7 13.8 15.6 

7 0.7 0.3 9.0 16.9 73.1 

8 1.5 1.1 15.2 33.0 49.3 

Females 9 5.6 7.3 33.6 24.1 29.3 

10 9.5 12.5 42.3 17.0 18.7 

11 17.7 21.3 40.6 11.0 9.4 



Ill-effects after getting drunk in young people 

The underlying data for Figure 141 and Figure 142 from the local Young People Health 

and Lifestyle Survey 2008-09 is given in the table below. The percentages are given for 

only those who have drunk alcohol. 

Ill-effect after getting drunk Percentage of young people (%) 

Males (n=665) Females (n=768) 

Got drunk 54.3 65.9 

Got into an argument 25.5 34.6 

Got into a fight 19.1 14.2 

Attended casualty (A&E) 9.0 6.9 

Missed school 13.1 13.6 

Was sick/vomited 29.0 37.5 

Had unprotected sex 7.2 10.1 

Tried smoking for the first time 7.9 17.2 

Tried illegal drugs 7.0 8.6 

Had memory loss 13.6 20.8 

Passed out 11.1 12.0 

Committed a crime 11.9 8.8 

Vandalised or damaged property 11.2 8.2 

Arrested 6.2 3.4 

Caused others to complain to the police 12.0 11.9 

Alcohol consumption in relation to deprivation quintile 

The underlying data for Figure 143 from the Prevalence Survey 2009 is given in the 

table below. 

Local 

deprivation 

quintile 

Number of 

respondents 

Never 

drinks 

Level of alcohol consumption (%) 

Within 

weekly limit 

& no binge 

drinking 

Within 

weekly limit 

& binge 

drinking 

Above 

weekly limit 

& no binge 

drinking 

Above 

weekly limit 

& binge 

drinking 

Most deprived 307 28.7 45.3 15.6 3.6 6.8 

2 330 26.1 54.2 9.7 1.8 8.2 

3 320 25.9 51.3 8.4 6.3 8.1 

4 476 23.1 53.4 11.8 2.1 9.7 

Least deprived 309 17.2 56.0 12.3 6.8 7.8 



Alcohol consumption in relation to employment status 

The underlying data for Figure 144 from the Prevalence Survey 2009 is given in the 

table below. 

Employment 

status 

Number of 

respondents 

Never 

drinks 

Level of alcohol consumption (%) 

Within 

weekly limit 

& no binge 

drinking 

Within 

weekly limit 

& binge 

drinking 

Above 

weekly limit 

& no binge 

drinking 

Above 

weekly limit 

& binge 

drinking 

Working 860 15.6 55.7 14.5 4.8 9.4 

Education 101 31.7 41.6 8.9 5.0 12.9 

Unemployed 149 18.8 44.3 16.1 2.7 18.1 

Long-term sick/ill 98 29.6 44.9 12.2 5.1 8.2 

Retired 386 38.9 51.8 5.4 2.3 1.6 

Looking after home 133 32.3 51.9 7.5 1.5 6.8 

Problem drug users by age 

The underlying data for Figure 145 from the local Substance Misuse Needs 

Assessment 2011/2012 (Hull Community Safety Partnership 2011). 

Area Problem drug users per 1,000 population (95% CI) by age 

15-24 25-34 35-64 

Hull 16.1 (14.9, 17.3) 38.6 (36.7, 40.6) 12.5 (11.8, 13.3) 

Yorkshire & Humber 9.3 (9.1, 9.5) 28.0 (27.6, 28.5) 6.8 (6.6, 6.9) 

England 8.0 (8.0, 8.1) 19.3 (19.1, 19.4) 6.7 (6.6, 6.7) 

Young people offered drugs by type of drug 



Offered drugs Year 9-11 boys (%) Year 9-11 girls (%) 

Anabolic steroids 1.0 0.3 

Cannabis 6.2 8.4 

Cocaine 1.5 1.3 

Ecstasy 1.3 1.7 

Heroin 0.6 0.3 

LSD 0.7 0.2 

Solvents 0.4 1.0 

Other drugs 0.9 0.9 



Young people ever used drugs by type of drug 



Gender Drug Percentage ever used drug (years 9-11 only) 

Within last Within past More than a At any time 

4 weeks year year ago / total 

Anabolic steroids 0.3 0.1 0.1 0.5 

Cannabis 1.2 1.6 1.1 3.9 

Cocaine 0.2 0.5 0.2 0.9 

Males 

Ecstasy 

Heroin 

0.0 

0.0 

0.4 

0.0 

0.1 

0.1 

0.5 

0.1 

LSD 0.2 0.4 0.2 0.8 

Solvents 0.1 0.3 0.1 0.5 

Other drugs 0.2 0.1 0.0 0.3 

Anabolic steroids 0.2 0.0 0.2 0.4 

Cannabis 3.0 3.2 1.4 7.6 

Cocaine 0.1 0.5 0.5 1.1 

Females 

Ecstasy 

Heroin 

0.2 

0.0 

0.3 

0.1 

0.5 

0.2 

1.0 

0.3 

LSD 0.0 0.2 0.2 0.4 

Solvents 0.4 0.2 0.4 1.0 

Other drugs 0.3 0.0 0.2 0.5 

Young people ever used drugs by deprivation quintile 



IMD 2007 local deprivation quintile Age-standardised percentage who have ever 

used drugs (years 9-11 only) 

Most deprived 12.9 

2 15.9 

3 12.2 

4 11.1 

Least deprived 9.5 



Young people ever used drugs comparison to England and previous survey 


2008-09 is given in the table below. Data is only available at age 16 years for the most 

recent survey in Hull. 

Gender Age 

Ever used drugs (%) 

(years) Hull 2008 Hull 2002 England 2007 England 2001 

11 0.0 0.0 13 13 

12 0.0 3.6 15 16 

Males 

13 

14 

4.6 

5.5 

7.5 

15.9 

20 

35 

30 

35 

15 14.5 30.0 42 51 

16 17.5 

11 1.3 5.7 8 12 

12 1.4 7.8 12 17 

Females 

13 

14 

6.0 

11.8 

11.0 

24.7 

21 

32 

27 

37 

15 16.8 40.9 41 45 

16 23.3 

Multiple risk factors in adult men 2007 

The underlying data for Figure 150 for men from the Health and Lifestyle Survey 2007 is 

given in the table below. 

Number of multiple risk Percentage with multiple risk factors by age of man 

factors (out of five) 18-24 25-44 45-64 65-74 75+ 

Zero 2.6 6.1 2.5 4.9 2.0 

One 18.8 15.3 14.5 16.3 17.2 

Two 32.8 32.3 32.0 38.4 50.3 

Three 26.2 31.3 34.1 29.1 29.8 

Four 18.1 12.7 15.5 10.8 0.7 

Five 1.5 2.2 1.4 0.5 0.0 



Multiple risk factors in adult women 2007 

The underlying data for Figure 151 for women from the Health and Lifestyle Survey 


Number of multiple risk Percentage with multiple risk factors by age of woman 

factors (out of five) 18-24 25-44 45-64 65-74 75+ 

Zero 4.3 4.8 4.9 1.6 3.7 

One 17.4 18.9 16.6 20.0 22.1 

Two 37.7 38.7 35.6 42.6 52.9 

Three 31.9 28.8 33.0 31.6 19.1 

Four 7.7 8.7 8.5 3.7 2.2 

Five 1.0 0.2 1.3 0.5 0.0 

Multiple risk factors in young people 2008-09 



Gender Number 

of risk 

Males 

Females 

factors 

Number of multiple risk factors out of five, by school year (%) 

Year 7 Year 8 Year 9 Year 10 Year 11 

Five 0.0 0.0 0.0 0.0 1.4 

Four 0.0 0.0 2.2 2.6 3.5 

Three 0.0 1.5 1.1 4.4 9.8 

Two 25.8 29.6 33.9 34.9 38.5 

One 42.9 44.9 38.9 37.1 34.3 

Zero 31.3 24.0 23.9 21.0 12.6 

Five 0.0 0.0 1.6 2.1 2.7 

Four 0.0 0.4 1.6 5.4 8.2 

Three 0.8 0.9 4.2 8.3 12.3 

Two 37.1 31.3 42.6 35.8 36.5 

One 43.7 44.8 34.7 34.2 29.2 

Zero 18.4 22.6 15.3 14.2 11.0 



One year child vaccination uptake rates by ward for North, East and West Localities for 

2008/2009 

The underlying data for Figure 153, Figure 154 and Figure 155 from the Child Health 

System is given below for diphtheria, tetanus and pertussis (DTP), polio, haemophilus 

influenzae type b (Hib), meningitis C (MenC) and pneumococcal vaccinations. 

Ward/Area/Locality One year child vaccination uptake (%) 

DTP Polio Hib MenC Pneumococcal 

Bransholme East 90.8 90.8 90.8 91.3 90.8 

Bransholme West 93.9 93.9 93.9 93.2 94.7 

Kings Park 97.8 97.8 97.8 95.5 96.3 

Area: North Carr 93.6 93.6 93.6 93.0 93.4 

Beverley 97.4 98.7 97.4 96.2 97.4 

Orchard Park & Greenwood 87.1 87.1 87.1 87.5 88.2 

University 91.8 91.8 91.8 91.8 92.7 

Area: Northern 90.1 90.3 90.1 90.1 91.0 

Locality: North 91.9 92.0 91.9 91.6 92.2 

Ings 94.0 94.0 94.0 93.2 94.0 

Longhill 93.1 93.1 93.1 93.1 93.6 

Sutton 98.6 98.6 98.6 98.6 98.6 

Area: East 95.1 95.1 95.1 94.9 95.4 

Holderness 96.9 96.9 96.9 96.9 96.9 

Marfleet 92.0 92.0 92.0 90.5 91.5 

Southcoates East 87.9 87.9 87.9 87.9 88.6 

Southcoates West 92.1 92.1 91.3 90.6 90.6 

Area: Park 92.4 92.4 92.2 91.6 92.1 

Drypool 95.8 95.8 95.8 95.2 94.5 

Area: Riverside (East) 95.8 95.8 95.8 95.2 94.5 

Locality: East 93.8 93.8 93.7 93.2 93.6 

Myton 94.2 93.6 93.0 91.3 92.4 

Newington 93.7 92.6 93.7 92.1 92.6 

St Andrew‟s 93.8 93.8 93.8 91.5 89.2 

Area: Riverside (West) 93.9 93.3 93.5 91.6 91.6 

Boothferry 97.6 97.6 97.6 96.7 96.7 

Derringham 96.9 96.9 97.6 98.4 99.2 

Pickering 91.6 91.6 91.6 91.6 91.6 

Area: West 95.4 95.4 95.7 95.7 95.9 

Avenue 94.4 93.7 94.4 93.7 93.7 

Bricknell 97.7 97.7 97.7 97.7 97.7 

Newland 92.0 92.0 91.2 90.4 89.6 

Area: Wyke 94.3 94.1 94.1 93.5 93.2 

Locality: West 94.5 94.1 94.3 93.4 93.4 

HULL 93.5 93.4 93.4 92.8 93.1 



One year child vaccination uptake rates by general practice for North, East and West 

Localities for 2008/2009 


System is given below for diphtheria, tetanus and pertussis (DTP), polio, haemophilus 

influenzae type b (Hib), meningitis C (MenC) and pneumococcal vaccinations. 

General practice One year child vaccination uptake (%) 


B81002:Dr Kumar-Choudhary 93.0 93.0 93.0 91.2 94.7 

B81018:Orchard 2000 83.5 83.5 83.5 82.5 84.5 

B81020:Sutton Manor 99.1 99.1 99.1 99.1 99.1 

B81021:Faith House 97.9 99.0 97.9 97.9 97.9 

B81049:New Hall 96.5 96.5 96.5 96.5 97.4 

B81094:Dr AK Datta 93.8 93.8 93.8 93.8 93.8 

B81095:Dr Cook 98.0 98.0 98.0 98.0 98.0 

B81112:Dr Ghosh 82.0 82.0 82.0 86.0 82.0 

B81119:Drs Palooran & George 97.1 97.1 97.1 94.1 94.1 

B81616:Dr Hendow 100.0 100.0 100.0 100.0 100.0 

B81631:Dr Raut 86.8 86.8 86.8 85.3 86.8 

B81634:Dr Venugopal 98.1 98.1 98.1 98.1 98.1 

B81662:Mizzen Road 100.0 100.0 100.0 100.0 100.0 

B81685:Dr Poulose 97.1 97.1 97.1 97.1 97.1 

B81688:Dr Gopal 96.2 96.2 96.2 100.0 96.2 

B81690:Dr Ray 100.0 100.0 100.0 95.5 100.0 

Y02344:Northpoint 93.3 93.3 93.3 93.3 96.7 

Y02747:Kingswood Surgery 100.0 100.0 100.0 100.0 100.0 

B81001:Drs Ali & Ahmed 100.0 100.0 100.0 100.0 100.0 

B81008:Dr Tommins & Ptnrs 95.9 95.9 95.9 95.4 95.0 

B81040:Dr Newman & Ptnrs 87.5 87.5 87.5 86.3 87.1 

B81053:Dr Maung & Ptnrs 95.1 95.1 95.1 92.7 94.3 

B81066:Dr Chowdhury 91.2 91.2 91.2 91.2 91.2 

B81074:Dr Rej 100.0 100.0 100.0 100.0 100.0 

B81080:Dr Malczewski 95.0 95.0 95.0 95.0 95.0 

B81081:Dr Tang 90.6 90.6 87.5 87.5 90.6 

B81085:Dr Richardson & Ptnrs 95.5 95.5 95.5 95.5 95.5 

B81089:Dr Witvliet 91.8 91.8 91.8 91.8 91.8 

B81097:Dr Yagnik 100.0 100.0 100.0 100.0 100.0 

B81635:Dr Dave 100.0 100.0 100.0 100.0 100.0 

B81644:Dr Mahendra 96.0 96.0 96.0 96.0 92.0 

B81645:Dr Abraham 84.0 84.0 84.0 84.0 84.0 

B81646:Dr Austin 96.9 96.9 96.9 96.9 96.9 

B81674:Dr Joseph 89.6 89.6 89.6 89.6 89.6 

B81682:Dr Shaikh & Ptnrs 95.3 95.3 95.3 95.3 95.3 

B81011:Wheeler Street 98.3 98.3 98.3 98.3 98.3 

B81017:Kingston Medical Grp 89.5 89.5 89.5 89.5 89.5 

B81027:St Andrews Group 87.3 87.3 87.3 87.3 90.5 

B81032:Dr Hussain & Ptnrs 95.7 95.7 95.7 95.7 95.7 

B81035:Dr Sande & Ptnrs 94.5 94.5 94.5 94.5 94.5 



General practice One year child vaccination uptake (%) 


B81038:Oaks Medical Centre 98.7 98.7 98.7 97.4 96.1 

B81046:Dr Blow & Ptnrs 88.8 88.8 88.8 88.8 89.5 

B81047:Wolseley Med Centre 95.9 95.9 95.9 94.9 94.9 

B81048:Newland Group 96.6 95.7 95.7 94.8 95.7 

B81052:Drs Musil & Queenan 97.0 94.0 95.5 91.0 92.5 

B81054:Dr Varma & Ptnrs 97.1 98.1 97.1 97.1 97.1 

B81056:Springhead Med Cntre 94.8 94.8 95.4 95.4 96.7 

B81057:Drs MacPhie & Koul 92.3 92.3 92.3 87.2 87.2 

B81058:Sydenham House Grp 97.4 97.4 97.4 97.4 94.8 

B81072:Dr Percival & Ptnrs 92.9 92.9 92.9 91.8 94.1 

B81075:Dr Mallik 100.0 100.0 100.0 100.0 100.0 

B81104:Dr Nayar 82.8 82.8 82.8 75.9 79.3 

B81675:Drs Tak&Stryjakiewicz 91.1 89.6 89.6 88.9 88.1 

B81683:Dr Koul 96.4 96.4 96.4 100.0 96.4 

B81692:Quays Medical Centre 100.0 100.0 100.0 100.0 100.0 

Y00955:Riverside Med Centre 83.3 83.3 83.3 81.0 83.3 

Y01200:Calvert Practice 96.2 96.2 96.2 96.2 96.2 

Y02786:Priory Surgery 85.7 85.7 85.7 85.7 85.7 



Two year child vaccination uptake rates by ward for North, East and West Localities for 

2008/2009 


System is given below for measles, mumps and rubella (MMR), haemophilus influenzae 

type b (Hib) and meningitis C (MenC) booster and pneumococcal booster vaccinations. 

Ward/Area/Locality Two year child vaccination uptake (%) 

MMR Hib/Men C Pneumococcal 

booster booster 

Bransholme East 88.5 83.5 80.5 

Bransholme West 86.8 84.7 84.0 

Kings Park 96.7 97.5 95.1 

Area: North Carr 90.1 87.6 85.4 

Beverley 88.9 93.8 86.4 

Orchard Park & Greenwood 81.7 80.8 74.6 

University 92.0 92.0 84.1 

Area: Northern 85.7 86.2 79.3 

Locality: North 88.0 86.9 82.4 

Ings 91.9 89.2 86.5 

Longhill 92.7 92.1 92.7 

Sutton 94.6 94.6 91.8 

Area: East 93.1 92.2 90.8 

Holderness 93.4 96.4 93.4 

Marfleet 91.2 83.3 82.0 

Southcoates East 84.2 85.0 78.3 

Southcoates West 87.8 84.7 83.7 

Area: Park 89.7 87.0 84.2 

Drypool 90.7 88.6 86.4 

Area: Riverside (East) 90.7 88.6 86.4 

Locality: East 91.1 89.1 86.9 

Myton 85.4 84.1 77.5 

Newington 86.0 86.5 82.9 

St Andrew‟s 89.5 82.9 82.9 

Area: Riverside (West) 86.6 84.9 81.1 

Boothferry 92.2 93.0 89.9 

Derringham 94.5 91.3 89.8 

Pickering 87.0 85.2 82.6 

Area: West 91.4 90.0 87.6 

Avenue 92.7 89.3 87.3 

Bricknell 97.5 93.8 92.5 

Newland 81.1 81.1 76.8 

Area: Wyke 90.5 88.0 85.5 

Locality: West 89.3 87.4 84.5 

HULL 89.6 87.9 84.8 



Two year child vaccination uptake rates by general practice for North, East and West 





General practice Two year child vaccination uptake (%) 


booster 

booster 

B81002:Dr Kumar-Choudhary 92.8 88.4 89.9 

B81018:Orchard 2000 68.2 61.4 47.7 

B81020:Sutton Manor 95.7 94.7 94.7 

B81021:Faith House 85.7 92.9 85.7 

B81049:New Hall 98.1 98.1 92.5 

B81094:Dr AK Datta 85.7 100.0 100.0 

B81095:Dr Cook 98.0 98.0 95.9 

B81112:Dr Ghosh 76.5 74.5 62.7 

B81119:Drs Palooran & George 88.1 94.0 86.6 

B81616:Dr Hendow 94.1 94.1 94.1 

B81631:Dr Raut 88.6 88.6 88.6 

B81634:Dr Venugopal 97.4 89.7 87.2 

B81662:Mizzen Road 100.0 100.0 100.0 

B81685:Dr Poulose 84.2 76.3 81.6 

B81688:Dr Gopal 94.1 97.1 97.1 

B81690:Dr Ray 100.0 100.0 100.0 

Y02344:Northpoint 82.4 94.1 76.5 

Y02747:Kingswood Surgery 100.0 100.0 100.0 

B81001:Drs Ali & Ahmed 85.0 90.0 85.0 

B81008:Dr Tommins & Ptnrs 93.6 94.6 92.6 

B81040:Dr Newman & Ptnrs 88.7 76.9 76.1 

B81053:Dr Maung & Ptnrs 91.6 90.1 91.6 

B81066:Dr Chowdhury 86.7 96.7 83.3 

B81074:Dr Rej 88.2 88.2 88.2 

B81080:Dr Malczewski 88.0 96.0 84.0 

B81081:Dr Tang 84.4 87.5 84.4 

B81085:Dr Richardson & Ptnrs 93.2 88.6 88.6 

B81089:Dr Witvliet 91.2 89.5 89.5 

B81097:Dr Yagnik 92.9 64.3 64.3 

B81635:Dr Dave 96.0 96.0 100.0 

B81644:Dr Mahendra 89.3 92.9 89.3 

B81645:Dr Abraham 86.7 86.7 80.0 

B81646:Dr Austin 100.0 100.0 100.0 

B81674:Dr Joseph 91.4 97.1 91.4 

B81682:Dr Shaikh & Ptnrs 93.3 86.7 82.2 

B81011:Wheeler Street 100.0 98.2 98.2 

B81017:Kingston Medical Grp 84.6 79.5 80.8 

B81027:St Andrews Group 86.4 81.8 78.8 

B81032:Dr Hussain & Ptnrs 63.6 68.2 59.1 



General practice Two year child vaccination uptake (%) 


booster 

booster 

B81035:Dr Sande & Ptnrs 91.7 88.3 85.0 

B81038:Oaks Medical Centre 91.1 93.7 88.6 

B81046:Dr Blow & Ptnrs 87.5 86.8 85.3 

B81047:Wolseley Med Centre 95.9 95.9 93.2 

B81048:Newland Group 83.3 88.5 83.3 

B81052:Drs Musil & Queenan 93.7 93.7 85.7 

B81054:Dr Varma & Ptnrs 88.4 77.9 76.7 

B81056:Springhead Med Cntre 93.8 95.2 91.0 

B81057:Drs MacPhie & Koul 84.4 78.1 71.9 

B81058:Sydenham House Grp 96.3 93.9 93.9 

B81072:Dr Percival & Ptnrs 89.5 88.4 86.0 

B81075:Dr Mallik 100.0 100.0 91.7 

B81104:Dr Nayar 97.0 87.9 90.9 

B81675:Drs Tak&Stryjakiewicz 84.6 80.5 76.4 

B81683:Dr Koul 90.6 90.6 84.4 

B81692:Quays Medical Centre 100.0 82.4 94.1 

Y00955:Riverside Med Centre 80.5 82.9 73.2 

Y01200:Calvert Practice 96.9 90.6 87.5 



Five year child booster vaccination uptake rates by ward for North, East and West 



System is given below for boosters for diphtheria, tetanus and pertussis (DTP), polio 

and measles, mumps and rubella (MMR). 

Ward/Area/Locality Five year child booster vaccination uptake (%) 

DTP Polio MMR 

Bransholme East 80.6 80.6 78.8 

Bransholme West 82.9 82.9 82.1 

Kings Park 87.9 87.9 87.9 

Area: North Carr 83.3 83.3 82.3 

Beverley 88.7 88.7 88.7 

Orchard Park & Greenwood 79.2 79.2 77.8 

University 79.6 78.7 78.7 

Area: Northern 80.8 80.6 79.8 

Locality: North 82.1 82.0 81.1 

Ings 89.5 88.7 85.5 

Longhill 85.9 85.9 87.2 

Sutton 89.8 89.8 87.5 

Area: East 88.3 88.0 86.8 

Holderness 86.1 86.1 85.4 

Marfleet 77.5 77.5 78.6 

Southcoates East 86.2 86.2 83.7 

Southcoates West 84.2 84.2 86.8 

Area: Park 82.8 82.8 82.8 

Drypool 81.4 81.4 80.6 

Area: Riverside (East) 81.4 81.4 80.6 

Locality: East 84.7 84.6 84.1 

Myton 79.3 79.3 73.9 

Newington 72.7 72.2 70.5 

St Andrew‟s 67.3 67.3 64.5 

Area: Riverside (West) 73.1 72.8 69.8 

Boothferry 87.7 87.7 85.2 

Derringham 89.5 89.5 86.0 

Pickering 79.8 79.8 75.5 

Area: West 86.1 86.1 82.7 

Avenue 81.6 80.9 78.7 

Bricknell 90.9 90.9 89.6 

Newland 76.3 77.6 69.7 

Area: Wyke 82.7 82.7 79.3 

Locality: West 80.1 80.0 76.7 

HULL 82.3 82.2 80.6 



Five year child vaccination uptake rates by general practice for North, East and West 





General practice Five year child booster vaccination uptake (%) 

DTP Polio MMR 

B81002:Dr Kumar-Choudhary 84.2 84.2 84.2 

B81018:Orchard 2000 72.9 72.9 72.9 

B81020:Sutton Manor 96.6 96.6 94.4 

B81021:Faith House 77.9 77.9 75.6 

B81049:New Hall 90.7 89.7 89.7 

B81094:Dr AK Datta 92.9 92.9 85.7 

B81095:Dr Cook 97.1 97.1 97.1 

B81112:Dr Ghosh 72.7 72.7 74.5 

B81119:Drs Palooran & George 93.9 93.9 93.9 

B81616:Dr Hendow 85.2 85.2 85.2 

B81631:Dr Raut 78.0 78.0 78.0 

B81634:Dr Venugopal 80.0 80.0 70.0 

B81662:Mizzen Road 81.3 81.3 75.0 

B81685:Dr Poulose 76.5 76.5 76.5 

B81688:Dr Gopal 88.0 88.0 88.0 

B81690:Dr Ray 87.0 87.0 91.3 

Y02344:Northpoint 85.0 85.0 85.0 

Y02747:Kingswood Surgery 100.0 100.0 100.0 

B81001:Drs Ali & Ahmed 88.6 88.6 88.6 

B81008:Dr Tommins & Ptnrs 86.2 86.2 84.4 

B81040:Dr Newman & Ptnrs 76.3 76.3 74.4 

B81053:Dr Maung & Ptnrs 87.5 87.5 86.5 

B81066:Dr Chowdhury 83.9 83.9 83.9 

B81074:Dr Rej 92.1 92.1 92.1 

B81080:Dr Malczewski 87.0 82.6 91.3 

B81081:Dr Tang 86.2 86.2 86.2 

B81085:Dr Richardson & Ptnrs 96.1 96.1 94.1 

B81089:Dr Witvliet 84.1 84.1 84.1 

B81097:Dr Yagnik 66.7 66.7 83.3 

B81635:Dr Dave 96.7 96.7 90.0 

B81644:Dr Mahendra 95.5 95.5 90.9 

B81645:Dr Abraham 94.4 94.4 94.4 

B81646:Dr Austin 73.9 73.9 73.9 

B81674:Dr Joseph 75.8 75.8 75.8 

B81682:Dr Shaikh & Ptnrs 84.2 84.2 84.2 

B81011:Wheeler Street 94.6 94.6 89.3 

B81017:Kingston Medical Grp 77.4 79.2 75.5 

B81027:St Andrews Group 64.8 66.7 64.8 

B81032:Dr Hussain & Ptnrs 76.2 76.2 71.4 

B81035:Dr Sande & Ptnrs 86.3 86.3 84.9 



General practice Five year child booster vaccination uptake (%) 

DTP Polio MMR 

B81038:Oaks Medical Centre 84.5 84.5 78.9 

B81046:Dr Blow & Ptnrs 78.1 78.1 76.2 

B81047:Wolseley Med Centre 90.5 90.5 89.2 

B81048:Newland Group 90.7 89.7 88.7 

B81052:Drs Musil & Queenan 82.8 82.8 73.4 

B81054:Dr Varma & Ptnrs 75.5 75.5 72.5 

B81056:Springhead Med Cntre 85.6 85.6 85.0 

B81057:Drs MacPhie & Koul 69.7 69.7 69.7 

B81058:Sydenham House Grp 81.6 81.6 78.9 

B81072:Dr Percival & Ptnrs 93.5 93.5 88.2 

B81075:Dr Mallik 100.0 100.0 100.0 

B81104:Dr Nayar 60.0 60.0 55.0 

B81675:Drs Tak&Stryjakiewicz 59.6 58.5 57.4 

B81683:Dr Koul 85.7 82.1 85.7 

B81692:Quays Medical Centre 88.9 88.9 77.8 

Y00955:Riverside Med Centre 72.7 72.7 63.6 

Y01200:Calvert Practice 76.9 76.9 76.9 

Y02786:Priory Surgery 0.0 0.0 0.0 

Percentage of women participating in breast cancer screening as at 31st March 2008 for 

North, East and West Localities 

The underlying data for Figure 171, Figure 172 and Figure 173 from Primary Care 

Information System (Open Exeter) is given below. The information is also presented 

within the PCIS for Hull overall and for England (see final row). 

Practice 

Code 

Practice Name Women aged 53-70 years screened for 

breast cancer 

Eligible (N) Screened (N) Screened (%) 

B81002 Kumar-Choudhary A 354 252 71.19 

B81018 Awan & Partners 457 278 60.83 

B81020 Mitchell & Partners 807 680 84.26 

B81021 Faith House Surgery 780 628 80.51 

B81049 Rawcliffe & Partners 928 720 77.59 

B81094 Datta AK 221 195 88.24 

B81095 Cook BF 507 409 80.67 

B81112 Ghosh PC 273 190 69.60 

B81119 Palooran & George 377 276 73.21 

B81616 Hendow GT 227 163 71.81 

B81631 Raut R 269 171 63.57 

B81634 Venugopal J 285 188 65.96 

B81662 Mizzen Road Surgery 210 161 76.67 

B81685 Poulose NA 205 117 57.07 

B81688 Gopal KV 181 124 68.51 



Practice 

Code 


breast cancer 


B81690 Ray SK 186 151 81.18 

Y02344 Northpoint 154 112 72.73 


Y02748 Haxby Orchard Pk Surg 12 8 66.67 

B81001 Ali & Partners 298 221 74.16 

B81008 Parker & Partners 1332 930 69.82 

B81040 Newman & Partners 1431 946 66.11 

B81053 Diadem Medical Practice 989 781 78.97 

B81066 Chowdhruy GM 236 160 67.80 

B81074 Rej AK 357 260 72.83 

B81080 Malczewski GS 200 139 69.50 

B81081 Tang KM 320 253 79.06 

B81085 Richardson JW 532 423 79.51 

B81089 Witvliet 292 194 66.44 

B81097 Yagnik RD 212 180 84.91 

B81635 Dave G 417 363 87.05 

B81644 Mahendra KK 168 121 72.02 

B81645 East Park Practice 211 144 68.25 

B81646 Shaikh M 176 128 72.73 

B81674 Joseph JC 197 129 65.48 

B81682 Shaikh & Partners 342 239 69.88 

B81011 Wheeler St Healthcare 481 339 70.48 

B81017 Kingston Medical Group 601 368 61.23 

B81027 St Andrews Group Pract 546 322 58.97 

B81032 Hussain AW & Partners 194 106 54.64 

B81035 Sande & Partners 673 540 80.24 

B81038 Mather & Partners 823 610 74.12 

B81046 Blow & Partners 733 467 63.71 

B81047 Singh & Partners 582 400 68.73 

B81048 Hussain SM & Partners 676 495 73.22 

B81052 Musil & Queenan 421 295 70.07 

B81054 Varma & Partners 991 636 64.18 

B81056 Springhead Medical 1422 1148 80.73 

B81057 MacPhie & Koul 267 183 68.54 

B81058 Foulds & Partner 889 650 73.12 

B81072 Percival & Partners 556 384 69.06 

B81075 Mallik MK 274 212 77.37 

B81104 Nayar JK 103 68 66.02 

B81675 Tak & Stryjakiewicz 587 394 67.12 

B81683 Raghunath & Partners 97 61 62.89 

B81692 Quays Medical Centre 28 12 42.86 



Practice 

Code 


breast cancer 


Y00955 Riverside Med Centre 122 71 58.20 

Y01200 The Calvert Practice 174 137 78.74 


Y02896 Story Street 33 24 72.73 

Hull overall 25,485 18,409 72.23 

England 5,230,485 4,025,737 76.97 

Percentage of women participating in cervical cancer screening as at 31st March 2010 

for North, East and West Localities 

The underlying data for Figure 174, Figure 175 and Figure 176 from Primary Care 

Information System (Open Exeter) is given below. The relevant age group is 25-64 

years. 

Practice 

Code 

Practice Name Eligible women screened for cervical cancer 

(%) by age group 

20-64 25-64 25-49 50-64 

B81002 Dr Kumar-Choudhary 69.9 81.5 82.9 78.1 

B81018 Dr Awan & Partners 63.5 74.7 74.6 75.1 

B81020 Dr Mitchell & Partners 77.5 85.1 87.1 81.2 

B81021 Faith House Surgery 75.2 83.5 83.6 83.3 

B81049 Dr Rawcliffe & Partners 65.1 79.7 79.8 79.4 

B81094 Dr Datta 79.2 90.1 89.4 91.0 

B81095 Dr Cook 75.4 83.8 85.6 81.2 

B81112 Dr Ghosh Raghunath & Partners 67.9 80.1 80.2 80.0 

B81119 Dr Palooran & Partners 71.3 84.2 85.4 81.0 

B81616 Dr Hendow 73.0 82.6 84.1 78.9 

B81631 Dr Raut 69.0 80.8 82.1 77.3 

B81634 Dr Venugopal 69.7 79.5 79.8 78.9 

B81662 Mizzen Road Surgery 76.7 87.3 87.5 86.9 

B81685 Dr Poulose 75.0 87.3 89.7 80.5 

B81688 Dr Gopal 76.0 88.5 89.9 85.1 

B81690 Dr Ray 83.6 91.2 92.4 88.6 

Y02344 Northpoint 68.4 81.3 81.2 81.7 

Y02747 Kingswood Surgery 80.0 90.7 92.7 77.6 

Y02748 Haxby Orchard Pk Surg 58.6 77.3 74.1 91.7 

B81001 Dr Ali & Partners 72.3 81.1 81.8 79.4 

B81008 Dr Parker & Partners 65.0 74.8 75.8 72.5 

B81040 Dr Newman & Partners 65.8 76.8 77.8 74.3 

B81053 Diadem Medical Practice 70.8 80.8 82.0 78.4 

B81066 Dr Chowdhury 72.0 83.7 86.5 78.2 



Practice 

Code 

Practice Name Eligible women screened for cervical cancer 

(%) by age group 

20-64 25-64 25-49 50-64 

B81074 Dr Rej 75.3 84.7 84.8 84.5 

B81080 Dr Malczewski 69.7 77.9 79.5 75.3 

B81081 Dr Tang & Partner 75.6 85.9 87.0 83.2 

B81085 Dr Richardson & Prtners 75.5 83.2 84.3 81.1 

B81089 Dr Witvliet 62.3 71.2 71.4 70.9 

B81097 Dr Yagnik 79.6 87.2 90.8 82.4 

B81635 Dr Dave 79.0 85.5 86.3 84.3 

B81644 Dr Mahendra 77.4 89.1 90.5 86.1 

B81645 East Park Practice 69.2 78.9 79.3 78.0 

B81646 Dr Shaikh 72.9 82.0 83.4 79.1 

B81674 Dr Joseph 73.2 82.9 84.6 78.5 

B81682 Dr Shaikh & Partners 71.2 81.0 83.1 76.5 

B81011 Wheeler St Healthcare 75.6 84.6 86.0 81.6 

B81017 Kingston Medical Group 61.4 71.4 69.7 75.1 

B81027 St Andrews Grp Practice 62.9 71.5 74.0 65.9 

B81032 Dr AW Hussain & Prtnrs 58.1 65.9 64.7 68.4 

B81035 Dr Sande & Partners 73.9 81.6 82.0 80.9 

B81038 Dr Mather & Partners 71.1 79.7 81.3 76.7 

B81046 Dr Blow & Partners 65.3 78.0 78.7 76.3 

B81047 Dr Singh & Partners 68.2 79.4 80.6 75.9 

B81048 Dr SM Hussain & Prtnrs 59.9 78.9 78.2 81.2 

B81052 Dr Musil & Dr Queenan 70.9 81.1 81.3 80.5 

B81054 Dr Varma & Partners 64.7 75.0 76.0 73.0 

B81056 Springhead Medl Centre 76.1 84.0 86.4 78.7 

B81057 Dr MacPhie & Koul 59.5 68.6 68.0 69.9 

B81058 Dr Foulds & Partner 71.0 80.4 81.5 78.2 

B81072 Dr Percival & Partners 61.0 74.6 74.5 74.8 

B81075 Dr Mallik 79.7 85.4 85.9 84.7 

B81104 Dr Nayar 21.4 52.3 50.2 71.6 

B81675 Drs Tak & Stryjakiewicz 60.6 71.6 71.8 70.8 

B81683 Dr Raghunath & Prtners 73.9 88.9 88.2 91.5 

B81692 Quays Medical Centre 62.9 73.3 73.9 66.7 

Y00955 Riverside Med Centre 59.2 72.7 72.1 75.0 

Y01200 The Calvert Practice 77.4 87.2 89.5 82.6 

Y02786 Priory Surgery 70.2 81.5 80.6 85.7 

Y02896 Story Street Practice 60.7 78.3 76.6 82.1 



Breast and cervical screening rates in relation to mean age of patients 

The underlying data for Figure 177 and Figure 178 are given on page 897 (breast 

cancer screening data) and on page 899 (cervical cancer screening data) respectively, 

with the mean age of the practice patients given in Table 28. 

Breast and cervical screening rates in relation to deprivation 

The underlying data for Figure 179 and Figure 180 are given on page 897 (breast 

cancer screening data) and on page 899 (cervical cancer screening data) respectively, 

with the deprivation scores given in Table 49. 

Comparison of breast and cervical cancer screening rates 

The underlying data for Figure 181 is given on page 897 (breast cancer screening data) 

and on page 899 (cervical cancer screening data). 

Percentage of men and women participating in colorectal cancer screening January to 

September 2010 for North, East and West Localities 

The underlying data for Figure 182, Figure 183 and Figure 184 is given below. The 

data was provided by the Hull & East Yorkshire Bowel Cancer Screening Centre. Due 

to small numbers, it is not possible to provide the number of definite abnormalties at 

practice level, but they have been provided for each Locality. 

Practice 

Code 

Practice Name Colorectal cancer screening 

Invited Screened Abnormalities 

N N % N % 

B81002 Dr Kumar-Choudhary 193 96 49.7 

B81018 Dr Awan & Partners 268 133 49.6 

B81020 Dr Mitchell & Partners 477 295 61.8 

B81021 Faith House Surgery 415 250 60.2 

B81049 Dr Rawcliffe & Partners 505 312 61.8 

B81094 Dr AK Datta 111 76 68.5 

B81095 Dr Cook 278 194 69.8 

B81112 Dr Ghosh Raghunath & Partners 134 59 44.0 

B81119 Dr Palooran & Partners 233 106 45.5 

B81616 Dr Hendow 125 68 54.4 

B81631 Dr Raut 137 59 43.1 

B81634 Dr Venugopal 136 69 50.7 

B81662 Mizzen Road Surgery 143 83 58.0 

B81685 Dr Poulose 115 56 48.7 

B81688 Dr Gopal 77 35 45.5 

B81690 Dr Ray 122 87 71.3 

Y02344 Northpoint 75 40 53.3 



44 1.97 



Practice 

Code 

Practice Name Colorectal cancer screening 

Invited Screened Abnormalities 

N N % N % 

B81001 Dr Ali & Partners 161 88 54.7 

B81008 Dr Parker & Partners 706 358 50.7 

B81040 Dr Newman & Partners 753 339 45.0 

B81053 Diadem Medical Practice 543 293 54.0 

B81066 Dr Chowdhury 120 64 53.3 

B81074 Dr Rej 203 104 51.2 

B81080 Dr Malczewski 143 71 49.7 

B81081 Dr Tang & Partner 170 99 58.2 

B81085 Dr Richardson & Partners 307 183 59.6 

B81089 Dr Witvliet 167 88 52.7 

B81097 Dr Yagnik 144 90 62.5 

B81635 Dr Dave 219 148 67.6 

B81644 Dr Mahendra 75 41 54.7 

B81645 East Park Practice 111 57 51.4 

B81646 Dr Shaikh 102 41 40.2 

B81674 Dr Joseph 74 35 47.3 

B81682 Dr Shaikh & Partners 213 130 61.0 

B81011 Wheeler Street Healthcare 292 153 52.4 

35 1.81 

B81017 Kingston Medical Group 355 174 49.0 

B81027 St Andrews Group Practice 293 130 44.4 

B81032 Dr AW Hussain & Partners 120 47 39.2 

B81035 Dr Sande & Partners 379 234 61.7 

B81038 Dr Mather & Partners 500 262 52.4 

B81046 Dr Blow & Partners 392 164 41.8 

B81047 Dr Singh & Partners 342 167 48.8 

B81048 Dr SM Hussain & Partners 352 198 56.3 

B81052 Dr Musil & Dr Queenan 245 132 53.9 

B81054 Dr Varma & Partners 579 293 50.6 

B81056 Springhead Medical Centre 770 487 63.2 

B81057 Dr MacPhie & Dr Koul 169 73 43.2 55 1.61 

B81058 Dr Foulds & Partner 564 311 55.1 

B81072 Dr Percival & Partners 288 129 44.8 

B81075 Dr Mallik 190 110 57.9 

B81104 Dr Nayar 52 29 55.8 

B81668 Dr Stryjakiewicz 47 20 42.6 

B81675 Dr Tak & Dr Stryjakiewicz 308 160 51.9 

B81683 Dr Raghunath & Partners 70 30 42.9 

B81692 Quays Medical Centre 24 6 25.0 

Y00955 Riverside Medical Centre 80 24 30.0 

Y01200 Calvert Practice 122 67 54.9 


Y02896 Story St Practice & Walk In Centre 21 13 61.9 

HULL 14,352 7,684 53.5 135 1.76 



Trend in under 75 circulatory disease mortality rate 


Area DSR (all age circulatory disease mortality) per 100,000 persons 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 


1998-00 

England 154 147 141 135 129 122 115 108 103 97 91 84 79 75 

Hull 190 179 169 169 166 160 148 138 133 126 120 114 107 105 

Y&H SHA 168 159 153 147 139 132 124 117 110 102 96 91 86 83 

Ind Hinterlands 193 184 177 169 160 151 141 133 127 120 113 105 98 93 

Spearheads 191 183 178 172 164 155 145 137 132 124 117 109 103 97 

Wolverhampton 177 179 180 170 163 153 142 130 125 120 114 106 100 92 

Salford 211 202 195 189 178 166 162 152 148 141 138 128 114 108 

Derby 167 157 147 138 138 135 125 116 112 110 104 98 91 87 

Stoke-on-Trent 209 198 194 181 172 165 159 151 143 138 125 113 102 92 

Coventry 173 174 174 162 153 142 137 124 115 107 104 99 92 86 

Plymouth 169 160 147 148 135 134 122 117 110 105 102 92 85 82 

Sandwell 207 198 194 187 176 166 155 146 139 133 132 124 121 111 

Middlesbrough 211 206 199 183 174 162 159 147 136 129 121 114 107 96 

Sunderland 207 193 183 171 157 146 139 133 128 119 114 108 98 89 

Leicester 188 183 176 171 169 157 153 144 150 140 132 120 116 113 

Av of latter 10 192 185 179 170 161 153 145 136 131 124 119 110 103 96 

NE Lincolnshire 179 156 152 146 140 126 118 113 106 99 97 98 96 93 

1999-01 

2000-02 

2001-03 

2002-04 

2003-05 

2004-06 

2005-07 

2006-08


Trend in all age CHD mortality rate 


Area DSR (all age CHD mortality) per 100,000 persons 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 


1998-00 

England 185 176 168 161 153 145 137 130 125 118 110 102 95 89 

Hull 215 203 191 182 181 175 167 157 152 144 136 127 124 115 

Y&H SHA 204 193 186 180 171 161 151 144 138 129 121 113 107 101 



Salford 235 220 213 202 191 174 167 160 156 149 144 138 126 120 

Derby 203 187 177 165 164 156 147 141 141 139 128 117 110 108 

Stoke-on-Trent 226 215 214 202 192 184 177 170 163 156 140 125 113 103 

Coventry 191 189 191 178 167 156 148 136 123 111 103 95 89 86 

Plymouth 202 189 175 168 157 153 144 139 136 129 126 115 107 100 

Sandwell 228 216 204 195 182 174 163 159 151 141 138 134 133 121 


Sunderland 251 235 218 204 187 172 162 153 150 139 134 124 116 107 

Leicester 209 202 193 188 183 174 173 162 162 150 145 136 131 127 

Av of latter 10 219 208 200 190 180 170 162 153 147 139 132 122 114 107 


Diagnosed CHD prevalence by deprivation score at practice level 

The underlying data for Figure 187 from QOF (with IMD at practice level calculated 

using deprivation scores at lower layer super output area weighted by resident 

population estimated from registered population) is given in the table below. 

The figure excludes practices Y02747, Y02786, Y02896 and Y02748. 

Code Practice name Locality Group Index of Multiple 

CHD 

Deprivation 2007 prevalence 

Score Rank Quintile 2009/10 (%) 

B81056 Springhead Med Cntre West A 17.0 2 5 3.72 

Y01200 The Calvert Practice West A 18.2 3 5 4.81 

B81635 Dr Dave East A 19.0 4 5 6.13 

B81662 Mizzen Road Surgery North A 21.5 5 5 4.31 

B81035 Dr Sande & Partners West A 21.8 6 5 3.16 

B81104 Dr Nayar West A 22.8 7 5 0.28 

B81094 Dr AK Datta North B 23.5 8 5 2.34 

B81075 Dr Mallik West B 23.9 9 5 3.09 

B81097 Dr Yagnik East B 24.4 10 5 3.67 

B81690 Dr Ray North B 25.6 11 5 3.17 

1999-01 

2000-02 

2001-03 

2002-04 

2003-05 

2004-06 

2005-07 

2006-08



CHD 



B81644 Dr Mahendra East C 26.4 12 5 3.07 

B81095 Dr Cook North B 26.8 13 4 3.75 

B81085 Dr Richardson & Ptns East B 26.9 14 4 5.19 

B81021 Faith House Surgery North B 27.0 15 4 3.80 

B81048 Dr SM Hussain & Ptns West C 27.1 16 4 2.91 

B81020 Dr Mitchell & Partners North B 27.2 17 4 3.58 

B81072 Dr Percival & Partners West C 27.7 18 4 3.68 

B81049 Dr Rawcliffe & Ptns North C 31.5 20 4 3.96 

B81001 Dr Ali & Partners East C 32.9 21 4 3.87 

B81052 Dr Musil & Queenan West C 33.2 22 4 2.85 

B81645 East Park Practice East D 33.3 23 4 3.91 

B81081 Dr Tang & Partner East D 34.1 24 4 4.52 

B81057 Dr MacPhie & Koul West D 34.1 25 3 3.91 

B81646 Dr Shaikh East D 34.5 26 3 3.18 

B81038 Dr Mather & Partners West D 34.6 27 3 4.82 

B81074 Dr Rej East D 34.7 28 3 3.74 

B81682 Dr Shaikh & Partners East D 35.0 29 3 4.81 

B81008 Dr Parker & Partners East C 35.2 30 3 3.53 

B81011 Wheeler St Healthcare West D 36.0 31 3 4.27 

B81616 Dr Hendow North E 37.1 32 3 4.51 

B81066 Dr Chowdhury East E 37.7 33 3 4.40 

B81058 Dr Foulds & Partner West E 37.9 34 3 4.79 

B81080 Dr Malczewski East E 37.9 35 3 5.37 

B81675 Drs Tak&Stryjakiewicz West F 39.4 36 3 3.01 

B81054 Dr Varma & Partners West E 40.7 37 2 4.26 

B81053 Diadem Med Practice East E 41.3 38 2 5.07 

B81685 Dr Poulose North F 41.3 39 2 3.60 

B81674 Dr Joseph East F 41.5 40 2 4.69 

B81119 Dr Palooran & Ptns North F 42.4 41 2 4.53 

B81112 Dr Ghosh Raghunath & Ptns North F 42.5 42 2 4.12 

B81634 Dr Venugopal North F 42.6 43 2 3.51 

B81002 Dr Kumar-Choudhary North F 42.6 44 2 4.32 

Y02344 Northpoint North F 42.6 45 2 3.65 

B81688 Dr Gopal North F 43.1 46 2 3.38 

B81047 Dr Singh & Partners West G 43.8 47 2 2.94 

B81631 Dr Raut North G 44.4 48 2 2.89 

B81027 St Andrews Gp Pract West G 45.4 49 1 5.12 

B81040 Dr Newman & Ptns East G 45.4 50 1 4.14 

B81683 Dr Raghunath & Ptns West G 47.4 51 1 4.03 

B81089 Dr Witvliet East G 47.7 52 1 3.54 

B81017 Kingston Medical Gp West H 50.6 54 1 3.91 

B81032 Dr AW Hussain & Ptns West H 51.8 55 1 3.14 

B81046 Dr Blow & Partners West H 52.0 56 1 4.18 

B81692 Quays Medical Centre West H 55.1 58 1 1.05 

B81018 Dr Awan & Partners North H 56.8 59 1 4.26 

Y00955 Riverside Med Centre West H 66.1 60 1 3.91 

Y02747 Kingswood Surgery North A 11.7 1 5 1.12 

Y02786 Priory Surgery West C 30.1 19 4 5.07 




CHD 



Y02896 Story St Pract&Walk In West G 47.8 53 1 N/A 

Y02748 Haxby Orch‟d Pk Surg North H 53.5 57 1 14.81 

Age-gender standardised CHD annual inpatient admission rate, angiography rate and 

revascularisation rate per 100,000 persons by local deprivation quintile 

The underlying data for Figure 188 and Figure 189 derived from Hospital Episode 

Statistics and Primary Care Information System (population) is given in the table below. 

Local deprivation for Standardised event rate per 100,000 persons 

Hull 

CHD admission Angiography Revascularisation 

Most deprived quintile 790 (744 to 837) 458 (424 to 495) 84 (69 to 100) 

Quintile 2 666 (625 to 709) 378 (347 to 410) 78 (64 to 93) 



Least deprived quintile 503 (469 to 539) 303 (277 to 331) 59 (48 to 72) 

Standardised mortality rate for persons aged under 75 years by local deprivation quintile 

for 2007-2009 (CHD) 

The underlying data for Figure 190 derived from the PHMF (deaths) and Primary Care 

Information System (population) using the European Standard Population as the 

standard population are given in the table below for premature CHD deaths. The overall 

SMRs for Hull are also given. 

Local deprivation Standardised mortality rate per 100,000 persons 

quintile 

aged under 75 years (95% CI) for CHD 

Most deprived 88 (73 to 105) 

2 85 (70 to 102) 

3 64 (52 to 78) 

4 41 (32 to 53) 

Least deprived 33 (25 to 43) 

Hull 61 (55 to 67) 



Trends in under 75 CHD standardised mortality ratios in men, women and persons in the most deprived national quintile of 

IMD 2007 

The underlying data for Figure 191 derived from the national public health mortality file and resident population estimates 

at lower layer super output area level, using England deprivation-specific reference rates. 

Gender and area 

Males 

Females 

Persons 

Trends in under 75 CHD standardised mortality ratios by gender for the most deprived national 

quintile of IMD 2007 (95% confidence intervals), Hull and comparator areas 

2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 

Hull 138 (123, 155) 123 (109, 139) 109 (96, 124) 109 (95, 123) 109 (95, 124) 108 (94, 123) 

North East Lincolnshire 137 (114, 164) 122 (100, 147) 120 (98, 145) 127 (105, 153) 146 (121, 173) 139 (115, 166) 

Comparator PCTs 130 (126, 134) 124 (120, 128) 119 (116, 123) 113 (110, 117) 109 (105, 113) 103 (99, 106) 

Spearhead PCTs 133 (131, 134) 126 (124, 128) 119 (117, 120) 111 (109, 112) 106 (104, 107) 101 (100, 102) 

20 most deprived PCTs 129 (127, 132) 121 (119, 124) 115 (112, 117) 107 (105, 110) 103 (101, 105) 97 (95, 99) 

Yorkshire & Humber SHA 137 (134, 141) 130 (127, 134) 122 (119, 126) 117 (114, 121) 112 (108, 115) 110 (107, 114) 

Hull 148 (123, 177) 148 (123, 177) 152 (126, 181) 155 (128, 185) 137 (112, 165) 126 (102, 153) 






Hull 142 (129, 156) 131 (118, 145) 122 (110, 136) 123 (110, 136) 118 (106, 131) 114 (102, 128) 








Trend in under 75 stroke mortality rate 


Area DSR (under 75 stroke mortality) per 100,000 persons 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 


1998-00 

England 27.2 26.6 26.0 25.3 24.2 22.9 21.6 20.5 19.8 18.7 17.4 15.9 14.8 13.7 

Hull 32.6 31.6 30.2 30.2 29.1 26.8 27.0 25.0 26.2 25.1 24.2 24.5 21.4 20.5 

Y&H SHA 29.5 28.9 27.9 26.8 25.9 25.2 23.8 22.1 21.0 19.4 18.3 16.7 16.0 15.0 

Ind Hinterlands 33.9 32.7 31.9 31.1 30.2 28.4 26.8 24.9 24.1 23.0 21.4 19.7 18.1 16.7 

Wolverhampton 34.3 35.9 33.0 32.6 30.7 31.8 28.4 27.7 25.3 27.0 24.7 23.1 20.3 18.8 

Salford 41.9 42.4 41.2 38.6 37.1 37.0 35.7 31.9 28.7 27.0 24.8 23.1 19.9 18.5 

Derby 31.7 29.0 25.4 22.5 22.1 22.9 22.2 21.5 20.7 20.6 17.1 16.3 14.6 14.9 

Stoke-on-Trent 31.8 31.3 30.9 30.5 28.7 27.3 25.4 24.3 24.1 23.3 21.6 20.0 17.8 16.5 

Coventry 33.6 32.9 31.5 32.6 30.8 27.8 24.4 23.3 23.1 22.9 21.5 19.9 16.9 14.1 

Plymouth 23.0 24.2 23.4 25.1 20.7 20.5 18.8 20.7 19.2 19.0 16.3 14.2 11.4 11.6 

Sandwell 36.9 36.2 35.2 34.5 33.2 33.3 31.2 28.4 28.6 29.0 29.1 25.7 23.6 21.2 

Middlesbrough 33.3 33.9 34.0 35.2 35.0 33.6 31.1 29.3 29.6 29.6 27.4 24.9 21.3 19.6 

Sunderland 37.6 37.3 35.5 35.0 31.8 28.1 27.4 26.2 25.6 23.5 20.4 19.0 16.4 14.4 

Leicester 35.2 34.3 32.4 33.0 31.9 29.1 27.3 26.7 27.5 27.1 23.9 21.3 18.8 18.9 

Av of latter 10 33.9 33.7 32.2 31.9 30.2 29.1 27.2 26.0 25.2 24.9 22.7 20.8 18.1 16.9 

NE Lincolnshire 31.8 28.5 28.2 25.8 26.1 25.3 23.0 23.4 20.8 21.7 19.7 19.2 16.4 15.3 

Diagnosed stroke and TIA prevalence by deprivation score at practice level 





Code Practice name Locality Group Index of Multiple Stroke 





B81635 Dr Dave East A 19.0 4 5 1.58 







B81690 Dr Ray North B 25.6 11 5 0.75 



1999-01 

2000-02 

2001-03 

2002-04 

2003-05 

2004-06 

2005-07 

2006-08


Code Practice name Locality Group Index of Multiple Stroke 
















B81074 Dr Rej East D 34.7 28 3 1.37 





































Age-gender standardised stroke annual inpatient admission rate per 100,000 persons by 

local deprivation quintile 

The underlying data for Figure 194 derived from Hospital Episode Statistics and Primary 

Care Information System (population) is given in the table below. 

Local deprivation Standardised admission rate per 100,000 persons 

quintile 

aged under 75 years (95% CI) for stroke 


2 217 (194 to 242) 

3 203 (183 to 226) 

4 182 (161 to 204) 


Hull 203 (193 to 213) 


for 2007-2009 (stroke) 



standard population are given in the table below for premature stroke deaths. The 

overall SMRs for Hull are also given. 


quintile 

aged under 75 years (95% CI) for stroke 

Most deprived 28.4 (20.2 to 38.7) 

2 18.9 (12.5 to 27.6) 

3 16.3 (10.6 to 24.1) 

4 10.8 (6.3 to 17.3) 

Least deprived 10.2 (5.9 to 16.4) 

Hull 16.5 (13.7 to 19.6) 



Trends in under 75 stroke standardised mortality ratios in men, women and persons in the most deprived national quintile 

of IMD 2007 




Males 

Females 

Persons 

Trends in under 75 stroke standardised mortality ratios by gender for the most deprived national 


2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 

Hull 137 (107, 173) 130 (101, 165) 131 (102, 166) 132 (103, 167) 116 (88, 149) 121 (93, 155) 






Hull 139 (105, 181) 143 (108, 186) 146 (110, 189) 159 (121, 204) 140 (104, 183) 125 (92, 167) 




20 most deprived PCT 121 (118, 125) 119 (116, 122) 115 (112, 118) 109 (106, 112) 105 (102, 108) 99 (96, 102) 


Hull 138 (115, 165) 136 (113, 162) 138 (115, 164) 144 (120, 171) 126 (104, 152) 123 (101, 149) 








Trend in under 75 cancer mortality rate 


Area DSR (under 75 cancer mortality) per 100,000 persons 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 


1998-00 

England 147 144 141 138 135 132 129 126 124 122 119 117 115 114 

Hull 187 187 175 171 163 163 157 156 150 150 144 147 144 147 

Y&H SHA 153 151 148 145 142 138 133 132 131 129 125 122 121 120 


Spearheads 168 166 162 159 156 152 149 146 143 140 137 135 133 133 


Salford 196 191 186 182 178 170 170 166 167 160 158 152 149 152 

Derby 147 140 136 132 125 124 122 124 119 121 116 115 112 120 

Stoke-on-Trent 184 175 163 160 158 158 151 144 145 150 150 144 142 144 

Coventry 143 145 143 143 141 137 135 134 130 128 129 128 127 121 

Plymouth 152 149 142 139 142 144 140 132 133 132 131 124 121 118 

Sandwell 173 172 162 159 153 153 151 151 149 145 138 136 132 135 


Sunderland 177 176 168 174 170 174 164 157 148 138 137 136 137 141 

Leicester 142 146 139 134 129 128 128 127 123 121 119 117 115 115 

Av of latter 10 166 163 156 155 152 151 146 143 141 139 136 133 132 132 


Cancer mortality in men – site of cancer, 2006-2008 

The underlying data for Figure 198, Figure 199 and Figure 200 are given in the report 

itself, but are given below in addition for completeness. 

Cancer site England, 2006-2008 Hull, 2006-2008 

Total number % Total number % 

Bladder 8,202 4.1 44 3.9 

Colorectal 21,474 10.7 104 9.3 

Leukaemia 6,239 3.1 22 2.0 

Lung 47,676 23.8 372 33.2 

Oesophagus 11,979 6.0 56 5.0 

Prostate 25,762 12.9 114 10.2 

Skin* 3,474 1.7 13 1.2 

Stomach 7,922 4.0 57 5.1 

Other 67,497 33.7 339 30.2 

All cancers 200,225 100.0 1,121 100.0 

*Includes malignant melanoma. 

1999-01 

2000-02 

2001-03 

2002-04 

2003-05 

2004-06 

2005-07 

2006-08


Cancer mortality in women – site of cancer, 2006-2008 

The underlying data for Figure 201, Figure 202 and Figure 203 are given in the report 

itself, but are given below in addition for completeness. 

Cancer site England, 2006-2008 Hull, 2006-2008 

Total number % Total number % 

Bladder 4,157 2.3 31 3.0 

Breast 30,294 16.5 165 16.0 

Cervical 2,284 1.2 21 2.0 

Colorectal 18,825 10.3 88 8.5 

Leukaemia 4,710 2.6 25 2.4 

Lung 35,612 19.5 280 27.1 

Oesophagus 6,171 3.4 30 2.9 

Skin* 2,760 1.5 6 0.6 

Stomach 4,775 2.6 39 3.8 

Other 73,487 40.1 348 33.7 

All cancers 183,075 100.0 1,033 100.0 

*Includes malignant melanoma. 

Diagnosed cancer prevalence by deprivation score at practice level 





Code Practice name Locality Group Index of Multiple Cancer 





B81635 Dr Dave East A 19.0 4 5 1.04 







B81690 Dr Ray North B 25.6 11 5 0.63 









Code Practice name Locality Group Index of Multiple Cancer 












B81074 Dr Rej East D 34.7 28 3 0.93 





































Age-gender standardised cancer annual inpatient admission rate per 1,000 persons by 

local deprivation quintile 



Local deprivation Standardised admission rate per 1,000 persons aged 

quintile 

under 75 years (95% CI) for cancer 


2 27.2 (26.4 to 28.1) 

3 25.2 (24.4 to 26.0) 

4 25.6 (24.8 to 26.4) 


Hull 26.4 (26.1 to 26.8) 


for 2007-2009 (cancer) 



standard population are given in the table below for premature cancer deaths. The 


Local deprivation Standardised mortality rates for persons aged under 75 

quintile 

years (95% CI) for cancer per 100,000 persons 


2 175 (154 to 198) 

3 142 (124 to 162) 

4 102 (86 to 119) 


Hull 143 (135 to 152) 



Trends in under 75 cancer standardised mortality ratios in men, women and persons in the most deprived national quintile 

of IMD 2007 




Males 

Females 

Persons 

Trends in under 75 cancer standardised mortality ratios by gender for the most deprived national 


2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 

Hull 119 (107, 131) 119 (107, 131) 108 (98, 120) 108 (97, 120) 107 (97, 119) 116 (104, 128) 






Hull 102 (90, 115) 108 (95, 121) 108 (95, 121) 115 (102, 129) 117 (104, 131) 124 (110, 138) 






Hull 112 (103, 121) 114 (106, 123) 108 (100, 117) 111 (103, 120) 112 (104, 121) 120 (111, 129) 








Annual age-standardised incidence rate compared to mortality rate during 2001 to 2003 

with a primary diagnosis of cancer by national deprivation quintile for those aged under 

75 years 

The underlying data for Figure 208 obtained from NYCRIS (incidence data) and derived 

from the PHMF (mortality) and Primary Care Information System (population) is given in 

the table below. The data is for Hull and East Riding of Yorkshire, and was analysed for 

the Cancer Equity Audit which was conducted during the financial year 2005/2006. 

Measure Standardised incidence and mortality rate for cancer per 100,000 

persons aged under 75 years by national deprivation quintile for Hull 

and East Riding of Yorkshire 

Most 

2 3 4 Least 

deprived 

deprived 

Incidence 432 403 421 416 441 

Mortality 199 154 137 128 122 

Difference 232 249 284 288 319 

Association between prevalence of daily smoking and premature mortality from lung 

cancer 

The underlying directly standardised mortality rate (DSR) for Figure 209 from the Public 

Health Mortality File (mortality) and Primary Care Information System (population) and 

the smoking prevalence from the Health and Lifestyle Survey 2007 is given below. 

Overall the rates for Hull are 45.9 for the DSR and 31.7% for the prevalence of daily and 

occasional smoking. 

Measure Local deprivation quintile (IMD 2007) 


deprived 

deprived 

Smoking prevalence 2007 67.4 62.4 49.4 32.0 23.5 

U75 lung cancer DSR 2005-07 47.2 44.6 30.7 26.1 20.7 



Trend in all age lung cancer mortality rate in men 


Area DSR (all age lung cancer mortality) per 100,000 males 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 


1998-00 

England 73 71 68 66 63 61 59 57 56 54 52 51 50 50 

Hull 105 102 93 94 98 99 99 92 96 93 92 92 87 88 

Y&H SHA 80 77 75 73 72 70 68 66 65 63 60 58 57 57 



Salford 118 114 108 105 97 88 88 88 86 81 80 80 78 76 

Derby 89 83 77 68 61 61 61 58 56 54 53 49 47 50 

Stoke-on-Trent 94 96 89 88 83 86 83 85 83 82 77 75 75 75 

Coventry 69 71 71 68 65 63 62 59 58 58 62 58 59 52 

Plymouth 66 71 66 71 69 66 61 59 58 57 58 56 54 51 

Sandwell 97 93 83 79 82 84 79 76 75 72 69 69 70 66 


Sunderland 102 102 97 101 95 93 90 88 84 71 65 68 74 81 

Leicester 67 68 61 57 52 59 66 65 59 51 52 52 54 55 

Av of latter 10 91 89 83 81 77 76 74 72 70 67 65 65 65 65 


Trend in all age lung cancer mortality rate in women 


Area DSR (all age lung cancer mortality) per 100,000 females 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 

1998-00 

England 29 29 29 29 28 28 28 28 28 28 28 29 29 30 

Hull 48 48 45 45 47 50 50 48 47 47 48 52 53 54 

Y&H SHA 33 34 34 34 34 34 34 34 34 34 35 35 36 37 



Salford 52 55 52 51 48 51 55 54 54 53 56 60 62 61 

Derby 25 23 22 25 26 28 28 26 26 26 27 31 31 35 

Stoke-on-Trent 37 33 31 29 31 31 34 33 34 33 36 37 37 41 

Coventry 31 32 33 30 31 28 26 28 29 34 33 34 31 32 

Plymouth 30 31 30 29 28 31 27 28 29 38 36 34 29 29 

Sandwell 34 35 34 29 30 33 34 35 31 30 27 29 30 34 


Sunderland 46 46 47 49 51 53 50 49 48 47 44 44 47 51 

Leicester 30 30 28 29 25 24 24 27 30 30 28 27 32 34 

Av of latter 10 37 36 36 35 35 35 35 36 37 38 37 38 39 40 


1999-01 

1999-01 

2000-02 

2000-02 

2001-03 

2001-03 

2002-04 

2002-04 

2003-05 

2003-05 

2004-06 

2004-06 

2005-07 

2005-07 

2006-08 

2006-08


Age-gender standardised lung cancer annual inpatient admission rate per 100,000 

persons by local deprivation quintile 




quintile 

aged under 75 years (95% CI) for lung cancer 


2 417 (385 to 451) 

3 343 (316 to 372) 

4 289 (262 to 317) 


Hull 343 (331 to 357) 

Standardised mortality rate per 100,000 persons aged under 75 years by local 

deprivation quintile for 2007-2009 (lung cancer) 



standard population are given in the table below for premature lung cancer deaths. The 



quintile 

aged under 75 years (95% CI) for lung cancer 


2 59.5 (47.4 to 73.9) 

3 50.1 (39.6 to 62.5) 

4 25.0 (17.6 to 34.5) 


Hull 46.7 (41.9 to 51.9) 



Trends in under 75 lung cancer standardised mortality ratios in men, women and persons in the most deprived national 

quintile of IMD 2007 




Males 

Females 

Persons 

Trends in under 75 lung cancer standardised mortality ratios by gender for the most deprived 

national quintile of IMD 2007 (95% confidence intervals), Hull and comparator areas 

2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 

Hull 144 (122, 169) 144 (123, 169) 131 (110, 154) 137 (116, 161) 128 (108, 151) 143 (121, 168) 






Hull 117 (94, 144) 124 (100, 151) 127 (102, 155) 145 (119, 176) 138 (112, 168) 145 (118, 176) 






Hull 133 (117, 151) 136 (120, 154) 130 (114, 148) 141 (124, 160) 133 (116, 151) 145 (127, 164) 









deprivation quintile for 2007-2009 (colorectal cancer) 



standard population are given in the table below for premature colorectal cancer deaths. 

The overall SMRs for Hull are also given. 

Local deprivation Standardised mortality rate per 100,000 persons aged 

quintile 

under 75 years (95% CI) for colorectal cancer 


2 15.8 (9.8 to 23.9) 

3 10.1 (5.8 to 16.2) 

4 8.5 (4.5 to 14.5) 


Hull 11.9 (9.5 to 14.6) 

Standardised mortality rate per 100,000 men aged under 75 years by local deprivation 

quintile for 2007-2009 (prostate cancer) 



standard population are given in the table below for premature prostate cancer deaths. 


Local deprivation Standardised mortality rate per 100,000 men aged 

quintile 

under 75 years (95% CI) for prostate cancer 


2 13.7 (6.6 to 25.3) 

3 4.8 (1.3 to 12.4) 

4 4.1 (0.8 to 11.9) 


Hull 7.5 (5.0 to 10.8) 



Trend in all age breast cancer mortality rate in women 


Area DSR (all age breast cancer mortality) per 100,000 females 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 


1998-00 

England 37.3 36.3 35.2 34.1 33.1 32.3 31.4 30.8 30.0 29.3 28.6 28.0 27.5 26.8 

Hull 41.3 39.2 35.6 32.7 31.4 30.3 28.1 25.4 24.6 25.6 27.3 30.4 32.6 33.2 

Y&H SHA 35.5 35.1 33.7 32.4 30.7 30.1 30.0 29.1 28.4 28.1 27.3 27.1 26.6 26.5 



Salford 42.2 38.1 37.8 33.4 34.5 29.7 32.5 32.3 35.7 32.5 28.6 24.3 23.2 26.2 

Derby 40.7 32.8 34.0 30.2 29.9 25.4 25.4 25.0 30.1 28.4 26.9 22.7 24.0 25.0 

Stoke-on-Trent 41.4 41.3 38.8 36.8 33.9 32.4 28.2 26.3 26.9 29.1 29.9 31.7 32.6 28.7 

Coventry 32.6 32.3 33.4 32.8 30.6 30.1 31.3 33.0 31.0 30.9 28.4 28.2 28.0 27.4 

Plymouth 32.5 31.7 28.9 27.8 24.0 27.4 26.1 28.0 24.7 25.2 28.1 28.1 27.6 22.5 

Sandwell 41.8 38.6 36.2 35.9 36.6 34.7 32.4 30.3 29.2 29.3 28.0 24.5 22.6 23.3 


Sunderland 38.7 36.6 35.2 33.4 34.1 34.9 31.5 26.8 24.3 24.4 28.7 30.8 29.4 27.2 

Leicester 38.6 36.5 36.0 31.1 30.3 28.4 31.2 30.6 31.6 31.1 31.8 30.7 27.9 28.6 

Av of latter 10 38.1 35.9 35.3 33.5 32.2 30.2 29.6 29.1 29.3 29.2 29.1 28.5 27.8 27.2 


Age-gender standardised breast cancer annual inpatient admission rate per 100,000 

women by local deprivation quintile 



Local deprivation Standardised admission rate per 100,000 women 

quintile 

aged under 75 years (95% CI) for breast cancer 


2 483 (434 to 536) 

3 680 (623 to 741) 

4 879 (815 to 948) 


Hull 668 (642 to 694) 

1999-01 

2000-02 

2001-03 

2002-04 

2003-05 

2004-06 

2005-07 

2006-08


Standardised mortality rate per 100,000 women aged under 75 years by local 

deprivation quintile for 2007-2009 (breast cancer) 



standard population are given in the table below for premature breast cancer deaths. 


Local deprivation Standardised mortality rate per 100,000 women aged 

quintile 

under 75 years (95% CI) for breast cancer 


2 13.8 (6.3 to 26.1) 

3 16.7 (8.8 to 28.7) 

4 28.1 (17.3 to 43.1) 


Hull 22.5 (17.9 to 27.9) 

Trend in all age diabetes mortality rate 


Area DSR (all age diabetes mortality) per 100,000 persons 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 


1998-00 

England 8.7 8.5 8.3 8.1 8.0 7.8 7.7 7.6 7.6 7.3 7.0 6.6 6.3 6.1 

Hull 8.5 7.6 7.8 7.5 7.1 6.7 6.6 6.7 6.2 6.4 6.1 8.0 7.5 7.3 

Y&H SHA 8.3 8.3 8.2 8.1 8.1 7.9 7.7 7.2 7.2 7.2 7.1 6.7 6.3 6.2 



Salford 9.1 8.9 10.2 11.5 10.9 9.1 8.6 8.6 8.7 8.3 7.1 6.6 5.5 7.0 

Derby 11.9 11.5 8.9 8.1 7.5 8.4 9.0 7.9 7.6 7.2 8.0 7.8 6.9 6.9 

Stoke-on-Trent 7.6 8.7 9.1 9.2 9.5 9.0 8.4 7.4 7.5 8.6 8.5 7.8 7.5 7.6 

Coventry 16.3 15.1 13.7 10.9 11.3 10.6 11.0 11.0 10.6 9.7 8.9 10.2 9.8 9.8 

Plymouth 9.1 10.4 10.5 9.1 7.7 6.8 7.0 6.8 7.0 6.5 5.8 5.2 5.5 5.5 

Sandwell 12.3 13.3 14.1 13.6 12.8 13.5 13.4 13.8 14.2 13.6 12.8 11.4 10.7 11.5 


Sunderland 8.7 9.4 9.2 9.5 9.2 9.9 10.3 9.5 9.1 8.9 8.3 8.2 7.2 6.3 

Leicester 10.6 11.5 12.2 10.7 11.8 11.8 11.7 11.1 11.0 11.1 11.2 10.9 10.3 8.9 

Av of latter 10 10.9 11.2 11.2 10.4 10.2 10.0 10.0 9.7 9.5 9.5 9.2 8.9 8.1 8.1 


1999-01 

2000-02 

2001-03 

2002-04 

2003-05 

2004-06 

2005-07 

2006-08


Diagnosed diabetes prevalence by deprivation score at practice level 



population estimated from registered population) is given in the table below. The 

prevalence figures are for those aged 17+ years. 


Code Practice name Locality Group Index of Multiple Diabetes 





B81635 Dr Dave East A 19.0 4 5 5.52 







B81690 Dr Ray North B 25.6 11 5 4.36 
















B81074 Dr Rej East D 34.7 28 3 5.85 















Code Practice name Locality Group Index of Multiple Diabetes 

























Age-gender standardised diabetes annual inpatient admission rate per 100,000 persons 

by local deprivation quintile 




quintile 

aged under 75 years (95% CI) for diabetes 


2 193 (172 to 217) 

3 123 (106 to 141) 

4 85 (71 to 101) 


Hull 130 (122 to 138) 




for 2007-2009 (diabetes) 



standard population are given in the table below for premature diabetes deaths. The 


Local deprivation 

quintile 

Number of deaths 

over three years 2005- 

2007 (under 75) 

Standardised mortality rates for 

persons aged under 75 years (95% 

CI) for diabetes per 100,000 persons 

Most deprived 7 4.8 (1.9 to 9.9) 

2 5 3.5 (1.1 to 8.3) 

3 2 1.0 (0.1 to 3.6) 

4 3 2.0 (0.4 to 5.8) 

Least deprived 2 1.2 (0.1 to 4.4) 

Hull 19 2.4 (1.5 to 3.8) 

Association between prevalence of daily smoking and premature mortality from COPD 

The underlying directly standardised mortality rate (DSR) for Figure 224 from the Public 

Health Mortality File (mortality) and Primary Care Information System (population) and 

the smoking prevalence from the Health and Lifestyle Survey 2007 is given below. 

Overall the rates for Hull are 45.9 for the DSR and 31.7% for the prevalence of daily and 

occasional smoking. 

Measure Local deprivation quintile (IMD 2007) 


deprived 

deprived 

Smoking prevalence 2007 67.4 62.4 49.4 32.0 23.5 

U75 COPD DSR 2005-07 33.7 25.8 21.6 8.9 6.6 



Trend in all age COPD mortality rate for men 


Area DSR (all age COPD mortality) per 100,000 men 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 


1998-00 

England 54.5 51.5 50.8 48.8 48.2 46.1 43.8 41.0 40.1 38.8 37.8 35.7 34.7 34.1 

Hull 68.1 67.5 72.4 74.4 73.5 68.8 55.0 52.4 50.9 51.1 50.7 45.1 45.3 48.4 

Y&H SHA 59.6 56.5 56.0 54.6 53.8 51.5 48.8 46.4 45.7 44.3 43.3 41.3 39.6 38.4 



Salford 77.9 73.0 75.2 73.9 72.8 64.1 59.3 54.7 54.4 47.7 50.4 45.8 51.0 47.2 

Derby 59.8 56.9 57.4 58.9 62.6 58.7 58.0 52.2 53.8 44.6 40.3 34.9 32.9 31.0 

Stoke-on-Trent 93.9 80.4 81.2 69.6 73.4 70.8 67.8 59.5 57.2 57.8 60.3 55.2 55.4 53.0 

Coventry 71.5 74.0 74.5 70.7 63.3 58.4 53.4 46.0 47.7 51.0 54.0 50.7 47.6 43.3 

Plymouth 48.3 46.6 50.3 50.2 53.1 51.6 47.4 49.3 46.9 44.0 39.1 36.7 35.7 29.5 

Sandwell 82.8 76.5 77.9 72.8 72.8 68.7 61.8 51.9 51.4 50.4 52.0 50.2 49.9 52.7 


Sunderland 60.6 63.8 70.1 76.0 72.4 69.9 67.6 65.8 63.5 62.7 59.3 56.4 50.3 50.4 

Leicester 56.4 51.5 48.8 48.5 51.1 51.7 49.9 43.5 43.5 39.1 39.8 36.6 42.9 47.2 

Av of latter 10 68.8 64.8 65.5 62.5 62.9 59.9 56.3 52.1 51.1 49.9 49.0 46.4 46.1 44.7 


Trend in all age COPD mortality rate for women 


Area DSR (all age COPD mortality) per 100,000 women 

1993-95 

1994-96 

1995-97 

1996-98 

1997-99 

1998-00 

England 22.4 22.3 23.1 23.1 23.5 23.2 22.8 22.1 22.6 22.5 22.4 21.5 21.7 21.7 

Hull 42.5 43.8 45.0 43.1 40.0 40.9 38.7 35.9 35.1 31.8 35.2 35.2 40.1 38.9 

Y&H SHA 27.8 27.6 28.8 29.2 29.4 28.9 27.9 27.1 27.6 27.0 27.2 25.3 26.5 26.6 



Salford 46.6 42.6 45.5 41.9 41.1 36.6 35.9 35.9 39.7 40.7 37.5 34.0 33.2 42.6 

Derby 23.0 24.5 23.6 26.6 24.9 23.5 21.5 22.5 22.2 19.9 18.6 19.9 22.2 24.4 

Stoke-on-Trent 26.7 22.5 23.2 22.4 24.3 23.6 27.8 28.6 30.7 27.9 27.9 26.6 28.6 30.4 

Coventry 28.2 28.8 32.8 31.6 34.3 32.2 31.0 26.6 27.8 29.3 32.3 30.8 32.0 30.4 

Plymouth 23.4 22.5 23.8 22.9 23.3 25.3 24.7 24.2 23.9 23.5 22.9 23.2 24.1 24.0 

Sandwell 30.4 26.6 27.4 28.3 31.8 33.7 33.0 30.3 31.0 33.0 33.2 29.8 29.8 28.6 


Sunderland 31.4 31.4 34.2 35.8 33.9 32.1 31.1 32.3 33.5 35.8 38.0 38.0 35.9 36.5 

Leicester 20.9 19.4 20.5 18.9 18.6 19.0 21.0 20.3 21.3 22.2 24.2 23.2 23.3 23.5 

Av of latter 10 29.4 28.1 29.6 29.1 29.9 29.8 29.6 28.8 29.5 29.6 30.4 29.2 29.7 30.4 


1999-01 

1999-01 

2000-02 

2000-02 

2001-03 

2001-03 

2002-04 

2002-04 

2003-05 

2003-05 

2004-06 

2004-06 

2005-07 

2005-07 

2006-08 

2006-08


Diagnosed COPD prevalence by deprivation score at practice level 





Code Practice name Locality Group Index of Multiple COPD 





B81635 Dr Dave East A 19.0 4 5 2.53 







B81690 Dr Ray North B 25.6 11 5 1.67 
















B81074 Dr Rej East D 34.7 28 3 3.16 















Code Practice name Locality Group Index of Multiple COPD 

























Age-gender standardised COPD annual inpatient admission rate per 100,000 persons 

by local deprivation quintile 




quintile 

(95% CI) for COPD 


2 530 (494 to 568) 

3 422 (392 to 454) 

4 301 (274 to 329) 


Hull 430 (416 to 445) 




deprivation quintile for 2007-2009 (COPD) 



standard population are given in the table below for premature COPD deaths. The 


Local deprivation Standardised mortality rate per 100,000 persons aged 

quintile 

under 75 years (95% CI) for COPD 


2 26.0 (18.4 to 35.8) 

3 26.1 (18.9 to 35.1) 

4 13.7 (8.5 to 21.0) 


Hull 23.4 (20.1 to 27.1) 



Trends in under 75 COPD standardised mortality ratios in men, women and persons in the most deprived national quintile 

of IMD 2007 




Males 

Females 

Persons 

Trends in under 75 COPD standardised mortality ratios by gender for the most deprived national 


2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 

Hull 83 (62, 108) 86 (65, 112) 77 (57, 101) 72 (53, 96) 78 (58, 103) 103 (80, 132) 






Hull 103 (77, 135) 102 (76, 135) 117 (88, 151) 112 (84, 147) 138 (107, 177) 130 (99, 167) 






Hull 92 (75, 111) 93 (76, 113) 94 (77, 114) 90 (73, 109) 104 (86, 125) 115 (96, 137) 








Feelings of safety after dark 

The underlying data for Figure 231 from the Social Capital Survey 2009 is given in the 

table below. 

Group Number answering Very safe or fairly safe walking 

question alone in area after dark (%) 

Males 1,954 67.6 

Females 2,099 36.2 

Aged 16-24 685 58.7 

Aged 24-35 664 57.8 

Aged 35-44 712 61.7 

Aged 45-54 658 57.6 

Aged 55-64 539 43.2 

Aged 65-74 423 35.2 

Aged 75+ 367 25.1 

North Locality resident 921 47.2 

East Locality resident 1,501 52.5 

West Locality resident 1,631 52.6 

Most deprived local quintile 696 39.2 

Quintile 2 739 42.1 



Least deprived local quintile 956 61.5 

Overall 4,053 51.3 

Degree of civic engagement by Area 

The underlying data for Figure 232 from the Social Capital Survey 2009 is given below, 

giving the percentage of people who feel well informed about things which affects their 

local area and the percentage who feel that they can influence local decisions. The 

number of people answering each question is given separately for both of these 

questions. 

Group Number 

answering 

question 

Well 

informed 


(%) 

Number 

answering 

question 

Can 

influence 

(%) 

Males 1,954 61.1 1,950 35.5 

Females 2,100 63.8 2,098 35.2 

Aged 16-24 685 49.8 684 26.0 

Aged 25-34 665 59.2 665 32.9 

Aged 35-44 710 61.1 709 38.1 

Aged 45-54 659 62.5 658 41.2 

Aged 55-64 539 70.5 538 39.2


Group Number 

answering 

question 

Well 

informed 


(%) 

Number 

answering 

question 

Can 

influence 

(%) 

Aged 65-74 423 70.9 422 37.9 

Aged 75+ 368 72.8 367 32.4 

North Locality resident 921 58.0 921 32.5 

East Locality resident 1,502 63.4 1,502 35.7 

West Locality resident 1,631 64.1 1,631 36.6 

Most deprived local quintile 695 56.3 693 32.0 

Quintile 2 740 57.6 738 32.0 

Quintile 3 912 60.2 911 35.6 

Quintile 4 752 65.8 751 35.4 

Least deprived local quintile 955 70.3 955 40.1 

Overall 4,054 62.5 4,048 35.3 

Frequency of speaking to non-household family 

The underlying data for Figure 233 from the Social Capital Survey 2009 is given below. 

Group Number Frequency of speaking to non- 

answering household family (%) 

question 

81 

Most 

days 


Males 1,950 51.4 37.2 7.3 4.1 

Females 2,099 68.0 25.8 4.2 2.0 

Aged 16-24 684 57.5 32.9 7.5 2.2 

Aged 25-34 665 62.9 30.1 5.0 2.1 

Aged 35-44 710 56.3 33.1 6.8 3.8 

Aged 45-54 658 58.7 30.5 7.1 3.6 

Aged 55-64 539 59.2 33.0 4.1 3.7 

Aged 65-74 422 66.4 25.8 4.5 3.3 

Aged 75+ 366 62.6 32.2 3.0 2.2 





Quintile 2 738 59.9 30.9 5.8 3.4 

Quintile 3 911 59.9 30.7 6.1 3.2 

Quintile 4 751 56.6 34.9 5.7 2.8 


Overall 4,049 60.0 31.3 5.7 3.0 

81 Most days=daily or 4-6 days per week; Weekly=1-4 days per week; Monthly=1-2 times per month or bi- 

monthly; Rarely=1-2 times per year or less


Frequency of speaking to friends (not family or neighbours) 


Group Number Frequency of speaking to friends 

answering (not family/neighbours) (%) 

question 

82 

Most 

days 


Males 1,954 58.2 33.6 5.7 2.5 

Females 2,097 59.0 32.6 5.6 2.8 

Aged 16-24 684 79.7 18.0 1.8 0.6 

Aged 25-34 665 65.4 29.2 4.5 0.9 

Aged 35-44 711 56.8 35.6 5.3 2.3 

Aged 45-54 658 55.2 36.8 5.3 2.7 

Aged 55-64 538 45.2 40.9 9.7 4.3 

Aged 65-74 423 51.3 35.7 8.0 5.0 

Aged 75+ 367 44.7 42.2 7.6 5.4 





Quintile 2 738 58.9 32.9 5.0 3.1 

Quintile 3 912 58.6 32.6 5.6 3.3 

Quintile 4 752 56.9 36.0 5.3 1.7 


Overall 4,051 58.6 33.1 5.7 2.7 

Frequency of speaking to neighbours (not family or friends) 


Group Number Freq of speaking to neighbours 

answering (not family/friends) (%) 

question 

83 

Most 

days 


Males 1,947 40.7 42.1 11.5 5.8 

Females 2,094 43.3 40.3 9.6 6.8 

Aged 16-24 682 31.1 37.5 16.1 15.2 

Aged 25-34 661 34.2 47.7 11.2 7.0 

Aged 35-44 710 40.7 44.9 9.7 4.6 

82 

Most days=daily or 4-6 days per week; Weekly=1-4 days per week; Monthly=1-2 times per month or bimonthly; 

Rarely=1-2 times per year or less 

83 

Most days=daily or 4-6 days per week; Weekly=1-4 days per week; Monthly=1-2 times per month or bi- 

monthly; Rarely=1-2 times per year or less 



Group Number Freq of speaking to neighbours 

answering (not family/friends) (%) 

question 

83 

Most 

days 


Aged 45-54 657 39.4 47.0 10.0 3.5 

Aged 55-64 537 45.1 40.2 11.5 3.2 

Aged 65-74 423 62.9 28.8 5.0 3.3 

Aged 75+ 366 55.2 33.6 6.0 5.2 





Quintile 2 736 42.0 37.6 12.4 8.0 

Quintile 3 908 42.2 39.5 10.7 7.6 

Quintile 4 749 37.8 44.2 11.9 6.1 


Overall 4,041 42.0 41.1 10.5 6.3 

Frequency of feeling happy and sad 

The underlying data for Figure 236 and Figure 237 from the Young People Health and 

Lifestyle Survey 2008-09 is given below. 

Happy or 

sad 

Happy 

Sad 

School Number 

Frequency (%) 

year / answering All of Most of Some Not much Rarely 

gender question time time of time of the time or never 

Year 7 627 11.5 61.1 20.4 5.1 1.9 

Year 8 591 11.2 64.1 18.6 5.1 1.0 

Year 9 538 13.4 59.5 20.8 4.8 1.5 

Year 10 674 12.9 59.9 20.8 5.2 1.2 

Year 11 461 11.7 64.0 18.2 5.0 1.1 

Males 1,422 12.5 61.7 19.2 4.8 1.8 

Females 1,483 11.9 61.4 20.4 5.3 1.1 

Year 7 628 1.1 8.0 25.6 45.7 19.6 

Year 8 588 0.9 7.5 27.6 45.6 18.5 

Year 9 537 1.5 6.9 32.2 42.1 17.3 

Year 10 674 1.0 8.5 29.7 43.2 17.7 

Year 11 461 0.7 8.9 33.8 41.0 15.6 

Males 1,420 1.3 6.0 23.0 47.6 22.1 

Females 1,482 0.9 9.9 35.5 40.1 13.7 



Mental Health Index (by age and gender) 


Gender Age 

(yrs) 

Men 

Women 

Number 

answering 

question 

Mental Health Index score (%) 

0-60 (poorest) 61-75 76-85 86-100 (best) 

16-24 334 16.5 20.1 19.5 44.0 

25-34 314 17.8 19.4 25.5 37.3 

35-44 362 18.8 21.5 19.3 40.3 

45-54 339 18.6 20.4 20.9 40.1 

55-64 259 23.6 17.0 18.9 40.5 

65-74 203 19.2 14.8 16.7 49.3 

75+ 142 8.5 20.4 22.5 48.6 

16-24 352 24.7 27.3 19.0 28.7 

25-34 351 27.1 22.2 25.4 25.4 

35-44 350 29.4 25.4 18.6 26.3 

45-54 320 26.9 22.2 23.4 27.5 

55-64 280 26.4 19.3 20.4 33.9 

65-74 220 20.5 18.6 18.6 42.3 

75+ 226 24.3 18.6 19.9 37.2 

Mental Health Index (by status in UK) 

The underlying data for Figure 239 from the main adult and BME Health and Lifestyle 

Surveys 2007 is given below. 

Status in UK Number Mental Health Index score (%) 

answering 0-60 61-75 76-85 86-100 

question (poorest) 

(best) 

British 3,928 25.5 27.8 26.7 20.0 

Student 164 15.2 30.5 30.5 23.8 

Granted asylum 122 41.8 38.5 12.3 7.4 

Failed asylum seeker 197 76.1 20.3 3.0 0.5 

Refugee 168 41.7 41.1 13.1 4.2 

Working in UK temporarily 253 15.8 37.2 31.6 15.4 

Working in UK long-term 155 22.6 35.5 27.7 14.2 

Other 68 30.9 36.8 20.6 11.8 

Incapacity benefit claimants for mental health reasons 

The underlying data for Figure 240 from the Department for Work and Pensions is given 

in Table 42. 



Diagnosed dementia prevalence by deprivation score at practice level 





Code Practice name Locality Group Index of Multiple Dementia 





B81635 Dr Dave East A 19.0 4 5 0.13 







B81690 Dr Ray North B 25.6 11 5 0.12 
















B81074 Dr Rej East D 34.7 28 3 0.27 
















Code Practice name Locality Group Index of Multiple Dementia 
























Diagnosed serious mental health prevalence by deprivation score at practice level 






Deprivation 2007 

Score Rank Quintile 

Mental 

health 

prevalence 

2009/10 (%) 



B81635 Dr Dave East A 19.0 4 5 0.27 







B81690 Dr Ray North B 25.6 11 5 0.35 







Deprivation 2007 

Score Rank Quintile 

Mental 

health 

prevalence 

2009/10 (%) 













B81074 Dr Rej East D 34.7 28 3 0.60 





































Standardised mortality rate per 100,000 persons by local deprivation quintile for 2007- 

2009 (mental health and suicide and undetermined injury) 



standard population are given in the table below for deaths from dementia, substance 

abuse and suicide and undetermined injury. The overall SMRs for Hull are also given. 

Local 

deprivation 

quintile 

Standardised mortality rate per 100,000 persons (95% CI) 

Dementia Substance abuse Suicide and 

undetermined injury 

Most deprived 23.3 (17.5 to 30.3) 8.5 (4.6 to 14.4) 13.0 (7.9 to 20.1) 

2 13.6 (9.4 to 19.0) 7.1 (3.5 to 12.8) 15.2 (9.6 to 22.7) 

3 16.0 (11.9 to 21.0) 6.4 (3.1 to 11.8) 16.0 (10.5 to 23.3) 

4 14.8 (10.6 to 20.1) 4.2 (1.7 to 8.7) 7.1 (3.5 to 12.8) 

Least deprived 9.3 (5.8 to 14.1) * 4.7 (2.0 to 9.3) 

Hull 15.5 (13.4 to 17.7) 5.2 (3.8 to 7.1) 11.1 (8.9 to 13.7) 

*Fewer than 3 deaths. 

Conception rate for females aged 15-17 years for Hull and England 

The underlying data for Figure 244 from the Office for National Statistics is given in the 

table below. 

Year Under 18 conception rate per 1,000 

female population aged 15-17 years 

England Hull 

1998 46.6 84.6 

1999 44.8 71.4 

2000 43.6 73.2 

2001 42.5 70.9 

2002 42.7 65.5 

2003 42.1 69.2 

2004 41.6 79.2 

2005 41.3 71.4 

2006 40.6 69.7 

2007 41.8 70.3 

2008 40.5 68.5 

2009 38.2 64.0 



Conception rate for females aged 15-17 years for Hull by wards 

The underlying data calculated from hospital birth and abortion records for Figure 245, 

Figure 246 and Figure 247 is given in the table below. The figures are not given for 

some wards as the numbers are too low for Beverley ward. 

Ward Under 18 Conception rate per 1,000 

conceptions 2008 females aged 15-17 yrs (95% CI) 

Bransholme East 31 97.8 (66.4, 138.8) 

Bransholme West 18 85.7 (50.8, 135.5) 

Kings Park 7 43.8 (17.5, 90.1) 

Area: North Carr 56 81.5 (61.6, 105.9) 

Beverley 7.8 (0.1, 43.5) 

Orchard Pk & Greenwd 100.0 (71.8, 135.7) 

University 56.3 (29.1, 98.4) 

Area: Northern 54 71.9 (54.0, 93.8) 

Locality: North 110 76.5 (62.9, 92.2) 

Ings 10 42.7 (20.5, 78.6) 

Longhill 11 51.2 (25.5, 91.6) 

Sutton 19 69.3 (41.7, 108.3) 

Area: East 40 55.3 (39.5, 75.3) 

Holderness 9 32.8 (15.0, 62.4) 

Marfleet 33 101.9 (70.1, 143.0) 

Southcoates East 17 74.6 (43.4, 119.4) 

Southcoates West 9 60.8 (27.7, 115.4) 

Area: Park 68 69.8 (54.2, 88.5) 

Drypool 11 50.2 (25.0, 89.9) 

Area: Riverside (E) 11 50.2 (25.0, 89.9) 

Locality: East 119 62.1 (51.5, 74.3) 

Myton 25 115.2 (74.5, 170.1) 

Newington 18 69.2 (41.0, 109.4) 

St Andrew's 14 91.5 (50.0, 153.5) 

Area: Riverside (W) 57 90.5 (68.5, 117.2) 

Boothferry 4 16.2 (4.4, 41.5) 

Derringham 9 54.2 (24.7, 102.9) 

Pickering 19 73.6 (44.3, 115.0) 

Area: West 32 47.7 (32.6, 67.3) 

Avenue 4 20.1 (5.4, 51.5) 

Bricknell 5 26.9 (8.7, 62.7) 

Newland 13 118.2 (62.9, 202.1) 

Area: Wyke 22 44.4 (27.8, 67.3) 

Locality: West 111 61.8 (50.8, 74.4) 

HULL 340 66.0 (59.2, 73.4) 



Age-gender standardised accident annual inpatient admission rate per 1,000 persons 

aged under 19 years by local deprivation quintile 



Local deprivation Standardised admission rate per 1,000 persons aged 

quintile 

under 19 years (95% CI) for accidents 


2 14.3 (13.2 to 15.5) 

3 11.4 (10.4 to 12.5) 

4 11.0 (9.9 to 12.2) 


Hull 12.2 (11.8 to 12.8) 

Breastfeeding initiation, 2009/2010 

The underlying data for Figure 249 relating to breastfeeding initiation for 2009/2010 is 

given below. 

Primary Care Trust Percentage of women known to 

initiate breastfeeding, 2009/2010 

England 72.7 

Industrial Hinterlands 54.4 

Yorkshire & Humber SHA 68.0 

Hull PCT 56.2 

Plymouth 64.6 

Salford 63.2 

Sunderland 49.3 

Middlesbrough 48.0 

Coventry 75.3 




Sandwell 55.5 

Stoke-on-Trent 57.6 

Average of 10 comparators 64.0 

North East Lincolnshire PCT 57.9 



Age-gender standardised inpatient hospital admission rate for fracture neck of the femur 

in those persons aged 65+ years by deprivation quintile 




quintile 

aged 65+ years (95% CI) for fractured neck of femur 

Most deprived 986 (853 to 1,135) 

2 733 (621 to 859) 

3 735 (635 to 846) 

4 871 (751 to 1,005) 


Hull 809 (757 to 864) 



13.7 Time Period for Information, Date Last Updated and Source 

for Each Table and Figure 

The data refer to the dates or years as indicated (Q refers to quarters generally based 

on financial years so April-June is referred to as Q1). Where dates or years are in 

brackets after the specified dates, it means that the data was applied to the specified 

time period by applying rates from the dates or years in brackets. For example, [2008- 

2031 (2008)] might be the population predicted for the years 2008-2031 from the 

population estimate of 2008. For example, [2003 (2010)] might be the prevalence of 

diabetes estimated for the Hull population for the year 2010 from national prevalence 

figures from the year 2003, i.e. national prevalence estimates for the year 2003 were 

applied to the most recent population estimates for Hull (2010). Where a range of years 

is given, the data may be either combined from a number of years (particularly if the 

event is relatively rare and small numbers might be a problem) or the data is presented 

over a period of time to assess the trend over time. 

For further details including web sites for the following data sources, see section 13.1 

on page 788. Where there is a source in brackets, this is generally secondary such as 

the source of data for the prevalence which was then applied to local population 

estimates or national age-specific mortality rates which were then applied to local data 

to calculate a standardised mortality ratio, etc. 

Reference Description of source 

ASH Action on Smoking and Health (www.ash.org.uk/) 

C&LG 

Index of Multiple Deprivation 2007 from Communities and Local 

Government (Communities and Local Government 2009) 

CACI 

ACORN and Health ACORN classifications purchased from CACI 

(www.caci.co.uk/insite) 

Cancer 

Various articles examining risk factors for cancer (Cancer Research UK 

2004) 

2001 Census (generally via Neighbourhood Statistics (Office for 

Census National Statistics 2009) or via Compendium (Information Centre for 

Health and Social Care 2008) 

CHS Child Health System (old local system – see SystmOne) 

Compendium 

Compendium of Clinical and Health Indicators (Information Centre for 

Health and Social Care, 2008a) 

CPAS Local Community Physical Activity Survey (see section 13.2.4) 

CQC Care Quality Commission (Care Quality Commission 2010) 

DoE 

Department of Education (formerly Department for Children, Schools 

and Families) 

DoH Department of Health (Department of Health 2009) 

DWP 

Department for Work and Pensions (Department for Work and Pensions 

2009) 

FF Fit Fans (local weight loss / fitness programme) 

GHS General Household Survey (now General Lifestyle Survey) 




GLS 

General Lifestyle Survey (previously General Household Survey) 

(Economic and Social Data Service 2008) 

H&L 

Local Health and Lifestyle Surveys conducted 2003 and 2007 (see 

section 13.2.1) 

HES 

Hospital Episode Statistics (Office for National Statistics 2009; The 

Information Centre for Health and Social Care 2009) 

HEYBCSC Hull & East Yorkshire Bowel Cancer Screening Centre 

HPA Health Protection Agency 

HSE Health Survey for England (Health Survey for England 2008) 

IC-SSS 

Information Centre – Stop Smoking Service data (Information Centre for 

Health and Social Care 2010) 

IC-V 

Information Centre – Vaccination data (Information Centre for Health 

and Social Care 2010) 

LAA Local Area Agreement (targets) 

LCPCS Local Community Pharmacy Commissioning Survey 

LSHSAP Conifer House/Local Sexual Health Strategy & Action Plan 2005 

MHCYP 

Mental Health of Children and Young People of Great Britain 2004 

(Green, McGinnity et al. 2005) 

NASCIS National Adult Social Care Intelligence Service 

NASCIS-RAP 

National Adult Social Care Intelligence Service, Referrals, Assessments 

and Packages of Care 

NCSP National Chlamydia Screening Programme 

nomis Official Labour Market Statistics (Office for National Statistics 2010) 

NYCRIS Northern and Yorkshire Cancer Registry and Information Service 

ONS Office for National Statistics (previously OPCS) 

ONS maps 

Boundary maps of wards and other geographical areas available from 

Office for National Statistics 

OPCS Office of Population Census and Surveys (now ONS) 

Diabetes model (see www.yhpho.org.uk). (Yorkshire and the Humber) 

PBS or 

PBS model 

Public Health Observatory, Brent PCT and School of Health and Related 

Research (ScHARR) model for estimating the number of people with 

diagnosed and undiagnosed diabetes (referred to as PBS model as 

takes first letter from each organisation) 

Primary Care Information System (Open Exeter). Hull and East Riding 

PCIS 

of Yorkshire population file of GP registrations (Connecting for Health, 

2009) 

PCMD Primary Care Mortality Database 

PHBF 

Hull and East Riding of Yorkshire Public Health Birth File (Office for 

National Statistics 2009) 

PHMF 

Hull and East Riding of Yorkshire Public Health Mortality File (Office for 

National Statistics 2009) 

POPPI 

Projecting Older 

www.poppi.org.uk) 

People Population Information System (see 

Prisoner MH 

Prison capacity figures from www.hmprisonservice.gov.uk/ 

Estimates of prevalence from Singleton (Singleton et al. 1997) 




PS Local Prevalence Survey 2009 (see section 13.2.1.4) 

Quality Management and Analysis System (from which QOF is derived) 

QMAS [Data extracted from local system – same information as for QOF but 

more up-to-date as can extract data from QMAS at any point in time] 

QOF 

Quality and Outcomes Framework (Information Centre for Health and 

Social Care 2010) 

RCGP Royal College of General Practitioners 

SC 

Local Social Capital Surveys conducted 2004 and 2009 (see section 

13.2.3) 

SPoA Single Point of Access weight loss services 

SSC 

Shapes Slimming Club – part of Stay Healthy Live Longer (local weight 

loss programme) 

SystmOne SystmOne (newer system which replaced Child Health System) 

WCC Targets from Hull‟s World Class Commissioning Strategy 

WCCDP World Class Commissioning Data Packs (Department of Health 2008) 

YP H&L 

Local Young People Health and Lifestyle Surveys conducted 2002 and 

2008-09 (see section 13.2.1) 

Y&H PHO Yorkshire & the Humber Public Health Observatory (www.yhpho.org.uk). 

Y&H PHO Yorkshire & the Humber Public Health Observatory Programme 

BPMA Budgeting and Marginal Analysis toolkit 



13.7.1 Tables 

Reference Page Data time period Last 

updated 

Data source(s) 

Table 1 41 2007, 2007/08 Jun 09 H&L, Y&H PHO BPMA, HES, PHMF 

Table 2 45 N/A Jun 09 (Hull City Council 2006) 

Table 3 46 2001-2009 Jun 09 Neighbourhood Statistics (& various) 

Table 4 48 Apr 2010 Sep 10 PCIS (C&LG) 

Table 5 61 N/A Jan 07 Hull City Council & NHS Hull 

Table 6 63 Oct 2010 Jan 11 PCIS 


Table 8 64 Apr 2010 May 10 PCIS 



Table 11 71 mid-year 2009 Jan 11 ONS 






Table 17 83 2007 – 2008 May 10 PCIS 

Table 18 84 2007 – 2008 May 10 PCIS 

Table 19 85 2007 – 2008 May 10 PCIS 

Table 20 86 2007 – 2008 May 10 PCIS 

Table 21 87 2007 – 2008 May 10 PCIS 








Table 29 100 2008 Jan 10 Compendium 

Table 30 102 2002 – 2009 Dec 10 Compendium (PHMF/PHBF for 09) 

Table 31 103 2001 – 2009 Dec 10 PHMF / PHBF 

Table 32 105 2008-2033 (2008) Sep 10 ONS 

Table 33 106 2001 Jan 07 Census 

Table 34 107 2001 Jan 07 Census 

Table 35 108 mid-2007 Feb 10 ONS 

Table 36 109 mid-2007 Feb 10 ONS 

Table 37 112 Jan-Dec 2009 Sep 10 nomis, ONS annual pop‟n survey 

Table 38 113 Jan-Dec 2009 Sep 10 nomis, ONS annual pop‟n survey 

Table 39 115 May 2009 Feb 10 DWP 

Table 40 116 May 2009 Feb 10 DWP (PCIS) 



Table 43 122 2007 – 2009 Oct 10 DoE 

Table 44 123 2008/09 Oct 10 DoE 

Table 45 125 2007 Mar 09 H&L 




updated 


Table 46 127 2009/10 Nov 10 Hull Citysafe 

Table 47 128 2009/10 Nov 10 Hull Citysafe / PCIS 

Table 48 132 2007 Mar 09 C&LG (PCIS to calc rankings) 

Table 49 135 2007 (Apr 2010) May 10 C&LG / PCIS 

Table 50 141 2009 Feb 11 CACI 




Table 54 151 2009 Jan 11 PS 

Table 55 152 2008-09 Jun 09 YP H&L 

Table 56 154 2001 Jan 07 Census (Compendium) 

Table 57 156 2008-09 Jun 09 YP H&L 

Table 58 159 2009/10 Jan 11 QOF 

Table 59 161 2009/10 Jan 11 QOF 

Table 60 162 2006/07 – 2009/10 Jan 11 QOF 

Table 61 163 2005 (2001) Jan 07 DoH, PCIS 

Table 62 165 Sept10 / Oct10 Jan 11 QMAS/PCIS (Doncaster PCT 2008) 

Table 63 168 2003 Mar 09 H&L 2003 

Table 64 169 2008-09 Jun 09 YP H&L 

Table 65 171 2009 Feb 11 (Information Centre for Health and Social Care 2010) 

Table 66 172 2008/09-2009/10 Feb 11 (Information Centre for Health and Social Care 2010) 

Table 67 173 2007 Mar 09 H&L 

Table 68 177 2008/09 Jan 11 Y&H PHO BPMA 

Table 69 178 2003 Jan 07 H&L 

Table 70 179 2003 Jan 07 H&L 

Table 71 180 2007/08 – 2009/10 Sep 10 HES / PCIS 

Table 72 183 2006 – 2008 May 10 Compendium 

Table 73 185 2007 – 2009 Jan 11 PHMF / PCIS 

Table 74 191 2001-03 & 2006-08 Jan 11 PHMF (national) / ONS (pop) 

Table 75 192 2001-03 & 2006-08 Jan 11 PHMF (national) / ONS (pop) 

Table 76 194 2006-08 Jan 11 PHMF (national) / ONS (pop) 

Table 77 195 2006-08 Jan 11 PHMF (national) / ONS (pop) 

Table 78 197 2004-06 – 2012-14 May 10 WCCDP / WCC targets 

Table 79 198 2002-06 – 2010-14 Jan 11 WCCDP / WCC targets (latest: YPHO report) 

Table 80 203 2007 – 2009 Dec 10 PHMF 



Table 83 211 2007 – 2013 May 10 WCC targets 

Table 84 213 2007 – 2009 Dec 10 PHMF / PCIS (Compendium) 


Table 86 222 2007 – 2009 Dec 10 PHMF / PCIS 

Table 87 224 2000 – 2011 May 10 Compendium / DoH trajectories 

Table 88 227 2007 Jul 09 PHMF / PCIS 

Table 89 228 2006-2008 May 10 Compendium 

Table 90 230 2007 – 2009 Dec 10 PHMF 

Table 91 234 2007 May 09 H&L / PCIS 





updated 




Table 95 238 2008 Jun 09 YP H&L / PCIS 

Table 96 245 2002 Mar 09 ASH 

Table 97 248 2003-04,07-09 / 08 Jan 11 H&L, SC, PS / GLS 

Table 98 252 2008-09 Jun 09 YP H&L 

Table 99 253 2008-09 / 2008 Jun 09 YP H&L / HSE 

Table 100 254 2002 & 2008 Jun 09 YP H&L 

Table 101 256 2009 Dec 10 ASH / PHMF 

Table 102 262 2009/2010 Feb 11 IC-SSS 

Table 103 263 2009/2010 Feb 11 IC-ISS 

Table 104 264 2006/07 – 2009/10 Feb 11 IC-SSS 




Table 108 269 2003-2005 Nov 09 IC-SSS/PHMF/PCIS/ASH 

Table 109 277 2007 / 2009 Jan 11 H&L / PS (Spencer, Appleby et al. 2002) 



Table 112 281 2008/09 Jan 11 SystmOne 

Table 113 282 1999/00 – 2008/09 Jan 11 CHS / SystmOne 


Table 115 285 2008/09 Jan 11 SystmOne 



Table 118 289 2001/02, 2007/08 Aug 09 CHS 

Table 119 289 2001/02, 2007/08 Aug 09 CHS 

Table 120 291 2001/02, 2007/08 Aug 09 CHS 

Table 121 291 2001/02, 2007/08 Aug 09 CHS 

Table 122 304 2008/09 – 2011/13 Jun 09 WCC 

Table 123 308 2007 / 2009 Jan 11 H&L / PS 

Table 124 309 2007 / 2009 Jan 11 H&L / PS 

Table 125 309 2007 / 2009 Jan 11 H&L / PS 

Table 126 314 2008-09 Jun 09 YP H&L 

Table 127 315 2003 Jan 07 H&L 

Table 128 321 2009 Nov 09 CPAS 

Table 129 322 2009 / 2007 Nov 09 CPAS / H&L 

Table 130 323 2009 / 2007 Nov 09 CPAS / H&L 

Table 131 327 2007 / 2009 Jan 11 H&L / PS 

Table 132 327 2009 Jan 11 PS 

Table 133 328 2009 Jan 11 PS 

Table 134 328 2008-09 Jun 09 YP H&L 

Table 135 329 2008-09 Jun 09 YP H&L 

Table 136 329 2008-09 Jun 09 YP H&L 

Table 137 331 2008 / 2009 Jan 11 HSE / PS 

Table 138 332 2009 Jan 11 PS 

Table 139 332 2009 Jan 11 PS 




updated 


Table 140 335 2008-09 Jun 09 YP H&L 

Table 141 336 2007 Jun 09 HSE 

Table 142 348 2005-08 / 2003-09 Jan 11 HSE / H&L & PS 

Table 143 348 2005-08 / 2003-09 Jan 11 HSE / H&L & PS 

Table 144 349 2009 Feb 11 PS 

Table 145 349 2009 / 2008 Jan 11 PS / HSE 

Table 146 350 2009 Feb 11 PS 

Table 147 355 2008-09 Jul 09 YP H&L 

Table 148 356 2008-09 Jul 09 YP H&L 

Table 149 359 2008-09 Jul 09 YP H&L 

Table 150 360 2006/07 – 2008/09 Jul 09 HES 

Table 151 360 2006/07 – 2008/09 Jul 09 HES / PCIS 

Table 152 361 2006 – 2008 Oct 10 Compendium 


Table 154 368 2006/07 & 2008/09 Jan 11 

(Hay, Gannon et al. 2006) & (Hull Community 

Safety Partnership 2011) 

Table 155 369 2008/09 Jan 11 (Hull Community Safety Partnership 2011) 

Table 156 370 2008-09 Jul 09 YP H&L 

Table 157 371 2008-09 Jul 09 YP H&L 

Table 158 374 2008-09 Jul 09 YP H&L 

Table 159 374 2008-09 Jul 09 YP H&L 

Table 160 377 2007 Jul 09 H&L 

Table 161 379 2007 Jul 09 H&L 

Table 162 381 2008-09 Jul 09 YP H&L 

Table 163 383 2008-09 Jul 09 YP H&L 

Table 164 386 2006 Jul 09 HH 

Table 165 387 2005 Jul 09 

(British Cardiac Society, British Hypertension 

Society et al. 2005) 

Table 166 387 2006 Jul 09 HH 

Table 167 388 N/A Jan 07 www.immunisation.nhs.uk/ 

Table 168 389 2009/10 Jan 11 IC-V 

Table 169 396 2009/10 Jan 11 IC-V 

Table 170 403 2009/10 Jan 11 IC-V 

Table 171 410 2008/2009 Dec 09 SystmOne 



Table 174 412 N/A Feb 11 (Department of Health 2010) 

Table 175 413 2006/07, 2007/08 Oct 09 WCCDP 

Table 176 414 2009/10 Jan 11 IC-V 

Table 177 415 2007/2008 Oct 09 (Begum and Pebody 2008) 

Table 178 416 2007/08 – 2009/10 Feb 11 (Information Centre for Health and Social Care 2009) 

Table 179 422 2005/06 – 2009/10 Jan 11 (Information Centre for Health and Social Care 2009) 

Table 180 430 Jan-Oct 2010 Feb 11 HEYBCSC 

Table 181 431 Jan-Oct 2010 Feb 11 HEYBCSC 

Table 182 435 2009/10 Jan 11 QOF 

Table 183 437 2009/10 Jan 11 QOF 

Table 184 439 2007/08 – 2009/10 Sep 10 HES 





updated 






Table 190 445 2007 – 2011 Jul 09 LAA2, Compendium 


Table 192 447 2009/10 Jan 11 QOF 

Table 193 448 2004/05 – 2009/10 Jan 11 QOF 









Table 202 459 2009/10 Sep 10 QMAS / PCIS 

Table 203 465 1995-97 – 2011-13 Oct 09 WCC, Compendium 

Table 204 466 2009/10 Jan 11 QOF 

Table 205 467 2004/05 – 2009/10 Jan 11 QOF 







Table 212 476 2008/09 Jul 09 QMAS / PCIS 

Table 213 483 1995-97 – 2011-13 Oct 09 WCC 

Table 214 484 2009/10 Jan 11 QOF 

Table 215 485 2006/07 – 2009/10 Jan 11 QOF 


Table 217 489 2009/10 Jan 11 QOF 

Table 218 490 2006/07 – 2009/10 Jan 11 QOF 


Table 220 494 2009/10 Jan 11 QOF 

Table 221 495 2004/05 – 2009/10 Jan 11 QOF 


Table 223 501 N/A Jun 09 Cancer 

Table 224 503 2004 – 2006 Jul 09 Compendium 

Table 225 503 2006 – 2008 Dec 10 NYCRIS 





Table 230 506 2009/10 Jan 11 QOF 

Table 231 508 2009/10 Jan 11 QOF 

Table 232 509 2004/05 – 2009/10 Jan 11 QOF 




updated 


Table 233 511 2007/08 – 2009/10 Sep 10 HES 






Table 239 521 1999 – 2003 (+1yr) Oct 09 NYCRIS 


Table 241 525 2009/10 Sep 10 QMAS (PCIS) 

Table 242 531 1995 – 2011 Aug 09 Compendium / WCC 








Table 250 545 2004-2008 Nov 09 PHMF / PCIS 

Table 251 546 Oct 08 Nov 09 CACI 

Table 252 547 2004-2008 Nov 09 PHMF / PCIS / CACI 


















Table 270 565 2009/10 Jan 11 QOF 

Table 271 567 2009/10 Jan 11 QOF 

Table 272 568 2004/05 – 2009/10 Jan 11 QOF 

Table 273 570 Sept10 / Oct10 Jan 11 QMAS/PCIS (PBS model) 






Table 279 581 2009/10 Sep 10 QMAS (PCIS) 




updated 


Table 280 585 2004-2007 Aug 09 QOF/PBS/HES/PHMF/PCMD/PCIS 

Table 281 586 2009/10 Jan 11 QOF 

Table 282 589 2009/10 Jan 11 QOF 


Table 284 591 2009/10 Jan 11 QOF 

Table 285 593 2009/10 Jan 11 QOF 

Table 286 594 2006/07 – 2009/10 Jan 11 QOF 


Table 288 599 2009/10 Jan 11 QOF 





Table 293 607 2009/10 Jan 11 QOF 

Table 294 608 2004/05 – 2009/10 Jan 11 QOF 


Table 296 614 2009/10 Jan 11 QOF 

Table 297 615 2004/05 – 2009/10 Jan 11 QOF 







Table 304 626 2009/10 Sep 10 QMAS, PCIS 

Table 305 632 2006/07 – 2012/13 Sep 09 QOF / QMAS, WCC 

Table 306 633 2009/10 Jan 11 QOF 

Table 307 635 2009/10 Jan 11 QOF 

Table 308 636 2004/05 – 2009/10 Jan 11 QOF 


Table 310 640 2009/10 Jan 11 QOF 

Table 311 642 2009/10 Jan 11 QOF 

Table 312 643 2004/05 – 2009/10 Jan 11 QOF 


Table 314 648 2009/10 Jan 11 QOF 

Table 315 650 2009/10 Jan 11 QOF 

Table 316 651 2006/07 – 2009/10 Jan 11 QOF 


Table 318 659 2009 Jan 11 SC 

Table 319 660 2009 Jan 11 SC 

Table 320 664 2009 Jan 11 SC 

Table 321 665 2009 Jan 11 SC 

Table 322 666 2009 Jan 11 SC 

Table 323 667 2009 Jan 11 SC 

Table 324 668 2009/10 Jan 11 QOF 

Table 325 674 2007 Sep 09 H&L 

Table 326 675 2009 Sep 09 SC 




updated 


Table 327 678 2005 (1991-1992) Jan 07 RCGP, OPCS, DoH / PCIS 

Table 328 679 1991 – 1992 Jan 07 RCGP, OPCS, DoH 

Table 329 680 2004 Jan 07 MHCYPGB 

Table 330 680 2005 (2004) Jan 07 MHCYPGB / PCIS 

Table 331 682 1997 (2007) Feb 11 Prisoner MH 


Table 333 694 2009/10 Jan 11 QOF 

Table 334 695 2006/07 to 2009/10 Jan 11 QOF 


Table 336 699 2009/10 Jan 11 QOF 

Table 337 700 2004/05 to 2009/10 Jan 11 QOF 


Table 339 705 2007/08 – 2009/10 Sep 10 HES 

Table 340 706 2007 – 2009 Dec 10 PHMF 


Table 342 707 2006 – 2008 Dec 10 Compendium 








Table 350 715 2002 – 2003 Jan 07 Conifer House / LSHSAP 

Table 351 716 1996 – 2007 Oct 09 HPA (local) 

Table 352 716 2008/09 – 2009/10 Jan 11 NCSP 

Table 353 717 2006/07 – 2009/10 Jan 11 WCCDP and CQC 

Table 354 719 2009 Feb 11 ONS 

Table 355 719 2004-2006 Sep 09 Compendium 



Table 358 726 1994-8, 2008, 2009 Jan 11 Department for Transport 

Table 359 727 1994-8, 2008, 2009 Jan 11 Department for Transport 

Table 360 727 2009 Jan 11 Department for Transport 

Table 361 728 2009 Jan 11 Department for Transport 

Table 362 729 2006 – 2008 Jan 11 Compendium 




Table 366 734 Feb09 – May09 Oct 09 SystmOne 

Table 367 735 Feb09 – May09 Oct 09 SystmOne, C&LG (IMD) 

Table 368 735 Feb09 – May09 Oct 09 SystmOne 

Table 369 736 Feb09 – May09 Oct 09 SystmOne / CACI 

Table 370 737 2010-2030 (2008) Oct 10 POPPI (ONS) / PCIS 

Table 371 738 2010-2030 (2008) Oct 10 POPPI (ONS) 

Table 372 738 2008 Oct 10 POPPI (DWP) 

Table 373 739 2001 Oct 10 POPPI (Census) 




updated 


Table 374 739 2001 Oct 10 POPPI (Census) 

Table 375 739 2006-31 (2006) Oct 10 POPPI (Census) 

Table 376 740 2006-31 (2006) Oct 10 POPPI (Communities and Local Government 2009) 

Table 377 741 2010-25 (2007) Oct 10 POPPI (Economic and Social Data Service 2008) 










Table 387 746 2010-30 (2004) Oct 10 POPPI (Emerson and Hatton 2004) 

Table 388 747 2010-30 (2007) Oct 10 POPPI (McDougall, Kvaal et al. 2007) 

Table 389 748 2010-30 (2007) Oct 10 POPPI (Dementia UK 2007) 




Table 393 750 2010-30 (2006) Oct 10 POPPI (Health Survey for England 2008) 


Table 395 751 2010-30 (2003) Oct 10 POPPI (Scuffham, Chaplin et al. 2003) 


Table 397 752 2010-30 (2006) Oct 10 POPPI (Charles 2006) 

Table 398 753 2010-30 (95/07) Oct 10 POPPI (Davis 1995; Davis 2007) 


Table 400 754 2010-30 (2008/9) Oct 10 POPPI (NASCIS) 

Table 401 754 2010-30 (2008/9) Oct 10 POPPI (NASCIS-RAP) 




Table 405 756 2010-30 (2008/9) Oct 10 POPPI (NASCIS social care data) 

Table 406 756 2007/08 – 2009/10 Oct 10 HES / PCIS 



13.7.2 Figures 


updated 


Figure 1 30 2008/09 Jan 11 Y&H PHO BPMA 



Figure 4 48 Apr 2010 Sep 10 PCIS (C&LG) 

Figure 5 57 N/A Dec 08 ONS maps 



Figure 8 60 N/A Mar 11 Dotted Eyes / ONS maps 

Figure 9 62 N/A Dec 08 ONS maps (Hull City Council & NHS Hull) 

Figure 10 66 Apr 2010 May 10 PCIS / ONS maps 

Figure 11 68 Oct 2010 Jan 11 PCIS 




Figure 15 77 Oct 2010 / 2009 Jan 11 PCIS / ONS 







Figure 22 90 2007 Jan 11 YHPHO / ONS maps 


Figure 24 101 2005 – 2008 Feb 10 Compendium 

Figure 25 104 2008-2033 (2008) Sep 10 ONS 

Figure 26 124 2007 Mar 09 H&L 

Figure 27 130 2009/2010 Nov 10 Hull Citysafe / ONS maps 

Figure 28 133 2007 Mar 09 C&LG (IMD) / ONS maps 

Figure 29 134 2007 Mar 09 C&LG (IMD) / ONS maps 

Figure 30 139 2009 Feb 11 CACI 




Figure 34 150 2009 Jan 11 PS 

Figure 35 153 2009 Jan 11 PS / C&LG (IMD) 

Figure 36 154 2009 Jan 11 PS 

Figure 37 155 2009 Jan 11 PS 

Figure 38 155 2009 Jan 11 PS 

Figure 39 157 2009 Jan 11 PS / C&LG (IMD) 

Figure 40 168 2003 Jan 07 H&L 

Figure 41 169 2008-09 Jun 09 YP H&L 

Figure 42 170 2003 Jan 07 H&L / C&LG (IMD) 

Figure 43 174 2007 May 09 H&L 

Figure 44 175 2007 Jan 11 H&L / BME H&L 





updated 


Figure 46 182 1991-93 – 2006-08 May 10 Compendium 


Figure 48 184 2007 – 2009 Jan 11 PHMF / PCIS 

Figure 49 184 2007 – 2009 Jan 11 PHMF / PCIS 

Figure 50 186 2006 – 2008 Jan 11 Compendium 

Figure 51 186 2006 – 2008 Jan 11 Compendium 

Figure 52 187 1999-01 – 2007-09 Jan 11 PHMF / PCIS 

Figure 53 187 1999-01 – 2007-09 Jan 11 PHMF / PCIS 

Figure 54 189 2006-08 Jan 11 PHMF (national) / ONS (pop) 

Figure 55 189 2006-08 Jan 11 PHMF (national) / ONS (pop) 

Figure 56 200 2007 – 2009 Dec 10 PHMF 








Figure 64 205 2005 – 2007 May 09 PHMF 





Figure 69 215 2007 – 2009 Dec 10 PHMF / PCIS (Compendium) 

Figure 70 217 2001-03 – 2006-08 Jan 11 PHMF (national) / ONS (pop) 




Figure 74 224 2000 – 2011 May 10 Compendium / DoH trajectories 

Figure 75 232 2007/08 Apr 10 National Energy Action 

Figure 76 232 2004/05 – 2008/09 Dec 10 PHMF, C&LG (IMD) 

Figure 77 244 2009 Jan 11 SC 

Figure 78 246 1998 – 2008 Jan 11 GLS 

Figure 79 247 2009 Jan 11 PS 

Figure 80 250 2009 Jan 11 PS / SC 



Figure 83 255 2009/2010 Jan 11 DoH 

Figure 84 257 2009 Jan 11 PS, C&LG (IMD) 

Figure 85 258 2001-2008 Jan 11 GLS 


Figure 87 265 2006/07 – 2009/10 Feb 11 IC-SSS 



Figure 90 275 2008 / 2009 Jan 11 HSE / PS (Spencer, Appleby et al. 2002) 

Figure 91 276 2008 / 2009 Jan 11 HSE / PS (Spencer, Appleby et al. 2002) 





updated 




Figure 95 282 1999/00 – 2008/09 Jan 11 CHS / SystmOne 




Figure 99 289 2001/02, 2007/08 Aug 09 CHS 

Figure 100 290 2001/02, 2007/08 Aug 09 CHS 

Figure 101 292 1999/01, 2005/07 Dec 07 CHS 

Figure 102 293 1999/01, 2005/07 Dec 07 CHS 



Figure 105 299 2010 Jan 11 SPoA service / ONS maps 

Figure 106 301 2006 Nov 09 SSC 

Figure 107 302 2009 Jan 11 FF 

Figure 108 307 2008 / 2009 Jan 11 HSE / PS 


Figure 110 310 2009 Feb 11 H&L / SC 











Figure 121 333 2009 Feb 11 PS / SC 




Figure 125 339 2003 Jan 07 H&L, C&LG (IMD) 


Figure 127 343 2009 Jan 11 SC 

Figure 128 344 2009 Jan 11 SC 

Figure 129 345 2003 / 2009 Jan 11 H&L / PS 






Figure 135 351 2007 Feb 11 H&L 

Figure 136 351 2007 Feb 11 H&L 

Figure 137 352 2009 Jan 11 SC 

Figure 138 354 2008-09 Jul 09 YP H&L 

Figure 139 355 2008-09/2008 Jul 09 YP H&L / PCIS 




updated 





Figure 143 363 2009 Jan 11 PS 

Figure 144 364 2009 Jan 11 PS 

Figure 145 368 2008/09 Jan 11 (Hull Community Safety Partnership 2011) 




Figure 149 375 2002&08-/2001&07 Jul 09 YP H&L / HSE 

Figure 150 378 2007 Jul 09 H&L 

Figure 151 380 2007 Jul 09 H&L 

Figure 152 385 2008-09 Aug 09 YP H&L 

Figure 153 390 2008/2009 Dec 09 SystmOne 


















Figure 171 417 2005/06 – 2009/10 Feb 11 PCIS 



Figure 174 423 2005/06 – 2009/10 Jan 11 PCIS 





Figure 179 428 2005/06 – 2009/10 Feb 11 PCIS, C&LG (IMD) 

Figure 180 428 2005/06 – 2009/10 Jan 11 PCIS, C&LG (IMD) 


Figure 182 431 Jan-Sep 2010 Feb 11 HEYBCSC 



Figure 185 442 1993-95 – 2006-08 Oct 10 Compendium 





updated 


Figure 187 459 2009/10 Sep 10 QMAS / PCIS / C&LG (IMD) 

Figure 188 460 2007/08 – 2009/10 Sep 10 HES / PCIS / C&LG (IMD) 


Figure 190 462 2007 – 2009 Dec 10 PHMF (PCIS) / C&LG (IMD) 








Figure 198 517 2006 – 2008 Oct 10 Compendium 










Figure 208 530 2001 – 2003 Jan 07 NYCRIS & PHMF / PCIS 

Figure 209 534 2005–2007 / 2007 Aug 09 PHMF / PCIS and H&L 














Figure 223 583 2007-2009 Dec 10 PHMF (PCIS) / C&LG (IMD) 

Figure 224 613 2005-2007 / 2007 Aug 09 PHMF / PCIS and H&L 







Figure 231 657 2009 Jan 11 SC 

Figure 232 658 2009 Jan 11 SC 

Figure 233 661 2009 Jan 11 SC 




updated 


Figure 234 662 2009 Jan 11 SC 

Figure 235 663 2009 Jan 11 SC 

Figure 236 670 2008-09 Nov 09 YP H&L 

Figure 237 671 2008-09 Nov 09 YP H&L 

Figure 238 672 2007 Sep 09 H&L 

Figure 239 673 2007 Sep 09 H&L 

Figure 240 676 May 2009 Oct 10 DWP (PCIS) 



Figure 243 711 2007 – 2009 Dec 10 PHMF (PCIS) 

Figure 244 718 1998 – 2009 Feb 11 ONS 

Figure 245 721 2008 Nov 09 HES (Births/Abortions) 




Figure 249 733 2009/2010 Jan 11 (Department of Health 2010) 

Figure 250 757 2007/08 – 2009/10 Oct 10 HES / PCIS / C&LG (IMD) 



14 INDEX 

10-year risk of cardiovascular event 

definitions ................................................... 810 

prevalence .................................................. 386 

5-A-DAY 

and deprivation ........................................... 338 

and employment status .............................. 340 

prevalence in 

adults ..................................................... 330 

young people ......................................... 335 

Abbreviations .................... 55, Also see Glossary 

Abdominal aortic aneurysm ............................ 500 

mortality ...................................................... 500 

risk factors .................................................. 500 

screening .................................................... 433 

Abortions......................................................... 712 

About this document ......................................... 42 

Accidents ........................................................ 723 

inpatient admissions and deprivation ......... 724 

traffic ........................................................... 725 

young people .............................................. 723 

ACORN ........................................................... 138 

and breastfeeding ...................................... 734 

and lung cancer .......................................... 545 

population migration ..................................... 88 

Activity ............................................ See Exercise 

Admissions .................. See Inpatient admissions 

Age of mothers ............................................... 101 

Age of patients at practice level ....................... 98 

Ageing population ....................... See Predictions 

AIDS ............................................................... 714 

Alcohol ............................................................ 342 


and employment status .............................. 364 

as a risk factor ............................................ 342 

attitudes/effect on health .................... 244, 362 

definitions ........................................... 807, 813 

factors predicting alcohol consumption ...... 364 

ill effects in young people after drinking ..... 356 

inpatient admissions ................................... 359 

knowledge of guideline limits ..................... 343 

mortality ...................................................... 361 

national recommendations ......................... 342 

prevalence in 

adults ..................................................... 344 

young people ......................................... 353 

social marketing ......................................... 364 

strategy ....................................................... 365 

targets ........................................................ 365 

All age all cause mortality rate 

problems with achieving targets ................. 223 

progress towards targets ............................ 223 

Angiography ................................................... 452 


Appendix ........................................................ 788 

Area committee areas ...................................... 61 

Areas and maps 

area committee areas .................................. 61 

localities ....................................................... 61 

wards ........................................................... 61 

Asthma ........................................................... 607 

expenditure ................................................ 611 

modelled prevalence ................................. 609 

prevalence ......................................... 599, 607 

Asylum seekers 

mental health ............................................. 672 

Atlas 

interactive atlas for Hull ............................... 60 

Atrial fibrillation ............................................... 489 

expenditure ................................................ 493 


prevalence ......................................... 434, 489 

Attitudes to health 

findings ...................................................... 794 

Attitudes to risk and lifestyle risk factors ........ 244 

Benchmarking .................................................. 44 

comparator areas ........................................ 44 

general practices ......................................... 47 

Benefit claimants 

all benefits ................................................. 114 

mental health ............................................. 675 

predictions for older people ....................... 738 

Birth weight low .............................................. 730 

Births 

number ...................................................... 102 

Black and minority ethnic groups .......... See BME 

Blind 

predictions of future need .......................... 752 

BME 

and breastfeeding ...................................... 734 

asylum seekers .......................................... 672 

child vaccination rates ............................... 410 

health and lifestyle survey ......................... 790 

risk factor prevalence ................................ 239 

Body mass index............................................ 805 

Bowel cancer .................... See Colorectal cancer 

Breast cancer ................................................. 557 

expenditure ................................................ 563 

influences on screening ............................. 426 

inpatient admissions .................................. 557 

inpatient admissions and deprivation ........ 562 

mortality ..................................................... 558 

mortality and deprivation ........................... 563 

risk factors ................................................. 557 

screening ................................................... 416 

screening targets ....................................... 420 

survival....................................................... 561 



Breastfeeding 

and ACORN ............................................... 734 


and ethnicity ............................................... 734 

factors influencing rates ............................. 734 

prevalance .................................................. 733 



Bronchitis 

predictions of future need ........................... 749 

Cancer ............................................................ 501 

all cancers .................................................. 501 

breast ......................................................... 557 

colorectal .................................................... 549 

equity audit ................................................. 523 

expenditure................................................. 532 

incidence .................................................... 502 



lung ............................................................. 534 

mortality ...................................................... 513 

mortality and deprivation .................... 527, 528 

mortality by cancer site .............................. 516 

outcomes .................................................... 532 

prevalence .................................................. 506 

prevalence and deprivation ........................ 524 

programme budgeting ................................ 532 


prostate ...................................................... 554 

risk factors .................................................. 501 

survival ....................................................... 521 

survival and deprivation ............................. 529 

targets ........................................420, 425, 433 

Car accidents .................................................. 725 

Care homes 


Caring for others ............................................. 167 


predictions of future need ................... 741, 754 

Causes of death 

by age ......................................................... 205 

detailed ....................................................... 203 

pie charts .................................................... 199 

Cervical cancer 

influences on screening ............................. 426 

screening .................................................... 421 

screening targets ........................................ 425 

CHD 

equity audit ................................................. 458 

expenditure................................................. 465 



modelled prevalence .................................. 449 

mortality ...................................................... 455 



prevalence ......................................... 434, 447 

prevalence and deprivation ....................... 458 

progress towards targets ........................... 464 

treatment ................................................... 452 

treatment and deprivation .......................... 460 

Child vaccinations .................... See Vaccinations 

Children ................................... See Young people 

Chlamydia .............................................. 714, 716 

Chronic kidney disease .................................. 591 


prevalence ................................................. 591 

Chronic obstructive pulmonary disease ......... See 

COPD 

Circulatory disease ........................................ 434 

expenditure ................................................ 445 


mortality ..................................................... 441 

outcomes ................................................... 445 

prevalence ................................................. 434 

programme budgeting ............................... 445 


risk factors ................................................. 434 

Civic engagement .......................................... 658 

Classifications .................................. See ACORN 

Colorectal cancer ........................................... 549 


mortality ..................................................... 550 


risk factors ................................................. 549 

screening ................................................... 430 

screening targets ....................................... 433 

survival....................................................... 552 

Combined risk factors 

prevalence 

adults ..................................................... 376 

young people ......................................... 380 

Commissoning of services ............................... 26 

Communities for health programme .............. 804 

Comparator areas ............................................ 44 

more information ........................................ 814 

Conception rate 

under 16s ................................................... 718 

under 18s ................................................... 718 

progress towards targets ....................... 722 

Confidence intervals 

explained ................................................... 775 

Confounding 

explained ................................................... 772 

Consortia .................................................... 26, 52 

Contents page .................................................... 3 

Cookery 

and young people ...................................... 329 

Cookery skills 

services ..................................................... 341 

COPD ............................................................. 612 

definition .................................................... 612 



equity audit ................................................. 625 

expenditure................................................. 632 




mortality ...................................................... 621 



prevalence .......................................... 599, 613 



risk factors .................................................. 612 


Coronary artery bypass graft .......................... 452 


Coronary heart disease ........................ See CHD 

Crime .............................................................. 126 

Cumulative plots 

causes of death .......................................... 205 

Data sources 

for each table/figure ................................... 944 

general ....................................................... 788 

Data underlying figures ................................... 814 

Date last updated 

tables and figures ....................................... 944 

Daycases ..................... See Inpatient admissions 

Deaf 


Deaths 

number ....................................................... 102 

occurrence versus registration ................... 778 

Deaths at home .............................................. 228 

Decent homes standard ................................. 121 

Definitions ....................................................... 805 

10-year risk of cardiovascular event .......... 810 

alcohol ................................................ 807, 813 

cause of death ............................................ 811 

COPD ......................................................... 612 

exercise ...................................................... 808 

ICD ............................................................. 811 

obesity ................................................ 273, 805 

social capital ............................................... 656 

surgical codes ............................................ 813 

Dementia 



mortality ...................................................... 706 

mortality and deprivation ............................ 711 


prevalence .......................................... 667, 694 


Demography ..................................................... 63 

Dental health .................................................. 171 

expenditure................................................. 176 

outcomes .................................................... 176 


Depression 


Deprivation ..................................................... 111 

5-A-DAY .................................................... 338 

accidents and inpatient admissions ........... 724 

alcohol ....................................................... 363 

benefit claimants ........................................ 114 

breast cancer and inpatient admissions .... 562 

breast cancer and mortality ....................... 563 

cancer screening rates .............................. 427 

cancers and inpatient admissions ............. 526 

cancers and mortality ........................ 527, 528 

cancers and prevalence ............................ 524 

cancers and survival .................................. 529 

caring ......................................................... 170 

change 2004 to 2007 (IMD) ....................... 137 

CHD and inpatient admissions .................. 460 

CHD and mortality ............................. 461, 462 

CHD and prevalence ................................. 458 

CHD and treatment .................................... 460 

colorectal cancer and mortality .................. 553 

cooking with fat .......................................... 339 

COPD and inpatient admissions ............... 627 

COPD and mortality ........................... 628, 629 

COPD and prevalence............................... 625 

dementia and mortality .............................. 711 

dementia and prevalence .......................... 708 

diabetes and inpatient admissions ............ 582 

diabetes and measures of need ................ 583 

diabetes and mortality ............................... 583 

diabetes and prevalence ........................... 580 

diet ............................................................. 338 

exercise ..................................................... 316 

fractured neck of femur and inpatient 

admissions ............................................ 757 

general health ............................................ 153 

IMD ............................................................ 131 

Index of multiple deprivation ...................... 131 

life expectancy ................................... 185, 188 

limiting long-term illness and disability ...... 157 

lung cancer and inpatient admissions ....... 541 

lung cancer and mortality .................. 542, 543 

mental health and mortality ....................... 711 

mental health and prevalence ................... 708 

mortality rates .................................... 214, 215 

obesity ....................................................... 294 

prostate cancer and mortality .................... 556 

smoking ..................................................... 257 

stroke and inpatient admissions ................ 477 

stroke and mortality ........................... 478, 479 

stroke and prevalence ............................... 476 

substance abuse and mortality .................. 711 

suicide and mortality .................................. 711 

transient ischaemic attack and prevalence 476 

Diabetes ......................................................... 564 

equity audit ................................................ 578 



expenditure................................................. 589 



modelled prevalence .......................... 569, 784 

modelled prevalence ....... Also see PBS model 

mortality ...................................................... 574 


need 

differences in measures ......................... 583 

outcomes .................................................... 589 

PBS model ......................................... 569, 784 


prevalence .................................................. 564 



programme budgeting pilot .......................... 34 


quality of care ............................................. 577 

risk factors .................................................. 564 

survey ......................................................... 578 

Diet ................................................................. 326 

5-A-DAY ..................................................... 330 

advice and cookery skills ........................... 341 


as a risk factor ............................................ 326 


cookery and young people ......................... 329 

cooking with fat and deprivation ................. 339 

difficulty in measuring ................................. 326 

factors predicting diet ......................... 336, 340 

food items eaten 

young people ......................................... 336 


targets ........................................................ 341 

Diet ..................................... Also see Healthy diet 

Diet ......................................... Also see 5-A-DAY 

Dietary advice 

services ...................................................... 341 

Diphtheria .............................................. See DTP 

Direct standardisation 

explained .................................................... 773 

Directly standardised mortality rate ....... See DSR 

Disease registers .................................. See QOF 

Drug use ........................... See Substance abuse 

Drunk 

ill effects in young people after drinking 

alcohol .................................................... 356 

DSR 

explained .................................................... 773 

DTP ................................................................. 388 

Education 

health impact assessments ........................ 802 

Educational attainment ........................... 121, 124 

Effect modification 

explained .................................................... 772 

Emphysema 



and 5-A-DAY ............................................. 340 

and alcohol ................................................ 364 

and exercise .............................................. 317 

and obesity ................................................ 295 

and smoking .............................................. 258 

Engagement in community ............................ 658 

Epilepsy ......................................................... 633 


prevalence ................................................. 633 

Equity audit ...................................................... 27 

cancer ........................................................ 523 

CHD ........................................................... 458 

COPD ........................................................ 625 

diabetes ..................................................... 578 

hypertension .............................................. 499 

mental health ............................................. 683 

stroke ......................................................... 475 

Ethnicity ................................. 106, Also see BME 

Evaluation 

of exercise programmes ............................ 319 

of weight loss services............................... 298 

Evaluation SF-36v2 TM .................................... 300 

Excess winter mortality .................................. 231 

Executive summary.......................................... 16 

Exercise 

and deprivation .......................................... 316 

and employment status ............................. 317 

as a risk factor ........................................... 306 

attitudes/effect on health ................... 244, 316 

definitions .................................................. 808 

evaluation of services ................................ 319 

factors predicting exercise levels .............. 318 

prevalence in 

adults ..................................................... 306 

young people ......................................... 313 

reasons for not exercising ......................... 315 

services ..................................................... 319 


strategy ...................................................... 324 

targets ........................................................ 325 

Expenditure ...................................................... 28 

Expenditure ........ Also see Programme budgeting 

Eye visual impairment 


Falls 

fractured neck of femur.............................. 756 

fractured neck of femur and deprivation .... 757 


Fertility ........................................................... 100 

age of mothers ........................................... 101 

total period fertility rate .............................. 100 

Figures 

date last updated ....................................... 956 

date sources .............................................. 956 



underlying data ........................................... 814 

Financial expenditure ....................................... 28 

Financial expenditure ........................................... 

...................... Also see Programme budgeting 

Fractured neck of femurs ................................ 756 

Fruit and vegetable consumption ... See 5-A-DAY 

General health ................................................ 150 


self-rated .................................................... 150 

General practice 

benchmarking ............................................... 47 

child vaccination rates ................................ 388 

consortia ................................................. 26, 52 

deprivation .................................................. 134 

groupings ...................................................... 47 

IMD ............................................................. 134 

list sizes ........................................................ 97 

location map ................................................. 66 

mean age of patients .................................... 98 

screening rates 

breast cancer ......................................... 416 

cervical cancer ....................................... 421 

colorectal cancer .................................... 430 

Geographical area ...................................... 44, 57 

Geosegmentation ............................ See ACORN 

Goal areas ............................................ See WCC 

Gonorrhoea .................................................... 714 

GP consortia ............................................... 26, 52 

GP consultations 

mental health .............................................. 677 

GP disease registers ............................ See QOF 

Grouping of general practices .......................... 47 

Gypsy and Travellers 

health and lifestyle survey .......................... 790 

risk factor prevalence ................................. 242 

Health ACORN ................................ See ACORN 

Health and lifestyle surveys ............................ 790 

Health and wellbeing strategic delivery 

partnership ................................................. 803 

Health equity audit ..................... See Equity audit 

Health impact assessments............................ 802 

Health needs assessment ................................ 27 

Health needs assessments 

young people ...................................... 736, 802 

Health utility index 

emotional health ......................................... 671 

Healthcare commission survey ...................... 578 

Healthcare useage ......................................... 170 

Healthy diet 

prevalence in 

adults ..................................................... 327 

young people ......................................... 328 

Healthy heart study ......................................... 386 

Hearing impairment 


Heart failure .................................................... 484 


mortality ..................................................... 488 

prevalence ......................................... 434, 484 

HIV ................................................................. 714 

Hospital admissions ..... See Inpatient admissions 

Hospital episode statistics 

explained ................................................... 781 

Housing 

health impact assessments ....................... 802 

stock and decent home standard .............. 121 

Hypertension .................................................. 494 

equity audit ................................................ 499 


prevalence ......................................... 434, 494 

Hypothyroidism .............................................. 640 


prevalence ................................................. 640 

ICD ................................................................. 811 

IMD ................................................................ 131 

areas .......................................................... 131 

change 2004 to 2007 ................................. 137 

differences in 

mortality .............................. See Deprivation 

risk factors .......................... See Deprivation 

general practices ....................................... 134 

localities ..................................................... 131 

lower layer super output level .................... 131 

national ranks ............................................ 131 

quintiles ..................................................... 131 

wards ......................................................... 131 

Immunisation ............................ See Vaccinations 

Impact of lifestyle risk factors on health ......... 244 

Incapacity benefit .............. See Benefit claimants 

Incidence 

cancers ...................................................... 502 

childhood diseases .................................... 731 

measles ..................................................... 731 

whooping cough ........................................ 732 

Incontinence 


Index of multiple deprivation .................. See IMD 

Indirect standardisation 

explained ................................................... 773 

Inequity .......................................................... 111 

Infant mortality ............................................... 209 

Influenza vaccination ..................................... 413 

targets ........................................................ 414 

Inpatient admissions ...................................... 179 

accidents and deprivation .......................... 724 

accidents in young people ......................... 723 

alcohol-related ........................................... 359 

breast cancer ............................................. 557 

breast cancer and deprivation ................... 562 

cancers ...................................................... 510 

cancers and deprivation ............................ 526 

CHD ........................................................... 452 



CHD and deprivation .................................. 460 

circulatory disease ..................................... 438 

colorectal cancer ........................................ 549 

COPD ......................................................... 619 

COPD and deprivation ............................... 627 

data explained ............................................ 781 

diabetes ...................................................... 573 

diabetes and deprivation ............................ 582 

fractured neck of femur .............................. 756 

fractured neck of femur and deprivation .... 757 

lung cancer ................................................. 535 

lung cancer and deprivation ....................... 541 

mental health .............................................. 705 

prostate cancer........................................... 554 

respiratory disease ..................................... 601 

stroke .......................................................... 471 

stroke and deprivation ................................ 477 

Instant atlas ...................................................... 60 

Interactive atlas for Hull .................................... 60 

International classification of diseases ........... 811 

Introduction ....................................................... 25 

Joint appointments ......................................... 802 

Joint strategic needs assessment ....... See JSNA 

JSNA ......................................................... 25, 802 

Learning disabilities ........................................ 158 


prevalence .................................................. 158 


Life expectancy ............................................... 181 

and deprivation ................................... 185, 188 

explained .................................................... 780 

targets ........................................................ 196 

wards .......................................................... 183 

Limiting long-term illness or disability ...... See LLI 

List sizes of general practices .......................... 97 

Listening exercise ........................................... 799 

Liver disease mortality .................................... 361 

LLI 


prevalence 

in adults .................................................. 154 

in young people...................................... 156 

LLSOAs .......................................................... 131 

Local area agreement ............................... 52, 803 

targets .......................................... See Targets 

Local stategic partnership............................... 803 

Local surveys .................................................. 790 

Localities ........................................................... 61 

Locality boards ............................................... 803 

Low birth weight .............................................. 730 

Lung cancer .................................................... 534 

ACORN ...................................................... 545 

expenditure................................................. 544 



mortality ...................................................... 536 

mortality and deprivation ................... 542, 543 

risk factors ................................................. 534 

survival....................................................... 540 

Map of Hull ....................................................... 57 

Maps 

area committee areas .................................. 61 

general practices ......................................... 66 

localities ....................................................... 61 

wards ........................................................... 59 

Measles ......................................... Also see MMR 

incidence ................................................... 731 

Median 

explained ................................................... 777 

Membership to NHS Hull ............................... 799 

Mental health ................................................. 656 

asylum seekers .......................................... 672 

benefit claimants ........................................ 675 

dementia ............................ Also see Dementia 

emotional health score .............................. 671 

equity audit ................................................ 683 

expenditure ................................................ 692 

GP consultations ....................................... 677 

health utility index ...................................... 671 


introduction ................................................ 656 

mental health index ................................... 671 

modelled prevalence 

dementia................................................ 696 

serious mental health ............................ 701 

mortality ..................................................... 706 


outcomes ................................................... 692 

prevalence 

dementia........................................ 667, 694 

GP consultations ................................... 677 

serious mental health .................... 667, 699 


prevalence in 

prisoners................................................ 681 

young people ......................................... 679 



social capital measures ............................. 657 

stress ......................................................... 674 

young people ............................................. 670 

MMR .............................................................. 388 

Mobility 


Modelled prevalence 

asthma ....................................................... 609 

atrial fibrillation ........................................... 491 

CHD ........................................................... 449 

chronic kidney disease .............................. 595 

COPD ........................................................ 616 

dementia .................................................... 696 

diabetes ............................................. 569, 784 



epilepsy ...................................................... 637 

heart failure ................................................ 486 

hypertension ............................................... 496 

hypothyroidism ........................................... 644 

mental health (serious) ............................... 701 

palliative care ............................................. 652 

stroke .......................................................... 468 

transient ischaemic attack .......................... 468 

Modelling .................................................. 28, 267 

Price Waterhouse Cooper ............................ 39 

scenario generator ....................................... 41 

Mortality 

abdominal aortic aneurysm ........................ 500 

alcohol-related ............................................ 361 

all cause mortality rates ............................. 212 

and deprivation ................................... 214, 215 

breast cancer.............................................. 558 

breast cancer and deprivation .................... 563 

by cancer site ............................................. 516 

cancers ....................................................... 513 

cancers and deprivation ..................... 527, 528 

causes of death 

by age .................................................... 205 

cumulative plots ..................................... 205 

detailed .................................................. 203 

pie charts ............................................... 199 

CHD ............................................................ 455 

CHD and deprivation .......................... 461, 462 



colorectal cancer and deprivation .............. 553 

COPD ......................................................... 621 

COPD and deprivation ....................... 628, 629 

deaths at home .......................................... 228 

dementia ..................................................... 706 

dementia and deprivation ........................... 711 

diabetes ...................................................... 574 

diabetes and deprivation ............................ 583 

due to smoking ........................................... 255 

heart failure ................................................ 488 

infants ......................................................... 209 

lung cancer ................................................. 536 

lung cancer and deprivation ............... 542, 543 

mental health .............................................. 706 

mental health and deprivation .................... 711 

occurrence versus registration ................... 778 

prostate cancer........................................... 555 

prostate cancer and deprivation ................. 556 


stroke .......................................................... 471 

stroke and deprivation ........................ 478, 479 

substance abuse ........................................ 706 

substance abuse and deprivation .............. 711 

suicide ........................................................ 706 

suicide and deprivation .............................. 711 

winter deaths .............................................. 231 

Moving average 

explained ................................................... 776 

Multiple risk factors 

prevalence in 

adults ..................................................... 376 

young people ......................................... 380 

Mumps ................................................. See MMR 

National child measurement programme ....... See 

NCMP 

NCMP ... Also see Obesity prevalence in children 

NCMP ............................................................ 280 

Neighbourliness ............................................. 659 

Networks social .............................................. 661 

NHS reorganisation.......................................... 51 

Nursing care 


Obesity 





definitions .......................................... 273, 805 


factors predicting obesity ........................... 296 


prevalence in 

adults ..................................................... 274 

children .................................................. 280 

aged 10-11 years .............................. 285 

aged 5 years ..................................... 281 

changes over time in same children . 287 

services ..................................................... 297 


strategy ...................................................... 303 

targets ........................................................ 304 

Older people ................737, Also see Predictions 

Ordering of topics....................................... 42, 50 

Overview of area .............................................. 57 

Overweight ........................................ See Obesity 

Paired analyses 

obesity in children ...................................... 287 

Pallative care ................................................. 648 


prevalence ................................................. 648 

Partnership working ....................................... 802 

project examples ....................................... 804 

Patient population ........................ See Population 

PBMA ............................................................... 28 

diabetes pilot ............................................... 34 

PBS model 

explained ................................................... 784 

phase 1 ...................................................... 569 

phase 2 ...................................................... 569 

Percentiles 

explained ................................................... 777 

Percutaneous coronary intervention .............. 452 




Performance targets ......................................... 52 

Pertussis ................................................ See DTP 

Physical activity .............................. See Exercise 

Pie charts 

causes of death .......................................... 199 

Pneumococcal vaccination ............................. 415 

POPPI .......................... 737, Also see Predictions 

Population ......................................................... 63 

change over time .......................................... 83 

change to age structure ..................... 104, 737 

density .......................................................... 90 

migration ....................................................... 83 

between areas ......................................... 84 

between localities..................................... 84 

by ACORN ............................................... 88 

by age ...................................................... 85 

by deprivation ........................................... 86 

patients ................... See Population registered 

projections .......................................... 104, 737 

pyramids ................................................. 77, 78 

registered ..................................................... 91 

for each area ............................................ 96 

for each locality .................................. 91, 96 

for each practice ...................................... 97 

registered versus resident ............................ 63 

residents ....................................................... 71 

distribution for each practice .................... 67 

for each area ............................................ 78 

for each locality .................................. 71, 78 

for each ward ........................................... 78 

pyramids ............................................ 77, 78 

structure ....................................................... 63 

Predictions 

needs for older people ............................... 737 

benefit claimants .................................... 738 

bronchitis and emphysema .................... 749 

care homes ............................................ 740 

carers who also receive a service .......... 754 

caring needs .......................................... 741 

CHD ....................................................... 748 

dementia ................................................ 747 

depression ............................................. 746 

diabetes ................................................. 749 

falls ......................................................... 750 

hearing impairment ................................ 752 

incontinence ........................................... 751 

intensive home care ............................... 755 

living alone ............................................. 740 

mobility ................................................... 744 

need help to live independently ............. 754 

nursing care ........................................... 755 

obesity .................................................... 753 

population changes ................................ 737 

residential care ....................................... 755 

respiratory disease................................. 749 

stroke ..................................................... 748 

visual impairment .................................. 752 

with learning disabilities ........................ 746 

with limiting long term illness or disability 

.......................................................... 745 

without central heating .......................... 739 

without transport .................................... 739 

Predictive modelling ................................. 28, 267 

John Hampson ............................................ 41 

Price Waterhouse Cooper ........................... 39 


Prevalence 

10-year risk of cardiovascular event .......... 386 

5-A-DAY 

adults ..................................................... 330 

young people ......................................... 335 

alcohol 

adults ..................................................... 344 

young people ......................................... 353 

asthma ............................................... 599, 607 

atrial fibrillation ................................... 434, 489 

breastfeeding ............................................. 733 

cancer ........................................................ 506 

cancer and deprivation .............................. 524 

CHD ................................................... 434, 447 

CHD and deprivation ................................. 458 

chronic kidney disease .............................. 591 


COPD ................................................ 599, 613 

COPD and deprivation............................... 625 

dementia ............................................ 667, 694 

dementia and deprivation .......................... 708 

diabetes ..................................................... 564 

diabetes and deprivation ........................... 580 

epilepsy ..................................................... 633 

exercise 

adults ..................................................... 306 

young people ......................................... 313 

healthy diet or not 

adults ..................................................... 327 

young people ......................................... 328 

heart failure ........................................ 434, 484 

hypertension ...................................... 434, 494 

hypothyroidism .......................................... 640 

limiting long-term illness or disabilty .......... 154 

mental health 

all ages .................................................. 677 

prisoners................................................ 681 

young people ......................................... 679 

mental health (serious) ...................... 667, 699 

mental health and deprivation ................... 708 

multiple risk factors 

adults ..................................................... 376 

young people ......................................... 380 

obesity ....................................................... 273 

adults ..................................................... 274 



children .................................................. 280 

palliative care ............................................. 648 

registers ............................................ See QOF 

smoking ...................................................... 246 

adults ..................................................... 246 

young people ......................................... 252 

stress .......................................................... 674 

stroke .................................................. 434, 466 

stroke and deprivation ................................ 476 

substance abuse 

adults ..................................................... 367 

prisoners ................................................ 369 

young people ......................................... 370 

transient ischaemic attack .................. 434, 466 

transient ischaemic attack and deprivation 476 

Price Waterhouse Cooper ................................ 39 

Prioritisation ...................................................... 28 

John Hampson ............................................. 41 

local model ................................................... 40 

Prisoners 

prevalence of 

mental health ......................................... 681 

substance abuse .................................... 369 

Procedure codes and surgical operations ...... 813 

Programme budgeting .......... 28, Also see PBMA 

asthma ........................................................ 611 

atrial fibrillation ........................................... 493 

breast cancer.............................................. 563 

cancers ....................................................... 532 

CHD ............................................................ 465 


COPD ......................................................... 632 

dental .......................................................... 176 

diabetes ...................................................... 589 

expenditure................................................... 28 

introduction ................................................... 28 

learning disabilities ..................................... 166 

lung cancer ................................................. 544 

mental health .............................................. 692 

quadrant charts ............................................ 31 


stroke .......................................................... 483 

Projected population estimates ...................... 104 

Projecting older people population information 

...................................................... See POPPI 

Prostate cancer .............................................. 554 


mortality ...................................................... 555 


risk factors .................................................. 554 

P-values 

explained .................................................... 774 

QMAS 

explained .................................................... 782 

QOF ..................................... Also see Prevalence 

explained .................................................... 782 

problems with comparing GPs .................. 782 

Quadrant charts ............................................... 31 

Qualifications ................................................. 124 

Qualitative research ....................................... 794 

findings ...................................................... 794 

Quality and outcomes framework ......... See QOF 

Quartiles 

explained ................................................... 777 

Quintiles 

explained ................................................... 777 

Reallocation of resources ................................ 28 

References ..................................................... 758 

Reflector groups 

findings ...................................................... 794 

Regeneration 

health impact assessments ....................... 802 

Registered population .................. See Population 

Registration of deaths .................................... 778 

Release of JSNA foundation ............................ 25 

Reorganisation of NHS .................................... 51 

Resident population ..................... See Population 

Residential care 


Resource reallocation ...................................... 28 

Respiratory disease 


Respiratory disease ....................................... 599 


mortality ..................................................... 603 




outcomes ................................................... 605 


expenditure ................................................ 605 

Respiratory disease .................. Also see Asthma 

Respiratory disease .................... Also see COPD 



Risk factors ................. 233, Also see Prevalence 

for 

abdominal aortic aneurysm ................... 500 

breast cancer ........................................ 557 

cancer .................................................... 501 

cardiovascular event ............................. 386 

circulatory disease ................................ 434 

colorectal cancer ................................... 549 

COPD .................................................... 612 

diabetes ................................................. 564 

lung cancer ............................................ 534 

prostate cancer ..................................... 554 

multiple risk factors 

adults ..................................................... 376 

young people ......................................... 380 

of 

alcohol ................................................... 342 



lack of exercise ...................................... 306 

obesity .................................................... 273 

poor diet ................................................. 326 

smoking .................................................. 245 

smoking in pregnancy ............................ 254 

perception of and attitudes to risk .............. 244 

prevalence in 

black and minority ethnic population...... 239 

Gypsy and Traveller population ............. 242 

total numbers with risk factors 

adults ............................................. 233, 376 

young people ................................. 238, 380 

Risk of cardiovascular event 

definitions ................................................... 810 

Road traffic accidents ..................................... 725 

Rubella.................................................. See MMR 

Safety (feelings of) .......................................... 657 

Scenario generator ........................................... 41 

Schools 

absence from schools ................................ 121 

cookery ....................................................... 329 

educational attainment ............................... 121 

Screening........................................................ 416 

abdominal aortic aneurysm ........................ 433 

bowel cancer .................................................... 

................. See Screening colorectal cancer 

breast cancer.............................................. 416 

cervical cancer ........................................... 421 

Chlamydia .................................................. 716 


influences on rates ..................................... 426 

Sections ...................................................... 42, 50 

Segmentation .................................. See ACORN 

Sensitivity analyses 

life expectancy............................................ 267 

Price Waterhouse Cooper ............................ 39 


smoking cessation ...................................... 267 

Services 

cookery skills improving ............................. 341 

dietary advice ............................................. 341 

exercise ...................................................... 319 

smoking ...................................................... 269 

weight loss .................................................. 297 

Severe disablement allowance ............................. 

...................................... See Benefit claimants 

Sexual health .................................................. 712 

Sexual transmitted infections.......................... 714 

SF-36v2 TM ....................................................... 300 

Sight problems 


Significance testing 

explained .................................................... 774 

Small numbers 

problem explained ...................................... 776 

Smoking .......................................................... 245 

4-week quits .............................................. 260 

and COPD ................................................. 612 



and lung cancer ......................................... 534 



cessation service ....................................... 260 

factors predicting smoking behaviour ........ 259 

in pregnancy .............................................. 254 

mortality due to smoking............................ 255 

prevalence ................................................. 246 

prevalence in 

adults ..................................................... 246 

young people ......................................... 252 

services ..................................................... 269 


stop smoking service ................................. 260 

strategy ...................................................... 269 

targets ........................................................ 270 

SMR 

explained ................................................... 773 

Social capital 

civic engagement ....................................... 658 

definitions .................................................. 656 

local surveys .............................................. 798 

measures ................................................... 657 

neighbourliness ......................................... 659 

safety ......................................................... 657 

social networks .......................................... 661 

social support ............................................ 665 

Social marketing .............. 794, Also see ACORN 

alcohol ....................................................... 364 

breastfeeding ............................................. 734 

COPD ........................................................ 631 

diet ............................................................. 340 

lack of exercise .......................................... 318 

lung cancer ................................................ 545 

obesity ....................................................... 296 

smoking ..................................................... 259 

stroke ......................................................... 481 

Social networks .............................................. 661 

Social support ................................................ 665 

Sources of data ...................................... 788, 944 

Standardisation 

explained ................................................... 773 

Standardised mortality ratio .................. See SMR 

Statistics 

problem of small numbers explained ......... 776 

Stillbirths ........................................................ 209 

Strategy 

alcohol ....................................................... 365 

obesity ....................................................... 303 

physical activity .......................................... 324 

smoking ..................................................... 269 

Stress ............................................................. 674 



attitudes/effect on health ............................ 244 

Stroke ............................................................. 466 

equity audit ................................................. 475 

expenditure................................................. 483 




mortality ...................................................... 471 



prevalence .......................................... 434, 466 




Substance abuse ............................................ 367 


mortality ...................................................... 706 


prevalence in 

adults ..................................................... 367 

prisoners ................................................ 369 

young people ......................................... 370 

Suicide 

mortality ...................................................... 706 


Summary .......................................................... 18 

Support networks ............................................ 665 

Surgical operations and procedure codes ...... 813 

Surveys 

5-A-DAY ..................................................... 799 

health and lifestyle surveys ........................ 790 

listening exercise ........................................ 799 

local ............................................................ 790 

membership................................................ 799 

of people with diabetes .............................. 578 

qualitative research .................................... 794 

social capital surveys ................................. 798 

social marketing research .......................... 794 

we‟re all ears .............................................. 799 

Survival 

breast cancer.............................................. 561 

cancer ......................................................... 521 

cancers and deprivation ............................. 529 


lung cancer ................................................. 540 

Tables 

date last updated ........................................ 947 

date sources ............................................... 947 

Targets.............................................................. 52 

alcohol ........................................................ 365 

all age all cause mortality rate.................... 223 

breast cancer screening ............................. 420 

breastfeeding.............................................. 736 

cancers ....................................................... 530 

cervical cancer screening ........................... 425 

CHD ............................................................ 464 

child vaccination rates ............................... 412 


colorectal cancer screening ....................... 433 

COPD ........................................................ 631 

diabetes ..................................................... 585 

diet ............................................................. 341 

exercise ..................................................... 325 

influenza vaccination ................................. 414 

life expectancy ........................................... 196 

mental health ............................................. 690 

obesity ....................................................... 304 

problems with achieving targets ................ 223 

respiratory disease .................................... 604 

smoking ..................................................... 270 

stroke ......................................................... 481 

under 18s conception rate ......................... 722 

young people ............................................. 211 

Teenage conception rate ............................... 718 


Ten year risk of cardiovascular event 

definitions .................................................. 810 

prevalence ................................................. 386 

Testing significance 

explained ................................................... 774 

Tetanus .................................................. See DTP 

Topics ........................................................ 42, 50 

Total period abortion ratio 

explained ................................................... 781 

Total period fertility ratio 

explained ................................................... 781 

Traffic accidents ............................................. 725 

Transient ischaemic attack ......... Also see Stroke 


prevalence ......................................... 434, 466 


social marketing 

Truancy .......................................................... 121 

Uncertainty 

problem of small numbers explained ......... 776 

Under 18s conception rate ............................. 718 


Underlying data for figures ............................. 814 

Unemployment ............................................... 112 

Updated tables/figures 

data sources .............................................. 944 

date last updated ....................................... 944 

Uses of this JSNA ............................................ 25 

Vaccinations 

adults ......................................................... 413 

children ............ 388, Also see specific disease 

aged five years ...................................... 403 

aged one year ....................................... 389 

aged two years ...................................... 396 

at ward level .......................................... 388 

by ethnicity ............................................ 410 

for each general practice ....................... 388 



targets .................................................... 412 

influenza ..................................................... 413 

targets .................................................... 414 

pneumococcal ............................................ 415 

schedule in children ................................... 388 

Variability 

and small numbers ..................................... 776 

Veterans 

health and lifestyle survey .......................... 790 

Visual impairment 


Wards ............................................................... 61 

instant atlas .................................................. 60 

interactive atlas for Hull ................................ 60 

map .............................................................. 59 

profiles .......................................................... 60 

WCC ........................................................... 26, 52 

targets .......................................... See Targets 

We‟re all ears ................................................. 799 

Weight loss 


services ..................................................... 297 

SF-36v2 TM .................................................. 300 

Whooping cough ............................ Also see DTP 

incidence ................................................... 732 

Winter deaths ................................................. 231 

World class commissioning ................. See WCC 

Young people ................................................. 730 

accidents ................................................... 723 

health and lifestyle survey ......................... 790 

health needs assessments ................ 736, 802 


risk factor prevalence ................................ 238 

total number with risk factors ..................... 238 

Young people ............... Also see specific disease 

Young people ... Also see specific area of interest

joint strategic needs assessment foundation profile - JSNA

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