Dudley Strategy for Tackling Health Inequalities 2010-15

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7.7 SEASONAL EXCESS DEATHSREDUCING SEASONAL EXCESS DEATHSExcess winter deaths (EWD) are widely attributed to the effects of cold. They occurmainly in the elderly and more particularly in the over 85 year age group. Themajority of deaths are linked to circulatory and respiratory diseases and there is asmaller, but relevant, number linked to falls. There are also increased numbers ofdeaths linked to seasonal influenza, which can increase greatly in a flu pandemic.Older people living in older or large properties who cannot afford to keep their housewarm are most at risk, and fuel poverty (spending more than 10% of annual incomeon energy bills to keep the house heated to adequate levels) affects the elderly andvulnerable groups the most.Initiatives designed to improve insulation and heating of properties are known toimpact on excess winter deaths. Other high impact initiatives are those designed toreduce falls in the elderly and to promote the uptake of influenza vaccinations. Whilstmost of the effective initiatives focus on reducing deaths from cold, it must be bornein mind that excess summer temperatures, also cause an increase in deaths amongthe very young, the vulnerable and the elderly. This is likely to become more of aproblem if the predicted effects of climate change come about.EXCESS WINTER DEATHS IN DUDLEYExcess winter deaths are defined as:The number of deaths in the four winter months (December to March) minus theaverage number of deaths in the preceding four months (August to November) andthe subsequent four months (April to July).This means the year used for calculations runs from August to July, compared withother data which is usually based on a calendar year (January to December) or afinancial year (April to March). The calculation of EWD is expressed as a percentageof the average number of deaths in the preceding four months and this provides theexcess winter deaths index (EWDI).143
Excess Winter Mortality Index (%)Mean Winter temperature (ºC) England & Wales01/8307/8301/8407/8401/8507/8501/8607/8601/8707/8701/8807/8801/8907/8901/9007/9001/9107/9101/9207/9201/9307/9301/9407/9401/9507/9501/9607/9601/9707/9701/9807/9801/9907/9901/0007/0001/0107/0101/0207/0201/0307/0301/0407/0401/0507/0501/0607/0601/0707/0701/0807/08Number of deathsSeasonal mortality patternsFigure 1Trend in all cause mortality in Dudley 1983 to 2008600500Monthly DeathsYearly Average4003002001000Month and year of occurrence of deathThe graph (Figure 1) shows the seasonal variation in deaths from all causes from1983 to 2008 with winter spikes in January 1990, 1996, 1997 and 1999. Since 2000the increase in numbers of winter deaths has fallen slightly in line with regional andnational trends.Figure 2Dudley Excess Winter Mortality Index, for deaths from all causes, All Ages, 1983-200740.07.0035.06.0030.025.05.004.0020.015.010.03.002.005.01.000.00.00Dudley EWM (%) 2007/08YearE & W Mean temperature(Dec - Mar)144
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2010FDudley Strategy forTackling He
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ENDORSEMENT OF THE 2010 - 2015HEALT
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CONTENTSFOREWORD………………
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Standardised Rate per 100,000 Popul
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There were three principles that un
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This work has been built on trustin
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ENSURE A HEALTHY STANDARD OF LIVING
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with, or at high risk of vascular d
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Tackling underage/illegal alcohol c
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2. VISION STATEMENTThe mission stat
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tackle health inequalities in the t
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These recommendations are addressed
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injustice and deprivation impact ne
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- Giving priority to pre and post-n
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Percentage of live and still births
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EYFS Median Scores by National Depr
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data which shows us locally what ac
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instability. Factors such as job se
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Proportion of population claiming J
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Data is available for those ALMPs f
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Labour market outcomes to date are
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achieved through transfer payments,
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% share of equivalised incomeA comp
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Figure 7 shows the income distribut
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Figure 9Proportion of the populatio
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Although temperature variations dur
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5. LEADERSHIP AND PARTNERSHIPDudley
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A Community Renewal team which coor
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6. COMMUNITY ENGAGEMENTCommunity En
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o DMBC sharing their community enga
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Transferring power to communitiesNI
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Secondary Prevention of CVDOptimum
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Ratio of obsevred vs. expected prev
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Performance variation cannot be exp
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Table 4: Range of performance gapDi
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Conclusions:The general conclusions
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7.2 ACUTE CARDIO-VASCULAR DISEASE (
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Timely ResponseApproximately 30% of
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IMD ScoreRevascularisation Ward Rat
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That an increase in access to diagn
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Establishing the level of health eq
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Timely ResponseTimely access to tre
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Continue implementation of current
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Page 100 and 101: Proportion of clients that have qui
Page 102 and 103: 3. Communication and EducationDSSS
Page 104 and 105: The PCT, Acute Trust, Local Authori
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Page 114 and 115: women the Mosaic groups with signif
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Page 118 and 119: These include:Securing additional i
Page 122 and 123: The deprivation gap in invasive can
Page 124 and 125: Age standardised incidence rate rat
Page 128 and 129: One of the priorities of the Cancer
Page 130 and 131: Colorectal cancerProstate cancerThe
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Page 134 and 135: As more people than ever are surviv
Page 136 and 137: • Benchmarking of surgery aspirin
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Page 146 and 147: Excess Winter Mortality Index (%)Me
Page 148 and 149: Brockmoor & PensnettSt JamesKingswi
Page 150 and 151: Percentage uptake of seasonal flu v
Page 152 and 153: Percentage uptake of seasonal flu v
Page 154 and 155: The group will establish terms of r
Page 158 and 159: Standardised Rate per 100,000 popul
Page 162 and 163: PercentagePercentageFigure 7aMechan
Page 164 and 165: PercentageFigure 8bMechanism of inj
Page 166 and 167: Key findings from analysis of morta
Page 168 and 169: Standardised rate per 100,000 popul
Page 174 and 175: PercentageFigure 17bMechanism of in
Page 176 and 177: Key findings from analysis of emerg
Page 178 and 179: Action plan updated in 2008 to rein
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Page 182 and 183: Further analysis shows that for hyp
Page 184 and 185: 8.2 SOCIAL CAREAdult Social CareSoc
Page 186 and 187: 8.3 TRANSFORMING COMMUNITY SERVICES
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Page 190 and 191: 8.4 DEVELOPING THE ROLE OF THE VOLU
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CHC‟s are trained and supported t
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capacity and confidence of individu
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which it has never done before. The
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centres‟ outreach workers and Hea
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9.1 DUDLEY HEALTH INEQUALITIES HIGH
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RECOMMENDATION ACTIVITY OUTCOMES LE
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Dudley Community Partnership (2005)
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Great Britain. Department of Health
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NHS Dudley and Dudley Metropolitan
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APPENDIX 1 - PERFORMANCE INDICATORS
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Indicator Dudley England Least Most
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APPENDIX 2 - DELIVERY PLANS FOR PRI
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PRIORITY AREA: TOBACCO CONTROLRECOM
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All of these initiatives will requi
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Empower community members toraise a
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Develop an integrated alcoholtreatm
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Offender ManagementRECOMMENDATION A
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PRIORITY AREA: SEASONAL EXCESS DEAT
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APPENDIX 3 - HEALTH INEQUALITIES CH
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PRIORITY ACTIONENGAGEMENT- WORKFORC
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Dudley Strategy for Tackling Health Inequalities 2010-15

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