Dudley Strategy for Tackling Health Inequalities 2010-15

7.8 OTHER CONTRIBUTORY CAUSESExternal causes of deathWhere are we and what are the gaps?The external causes of death are defined as those from injury and poisoning andthey account for less than 5 per cent of all deaths in England and Wales (3.5% in2008, Vital Statistics). In Dudley for the same period 1.5% of deaths were due toinjury and poisoning. Deaths from injury and poisoning account for nearly half of alldeaths in the 15-34 age group for England and Wales (48.4% in 2008) and 21.4% inthe same age group in Dudley. This proportion is significantly higher in men thanwomen. Therefore deaths from injury and poisoning have a large impact in terms ofpremature deaths and potential years of life lost. In addition to this there isconsiderable research in the literature confirming that the risks of both unintentionaland intentional injury are related to deprivation status, with those at the greatest riskliving in the most deprived areas (Laflamme, Burrows and Hasselberg, 2009).Deaths from injury and poisoning make a significant contribution to the gap seen inlife expectancy between the most and least deprived quintiles in Dudley (LHO,2010). The estimated life expectancy years gained (2001-2005) if the Most DeprivedQuintile (MDQ) of Dudley MCD had the same mortality rate as the least deprivedquintile in the local authority for external causes are 1.09 years (16.6%) for men and0.03 years (0.8%) for women.Figures 1-2 show the trend in mortality from accidents and suicides andundetermined injuries for Dudley and England and Wales. Five year rates areshown due to the relatively low numbers. For accidents the directly standardisedmortality rates in Dudley over the last 20 years have been below those for Englandand Wales, but in the last five years Dudley has seen a rise in the rate of deathsfrom accidents and now has mortality rates equivalent to England and Wales.Dudley is no longer on target to meet “Our Healthier Nation” target of a 20%reduction on the 1996 baseline by 2010. Directly standardised mortality rates forsuicides and undetermined injury have declined over the last 20 years and havecontinued to track levels for England and Wales. The target reduction has been metfor women but is unlikely to be achieved for men. Mortality rates both from accidentsand suicide and undetermined injury are higher in men than women.There is a strong gradient of deprivation for mortality from both accidents and suicideand undetermined injuries particularly for men as shown in Figures 3-4 respectively.To further understand the data it has been further analysed using the InternationalCollaborative Effort (ICE) on injury statistics matrix which classifies injury andpoisoning deaths according to both mechanism and intent using standard groups ofthe ICD codes (ONS, 2006).154