Dudley Strategy for Tackling Health Inequalities 2010-15

Key findings from analysis of mortality data using the ICE matrixOverall mortality rates due to accidents, suicides and undetermined injury arehigher in males than females. Mortality rates have declined over time andcontinue to do so for suicides and undetermined injury, whereas for accidentsthere has been an upturn since 2000 and rates for Dudley are again similar tothose for England and Wales.There is a health inequalities gradient for mortality from external causes(higher rates in the most deprived areas) and this is worse for males.The rise in mortality rates for accidents over the last 10 years is mostapparent in the over 75 age band with the main mechanism being falls andfractures. In males there has been little change over time in mortality ratesfrom accidents for the 15-54 age band, whereas it has declined for females.This is true also for this age band with mortality rates from suicide andundetermined injury.In 2004-2008 falls and fractures were the most common mechanism of injurymortality, followed by poisoning and transport. The move in emphasis awayfrom transport as the main mechanism is due to a real decline in trafficaccidents and to the inclusion of deaths from drug abuse/dependence withdeaths from poisoning and deaths from osteoporosis and fracture withexternal cause unspecified with deaths from falls.There has been an increase in the death rates for drug abuse/dependenceand homicide rates in males since 1994-1998.In terms of deprivation the main mechanisms which show a negative socialgradient are poisoning (particularly ages 15-54 and 75+ for males and age 35-74 for females), transport for males where the negative gradient is prominentin the 15-34 age band, suffocation which shows a negative gradient overall formales and females and this is emphasised in the under 75 age for males andthe under 35 age band for females. Falls and fractures showed no overallsocial gradient for males and showed a positive gradient for females over 75,but a negative gradient for the younger age bands.Hospital Admissions from external causesFigures 10-11 show the trend in hospital admissions from accidents and suicidesand unintentional injuries for Dudley. For accidents the directly standardisedemergency hospital admission rates in Dudley over the last 6 years have been risingand are significantly higher for men than women. Directly standardised emergencyhospital admission rates for suicides and undetermined injury have increased overthe last 6 years and this has been at a faster rate for females and hence admissionrates are higher for females than males. There is a strong gradient of deprivation foremergency hospital admissions from both accidents and suicide and undeterminedinjuries particularly for men for accidents and for both sexes for suicide andundetermined injury as shown in Figures 12 and 13 respectively. To furtherunderstand the data it has been analysed using the International Collaborative Effort(ICE) on injury statistics matrix.165