Dudley Strategy for Tackling Health Inequalities 2010-15

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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
Standardised Rate per 100,000 populationStandardised Rate per 100,000 populationFigure 10Directly standardised emergency hospital admissions from accidents byyear single year rates, males and females, 2003 to 2008, Dudley1200100080060040020002003/04 2004/05 2005/06 2006/07 2007/08 2008/09MaleYearFemaleSource: Secondary Users Service (SUS) Hospital AdmissionsOffice of National Statistics (ONS) mid-year population estimateFigure 11250Directly standardised emergency hospital admissions from suicides andundetermined injuries by year single year rates, males and females, 2003 to2008, Dudley2001501005002003/04 2004/05 2005/06 2006/07 2007/08 2008/09YearMale FemaleSource: Secondary Users Service (SUS) Hospital AdmissionsOffice of National Statistics (ONS) mid-year population estimate166
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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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“reduce smoking during pregnancy
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Percentage who currently smokePerce
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1. Stop Smoking Service ProvisionDu
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Proportion of clients that have qui
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3. Communication and EducationDSSS
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The PCT, Acute Trust, Local Authori
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admissions. The following year Dudl
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Standardised Rate per 100,00 popula
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Netherton &WoodsideHalesowen NorthC
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women the Mosaic groups with signif
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Page 118 and 119: These include:Securing additional i
Page 120 and 121: Standardised Rate per 100,000 Popul
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
Page 132 and 133: and less radical treatment than you
Page 134 and 135: As more people than ever are surviv
Page 136 and 137: • Benchmarking of surgery aspirin
Page 142 and 143: There is a weak correlation between
Page 144 and 145: 7.7 SEASONAL EXCESS DEATHSREDUCING
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 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
Page 180 and 181: the minimum standards set out by th
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
Page 188 and 189: DCS has some key performance target
Page 190 and 191: 8.4 DEVELOPING THE ROLE OF THE VOLU
Page 192 and 193: at the heart of action to address c
Page 194 and 195: CHC‟s are trained and supported t
Page 196 and 197: capacity and confidence of individu
Page 198 and 199: which it has never done before. The
Page 200 and 201: centres‟ outreach workers and Hea
Page 202 and 203: 9.1 DUDLEY HEALTH INEQUALITIES HIGH
Page 204 and 205: RECOMMENDATION ACTIVITY OUTCOMES LE
Page 210 and 211: Dudley Community Partnership (2005)
Page 212 and 213: Great Britain. Department of Health
Page 214 and 215: 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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RECOMMENDATION ACTIVITY OUTCOMES LE
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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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