Dudley Strategy for Tackling Health Inequalities 2010-15

Key findings from analysis of emergency hospital admissions data using theICE matrixOverall emergency hospital admission rates due to accidents, suicides andundetermined injury are higher in males than females. Emergency hospitaladmission rates have increased over time and continue to do so particularlyfor suicides and undetermined injury in females.There is a health inequalities gradient for emergency hospital admissions fromexternal causes (higher rates in the most deprived areas) and this is morepronounced for males.The rise in emergency hospital admissions rates for accidents over the last 6years is most apparent in the over 75 age band with the main mechanismbeing falls and fractures. There has been an increase in admissions ratesacross all age bands and mechanisms.In 2004-2008 falls and fractures were the most common mechanism of injuryadmission, followed by poisoning and transport.In terms of deprivation the main mechanisms which show a negative socialgradient are poisoning (particularly ages 15-54 for males and age 0-54 forfemales), transport for males where the negative gradient is prominent in the0-54 age band. Falls and fractures showed a smaller social gradient for malesand showed a no gradient for females over 75, but a negative gradient for theyounger age bands. Although the rate of admissions for drowning overall arelow they do all arise from the most deprived quintile mainly in the 0-4 ageband.How do we get there?In 1999, the Government White Paper Saving Lives: Our Healthier Nation (GreatBritain. Department of Health, 1999) set out the first comprehensive Governmentplan focused on the main killers: cancer, coronary heart disease and stroke,accidents, mental illness. It set out to establish tough but attainable targets in priorityareas. These were that by 2010 death rates accidents would be reduced by at least afifth and serious injury by at least a tenth and for mental health to reduce the deathrate from suicide and undetermined injury by at least a fifth. As seen earlier thesetargets are unlikely to be achieved both nationally and in Dudley. Additionally thesetargets are even more unrealistic in the lower socioeconomic groups.Dudley has had a Joint Accident Prevention Strategy Partnership since the year2000, and the current Joint Accident Prevention Strategy runs from 2009-2012 withannual action plans (Dudley MBC and Dudley PCT, 2009). The strategy to daterecognised the impact of health inequalities on accident and unintentional injuries,and the current action plan has key programmes that work across Dudley andaddresses the key areas highlighted in this needs assessment (Moss, 2010).In terms of suicide and undetermined injury, these are covered in the NationalService Framework for Mental Health (Great Britain. Department of Health, 1999)which had seven standards of which Suicide Prevention was Standard Seven andMental Health Promotion was Standard One.175