Dudley Strategy for Tackling Health Inequalities 2010-15

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7. PRIORITY ACTIONS TO IMPACT ON HEALTH INEQUALITIESBuilding on its experience of supporting the spearhead areas to reduce healthinequalities, the Health Inequalities National Support Team has been able to developa number of priority actions that have been shown to have the greatest impact onmortality targets. Their recommendations for Dudley included a number of importantactions for us to implement in order to address our inequality gap. This sectionfocuses on the key disease areas that contribute to the biggest gaps locally.7.1 SECONDARY PREVENTION CARDIO-VASCULAR DISEASEIntroduction:Cardiovascular Disease (CVD) is a collective term for a group of related conditionsaffecting the heart, arteries or blood vessels. It includes Coronary Heart Disease(CHD) (about 50%) and stroke (about 25%).Nationally there has been a steady and marked decline in death rates from CVD. Infact the overall reduction has surpassed the government target:„substantially reduce mortality rates by 2010 from heart disease and stroke andrelated diseases by at least 40% in people under 75, with a 40% reduction in theinequalities gap between the fifth of areas with the worst health and deprivationindicators and the population as a whole from a 1996/7 baseline‟.The health inequalities gap in relation to CVD mortality and prevalence is welldocumented with higher levels for men than women, lower income levels than higherand for specific ethnic groups. Deaths from CHD are three times higher amongunskilled men than professionals and around 50% higher in South Asiancommunities than the general population and early onset of the disease two to threetimes higher (CQC, 2009).Nationally the CVD inequalities gap is reducing, with latest data (2007) showing areduction of 36% in the absolute gap between the Spearhead PCTs and the Englandaverage. The national gap in 2007 was 23.5 deaths/100,000. (CQC, 2009, p. 12).Dudley reflects the national picture overall but our inequalities gap is widening formen. CVD levels have declined steadily, but remain the biggest single cause ofpremature death in Dudley accounting for around 150 deaths in the under 75s eachyear. There is some evidence that for men the rate of decline is beginning to slow.CVD continues to be a major factor in overall health inequalities, with rates in somewards being more than 3 times those in other wards. The gap between the wardswith the highest and lowest rates has widened for men but not for women. Thedeprivation gradient in premature mortality from circulatory diseases is much steeperin men than in women. (Little and Moss, 2009)61
Standardised Rate per 100,000 PopulationStand ardised R ate per 100,000 Population1985-19831986-19841987-19851988-19861989-19871990-19881991-19891992-19901993-19911994-19921995-19931996-19941997-19951998-19961999-19972000-19982001-19992002-20002003-20012004-20022005-20032006-20042007-20052008-20062009-20072010-2008Figure 1Directly Standardised Mortality Rates from All Circulatory Diseases by Year3 year rates, Dudley, Males & Females Aged Under 75, 1983-1985 to 2008-2010-Target: Reduce mortality from All Circulatory Diseases by 20% by 2009 from 1996400350Standardised Rate per 100,000 Population300250200150100500Figure 2200Directly Standardised Mortality Rates from All Circulatory Diseases by IMD 2007 NationalQuintile5-Year Rates, Dudley MBC, Males & Females Aged Under 75, 2004-2008180160140120100806040200There has been a slow-down in the rate of decline in mortality for stroke, particularlyfor men in the last few years. The rate of premature mortality for stroke in men isnow significantly higher than the England and Wales average (Figure 3).62
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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
Page 11 and 12: This work has been built on trustin
Page 13 and 14: ENSURE A HEALTHY STANDARD OF LIVING
Page 15 and 16: with, or at high risk of vascular d
Page 17 and 18: Tackling underage/illegal alcohol c
Page 19 and 20: 2. VISION STATEMENTThe mission stat
Page 21 and 22: tackle health inequalities in the t
Page 23 and 24: These recommendations are addressed
Page 25 and 26: injustice and deprivation impact ne
Page 27 and 28: - Giving priority to pre and post-n
Page 29 and 30: Percentage of live and still births
Page 31 and 32: EYFS Median Scores by National Depr
Page 33 and 34: data which shows us locally what ac
Page 35 and 36: instability. Factors such as job se
Page 37 and 38: Proportion of population claiming J
Page 39 and 40: Data is available for those ALMPs f
Page 41 and 42: Labour market outcomes to date are
Page 43 and 44: achieved through transfer payments,
Page 45 and 46: % share of equivalised incomeA comp
Page 47 and 48: Figure 7 shows the income distribut
Page 49 and 50: Figure 9Proportion of the populatio
Page 51 and 52: Although temperature variations dur
Page 53 and 54: 5. LEADERSHIP AND PARTNERSHIPDudley
Page 55 and 56: A Community Renewal team which coor
Page 57 and 58: 6. COMMUNITY ENGAGEMENTCommunity En
Page 59 and 60: o DMBC sharing their community enga
Page 61: Transferring power to communitiesNI
Page 65 and 66: Secondary Prevention of CVDOptimum
Page 67 and 68: Ratio of obsevred vs. expected prev
Page 69 and 70: Performance variation cannot be exp
Page 71 and 72: Table 4: Range of performance gapDi
Page 73 and 74: Conclusions:The general conclusions
Page 75 and 76: 7.2 ACUTE CARDIO-VASCULAR DISEASE (
Page 77 and 78: Standardised Rate per 100,000 Popul
Page 79: Timely ResponseApproximately 30% of
Page 82 and 83: IMD ScoreRevascularisation Ward Rat
Page 84 and 85: That an increase in access to diagn
Page 86 and 87: Establishing the level of health eq
Page 90 and 91: Timely ResponseTimely access to tre
Page 92 and 93: Continue implementation of current
Page 94 and 95: “reduce smoking during pregnancy
Page 96 and 97: Percentage who currently smokePerce
Page 98 and 99: 1. Stop Smoking Service ProvisionDu
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
Page 108 and 109: admissions. The following year Dudl
Page 110 and 111: 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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numbers of alcohol related sexual o
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These include:Securing additional i
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The deprivation gap in invasive can
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Age standardised incidence rate rat
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One of the priorities of the Cancer
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Colorectal cancerProstate cancerThe
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and less radical treatment than you
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As more people than ever are surviv
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• Benchmarking of surgery aspirin
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There is a weak correlation between
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7.7 SEASONAL EXCESS DEATHSREDUCING
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Excess Winter Mortality Index (%)Me
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Brockmoor & PensnettSt JamesKingswi
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Percentage uptake of seasonal flu v
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Percentage uptake of seasonal flu v
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The group will establish terms of r
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Standardised Rate per 100,000 popul
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PercentagePercentageFigure 7aMechan
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PercentageFigure 8bMechanism of inj
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Key findings from analysis of morta
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Standardised rate per 100,000 popul
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PercentageFigure 17bMechanism of in
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Key findings from analysis of emerg
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Action plan updated in 2008 to rein
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the minimum standards set out by th
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Further analysis shows that for hyp
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8.2 SOCIAL CAREAdult Social CareSoc
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8.3 TRANSFORMING COMMUNITY SERVICES
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DCS has some key performance target
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8.4 DEVELOPING THE ROLE OF THE VOLU
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at the heart of action to address c
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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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