joint strategic needs assessment foundation profile - JSNA

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7.8.4 All Cause Mortality
In general, as all people must die, it is preferable to examine premature mortality rather
than mortality at any age (all ages). Therefore, within this document, the focus is
generally on premature mortality relating to deaths which occurred under the age of 75
years. Nevertheless, Department of Health targets exist for life expectancy and the all
age all cause mortality rate (AAACMR), so this „all age‟ measure is presented within this
section as well as the under 75 mortality rates. Both the under 75 year and all age rates
are standardised for age. The AAACMR uses direct standardisation, and results in a
mortality rate per 100,000 standard population. It is possible to use direct
standardisation for the under 75 year rate as well, but within the section below indirect
standardisation is used and the standardised mortality ratios (SMRs) are presented.
See section 12.3 on page 773 for more information on standardisation.
7.8.4.1 Under 75 Year All Cause Mortality Ratio
From the Public Health Mortality File (PHMF), the age standardised mortality ratios
(SMRs) from deaths from all causes for males and females under the age of 75 years
are given in Table 84 for each ward in Hull for the period 2007 to 2009. The rates are
compared with England (that is, the value 100). A value higher than 100 denotes that
the mortality is higher than England and a value lower than 100 denotes a lower allcause
mortality than England. Thus the overall mortality rate for Hull was just over 30%
higher than the mortality rate in England. As expected the majority of wards in Hull had
higher under 75 mortality rates compared to England, with Beverley the only ward that
had a mortality rate that was statistically significantly lower than England 26 . Of the
Areas, Riverside (not shown) had the highest under 75 mortality rate being 73% higher
(95% CI 61% to 87% higher) than England. West and Wyke have the lowest mortality
rates in Hull with Wyke having a similar under 75 mortality rate to England and West‟s
rate being around 10% higher than England. The rest of the areas had under 75
mortality rates around 30% higher than England and were all significantly higher than
England (the 95% lower confidence limit was higher than 100). The Localities each had
under 75 mortality rates statistically significantly higher than England, with the lowest in
North Locality (28% higher than England) and the highest in West Locality (33% higher
than England). There was more variability at ward level due to the smaller number of
deaths, with the SMRs ranging from 75 (Beverley) and 85 (Holderness) to 201 (St
Andrew‟s) and 213 (Myton).
Whilst the absolute mortality rates are higher for males compared to females in Hull (see
directly standardised mortality rates in section 7.8.4.4 and life expectancy in section
7.7), mortality in Hull women relative to women in England (31% higher than England) is
26 If the 95% CI does not include 100 then the rate differs significantly than the national rate (see section
12.4 and section 12.5 for more information). However, even when there was no difference between the
local and national mortality rates, one would expect 5% of statistical comparisons to be classified
„statistically significant‟ by chance, so this must be borne in mind. Is it a true difference or could it be by
chance as a number of statistical comparisons have been made?
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 212