nhs wakefield district - information team health inequalities gap analysis nhs wakefield district...

NHS Wakefield District - Information Team

Health InequalitiesGap Analysis

NHS Wakefield DistrictInformation Team


Smoking in Pregnancy• Analysis based on Mid-Yorkshire Data by

Postcode for Wakefield Residents.• Figures will vary slightly from Performance

Data Submissions which are on a Commissioner-basis including other Providers.


Least Deprived

Most Deprived

Wakefield Rate

Gap

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

2007-2008 2008-2009 2009-2010

The gap between the most and least deprived quintiles is reducing.(Percentage of mothers smoking at time of delivery, Wakefield District, 07/08 - 09/10, Source: MYHT)



0%

5%

10%

15%

20%

25%

30%

35%

40%

2007-2008 2008-2009 2009-2010

The gap between the most and least deprived quintiles is reducing.(Difference between the Most and the Least Deprived Quintile for smoking at time of delivery, Wakefield District,

07/08 - 09/10, Source: MYHT)


Fiscal Year Deprivation Quintile Smoking in Pregnancy Rate

Smoking in Pregnancy Year Rate Gap

2007-2008

High 38.51%

22.80% 30.33%

Median-High 23.25%

Median 21.35%

Low-Median 13.55%

Low 8.18%

2008-2009

High 37.34%

24.45% 25.59%

Median-High 25.37%

Median 21.27%

Low-Median 17.76%

Low 11.75%

2009-2010

High 35.04%

24.68% 22.51%

Median-High 26.64%

Median 22.55%

Low-Median 17.25%

Low 12.53%



Priority Neighbourhood

All Others

Wakefield Rate

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

2007-2008 2008-2009 2009-2010

The gap between the Priority Neighbourhoods and All Other Areas is decreasing.

(Percentage of mothers smoking at time of delivery, Wakefield District, 07/08 - 09/10, Source: MYHT)


Year Priority Neighbourhood All Others

2007-2008 41.20% 18.92%

2008-2009 40.76% 20.66%

2009-2010 36.38% 21.80%

Smoking in Pregnancy – Comparison amongst Priority Neighbourhoods and All other Areas


Conclusions for Smoking in Pregnancy

• The rate for the Most Deprived and the Priority Neighbourhoods is decreasing.

• However, the rate for the Least Deprived areas is increasing.

• The overall District average is increasing.


Childhood Obesity - Reception• Analysis based on cleaned National Child

Measurement Programme (NCMP) data for the years 2007-2008 and 2008-2009.


Most Deprived

Wakefield RateMedian-High Deprivation

Median Deprivation

Low-Median Deprivation

Low Deprivation

0%

2%

4%

6%

8%

10%

12%

14%

2007/2008 2008/2009

The level of obesity is fluctuating across the district.(Percentage of Reception children measured as obese, Wakefield District, 07/08 - 08/09, Source: NCMP)


Gap

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

10%

2007/2008 2008/2009

The gap between the highest level of obesity and the lowest is decreasing.(Difference between the highest level of obesity and the lowest for the percentage of Reception children measured as obese,

Wakefield District, 07/08 - 08/09, Source: NCMP)


Fiscal Year Deprivation Quintile % Obese% Obese

District RateGap

High 11.0%Median-High* 13.0%Median 11.8%Low-Median 8.8%Low* 6.9%High* 12.2%Median-High 10.6%Median 7.7%Low-Median 9.5%Low* 6.7%

2008/2009 9.5% 5.5%

2007/2008 10.5% 6.1%

* = Indicates the Quintiles used to calculate the Gap.



All OthersWakefield Rate

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

2007-2008 2008-2009

The gap between the overall level of obesity in the Priority Neighbourhoods compared to All Others Areas is increasing.

(Percentage of Reception children measured as obese, Wakefield District, 07/08 - 08/09, Source: NCMP)


Year Priority Neighbourhood All Others2007-2008 11.0% 10.4%2008-2009 12.2% 9.0%

Obesity in Reception – Comparison between the Overall Percentage of Obesity in the Priority Neighbourhoods and All

Other Areas


Childhood Obesity – Year 6• Analysis based on cleaned National Child

Measurement Programme (NCMP) data for the years 2007-2008 and 2008-2009.


Wakefield RateHigh Deprivation

Median-High Deprivation

Median Deprivation

Low-Median DeprivationLow Deprivation

0%

5%

10%

15%

20%

25%

30%

2007/2008 2008/2009

Each quintile of deprivation is showing a reduction in the level of obesity.(Percentage of Year 6 children measured as obese, Wakefield District, 07/08 - 08/09, Source: NCMP)


Gap

0%

1%

2%

3%

4%

5%

6%

7%

8%

2007/2008 2008/2009

The gap between the highest level of obesity and the lowest is increasing.(Difference between the highest level of obesity and the lowest, for percentage of Year 6 children measured as obese,

Wakefield District, 07/08 - 08/09, Source: NCMP)


Fiscal Year Deprivation Quintile % Obese% Obese

District RateGap

High 20.7%Median-High* 24.1%Median 22.4%Low-Median 16.5%Low* 18.1%High 18.8%Median-High* 21.7%Median 20.2%Low-Median 14.8%Low* 14.8%

2008/2009

2007/2008 20.4%

18.0%

6.0%

6.9%



All Others

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%

22.0%

2007-2008 2008-2009

In 2008/2009 the overall level of obesity in the Priority Neighbourhoods was lower than in All Other Areas.

(Percentage of Year 6 children measured as obese, Wakefield District, 07/08 - 08/09, Source: NCMP)


Obesity in Year 6 – Comparison between the Overall Percentage of Obesity in the Priority Neighbourhoods and All Other Areas

Year Priority Neighbourhood All Others2007-2008 21.0% 20.3%2008-2009 17.6% 18.1%


Conclusions for Childhood Obesity• Childhood obesity does not always share a direct

correlation with deprivation.• The overall rate of obesity is falling in both Reception

and Year 6.• Reception: The level of obesity in the Priority

Neighbourhoods is increasing, compared to a regional downward trend.

• Year 6: The level of obesity in the Priority Neighbourhoods is falling quicker than across the rest of the district.


Breastfeeding Initiation• Analysis based on Mid-Yorkshire Data by

Postcode for Wakefield Residents.• Figures will vary slightly from Performance

Data Submissions which are on a Commissioner-basis including other Providers.


Fiscal Year Deprivation Quintile Breast feeding rate Wakefield Rate GapHigh 42.1%Median-High 53.7%Median 58.3%Low-Median 66.7%Low 75.7%High 47.7%Median-High 55.8%Median 57.3%Low-Median 66.6%Low 74.1%High 46.8%Median-High 54.8%Median 59.7%Low-Median 65.5%Low 77.8%

33.1%

26.4%

30.8%

2007/2008

2008/2009

2009/2010

57.1%

58.4%

58.4%


Breastfeeding Initiation – Comparison amongst Priority Neighbourhoods and All other Areas

Year Priority Neighbourhood All Others2007/2008 39.5% 60.8%2008/2009 46.7% 60.9%2009/2010 45.2% 61.4%


Priority Neighbourhood 2007/2008 2008/2009 2009/2010

Airedale 29% 34% 42%

Cutsyke 38% 68% 36%

Eastmoor 46% 56% 57%

Featherstone, Priory 21% 57% 48%

Kinsley with Hemsworth, West End & Ashfield 38% 44% 40%

Knottingley, Warwick 36% 47% 34%

Lupset 36% 55% 46%

Portobello 64% 43% 31%

South Elmsall, Moorthorpe, Westfield & Broad Lane 47% 48% 53%

South Kirkby, Holmsley 38% 38% 37%

Wakefield City Centre 73% 65% 71%

Wakefield, Belle Vue 52% 53% 58%

Yearly Total 39% 47% 45%

Initiation Rate


Full District

Most Deprived

Least Deprived

Breastfeeding Initiation

Wakefield District, 2009-10MSOA level data plotted at Postcode level

Contains Ordnance Survey data © Crown copyright and database right 2010

Contains Royal Mail data © Royal Mail copyright and database right 2010.

Sources:

MYHT


Conclusions for Breastfeeding Initiation

• There is a definite correlation between deprivation and Breastfeeding Initiation.

• The gap between the most and least deprived quintile is around 30%

• There has been a slight improvement in the initiation rate across the priority neighbourhood during the 3 year period from 39% to 45%.

• The Wakefield City Centre priority neighbourhood has an unusually high initiation rate, around 70% each year.


A&E Attendances• Analysis based on Secondary Uses Service

(SUS) extract for 2007-08 to 2009-10• Data extracted on a resident basis i.e. details

relate to all patients who live within Wakefield District regardless of where they are registered.


Fiscal YearDeprivation

QuintileAttendance Rate (per

1,000)Wakefield

RateGap

High 454.8

Median-High 395.7

Median 346.0

Low-Median 307.2

Low 262.1

High 449.1

Median-High 394.1

Median 353.2

Low-Median 303.5

Low 259.2

High 449.5

Median-High 396.7

Median 351.4

Low-Median 320.1

Low 265.2

352.9 192.8

351.6 189.9

2007 - 08

2008 - 09

2009 - 10 356.5 184.3



2007/2008 462.9 336.3

2008/2009 455.7 336.0

2009/2010 456.1 341.5

A&E Attendance Rate – Comparison amongst Priority Neighbourhoods and All other Areas


Priority Neighbourhood 2007 - 08 2008 - 09 2009 - 10

Airedale 480 524 508

Cutsyke 469 446 456

Eastmoor 594 547 557

Featherstone, Priory 475 476 427

Kinsley with Hemsworth, West End & Ashfield 366 377 388

Knottingley, Warwick 493 529 522

Lupset 450 425 445

Portobello 493 449 497

South Elmsall, Moorthorpe, Westfield & Broad Lane 337 315 319

South Kirkby, Holmsley 312 333 386

Wakefield City Centre 805 553 475

Wakefield, Belle Vue 451 492 486

Attendance rate per 1,000 population


Full District

Most Deprived

Least Deprived

A&E Attendance Rate

Per 1,000 population

Wakefield District, 2009-10LSOA level data plotted at postcode level



Sources:

ONS Mid 2009 population estimates

SUS


Conclusions for A&E Attendances• There is a definite correlation between

deprivation and A&E attendance rate.• The rate of attendances in the most deprived

quintile is far greater than in the least deprived quintile

• The priority neighbourhoods also have a rate that is much higher than both the District rate and the rate for all other areas in the district.


Emergency Admissions• Analysis based on Secondary Uses Service

(SUS) extract for 2007-08 to 2009-10• Data extracted on a resident basis i.e. details

relate to all patients who live within Wakefield District regardless of where they are registered.



QuintileAdmission Rate (per

1,000)Wakefield

RateGap

High 142.3

Median-High 120.6

Median 103.0

Low-Median 94.6

Low 77.0

High 144.5

Median-High 121.4

Median 112.4

Low-Median 96.3

Low 81.5

High 145.8

Median-High 121.6

Median 110.7

Low-Median 102.2

Low 80.9

2007-08

2008-09

2009-10

65.2

63.0

64.9

107.4

111.1

112.2


Emergency Admission Rate – Comparison amongst Priority Neighbourhoods and All other Areas


2007/2008 143.4 102.0

2008/2009 147.5 105.7

2009/2010 145.9 107.2



Airedale 157 151 157

Cutsyke 199 161 158

Eastmoor 187 203 192




Lupset 135 138 144

Portobello 139 148 142





Admission rate per 1,000 population


Full District

Most Deprived

Least Deprived

Emergency Admission Rate





Sources:


SUS


Conclusions for Emergency Admissions

• There is a definite correlation between deprivation and Emergency Admission rate.

• The rate of emergency admissions has been steadily increasing across the district

• Within the priority neighbourhoods Eastmoor stands out as having a particularly high rate of emergency admissions.


Emergency Re-admissions within 30 days

• Analysis based on Secondary Uses Service (SUS) extract for 2007-08 to 2009-10

• Data extracted on a resident basis i.e. details relate to all patients who live within Wakefield District regardless of where they are registered.



QuintileReadmit Rate (per 1,000 population)

Wakefield Rate

Gap

High 22.1

Median-High 16.7

Median 14.7

Low-Median 11.8

Low 9.5

High 21.9

Median-High 17.4

Median 16.3

Low-Median 13.6

Low 10.4

High 22.9

Median-High 17.4

Median 17.5

Low-Median 14.7

Low 10.4

2009-10 16.6 12.5

2007-08 14.9 12.6

2008-09 15.9 11.5


Emergency Re-admission Rate – Comparison amongst Priority Neighbourhoods and All other Areas


2007/2008 22.2 13.9

2008/2009 22.3 14.9

2009/2010 22.3 15.7



Airedale 28 21 26

Cutsyke 34 22 31

Eastmoor 32 38 35




Lupset 19 20 22

Portobello 19 21 19





Re-admission rate per 1,000 population


Full District

Most Deprived

Least Deprived

Emergency Re-admission Rate (30 days)





Sources:


SUS


Conclusions for Emergency Re-admissions within 30 days

• There is a definite correlation between deprivation and Emergency Re-admission rate.

• The rate of emergency re-admissions has been steadily increasing across the district

• Within the priority neighbourhoods Eastmoor and Cutskye stand out as having a particularly high rate of emergency admissions.


CVD Mortality – All ages• Analysis based on ONS Deaths files 2007 -

2009• Data is based on Wakefield residents i.e

anybody who lives within the Wakefield District boundary.


Full District

Most Deprived

Least Deprived

CVD Mortality

DSR per 100,000

Wakefield District, 2007-2009MSOA level data plotted at postcode level



Sources:

ONS Mid year population estimates

SUS


Conclusions for CVD Mortality – all ages

• There is a definite correlation between deprivation and CVD Mortality.

• The priority neighbourhoods have a DSR that is much higher than the Wakefield average.

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