Joint Strategic Needs Assessment

People are prepared for and supported in old age – Life expectancy, mortality & end of life care Last updated: September 2013

Summary / Key Points Chart Key Male Female

England Life expectancy for males on the Island is 79.1 Isle of Wight and 83.6 for females ONS Comparators Life expectancy rates for both males and

females on the Island has improved since Local Comparators 2003-05 Life expectancy for females on the Island is 83.6 Life expectancy in the most deprived areas for years, three and a half years longer than Island males both males and females is lower (worse) than and one year longer than the England female average those in the least deprived areas of 82.6 years, these differences are both statistically The Islands mortality rate is 516.17 per 100,00 significant. population and is lower (better) than the England average Life Expectancy at Birth: 2008-10 (pooled) Isle of Wight & ONS Comparator Local Authorities: FEMALES

Mortality rates in line with the national picture Hampshire are higher for males than they are for females Waveney Isle of Wight

Mortality rates for both males and females has Shepway decreased since 2003 Weymouth and Portland Mortality rates from causes considered both Portsmouth Southampton preventable and amenable to treatment are England below the England average and one of the Torbay Dover

lowest compared to our local and ONS Scarborough comparators. Great Yarmouth Thanet

Allerdale

The level of population need Carlisle

Blackpool

0 20 40 60 80 100

On the Island the life expectancy at birth for males is Life Expectancy at Birth 79.1 years. This is slightly above the England average Source : Health & Social Care Information Centre of 78.5 years. Comparing life expectancy at locality level is also Life Expectancy at Birth: 2008-10 (pooled) Isle of Wight & ONS Comparator Local Authorities: MALES important in order to highlight any inequalities that may Hampshire exist within the Island. The Ventnor and South Wight Waveney area has a life expectancy rate of 89.1 years for males Isle of Wight whilst the Bay area has the lowest life expectancy of Shepway

Southampton 76.9 years for males.

England Life Expectancy at Birth - 2009 to 2012 (pooled): Isle of Dover Wight Wards and Localities: MALES Scarborough Ventnor & South Wight Torbay

Great Yarmouth Cowes / East Cowes Portsmouth Newport Weymouth and Portland Allerdale West / Central Wight Carlisle

Thanet Ryde Blackpool The Bays 0 20 40 60 80 100 Life Expectancy at Birth 70 75 80 85 90 95 Source : Health & Social Care Information Centre Life Expectancy at Birth Sources: ONS Annual Death Extract & ONS Mid Year Population Estimates

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Differences in life expectancy across the Island for Life expectancy from birth for females is lower (worse) females are smaller with the Ventnor & South Wight in the most deprived areas on the Island with an area having an average life expectancy of 86.3 years average expected life span of 81.3 years. Life compared to West and Central Wight which has the expectancy in the least deprived area is 82.8 years, lowest average rate of 81.7 years; this is a statistically although this is not significantly different to any other significant difference. deprivation quintile.

Life Expectancy at Birth - 2009 to 2012 (pooled): Isle of Life Expectancy at Birth by Deprivation Quintile (2009-11) Wight Wards and Localities: FEMALES FEMALES 95 Ventnor & South Wight 90 85 Cowes / East Cowes 80 75 The Bays Age 70 65 Newport 60 55 Ryde 50 1 2 3 4 5 West / Central Wight Most Deprived Local Deprivation Quintile Least Deprived 70 75 80 85 90 95 Life Expectancy at Birth Data Source: ONS Annual Deaths Extracts/ONS Mid Year Population Estimates / SEPHO Life Expectancy Calculator Sources: ONS Annual Death Extract & ONS Mid Year Population Estimates

The ‘Slope Index’ represents the gap in life expectancy In England, people living in the poorest between the most deprived and least deprived deciles neighbourhoods will, on average die seven years early on the Island. It is a statistical analysis of the than those people living in the most affluent relationship between life expectancy and deprivation neighbourhoods (Marmot). The Department of Health scores across the Local Authority area. The Slope has made tackling inequalities a priority and aims to Index indicates that there is a 4.9 year gap between reduce differences in life expectancy and healthy life the least and most deprived areas on the Island for expectancy between communities which will promote males and 3.9 years for females. greater improvements in more disadvantaged communities (LHIN). Life expectancy at age 65 is an estimate of the number of years a person aged 65 would survive if he or she Inequalities in life expectancy can be monitored by were to experience the particular areas age-specific using the Indices of Multiple Deprivation (IMD 2010) to mortality rates for that time period throughout his or compare areas of relative deprivation on the Island. her life. Data is pooled over three year periods to Life expectancy from birth for males is lower (worse) in present more even trends over time. the most deprived areas on the Island with an average expected life span of 76.1 years compared to the least Life expectancy at age 65 for males on the Island has deprived areas which have an average life expectancy increased by 7% since 2003/05 from 17.6 to 19.0 of 83.7 years; a statistically significant difference. years in 2009/11 (a statistically significant difference) which is above both the England and South East

Life Expectancy at Birth by Deprivation Quintile (2009-11) average. MALES 95 90 Life Expectancy at 65: 85 2003-05 to 2008-10 Time Trend: MALES 80 25 Isle of Wight England South East 75

Age 70 65 20 60 55 50 15 1 2 3 4 5

Most Deprived Local Deprivation Quintile Least Deprived expectancy life of years

10 Data Source: ONS Annual Deaths Extracts/ONS Mid Year Population Estimates / SEPHO Life 2003/05 2004/06 2005/07 2006/08 2007/09 2008/10 2009/11 Expectancy Calculator

Data Source: Office for National Statistics

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People are prepared for and supported in old age – Life expectancy, mortality & end of life

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Life expectancy at age 65 for females on the Island Disability-free life expectancy at birth - Isle of Wight & ONS has increased at a slower rate of 5% but is still a Comparators 2001: FEMALES statistically significant improvement. In 2003/05 the Isle of Wight average was 20.7 years and increased to 21.7 years in Waveney

2009/11. The average rate for females is slightly Weymouth and Portland above the England and South East average. Scarborough

England

Life Expectancy at 65: Allerdale 2003-05 to 2008-10 Time Trend: FEMALES 25 Isle of Wight England South East Shepway Torbay

Carlisle 20 Portsmouth

Dover

15 Southampton years of life expectancy life of years Great Yarmouth

Thanet 10 2003/05 2004/06 2005/07 2006/08 2007/09 2008/10 2009/11 Blackpool

0 20 40 60 80 Data Source: Office for National Statistics Estimated Crude prevalence rate (%) Sources: Office for National Statistics, Crown Copyright. Notes: Disability-free life expectancy incorporates an adjustment to life expectancy using information from survey data sources for disability to arrive at expected years life free from disability. Disability free life expectancy is the average number of years a person from birth would live disability free (no Mortality limiting long term illness) if they experienced the The mortality rate is the number of deaths in a particular areas age specific mortality and health rates population during a certain period of time and is for 2001 throughout their life (GLA). usually expressed as a rate per 100,000 resident Disability Free life expectancy at birth for males on the population. Mortality rates are also standardised for Isle of Wight in 2001 was 61.0 years, slightly under the age to take account of the underlying age structure of England average of 61.7 years. an area’s population.

Mortality rates from all causes on the Island are Disability-free life expectancy at birth - Isle of Wight & ONS Comparators 2001: MALES significantly lower (better) than the England average of

Waveney 553.3 per 100,000 with a mortality rate of 516.2 per England 100,000 population for the 2008/10 3-year pooled Shepway period. Carlisle Isle of Wight Mortality from All Causes (All Ages): 2008-10 (pooled) Southampton Isle of Wight & ONS Comparator Local Authorities: PERSONS Allerdale Blackpool UA Portsmouth Thanet Scarborough Carlisle Dover Allerdale Torbay Great Yarmouth

Weymouth and Portland Portsmouth

Great Yarmouth Scarborough

Thanet Southampton Blackpool Weymouth and Portland 0 20 40 60 80 England Estimated Crude prevalence rate (%) Torbay UA Sources: Office for National Statistics, Crown Copyright. Shepway Notes: Disability-free life expectancy incorporates an adjustment to life expectancy using information from survey data sources for disability to arrive at expected years life free from disability. Cornwall UA

Isle of Wight Waveney Disability free life expectancy at birth for females on Hampshire the Isle of Wight in 2001 was 65.2 years, slightly 0 100 200 300 400 500 600 700 800 900 Directly Age Standardised Rate per 100,000 Population higher the England average of 64.2 years. Sources: Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base (www.nchod.nhs.uk or nww.nchod.nhs.uk)

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People are prepared for and supported in old age – Life expectancy, mortality & end of life

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On the Island the male and female mortality rates were Mortality rates for males aged 75 and under is 627.9 and 426.1 per 100,000 population respectively, statistically significantly higher than the female rate which are both significantly lower (better) than the both on the Island and nationally. The rate for Island England averages of 656.0 and 467.1 per 100,000 males is 324.0 per 100,000 whilst the rate for females respectively. is 200.6 per 100,000 population. Both are lower than the national average (345.3 and 219.3 respectively), The highest major cause of deaths on the Islands in although neither difference is statistically significant. 2011 was cancer (28%) followed by heart disease (13%) which are both slightly lower than the England The mortality rate from all causes across the Islands average. Both circulatory disease (10%) and Stroke locality areas range from 466.2 per 100,000 population (8%) account for a slightly higher proportion of deaths in Cowes, to 569.4 per 100,000 population in the Bay than the England average with accidents (1%) and area. The Bay area is statistically significantly higher suicides (<1%) slightly lower. than the Ryde, West Wight and Cowes locality areas.

Mortality from all causes for the under 75’s across the Major Causes of Death on Isle of Wight: 2011 Island ranges from 215.29 per 100,000 population in 45 Isle of Wight UA England 40 Cowes to 450.06 per 100,000 in the Bay area with the 35 30 Bay area statistically significantly higher than the Ryde 25 and Cowes locality areas. 20 15 % of deaths of % 10 5 Mortality from all causes (under 75's): Isle of Wight wards and 0 localities 2010-2012 Other Cancer: Coronary Other Stroke: I60- Accidents: Suicide: Causes C00-C97 Heart Circulatory I69 V01-X59 X60-X84 The Bays Disease: Diseases I20-I25 Newport

South Wight

In the 2008-10 period all-cause mortality rates for The Isle of Wight under 75s on the Island was the third lowest (better) compared to local and ONS comparators with an Ryde overall rate of 261.2 per 100,000 population which is West Wight lower but not statistically significantly different to the

England average of 280.7 per 100,000. Cowes

0 50 100 150 200 250 300 350 400

Mortality from All Causes (<75): 2008-10 (pooled) Directly Age Standardised Rate per 100,000 Population Isle of Wight & ONS Comparator Local Authorities: PERSONS Sources: ONS Annual Death Extract & ONS Census 2011 Mid Year Population multiplied by three to cover the 2010-2012 population period Carlisle Weymouth and Portland Over time, mortality rates on the Island have fallen Blackpool UA significantly from 568.1 per 100,000 in 2003-05 to Waveney

Thanet 516.2 per 100,000 in 2008-10 and have consistently Portsmouth remained below the England average. Southampton

Great Yarmouth Mortality from All Causes (All Ages): Allerdale 2003-05 to 2008-10 Time Trend: PERSONS Scarborough 800 Isle of Wight England Torbay UA 700 England 600 Shepway

Isle of Wight 500

Cornwall UA 400 Hampshire 300 0 100 200 300 400 500 600

Directly Age Standardised Rate per 100,000 Population 200

Sources: Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base 100 (www.nchod.nhs.uk or nww.nchod.nhs.uk) 0 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 Population 100,000 per Rate Standardised Age Directly Sources: Compendium of Clinical and Health Indicators / Clinical and Health Outcomes

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People are prepared for and supported in old age – Life expectancy, mortality & end of life

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The all-cause mortality rate for males has decreased The Islands mortality rate from causes considered by 9% from 691.11 per 100,000 in 2003-05 to 627.90 preventable is one of the lowest against its per 100,000 in 2008-10. The England average has comparators with a directly standardised rate of 133.4 decreased over the same period by 14%. per 100,000, although it is not statistically significantly different to the England average of 146.1 per 100,000 The all-cause mortality rate for females on the Island population. has also decreased by 9% from 471.1 per 100,000 in Mortality rates from causes considered preventable (provisional 2009-11): 2003-05 to 426.1 per 100,000 in 2008-10. The female Isle of Wight & ONS Comparator Counties England average rate has decreased by 12% over the Blackpool UA same period. Portsmouth

The all-cause mortality rates for the under 75 Southampton population between 1993 and 2010 has decreased by Torbay UA 28% from 354.4 per 100,000 population in 1993 to England 254.5 per 100,000 population in 2010. Cornwall UA

Mortality from All Causes (Directly Age Standardised Rates): Isle of Wight Persons aged under 75 600 Isle of Wight England South East Hampshire

0 50 100 150 200 250 300

Directly Age Standardised Rate per 100,000 Population 400 Sources: Public Health Outcomes Framework (http://www.phoutcomes.info/)

200 Mortality rates from causes considered amenable to

treatment are conditions that are defined as those from mortality per 100,000 population 100,000 per mortality 0 which it is reasonable to expect death to be averted even after the condition has developed, for example, Data Source: National Centre for Health Outcomes Development (NCHOD) through early discovery and effective treatment (such The all-cause mortality for the under 75 population has as breast cancer). decreased in both males and females on the Island. This decrease for males aged under 75 has been Mortality from causes considered amenable to dramatically closing the gap in mortality rates between treatment for the under 75 population is the lowest males and females from 290.2 per 100,000 in 2003 to (best) against its ONS comparators and second lowest 123.4 per 100,000 in 2010. against its local and ONS comparators. It is also statistically significantly lower than the England

Isle of Wight: Mortality from All Causes (Directly Age Standardised Rates): average. On both the Island and in England the Age under 75 by Gender 600 males females female mortality rate from causes considered amenable to treatment is statistically significantly lower 400 than the rate for males.

Mortality from Causes Considered Amenable to Health Care 200 (Various Under 75's): 2008-10 (pooled) Isle of Wight & ONS Comparator Local Authorities: PERSONS

mortality per 100,000 population 100,000 per mortality Blackpool UA 0 Scarborough 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Carlisle Data Source: National Centre for Health Outcomes Development (NCHOD) Thanet

Southampton Mortality rates from causes considered preventable Allerdale Weymouth and Portland refer to deaths from conditions that are considered Portsmouth avoidable given timely and effective health care. England Torbay UA

Great Yarmouth

Preventable conditions include those for which there Shepway are effective means of preventing the condition from Waveney Cornwall UA occurring. They are related to lifestyle factors such as Isle of Wight smoking and preventable deaths such as traffic Hampshire 0 20 40 60 80 100 120 140 160 180 200 220 accidents due to not wearing a seat belt or speeding. Directly Age Standardised Rate per 100,000 Population

Sources: Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base (www.nchod.nhs.uk or nww.nchod.nhs.uk) 5 Produced by IWC Public Health Information Team

People are prepared for and supported in old age – Life expectancy, mortality & end of life

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Mortality from causes considered amenable to References and useful links treatment for the under 75s has reduced on the Island by 26% from 2003-05 to 2008-10, which is greater (better) than the England reduction of 22% over the http://www.news-medical.net/health/Life-Expectancy-What-is-Life- same period. Expectancy.aspx

The female rate for the Island has reduced by 18% Fair Society, Healthy Lives. The Marmot Review compared to the England average of 21% and the (2010), The Marmot Review. male rate for the Island has reduced by 32% compared to the England average of 23%. Greater London Authority, Healthy & Disability Free Mortality from Causes Considered Amenable to Health Care Life Expectancy (Various Under 75's): 2003-05 to 2008-10 Time Trend: http://data.london.gov.uk/datastore/package/healthy-and-disability- 140 PERSONS free-life-expectancy 120 Isle of Wight England

100 House of Commons Committee of Public Accounts

80 (2010-11), Tackling inequalities in life expectancy in areas with the worst health and deprivation (2010), 60 The Stationery Office Ltd 40

20 London Health Inequalities Network (2012), The Slope

0 Index of Inequality (SII) in life expectancy – interpreting Directly Age Standardised Rate per 100,000 Population 100,000 per Rate Standardised Age Directly 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 it and comparisons across London, Regional Public Sources: Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base (www.nchod.nhs.uk or nww.nchod.nhs.uk) Health Group, 2012, NHS

Across three of the main mortality causes, the number www.england.nhs.uk of deaths due to circulatory disease is projected to fall by 29% between 2011 and 2017, whilst deaths from respiratory diseases and cancer are projected to remain at similar levels or increase slightly.

Forecast Trend in All Cancer Mortality: 1995 to 2017 600 Isle of Wight

500

400

300

200 Actual Forecast Registered Deaths Registered 100

0

2000 2013 1995 1996 1997 1998 1999 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2014 2015 2016 2017

Since 2006 the proportion of deaths occurring in hospital has fallen, whilst deaths in the home, nursing home and residential homes have increased.

Place of death / 2006 2007 2008 2009 2010 2011 Year Hospital 48.5% 47.1% 46.7% 48.2% 46.4% 45.6% Home 15.7% 15.7% 18.1% 16.9% 19.9% 18.6% Nursing Home 10.1% 7.9% 9.0% 9.2% 10.5% 11.6% Residential Home 8.5% 11.3% 10.3% 9.6% 9.6% 9.7%

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