Community Assembly East Arbourthorne, Darnall, Manor

Community Assembly East

Arbourthorne, Darnall, Manor Castle and Richmond Wards

Health Effects of Inequalities and Air Pollution

Air Quality

Some Health Trends

Sheffield Neighbourhoods Information System (SNIS)

Prepared by Barbara Rimmington East End Quality of Life Initiative 10 Montgomery Terrace Road Sheffield S6 3BU Tel. 0114 2859931 Fax 0114 2787173 Ass7HealthAir 1 Email [email protected] April 2009 Health Effects of Inequality ... health disparities are not simply a contrast between the ill-health of the poor and the better health of everybody else. Instead, they run right across society so that even the reasonably well-off have shorter lives than the very rich. Likewise, the benefits of greater equality spread right across society, improving health for everyone – not just those at the bottom. In other words, at almost any level of income, it’s better to live in a more equal place (p84)

... in the course of our research we became aware that almost all problems which are more common at the bottom of the social ladder are more common in more unequal societies. It is not just ill-health and violence, but also, we will show in later chapters, a host of other social problems. Almost all of them contribute to the widespread concern that modern societies are, despite their affluence, social failures. To see whether these problems were more common in more unequal countries, we collected internationally comparable data on health and as many social problems as we could find reliable figures for. The list we ended up with included: Level of trust Mental illness (including drug and alcohol addiction) Life expectancy and infant mortality Obesity Children’s educational performance The Spirit Level: Teenage births Homicides why more equal Imprisonment rates societies almost Social mobility (pp18-19) always do better, by Richard Wilkinson If you want to know why one country does better or worse than another, the first thing to look at is the and Kate Pickett. extent of inequality. There is not one policy for reducing inequality in health or the educational London: Penguin performance of school children, and another for raising national standards of performance. Reducing inequality is the best way of doing both. And if, for instance, a country wants higher average levels of Books, 2009 educational achievement among its school children, it must address the underlying inequality which creates a steeper social gradient in educational achievement (pp29-30)

Ass7HealthAir 2

Pollutant Effects related to short-term exposure Effects related to long-term exposure Particulate matter • Lung inflammatory reactions • Increase in lower respiratory • Respiratory symptoms symptoms • Adverse effects on the • Reduction in lung function in children cardiovascular system • Increase in chronic obstructive • Increase in medication usage pulmonary disease • Increase in hospital admissions • Reduction in lung function in adults • Increase in mortality • Reduction in life expectancy, owing mainly to cardiopulmonary mortality and probably to lung cancer Ozone • Adverse effects on pulmonary • Reduction in lung function function development • Lung inflammatory reactions • Adverse effects on respiratory symptoms • Increase in medication usage • Increase in hospital admissions • Increase in mortality Nitrogen dioxide • Effects on pulmonary function, • Reduction in lung function (in ambient air, NO2 serves as particularly in asthmatics • Increased probability of respiratory an indicator for a complex • Increase in airway allergic symptoms mixture of mainly traffic-related inflammatory reactions air pollution) • Increase in hospital admissions • Increase in mortality

Source: World Health Organization, June 2004, Health Aspects of Air Pollution: Results from the WHO project ’Systematic Review of Health Aspects of Air Pollution in Europe.’ p7

Ass7HealthAir 3 Air Pollution and Noise: their effects on human health and social inclusion - a review of recent literature

Executive Summary

This review of recent papers looks at the growing body of evidence of how environmental factors, and particularly road-traffic related air pollution, affect health. Some of the most recent studies focus on the effects of small particulates which penetrate to the lungs and their adverse effects on cardiovascular disease, coronary heart disease, and stroke. Other studies have highlighted the disproportionate burden of environmental degradation, particularly air quality and noise, on deprived communities, with consequent impacts on increasing social deprivation.

Children (and the unborn foetus) are especially vulnerable to the effects of air pollution, because their lungs, metabolic and immune systems are still developing, they have higher rates of respiratory infections, and have activity patterns which lead to higher exposure. The effects in childhood and foetal development can include: • aggravation of asthma • increased cough and bronchitis • low birth weight • infant deaths (due to respiratory and Sudden Infant Death Syndrome) • pre-term births • birth defects leading to effects throughout adult life: • premature ageing • higher risk of infection • susceptibility to tobacco smoke • susceptibility to occupational exposure.

Air pollution has been associated with a range of health impacts, including: • aggravating and causing respiratory disease (including asthma, bronchitis, emphysema, etc.) • increased risk of cardiovascular disease and death • increased risk of coronary heart disease and death • increased risk of stroke • Increased risk of diabetes • eye disease • DNA damage.

Ass7HealthAir 4 Air Pollution and Noise: their effects on human health and social inclusion - a review of recent literature

Examples of the costs of air pollution from Europe, the UK and Sheffield European Union kills 370,000 people per year reduces life expectancy by up to 9 months on average costs between €427 billion and €790 billion per year United Kingdom 6,500 deaths brought forward (in 2002) 6,400 hospital admissions (in 2002) 3 A 1 mg/m decrease in PM2.5 would give between 1.5 and 3.5 extra days of life per person NOx damage per tonne emission for 2010 €3,900 (low estimate) PM2.5 damage per tonne emission for 2010 €37,000 (low estimate) SO2 damage per tonne emission for 2010 €6,600 (low estimate) Sheffield 6% coronary heart disease deaths 11% stroke deaths Annual health costs of £48.1m (low estimate) based on: 8,000 tonnes per annum NOx emissions (£20.9m) 1,480 tonnes per annum SO2 emissions (£6.5m) 1,190 tonnes per annum PM10 emissions (£20.7m - costs estimated on PM2.5 being 70% of PM10) Estimated annual cost benefits of introducing a Low Emission Zone between £1.8 million and £11.4 million per year (compared with inner relief road, costing £59m capital costs, bringing annual cost benefits of £0.03m to £0.2m)

Ass7HealthAir 5 Air Pollution and Noise: their effects on human health and social inclusion - a review of recent literature

Noise and health As well as the adverse effects of air pollution on health, road traffic generates noise which affects health in the following ways: annoyance sleep disturbance quality of sleep ischaemic heart disease impaired performance by school children some evidence to suggest that it may cause low birthweight in babies and psychiatric disorders.

Conclusion The growing body of evidence would suggest that bolder and more effective measures should be taken to reduce people's exposure to air pollution and noise attributable to road-traffic and thus reduce their risk of disease and mortality due to cardiovascular, respiratory, and other symptoms. The evidence suggests that there is no safe level of exposure to particulate matter, and especially to very small particles (PM2.5) which penetrate into the lungs. Many studies highlight the possible under-estimates of the health effects of traffic-related air pollution and noise, due to problems in isolating these from other effects on health.

The most deprived communities experience the worst environmental degradation. The implications for policy therefore would seem to be to target measures to reduce air pollution in deprived areas and highly populated urban areas, where the relatively small individual health benefits can make a big impact because they reach a large population. Concerns about the U.K.'s ability to meet current targets to reduce air pollution, particularly in urban areas, further emphasise the need for reducing motor vehicle traffic but at the same time enhancing alternatives such as walking, cycling, and public transport.

East End Quality of Life Initiative, revised January 2006

Ass7HealthAir 6 Cardiovascular Disease and Air Pollution

“Cardiovascular disease is very common and, as exposure to air pollution, both in the long and short term contributes to initiation and exacerbation of disease, it is likely that even modest reductions in exposure will result in significant health

gain”

The term cardiovascular disease includes all diseases of the heart and blood vessels including stroke.

Ass7HealthAir 7 The Effects of Air Pollution on Children’s Health

Ass7HealthAir 8 Community Air Quality Monitoring of Nitrogen Dioxide - Annual Averages

Darnall Tinsley

Handsworth Tinsley

Ass7HealthAir 9 Community Air Quality Monitoring of Nitrogen Dioxide - Annual Averages

Park Hill

2008 results for Breathe Easy Group - no annual data available yet

Ass7HealthAir 10 Female Life Expectancy and Deaths

Female Life Expectancy Darnall Ward Female Life Expectancy Manor Castle Ward

90 90 88 88 86 86 84 84 82 Tinsley 82 Wybourn Darnall 80 80 Manor Handsworth 78 78 Park Hill

years Housteads years 76 Granville Acres Hill 76 Sheffield 74 Sheffield 74 72 72 70 70 68 68 66 66 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Female Life Expectancy Richmond Ward Female Life Expectancy Arbourthorne Ward

90 90 88 88 86 86 84 84 82 82 Richmond Norfolk Park 80 Woodthorpe 80 Arbourthorne 78 Hollins End 78

years years Gleadless 76 Base Green 76 Sheffield Sheffield 74 74 72 72 70 70 68 68 66 66 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Ass7HealthAir 11 Data Source: Public Health Mortality Files, Office for National Statistics, 2002-2006; Population Health Register, 2002-2006.. Life Expectancy calculation based on a method calculated by the West Midlands Public Health Observatory. Male Life Expectancy and Deaths

Male Life Expectancy Darnall Ward Male Life Expectancy Manor Castle Ward

90 90 88 88 86 86 84 84 82 Tinsley 82 Wybourn Darnall 80 80 Manor Handsworth 78 78 Park Hill years Housteads years 76 76 Granville Acres Hill 74 74 Sheffield Sheffield 72 72 70 70 68 68 66 66 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Male Life Expectancy Richmond Ward Male Life Expectancy Arbourthorne Ward

90 90 88 88 86 86 84 84 82 82 Richmond Norfolk Park 80 Woodthorpe 80 Arbourthorne 78 Hollins End 78

years years Gleadless 76 Base Green 76 Sheffield 74 Sheffield 74 72 72 70 70 68 68 66 66 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Ass7HealthAir 12 Data Source: Public Health Mortality Files, Office for National Statistics, 2002-2006; Population Health Register, 2002-2006.. Life Expectancy calculation based on a method calculated by the West Midlands Public Health Observatory. Deaths - all causes

Mortality all causes aged < 75 Darnall Ward Mortality all causes aged < 75 Manor Castle Ward

900 900

800 800

700 700

600 Tinsley 600 Wybourn Darnall 500 500 Manor Handsworth Park Hill popn aged < 75 yrs < 75 popn aged popn aged < 75 yrs < 75 popn aged 400 Housteads 400 Granville Acres Hill 300 300 Sheffield Sheffield 200 200 rate per 100,000 100 rate per 100,000 100

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Mortality all causes aged < 75 Richmond Ward Mortality all causes aged < 75 Arbourthorne Ward

900 900

800 800

700 700

600 600 Richmond Norfolk Park 500 Woodthorpe 500 Arbourthorne Hollins End popn aged < 75 yrs < 75 popn aged 400 yrs < 75 popn aged 400 Gleadless Base Green Sheffield 300 Sheffield 300

200 200

rate per 100,000 100 rate per 100,000 100

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Ass7HealthAir 13 Data Source: Public Health Mortality Files, Office for National Statistics, 2002-2006; Population Health Register extracts, 2002-2006. All mortality rates expressed as European Age Standardised rates per 100,000 population except infant deaths aged <1 year expressed as rate per 1,000 live births. Deaths - cancer

Mortality cancer aged < 75 Darnall Ward Mortality cancer aged < 75 Manor Castle Ward

500 500

400 400

Tinsley Wybourn 300 Darnall 300 Manor Handsworth Park Hill popn aged < 75 yrs < 75 popn aged popn aged < 75 yrs < 75 popn aged Housteads Granville 200 Acres Hill 200 Sheffield Sheffield

100 100 rateper 100,000 rate per 100,000

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Mortality cancer aged < 75 Richmond Ward Mortality cancer aged < 75 Arbourthorne Ward

500 500

400 400

Richmond 300 300 Norfolk Park Woodthorpe Arbourthorne Hollins End

popn aged < 75 yrs < 75 popn aged yrs < 75 popn aged Gleadless Base Green 200 200 Sheffield Sheffield

100 100 rate per 100,000 rate per 100,000

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Ass7HealthAir 14 Data Source: Public Health Mortality Files, Office for National Statistics, 2002-2006; Population Health Register extracts, 2002-2006. All mortality rates expressed as European Age Standardised rates per 100,000 population except infant deaths aged <1 year expressed as rate per 1,000 live births. Deaths - Coronary Heart Disease

Mortality CHD aged < 75 Darnall Ward Mortality CHD aged < 75 Manor Castle Ward

200 200

150 150 Tinsley Wybourn Darnall Manor Handsworth 100 100 Park Hill popn aged < 75 yrs < 75 popn aged popn aged < 75 yrs < 75 popn aged Housteads Granville Acres Hill Sheffield Sheffield 50 50 rateper 100,000 rate per 100,000

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Mortality CHD aged < 75 Richmond Ward Mortality CHD aged < 75 Arbourthorne Ward

200 200

150 150

Richmond Norfolk Park Woodthorpe Arbourthorne 100 Hollins End 100

popn aged < 75 yrs < 75 popn aged yrs < 75 popn aged Gleadless Base Green Sheffield Sheffield 50 50 rate per 100,000 rate per 100,000

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Ass7HealthAir 15 Data Source: Public Health Mortality Files, Office for National Statistics, 2002-2006; Population Health Register extracts, 2002-2006. All mortality rates expressed as European Age Standardised rates per 100,000 population except infant deaths aged <1 year expressed as rate per 1,000 live births. Deaths - circulatory diseases

Mortality circulatory diseases aged < 75 Darnall Ward Mortality circulatory diseases aged < 75 Manor Castle Ward

300 300

250 250

200 Tinsley 200 Wybourn Darnall Manor Handsworth 150 150 Park Hill popn aged < 75 yrs < 75 popn aged Housteads yrs < 75 popn aged Granville Acres Hill 100 100 Sheffield Sheffield

50 50 rate per 100,000 rate per 100,000

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Mortality circulatory diseases aged < 75 Richmond Ward Mortality circulatory diseases aged < 75 Arbourthorne Ward

300 300

250 250

200 200 Richmond Norfolk Park Woodthorpe Arbourthorne 150 Hollins End 150

popn aged < 75 yrs < 75 popn aged yrs < 75 popn aged Gleadless Base Green Sheffield 100 Sheffield 100

50 50 rate per 100,000 rate per 100,000

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Ass7HealthAir 16 Data Source: Public Health Mortality Files, Office for National Statistics, 2002-2006; Population Health Register extracts, 2002-2006. All mortality rates expressed as European Age Standardised rates per 100,000 population except infant deaths aged <1 year expressed as rate per 1,000 live births. Deaths - respiratory diseases

Mortality respiratory diseases aged < 75 Darnall Ward Mortality respiratory diseases aged < 75 Manor Castle Ward

150 150

125 125

100 Tinsley 100 Wybourn Darnall Manor Handsworth 75 75 Park Hill Housteads Granville Acres Hill 50 50 Sheffield Sheffield

25 25 rate per 100,000 popn aged < yrs 75 rate per 100,000 popn aged < yrs 75

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Mortality respiratory diseases aged < 75 Richmond Ward Mortality respiratory diseases aged < 75 Arbourthorne Ward

150 150

125 125

100 100 Richmond Norfolk Park Woodthorpe Arbourthorne 75 Hollins End 75 Gleadless Base Green Sheffield 50 Sheffield 50

25 25 rate per 100,000 popn aged < 75 yrs rate per 100,000 popn aged < 75 yrs

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Ass7HealthAir 17 Data Source: Public Health Mortality Files, Office for National Statistics, 2002-2006; Population Health Register extracts, 2002-2006. All mortality rates expressed as European Age Standardised rates per 100,000 population except infant deaths aged <1 year expressed as rate per 1,000 live births. Deaths - Stroke

Mortality Stroke aged < 75 Darnall Ward Mortality Stroke aged < 75 Manor Castle Ward

100 100

90 90

80 80

70 Tinsley 70 Wybourn 60 Darnall 60 Manor Handsworth 50 50 Park Hill Housteads Granville 40 Acres Hill 40 Sheffield 30 Sheffield 30

20 20 rate per 100,000 popn aged < yrs 75 rate per 100,000 popn aged < yrs 75 10 10

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Mortality Stroke aged < 75 Richmond Ward Mortality Stroke aged < 75 Arbourthorne Ward

100 100

90 90

80 80

70 70 Richmond 60 60 Norfolk Park Woodthorpe Arbourthorne 50 Hollins End 50 Gleadless Base Green 40 40 Sheffield Sheffield 30 30

20 20

rate per 100,000 popn aged < 75 yrs 10 rate per 100,000 popn aged < 75 yrs 10

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Ass7HealthAir 18 Data Source: Public Health Mortality Files, Office for National Statistics, 2002-2006; Population Health Register extracts, 2002-2006. All mortality rates expressed as European Age Standardised rates per 100,000 population except infant deaths aged <1 year expressed as rate per 1,000 live births. Hospital Admission Rates - Emergency Admissions for Coronary Heart Disease

Emergency admissions to hospital for CHD all ages Darnall Emergency admissions to hospital for CHD all ages Manor Ward Castle Ward

900 900 800 800 700 700 Tinsley 600 600 Wybourn Darnall Manor 500 Handsworth 500 Park Hill 400 Housteads 400 Granville 300 Acres Hill 300 Sheffield Sheffield 200 200 rate perrate 100,000 popn rate perrate 100,000 popn 100 100 0 0 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 1997/08- 1998/99- 1999/00- 2000/01- 2001/02- 2002/03- 1997/08- 1998/99- 1999/00- 2000/01- 2001/02- 2002/03-

Emergency admissions to hospital for CHD all ages Richmond Emergency admissions to hospital for CHD all ages Ward Arbourthorne Ward

900 900 800 800 700 700 600 Richmond 600 Norfolk Park Woodthorpe 500 500 Arbourthorne Hollins End 400 400 Gleadless Base Green 300 300 Sheffield Sheffield 200 200 rateper 100,000 popn rateper 100,000 popn 100 100 0 0 2006/07 2006/07 2005/06 2005/06 2004/05 2004/05 2003/04 2003/04 2002/03 2002/03 2001/02 2001/02 2002/03- 2002/03- 2001/02- 2001/02- 2000/01- 2000/01- 1999/00- 1999/00- 1998/99- 1998/99- 1997/08- 1997/08-

Data Source: Inpatient Minimum Data Sets, 2006/07; All rates expressed as European Age Ass7HealthAir 19 Standardised rates per 100,000 population Population Health Register extracts, 2006/07. except emergency admissions aged <18yrs expressed as rate per 1,000 population. Hospital Admission Rates - Emergency Admissions for Chronic Diseases

Emergency admissions to hospital for chronic diseases all Emergency admissions to hospital for chronic diseases all ages Darnall Ward ages Manor Castle Ward

3000 3000

2500 2500

Tinsley 2000 2000 Wybourn Darnall Manor Handsworth 1500 1500 Park Hill Housteads Granville 1000 Acres Hill 1000 Sheffield Sheffield rate perrate 100,000 popn 500 perrate 100,000 popn 500

0 0 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 1997/08- 1998/99- 1999/00- 2000/01- 2001/02- 2002/03- 1997/08- 1998/99- 1999/00- 2000/01- 2001/02- 2002/03-

Emergency admissions to hospital for chronic diseases all Emergency admissions to hospital for chronic diseases all ages Richmond Ward ages Arbourthorne Ward

3000 3000

2500 2500

2000 Richmond 2000 Norfolk Park Woodthorpe Arbourthorne 1500 Hollins End 1500 Gleadless Base Green 1000 1000 Sheffield Sheffield rateper 100,000 popn rateper 100,000 popn 500 500

Data Source: Inpatient Minimum Data Sets, 2006/07; All rates expressed as European Age Ass7HealthAir 20 Standardised rates per 100,000 population Population Health Register extracts, 2006/07. except emergency admissions aged <18yrs expressed as rate per 1,000 population. Hospital Admission Rates - Chronic Obstructive Pulmonary Disease

Admissions to hospital for COPD all ages Darnall Ward Admissions to hospital for COPD all ages Manor Castle Ward

1000 1000 900 900

800 800 700 Tinsley 700 Wybourn Darnall 600 600 Manor Handsworth 500 500 Park Hill Housteads Granville 400 Acres Hill 400 Sheffield 300 Sheffield 300 rate per 100,000 popn rate per 100,000 popn 200 200

100 100 0 0 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 1997/08- 1998/99- 1999/00- 2000/01- 2001/02- 2002/03- 1997/08- 1998/99- 1999/00- 2000/01- 2001/02- 2002/03-

Admissions to hospital for COPD all ages Richmond Ward Admissions to hospital for cancer all ages Arbourthorne Ward

1000 1000 900 900 800 800 700 700 Richmond 600 Norfolk Park 600 Woodthorpe Arbourthorne 500 Hollins End 500 Gleadless Base Green 400 400 Sheffield Sheffield 300 300 rate perrate 100,000popn 200 rate per 100,000 popn 200

Ass7HealthAir 21 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Hospital Admission Rates - Stroke

Admissions to hospital for Stroke all ages Darnall Ward Admissions to hospital for Stroke all ages Manor Castle Ward 400 400

350 350

300 300 Tinsley 250 250 Wybourn Darnall popn popn Manor 200 Handsworth 200 Park Hill Housteads Granville 150 Acres Hill 150 Sheffield 100 Sheffield 100 rate per100,000 rate per 100,000 50 50

Admissions to hospital for Stroke all ages Richmond Ward Admissions to hospital for Stroke all ages Arbourthorne Ward 400 400

350 350

300 300

250 Richmond 250 Norfolk Park Woodthorpe 200 200 Arbourthorne Hollins End Gleadless Base Green 150 150 Sheffield Sheffield 100 100 rate per 100,000 popn rate per 100,000 popn 50 50

Ass7HealthAir 22 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Hospital Admission Rates - Asthma

Admissions to hospital for asthma all ages Darnall Ward Admissions to hospital for asthma all ages Manor Castle Ward

500 500

400 400

Tinsley Wybourn Darnall popn 300 300 popn Manor Handsworth Park Hill Housteads 200 200 Granville Acres Hill Sheffield Sheffield rate per 100,000 100 rate per 100,000 100

Admissions to hospital for asthma all ages Richmond Ward Admissions to hospital for asthma all ages Arbourthorne Ward

500 500

400 400

Richmond 300 300 Norfolk Park Woodthorpe Arbourthorne Hollins End Gleadless 200 Base Green 200 Sheffield Sheffield

rate per 100,000 popn 100 rate per 100,000 popn 100

0 0 2006/07 2006/07 2005/06 2005/06 2004/05 2004/05 2003/04 2003/04 2002/03 2002/03 2001/02 2001/02 2002/03- 2002/03- 2001/02- 2001/02- 2000/01- 2000/01- 1999/00- 1999/00- 1998/99- 1998/99- 1997/08- 1997/08-

Ass7HealthAir 23 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Hospital Admission Rates - Diabetes

Admissions to hospital for diabetes all ages Darnall Ward Admissions to hospital for diabetes all ages Manor Castle Ward

150 150

125 125

Tinsley 100 100 Wybourn popn Darnall popn Manor Handsworth 75 75 Park Hill Housteads Granville Acres Hill 50 50 Sheffield Sheffield rate per 100,000 rate per 100,000 25 25

Admissions to hospital for diabetes all ages Richmond Ward Admissions to hospital for diabetes all ages Arbourthorne Ward

150 150

125 125

100 Richmond 100 popn popn Norfolk Park Woodthorpe Arbourthorne 75 Hollins End 75 Gleadless Base Green Sheffield 50 Sheffield 50 rate per 100,000 rate per 100,000 25 25

Ass7HealthAir 24 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Hospital Admission Rates - Cancer

Admissions to hospital for cancer all ages Darnall Ward Admissions to hospital for cancer all ages Manor Castle Ward

3000 3000

2500 2500

Tinsley 2000 2000 Wybourn Darnall Manor Handsworth 1500 1500 Park Hill Housteads Granville Acres Hill 1000 1000 Sheffield Sheffield rate per 100,000 popn 100,000 per rate rate per 100,000 popn 100,000 per rate 500 500

Admissions to hospital for cancer all ages Richmond Ward Admissions to hospital for cancer all ages Arbourthorne Ward

3000 3000

2500 2500

2000 Richmond 2000 Norfolk Park Woodthorpe Arbourthorne 1500 Hollins End 1500 Gleadless Base Green Sheffield 1000 Sheffield 1000 rate per 100,000 popn 100,000 per rate rate per 100,000 popn 100,000 per rate 500 500

Ass7HealthAir 25 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Hospital Admission Rates - Mental Health

Admissions to hospital under mental health specialties all ages Admissions to hospital under mental health specialties all ages Darnall Ward Manor Castle Ward

650 650 600 600 550 550 500 500 Tinsley 450 450 Wybourn 400 Darnall 400 Manor 350 Handsworth 350 Park Hill 300 Housteads 300 250 250 Granville Acres Hill 200 200 Sheffield Sheffield 150 150 rate per 100,000popn rate per 100,000 popn 100 100 50 50 0 0 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 1997/08- 1998/99- 1999/00- 2000/01- 2001/02- 2002/03- 1997/08- 1998/99- 1999/00- 2000/01- 2001/02- 2002/03-

Admissions to hospital under mental health specialties all ages Admissions to hospital under mental health specialties all ages Richmond Ward Arbourthorne Ward

650 650 600 600 550 550 500 500 450 Richmond 450 popn popn 400 400 Norfolk Park Woodthorpe 350 350 Arbourthorne Hollins End 300 300 Gleadless 250 Base Green 250 Sheffield 200 Sheffield 200 150 150 rate per 100,000 rate per 100,000 100 100 50 50 0 0 2006/07 2006/07 2005/06 2005/06 2004/05 2004/05 2003/04 2003/04 2002/03 2002/03 2001/02 2001/02 2002/03- 2002/03- 2001/02- 2001/02- 2000/01- 2000/01- 1999/00- 1999/00- 1998/99- 1998/99- 1997/08- 1997/08-

Ass7HealthAir 26 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Births, Pregnancies and Children’s Health - Infant Mortality

Infant Mortality aged < 1 Darnall Ward Infant Mortality aged < 1 Manor Castle Ward

25 25

20 20

Tinsley Wybourn 15 Darnall 15 Manor Handsworth Park Hill Housteads 10 10 Granville Acres Hill Sheffield Sheffield rateper 1,000 live births rate per 1,000live births 5 5

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Infant Mortality aged < 1 Richmond Ward Infant Mortality aged < 1 Arbourthorne Ward

25 25

20 20

Richmond 15 15 Norfolk Park Woodthorpe Arbourthorne Hollins End Gleadless 10 Base Green 10 Sheffield Sheffield

rate per 1,000 live births 5 rate per 1,000 live births 5

0 0 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006

Ass7HealthAir 27 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Births, Pregnancies and Children’s Health - Low Birth Weight

Low birth weight (under 2500g) Darnall Ward Low birth weight (under 2500g) Manor Castle Ward

20 20

15 15 Tinsley Wybourn Darnall Manor Handsworth 10 10 Park Hill Housteads Granville Acres Hill Sheffield Sheffield 5 5 rate per 1,000 livebirths rate per 1,000 live births

0 0 1997-01 1998-02 1999-03 2000-04 2001-05 2002-06 1997-01 1998-02 1999-03 2000-04 2001-05 2002-06

Low birth weight (under 2500g) Richmond Ward Low birth weight (under 2500g) Arbourthorne Ward

20 20

15 15

Richmond Norfolk Park Woodthorpe Arbourthorne 10 Hollins End 10 Gleadless Base Green Sheffield Sheffield 5 5 rate per 1,000 live births rate per 1,000 live births

0 0 1997-01 1998-02 1999-03 2000-04 2001-05 2002-06 1997-01 1998-02 1999-03 2000-04 2001-05 2002-06

Ass7HealthAir 28 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Births, Pregnancies and Children’s Health - Breastfeeding Rates

Breastfeeding intention at delivery Darnall Ward Breastfeeding intention at delivery Manor Castle Ward

100 100

90 90

80 80

70 70 Tinsley Wybourn 60 Darnall 60 Manor Handsworth 50 50 Park Hill Housteads 40 40 Granville Acres Hill Sheffield 30 Sheffield 30

20 20

10 10 rate per deliveries 100 >23 gestation weeks 0 rate per deliveries 100 >23 gestation weeks 0 2001 2002 2003 2004 2005 2006 2001 2002 2003 2004 2005 2006

Breastfeeding intention at delivery Richmond Ward Breastfeeding intention at delivery Arbourthorne Ward

100 100

90 90

80 80

70 70 Richmond 60 60 Norfolk Park Woodthorpe Arbourthorne 50 Hollins End 50 Gleadless 40 Base Green 40 Sheffield Sheffield 30 30

20 20

10 10 rate per100 deliveries >23 gestation weeks rate per 100 delivieries >23 gestationweeks 0 0 2001 2002 2003 2004 2005 2006 2001 2002 2003 2004 2005 2006

Ass7HealthAir 29 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Births, Pregnancies and Children’s Health - Average Age of Mother

Average age of mother at first registerable birth Darnall Ward Average age of mother at first registerable birth Manor Castle Ward 30 30 25 25

20 Tinsley Darnall 20 Wybourn

15 Handsworth Manor 15

years Housteads Park Hill

Acres Hill years Granville 10 Sheffield 10 Sheffield

5 5

0 0 2001 2002 2003 2004 2005 2006 2001 2002 2003 2004 2005 2006

Average age of mother at first registerable birth Richmond Average age of mother at first registerable birth Arbourthorne Ward Ward

30 30

25 25

20 Richmond 20 Norfolk Park Woodthorpe Arbourthorne 15 Hollins End 15

years years Gleadless Base Green Sheffield 10 Sheffield 10

5 5

0 0 2001 2002 2003 2004 2005 2006 2001 2002 2003 2004 2005 2006

Ass7HealthAir 30 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Births, Pregnancies and Children’s Health - Teenage Pregnancy Rates

Conception rates aged under 18 Darnall Ward Conception rates aged under 18 Manor Castle Ward 140 140

120 120

100 100 Tinsley Wybourn 80 Darnall 80 Manor Handsworth Park Hill 60 Housteads 60 Granville Acres Hill Sheffield 40 Sheffield 40 rate per 1,000 females aged <18 rate per 1,000 females aged <18 20 20

0 0 1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 1999-01 2000-02 2001-03 2002-04 2003-05 2004-06

Conception rates aged under 18 Richmond Ward Conception rates aged under 18 Arbourthorne Ward 140 140

120 120

100 100

Richmond 80 80 Norfolk Park Woodthorpe Arbourthorne Hollins End 60 60 Gleadless Base Green Sheffield Sheffield 40 40

rate per 1,000females aged <18 20 rate per 1,000 females aged <18 20

0 0 1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 1999-01 2000-02 2001-03 2002-04 2003-05 2004-06

Ass7HealthAir 31 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Births, Pregnancies and Children’s Health - Mothers Recorded as Smokers

Mothers recorded as smokers at delivery Darnall Ward Mothers recorded as smokers at delivery Manor Castle Ward 60 60 55 55 50 50 45 45

40 Tinsley 40 Wybourn 35 Darnall 35 Manor 30 Handsworth 30 Park Hill Housteads 25 25 Granville Acres Hill 20 20 Sheffield Sheffield rate per deliveries 100 rate per deliveries 100 15 15 10 10 5 5 0 0 2001 2002 2003 2004 2005 2006 2001 2002 2003 2004 2005 2006

Mothers recorded as smokers at delivery Richmond Ward Mothers recorded as smokers at delivery Arbourthorne Ward 60 60 55 55 50 50 45 45 40 40 Richmond 35 35 Norfolk Park Woodthorpe 30 30 Arbourthorne Hollins End Gleadless 25 Base Green 25 Sheffield 20 Sheffield 20

15 rate per 100 deliveries 15 rate per 100 delivieries 100 per rate 10 10 5 5 0 0 2001 2002 2003 2004 2005 2006 2001 2002 2003 2004 2005 2006

Ass7HealthAir 32 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population. Births, Pregnancies and Children’s Health - Dental Health of Children

Decayed, missing or filled teeth in children aged 5 Darnall Ward Decayed, missing or filled teeth in children aged 5 Manor Castle 5.0 Ward 5.0 4.5 4.5 4.0 4.0 3.5 Tinsley 3.5 3.0 Darnall Wybourn 3.0 2.5 Handsworth Manor 2.5 Housteads Park Hill 2.0 Acres Hill 2.0 Granville 1.5 Sheffield 1.5 Sheffield average number ofteeth 1.0 average number ofteeth 1.0 0.5 0.5

0.0 0.0 1999-00 2001-02 2003-04 2004-05 2005-06 2006-07 1999-00 2001-02 2003-04 2004-05 2005-06 2006-07

Decayed, missing or filled teeth in children aged 5 Richmond Decayed, missing or filled teeth in children aged 5 Arbourthorne Ward Ward 5.0 5.0

4.5 4.5 4.0 4.0 3.5 3.5 Richmond 3.0 3.0 Norfolk Park Woodthorpe 2.5 2.5 Arbourthorne Hollins End Gleadless 2.0 Base Green 2.0 Sheffield 1.5 Sheffield 1.5

averagenumber of teeth 1.0 averagenumber of teeth 1.0

0.5 0.5 0.0 0.0 1999-00 2001-02 2003-04 2004-05 2005-06 2006-07 1999-00 2001-02 2003-04 2004-05 2005-06 2006-07

Ass7HealthAir 33 Data Source: Inpatient Minimum Data Sets, 2006/07; Population Health Register extracts, 2006/07. All rates expressed as European Age Standardised rates per 100,000 population except emergency admissions aged <18yrs expressed as rate per 1,000 population.

Data source: Sheffield City Council Neighbourhoods, 2007

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Ass7HealthAir 35 Data source: Sheffield City Council Neighbourhoods, 2007

Ass7HealthAir 36 Data source: Sheffield City Council Neighbourhoods, 2007

Ass7HealthAir 37 Data source: Sheffield City Council Neighbourhoods, 2007

Data source: Sheffield City Council Neighbourhoods, 2007

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