Spring 2005 NO 25 Health Statistics Quarterly In this issue Page In brief 3 Recent publications 4 Health indicators 5 The impact of the 2003 heat wave on mortality and hospital admissions in England 6 Examines the impact of the heat wave, 4 to 13 August 2003, on mortality and emergency hospital admissions in England by region and age group. Helen Johnson, R Sari Kovats, Glenn McGregor, John Stedman, Mark Gibbs, Heather Walton, Lois Cook and Emily Black Is the health of the long-term unemployed better or worse in high unemployment areas? 12 Examines the geographic and socio-economic context in which long-term unemployment occurs and their impacts on health outcomes. Margaret Whitehead, Frances Drever and Tim Doran Healthy life expectancy by area deprivation: magnitude and trends in England, 1994–1999 18 Examines the magnitude of inequalities in healthy life expectancy and disability-free life expectancy at birth, at age 15 and at age 65 in England by area deprivation. Trends in healthy life expectancy for the most and least deprived areas over the period 1994–1999 are also described. Madhavi Bajekal Ta bl e s List of tables 28 Notes to tables 29 Tables 1.1–6.3 30 Reports: Deaths related to drug poisoning: England and Wales, 1999–2003 52 Deaths involving MRSA: England and Wales, 1999–2003 60 Annual Updates: Congenital anomaly statistics: notifi cations, 2003, England and Wales 66 2003 Mortality statistics: cause, England and Wales 69 About the Offi ce for National Statistics The Offi ce for National Statistics (ONS) is the Government Agency responsible for compiling, ana lys ing and disseminating many of the United Kingdom’s economic, social and demo- graphic statistics, including the retail prices index, trade fi gures and labour market data, as well as the periodic census of the pop u la tion and health statistics. It is also the agency that admin- isters the statutory registration of births, marriages and deaths in England and Wales. The Director of ONS is also the National Statistician and the Registrar General for England and Wales. A National Statistics publication National Statistics are produced to high professional stand- ards set out in the National Statistics Code of Practice. They undergo regular quality assur ance reviews to ensure that they meet customer needs. They are produced free from any political infl uence. About Health Statistics Quarterly and Population Trends Health Statistics Quarterly and Population Trends are journals of the Offi ce for National Statistics. Each is published four times a year in February, May, August and November and March, June, Sep tem ber and December, respectively. In addition to bringing together articles on a wide range of popu la tion and health top- ics, Health Statistics Quarterly and Population Trends contain regu- Contact points at ONS lar series of tables on a wide range of subjects for which ONS People with enquiries about the statistics published regularly in is responsible, including the most recently availa ble statistics. Health Statistics Quarterly and Pop u la tion Trends can contact the following enquiry points. Subscription Annual subscription, including postage, is £80; single issues are £25. Topic enquiries Abortions: 020 7972 5537 (Department of Health) Online E-mail: [email protected] Health Statistics Quarterly and Population Trends can be viewed or Births: 01329 813758 downloaded as Adobe Acrobat PDF fi les from the National Sta- E-mail: [email protected] tistics website www.statistics.gov.uk/products/p6725.asp (Health Conceptions: 020 7533 5113 Statistics Quarterly) or www.statistics.gov.uk/products/p6303.asp Expectation of life: 020 7211 2622 (Government Actuary’s Department) (Pop u la tion Trends). Marriages and divorces: 01329 813758 E-mail: [email protected] Migration: 01329 813872/813255 Editorial board Mortality: 01329 813758 E-mail: [email protected] Peter Goldblatt (editor) Population estimates: 01329 813318 Roma Chappell (editor) E-mail: [email protected] Angela Dale Population projections: Paul Hyatt National – 020 7211 2622 (Government Actuary’s De part ment) Judith Jones Subnational – 01329 813474/813865 Azeem Majeed Jil Matheson General enquiries Ian R Scott National Statistics Customer Contact Centre Room 1015 Government Buildings Contributions Cardiff Road Articles: 5,000 words max. Newport NP10 8XG Tel: 0845 601 3034 E-mail: [email protected] Dates for submissions Website: www.statistics.gov.uk © Crown copyright 2005. Published with the permission of the Issue mer Title tumn ter Controller of Her Majesty’s Station ery Offi ce (HMSO). Spring Sum Au Win This publication, excluding logos, may be reproduced free of Health Statistics Quarterly by 11 Sept by 11 Dec by 22 Mar by 21 June charge, in any format or medium for research or private study subject to it being reproduced accurately and not used in a misleading context. The material must be acknowledged as Population Trends by 23 Oct by 2 Feb by 4 May by 26 July crown copyright and the title of the publication specifi ed. This publication can also be accessed at the National Statistics website: www.statistics.gov.uk Please send to: Clare Parrish, executive secretary For any other use of this material please apply for a free Click- Use Licence on the HMSO website: www.hmso.gov.uk/click- Health Statistics Quarterly/Population Trends use-home.htm or write to HMSO at The Licensing Division, St Offi ce for National Statistics Clement's House, 2–16 Colegate, Norwich, NR3 1BQ. Fax 01603 B7/06 723000 or e-mail: 1 Drummond Gate hmsolicensing@cabinetoffi ce.x.gsi.gov.uk London SW1V 2QQ ISBN 1 4039 9086 7 Tel: 020 7533 5264 ISSN 1465-1645 Fax: 020 7533 5103 E-mail: [email protected] Health Statistics Quarterly 25 Spring 2005 in brief Focus on Social Final Atkinson Review Inequalities In December 2004 the fi rst detailed full report in the ‘Focus onʼ series – Focus on Social report published Inequalities – was published. Focus on Social Inequalities describes the different experiences of social groups in the UK Sir Tony Atkinson has published the Final Report of his Review of the Measurement of today in six key areas: education, work, income, Government Output and Productivity for the National Accounts. living standards, health, and participation. It looks at the ‘advantagedʼ as well as the The Final Report builds on and refi nes the an interim report in July, published on 19 July ‘disadvantagedʼ and explores the relative material and provisional conclusions in the 2004, and a fi nal report in January 2005. The differences between them. Interim Report. It explains what Sir Tony Terms of Reference for the Review were: sees as a principled framework for measuring The report highlights that household income government output in the National Accounts, ‘To advance methodologies for the and educational attainment have improved within international guidelines, and sets out measurement of government output, overall but the gaps remain large. However, a number of recommendations on how these productivity and associated price indices in the employment rates for most key groups that should be implemented. It reports on plans to context of the National Accounts, recognising: have been disadvantaged in the labour market improve further measurement of output in four have improved recently and at a greater rate spending areas: health; education; public order • the full scope of government outputs; than for the population overall. Nevertheless, a and safety, and social protection. signifi cant minority of people are affected by a • differences in the nature and quality of lack of material resources and the inequality in For health, there are eight recommendations, these outputs over time; the health of the population has widened over covering: using computerised databases to the last few decades. improve measurement of output in general • the relationship between government practice; extending the output measure for outputs and social outcomes; The key fi ndings on health are that the secondary care as coverage of the National difference between manual and non-manual Schedule of Reference Costs expands and as • the need for comparability with measures workers remains. For the period 1997–1999, data sources are made available for Devolved of private sector services outputs and costs; life expectancy at birth in England and Wales Administrations; exploring ways for taking for males in the professional group was 7.4 forward work to measure output on the basis • the existing work of the ONS; and years more than for males in the unskilled of whole courses of treatment rather than manual groups. This was almost two years individual components of treatment; developing • the appropriate measurement of inputs, greater than in 1972–1976. In women, the gap measures of change in quality; improving including quality and the distinction in life expectancy was 5.3 years in 1972–1976 measurement of the volume of resources between resource and capital, so that, and 5.7 years in 1997–1999. Other health consumed by the NHS; continuing to publish together with the measurement of output, indicators, such as self-reported poor health health productivity articles; and developing a light can be thrown on developments in and limiting long-term illness (LLTI), show framework for health satellite accounts. government productivity.ʼ similar patterns. The highest levels of poor health and LLTI are found among the long-term The report is concerned with methodological The report is available free on the National unemployed and never worked and the lowest issues; it does not contain any new statistics on Statistics website: http://www.statistics.gov.uk/ levels being among those in managerial and government output or productivity. about/data/methodology/specifi c/PublicSector/ professional occupations. Atkinson/fi nal_report.asp The review was commissioned by Len Cook, the National Statistician, as announced on 4 Publication details are available on page 4.