Demography Seminar - Liz Rolfe, South West PHO (05.11.2009)

South West Public Health Observatory

Health Inequalities within an Ageing PopulationSWO seminar – Gloucestershire LIN

Liz Rolfe

5th November 2009


Health Inequalities within an Ageing Population

• Population changes• Key aspects of mortality and morbidity• The importance of prevention• The effects of inequalities


An ageing population

• England : The proportion of the total population aged 65 and over

0

5

10

15

20

25

2006 2010 2020 2030

Prop

orti

on o

f al

l age

s po

pula

tion

65-74

75-84

85+

Source :Office of National Statistics http://www.statistics.gov.uk/downloads/theme_population/NPP-2006/NPP06_NSOnline.pdf


An ageing population

The predicted increase in population for all ages and those aged 75 and over in South West PCTs 2006-2020

0.0

10.0

20.0

30.0

40.0

50.0

60.0

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

Chan

ge fr

om 2

006

to 2

020

as %

of 2

006

Popu

lati

on (m

illio

ns)

Increase in 2020 2006 % Change: All ages % Change: 75 years and older

Source : ONS Sub National Population Projections, www.statistics.gov.uk/snpp/ accessed September 2008


Cause of Death

• 2007

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Under 65 65-84 85+

Age at death

Other

Respiritory

Circulatory

Cancer

Source: Office of National Statistics Mortality data DH1


Years of Life Lost by causeAverage years of life lost per 100,000 population (at risk)

aged under 75 years in England and Wales: 2003-05Source: National Statistics / National Centre for Health Outcomes Development (NCHOD)

0 100 200 300 400 500 600 700 800 900 1000

Cervical cancer

Infectious and parasitic disease

Pneumonia

Cancer of small intestine, colon, rectum & anus

Land transport accidents

Chronic liver disease including cirrhosis

Stroke

Suicide and injury undetermined

Lung cancer

Accidents

Breast cancer

Coronary heart disease

Years Lost


Coronary Heart Disease

0%

1%

2%

3%

4%

5%

6%

7%

8%

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Perc

enta

ge o

f po

pula

tion

wit

h CH

D

Year

Predicted prevalence of CHD in Gloucester and England, persons age 16+, 2005-2020

England

Gloucester

Source: ERPHO


CancerPredicted cases for 2020 and mean actual diagnoses in 2004-

2006 (ICD10 C00-C97 excluding C44 non-melanoma Skin Cancer) for Primary Care Trusts in the South West

0

10

20

30

40

50

60

70

0

1000

2000

3000

4000

5000

6000

7000

% C

hang

e fr

om 2

004-

6 t

o 20

20

Num

ber o

f dia

gnos

esPredicted Increase in 2020 Mean annual cases in 2004-2006 % Change from 2004-2006 to 2020

Source: SWPHO Cancer Registry (SWPHO forthcoming report)


Dementia

• One in five people over 80 years • Estimated over 680,000 people with dementia in the UK• Forecast to rise by 38% by 2021 (over 900,000 people) and 154% by

2051 (1.7m people)• 62% (over 400,000) have Alzheimer’s disease

• Contributes 11% of all years lived with disability among people aged 60 and over, more than stroke, cancer or cardiovascular disease (2003 World Health Report Global Burden Of Disease)

• Overall, 10% of deaths in men over 65 years, and 15% of deaths in women over 65 years may be attributable to dementia.

• Total cost of dementia in the UK is £17.03 billionSource: Dementia UK


Prevention – Dementia example

• If onset of dementia could be delayed by 5 years, by a combination of improvements in public health (cardiovascular risk factor reduction and diet) and specific preventive treatments.

• This would halve the prevalence of dementia in each five year age band and, in principle, halve the numbers of death attributed here to dementia – saving nearly 30,000 lives annually.


Participation in sports, games or physical activity


Adults who smokeAdults who smoke

15 20 25 30 35

England

South West

Cornwall

Gloucestershire

Devon

Wiltshire

Somerset

Dorset

Bristol

Restormel

Exeter

Bournemouth

Penwith

North Cornwall

Kerrier

Gloucester

Plymouth

Swindon

Torridge

Torbay

Cheltenham

Weymouth and Portland

West Somerset

North Devon

Poole

Carrick

Sedgemoor

Caradon

Taunton Deane

Mid Devon

Teignbridge

Forest of Dean

South Somerset

Bath and North East Somerset

Mendip

West Wiltshire

South Gloucestershire

Salisbury

Purbeck

North Somerset

East Devon

North Dorset

West Devon

Christchurch

South Hams

West Dorset

Tewkesbury

Kennet

Stroud

North Wiltshire

Cotswold

East Dorset

Percentage of adults who report that they currently smoke

Quartile 1

Quartile 2

Quartile 3

Quartile 4

South West

England


Early deaths attributable to smoking Early deaths attributable to smoking

145 155 165 175 185 195 205 215 225 235 245 255 265 275 285 295 305 315 325 335 345 355 365

England

South West

Cornwall

Gloucestershire

Wiltshire

Somerset

Devon

Dorset

Plymouth

Bristol

Gloucester

Swindon

Penwith

Kerrier

Forest of Dean

North Devon

Torbay

Torridge

Restormel

Exeter

Caradon

Weymouth and Portland

North Cornwall

Sedgemoor

Cheltenham

Bournemouth

Mendip

North Wiltshire

South Gloucestershire

North Somerset

Poole

Salisbury

Stroud

Kennet

Carrick

Tewkesbury

Teignbridge

Bath and North East Somerset

West Wiltshire

Taunton Deane

South Somerset

West Dorset

Purbeck

South Hams

Mid Devon

West Devon

North Dorset

West Somerset

Christchurch

Cotswold

East Devon

East Dorset

Directly standardised rate of early deaths (persons aged 35 or over) attributable to smoking(per 100,000 population aged 35 or over)

Quartile 1

Quartile 2

Quartile 3

Quartile 4

South West

England


Income deprivation affecting older people


Limiting long term illness


Inequalities in life expectancy within SW local authorities

Male life expectancy at birth 2001-05: inequalities between most and least deprived areas within South West Local Authorities

66.0

68.0

70.0

72.0

74.0

76.0

78.0

80.0

82.0

84.0W

eym

outh

and

Por

tland

Tor

bay

Ply

mou

th

Bou

rnem

outh

Pen

with

Nor

th D

evon

Bris

tol

Sw

indo

n

Nor

th S

omer

set

Glo

uces

ter

Sed

gem

oor

Exe

ter

Tau

nton

Dea

ne

Mid

Dev

on

For

est

of D

ean

Ken

net

Res

torm

el

Wes

t D

orse

t

Sou

th S

omer

set

Nor

th C

ornw

all

Che

ltenh

am

Men

dip

Ker

rier

Car

adon

Sal

isbu

ry

Wes

t D

evon

Chr

istc

hurc

h

Tew

kesb

ury

Nor

th D

orse

t

Wes

t S

omer

set

Eas

t D

evon

Nor

th W

iltsh

ire

Sou

th H

ams

Tei

gnbr

idge

Tor

ridge

Car

rick

Cot

swol

d

Poo

le

Sou

th G

louc

este

rshi

re

Wes

t W

iltsh

ire

Bat

h an

d N

orth

Eas

t S

omer

set

Str

oud

Pur

beck

Eas

t D

orse

t

Local Authorities

Lif

e ex

pec

tan

cy a

t b

irth

(ye

ars)


Identifying priorities….

Anywhere AnywhereAnywhere Anywhere


SWPHO work programme 2009/10

• Health of older people – predicted trends and changes in mortality and morbidity

• Demographic profile – migration adjusted life expectancy

• Public Health chapter – State of the South West 2010


Further information

• Website– www.swpho.nhs.uk– Register for email alerts and newsletters

• Contact us– [email protected]


Thank you

Demography Seminar - Liz Rolfe, South West PHO (05.11.2009)

Health & Medicine

Transcript of Demography Seminar - Liz Rolfe, South West PHO (05.11.2009)