This section provides a more in depth review of the main conditions that impact on life expectancy.
Life expectancy is used as an indicator of the overall health status of a given population. It is the average number of years a baby born into an area could expect to live if it was to experience that area’s current death rates throughout life.
Figure 28 - Male Life Expectancy. Source: Office for National Statistics - www.neighbourhood.statistics.gov.uk
For males in West Lancashire there has been a steady improvement in life expectancy at birth, reaching 78.4 years in 2011 (figure 26 above) higher than that of England (78.3) and is fourth best in Lancashire (figure 28).
Similarly female life expectancy has also improved to 80.8 years in 2011, below the national average of 82.3 and only 7th best in Lancashire (figure 29 below).
68 70 72 74 76 78 80 82
Years
Local Authority
Male Life Expectancy at Birth by Local Authority 2007 - 2009
Life Expectancy at Birth; Males North West England
Figure 29 - Female Life Expectancy. Source: Office for National Statistics - www.neighbourhood.statistics.gov.ukFigure 23 - Life expectancy and causes of death
Of course life expectancy not only varies at district level and there can be many years variance between communities.
Figure 30 below shows the variances between communities within the West Lancashire district and it is quite clear that the LE of those people living in the most deprived 10% (decile) of the population have a much lower life expectancy than those in the highest decile.
Males in decile 1 have a life expectancy of 74.2 years compared to those in decile 10 with a life
expectancy of 82.9 – a difference of 8.7 years. For women this variation is 77.6 and 83.9 respectively, a variance of 6.3 years.
76 77 78 79 80 81 82 83 84
Years
Local Authority
Female Life Expectancy at Birth by Local Authority 2007 - 2009
Life Expectancy at Birth; Females North West England
Figure 30 – Life expectancy by deprivation decile
Many factors influence life expectancy and figure 29 below show the variations.
Health outcome for babies born to teenage mothers are worse than for babies born to older mothers.
The main contributing factors are that younger mothers are less likely to attend for antenatal care, more likely to smoke, less likely to breast feed and have poorer diets during pregnancy.
60 65 70 75 80 85 90
Males D1 Females D1 Males D2 Females D2 Males D3 Females D3 Males D4 Females D4 Males D5 Females D5 Males D6 Females D6 Males D7 Females D7 Males D8 Females D8 Males D9 Females D9 Males D10 Females D10
Years
Life Expectancy at Birth by Deprivation Deciles - 2006-10, West Lancashire district
Decile 1 Decile 2 Decile 3 Decile 4 Decile 5 Decile 6 Decile 7 Decile 8 Decile 9 Decile 10 Data source: London Health Observatory and East Midlands Public Health Observatory
Figure 31 – Life expectancy and causes of death (Community health profiles 2012). Source: Office for National Statistics – Community health profiles 2012
The Community health profiles published annually by the Office for National Statistics provides much data at a district level on many aspects of the wider determinants of health and figure 31 provides this data for the life expectancy and causes of deaths for the districts making up NHS West Lancashire CCG.
All parts of the CCG area are higher than England (directly standardised rate of 211 deaths per 100,000 population aged 35 +, (2007-2009)) for smoking related deaths. Wigan has the highest rate at 276 but has only 2.6% of the CCG population within it. Chorley (with 1.2% of the CCG population) is also high on 224 with West Lancashire lowest on 213.
Early deaths from heart disease and stroke are highest again in Wigan with 86.7 per 100,000 deaths to those under 75 compared to 67.3 for England. West Lancashire is lower than England on 63.4.
Wigan is again highest for early Cancer deaths, with 122 deaths per 100,000 compared to 110.1 for England. West Lancashire is also high with 114.4 but Chorley is lowest with 102.6.
Much of the CCG area has rates higher than England (44.3) for Road traffic deaths with West Lancashire substantially higher on 75.6, perhaps not surprising in a large farming community.
Although percentage populations in the CCG are low for some districts that table of District data indicates areas of concerns for the CCG that still require to be tackled albeit in partnership with other CCG’s, health and well-being partnerships and the Lancashire wide Health and Well-being Board
All Age, All Cause Mortality
Figure 32 shows mortality data analysed to NHS West Lancashire CCG level and gives an indication of the level of mortality within the CCG. It confirms that men are dying at a higher rate than women (641 against 513 per 100,000 population) and are doing better than the England rate giving them a better outcome than for England. However mortality in women is higher than England’s mortality rate for women.
Life expectancy and causes of death
25 Excess winter deaths 73 24.7 199 20.3 72 20.9 171 18.2 18.7
26 Life expectancy - male n/a 77.6 n/a 77.0 n/a 78.0 n/a 76.5 78.6 27 Life expectancy - female n/a 81.4 n/a 82.0 n/a 81.3 n/a 80.7 82.6
28 Infant deaths 7 6.1 15 5.3 6 5.3 15 3.8 4.6
29 Smoking related deaths 178 224.0 605 242.0 193 213.0 606 276.0 211.0 30 Early deaths: heart
disease & stroke
Figure 32 – All Age, All Cause Mortality(2008/10). Source: Primary Care Mortality Database and NHS IC Indicators
Under 75 Cancer Mortality
Cancer is more common with advancing age and, with an ageing population, demand for specialist cancer services and end of life care will continue to rise. The most effective programmes in cancer prevention include stop smoking services, human papilloma virus (HPV) vaccination, and healthy nutrition support.
Screening programmes effectively detect the pre-cancerous or early stages of cervical, breast and colon cancer while targeted screening for lung cancer also shows promise of being effective
Analysis in figure 33 below shows the CCG premature mortality rate for Cancer is 118.5 per 100,000 for men (lower than England on 121) and 104 for women (higher than England on 99) but NHS West Lancashire CCG patients do better than others within the North West but nevertheless rates are high.
More work needs to be done into mortality and survival rates for specific cancers to assess which cancers are giving the greatest causes of concern although it is likely to be that of Lung, Breast and Prostate cancer.
0 100 200 300 400 500 600 700 800
NHS West Lancashire CCG North West England NHS West Lancashire CCG North West England NHS West Lancashire CCG North West England
Male Female All Persons
Directly Standardised Rate per 100,000 population
All Age, All Cause Mortality Directly Standardised Rate - 2008 to 2010
Figure 33 – Cancer under 75 (2008/10). Source: Primary Care Mortality Database and NHS IC Indicators
Under 75 Cardiovascular Disease Mortality
For cardiovascular mortality the NHS West Lancashire CCG rates are not different from England rates for both men and women.
Figure 34 below shows that men have higher rates than women, with a directly standardised rate of 78. In women the rate is higher than England’s rate for women (41.5 to 40.9) but for men a lower rate than that of England is seen (78.7 to 95.2), per 100,000 population.
Figure 34 – Cardiovascular disease under 75 (2008/10). Source: Primary Care Mortality Database and NHS IC Indicators 0
20 40 60 80 100 120 140 160
NHS West Lancashire CCG North West England NHS West Lancashire CCG North West England NHS West Lancashire CCG North West England
Male Female All Persons
Directly Standardised Rate per 100,000 population
Cancer Under 75 Directly Standardised Rate - 2008 to 2010
200 4060 10080 120140
NHS West Lancashire CCG North West England NHS West Lancashire CCG North West England NHS West Lancashire CCG North West England
Male Female All Persons
Directly Standardised Rate per 100,000 population
Cardiovascular Disease Under 75 Directly Standardised Rate - 2008 to 2010