Health Inequalities – Annual Report 2018

The Department of Health today published the Health Inequalities Annual Report 2018.

This new publication presents a comprehensive analysis of regional health inequality gaps between the most and least deprived areas of NI, and sub-regional gaps within Health & Social Care (HSC) Trust and Local Government District (LGD) areas across a range of health indicators.

Key findings - Regional

• Male life expectancy at birth has continued to improve in NI and the most and least deprived areas, with the most-least deprived gap narrowing from 7.3 years in 2010-12 to 6.6 years in 2014-16. Female life expectancy remained constant in NI and the most deprived areas and, although it increased slightly in the least deprived areas, the gap remained fairly constant at 4.5 years in 2014-16
• Healthy and Disability Free Life Expectancies either declined or remained constant between 2010-12 and 2014-16, and no changes to inequality gaps were observed with the exception of male disability free life expectancy where the gap widened from 10.2 to 12.7 years
• Alcohol and drug related indicators continue to show some of the largest health inequalities monitored in NI, with drug related and alcohol specific mortality in the most deprived areas around five times the rates seen in the least deprived.
• In 2016, the under 20 teenage birth rate in the most deprived areas was almost six times the rate in the least deprived and the proportion of mothers reporting smoking in pregnancy in the most deprived areas was almost five times that in the least deprived
• Primary 1 obesity levels fell in the most deprived areas while increasing in both the least deprived areas and NI overall which led to a narrowing of the deprivation inequality gap between 2011/12 and 2015/16
• Rates of premature mortality generally decreased over the last five years in NI and both its most and least deprived areas. Inequality gaps narrowed or remained broadly similar, with the exception of death rates among under 75s due to respiratory disease
• The inequality gap in self-harm admissions narrowed by a quarter between 2008/09-12/13 and 2012/13-16/17 with improvements observed for NI and its most and least deprived areas

Key findings - Sub-Regional

• Male life expectancy either increased or remained similar between 2010-12 and 2014-16 in all Trust and Local Government Districts (LGDs) and their most deprived areas
• Female life expectancy also increased or remained similar across the period in all Trusts & LGDs and their most deprived areas, with the exception of the most deprived areas in both Antrim & Newtownabbey LGD and Fermanagh & Omagh LGD, where it declined
• Similar to the regional picture, deprivation related inequality was most prominent in indicators relating to alcohol and drugs, self-harm, smoking in pregnancy and teenage births, which were among the five largest inequality gaps for the majority of Trusts and LGDs
• Large inequality gaps relating to suicide and respiratory mortality among under 75s were also seen in many of the LGD and Trust areas. Under 75 respiratory mortality was among the five largest inequality gaps for Belfast Trust and Lisburn & Castlereagh, Derry & Strabane, and Belfast LGDs
• Drug related mortality was the largest inequality gap within the Belfast Trust (113%), Northern Trust (143%), and South Eastern Trust (138%), and deaths due to drug misuse was the largest inequality gap seen in the Western Trust (159%). Within the Southern Trust, the largest inequality gap was seen with alcohol specific mortality where the rate in the most deprived areas was double the Trust average
• Drug related mortality was also the largest inequality gap seen in six of the eleven LGDs, where rates in the most deprived LGD areas were between two and three times the LGD average rates. In Belfast LGD the largest gap was seen with drug related admissions (99%)
• Self-harm admissions showed the largest gap in Armagh, Banbridge & Craigavon (102%), alcohol related admissions showed the largest gap in Fermanagh & Omagh (91%), and alcohol specific mortality showed the largest gap for both Derry & Strabane (149%) and Newry, Mourne & Down LGD (109%)

Notes to editors: 

1. This new annual publication is one of a series of reports produced as part of the NI Health & Social Care Inequalities Monitoring System (HSCIMS) and presents a comprehensive analysis of health inequality gaps between the most and least deprived areas of NI, and within Health & Social Care (HSC) Trust and Local Government District (LGD) areas across a range of indicators.

2. This report replaces the previous separately published biennial regional and sub-regional health inequalities reports and is an accompaniment to the 2017 Public Health NI Fact Sheet which was published on 5th December 2017. While the 2017 Public Health NI Fact Sheet presented the latest statistics at NI, HSC Trust and Local Government District levels for a range of public health outcome statistics, this report provides a more detailed assessment of the associated trends and health inequalities gaps. The report is accompanied by downloadable data tables which contain all figures, including urban and rural breakdowns.

3. Life expectancy figures presented for NI have been calculated by Public Health Information & Research Branch as part of the Health & Social Care Inequalities Monitoring System (HSCIMS), it should be noted however that Demography Methodology Branch within NISRA publish the official life expectancy estimates at NI, Local Government District and Parliamentary Constituency level, however figures should be similar.

4. The Health and Social Care Inequalities Monitoring System (HSCIMS) comprises a basket of indicators which are monitored over time to assess area differences in mortality, morbidity, utilisation of and access to health and social care services in the north of Ireland, and has expanded over recent years to include additional work streams relating to health inequality.

5. Inequalities between the 20% most deprived areas and the 20% least deprived areas are measured. These areas are defined according to the Northern Ireland Multiple Deprivation Measure (NIMDM). For each indicator, the latest two years / data points presented are newly published figures and are defined according to the 2017 NIMDM, all other data points are based on the 2010 NIMDM.

6. Results for the most rural areas are also compared against the regional average. The definitions for rural and urban areas are consistent with those outlined in the ‘Review of the Statistical Classification and Delineation of Settlements’ (NISRA 2015), with the exception of Healthy Life Expectancy and Disability Free Life Expectancy which use the 2005 urban rural classification, due to data limitations.

7. The information presented in this publication is based on data from General Register Office, Hospital Inpatient System, Child Health System, Northern Ireland Cancer Registry, Business Services Organisation, Northern Ireland Fire and Rescue Service, Northern Ireland Ambulance Service, Community Information Branch and the Health Survey Northern Ireland.

All HSCIMS reports and data tables are available to view and download from the Departmental website.

8. Further information on the Health and Social Care inequalities Monitoring System is available from:

Health Inequalities Section
Public Health Information & Research Branch
Department of Health
Annexe 2, Castle Buildings
Stormont, BT4 3SQ
Tel: 028 90 522501 or 028 90 522043
Fax: 028 90 523288

Email: healthinequalities@health-ni.gov.uk

9. For media queries please contact the Department of Health Press Office on 028 9052 0575 or email pressoffice@health-ni.gov.uk.  Out of office hours please contact the Duty Press Office via pager number 07623 974383 and your call will be returned. Follow us on twitter @healthdpt

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