Health Inequalities Annual Report 2019

The Department of Health today published the Health Inequalities Annual Report 2019.

This 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 and 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 its most deprived areas. However, no notable change in the least deprived areas has led to a narrowing of the most-least deprived gap from 7.5 years in 2011-13 to 7.1 years in 2015-17. Female life expectancy remained constant in NI and its most and least deprived areas with the gap remaining fairly constant at 4.5 years in 2015-17.
• Generally, Healthy Life Expectancy (HLE) and Disability Free Life Expectancy (DFLE) declined in all areas between 2011-13 and 2015-17, although Male Healthy Life Expectancy remained constant in NI overall and improved in the least deprived areas. The inequality gap in each of these indicators has widened with the exception of Female Healthy Life Expectancy where there was no change.
• For indicators of premature mortality, rates generally decreased over the period 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 where the gap widened to 264%.
• The rate of hospital admissions due to self-harm for those in the most deprived areas was three and a half times that in the least deprived areas. However the inequality gap has narrowed across the period.
• 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 four and a half times the rates seen in the least deprived.
• In 2017, the proportion of births where the mother reported smoking during pregnancy in the most deprived areas was almost five times the rate in the least deprived.

Key findings – Sub-regional

• Male life expectancy either increased or remained similar across the period in all Trust and Local Government Districts (LGDs) and their most deprived areas.
• Female life expectancy increased across the Causeway Coast and Glens LGD and the most deprived areas of the Newry, Mourne and Down LGD over the period. It remained constant across all other areas except to for the Fermanagh and Omagh LGD and the most deprived areas in both the South Eastern Trust and Derry and Strabane 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 during 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 lung cancer mortality were also seen in many of the LGD and Trust areas. Suicide was among the five largest inequality gaps for Belfast Trust, and Antrim and Newtownabbey and Causeway Coast and Glens LGDs.
• Deaths due to drug misuse was the largest inequality gap seen in the Northern Trust (129%), South Eastern Trust (142%) and Western Trust (171%). Within the Belfast Trust the largest inequality gap was suicide (122%) whereas the largest inequality gap in the Southern Trust was teenage births (100%).
• Drug related mortality was the largest inequality gap seen in six of the eleven LGDs, with the rate in the most deprived areas of the Lisburn and Castlereagh LGD almost three times the LGD average. In Belfast LGD the largest gap was seen with drug related admissions (97%).
• Smoking during pregnancy showed the largest gap in Ards and North Down LGD (111%); teenage births showed the largest gap in Armagh City, Banbridge and Craigavon (108%); while alcohol related admissions showed the largest gap in Derry and Strabane (141%), Fermanagh and Omagh (86%) and Mid Ulster (77%).

Notes to editors: 

1. This annual publication is one of a series of reports produced as part of the NI Health and 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 and Social Care (HSC) Trust and Local Government District (LGD) areas across a range of indicators.
2. This report is an accompaniment to the 2018 Public Health NI Fact Sheet which was published on 6 December 2018. While the 2018 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. As of December 2018, the Department of Health are the official producers of life expectancy estimates for Northern Ireland. Previously this was the responsibility of Demography and Methodology Branch within the Department of Finance. As such, the figures contained within this report and the previously published 2018 Public Health NI Fact Sheet are the latest, official life expectancy estimates for Northern Ireland.
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 three 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 Maternity 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.
   
   Further information on the Health and Social Care inequalities Monitoring System is available from:
   
   Health Inequalities Section
   Public Health Information and Research Branch
   Department of Health
   Stormont
   Belfast BT4 3SQ
   
   Telephone: 028 9052 2501 or 028 9052 2043
   
   Fax: 028 9052 3288
   
   Email 
   
   Web 
8. For media queries please contact the Department of Health Press Office team on 028 9052 0074 or by email. For out of hours please contact the Duty Press Officer on 028 9037 8110 and your call will be returned. Follow us on twitter @healthdpt

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