Health Inequalities Annual Report 2020

Date published: 25 March 2020

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 & Social Care (HSC) Trust and Local Government District (LGD) areas across a range of health indicators.

Key Findings – Regional

• In 2016-18, male life expectancy at birth has continued to improve in NI and its most and least deprived areas, with no notable change in the deprivation gap (7.1 years) observed since 2012-14. Female life expectancy remained constant in NI and its most and least deprived areas, with no notable change in the deprivation gap (4.4 years).
• Between 2012-14 and 2016-18 there was no change in the male or female healthy life expectancy inequality gaps, although male healthy life expectancy did improve for NI. While there was no change in female healthy life expectancy for NI, there was a negative change in the most deprived areas. Disability-free life expectancy has changed negatively for both genders since 2012-14 with the inequality gaps widening.
• For indicators of premature mortality, rates generally decreased over the period in NI and its most and least deprived areas. The inequality gaps narrowed or remained broadly similar except for death rates among under 75s due to respiratory diseases, where the deprivation gap widened due to increased mortality in the most deprived areas where the rate is now three and a half times the rate in the least deprived areas.
• The inequality gap for suicide widened as a result of negative changes in the most deprived areas, where the rate is almost three and a half times that in the least deprived areas.
• 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 more than four times the rates seen in the least deprived.
• In 2018, the proportion of births where the mother reported smoking during pregnancy in the most deprived areas was five and a half times the rate in the least deprived, with the inequality gap widening.

Key Findings – Sub-Regional

• Male life expectancy either increased or remained similar across the period in all Trusts and Local Government Districts (LGDs), and their most deprived areas, with the exception of the most deprived areas of Antrim & Newtownabbey LGD.
• For male life expectancy, the inequality gap between the 20% most deprived areas and the area average widened in Northern Trust and the Antrim & Newtownabbey; Derry City & Strabane and Mid & East Antrim LGDs. Only the Southern Trust and the Newry, Mourne & Down LGD experienced a narrowing of the inequality gap.
• Female life expectancy either increased or remained similar across the period in all Trusts and LGDs, and their most deprived areas. The exception to this was the most deprived areas of the South Eastern Trust and the most deprived areas of the Antrim & Newtownabbey; Belfast; Derry City & Strabane and Fermanagh & Omagh LGDs where it declined.
• For female life expectancy, the inequality gap between the 20% most deprived areas and the area average widened in South Eastern Trust and in the Antrim & Newtownabbey; Armagh City, Banbridge & Craigavon; Belfast and Fermanagh & Omagh LGDs. Conversely, the Southern Trust and the Mid Ulster, and Newry, Mourne & Down LGDs experienced a narrowing of their respective inequality gaps.
• 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.
• Drug related mortality was the largest inequality gap seen in three of the five HSC Trusts and nine of the eleven LGDs. In the South Eastern Trust, the rate in its most deprived areas was more than two and a half times (159%) that of the Trust average. While in Lisburn & Castlereagh LGD the rate in the most deprived areas was almost three times (188%) the LGD average.