The Department of Health today published the Health Inequalities Annual Report 2021.
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 2017-19, 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 (7.0 years) observed since 2013-15. Female life expectancy improved in NI, with no notable change in the most and least deprived areas or the deprivation gap (4.8 years).
- Between 2013-15 and 2017-19 there was no change in male or female healthy life expectancy in NI and its most and least deprived areas, including no notable change in the deprivation gap. Similarly, disability-free life expectancy saw no notable changes across NI, its most and least deprived areas or the deprivation gap for both males and females.
- For indicators of premature mortality, rates generally decreased over the period in NI and its most and least deprived areas. However, large inequality gaps continue to persist, with the rate of respiratory mortality among under 75s in the most deprived areas three and a half times that in the least deprived. Across indicators of premature mortality, the inequality gaps narrowed or remained broadly similar except for potential years of life lost and death rates for preventable causes where the gap widened.
- The inequality gap for crude death rate for intentional self-harm narrowed as a result of positive changes in the most deprived areas, where the rate is approximately double that in the least deprived areas.
- Alcohol and drug related indicators continue to show some of the largest health inequalities monitored in NI, with rates in the most deprived areas five times that in the least deprived for drug related mortality and four times that for alcohol specific mortality.
- In 2019, within the most deprived areas the proportion of births where the mother reported smoking during pregnancy in the most deprived areas was four and a half times the rate in the least deprived areas, with the inequality gap widening over the last five years.
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 the South Eastern Trust, Western Trust and Ards & North Down LGD.
- For male life expectancy, the inequality gap between the 20% most deprived areas and the area average widened in the Northern, South Eastern and Western Trusts and the Antrim & Newtownabbey, Ards & North Down and Derry City & Strabane LGDs. The Southern Trust and the Armagh, Banbridge & Craigavon, Mid Ulster and Newry, Mourne & Down LGDs 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 Ards & North Down and Belfast LGDs where it declined.
- For female life expectancy, the inequality gap between the 20% most deprived areas and the area average widened in the Ards & North Down, Armagh City, Banbridge & Craigavon and Belfast LGDs. Conversely, the Antrim & Newtownabbey, Lisburn & Castlereagh, 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 in two of the five HSC Trusts and five of the eleven LGDs. In the Western Trust, the rate in its most deprived areas was more than two and a half times (162%) that of the Trust average. While in the Mid & East Antrim LGD the rate in the most deprived areas was more than three times (210%) the LGD average.
- Large inequality gaps for alcohol related admissions also exist in the majority of Trusts and LGDs. In the Western Trust, the rate in its most deprived areas was more than double (128%) that of the Trust average. While in the Derry City & Strabane LGD the rate in the most deprived areas was almost two and half times (139%) the LGD average.
- Deaths due to drug misuse was the largest inequality gap in the Northern (153%) and Western Trusts (177%), with the teenage birth rate the largest inequality gap in the Southern Trust (112%).
- The teenage birth rate was the largest inequality gap in the Armagh City, Banbridge & Craigavon LGD (132%); while alcohol specific mortality showed the largest gap in the Lisburn & Castlereagh LGD (151%).
Notes to editors:
1. The Health Inequalities Annual Report 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. 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 Northern Ireland, and has expanded over recent years to include additional work streams relating to health inequality.
3. Inequalities between the 20% most deprived areas and the 20% least deprived areas are measured. These areas are defined according to the 2017 Northern Ireland Multiple Deprivation Measure (NIMDM).
4. The information presented in this publication is based on data from General Register Office, Hospital Inpatient System, Northern Ireland Emergency Departments, 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.
5. The majority of this release is calculated based on figures prior to the coronavirus (COVID-19) pandemic and will not reflect the impact of the pandemic on health and life expectancies. Instances where figures have been affected by the pandemic, and the extent of the impact, are noted where relevant
6. In response to the pandemic, analyses of coronavirus (COVID-19) related health inequalities for positive COVID-19 test cases, admissions and deaths were produced and can be found on the Department's website.
7. 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 & Research Branch
Department of Health
Annexe 2, Castle Buildings
Stormont, BT4 3SQ
Telephone: 028 9052 2501 or 028 9052 2591
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