Health and social care inequalities monitoring system update bulletin

The Department of Health, Social Services and Public Safety today published its second update bulletin on the Health and Social Care Inequalities Monitoring System.

The bulletin provides an up-to-date picture of health inequalities in relation to area differences in morbidity, mortality, utilisation and access to health and social services. Baseline results were presented in Chapter 8 of Equality and Inequalities in Health and Social care in Northern Ireland – A Statistical Overview (DHSSPS 2004). Changes in the relative health inequalities gaps since the baseline period are highlighted.

Both the first and second update bulletins and the original report are published on the Departmental website at http://www.dhsspsni.gov.uk/index/stats_research/stats-equality.htm

Following the publication of this report, data from the Inequalities Monitoring Report relating to the Investing for Health (IfH) goals, themes and objectives will be published on the Northern Ireland Neighbourhood Information Service (NINIS) for IfH website http://www.ninis.nisra.gov.uk/ifh

Key points – at October 2007

The key findings presented in the bulletin are outlined below.

Deprived areas

• Despite some relative improvements in recent years, there is a continuing health gap between the most deprived areas and NI overall (see figure 1 in Appendix).
• Life expectancy in deprived areas compared with NI overall was 3.8 years lower for males and 2.6 years lower for females.
• Lung cancer incidence rates for all persons are 71% higher in deprived areas than NI overall.
• The teenage birth rate in deprived areas is 80% higher than in Northern Ireland as a whole.
• The admission rate to hospital for self-harm in deprived areas is twice that in Northern Ireland generally.

Rural areas

• Although health gaps exist between rural areas and Northern Ireland generally, health outcomes in rural areas tend to be generally better (see figure 2 in Appendix).
• Life expectancy in rural areas was 1.0 years higher for males and 0.5 years higher for females compared with NI overall.
• The teenage birth rate in rural areas is 42% lower than in Northern Ireland generally.
• The admission rate to hospital for self-harm in rural areas is 46% lower than in Northern Ireland overall.
• Lung cancer incidence rates for all persons are 31% lower in rural areas than in NI as a whole.
• Ambulance response times in rural areas are 91% higher than the NI average.

Accessibility

• The travelling time from the most deprived areas to all health and social care facilities is less than the NI average (for most health facilities at least 20% lower).
• For all health and social care facilities with the exception of hospitals providing learning disability inpatient services, the average access time from rural areas was more than 40% worse than for Northern Ireland generally.

Equality

• The proportion of Catholics in the areas with the worst health outcomes was at least five percentage points higher than the overall proportion in Northern Ireland for all indicators (with the exception of waiting times and the standardised death rate due to respiratory diseases).
• There was a lower proportion of married persons in the worst affected areas than in NI as a whole for Standardised Mortality Ratios, emergency hospital admission rates, hospital admission rates for respiratory disease, circulatory and respiratory death rates and dental registration rates.
• For all facilities under consideration, (with the exception of GPs, pharmacies and hospitals providing learning disability outpatient services) Catholics were overrepresented in the areas with worst access times.

Inequality gap – comparison over time

• The health inequality gap for indicators such as potential years of life lost, infant mortality rates, teenage births, standardised admission rates to hospitals, cancer incidence and suicide rates between the 20% most deprived areas and NI as a whole have all reduced.
• Despite improving health outcomes across all areas there is no evidence of a narrowing of the inequality gap for life expectancy, circulatory and respiratory standardised death rates, and the proportion of people suffering from a mood or anxiety disorder.
• The gaps between rural areas and NI generally in suicide, lung cancer incidence and standardised hospital admission rates have all narrowed to varying degrees, sometimes due to worsening health outcomes in rural areas rather than improvement in urban areas.
• The inequality gaps between rural areas and Northern Ireland as a whole for teenage birth rates, infant mortality rates and the standardised death rates due to circulatory disease and cancer have increased over recent years due to improvements occurring at a faster rate in rural areas.
• Although the relative inequality gaps in access time in both deprived and rural areas have generally decreased in recent years, the gaps that exist are still reasonably large (however differences in service accessibility between urban and rural areas will always be inevitable).

Notes to Editors:

1. The Inequalities Monitoring System (IMS) 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. Inequalities between the 20% most deprived areas and Northern Ireland as a whole are measured. Results for rural areas are also compared against Northern Ireland overall. This report is the second update of the Inequalities Monitoring System. Baseline results were presented in Chapter 8 of Equality and Inequalities in Health and Social care in Northern Ireland – A Statistical Overview (DHSSPS 2004) which focused on 2001/2002. The information in the bulletin is the latest available.
2. This report is based on the most recent multiple deprivation measure published by the Northern Ireland Statistics and Research Agency (NISRA) in 2005. The 2005 NI Multiple Deprivation Measure provides a relative ranking of small geographic areas (Super Output Areas) which allows better identification of ‘pockets of deprivation’ than the previous classification (which was based on electoral wards). For this report, revised definitions of rural and urban areas are used, which are consistent with those outlined in the “Report of the Inter-Departmental Urban-Rural Definition Group” (NISRA 2005).
3. All the indicators included in the first update bulletin (with the exception of fire response times) remain. A number of new indicators have also been added including Potential Years of Life Lost, Childhood Obesity, Suicide, Standardised hospital admission rates for self-harm and Standardised death rates (under 75s) for circulatory diseases, respiratory diseases and cancer.
4. The results presented in the report are based on data from the General Register Office, Hospital Inpatient System, Child Health System, Northern Ireland Cancer Registry, Central Services Agency and the Northern Ireland Ambulance Service. The HSS Trusts provided information on the location of health and social care facilities.
5. Press enquiries to the DHSSPS Press Office on 028 90520575, Out of hours, contact the duty press office via pager number 076 9971 5440 and your call will be returned.

Additional information

Further information on the Health and Social Care Inequalities Monitoring System is available from: