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First sub-regional bulletin of Health and Social Care Inequalities Monitoring System (HSCIMS) published

Wednesday, 7 July 2010

The Department of Health, Social Services and Public Safety today published its first sub-regional bulletin of the Health and Social Care Inequalities Monitoring System (HSCIMS).

The bulletin provides a picture of health inequalities at Health and Social Care (HSC) Trust level and a detailed comparison of morbidity, mortality, utilisation and access to
health and social services between the 20% most deprived areas within a Trust and the overall Trust as well as NI as a whole.

Key Points:

Belfast HSC Trust

  • The largest sub-regional inequality gaps between the health outcomes experienced in the most deprived areas in Belfast Trust and the Trust itself occurred in alcohol related mortality (103% higher in the most deprived Belfast Trust areas), self-harm admissions to hospital (96% higher) and teenage birth rates (93% higher).
  • In addition, there were still other relatively large inequality gaps cross many areas (14 of all 33 indicators examined for the Belfast Trust showed gaps of 40% or greater).
  • More encouragingly, gaps were relatively small for mood and anxiety disorders, cancer incidence, elective admissions (although this might be an indication of worsening access in the most deprived areas) and infant mortality rates.
  • There were a number of noticeable improvements over recent years in the gaps that existed in Belfast Trust – the size of infant mortality, hospital admission rates (all, emergency and elective), cancer mortality, cancer incidence, mood and anxiety disorders and dental registration rates inequality gaps all decreased.
  • Conversely some inequality gaps widened over time, most notably for male life expectancy, respiratory mortality, self-harm admissions, smoking during pregnancy and breastfeeding on discharge from hospital.

Northern HSC Trust

  • The largest inequality gaps in the Northern Trust occurred in teenage births (86% higher in the most deprived Trust areas), alcohol related deaths (76%) and admission rates to hospital for self-harm (67%).
  • Of the 33 health indicators analysed, seven showed relatively large gaps (i.e. greater than 40% in magnitude) between the 20% most deprived areas in the Northern Trust and the Trust itself.
  • More than two-thirds of the health indicators analysed showed only relatively small inequality gaps (i.e. less than 20% in magnitude).
  • There were improvements in most of the Northern Trust inequality gaps over time, for instance the gaps for infant mortality and cancer mortality virtually disappeared. However the relative gaps for male life expectancy, lung cancer incidence, ambulance response times and mood and anxiety disorders all remained fairly consistent over time, while the gaps for suicide and teenage births both increased over the period under review.

South-Eastern HSC Trust

  • The largest health inequality gap occurred in alcohol related mortality where the death rate in the most deprived South Eastern Trust areas was almost double (98% higher) that in the wider Trust.
  • There were also large differences in health outcomes for teenage births (77% higher) and smoking during pregnancy (75% higher).
  • In all, six of the 33 indicators analysed showed relatively large inequality gaps (of greater than 40%). Conversely 20 indicators had relatively small gaps of less than 20% in magnitude with the smallest gaps occurring in outcomes for life expectancy (for both males and females), mood and anxiety disorders, cancer incidence, elective admission rates and childhood immunisation.
  • For most of the indicators, the inequality gap in the South Eastern Trust area remained broadly constant over time. However there were improvements in the extent of the gaps for infant mortality, hospital admission rates (all admissions, emergency admissions, circulatory disease and self harm), cancer mortality, smoking during pregnancy and breastfeeding on discharge from hospital.
  • Gaps for teenage births and amenable mortality actually increased over the period.

Southern HSC Trust

  • The largest inequality gaps in the Southern Trust area occurred in alcohol related mortality (94% higher in the most deprived areas), self-harm admissions (68% higher) and smoking during pregnancy (64% higher).
  • Overall six of the 33 indicators analysed in this report showed relatively large inequality gaps of 40% or more whereas two-thirds of the indicators showed relatively small gaps (i.e. less than 20% in magnitude, positive or negative inequality gaps).
  • Over time notable improvements in Trust inequality gaps within the Southern Trust Area occurred in teenage births, suicide and self-harm admissions to hospital. In fact, most of the inequality gaps improved although female life expectancy, cancer incidence, hospital admissions for circulatory disease, smoking during pregnancy, smoking related mortality and dental registrations all remained fairly constant.
  • Gaps widened for circulatory deaths, alcohol related deaths, amenable deaths and ambulance response times.

Western HSC Trust

  • The largest Western Trust inequality gaps occurred in alcohol related mortality (112% higher in the most deprived areas) and self-harm admissions (89% higher), teenage births (76% higher) and smoking during pregnancy (71% higher).
  • Overall seven of the 33 indicators had gaps of 40% or greater. Irrespective of the direction, gaps in 19 of the indicators were of a magnitude of less than 20%.
  • Within the Western Trust, there was a narrowing of the gaps for most of the indicators over time.
  • The most notable reduction (in proportionate terms) in Trust inequality gaps occurred for circulatory admissions, cancer mortality and lung cancer incidence.
  • The gaps for male life expectancy, elective hospital admissions and alcohol related mortality all remained broadly similar, while those for ambulance response times and suicide widened over their respective periods.

Notes to editors:

1. 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. The regional analysis measures inequalities between the 20% most deprived areas and Northern Ireland as a whole (results for rural areas are also compared against Northern Ireland overall).

2. Inequalities between the 20% most deprived areas within a Trust area (defined using the NISRA 2005 Northern Ireland Multiple Deprivation Measure) and the overall Trust are measured.

3. Most of the indicators included in the third regional HSCIMS update bulletin (with the exception of childhood obesity and drug related deaths, as data was not sufficiently robust at the more localised level) remain. The teenage births indicator is reported using a three years average, as opposed to a single year as in the third update bulletin, in order to provide more robust comparisons at HSC Trust level.

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, Business Services Organisation and the Northern Ireland Ambulance Service.

All HSCIMS reports are published on the DHSSPS website

5. Additional Information

Further information on Health and Social Care inequalities Monitoring System is available from:
Public Health Section
Project Support Analysis Branch
Department of Health, Social Services and Public Safety
Annexe 2, Castle Buildings
Stormont, BT4 3SQ

Tel: 028 90 522458 or 028 90 522043

Fax: 028 90 523288

Email:

Internet:

6. For media enquiries please contact the DHSSPS Press Office on 02890 520575. Out of office hours please contact the Duty Press Officer via pager number 07699 715 440 and your call will be returned.