Search

Table of contents

Premature mortality

Summary :: Our health and well-being :: Premature mortality

The age which deaths are considered to be premature has increased as health and life expectancy has increased and currently deaths under the age of 75 years are classified as premature.

Between 2013 and 2015 Medway was ranked 97th out of 150 local authorities for overall rate of premature deaths with an age-adjusted rate of 378 per 100,000[1]. There are roughly 2,200 deaths that occur in Medway each year. Almost a third of deaths in females and almost half of deaths in males occur before the age of 75 (29.9% and 44.8% in 2013-2015 respectively).[2] Between 2013-2015 for both males and females the leading cause of premature deaths is cancer, accounting for almost half of deaths in women (47.6%) and two in five men (37.2%) of this age[2]. There has been a downward trend in mortality for all cancers in Medway since 1993 but cancer death rates have remained higher than in comparator groups, regional and national rates. Currently, there are an estimated 159 premature deaths per 100,000 resulting from cancer, equating to a ranking of 120th out of 150 local authorities[1].

The smoking prevalence in Medway is consistently higher than the national average, especially in pregnant women and young people, and this is known to be the biggest cause of cancer. There is also a correlation shown between deprivation and cancer prevalence. There are many services available to help people change their lifestyles including the Stop Smoking Service, the MEND programme and Tipping the Balance. For more information on these services, please see the 'Our Programmes and Services' section. For support living with and following on from cancer, there is a Macmillan Information Centre at Medway Maritime Hospital.

The next largest cause of death in those under the age of 75 years is circulatory diseases (for example heart attacks, stroke and heart failure), accounting for 16.5% of premature deaths in women and 23.9% in men between 2013-2015[2]. Lifestyle factors such as smoking, unhealthy diet and lack of physical activity and their consequences such as obesity, high cholesterol, high blood pressure and diabetes, are major risk factors for circulatory diseases.

A further 10.1% of premature deaths are due to respiratory diseases, 2013-15[2], notably chronic obstructive pulmonary disease (COPD). COPD is primarily caused by chronic tobacco smoking. The likelihood of developing COPD increases with age and cumulative smoke exposure, and almost all life-long smokers will develop COPD. Airflow obstruction is progressive and whilst it is treatable, it is not curable. Early detection is vital to allow a patient to enjoy an active life. See the Adults —> COPD for more information on COPD in Medway.

There are three times as many premature deaths due to suicide or unexplained injuries in men as there are in women. The numbers are relatively small in statistical terms, however most of these deaths occur under the age of 65 years.[3]

Premature mortality and deprivation

Premature mortality is strongly associated with deprivation. The mortality rate in the most deprived twenty percent of the population is double the rate in the least deprived twenty percent, and there is a clear mortality gradient in both males and females from the least to the most deprived. This is a very vivid example of the inequalities highlighted in the Marmot report.[4] The Slope Index of Inequality (SII) for life expectancy by deprivation deciles is significantly above zero in both males and females[5].

Figure 1: Age-standardarised mortality rates per 100,000 in Medway.
Figure 1: Age-standardarised mortality rates per 100,000 in Medway from all causes, 2013–15 (Under 75).
2013 European standard population
Source: PHIT analysis on Primary Care Mortality Database (ONS)

The gradient in mortality rates is also seen in individual causes, with premature mortality rates increasing with deprivation in cancer, circulatory disease, heart disease, and respiratory disease, and also likely in other diseases, although the numbers are smaller and it is harder to show this association statistically. Issues of deprivation and health are covered in more detail in “Our inequalities”.

Premature mortality by ward

There is great variation in premature mortality rates by electoral ward, although the number of deaths per ward is relatively small and as a result the most of the differences are not statistically significant. The differences at the extremes, however, are statistically significant. The highest mortality rates include River, Chatham Central, Luton and Wayfield and Gillingham North. The lowest mortality rates include wards Hempstead and Wigmore, Rainham Central, Cuxton and Halling and Lordswood and Capstone. [6]


References

[1]   Public Health England. Mortality Rankings: Medway 2013-15
[2]   Medway Public Health Intelligence team. Primary Care Mortality Database analysis
[3]   Public Health England. Suicide rate 2013-2015;
[4]   Marmot M. Fair Society, Healthy lives 2010; Strategic Review of Health Inequalities in England post-2010. http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review .
[5]   Public Health England, Association of Public Health Observatories. Slope Index of Inequality Data for LAs 2011;
[6]   Medway Public Health Intelligence Team. Primary Care Mortality Database Analysis