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Health inequalities within Medway

Summary :: Our health inequalities :: Health inequalities within Medway

1. Life expectancy in Medway by Ward

Within Medway there is a clear social gradient in health. The lower a person's socio-economic position, the worse his or her health, which also equates to a shorter average life expectancy. This is shown by the difference in life expectancy between deprived and affluent wards in Medway. The gap in male life expectancy is 8.5 years between Cuxton and Halling, and Luton and Wayfield and the gap in female life expectancy is 7.2 years between Cuxton and Halling, and Watling as shown in Figure 1. Wards with the lowest life expectancies overall include Chatham Central; Luton and Wayfield; Watling; Gillingham South; and River. Conversely, wards with the highest life expectancies overall include Cuxton and Halling; Hempstead and Wigmore; Rainham Central; Lordswood and Capstone; and Walderslade (2012-2016).[1].

Figure 1: Life expectancy at birth by ward, 2012-2016
Figure 1: Life expectancy at birth by ward, 2012-2016

2. Deprivation in Medway and health inequalities

Figure 2 shows the number of people in each deprivation quintile within each ward in Medway, with deprivation quintile 1 being the most deprived. It is clear that deprivation is more prevalent in certain wards than others. However, this figure also shows that certain wards contain individuals across a range of deprivation levels.

Figure 2: Number of people in each deprivation quintile by ward
Figure 2: Number of people in each deprivation quintile by ward, 2015 [2]

The Slope Index of Inequality (SII) at birth is a measure of the social gradient in life expectancy, i.e. how much life expectancy varies with deprivation. It takes into account health inequalities across the whole range of deprivation and summarises this in a single number; based on statistical analysis of the relationship between life expectancy and deprivation across all deprivation deciles. In Medway the SII was 8.2 years for males (PHOF) and 5.8 years for females (PHOF; 2013-15); these values have increased since 2012-14 for both males (6.6 years) and females (5.2 years).

The SII is displayed for males and females in the figures below for 2013-15, where life expectancy for each deprivation decile is plotted in blue and the SII is the gradient of the line of best fit (red). In the most deprived decile in Medway the life expectancy for males and females is 73.8 and 79.5 years respectively. These values are significantly lower that the life expectancies of males and females in the least deprived decile; 82.9 and 84.8 years respectively. In both males and females life expectancy appears to be directly related to deprivation decile (figures 3 and 4).[3]

Figure 3: Life expectancy by deprivation decile with the slope of inequality for Medway, males, 2013--15
Figure 3: Life expectancy by deprivation decile with the slope of inequality for Medway, males, 2013–15.
Slope index of inequality = 8.2 years (95% confidence interval: 6.6 to 9.7) [4]
Figure 3: Figure 4: Life expectancy by deprivation decile with the slope of inequality for Medway, females, 2013--15.
Figure 4: Life expectancy by deprivation decile with the slope of inequality for Medway, females, 2013–15.
Slope index of inequality = 5.8 years (95% confidence interval: 4.3 to 7.3) [4]

3. Ethnic differences in health inequalities in Medway

The most recent data relating to ethnicity is from the 2011 Census, which showed that the largest ethnic group in Medway was White British (89.6%) and the next largest was Asian or Asian British (5.2%). Black/African/Caribbean and Black British residents made up 2.5% of the population and Mixed/multiple ethnic groups made up 2.0% of the population.[5] More information relating to ethnicity can be found in the following location of the Medway JSNA: Summary -> Our people and Place -> Demography -> Ethnicity.

It is known that there are differences in risk factors between ethnic groups. Black and minority ethnic (BME) groups generally have worse health outcomes than the overall population. Evidence suggests that the poorer socio-economic status of BME groups and associated factors are the driving force behind ethnic health inequalities.[6]

Under the Race Relations Amendment Act (2000) all public bodies have a legal obligation to outlaw racial discrimination and promote equal opportunities. All policies should therefore take ethnic diversity into account to ensure the reduction of ethnic health inequities.[7]


References

[1]   Medway Public Health Intelligence Team. Public Health Births File Analysis
[2]   Smith T, Noble M, Noble S, et al. English Indices of Deprivation 2015; Department for Communities and Local Government. https://www.gov.uk/government/statistics/english-indices-of-deprivation-2015 .
[3]   Public Health England. Life expectancy at birth 2013-2015;
[4]   Public Health England. Slope index of inequality in life expectancy at birth 2013-2015;
[5]   Office for National Statistics. Table KS201EW: 2011 Census: Ethnic group, local authorities in England and Wales.
[6]   POST. Postnote - Ethnicity and Health 2007; Parliamentary Office of Science and Technology.
[7]   Becares L. Which ethnic groups have the poorest health? Ethnic health inequalities 1991 to 2011 2013;