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Life expectancy

Key messages:

  • Average life expectancy in Bedford Borough is 79.3 years for men and 83.1 years for women and this gap is closing gradually.
  • Average life expectancy is increasing in Bedford Borough; however there is room for further improvement.           
  • There are variations in life expectancy within Bedford Borough associated with social class / deprivation and gender.
  • For small areas within the  Bedford Borough life expectancy varies from 77.2 to 90.0 years for women and from 71.9 to 86.5 years for men (2008-2010 data).
  • Cancer, heart disease and stroke are the biggest causes of premature death which reduce life expectancy.
  • Smoking and obesity are the biggest risk factors for poor health and diseases that reduce life expectancy.

 

To increase healthy life expectancy within Bedford Borough the focus should be on:

  • Reducing inequalities in health through tackling the wider determinants of health such as education, housing and employment.
  • Preventative initiatives such as NHS Health Checks and reducing the prevalence of smoking, obesity and harmful drinking.
  • Minimising the impact of long-term conditions and ensuring services are designed to reduce mortality and morbidity due to heart attack, stroke, cancers and respiratory disease.
  • Improving cancer awareness to increase early detection and treatment.
  • Promoting the influenza vaccine to people in ‘at risk groups’.
  • Suicide prevention.

 

Overall picture

The overall health of a population can be measured using life expectancy at birth.

Life expectancy at birth is a summary measure, which describes in a single number the average length of life of babies born now if they experience current death rates at each age throughout their lives. It reflects the current death rates of people living in the area, whether they were born in the area or not.

Within Bedford Borough in 2010-12, life expectancy was 79.3 years for men and 83.1 years for women. This compares to 80.1 years for men and 83.7 years for women in the East of England (data is not available for ONS neighbours). In Bedford Borough, since 1991-93, the gap between male and female life expectancy has narrowed from 5.5 years to 3.8 years due to faster improvement in male life expectancy (figure 1).

Life expectancy has been increasing in England, the East of England and Bedford Borough over the last few decades (see figure 1). Male and female life expectancy in Bedford Borough are similar to those in England, however, the trend for male life expectancy in the future looks to be increasing slower than in the East of England and the female life expectancy trend has already dropped below the East of England. Male life expectancy is similar to that in countries with the highest male life expectancy but female life expectancy is lower than that in countries with the highest female life expectancy.

Life expectancy can also be measured from other ages as starting points. Life expectancy at age 65 is 19.0 years for men and 21.5 years for women in Bedford Borough (2010-12) compared to England (18.6 and 21.1) and East of England (19.1 and 21.5)]

 

LE1

 

 

Drivers of life expectancy

Calculation of life expectancy is complex,  but the contribution of the different factors that reduce life expectancy can be seen by using Years of Life Lost (YLL) due to deaths before age 75 years. YLL is calculated by adding together the years before 75 that people die. So a death at 70 contributes 5 years to the total and a death at 25 contributes 50 years.

 

LE2

 

Inequalities in life expectancy

Geographically there is a large range of life expectancy within Bedford Borough; the gap between the "best" and "worst" areas is 12.8 years for women, and 14.6 years for men.

 

Figure 3: Life Expectancy at birth

Life expectancy at birth

Source: ERPHO (Fingertips)

.

Life expectancy has been calculated for Middle Super Output Areas (MSOAs). Some of these correspond exactly to wards, for others the match is not so straight forward. For women the gap in life expectancy is 12.8 years (77.2 years in Harpur Ward and the southern part of Clapham Ward and 90.0 years in Bromham and Biddenham Ward and the eastern part of Kempston Rural Ward). For men the gap is 14.6 years (71.9 years in the Harpur Ward and the southern part of Clapham Ward and 86.5 years in Wootton Ward and the southern part of Elstow Ward).

Using MSOA data may exaggerate the differences, as the confidence intervals are large. Additionally, certain disadvantaged groups have even lower life expectancy which is not identified in these area based measures.

 

Figure 4: Life Expectancy for males and females 2008-2010

Life expectancy for males and females 2008-10

Source of data for map: ERPHO

The gap in life expectancy is driven by increased mortality rates across a range of diseases as shown in the charts below.

 

Figure 5: Cause specific mortality for Bedford Borough males top 4 quintiles of deprivation and bottom quintile, 2005 to 2009 combined

Cause specific mortality for Bedford Borough males 2005 to 2009 combined

Figure 6: Cause specific mortality for Bedford Borough females top 4 quintiles of deprivation and bottom quintile, 2005 to 2009 combined

Cause specific mortality for Bedford Borough females 2005 to 2009 combined

Figure 7: Cause specific mortality for Bedford Borough persons top 4 quintiles of deprivation and bottom quintile, 2005 to 2009 combined

Cause specific mortality for Bedford Borough persons 2005 to 2009 combined

Figure 7 shows that the mortality rate is higher in the bottom (most deprived)quintile for all diseases except for stroke which is 84% higher in the top 4 quintiles when compared to the bottom 4 quintiles.  Diseases of the nervous system are 70% higher in the top 4 quintiles when compared to the bottom 4 quintiles. This is shown in more detail in table 1 below.

In table 1 it is most useful to focus on the two columns on the right showing the difference in rates. The difference in rates as a value shows the size of the contribution of that disease to the overall gap in mortality rate. The percentage difference in rates shows the size of the gap for that disease. Thus bronchitis, emphysema and chronic obstructive diseases have 102% higher death rate in the most deprived areas (twice that of the rest – not counting external causes) but these diseases contribute 22.7 deaths per 100,000 to the overall death rate or 14.9% of the overall death rate.

This  shows that to decrease inequalities in overall mortality rate, the focus needs to be on diseases of the circulatory system especially coronary heart disease; cancers especially lung cancer; infectious and parasitic diseases; diseases of the respiratory system especially bronchitis, emphysema and chronic obstructive diseases; diseases of the genitourinary system; and diseases of the digestive system. The much higher rate from external causes of morbidity and mortality is also a significant area that needs focus.

 

Table 1: Inequalities in mortality rates

 

Top 4 quintiles

Bottom quintile

Difference in rates

Disease group

Number of deaths

Rate† per 100,000

Number of deaths

Rate† per 100,000

Value

Percentage

All causes

5346

534.8

1343

703.5

168.7

31.5%

Diseases of the circulatory system  (I)

1833

171.2

451

228.7

57.5

33.6%

Coronary heart disease (I20-I25)

805

77.2

237

124.8

47.7

61.8%

Stroke (I60-I69)

555

49.1

92

41.4

-7.7

-15.6%

Cancers (C00-C97)

1388

156.2

324

185.4

29.2

18.7%

Lung cancer (C33-C34)

234

26.7

71

40.6

13.9

52.0%

Breast cancer (C50)

135

16.6

30

17.2

0.6

3.7%

Diseases of the respiratory system (J)

676

62.9

171

83.4

20.6

32.7%

Pneumonia (J12-J18)

290

24.8

56

24.8

0.0

0.1%

Bronchitis, emphysema and chronic obstructive diseases (J40-J44)

215

21.3

83

43.0

21.7

102.2%

Diseases of the digestive system (K)

262

26.9

75

44.7

17.8

66.0%

Mental and behavioural disorders (F)

227

19.1

52

20.8

1.7

8.9%

Diseases of the nervous system (G)

194

19.4

25

13.6

-5.8

-30.0%

Diseases of the genitourinary system (N)

120

10.2

34

14.4

4.2

41.3%

External causes of morbidity and mortality (V-Y)

182

22.9

84

48.0

25.1

109.5%

Infectious and parasitic diseases (A-B)

105

10.3

41

19.6

9.3

90.6%

Other (D00-D89, E, H, L, M, O-T,  Z)

359

35.8

86

45.0

9.1

25.5%

†Directly age-standardised mortality rate per 100,000 population

 

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