State of the Region

• There have been increases in both male and female life expectancy in the East Midlands. Female life expectancy is still higher but the gap has narrowed and there is no significant difference between the East Midlands and the national average.
• The rate of pregnancies among under 18 year olds in England and the East Midlands has fallen since 1998. The East Midlands figure is slightly lower than England (40.2% and 41.1% respectively).
• The premature mortality rate from coronary heart disease and circulatory disease in the East Midlands is falling and has met the 2010 target. Both are slightly above the rate for England.
• The premature mortality rate from cancer in the East Midlands has decreased since 1995 and is on course to meet the 2010 target, and is slightly below the rate for England.
• The mortality rate from accidents in the East Midlands is still higher than the England rate, and shows no progress towards the 2010 target.
• Smoking prevalence for both men and women in the East Midlands since 1995/97 shows no clear sign of reducing. Both are four percentage points higher than the England average.
• As indicated in previous State of the Region reports there are few signs that inequalities in health are decreasing.

Commentary

The regional public health strategy Investment for Health described two targets for the East Midlands; to improve health and to reduce health inequalities.

Some indicators of the health of the East Midlands population show marked improvement – premature death rates from coronary heart disease, circulatory disease and cancer are falling and life expectancy is increasing. These improving trends are apparent in areas of the region with relatively poor health as well as in areas with relatively good health. However, there are few signs, at least from these indicators at county/unitary authority level that inequalities in health in the region decreased between the mid-1990s and the early 2000s.

Figure 2.1 shows that both male and female life expectancy have increased since 1995/97. Male life expectancy has increased by 2.5 years and female life expectancy by 1.6 years. There is still a marked difference between male and female life expectancy with in 2004/06 male life expectancy reaching 77.3 years and female life expectancy far higher at 81.3 years, but the gap has narrowed. It is not possible to make comparison in life expectancy across the region as data is not provided at county authority level.

Figure 2.1 – Life expectancy at birth in years: 1995/97 – 2004/06

The rate of pregnancies among under 18 year olds in the East Midlands has fallen from 45 per 1,000 women aged 15-17 in 1998 to 40.2 per 1,000 women in 2005. Figure 2.2 shows that across the region, the rates are highest in the cities of Derby, Leicester and Nottingham.

The premature mortality rate from coronary heart disease, circulatory disease and cancer has decreased between 1995/97 and 2004/06 in the East Midlands and is well on course to meet future targets. ‘Saving Lives: Our Healthier Nation’ targets to reduce the premature (i.e. under age 75) mortality rate from circulatory disease (coronary heart disease, stroke and related conditions) from the 1995–97 average by at least two fifths (40%) by 2010 and targets to reduce the mortality rate from all cancers in the under 75s by at least a fifth (20%) by 2010 from the baseline rate in 1995–97. As can be seen in figure 2.3 between 1995-97 and 2001-02 the premature mortality rates for coronary heart disease, circulatory disease and cancer dropped dramatically and the reduction has since slowed.

Figure 2.3 shows that circulatory disease has had the largest drop in the premature mortality rate which has dropped from 141.9 per 100,000 in 1995/97 to 84.6 per 100,000 in 2004/06, a decrease of 40.38%. The premature mortality rate from coronary heart disease decreased by 40.6% between 1995/97 and 2004/06. This meets the ‘Saving Lives: Our Healthier Nation’ targets to reduce the premature (i.e. under age 75) mortality rate from circulatory disease (coronary heart disease, stroke and related conditions) from the 1995–97 average by at least two fifths (40%) by 2010.

The premature mortality rate from cancer has shown the slowest decrease falling from 137.7 per 100,000 in 1995/97 to 115.1 per 100,000 in 2004/06, a decrease of 16.41%. This is on course to meet the ‘Saving Lives: Our Healthier Nation’ targets to reduce the mortality rate from all cancers in the under 75s by at least a fifth (20%) by 2010 from the baseline rate in 1995–97.

Figure 2.3 – Premature mortality rate per 100,000 population: 1995-97 – 2004-06

In figure 2.4 it can be seen that the premature mortality rate varies across the region. The highest rates can be seen in the cities and the lowest rates in the more rural areas.

Figure 2.4 – Premature mortality rate per 100,000 population for counties and unitary authorities: 2004/06 

The mortality rate from accidents in the East Midlands has not changed significantly since the 1995-97 baseline rate, as seen in figure 2.5, but is still higher than the England rate (18.0 per 100,000 compared with 15.9 per 100,000 nationally). There is little sign of progress towards the ‘ Saving Lives: Our Healthier Nation’ target to reduce the mortality rate from accidents in all ages by at least a fifth (20%) by 2010 from the baseline 1995–97 rate. Figure 2.6 shows that across the region the mortality rate from accidents is highest in Nottingham at 23.1 per 100,000 and Lincolnshire at 20.1 per 100,000 and lowest in Derby at 14.8 per 100,000 population.

Figure 2.5 – Mortality rate from accidents per 100,000 population: 1995/97 - 2004/06

Figure 2.6 – Mortality rate from accidents per 100,000 population for counties and unitary authorities: 2004/06 

The mortality rate from suicide and undetermined injury in the East Midlands has varied within a narrow range since 1995-97, and is similar to the rate in England as a whole. Although it has shown a small but regular decrease in more recent years in figure 2.7, continuation of this trend at the current rate will not be sufficient to meet the ‘ Saving Lives: Our Healthier Nation’ target to reduce the mortality rate from suicide and undetermined injury by at least a fifth (20%) by 2010 from the baseline 1995–97 rate. Figure 2.8 shows that the mortality rate from suicide and undetermined injury varies across the region with the highest rate in Nottingham at 12.1 per 100,000 and the lowest rates are Derbyshire at 6.5 per 100,000, Leicestershire at 6.8 per 100,000 and Northamptonshire at 7.2 per 100,000.

Figure 2.7 – Mortality rate from suicide and injury undetermined per 100,000 population: 1995/97 - 2004/06

Figure 2.8 – Mortality rate from suicide and injury undetermined per 100,000 population for counties and unitary authorities: 2004/06 

Figure 2.9 shows that the number of people killed or seriously injured in traffic accidents has decreased over time from 4,134 in 1996 to 2,605 in 2006/07. This is moving toward the target of a decrease in accidents at the regional level towards the national target of 40% by 2010. The number of people killed in traffic accidents has fluctuated over time and numbers are the same for 2006/07 as for 1996. Figure 2.10 shows that across the region the number of people killed in traffic accidents is highest in Northamptonshire and the lowest in Derby and Rutland. The number of people killed and seriously injured in traffic accidents is highest in Derbyshire and Northamptonshire and lowest in Leicester and Rutland. However, when the casualty rate per 100,000 population is considered, as in figure 2.11, it can be seen that the highest rates are in Lincolnshire and the lowest in Derby and Northamptonshire.

Figure 2.9 – Number of people killed or seriously injured in traffic accidents: 1996 – 2006/07

Figure 2.10 – Number of people killed or seriously injured in traffic accidents for counties and unitary authorities: 2006/07 

Figure 2.11 – Casualty rate per 100,000 population for counties and unitary authorities: 2006

Indicators: IRS Framework Objective 2 – Health

INDICATORS	East Midlands Latest (year)	East Midlands change over time		Current English Average (Year)	How the East Midlands compares to the English average		Final Source
Life expectancy at birth in years – Male NAT	77.3 (2004-06)	2.5 (1995-97)		77.2 (2004-06)	0.1		ONS
Life expectancy at birth in years – Female NAT	81.3 (2004-06)	1.6 (1995-97)		81.5 (2004-06)	-0.2		ONS
Teenage Pregnancy Rates per 1000 women age 15-17	40.2 (2005)	-4.8 (1998)		41.1 (2005)	-0.9		ONS and Teenage Pregnancy Unit
Premature mortality rate from coronary heart disease per 100,000 population	49.7 (2004-06)	-40.6 (1995-97)		48.4 (2004-06)	1.3		NCHOD
Premature mortality rate from circulatory disease per 100,000 population NAT	84.6 (2004-06)	-57.3 (1995-97)		84.2 (2004-06)	0.4		NCHOD
Premature mortality rate from cancer per 100,000 population NAT	115.1 (2004-06)	-22.6 (1995-97)		117.1 (2004-06)	-2.0		NCHOD
Mortality rate from accidents per 100,000 population	18.0 (2004-06)	0.1 (1995-97)	=	15.9 (2004-06)	2.1		NCHOD
People killed in traffic accidents RSS	329 (2006/07)	0 (1996)	=	2,695 (2006)	N/C	N/C	RSS Annual Monitoring Report 2006/07 – Local Transport Authorities
People killed or seriously injured in traffic accidents RSS NAT	2,605 (2006/07)	-1,529 (1996)		27,551 (2006)	N/C	N/C	RSS Annual Monitoring Report 2006/07 – Local Transport Authorities
Mortality rate from suicide and injury undetermined per 100,000 population NAT	8.1 (2004-06)	-0.6 (1995-97)	=	8.3 (2004-06)	-0.2		NCHOD
Prevalence of cigarette smoking – Male (%) NAT	28.0 (2006)	-0.9 (1995-97)	=	24.0 (2006)	4.0		Health Survey for England
Prevalence of cigarette smoking – Female (%) NAT	25.0 (2006)	0.1 (1995-97)	=	21.0 (2006)	4.0		Health Survey for England

Key to the Table

Comments on Table

Road casualty data has been collected directly from local authorities and may differ slightly to national statistics. 

County and Unitary Indicators