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Maps of premature deaths across England will help tackle variation, say public health chiefs

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3796 (Published 11 June 2013) Cite this as: BMJ 2013;346:f3796
  1. Ingrid Torjesen
  1. 1London

Wide variation between local authority areas in England in numbers of avoidable premature deaths, independent of levels of social deprivation, has been shown by a new website launched by Public Health England today.

The Longer Lives website (longerlives.phe.org.uk) uses data from the government’s Public Health Outcomes Framework to map the overall rate of premature death in local authorities across England and also gives specific rates for the four major causes of premature death: cancer, heart disease and stroke, lung disease, and liver disease. These four conditions are responsible for 75% of the 153 000 premature deaths that occur each year in England.

John Newton, chief knowledge officer at Public Health England, said that around 103 000 of these deaths were avoidable because the conditions could have been either better treated or prevented by reducing risk factors such as obesity, alcohol consumption, smoking, and inactivity and by improving diagnosis and tackling environmental factors such as poor housing.

He said that differences in how these factors were tackled contributed to a twofold difference between the best and worst performing local authorities in the rate of premature death from all causes and from cancer, a threefold difference in the rate of premature death from heart disease, and a fourfold difference in the rate from lung and liver diseases, he said.

The website is aimed at local authorities, which were made responsible for public health in April, to help them see where they most need to improve so they can better target their efforts and resources. It highlights which local authorities with similar levels of deprivation are performing better and provides links to guidance from the National Institute for Health and Care Excellence and national campaigns such as Change4Life.

The maps use a traffic light colouring system to show how each local authority area performs relative to the national average and also compares each area’s performance against the average of local authorities with similar levels of deprivation (by using their score on the Index of Multiple Deprivation to separate them into 10 groups).

The highest rates of early death are seen in the north of England, but comparisons between local authorities of similar deprivation levels show a more complex picture. For example, Rotherham Metropolitan Borough Council and Redcar and Cleveland Borough Council have low rates of premature death among the group of local authorities with the greatest deprivation, while Bracknell Forest and Central Bedfordshire have some of the worst rates among the most affluent areas.

In addition, some areas do relatively well overall on premature mortality but less well in terms of premature death from one or two conditions.

Newton said that even the best performing local authorities needed to improve. “Even our best authorities are not doing as well as other places in Europe,” he said. England has the seventh highest rate of premature death of men under 75 of 17 European countries and the 15th highest rate in women. It has the second worst rate of premature death from lung disease, and the number of deaths from liver disease is increasing.

Lindsey Davies, president of the UK Faculty of Public Health, said, “This new map from Public Health England may not contain many surprises, but it is a useful tool for people working for councils who are now responsible for the public health of people in their areas. It is not acceptable that there is such a divide between the ‘health haves’ and ‘have nots’ in some parts of England.”

England’s health secretary, Jeremy Hunt, said, “This shocking variation in early and unnecessary deaths means people’s lives are needlessly cut short, and that cannot continue unchecked.

“I want areas to use the data released today to identify local public health challenges like smoking, drinking, and obesity and to take action to help achieve our ambition for saving 30 000 lives a year by 2020.”

The Longer Lives website maps data for 150 local authorities. Two local authorities, the City of London and Isles of Scilly, are excluded because their small populations mean data are insufficient to make meaningful comparisons.

The site will develop further over the next two years by the addition of new indicators, such as smoking rates, body mass index, quality of life, and people’s perception of wellbeing.

Notes

Cite this as: BMJ 2013;346:f3796