Alcohol-related and hepatocellular cancer deaths by country of birth in England and Wales: analysis of mortality and census data.

BACKGROUND: The incidence of and mortality from alcohol-related conditions, liver disease and hepatocellular cancer (HCC) are increasing in the UK. We compared mortality rates by country of birth to explore potential inequalities and inform clinical and preventive care. DESIGN: Analysis of mortality for people aged 20 years and over using the 2001 Census data and death data from 1999 and 2001-2003. SETTING: England and Wales. MAIN OUTCOME MEASURES: Standardized mortality ratios (SMRs) for alcohol-related deaths and HCC. RESULTS: Mortality from alcohol-related deaths (23 502 deaths) was particularly high for people born in Ireland (SMR for men [M]: 236, 95% confidence interval [CI]: 219-254; SMR for women [F]: 212, 95% CI: 191-235) and Scotland (SMR-M: 187, CI: 173-213; SMR-F 182, CI: 163-205) and men born in India (SMR-M: 161, CI: 144-181). Low alcohol-related mortality was found in women born in other countries and men born in Bangladesh, Middle East, West Africa, Pakistan, China and Hong Kong, and the West Indies. Similar mortality patterns were observed by country of birth for alcoholic liver disease and other liver diseases. Mortality from HCC (8266 deaths) was particularly high for people born in Bangladesh (SMR-M: 523, CI: 380-701; SMR-F: 319, CI: 146-605), China and Hong Kong (SMR-M: 492, CI: 168-667; SMR-F: 323, CI: 184-524), West Africa (SMR-M: 440, CI, 308-609; SMR-F: 319, CI: 165-557) and Pakistan (SMR-M: 216, CI: 113-287; SMR-F: 215, CI: 133-319). CONCLUSIONS: These findings show persistent differences in mortality by country of birth for both alcohol-related and HCC deaths and have important clinical and public health implications. New policy, research and practical action are required to address these differences.This resource was contributed by The National Documentation Centre on Drug Use.

Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarters 1 to 3 2009/10

Hospitals and care homes are making use of new measures designed to protect people unable to give consent for their care.The Mental Capacity Act Deprivation of Liberty Safeguards were introduced by law on 1 April 2009 to provide a legal framework for depriving someone of their liberty where they are unable to give informed consent regarding their care. The statistics presented here provide the first official information about authorisations to legally detain a person using the legislation.The safeguards apply to people aged 18 and above who suffer from a mental disorder of the mind (such as dementia or a profound learning disability) and who lack capacity to give consent to the arrangements made for their care and / or treatment. The safeguards cover people in all hospitals and care homes in the statutory, independent and voluntary sectors.A rigorous, standardised assessment and authorisation process is used to ensure only appropriate use is made of the safeguards.Key facts?The number of authorisation requests were: 1,772 in quarter 1 1,681 in quarter 2 and, 1,869 in quarter 3. ?Of the total assessments completed in each quarter, a higher proportion were for females than for males ?For each quarter, around three out of four assessments were made by local authorities while the remaining ones were made by primary care trusts. ?The percentage of authorisations granted leading to someone being deprived of their liberty varied between 33.5 per cent and 50.7 per cent across quarters 1 to 3. ?At 31 December 2009 1,074 people were subject to such authorisations.Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarter 1 (0.31MB)Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarter 2 (0.31MB)Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarter 3 (0.31MB)Have your say - give us your comments on this publication��

Inequalities in Old Age: The impact of the recession on older people in Ireland, North and South CARDI Grants

Inequalities in Old Age: the impact of the recession on older people in Ireland, North and SouthAbout the research:This research, led by Professor Paddy Hillyard, Emeritus Professor Queen’s University Belfast, was carried out with funding from CARDI’s Grants Programme Call 2. The purpose of the study was to analyse the impact of the recession on older people in Northern Ireland (NI) and the Republic of Ireland (ROI) and the extent to which inequalities within the older population have been affected by the economic crisis.Research Brief:This brief, authored by CARDI staff, is based on the findings of the research project and also contains additional information of interest.Research Team:Professor Paddy Hillyard, Emeritus Professor Queen’s University Belfast - lead researcher;Dr Francesca Lundstr̦m, Research Consultant;Dr Demi Patsios, Policy Research Consultant;Sarah Machniewski, Researcher;David Taylor, Chartered Accountant and Management Consultant;Dr Maureen Lyons, Research Manager, School of Social Justice, UCD.Methodology and availability of data:Several methods were used in the research, including:�� a review of relevant literature;����a detailed analysis of many databases relevant to older people’s incomes and lives;��building a model to assess the impact of the recession on older people;surveys of financial advisers in voluntary, private and public sectors;��six focus groups, three each in NI and RoI.Availability of data:Despite the huge amount of information which is officially collected and published in NI and RoI, very little is directly comparable. ��The development of a mechanism to encourage the production of more comparable data North and South would be very beneficial.��For example, this study identified a basket of 25 factors that can be used to compare the living standards of older people in NI and RoI and to monitor changes in future yearsTo access the full report please click on the following link:Inequalities in Old Age: the impact of the recession on older people in Ireland, North and SouthPlease find the presentation from the launch below:Inequalities, Pensions and the Recession by Prof Paddy Hillyard, Queen’s University Belfast and Dr Demi Patsios, Policy Research Consultant, Dr Francesca Lundstr̦m, Research Consultant.��������

Tackling inequalities in life expectancy in areas with the worst health and deprivation: England

While overall health outcomes in England has improved during the last Labour administration - inequalities in health has increased, according to the latest report published by the House of Commons Public Accounts Committee today. People living in the poorest communities in England are more likely to die two years earlier than people living in more affluent neighbourhoods, leading to 3,335 premature mortality the report claims. Between, 1997 and 2010, the NHS budget has doubled and the country is more prosperous than ever before, yet the gap in life expectancy between the poorest areas and the national average grew by 7% for men and 14% for women, the committee concluded.

Deaths from Alzheimer's disease, dementia and senility in England: (NEoLCIN)

Care homes will face particular challenges in responding to the inevitable rise in dementia, including Alzheimer’s, according to a report published by the National End of Life Care Intelligence Network (NEoLCIN). It says commissioners and providers across adult health and social care will be faced with meeting the needs of more people dying with these conditions as the population ages. It confirms that, unlike other conditions, most people with dementia, including Alzheimer’s, die in care homes.Of those who died with one of these conditions recorded as the main underlying cause of death, some 59% died in a nursing or residential home compared to 32% in hospital. That contrasts sharply with the figure for deaths overall: nationally 58% of us die in hospital and only 16% in care homes.The report also shows that people who die from cardiovascular disease, cancer or respiratory illness are significantly more likely to die in a care home if dementia including Alzheimer’s is a contributory factor in their death.Download Deaths from Alzheimer’s disease, dementia and senility in England from the NEoLCIN website

Inequality in Healthy Life Expectancy at Birth by National Deciles of Area Deprivation: England, 2010-12

This release from the Office for National Statistics contains a reference table providing Healthy Life Expectancy (HLE) and Life Expectancy (LE) at birth for national deciles of area deprivation in England. It also provides two measures of inequality, the range and Slope Index of Inequality (SII), for the period 2010-12.Key findingsMales in the most deprived areas have a life expectancy 9.1 years shorter (when measured by the range) than males in the least deprived areas; they also spend a smaller proportion of their shorter lives in ‘Good’ health (70.8% compared to 85.0%).Females in the most deprived areas have a life expectancy 6.8 years shorter (when measured by the range) than females in the least deprived areas; they also expect to spend 17.2% less of their life in ‘Good’ health (66.1% compared to 83.2%).Males in the most advantaged areas can expect to live 19.4 years longer in ‘Good’ health than those in the least advantaged areas as measured by the Slope Index of Inequality (SII). For females this was 19.8 years.Read the release here.��

Briefing 02: Mortality in children and young people in the East of England

The current trend in infant mortality in the East compared with the UK as a whole, the contribution of different causes to the total number of deaths, and PCT-specific information on 8 years of combined data.

Health Profiles for the East of England

A collection of Health Profiles for the East of England

Active East - A Physical Activity Framework for the East of England 2006

This document sets out the role of physical activity, not just in terms of its known health benefits (prevention of obesity), but also its wider social contribution. Physical activity is a cross cutting agenda and needs to involve a variety of organisations working in partnership with the health sector.

Health Status of Gypsies and Travellers in England

Qualitative study into the effect of the attitudes, beliefs and lifestyles of Travellers and Gypsies on health inequality issues.

Health Challenge England: factsheets

Factsheets covering specific topics on health improvement including the Public Service Agreement target areas specifically associated with the achievement of improvement of overall public health, and the reduction of health inequalities.

Health Inequalities Intervention Tool. East of England. Draft Spec - Autumn 2007

Pilot approaches that will be used in the Phase 2 of National Health Inequalities Intervention Tool, due to be launched early 2008.

Statistics on Obesity, Physical Activity and Diet, England 2006

This is a statistical bulletin from the Information Centre which presents a range of information on obesity, physical activity and diet, drawn together from a variety of sources. The topics covered include: overweight and obesity prevalence among adults and children physical activity levels among adults and children trends in purchases and consumption of food and drink, and energy intake health outcomes of being obese hospital admissions and prescriptions dispensed related to obesity. The bulletin also summarises government plans and targets in this area, as well as providing sources of further information and links to relevant documents.

Statistics on obesity, physical activity and diet: England, January 2008

This statistical report from the Information Centre presents a range of information on obesity, physical activity and diet, drawn together from a variety of sources. The publication also summarises government plans and targets in this area, as well as providing sources of further information and links to relevant documents and key sources. There are several notable additions to this, The Information Centre's second report on obesity, physical activity and diet. Waist circumference analysis has been included where possible to reflect the importance of using this measurement in conjunction with Body Mass Index (BMI) in order to identify those at increased risk of health problems associated with obesity. More regional data is presented with a greater number of tables providing government office region and Strategic Health Authority breakdowns. Where possible information at a more local level has been reported on.

Briefing 21: Inequalities in Primary Care in the East of England

This report focuses on inequalities in primary care as indicated by the Quality and Outcomes Framework.