Mortality (health and wellbeing needs in South Tyneside)

Life expectancy is the average number of years a person would expect to live based on current mortality rates for a particular area and time period.

It is an estimate of the average number of years a newborn baby, or 65 year-old, would survive if he or she experienced the age-specific mortality rates for that area and time period throughout his or her life.

Figures are calculated from deaths from all causes and mid-year population estimates, based on data aggregated over a three year period.

Figures reflect mortality among those living in an area in each time period, rather than what will be experienced throughout life among those born in the area.

The figures are not therefore the number of years a baby born in the area could actually expect to live, both because the mortality rates of the area are likely to change in the future and because many of those born in the area will live elsewhere for at least some part of their lives.

Life Expectancy at Birth (male)

The life expectancy at birth for males is significantly lower than the national average.  South Tyneside males have a life expectancy of 77.5 years, two years less than the England population as a whole.

South Tyneside's trend and the most recent life expectancy for North East Local Authorities can be found Figs. 1 and 2 of the appendices.

Life Expectancy at Birth (female)

The life expectancy at birth for females is significantly lower than the national average.  South Tyneside males have a life expectancy of 81.5 years, 1.6 years less than the England population as a whole.

South Tyneside's trend and the most recent life expectancy for North East Local Authorities can be found Figs. 3 and 4 of the appendices.

Life Expectancy at 65 (male)

The life expectancy at 65 for males is significantly lower than the national average.  South Tyneside males have a life expectancy of 17.5 years, 1.2 years less than the England population as a whole.

South Tyneside's trend and the most recent life expectancy for North East Local Authorities can be found Figs. 5 and 6 of the appendices.

Life Expectancy at 65 (female)

The life expectancy at 65 for females is significantly lower than the national average.  South Tyneside males have a life expectancy of 20.1 years, 1 year less than the England population as a whole.

South Tyneside's trend and the most recent life expectancy for North East Local Authorities can be found Figs. 7 and 8 of the appendices.

Healthy Life Expectancy

Healthy life expectancy is a measure of the average number of years a person would expect to live in good health based on mortality rates and prevalence of self-reported good health.

The prevalence of good health is taken from responses to a question on general health as part of the Annual Population Survey (APS).

Healthy life expectancy is an estimate of the average number of years a baby would live in good general health if he or she experienced the age-specific mortality rates and prevalence of good health for that area throughout his or her life.

The figure is not the number of years a baby born in the area could actually expect to live in good general health.  This is because the health prevalence and mortality rates of the area are likely to change in the future and many of those born in the area will live elsewhere for at least some part of their lives.

Nationally children born between 2013 and 2015 are likely to spend at least 20% of their lives in poorer health.  Boys born in 2013 to 2015 will enjoy just 63 years of good health on average, while girls can expect 64 healthy years.

The Office for National Statistics (ONS) have created a tool which shows how changes in certain lifestyle behaviours, for example smoking or diet, can impact on the healthy life expectancy of the population.  The tool can be found at Office for National Statistics: What affects an area's healthy life expectancy?

Healthy Life Expectancy in males

Healthy life expectancy in males was 56.8 years in South Tyneside, this is significantly lower than the North East Regions 59.6 years and the England estimate of 63.4 years.  South Tyneside has a lower healthy life expectancy in males than all other North East local Authorities. 

South Tyneside's trend and the most recent life expectancy for North East Local Authorities can be found Figs. 9 and 10 of the appendices.

Healthy Life Expectancy in females

Healthy life expectancy in males was 57.9 years in South Tyneside, this is significantly lower than the North East Regions 60.1 years and the England estimate of 64.1 years.  

South Tyneside's trend and the most recent life expectancy for North East Local Authorities can be found Figs. 11 and 12 of the appendices.

Additional resources

Life expectancy appendices

Potential years of life lost (PYLL), is an estimate of the average years a person would have lived if he or she had not died prematurely.

It is, therefore, a measure of premature mortality.  As an alternative to death rates, it is a method that gives more weight to deaths that occur among younger people.

The NHS Outcome tool (http://tools.england.nhs.uk/ccgoutcomes/html/atlas.html) includes indicators for potential years of life lost for both the male and female population at CCG Level.

The indicator provides an age standardised rate of years lost per 100,000 registered patients.  Age standardisation makes it possible to compare areas which have different demographic age profiles.  A population with a higher than normal rate of people in their 20s would be likely to see a different set of health issues to a population with a disproportionate number of people in their 60s.

The concept of amenable and preventable mortality is based on the idea that certain deaths could be 'avoided', that means would not have occurred at this stage, if there had been more effective public health and medical interventions in place.

A death can be considered as amenable if it could have been avoided through optimal quality health care.  Preventable deaths are broader and includes deaths which could have been avoided by changes to behaviour and lifestyle factors, socioeconomic status and environmental factors.

Potential years of life lost in South Tyneside from causes considered amenable to healthcare (per 100,000 directly standardised rate)

• While males have more potential years of life lost than females there is not a statistically significant difference.
• Females in South Tyneside are among the worst quartile in England, with 2,215 years of life lost per 100,000 population compared to 1,868 in England.
• Despite both genders having a higher number of years lost than the England average neither were statistically different to the national rate.

Supporting information can be found in the appendices. 

Additional resources

Potential Years of Life Lost Appendices

The Summary Hospital Mortality Indicator (SHMI) is the ratio between the actual number of patients who die following hospitalisation at the trust and the number that would be expected to die on the basis of average England figures, given the characteristics of the patients treated there.

It includes deaths which occur in hospital and deaths which occur outside of hospital within 30 days of discharge. 

SHMI banding gives an indication for each non-specialist acute NHS trust in England how the observed number of deaths within 30 days of discharge from hospital compared to the national baseline:

The SHMI can be used by trusts to compare their mortality outcomes to the national baseline, with some caveats.  Where a trust has an 'as expected' SHMI, it is inappropriate to conclude that their SHMI is lower or higher than the national baseline, even if the number of observed deaths is smaller or larger than the number of expected deaths.

The difference between the number of observed deaths and the number of expected deaths cannot be interpreted as the number of avoidable deaths for the trust.  Whether or not a death could have been prevented can only be investigated by a detailed case-note review, the SHMI is not a direct measure of quality of care.

The expected number of deaths for each trust is not an actual count of patients, it's a statistical construct which estimates the number of deaths that may be expected at the trust on the basis of average England figures and the characteristics of the patients treated there.

A 'higher than expected' SHMI should not immediately be interpreted as indicating bad performance, it should be viewed as a 'smoke alarm' which requires further investigation by the trust.  The SHMI cannot be used to directly compare mortality outcomes between trusts and it's inappropriate to rank trusts according to their SHMI.

Instead, the SHMI banding can be used to compare mortality outcomes to the national baseline.

It's important to note that South Tyneside Hospital has a palliative care unit which provides care for the terminally ill.  This inflates the rate of deaths at the hospital.  Between April 2016 and March 2017 in England just 1.8% of people that died in hospital (or within 30 days of leaving hospital) had received speciality palliative care, in South Tyneside the rate was 14.2%. 

South Tyneside SHMI

SHMI Value:

Number of deaths:

The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO).  The ICD-10 is used worldwide for morbidity and mortality statistics.

Diseases and health conditions all have unique codes; there are over 14,000 codes in the latest version of the ICD-10.  To make the ICD-10 more usable conditions are grouped together into 22 chapters.

This page looks at the main causes of mortality in South Tyneside by ICD-10 chapter.  All statistics are three-years pooled; this reduces the chances of suppression due to low numbers.

The main causes of death in South Tyneside are cancers, circulatory diseases such as heart disease, and diseases of the respiratory system such as Emphysema.

ICD Chapters are available in the supporting appendices; chapters where the number of deaths was five or less have not been presented.

Additional resources

Causes of Death

More people die in the winter than in the summer in England and Wales, this is known as Excess Winter Deaths (EWD), or Excess Winter Mortality (EWM).

Historically, above-average mortality is seen between December and March in England and Wales. 

The standard method defines the winter period as December to March, and compares the number of deaths that occurred in this winter period with the average number of deaths occurring in the preceding August to November and the following April to July.

Excess Winter Mortality calculation:

EWM = winter deaths - average non-winter deaths

This produces the number of excess winter deaths (EWDs).

Trend

While there was an unusually high rate of excess winter deaths both locally and nationally in 2014/15, figures for 2015/16 indicate the excess deaths have returned to a more normal rate.

Excess winter deaths are more likely to occur in the elderly.  In 2014/15 the excess winter death rate for Females aged 85 and over was significantly higher than the national rate.  

Excess winter mortality statistics for 2015/16 suggest that the rate of 85+ deaths declined, this is likely due to the most prevalent strain of the flu virus impacting younger people rather older people, who are more at risk.

Resources

Further information on excess winter deaths in South Tyneside can be found in the appendices

Additional resources

Causes of Death