5.2 Main causes of death Brighton & Hove JSNA 2013

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1 Why is this issue important? We need to know how many people are born and die each year and the main causes of their deaths in order to have well-functioning health s. 1 Key outcomes Mortality rate from all cardiovascular (including heart and stroke) in persons less than 5 years of age (Public Health Outcomes Framework, NHS Outcomes Framework) Mortality rate from cancer in persons less than 5 years of age (Public Health Outcomes Framework, NHS Outcomes Framework) Mortality rate from Chronic Liver Disease in persons less than 5 years of age (Public Health Outcomes Framework, NHS Outcomes Framework) Mortality rate from chronic respiratory in persons less than 5 years of age (Public Health Outcomes Framework, NHS Outcomes Framework) Mortality rate of people with mental illness (Public Health Outcomes Framework) Impact in Brighton & Hove The commonest causes of death within the city are cancers, circulatory, respiratory and digestive (including liver ). In 2011 there were a total of 2,01 deaths of Brighton & Hove residents. The main causes of death were cancer (30%), followed by circulatory conditions (2%), respiratory conditions (13%). However one in twenty deaths in the city are not caused by these are predominantly accidents or suicide (See figures at end of section). The main causes of death in the city are similar to the South East but in Brighton & Hove mortality rates are higher for all groupings with the exception of mental disorders and genitourinary (Figure 1). 2 Figure 1: Cause-specific mortality profiles for Brighton & Hove and the South East, (directly age standardised rate per 100,000) Directly age-standardised mortality rate Brighton and Hove PCT South East Infectious External causes Nervous Mental disorders Digestive Respiratory Cancers Circulatory Source: South East Public Health Observatory 1 World Health Organisation. Civil registration: why counting births and deaths is important. Fact sheet N 324; South East Public Health Observatory. Health Inequalities Gap Measurement Tool. Available at [Accessed on 21/0/2012] 1

2 Cancer: The recent cancer mortality trend for all ages in the city has been relatively stable but saw a fall in 200. Mortality from all cancers in under 5 year olds is significantly higher in Brighton & Hove than England and the South East. Mortality rates for cancer in this age group in the city had been increasing since but in were around the level. If current trends continue, Brighton & Hove is unlikely to see a 20% reduction in cancer mortality rates. 3 Cancer is explored in more detail in the cancer section. Heart and stroke: Between 200 and 200 in Brighton & Hove the mortality rate among the under 5s due to heart & stroke was per 100,000 population, compared with 1 in England & 5 in the South East. This is explored in more detail in the relevant section of the report. Respiratory : The mortality rate in the city for respiratory for those aged under 5 years is similar to the England rate. Liver & chronic liver : Mortality rates in those aged under 5 years are significantly higher in Brighton & Hove than in England. Where we are doing well The recent trend in circulatory deaths for all ages in Brighton & Hove has been downwards. Local inequalities Age: The breakdown of cause of death is very different for children, adults and older people. Since there are a small number of deaths in children in the city each year it has not been possible to produce charts showing the main causes of death. In 2010 there were 12 deaths of children aged under one year, with an additional five deaths of children aged 1-14 years. In 2010 there were 0 deaths of people aged under 5 years (see figures at end of section). Here, the main cause of death is cancer (3%) followed by circulatory (24%). Death not caused by is the third most common cause of death in this age group and comprises one in 10 deaths. For those aged 5 years or over (see figures at end of section), the most common causes are circulatory (35%), cancer (25%) and respiratory (15%). In 2010 there were 1,34 deaths in this age group. Gender: The main causes of death (for all ages) are similar for males and females. The main difference is the higher proportion of deaths in males to external causes (mainly accidents, suicide and drug or alcohol poisoning). For males, the proportion of deaths to circulatory and cancer are similar, but for females a higher proportion of deaths are due to circulatory than cancer. Deprivation: Figure 2 compares mortality rates for the most deprived quintile and the least deprived quintile in the city. The large difference seen in overall mortality is present for all commonest causes of death except for of the nervous or genitourinary. Circulatory death rates have been falling overall, for the most and least deprived quintiles in the city. However the mortality rate is higher in the more deprived areas. Between 200 and 2010 circulatory death rates in those aged under 5 years in the most deprived quintile of the city were three times higher than for the least deprived quintile. This difference has increased: for the period the rate in the most deprived quintile was twice that in the least deprived quintile. For cancer, under 5 deaths rates are increasing in the most deprived group. In cancer mortality for the under 5s was 1.5 times higher in the most deprived quintile compared with the least deprived and by this had increased to 1.. Predicted future need If current trends continue, the ONS projects that by 2015 there will be 1,00 deaths per year, and 1,00 deaths by Without a change in current trends, inequalities in all deaths and early deaths from cancer and circulatory will widen. What we don t know Ethnicity is not recorded on death registration in England, nor is religion, sexual orientation or gender reassignment. National definitions for 3 The national target is to reduce mortality rates from cancer by at least 20% in people under 5 by (which will be known at the end of 2012). 4 ONS sub national population projections (2010 based). Available at: [Accessed on 21/0/2012]. 2

3 communicable deaths and deaths of people with a mental illness have yet to be defined. Death certification also does not include information on sexual orientation, trans, or carers. See specific sections for recommended future local priorities Key links to other sections Coronary heart Cancer Respiratory Suicide Last updated August 2013 Figure 2: Mortality rate per 100,000 population for the most and least deprived quintiles of deprivation in Brighton & Hove, Source: South East Public Health Observatory Health Inequalities Gap Measurement Tool 3

4 Main causes of death in Brighton and Hove 2011 Source: Office for National Statistics Vital Statistics tables (VS3) and Public Health Mortality Files Senility without mention of psychosis Dementia % Due to psychoactive Alcohol substance use Multiple Renal failure Sclerosis Motor neurone Epilepsy 5 Alzheimer s Pneumonia Diseases of the nervous 1 Bronchitis, emphysema & other chronic obstructive pulmonary Respiratory 25 13% Mental & behavioural disorders Parkinson s 3 Vascular disorders of intestine Liver 23 3 Alcoholic liver Unknown causes Congenital and chromosomal abnormalities Infants 1 Digestive 133 % 10 Total deaths 2,01 Hernia 20 Gallbladder, biliary tract & pancreas Death not caused by % 24 Endocrine, nutritional & metabolic Gastric & duodenal ulcer Accidents Falls Diabetes 151 Musculoskeletal 32 Ischaemic heart (not MI) 2 3 Infectious Acute myocardial infarction (MI): heart attack Accidental poisoning Hanging 21 Suicide or undetermined intent 1 Osteoporosis Coronary heart 21 Stroke Brighton & Hove Public Health Directorate 14 Colorectal 1 Oesophagus Prostate Pancreas 4 15 Leukaemia 1 Ovary 1 High blood pressure Cancers & neoplasms 30% Circulatory 532 2% Stomach and digestive organs 1 Non Hodgkin s Lymphoma 1 2 Female genital organs Kidney 10 3 Other heart 14 Stomach Lung 50 Liver Skin cancer melanomas Breast 12 Bladder Uterus Diseases of veins, lymphatic vessels & lymph nodes Diseases of arteries, arterioles & capillaries Pulmonary heart Central nervous 4

5 Main causes of death in the under 5s - Brighton and Hove 2011 Source: Office for National Statistics Vital Statistics tables (VS3) and Public Health Mortality Files Alcohol Due to psychoactive substance use Mental & behavioural disorders 12 Multiple Sclerosis 5 Epilepsy Pneumonia Bronchitis, emphysema & other chronic obstructive pulmonary Diseases of the nervous 2 Respiratory Vascular disorders of intestine Liver Alcoholic liver Digestive Congenital and chromosomal abnormalities Infants 1 Total deaths Gastric and duodenal ulcer Accidents Death not caused by Falls Endocrine, nutritional & metabolic 5 (13%) 3 4 Musculoskeletal 13 Infectious Accidental poisoning Coronary heart Ischaemic heart (not MI) 20 Acute myocardial infarction (MI): heart attack Hanging 1 Suicide or undetermined intent 12 Prostate Non Hodgkin s Lymphoma Brighton & Hove Public Health Directorate Colorectal Oesophagus 104 (1%) Pancreas 11 Ovary High blood pressure Cancers and neoplasms 25 (3%) Circulatory Stomach and digestive organs 4 14 Female genital organs 22 Other heart 24 Stroke Liver Breast 0 Bladder Uterus Lung Central nervous Diseases of veins, lymphatic vessels & lymph nodes Diseases of arteries, arterioles & capillaries 5

6 Main causes of death in 5s or over - Brighton and Hove 2011 Source: Office for National Statistics Vital Statistics tables (VS3) and Public Health Mortality Files 10 Dementia Alzheimer s Diseases of the nervous 5 2 Pneumonia Mental & behavioural disorders 111 % Respiratory (14%) 1 Renal failure Parkinson s Bronchitis, emphysema & other chronic obstructive pulmonary 33 3 Vascular disorders of intestine 11 Liver Senility without mention of psychosis 42 Digestive Total deaths 1,415 Gallbladder, biliary tract & pancreas 1 Falls Death not caused by Gastric and 13 Duodenal Cancer Diabetes Endocrine, nutritional & metabolic Ischaemic heart (not MI) Musculoskeletal Infectious Acute myocardial infarction (MI): heart attack Accidents 4? Osteoporosis 1 Coronary heart 11 Stroke Brighton & Hove Public Health Directorate Colorectal Oesophagus Prostate Leukaemia Pancreas Ovary High blood pressure Cancers and neoplasms 34 (2%) Circulatory 42 (30%) Stomach and digestive organs Female genital organs Bladder Liver Stomach Breast Diseases of veins, lymphatic vessels & lymph nodes Other heart Lung Skin cancer melanomas Diseases of arteries, arterioles & capillaries Pulmonary heart Central nervous 10 Non Hodgkin s Lymphoma