In this month’s update we have added the latest data to indicators covering international life expectancy, cancer mortality, diabetes care for children and alcohol drinking behaviour and harms.
Life expectancy at birth quantifies the average number of years a new-born is expected to live if mortality patterns at the time of its birth remain the same into the future. Life expectancy at birth offers a useful summary of the health of a population and has been used for over a century. (WHO, 2017)
We compare the UK life expectancy at birth with select countries from the Organisation for Economic Co-operation and Development (OECD). Life expectancy at birth has improved in all the selected countries over the previous three decades. In the UK in 2015, life expectancy at birth increased by 7.9 years from 73 in 1980 to 81 in 2015. Despite this increase, life expectancy in the UK remains below that of many other OECD countries including Spain, Italy, France and Australia.
International comparisons of cancer mortality
The OECD currently uses survival rates for three types of cancer – breast, cervical and colorectal – as indicators of the quality of care provided by healthcare systems across the world.
Breast cancer mortality in the UK has been declining for over a decade and fell from 38 deaths per 100,000 women in 2001 to 29 deaths per 100,000 women in 2013. However, the UK is consistently amongst the top four countries with the highest mortality rate.
Cervical cancer mortality rates in the UK also fell between 2001 and 2013 from 4 to 3 deaths per 100,000, one of the highest mortality rates of all the comparator countries. Finally, colorectal cancer mortality fell from 21 deaths per 100,000 population in 2001 to 18 deaths per 100,000 population in 2013.
Diabetes care for children and young people
The majority of children who develop diabetes have type 1 diabetes, due to their body being unable to produce insulin. These children need regular insulin injections as a result. As well as type 1, a small but growing number of UK children are being diagnosed with type 2 diabetes, which can be associated with lifestyle factors such as being overweight. (NHS Choice, 2016)
The National Institute for Health and Clinical Excellence (NICE) makes a range of recommendations on processes for diabetes care for children and young people. This month there have been updates to national paediatric diabetes audit data which reports on the delivery of care based on the standards set by NICE.
The guidelines recommend that all patients aged 12 years and over should receive all of the nine NICE recommended care processes. These include annual checks for the effectiveness of diabetes treatment (HbA1c), blood pressure, serum cholesterol, body mass index, and emergence of early complications (eye screening, foot surveillance and urine albumin surveillance).
Though the percentage of children receiving all the care processes increased from 2% in 2004/2005 to 17% in 2015/2016, many children still do not receive all the recommended care for diabetes.
Alcohol-related harm and drinking behaviour
Drinking too much alcohol can have harmful health consequences, including liver disease, stroke and certain cancers. After smoking and obesity, alcohol is one of the biggest lifestyle risk factors for disease and death in the UK. It is estimated that over 7 million people are unaware of the damage their drinking could be causing. Alcohol related harm in England costs the NHS about £3.5bn per year. In addition, around £11bn is spent tackling alcohol-related crime, and the economy loses £7bn worth of lost work days and productivity to alcohol each year. (Alcohol Concern, 2016)
Despite the UK government publishing policies, strategies and consumption guidelines, ill health due to alcohol-related harm still presents a serious challenge to the health system and wider society. In the UK, the rate of alcohol-related deaths increased from 9 to 14 per 100,000 people between 1994 and 2015. The latest data also indicates considerable regional variation in alcohol-related deaths. For example the rate is substantially larger in Scotland compared to England, Wales and Northern Ireland. Regional variations persist despite efforts to reduce them, such as the release of Changing Scotland’s Relationship with Alcohol: A Framework for Action.
Variation also exists between males and females, with men experiencing higher levels of death due to alcohol than women. This is a pattern that has persisted for decades. In 2015 the rate was 19.2 men per 100,000 population, compared with 9.7 per 100,000 for women.
There are positives to be taken from the data in this month’s update, including continued increases in life expectancy, falling cancer mortality rates and a larger proportion of children receiving the recommended care processes for their diabetes. However, despite the positive trends, areas of concern exist - particularly with a slowing in the decline of cancer mortality, relatively low levels of eye screening amongst children with diabetes and stubborn regional variations in alcohol-related harm.