Proposed National Targets - to reduce mortality from: Heart Disease and Stroke and related illnesses; Cancer; Suicide; and to reduce Accidents. Target year: 2010 for all four targets. Baseline year: Mortality targets: the average of the European age standardised rates for the three years 1995, 1996 and 1997. [NB 1997 data not available until mid-1998, i.e. White Paper stage]. Accident target: the average of the accident rates for the years 1995 and 1996. Sources of data: Mortality targets: Office for National Statistics (ONS) mortality statistics from death registrations. Mortality rates are age standardised to allow for changes in the age structure of the population (using the European standard population as defined by the WHO). Accident target: Estimated "major" accident rates from the Health Survey for England. Definitions: Heart Disease and Stroke and related illnesses - includes all circulatory diseases - International Classification of Diseases (ICD) codes 390-459 inclusive. Age group: under 65. Target reduction by year 2010 - at least a further third (33%). Cancer - all malignant neoplasms - ICD codes 140-208 inclusive. Age group: under 65. Target reduction by year 2010 - at least a further fifth (20%). Suicide - suicide and undetermined injury - ICD codes (E950-E959) plus (E980-E989) minus E988.8 Age group: all ages. Target reduction by year 2010 - at least a further sixth (17%). Accidents - defined as an accident which is sufficiently severe to require medical attention either at hospital or from a family doctor. Respondents to the Health Survey for England are asked if they had had one or more such accident in the 6 months prior to interview. For children aged 2-15, an adult is asked to respond on their behalf. Age group: ages 2 and above. Target reduction by year 2010 - at least a fifth (20%). Standardised Mortality Ratio (SMR) The SMR is used to compare mortality rates in different population groupings because it takes account of differences in the age structure of the population. For example, in Figure 5, mortality in different geographical areas of the country is compared with a national standard (SMR for England = 100). If a Health Authority (HA) area has an SMR greater than 100, then the population of that HA has a mortality rate higher than the average for England (after taking account of differences in the age structure of the HA population and the national population).
The SMR is calculated as: The observed number of deaths is the actual number of deaths occurring in the geographical area or subgroup of the population. The expected number is calculated by applying the national age specific mortality rates to the population of the HA area or population subgroup. Notes
1 Drever F and Whitehead M (eds). Health Inequalities. Office for National Statistics. London: The Stationery Office, 1997 (Series DS, No 15).
1 Drever F and Whitehead M (eds). Health Inequalities. Office for National Statistics. London: The Stationery Office, 1997 (Series DS, No 15).
2 Confederation of British Industry. Managing Absence: in sickness and health London: CBI, 1997.
3 Department of Health. NHS Executive. Burdens of Disease: a discussion document. London: Department of Health. 1996.
3 Department of Health. NHS Executive. Burdens of Disease: a discussion document. London: Department of Health. 1996.
3 Department of Health. NHS Executive. Burdens of Disease: a discussion document. London: Department of Health. 1996.
3 Department of Health. NHS Executive. Burdens of Disease: a discussion document. London: Department of Health. 1996.
4 Charlton J and Murphy M (eds) The Health of Adult Britain 1841-1994, Vol2. Office for National Statistics. London: The Stationery Office, 1997. (Series DS: No 13).
5 Department of Health. The new NHS: modern, dependable. London: The Stationery Office, 1997. (Session 1997-98; Cm 3807).
6 Marsh A, MacKay S. Poor Smokers. London: Policy Studies Institute, 1994 (Research Report; No 771).
7 Stedman JR, Anderson HR, Atkinson RW, Maynard RL. Emergency hospital admissions for respiratory disorders attributable to summer time ozone episodes in Great Britain. Thorax 1997; 52 958-963.
8 Department of Health. Committee on the Medical Effects of Air Pollutants. Quantification of the effects of air pollution on health in the United Kingdom. London: The Stationery Office, 1998. Chairman: Professor ST Holgate.
9 Sanders CH, Cornish JP. Dampness: one week's complaints in five Local Authorities in England and Wales. London: HMSO, 1982. (Building Research Establishments Report).
10 Department of the Environment. English house condition survey. London: HMSO, 1993.
11 Luczynska CM. Risk factors for indoor allergen exposure: health aspects of indoor air: Berzelius Symposium XXVIII. Stockholm 1994.
12 Platt SD, Martin CJ, Hunt SM, Lewis CW. Damp Housing, mould growth, and symptomatic health state. BMJ 1989; 298: 1673-1678.
13 National Radiological Protection Board. Exposure to radon in UK dwellings. Chilton: National Radiological Protection Board, 1994. (NRPB-R272).
14 Central Office of Information. Radon: a guide to reducing levels in your home. London: Department of the Environment, 1996.
15 Kawachi I, Colditz GA, Ascherio A et al. A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA. J Epidemiol Community Health 1996; 50: 245-251.
16 Department of Health. Nutritional aspects of cardiovascular disease : report of the cardiovascular review group. London: HMSO,1994 (report on health and social subjects; 46).
17 Department of Health. Dietary reference values for food energy and nutrients for the UK: Report of the panel on dietary reference values. London HMSO,1991 (Report on health and social subjects; 41)
18 Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J. Natl Cancer Inst 1981; 66: 1191-1308.
19 Health Education Authority. Smoking kills 330 people every day. London Health Education Authority 1996 (News release; SMOK/96/0011)
20 Anderson HR, Cook D. Passive smoking and sudden infant death syndrome: review of the epidemiological evidence. Thorax 1997; 52: 1003-1009.
21 Peto R, Lopez AD, Boreham J, Thun M, Clarke Heath Jr. Mortality from smoking in developed countries 1950-2000. Oxford University Press 1994.
22 Watson, R. Passive smoking is a major threat. BMJ 1998; 316: 9.
23 NHS centre for reviews and dissemination. Preventing and reducing the adverse effects of unintended teenage pregnancies: EHCB 1997; 3.
24 Office for National Statistics, Government Statistical Service. Mortality statistics - childhood, Infant and perinatal, England and Wales, 1995. London: The Stationery Office (Series DH3 No 28), 1997.
25 Department of Health Task Force to Review Services for Drug Misusers. Report of an independent review of drug treatment services in England. London: Department of Health, 1996.
26 Wadsworth MEJ. Changing social factors and their long term implications for health. Br Med Bull 1997; 53: 198-209.
26 Wadsworth MEJ. Changing social factors and their long term implications for health. Br Med Bull 1997; 53: 198-209.
27 Sylva K. Critical periods in childhood learning. Br Med Bull 1997; 53: 185-197.
27 Sylva K. Critical periods in childhood learning. Br Med Bull 1997; 53: 185-197.
28 Nugent ZJ, Pitts NB. Patterns of change and results overview 1985/86 - 1995/96 from the British Association for the Study of Community Dentistry co-ordinated survey of cavity prevalence. Community Dent. Health 1997; 14: 30-54.
29 Department of the Environment, Department of Health, National Environmental Health Action Plan. London: HMSO, 1996.
30 Hackshaw AK, Law MR, Wald NJ. The accumulated evidence on lung cancer and environmental tobacco smoke. BMJ 1997; 315: 980-988.
31 Royal College of Physicians. Smoking and the young: a report of a working party of the Royal College of Physicians. London: Royal College of Physicians,1992.
32 Prescott-Clarke P, Primatesta P, eds. Health Survey for England 1996: findings: a survey carried out on behalf of the Department of Health. London. The Stationery Office,1998. (series HS; No 6; Vol 1).
33 Roberts I, Power C. Does the decline in child injury mortality vary by social class? A comparison of class specific mortality in 1981 and 1991. BMJ 1996; 313: 784-786.
34 University of Surrey, National Institute of Epidemiology, Department of Health. Public Health Common Data Set 1996,incorporating Health of the Nation Indicators and population health outcome indicators. Guildford: University of Surrey. National Institute of Epidemiology, 1997.
35 Prescott-Clarke P, Primatesta P.eds. Health Survey for England 1995: findings: a survey carried out on behalf of the Department of Health. London: The Stationery Office, 1997. (Series HS; No5; vol 1).
35 Prescott-Clarke P, Primatesta P.eds. Health Survey for England 1995: findings: a survey carried out on behalf of the Department of Health. London: The Stationery Office, 1997. (Series HS; No5; vol 1).
36 Rutter M, Smith DJ eds. Psychosocial disorders in young people: time trends and their causes. New York: John Wiley, 1995.
| |||||||
