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Premature mortality accounts for twice as many years of life lost in the most deprived areas in 2016-2018

Published: 25 May 2022

Click here to view Years of Life Lost. 

There are over 11,000 premature deaths per year in Wales. This equates to almost 150,000 years of life lost annually to premature mortality, of which 54,000 are excess years of life lost. The number of years of life lost in the most deprived fifth of areas is over twice that of the least deprived fifth of areas.

Years of life lost (YLL) calculates the number of years lost when a person dies prematurely (under 75 years of age) from any cause. With YLL both the number of deaths and the age of the person at death are taken into account thereby giving a greater weight to a death at age 5 compared to a death aged 70. Consequently YLL is a mortality measure which takes into account premature deaths which can inform public health priorities to help target interventions to prevent such deaths1.

Click here to view Years of Life Lost. 

The above charts illustrate the full extent of premature mortality and YLL in each deprivation fifth in 2016-2018. They are split by colour to show the portion we would expect to see in each fifth if the mortality rates were the same as in the least deprived fifth and the amount which exceeds that. With each increase in level of deprivation, both the premature deaths and the YLL also increase. In addition, when the mortality rates of the least deprived are applied across all deprivation fifths, excess also rise in line with deprivation.  Therefore, both premature mortality and YLL are around double that of the least deprived fifth in the most deprived fifth.

The large differences in both premature mortality rates and YLL between the most and least deprived areas are likely influenced by the social determinants of health (SDOH). The SDOH are complex and lead to inequalities in health across populations. They include general socio-economic, cultural and environmental factors; as well as social and community networks.  Whilst many factors contribute to health, most lie outside of the control of health care systems such as employment and education opportunities and quality of housing. Many of these influences are also outside the control of an individual, although still contribute to an individual’s health and affect the ability to live a healthy life.  

It is known that the prevalence of behavioural risk factors, e.g. smoking and poor nutrition, is higher among those living in the most deprived areas and this contributes towards worsening health outcomes. In addition, those in the most deprived areas face more barriers in accessing healthcare; issues such as less availability of transport or having poor health literacy leading to uncertainty of when to seek medical advice. This leads to those in deprived areas having a greater chance of being diagnosed later when a treatable disease may have progressed further and losing their life prematurely2.

Childhood mortality makes a larger contribution to YLL due to the greater number of years they could have lived. As children aged under 5 years living in deprived areas are over twice as likely to die prematurely as a child of the same age from the least deprived areas there will be a greater contribution to YLL in deprived areas 3.

There are large and persistent health inequalities in Wales which lead to worse health outcomes and lower life expectancy in the most deprived areas. Public Health Wales are committed to reducing health inequalities with the long term strategy focusing on how we can have maximum impact in improving health and well-being and reducing health inequalities in Wales. Further information regarding the Public Health Wales priorities can be found here;  https://phw.nhs.wales/about-us/our-priorities/.

Click here to view Years of Life Lost. 

 

References

  1. Years of life lost (YLL) (per 100 000 population), World Health Organisation, 2022.  Available at:  - Years of life lost (YLL) (per 100 000 population) (who.int)
  1. “Improving access for all: reducing inequalities in access to general practice services”, NHS England, 2018. Available at: https://www.england.nhs.uk/wp-content/uploads/2017/07/inequalities-resource-sep-2018.pdf
  1. “Child Mortality and Social Deprivation”, National Child Mortality Database (England), 2021 Available at: https://ncmd.info/wp-content/uploads/2021/05/NCMD-Child-Mortality-and-Social-Deprivation-report_20210513.pdf

 

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