Information

Long Term Monitoring of Health Inequalities: Headline Indicators – October 2015

Annual update of the 'Long-term Monitoring of Health Inequalities' headline indicators.

This document is part of a collection


Annex 2: Data sources and quality

Data quality

Except where the source data is held by Scottish Government (i.e. the mental wellbeing indicator), aggregate data is provided by National Records of Scotland for the all-cause mortality and alcohol mortality indicators, and by ISD Scotland for all other indicators in this report. Scottish Government statisticians carry out quality assurance checks on the aggregate data, comparing it with past trends and against other published data, such as national level data published by NRS or ISD. For the mental wellbeing indicator, Scottish Government statisticians quality assure the aggregate data in the same way but take the additional step of double checking the programming methods used to derive the figures within the responsible team.

ISD Scotland and NRS are responsible for the quality assurance of their own datasets. Detailed information on the quality control of the relevant ISD datasets is available online[7]. National Records of Scotland have published detailed information on the quality of data on deaths[8]. Analysts at both ISD and NRS are provided with income-employment decile-datazone lookups and population estimates before a request for aggregate data is submitted.

Revisions and timeliness of report

Our general approach to revisions and release schedules is described at the following web address: http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/TrendHealthOutcome/Results

For this year's publication, the low and healthy birthweight indicators could not be updated as the data would not be available until November 2015. Users will be consulted about the most appropriate time and method for the next release of these statistics.

Revised Healthy Life Expectancy data were supplied by ISD Scotland in February 2016 following quality assurance issues identified after the original release of this publication. Therefore, Healthy Life Expectancy sections of this report were revised in March 2016.

Pre-release access

In accordance with the Pre-release Access to Official Statistics (Scotland) Order 2008, pre-release access to these statistics was provided to Scottish Government policy and communications officials 5 working days before release for the purposes of briefing ministers. NHS Health Scotland colleagues were also provided pre-release access from 5 working days before release for the purposes of making a statement or issuing a press release at the time of, or shortly after, publication.

Indicators

Healthy Life Expectancy

Source: ScotPHO (using raw deaths data from the National Register of Scotland); Scottish Household Survey data on self-assessed health for adults aged 16+ years, Scottish Health Survey data for self-assessed health for those aged <16 years.

Definition: Healthy life expectancy (HLE) is defined as the number of years people can expect to live in good health. The difference between healthy and total life expectancy (LE) therefore indicates the length of time people can expect to spend not in good health.

HLE is calculated through a combination of life expectancy data and survey data on people's self-assessed health. The method used to calculated the Life Expectancy estimates is based on Chiang (II) methodology; the HLE calculation is based on the Sullivan method. The uncertainty around estimates of HLE are larger than those around life expectancy because relatively small samples are involved in the age and sex specific breakdowns of survey data required to calculate HLE.

In 2009, the format of the self-assessed health question (on which the life expectancy data is based) was changed to align with the European Union. The options for response changed from a three-point scale (Good, Fairly good, Not good) to a five point scale (Very good, Good, Fair, Bad, Very bad). Under the three-point scale, 'Good' and 'Fairly good' were categorised as 'healthy'. Under the five point scale only 'Very good' and 'Good' are categorised as 'healthy'. This has led to a major discontinuity in the series. For both men and women, there is a markedly lower estimate of HLE at birth from 2009 than previous years.

Premature Mortality (from all causes, aged under 75 years)

Source: National Records of Scotland.

Definition: European age-standardised rates of deaths from any cause amongst those aged under 75 years.

Mental Wellbeing (adults aged 16 years and over)

Source: Scottish Health Survey (2008-2014).

Definition: Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). This has been developed as a tool for measuring positive mental wellbeing at a population level. The scale comprises fourteen separate statements describing feelings related to mental wellbeing; respondents are asked to indicate how often they have felt such feelings over the last two weeks.

Results are presented as average WEMWBS score for the population concerned, and are age-standardised using the age distribution of the Scotland population each year. In 2014, population data for 2013 was used as it was the latest available. WEMWBS scores for individuals can range from 14 (for the lowest possible score for each of the fourteen statements) to 70 (for the maximum possible score for each of the fourteen statements).

An additional indicator based on the proportion of adults with 'below' average wellbeing was added to the report this year. This takes a 'below average' WEMWBS score to be at least one standard deviation below the population mean, which equates to scores of 41 or lower in all years.

In order to improve the precision of estimates of mean and below average WEMWBS scores, data has been presented for two year combined periods in this report (2008/2009 to 2012/2013) for the first time, together with confidence limits around each estimate.

Coronary Heart Disease - first ever hospital admission for heart attack aged under 75 years

Source: NHS Information Services Division (ISD); SMR1/01 records (all inpatient and daycase discharges).

Definition: European age-standardised rates of first ever hospital admission for acute myocardial infarction (heart attack) amongst those aged under 75 years. The following World Health Organisation International Classification of Disease coding was used: ICD10 'I21-I22'; ICD9 '410'.

Coronary Heart Disease - deaths aged 45-74 years

Source: NHS Information Services Division (ISD); using deaths data from National Records of Scotland.

Definition: European age-standardised rates death from coronary heart disease amongst those aged 45-74 years. The following World Health Organisation International Classification of Disease coding was used: ICD10 'I20-I25'; ICD9 '410-414'. Because of the dynamic nature of the linked database, previous years' data are sometimes updated in subsequent publications.

Cancer - incidence rate aged under 75 years

Source: NHS Information Services Division (ISD); Scottish Cancer Registry.

Definition: European age-standardised rates of new cases of cancer amongst those aged under 75 years.

All Cancers- cancer defined as all malignant neoplasms excluding non-melanoma skin cancer. The following World Health Organisation International Classification of Disease coding was used: ICD10 'C00-C96' excluding 'C44' (the Scottish Cancer Registry does not use code 'C97').

Prostate cancer (males only)- ICD-10 C61

Breast cancer (females only)- ICD-10 C50

Cancer of the trachea, bronchus and lung- ICD-10 C33-C34

Colorectal cancer- ICD-10 C18-C20

Cancer - deaths aged 45-74 years

Source: NHS Information Services Division (ISD); Scottish Cancer Registry.

Definition: European age-standardised rates of deaths from cancer amongst those aged under 45-74 years.

All cancers- cancer defined as all malignant neoplasms excluding non-melanoma skin cancer. The following World Health Organisation International Classification of Disease coding was used: ICD10 (2000 onwards) 'C00-C97' excluding 'C44'.

Prostate cancer (males only) - ICD-10 C61

Breast cancer (females only) - ICD-10 C50

Cancer of the trachea, bronchus and lung- ICD-10 C33-C34

Colorectal cancer- ICD-10 C18-C20

Alcohol - first hospital admission aged under 75 years

Source: NHS Information Services Division (ISD).

Definition: European age-standardised rates of first hospital admission for alcohol related conditions amongst those aged under 75 years. These rates include hospitals discharges where alcohol-related problems are recorded as either primary or secondary reasons for admission to hospital and will cover first admission in the last ten years. These figures exclude private hospitals, mental illness hospitals, psychiatric units and maternity hospitals and include Scottish residents only. Caution is necessary when interpreting these figures. The recording of alcohol misuse may vary from hospital to hospital. Where alcohol misuse is suspected but unconfirmed it may not be recorded by the hospital. The following revised World Health Organisation International Classification of Disease coding was used: ICD10: F10, K70, X45, X65, Y15, Y90, Y91, E244, E512, G312, G621, G721, I426, K292, K860, O354, P043, Q860, T510, T511, T519, Y573, R780, Z502, Z714, Z721.

Alcohol - deaths aged 45-74 years

Source: National Records of Scotland.

Definition: European age-standardised rates of death from alcohol related conditions amongst those aged 45-74 years. The definition of alcohol related deaths includes deaths where there was any mention of alcohol related conditions on the death certificate, rather than just as the main cause of death. The following World Health Organisation International Classification of Disease coding was used: ICD10 F10, G31.2, G62.1, I42.6, K29.2, K70, K73, K74.0, K74.1, K74.2, K74.6, K86.0, X45, X65, Y15; ICD9 291, 303, 305.0, 425.5, 571.0, 571.1, 571.2, 571.3, 571.4, 571.5, 571.8, 571.9, E860.

All-cause mortality aged 15-44 years

Source: National Records of Scotland.

Definition: European age-standardised rates of deaths from any cause amongst those aged 15-44 years. Specific breakdowns for deaths from assault, drug related deaths and suicide are also provided, as the major causes of death for which there are large inequalities amongst young people. There may be some double counting in these breakdowns. The following World Health Organisation International Classification of Disease coding was used: Assault ICD10 'X85-Y09', 'Y87.1' ICD9 'E960-969'; Drug-related ICD10 'F11-16', 'F19', 'X40-44', 'X60-64', 'X85', 'Y10-Y14'; Suicide (intentional self-harm + undetermined intent) ICD10 'X60-84', 'Y87.0' ICD9 'E950-959', 'E980-989'.

Contact

Email: Craig Kellock

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