Title of Research: Investigating patterns of Cardiovascular disease linked mortality in London.
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Cardiovascular disease (CVD) mortality rates in London An investigation into the distribution of mortality across the different London boroughs Joshua Valverde University of Bristol Email: [email protected]
Transcript of Title of Research: Investigating patterns of Cardiovascular disease linked mortality in London.
Cardiovascular disease (CVD) mortality rates
in LondonAn investigation into the distribution of
mortality across the different London boroughs
Joshua ValverdeUniversity of Bristol
Email: [email protected]
Aims •To identify patterns in the distribution of CVD mortality, in terms of general spatial gradients.
•To correlate influencing factors with CVD mortality. •The factors were: ethnicity, socio-economic deprivation, lifestyle habits and geodemographics.
•To attempt to explain the underlying causes of CVD specific to London.
•To, perhaps, extend this model to other cities and perhaps other diseases of affluence.
Definitions•Disease of affluence: a disease which is brought about by the lifestyle changes associated with wealth (such as increased meat consumption), they usually considered non-infectious.
•CVD: a group of diseases related to failure of the heart and blood vessels. Diseases include Coronary Heart Disease (CHD), stroke and hypertension.
•Depravation: a primarily economic measure of wealth. Rated on a scale of 1-5 with 1 being the most deprived.
•Geodemographics: this is a classification of the population into groups based on their lifestyle and age. E.g. ‘Multicultural urban’
•Meta-analysis: a study which focuses on multiple data sets, comparing and contrasting them to understand general trends and patterns and place them in appropriate context.
Methods •Transects were made along main arterial routes out of London: A1, A3, A13, A40. They represent routes which are northbound, southbound, eastbound and westbound respectively from central London.
•The gross mortality rate was graphed along each transect, and the data from influencing factors was used to support correlative data or try to explain anomalous data. Data was analysed using r2 polynomial regression analysis.
•The main source of data has come from publically accessible “Cardiovascular disease PCT health profiles” compiled by the South East Public Health Observatory (SEPHO).
© OpenStreetMap contributors
© OpenStreetMap contributors
Source - BBC Bitesize- © [2014] BBC
Source - BBC Bitesize- © [2014] BBC
Graphs of mortality
City and Hackney
Islington Haringey Barnet
100.4 11
9.3
85.8
51.5
R² = 0.945977137431065
CVD mortality rate for boroughs along the A1CVD mortality rate per 100000Polynomial (CVD mortality rate per 100000)
City and Hackney
Tower Hamlets
Newham Barking and
Dagenham
Havering
100.4 113.6
116
100.8
67.9
R² = 0.996329550034049
CVD mortality rate for boroughs along the A13
CVD mortality rate per 100000Polynomial (CVD mortality rate per 100000)
City and Hackney
Southwark
Lambeth
Wandsworth
Richmond and Twickenham
Kingston upon Thames
0
20
40
60
80
100
120
R² = 0.789190695784506
CVD mortality rate for boroughs along the A3
CVD mortality rate per 100000Polynomial (CVD mortality rate per 100000)
0
20
40
60
80
100
120
R² = 0.362873022905306
CVD mortality rates for boroughs along the A40
CVD mortality rate per 100000
Polynomial (CVD mortality rate per 100000)
City and Hackney
Camden Westminster Kensington and Chelsea
Hammersmith and Fulham
Ealing Hillingdon Average A400.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
9.40%11.90% 11.30%
6.90% 5.60%
23.10%
15.30%11.93%
White Black Asian Other
City and Hackney
Southwark
Lambeth
WandsworthRichmond and Twickenham
Kingston upon Thames
Average A3
Smoking Binge DrinkingObesity Unhealthy Eating
City and Hackney
Southwark Lambeth Wandsworth Richmond and
Twickenham
Kingston upon
Thames
Average A30.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
Mature City ProfessionalsEductional CentresYoung City ProfessionMulticultural SuburbiaMulticultural Inner CityMulticultural UrbanSuburbia
Results •The general mortality rate was had a strong r2 correlation coefficient, using a quadratic model.
•Ethnicity was a strong indicator of CVD mortality with certain groups being both more generally likely to die from CVD, and certain groups suffering from a particular CVD.
•Deprivation was found to correlate strongly to CVD mortality with no major anomalies.
•Lifestyle habits and geodemographics showed no clear trends or stark contrasts along the transects.
Conclusions•There seems to be an inner city zone where CVD mortality is prevalent.
•Anomalies are found mainly in the westward transect (A40) where Kensington and Chelsea breaks the trend, but there are socio-economic reasons which help to explain this.
•Ethnicity correlates well with CVD mortality, there are groups which are more at risk.
•The Hoyt model can be adjusted for London and forms a strong foundation for studying the distribution of disease in urban areas.
Source - BBC Bitesize- © [2014] BBC
Discussion •What is a disease of affluence?
•It seems that these diseases are more prevalent in developing countries where changes to diet and lifestyle are driving urbanisation.
•How do we advise and prevent these diseases?•Similarly to ‘smoking kills’ warning on cigarettes do we need to have more TV broadcasts towards healthy eating and lifestyle choices?
•How do we look at the mismatch between incidence and mortality in terms of the NHS?•Money seems to buy better health care, all over the world. However our situation is different because of the legacy of the NHS.
•At the end of the day is it genetic predisposition that has a deciding role in CVD mortality?•Mortality rates correlated most strongly with ethnicity.
Any Questions?
Useful Websites•Information on poverty and socio-economics: http://www.trustforlondon.org.uk/
•Information on CVD in London: http://www.sepho.org.uk/CVDprofiles.aspx
