Suicides in the North West - epidemiology update Developing Suicide Prevention in Primary Care...

Suicides in the North West - epidemiology updateDeveloping Suicide Prevention in Primary Care Trusts

Update for PCTs in Greater Manchester 10th December 2004.

Tom Hennell - Regional Analyst, NW Public Health Team

[email protected] tel: 0161 952 4359

Data Sources for 2004 update Revised Population Estimates 1995-2003

Final adjustments from 2001 census and post census studies

No populations yet for Primary Care Organisations

Sub-national Population projections 2003-2028 Implied “Neutral Trajectory” for mortality and life

expectancy

District Annual Deaths extracts 1995-2003 coded version of deaths registration consistent with the Vital Statistics Tabulations

“Neutral Trajectory” and “Historic Trends” models

Growth in Total Population - Greater ManchesterHistoric and projected

90

92

94

96

98

100

102

104

106

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

years

199

5 =

100

Bolton

Bury

Manchester

Oldham

Rochdale

Salford

Stockport

Tameside

Trafford

Wigan

Growth in Total Population - CheshireHistoric and projected

90

95

100

105

110

115

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

years

199

5 =

100

Chester

Congleton

Crewe and Nantwich

Ellesmere Port and Neston

Halton UA

Macclesfield

Vale Royal

Warrington UA

Growth in Total Population - MerseysideHistoric and projected

90

92

94

96

98

100

102

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

years

199

5 =

100

Knowsley

Liverpool

Sefton

St. Helens

Wirral

Growth in Total Population - CumbriaHistoric and projected

90

95

100

105

110

115

120

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

years

199

5 =

100

Allerdale

Barrow-in-Furness

Carlisle

Copeland

Eden

South Lakeland

Growth in Total Population - LancashireHistoric and projected

90

95

100

105

110

115

120

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

years

199

5 =

100

Blackburn with Darwen UA

Blackpool UA

Burnley

Chorley

Fylde

Hyndburn

Lancaster

Pendle

Preston

Ribble Valley

Rossendale

South Ribble

West Lancashire

Wyre

All-age Standardised Mortality in Greater ManchesterHistoric and Projected

500.00

550.00

600.00

650.00

700.00

750.00

800.00

850.00

900.00

950.00

1000.00

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

three year averages

BOLTON

BURY

MANCHESTER

OLDHAM

ROCHDALE

SALFORD

STOCKPORT

TAMESIDE

TRAFFORD

WIGAN

Age Standardised Mortality - CheshireHistoric and Projected

500

550

600

650

700

750

800

850

900

950

1000

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

three year averages

de

ath

s p

er 1

00,

000

Chester

Congleton

Crewe and Nantwich


Halton UA

Macclesfield

Vale Royal

Warrington UA

Age Standardised Mortality - MerseysideHistoric and Projected

500

550

600

650

700

750

800

850

900

950

1000

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

three year averages

de

ath

s p

er 1

00,

000

Knowsley

Liverpool

Sefton

St. Helens

Wirral

Age Standardised Mortality - CumbriaHistoric and Projected

500

550

600

650

700

750

800

850

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

three year averages

de

ath

s p

er 1

00,

000

Allerdale

Barrow-in-Furness

Carlisle

Copeland

Eden

South Lakeland

Age Standardised Mortality - LancashireHistoric and Projected

500

550

600

650

700

750

800

850

900

950

1995-1997

1996-1998

1997-1999

1998-2000

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2009-2011

three year averages

de

ath

s p

er 1

00,

000


Blackpool UA

Burnley

Chorley

Fylde

Hyndburn

Lancaster

Pendle

Preston

Ribble Valley

Rossendale

South Ribble

West Lancashire

Wyre

Reduced Life Expectancy: 'Spearhead Local Authorities' in the North West

Males under 75 dying 1995-1997, by cause

coronary heart disease28%

chest disease13%

lung cancer12%

overdose and other accidents

10%

digestive disease (inc. cirrhosis)

7%

stroke7%

other cancer6%

infant mortality5%

self harm4%

other circulatory disease3%

colorectal cancer2%

violence2%

other causes1%

Reduced Life Expectancy: 'Spearhead Local Authorities' in the North West

Males under 75 dying 2001-2003, by cause

coronary heart disease23%

digestive disease (inc. cirrhosis)

12%

lung cancer11%

chest disease10%

other cancer9%

other causes7%

stroke6%

overdose and other accidents

5%

infant mortality5%

other circulatory disease4%

self harm4%

violence3%

colorectal cancer1%

Trends in Directly Standardised All-age MortalityFemale Self Harm in the North West Region

2

3

4

5

6

7

8

1995 1996 1997 1998 1999 2000 2001 2002 2003

years

de

ath

s/10

0,00

0 Cheshire

Greater Manchester

Merseyside

Cumbria

Lancashire

England & Wales

Trends in Directly Standardised All-age MortalityMale Self Harm in the North West Region

10

12

14

16

18

20

22

24

26

1995 1996 1997 1998 1999 2000 2001 2002 2003

years

de

ath

s/10

0,00

0 Cheshire

Greater Manchester

Merseyside

Cumbria

Lancashire

England & Wales

Female Reduced Life Expectancy by Cause: Self Harm in Greater ManchesterDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-1 -0.5 0 0.5 1 1.5 2

BOLTON

BURY

MANCHESTER

OLDHAM

ROCHDALE

SALFORD

STOCKPORT

TAMESIDE

TRAFFORD

WIGANlo

cal a

uth

ori

ty

months

95-97

98-00

01-03

Female Reduced Life Expectancy by Cause: Self Harm in CheshireDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-1.5 -1 -0.5 0 0.5 1 1.5

CHESTER

CONGLETON

CREWE & NANTWICH

ELLESMERE PORT & NESTON

HALTON

MACCLESFIELD

VALE ROYAL

WARRINGTONlo

cal a

uth

ori

ty

months

95-97

98-00

01-03

Female Reduced Life Expectancy by Cause: Self Harm in MerseysideDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-1.5 -1 -0.5 0 0.5 1 1.5 2

KNOWSLEY

LIVERPOOL

SEFTON

ST HELENS

WIRRAL

loca

l au

tho

rity

months

95-97

98-00

01-03

Female Reduced Life Expectancy by Cause: Self Harm in CumbriaDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-2 -1.5 -1 -0.5 0 0.5 1 1.5 2

ALLERDALE

BARROW-IN-FURNESS

CARLISLE

COPELAND

EDEN

SOUTH LAKELANDlo

cal a

uth

ori

ty

months

95-97

98-00

01-03

Female Reduced Life Expectancy by Cause: Self Harm in LancashireDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-1.5 -1 -0.5 0 0.5 1 1.5 2 2.5

BLACKBURN

BLACKPOOL

BURNLEY

CHORLEY

FYLDE

HYNDBURN

LANCASTER

PENDLE

PRESTON

RIBBLE VALLEY

ROSSENDALE

SOUTH RIBBLE

WEST LANCASHIRE

WYRElo

cal a

uth

ori

ty

months

95-97

98-00

01-03

Directly Standardised all-age Mortality Female Self Harm in Greater Manchester

0

1

2

3

4

5

6

7

8

9

10

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000

Bolton

Bury

Manchester

Oldham

Rochdale

Salford

Stockport

Tameside

Trafford

Wigan

Directly Standardised all-age Mortality Female Self Harm in Cheshire

0

1

2

3

4

5

6

7

8

9

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000

Chester

Congleton

Crewe and Nantwich


Halton UA

Macclesfield

Vale Royal

Warrington UA

Directly Standardised all-age Mortality Female Self Harm in Merseyside

0

1

2

3

4

5

6

7

8

9

10

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000

Knowsley

Liverpool

Sefton

St. Helens

Wirral

Directly Standardised all-age Mortality Female Self Harm in Cumbria

0

1

2

3

4

5

6

7

8

9

10

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000

Allerdale

Barrow-in-Furness

Carlisle

Copeland

Eden

South Lakeland

Directly Standardised all-age Mortality Female Self Harm in Lancashire

0

2

4

6

8

10

12

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000


Blackpool UA

Burnley

Chorley

Fylde

Hyndburn

Lancaster

Pendle

Preston

Ribble Valley

Rossendale

South Ribble

West Lancashire

Wyre

Male Reduced Life Expectancy by Cause: Self Harm in Greater ManchesterDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-3 -2 -1 0 1 2 3 4 5

BOLTON

BURY

MANCHESTER

OLDHAM

ROCHDALE

SALFORD

STOCKPORT

TAMESIDE

TRAFFORD

WIGANlo

cal a

uth

ori

ty

months

95-97

98-00

01-03

Male Reduced Life Expectancy by Cause: Self Harm in CheshireDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-3 -2.5 -2 -1.5 -1 -0.5 0 0.5 1 1.5 2

CHESTER

CONGLETON

CREWE & NANTWICH

ELLESMERE PORT & NESTON

HALTON

MACCLESFIELD

VALE ROYAL

WARRINGTON

loca

l au

tho

rity

months

95-97

98-00

01-03

Male Reduced Life Expectancy by Cause: Self Harm in MerseysideDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-2 -1.5 -1 -0.5 0 0.5 1 1.5 2 2.5 3 3.5

KNOWSLEY

LIVERPOOL

SEFTON

ST HELENS

WIRRAL

loca

l au

tho

rity

months

95-97

98-00

01-03

Male Reduced Life Expectancy by Cause: Self Harm in CumbriaDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-3 -2 -1 0 1 2 3 4 5

ALLERDALE

BARROW-IN-FURNESS

CARLISLE

COPELAND

EDEN

SOUTH LAKELAND

loca

l au

tho

rity

months

95-97

98-00

01-03

Male Reduced Life Expectancy by Cause: Self Harm in LancashireDeaths of persons aged <75 - Comparing 1995-1997 with 2001-2003

-4 -2 0 2 4 6 8 10

BLACKBURN

BLACKPOOL

BURNLEY

CHORLEY

FYLDE

HYNDBURN

LANCASTER

PENDLE

PRESTON

RIBBLE VALLEY

ROSSENDALE

SOUTH RIBBLE

WEST LANCASHIRE

WYRE

loca

l au

tho

rity

months

95-97

98-00

01-03

Directly Standardised all-age Mortality Male Self Harm in Greater Manchester

0

5

10

15

20

25

30

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000

Bolton

Bury

Manchester

Oldham

Rochdale

Salford

Stockport

Tameside

Trafford

Wigan

Directly Standardised all-age Mortality Male Self Harm in Cheshire

0

5

10

15

20

25

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000

Chester

Congleton

Crewe and Nantwich


Halton UA

Macclesfield

Vale Royal

Warrington UA

Directly Standardised all-age Mortality Male Self Harm in Merseyside

0

5

10

15

20

25

30

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000

Knowsley

Liverpool

Sefton

St. Helens

Wirral

Directly Standardised all-age Mortality Male Self Harm in Cumbria

0

5

10

15

20

25

30

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000

Allerdale

Barrow-in-Furness

Carlisle

Copeland

Eden

South Lakeland

Directly Standardised all-age Mortality Male Self Harm in Lancashire

0

5

10

15

20

25

30

35

40

45

50

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003

three year averages

de

ath

s p

er 1

00,

000


Blackpool UA

Burnley

Chorley

Fylde

Hyndburn

Lancaster

Pendle

Preston

Ribble Valley

Rossendale

South Ribble

West Lancashire

Wyre

Age profile of self harm in Greater Manchester 2001-2003

0 5 10 15 20 25 30

Bolton

Bury

Manchester

Oldham

Rochdale

Salford

Stockport

Tameside

Trafford

Wigan

deaths per 100,000

75+

55-74

35-54

15-34

0-14

Age profile of self harm in Cheshire 2001-2003

0 2 4 6 8 10 12 14 16 18 20

Chester

Congleton

Crewe and Nantwich


Halton UA

Macclesfield

Vale Royal

Warrington UA

deaths per 100,000

75+

55-74

35-54

15-34

0-14

Age profile of self harm in Merseyside 2001-2003

0 5 10 15 20 25

Knowsley

Liverpool

Sefton

St. Helens

Wirral

deaths per 100,000

75+

55-74

35-54

15-34

0-14

Age profile of self harm in Cumbria 2001-2003

0 5 10 15 20 25 30

Allerdale

Barrow-in-Furness

Carlisle

Copeland

Eden

South Lakeland

deaths per 100,000

75+

55-74

35-54

15-34

0-14

Age profile of self harm in Lancashire 2001-2003

0 5 10 15 20 25 30 35 40 45


Blackpool UA

Burnley

Chorley

Fylde

Hyndburn

Lancaster

Pendle

Preston

Ribble Valley

Rossendale

South Ribble

West Lancashire

Wyre

deaths per 100,000

75+

55-74

35-54

15-34

0-14

Dea

ths

/ 100

,000

per

son

sAge profile of self harm in Greater Manchester 2001-2003

compared to the profile for England and Wales

-10 -5 0 5 10 15 20

Bolton

Bury

Manchester

Oldham

Rochdale

Salford

Stockport

Tameside

Trafford

Wigan

excess deaths per 100,000

75+

55-74

35-54

15-34

0-14

Age profile of self harm in Cheshire 2001-2003compared to the profile for England and Wales

-12 -10 -8 -6 -4 -2 0 2 4 6 8

Chester

Congleton

Crewe and Nantwich


Halton UA

Macclesfield

Vale Royal

Warrington UA


75+

55-74

35-54

15-34

0-14

Age profile of self harm in Merseyside 2001-2003compared to the profile for England and Wales

-8 -6 -4 -2 0 2 4 6 8 10 12

Knowsley

Liverpool

Sefton

St. Helens

Wirral


75+

55-74

35-54

15-34

0-14

Age profile of self harm in Cumbria 2001-2003compared to the profile for England and Wales

-10 -5 0 5 10 15 20

Allerdale

Barrow-in-Furness

Carlisle

Copeland

Eden

South Lakeland


75+

55-74

35-54

15-34

0-14

Age profile of self harm in Lancashire 2001-2003compared to the profile for England and Wales

-15 -10 -5 0 5 10 15 20 25 30


Blackpool UA

Burnley

Chorley

Fylde

Hyndburn

Lancaster

Pendle

Preston

Ribble Valley

Rossendale

South Ribble

West Lancashire

Wyre


75+

55-74

35-54

15-34

0-14

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Mode of Self Harm in Greater Manchester 2001-2003

poisoning and drugs hanging and suffocation carbon monoxide drowning moving vehicle jumping other

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Mode of Self Harm in Cheshire 2001-2003


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Mode of Self Harm in Merseyside 2001-2003


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Mode of Self Harm in Cumbria 2001-2003


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Mode of Self Harm in Lancashire 2001-2003


Mode of Self Harm - LADs in Greater Manchester 2001-2003

0% 20% 40% 60% 80% 100%

Bolton

Bury

Manchester

Oldham

Rochdale

Salford

Stockport

Tameside

Trafford

Wigan


Mode of Self Harm - LADs in Cheshire 2001-2003

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Halton UA

Warrington UA

Chester

Congleton

Crewe and Nantwich


Macclesfield

Vale Royal


Mode of Self Harm - LADs in Merseyside 2001-2003

0% 20% 40% 60% 80% 100%

Knowsley

Liverpool

St. Helens

Sefton

Wirral


Mode of Self Harm - LADs in Cumbria 2001-2003

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Allerdale

Barrow in Furness

Carlisle

Copeland

Eden

South Lakeland


Mode of Self Harm - LADs in Lancashire 2001-2003

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Blackpool UA

Burnley

Chorley

Fylde

Hyndburn

Lancaster

Pendle

Preston

Ribble Valley

Rossendale

South Ribble

West Lancashire

Wyre


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Place of Occurence - Self Harm in Greater Manchester 2001-2003

private house residential/prison school/hospital sports facility road trade primises industrial premises farm other (inc railway) unspecified

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Place of Occurence - Self Harm in Cheshire 2001-2003


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Place of Occurence - Self Harm in Merseyside 2001-2003


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Place of Occurence - Self Harm in Cumbria 2001-2003


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MALE

FEMALE

Place of Occurence - Self Harm in Lancashire 2001-2003


Place of Occurrence - Self Harm in Greater Manchester LADs 2001-2003

0% 20% 40% 60% 80% 100%

Bolton

Bury

Manchester

Oldham

Rochdale

Salford

Stockport

Tameside

Trafford

Wigan

unspecified

private house

residential/prison

school/hospital

sports facility

road

trade primises

industrial premises

farm

other (inc railway)

Place of Occurrence - Self Harm in Cheshire LADs 2001-2003

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Halton UA

Warrington UA

Chester

Congleton

Crewe and Nantwich


Macclesfield

Vale Royal

unspecified

private house

residential/prison

school/hospital

sports facility

road

trade primises

industrial premises

farm

other (inc railway)

Place of Occurrence - Self Harm in Merseyside LADs 2001-2003

0% 20% 40% 60% 80% 100%

Knowsley

Liverpool

St. Helens

Sefton

Wirral

unspecified

private house

residential/prison

school/hospital

sports facility

road

trade primises

industrial premises

farm

other (inc railway)

Place of Occurrence - Self Harm in Cumbria LADs 2001-2003

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Allerdale

Barrow in Furness

Carlisle

Copeland

Eden

South Lakeland

unspecified

private house

residential/prison

school/hospital

sports facility

road

trade primises

industrial premises

farm

other (inc railway)

Place of Occurrence - Self Harm in Lancashire LADs 2001-2003

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Blackpool UA

Burnley

Chorley

Fylde

Hyndburn

Lancaster

Pendle

Preston

Ribble Valley

Rossendale

South Ribble

West Lancashire

Wyre

unspecified

private house

residential/prison

school/hospital

sports facility

road

trade primises

industrial premises

farm

other (inc railway)

Key Points Local Delivery plans are required to show

progress toward the overall target of reducing age standardised mortality by at least 20% compared to a 1995-1997 baseline – to be achieved by 2009-2011.

Within Greater Manchester Mortality rates continue to be above the national

average for most local authority districts; except Salford and Bolton for women, Salford and Stockport for men

Female suicide rates are deteriorating in Rochdale, Trafford and Stockport

Male suicide rates are deteriorating in Wigan, Trafford and Oldham

Younger persons rates are highest in Tameside

Suicides in the North West - epidemiology update Developing Suicide Prevention in Primary Care...

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