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New liver disease atlas shows major variation across England

The rate of people dying early from liver disease in some parts of England is almost 8 times higher than others.

New data published by Public Health England (PHE) today (14 September 2017) shows a wide variation of premature mortality rates from liver disease across England.

Liver disease is almost entirely preventable with the major risk factors, alcohol, obesity and Hepatitis B and C, accounting for up to 90% of cases. The atlas will help health professionals to allocate their resources to improve patient outcomes.

The atlas shows premature mortality rates – dying before the age of 75 – ranged from 3.9 per 100,000 in South Norfolk clinical commissioning group (CCG) to 30.1 per 100,000 in Blackpool CCG, a 7.7 fold difference.

The atlas paints a mixed picture, with 10 indicators showing improvements including a reduction of premature deaths and fewer alcohol-specific hospital admissions for under 18s.

Nine of the indicators have become worse over time, including a doubling of hospital admission rates for cirrhosis from 54.8 per 100,000 to 108.4 per 100,000 people over the past decade. This indicator also varies significantly across the country with an 8.5 fold variation across CCGs and this gap has widened over the past decade.

Liver disease is responsible for almost 12% of deaths in men aged 40 to 49 years and is now the fourth most common cause of ‘years of life lost’ in people aged under 75, after heart disease and lung cancer.

Professor Julia Verne, Head of Clinical Epidemiology at PHE said:

“Chronic liver disease is a silent killer of young adults, creeping up and showing itself when it’s often too late. However, around 90% of liver disease is preventable.

“We hope local health professionals will make the most of this rich data source to inform how they reduce the burden of liver disease in their areas.”

The atlas also lays bare the impact of the stark health inequalities in England. Inequality plays a role in the significant variation in risk factors of liver disease – excessive alcohol consumption, obesity, and hepatitis B and C.

For example, there is a 7.4 fold difference in the rate of alcohol-specific hospital admissions across the country, with the majority of the higher rates being clustered in the more deprived areas. Also, in the most deprived fifth of the country, people with liver disease die 9 years earlier than those in the most affluent fifth.

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