Population Trends - Office for National Statistics

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93 trends

Population In this issue

In brief New proposals for population and health regular publications, ONS Longitudinal Study, Annual Report GRO (Scotland), New ONS catalogue published

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Recent ONS publications

5

Updates and demographic indicators

6

Geographic variations in suicide mortality, 1982-96 Analyses suicide trends by age and sex for the constituent countries of the UK Julia Bunting and Sue Kelly

7

Teenage mothers and the health of their children Discusses trends in teenage conception rates, their outcomes and long-term consequences Beverley Botting, Michael Rosato and Rebecca Wood

19

Drug-related mortality: methods and trends Describes the processes involved in collecting and compiling data on drug-related deaths in England and Wales, and documents recent trends in drug-related deaths Olivia Christophersen, Cleo Rooney and Sue Kelly

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Marriages in ‘Approved Premises’ in England and Wales: the impact of the 1994 Marriage Act Considers the impact of the introduction of approved premises marriages following the 1994 Marriage Act John Haskey

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Tables List of tables Tables 1-24 Notes to tables

53 54 80

Contact points at ONS

82

London: The Stationery Office

A publication of the Government Statistical Service

© Crown copyright 1998. Published with the permission of the Office for National Statistics on behalf of the Controller of Her Majesty’s Stationery Office. ISBN 0 11 620971 2 ISSN 0307-4436 Population Trends Office for National Statistics B7/05 1 Drummond Gate London SW1V 2QQ Editorial office: tel: 0171 533 5101 Editorial board John Fox (editor) David Pearce (deputy editor) Patricia Broad Angela Dale Karen Dunnell Graham C Jones Ian R Scott Judith Walton Population Trends is a journal of the Office for National Statistics. It is published four times a year in March, June, September and December. In addition to bringing together articles on a wide range of population and health topics, Population Trends contains regular series of tables on a wide range of subjects for which ONS is responsible. Annual subscription, including postage, £70.00, single issues £19.00.

ONS EDITORIAL POLICY The Office for National Statistics works in partnership with others in the Government Statistical Service to provide Parliament, government and the wider community with the statistical information, analysis and advice needed to improve decision-making, stimulate research and inform debate. It also registers key life events. It aims to provide an authoritative and impartial picture of society and a window on the work and performance of government, allowing the impact of government policies and actions to be assessed. Contributions Articles: 5,000 words max dates for submissions: Spring issue: by 30 Oct Summer issue: by 29 Jan Autumn issue: by 28 April Winter issue: by 27 July Please send to: Denise Tanner, executive secretary Permission to reproduce material in this publication: Copyright enquiries Office for National Statistics B1/04 1 Drummond Gate London SW1V 2QQ tel: 0171 533 5674 fax: 0171 533 5689

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in brief other groups. Only among the academics was there more support for the status quo. One tenth of those in favour however mentioned the importance of including some mortality data in the population quarterly, and some population data, especially fertility, in the health quarterly. This fits in with the idea that each journal would flag up the contents and summaries of the other.

New proposals for population and health regular publications

In spite of this level of support we should remember that almost one in 5 of respondents were against the separation – praising the wide scope of Population Trends and often mentioning the usefulness of the annual publication, Key Population and Vital Statistics for local government and health authority areas in England and Wales.

Regular readers of Population Trends will be aware that a consultation paper was sent out with Population Trends 91, in March of this year, setting out new proposals for population and health regular publications.The consultation document was also sent to users of ONS’s Population and Health Monitors, and to key customers in Government Departments, members of advisory committees and other interested parties. Replies were requested by the end of April. The document asked for comments on the following 3 questions: (a) Would you welcome the focusing of population and health material from ONS into 2 separate publications? (b) Would you welcome receiving all our current regular commentary, annual updates, articles, monitors and quarterly tables in a single quarterly publication ñ one for health, one for population and demography? (c) What are your views on costs and timetable? Responses By 7 May, 124 replies had been received. Table A shows responses to questions (a) and (b) by type of customer. Half of all replies (59) came from local government. The next largest group was health authorities (20). There were 13 replies from other Government Departments, 10 from libraries and 8 from individual academics. The fourteen ‘others’ comprised charities, individuals and unknown sources.

Findings There was overwhelming support for the proposal to publish, and report, separately population and health statistics. Overall 82 per cent of respondents were in favour. This was true of local and health authorities and the Table Table A 6

There was also strong support for the idea of combining existing articles, tables, monitors and annual updates in 2 quarterly publications. Seventy-four per cent of respondents were in favour of this – although another 17 per cent did not reply. Again there was a similar response from the main categories of responders.

Responses to consultation about new proposals for population and health regular publications All

Local Authority

Health Authority

Other Libraries Govt. Dept

Academics Others

a. Separation of population & health Yes No Qualified answer No answer

101 17 5 1

49 8 2 -

17 2 1 -

10 1 2 -

9 1 -

4 3 1 -

12 2 -

Total

124

59

20

13

10

8

14

92 10 2 20

44 3 12

16 1 3

11 2 -

8 2

3 3 2

10 3 1

124

59

20

13

10

8

14

b. All in a single Quarterly Yes No Qualified answer No answer Total

O f f i c e

f o r

N a t i o n a l

S t a t i s t i c s

1

P o p u l a t i o n

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The answers to the question on costs and timetables are more difficult to interpret. The consultation paper states that local and health authorities would get one free copy each. Many acknowledged this and said they were happy with that and the proposed timetable. Others gave qualified answers or did not reply. Replies came from a variety of departments in these organisations, not all of which would have first access to the one free copy. Nevertheless, 67 per cent of all respondents gave their approval to the proposal to keep the total cost to about £150 – the current cost of Population Trends and all monitors. Customers were very averse to price rises, some even suggested reducing the cost of PopulationTrends to reflect the reduction in scope.

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ONS Longitudinal Study

Other Government Departments There were some interesting comments from other Government Departments raising issues about Great Britain and UK Statistics as well as country specific results. The issue of an overall strategy for health publications is being addressed by the Department of Health.

• more likely to remain in non-private households • in a lower socio-economic status • experienced poorer health and survival • more difficult to trace over time

Virtually all the letters acknowledged the value of such consultation exercises. Many respondents replied at some length with ideas and questions. The latter are being referred to the relevant person in ONS for reply. Some of the additional points made are set out below: • crossover of key mortality and fertility data in both journals • cumulative indexes would be of value • importance of keeping population estimates as a separate annual reference publication • guest articles • free tables on the internet • flag forthcoming items in each edition • problems for cataloguing in libraries • will be able to stop having separate binders for monitors • take account of Wales, Scotland, HSE, and so on • aim for more Great Britain and UK coverage

Conventionally in LS analyses, those who could not be found at a subsequent census or by registering a vital event are assumed to be lost to follow-up. Loss to follow-up of those in children’s homes (38 per cent) and of men, aged 15–30, in places of detention (41 per cent) was higher than for all other children (20 per cent) and other men (18 per cent) of comparable age. The higher loss to follow-up of these two groups introduces a bias if those who were lost gained a socio-economic status which was different to those who remained in the study.

Recent analysis of ONS Longitudinal Study (LS) data by Seeromanie Harding, Michael Rosato, Karen Dunnell illustrates the use of LS data in the study of social exclusion. The socio-economic status and health of children aged under 18 years, who were living in children’s homes, and young men aged 15– 29, in places of detention, identified in the 1971 Census have been followed-up for 25 years. The analysis showed that compared with all other children and all other men of the same age, both groups were:

General comments

those in places in detention) was measured using Cox regression.

Children aged under 18 years and living in children’s homes in 1971 At the 1971 Census, 292 children were living in children’s homes, and of these, 172 were found in both the 1981 and 1991 Censuses. Table 1 shows that the proportion of these children who remained in non-private households was greater than that of all other children of the same age. In 1981, 24 per cent were in non-private households compared with only 2 per cent of all other children, and by 1991, 13 per cent compared with 4 per cent.

The advantage of studies using longitudinal rather than cross-sectional data is that the same individuals can be tracked over time and changes in their social status can be measured. This allows the influence of factors at an earlier point in life to be examined in relation to adult circumstances. The notion of accumulation of risk of adverse events over time has direct relevance to policies that aim to arrest or reverse social deprivation.

Figures 1a and 1b show the socio-economic status at the 1981 and 1991 Censuses of children who were in homes and of all other children. All three indicators show that higher proportions of those in children’s homes were in a lower socio-economic status in 1981 and 1991 compared with that of all other children. For example, 53 per cent of children in homes were living in rented housing in 1981 and 49 per cent in 1991. This compares with 40 per cent and 26 per cent respectively for all other children. Similarly, 51 per cent and 60 per cent were in a manual class in 1981 and 1991, respectively, compared with 40 per cent and 43 per cent for all other children.

The socio-economic status for the two groups, at the 1981 and 1991 Censuses, was measured using established indicators –occupation based social class, housing tenure and access to cars. In the analysis of health, two outcome measures were used: prevalence of limiting long-term illness as recorded at the 1991 Census, and death from any cause during the period 1971-95. Age-adjusted risk of death compared with that of all others (men for Table 1

Children, aged under 18 years, and living in children’s homes in 1971: proportions remaining in non-private households in the 1981 and 1991 Censuses. ONS Longitudinal Study

Next steps

Household status

The plans to have two quarterly publications from the beginning of 1999 is being progressed within ONS. We would like to thank those people and organisations who replied.

1981 Census

O f f i c e

f o r

N a t i o n a l

1991 Census

1981 Census

1991 Census

98

96

76

87

0 0 2

0 0 4

12 1 11

0 1 12

112,325

112,324

172

172

Private households Non-private households children’s homes prison other All = 100%

2

All other children aged under 18 in 1971 Children in chidren’s homes

S t a t i s t i c s

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Figure 1a

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Children, aged under 18 years, living in children’s homes in the 1971 Census: socio-economic status in the 1981 and 1991 Censuses

100

Percentage

80

1981

1991

60 40 20 0 owner occupied

rented

NPH*

car access

no car access

NPH*

non-manual

manual

unclassified

* NPH refers to non-private household

Figure 1b

All other children, aged under 18 years, in the 1971 Census: socio-economic status in the 1981 and 1991 Censuses

100 1981

Percentage

80

1991

60 40 20 0 owner occupied

rented

NPH*

car access

no car access

NPH*

non-manual

manual

unclassified

* NPH refers to non-private household

Table 2 shows the risks of limiting long-term illness and death from any cause among those who were in children’s homes. Both of these outcome measures suggest poorer health compared with other children. The prevalence of limiting long-term illness was almost four times greater among children who were in homes compared with others. Their risk of mortality was two and a half times higher. Male, aged 15–29, in places of detention in 1971 Of the 291 men, aged 15–29, who were in places of detention at the 1971 Census, 147 were present at both the 1981 and 1991 Censuses. The pattern of results is similar to that of children in homes – lower socioeconomic status and poorer health outcomes compared with all other men of the same age.

Table 2

Children, aged under 18 years, and living in children’s homes in 1971: Health outcome indicators- prevalence of limiting long-term illness in 1991 Census and mortality ONS Longitudinal Study during the period 1971-95.

Health outcome

All other children aged under 18 in 1971

Limiting long-term illness Yes No All = 100%

4 96

15 85

112,325

172

1.00

2.5* 1.34–4.66

Mortality Hazard ratio 95% confidence interval

10

Deaths * p