The 2nd Atlas of Variation in risk factors and healthcare for liver disease was published by Public Health England on September 14. It shows a wide variation of premature mortality rates from liver disease across England. Up to 90% of cases of liver disease are due to alcohol misuse, obesity and Hepatitis B and C. The atlas will help health professionals to allocate their resources to improve patient outcomes.
The report 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 is made up of 39 indicators, 19 of which show trend data over time. Progress is mixed, 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.
The atlas also exposes health inequalities in England. 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.