Tuesday, March 26, 2013

Recent reads: Capital by John Lanchester

CapitalCapital by John Lanchester
My rating: 3 of 5 stars

This started promisingly, with an interesting selection of characters all living in or connected to Pepys Road, a fictional street in Clapham somewhere. I almost wished it had been set in the real Pepys Road, which is in New Cross, but never mind, Clapham probably fitted the story better.

I enjoyed reading it, and the story went along at a decent pace, but in the end I didn't find the characters deep enough to care about too much, except perhaps Zbigniew and, surprisingly, Roger, the investment banker whose heart just wasn't really in it and who had to put up with Arabella, his wife and probably the most obnoxious character in the book.

The postcards idea was an interesting thread that drew the whole thing together, but in a way I'm not sure it was needed and when all of the loose ends were tied up at the close of the book, I was left thinking, "oh, ok, that's it then." I'd basically worked out what had been going on with the postcards well before that and there was no twist in the tale.

Still, it was a nice easy read, it was 20p on kindle and would probably make quite a good book club pick for any London-based book clubs.

View all my reviews

Monday, March 18, 2013

Trends in homicides in England and Wales: comparison of death registration and police report data

This paper was originally written by my former colleague, Cleo Rooney, and me for the WHO Family of International Classifications Network meeting held in Reykjavik on 24-30 October 2004. It used to be online at http://www.nordclass.uu.se/WHOFIC/papers/reykjavik84.pdf but that URL no longer works so I'm putting it online here so it isn't totally lost to the world!

Title: Trends in homicides in England and Wales: comparison of death registration and police report data
Authors: Cleone Rooney Clare Griffiths
Purpose: For information.
Recommendations: Further work is needed on improving the international comparability of vital statistics on homicide.
It is difficult to produce timely statistics on the annual number of deaths from assault from vital registration data. Full information about these deaths only becomes available after legal processes, which may take many months to complete. This can mean that these deaths are not registered in time to be included in annual statistics, or that they are registered before the cause of death is known.

In England and Wales, up to half the deaths eventually classified as assault (X85- Y09) may not appear as such in the original annual statistics. Deaths being investigated as homicide and registered before the cause can be certified fully are assigned a temporary underlying cause code of Y33.9 (E988.8 in ICD-9), and a manner of death code indicating that the verdict is still 'pending investigation'. These are identified as 'probable homicide /assault' in ONS mortality statistics, but not in WHO or EUROSTAT publications, which cannot accommodate such national departures from standard ICD coding and tabulation.

We have compared vital registration and police statistics from the Home Office to derive best estimates of numbers and patterns of deaths from homicide in England and Wales. Both data sources give similar pictures, and confirm that ONS figures on 'homicide and probable homicide' are consistent with statistics of deaths reported to the police / being investigated as homicide.

Work by the International Collaborative Effort on Injury Statistics(1) suggests that the quality and completeness of deaths registered as homicide may vary considerably between countries. Policy makers and pressure groups use these data for international comparisons. More work is needed to improve the comparability of these data and to educate users about these issues.

In England and Wales, all suspicious deaths must be reported to the coroner for investigation before they can be registered.(2,3) If the police report that charges are to be brought against anyone in relation to the death or that the death is being investigated as homicide, the coroner adjourns the inquest to await the results of investigation and legal proceedings. Since 1978 it has been possible to register deaths at this point – known as accelerated registration.(4) ONS assigns a temporary underlying cause code of Y33.9 (E988.8) to these deaths. Since 1993, ONS has also coded coroner’s verdicts or 'manner of death'. These adjourned inquest deaths are assigned a code indicating that the verdict is 'pending investigation'. The coroner will normally update ONS with the final verdict and cause of death when these are known. This process can take months, or even years. This means that up to half the deaths eventually classified as homicide/assault (X85-Y09, E960-E969) may not appear as such in the original annual statistics.

For deaths since the beginning of January 1993, ONS updates the coding on its dynamic national mortality database when further information is received. Deaths on this database coded to Y33.9/E988.8 at any given time will include:

(a) deaths where an inquest has been adjourned as described above. Most of these will eventually be recoded on receipt of further information, and all but a few will be recoded either to homicide or to land transport accidents.

(b) a very small number of deaths registered after a completed inquest which delivered an 'open' verdict and a cause of death of injury or poisoning which could not be assigned to any more precise code. These deaths will retain the Y33.9/E988.8 code for underlying cause of death.

Methods of producing statistics on homicides
There are therefore several different ways of examining homicide trends in England and Wales,(5) using the number of deaths coded to:

1. X85-Y09 (E960-E969). This is the basic ICD classification, to which all homicides should eventually be assigned.

2. X85-Y09, plus Y33.9 (E988.8). This takes account of accelerated registrations, as described above. This is a simple adjustment, which can be done using published figures by underlying cause, without requiring knowledge of the progress of inquest proceedings. It will include a handful of deaths which were probably not homicides, since the inquest verdict was 'open'.

3. X85-Y09, plus Y33.9 with a pending verdict. This allows more exactly for accelerated registrations which are likely to become coded to homicide.

[Note that in 2007 ONS changed the code it used for deaths where the inquest was adjourned to U50.9 in order reduce the possibility of confusion in suicide statistics. This means the best estimate of homicide deaths is now obtained by using X85-Y09 plus U50.9]

Comparison of ONS and Home Office data
Home Office (Justice Department) figures are based on the year in which the offence was first recorded by the police, which may not be the year that the death occurred or was registered. The initial number recorded for the year may subsequently be reduced as a result of decisions by the police or the courts that no offence of homicide took place.(6) Revised figures which take account of these changes are published regularly.

* As at 23 August 2004
** includes homicides by Harold Shipman in the year they occurred
*** As at 13 November 2003
Source: ONS and Home Office

ONS deaths data are now tabulated by the year in which they occurred, so the figures cannot be matched exactly with Home Office data. However, they do show very similar patterns and trends since about 1960 (Figure 1). In the 1950s numbers from death registrations were considerably lower than homicides recorded by the Home Office, and may have been incomplete. The closest correspondence is between Home Office figures for deaths initially recorded as homicide, and ONS 'total' figure – that is the sum of deaths certified as homicide, and coded to X85-Y09 in time for routine annual publication and deaths certified after adjourned inquest coded to Y33.9.

Figure 1 also illustrates the variation which may occur in ONS annual figures due to differences in how long after the end of the data year the data are extracted and analysed. The number of deaths coded to homicide in the 1993 annual publication was among the highest ever, whereas the total including E988.8 'pending' was similar to other years in the early 1990s. The reason is that the annual extract for 1993 was taken 15 months later than usual, because of changes in ONS computer systems. By that time, ONS had received many more updates on accelerated registrations than would be usual.

Patterns of homicide in England and Wales

Death rates due to homicide are generally higher in males than in females, this difference being greatest in young adults. Rates among children and the elderly are more similar between males and females (Figure 2). The highest homicide rates in both sexes are in infants. Rates for young men have increased between 1993-1997 and 1998-2002, as have rates among infants of both sexes. In other age groups, rates have remained similar between the 2 time periods.

Comparison with European Union data
Table 1 shows a comparison of homicide rates in the EU15 countries from Key Data on Health 2002, based on annual published data. We have also added the England and Wales rate based on the best estimate of homicides described above. Clearly, the ranking changes considerably when corrected figures are used. England and Wales had the 6th highest rates in men and 5th highest in women, compared with the ranking for the UK on published data of 14th and last respectively. As Scotland and Northern Ireland have higher homicide rates than England and Wales, UK rates would show an even greater difference. However, this comparison ignores any differences in data from other countries. A recent study of the comparability of cause of death statistics in the European Union(7) found that death rates could vary substantially due to differences in certification practice and laws. This particularly applies to external causes of mortality, such as homicide and suicide, where legal definitions also come into play.

Table 1. Age-standardised homicide rates per 100,000 population, European Union 15 countries, 1998

The need for better international comparisons
Work by the International Collaborative Effort on Injury Statistics suggests that the quality and completeness of deaths registered as homicide may vary considerably between countries. Comparisons of homicide rates in countries participating in the ICE(8) showed that rates in England and Wales were lower than those in Scotland, New Zealand, Israel, Australia and Canada even after including adjourned inquest deaths. They were higher than Denmark, the Netherlands, Norway and France. However, French death registration figures probably underestimate homicides and other injury deaths because INSERM does not have access to cause of death information on deaths subject to forensic investigation.(9) The directly age-standardised homicide rate in the USA was six and a half times that in England and Wales.

Policy makers and pressure groups use homicide data for international comparisons. More work is needed to improve the comparability of these data in international publications and to educate users about their use.

1 Rooney C, Warner M, Fingerhut L. Results of the ICE on injury survey of death certification and vital statistics. Proceedings of the International Collaborative Effort on Injury Statistics. Volume III. Washington DC, June 1999.
2 Coroners Act 1988
3 Devis T and Rooney C. Death Certification and the epidemiologist. Health Statistics Quarterly 1, pp 21-33, 1999.
4 OPCS Mortality statistics England and Wales; Deaths from injury and poisoning; 1978. HMSO: London, 1980.
5 Rooney C and Devis T. Recent trends in deaths from homicide in England and Wales. Health Statistics Quarterly 3, pp 5-13, 1999.
6 Home Office. Criminal Statistics: England and Wales: 1997. TSO: London, 1998.
7 European Commission DG SANCO agreement. Comparability and Quality Improvement of European Causes of Death Statistics. Final Report. Centre d'épidémiologie sur les causes médicales de décès. Institut national de la santé et de la recherche médicale, July 2001.
8 Fingerhut L, Cox C and Warner M, International Comparative analysis of injury mortality: Findings from the ICE on Injury Statistics. NCHS Advance Data No 303, October 1998. NCHS, CDC, US Department of Health and Human Services.
9 Lecomte D, Hatton F, Renaud G, et Le Toullec A, Les suicides en Ile-de-France chez les sujets de 15 a 44 ans; resutats d’une étude coopérative. Bulletin épidémiologique hebdomadaire 2, pp 5-6, 1994.

Wednesday, March 13, 2013

Born in Lewisham

The next event for the Save Lewisham Hospital Campaign is a Born in Lewisham Hospital 'hands around our hospital' this Saturday 16th March. The plan is to assemble in front of the hospital at 2pm, with the chain starting at 2:30pm followed by events and music from 2:45pm to 4pm. The campaign say If you, your children, your sister or brother, your boyfriend or anyone you know was born in Lewisham Hospital – or if you to continue to defend the services at our hospital come along.

The Millwall bus and mascot will be there too if Millwall are your sort of thing.

The campaign are also asking you to share your photos for the Born in Lewisham Hospital Hall of Fame. The photos can be of you, if you were born in Lewisham, your grown up children or grandchildren, as long as you have permission, or your own young children and babies.

Both my children were born in Lewisham hospital and I've written about my experience with James elsewhere. With Claud things ran a little more smoothly, but I'm grateful to the hospital for looking after me and them on both occasions.

Unfortunately we can't be there on Saturday, so I'm sharing my photos here instead and encourage you to share yours with the campaign too by emailing the campaign with your photos at savelewishamhospital@yahoo.com.

James then:

James now:

Claud then:

Claud now:

Friday, March 08, 2013

Boris's disaster in Catford

Last night Boris held one of his People's Question Time events in Catford (because he has to rather than because he wants to). Let's just say it didn't go too well for him....

Here are my collated tweets.

And I also recorded the whole thing. This was on a phone on my knee so apologies if sometimes the clapping and shouting of those around me gets a bit too loud! You can hear most of it though. It starts with the booing as Boris comes in.

Other write ups/links:


@darryl1974's audioboo of Boris getting a bit cross.

East London Lines

New Statesman

Wednesday, March 06, 2013

Latest Lewisham Life

This could be just my reading of the latest missive from Lewisham Council, but I think the latest Lewisham Life enewsletter (Sign up to receive your own copy here) suggests that the Council going ahead with seeking a judicial review over the Lewisham hospital decision isn't totally certain.

At the last council meeting my understanding of the discussion was that legal advice had been received on the response to the council's pre-action notice (required in law before a judicial review can be sought) and that the advice suggested the council should go ahead and seek a judicial review.

However, the latest enewsletter says Before making its next move the Council is taking legal advice on responses to the pre-action protocol letter that it sent in February.

I hope this is just a question of timing and not indicative that a judicial review may not actually go ahead after all. Watch this space.

Tuesday, March 05, 2013

Boris comes to Catford

(picture from Save Lewisham Hospital campaign)

Everyone's favourite Mayor of London, Boris Johnson, is coming to Catford on Thursday to talk to us about

  • Growing London's economy
  • Housing
  • Transport and environment
  • Policing and community safety

(according to the GLA website, anyway. Somehow I think Lewisham hospital might figure on the attendees' agenda a little more highly, and this is People's Question Time after all....)

Registrations for the event have closed, which surprises me given that the main theatre holds 800 people (although perhaps we'll be in the studio theatre which holds 100). Doors open at 6pm, and if there are any spaces left then you can get in without a ticket from 6:45pm.

The Save Lewisham hospital campaign are planning to welcome Boris with a protest outside the theatre. They say: Gather from 6pm onwards outside the Catford Broadway theatre for this red carpet event! Boris Lookalikes, street theatre and much more.

Hope to see you there!