Regional inequalities in mortality.

Raymond Illsley · Julian Le Grand

45 citations0/0 files storedJournal of Epidemiology & Community Health

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Health disparities and outcomes Insurance, Mortality, Demography, Risk Management Healthcare Systems and Public Health

Abstract

STUDY OBJECTIVE: To examine the hypothesis of sustained and persistent inequalities in health between British regions and to ask how far they are a consequence of using standardised mortality ratios as the tool of measurement. DESIGN, SETTING AND PARTICIPANTS: Data are regional, age specific death rates at seven points in time from 1931 to 1987-89 for the British regions, reconstructed to make them comparable with the 1981 regional definitions. Log variance is used to measure inequality; regional rankings are also used. MEASUREMENTS AND MAIN RESULTS: There has been a substantial convergence in age specific death rates between regions in younger but not in older age groups. In younger age groups the historic north/south gradient has disappeared; it persists in older groups. CONCLUSIONS: Use of standardised mortality ratios obscures differences in the convergence rates of age specific death rates between regions. Simple conclusions about the persistence of a north/south divide are not justified. Different processes of change seem to be at work in different age groups.

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References

1990The Black report on socioeconomic inequalities in health 10 years on.1988Inequalities? Social class differentials in health in British youth 1990Socio-economic mortality differences in Finland 1971-85.1992Adolescence and health inequalities: Extensions to macintyre and west 1991Contextual variations in the meaning of health inequality 1987The Measurement of Inequality in Health

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