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. 1993 Oct 30;307(6912):1097–1102. doi: 10.1136/bmj.307.6912.1097

Social deprivation and premature mortality: regional comparison across England.

M Eames 1, Y Ben-Shlomo 1, M G Marmot 1
PMCID: PMC1679128  PMID: 8251806

Abstract

OBJECTIVE--To investigate the pattern and size of the relationship between social deprivation in electoral wards and premature mortality for each health region in England. DESIGN--Ecological study using 1981 census variables and data on mortality for 1981-5. SETTING--14 regional health authorities in England. MAIN OUTCOME MEASURE--Mortality under the age of 65 years from all causes, coronary heart disease, and smoking related diseases in men and women. RESULTS--Increasing deprivation was significantly associated with mortality from all causes, coronary heart disease, and smoking related diseases. The relationship was linear with no apparent threshold. Correlation coefficients were generally greater for deaths from all causes and smoking related diseases and for men compared with women. The slope of the relationship between deprivation and mortality varied among regions. Variations in mortality still existed between regions for equal levels of deprivation. CONCLUSION--Deprivation of an area and premature mortality are strongly linked. The effects of deprivation can be seen throughout the range of affluence and are not limited to the poorest areas. Current targets for reducing coronary heart disease mortality may be achievable if the mortality in poor areas can be reduced to the rates in affluent areas.

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Selected References

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  1. Barker D. J., Osmond C. Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales. Lancet. 1986 May 10;1(8489):1077–1081. doi: 10.1016/s0140-6736(86)91340-1. [DOI] [PubMed] [Google Scholar]
  2. Ben-Shlomo Y., Smith G. D. Deprivation in infancy or in adult life: which is more important for mortality risk? Lancet. 1991 Mar 2;337(8740):530–534. doi: 10.1016/0140-6736(91)91307-g. [DOI] [PubMed] [Google Scholar]
  3. Blane D., Smith G. D., Bartley M. Social class differences in years of potential life lost: size, trends, and principal causes. BMJ. 1990 Sep 1;301(6749):429–432. doi: 10.1136/bmj.301.6749.429. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Carstairs V., Morris R. Deprivation: explaining differences in mortality between Scotland and England and Wales. BMJ. 1989 Oct 7;299(6704):886–889. doi: 10.1136/bmj.299.6704.886. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Egolf B., Lasker J., Wolf S., Potvin L. The Roseto effect: a 50-year comparison of mortality rates. Am J Public Health. 1992 Aug;82(8):1089–1092. doi: 10.2105/ajph.82.8.1089. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Elliott P., Hills M., Beresford J., Kleinschmidt I., Jolley D., Pattenden S., Rodrigues L., Westlake A., Rose G. Incidence of cancers of the larynx and lung near incinerators of waste solvents and oils in Great Britain. Lancet. 1992 Apr 4;339(8797):854–858. doi: 10.1016/0140-6736(92)90290-j. [DOI] [PubMed] [Google Scholar]
  7. Graham H. Women's smoking and family health. Soc Sci Med. 1987;25(1):47–56. doi: 10.1016/0277-9536(87)90206-1. [DOI] [PubMed] [Google Scholar]
  8. Haan M., Kaplan G. A., Camacho T. Poverty and health. Prospective evidence from the Alameda County Study. Am J Epidemiol. 1987 Jun;125(6):989–998. doi: 10.1093/oxfordjournals.aje.a114637. [DOI] [PubMed] [Google Scholar]
  9. Jarman B. Identification of underprivileged areas. Br Med J (Clin Res Ed) 1983 May 28;286(6379):1705–1709. doi: 10.1136/bmj.286.6379.1705. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Johnson Z., Jennings S., Fogarty J., Johnson H., Lyons R., Doorley P., Hynes M. Behavioural risk factors among young adults in small areas with high mortality versus those in low-mortality areas. Int J Epidemiol. 1991 Dec;20(4):989–996. doi: 10.1093/ije/20.4.989. [DOI] [PubMed] [Google Scholar]
  11. Mackenbach J. P., Bouvier-Colle M. H., Jougla E. "Avoidable" mortality and health services: a review of aggregate data studies. J Epidemiol Community Health. 1990 Jun;44(2):106–111. doi: 10.1136/jech.44.2.106. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Marmot M. G., McDowall M. E. Mortality decline and widening social inequalities. Lancet. 1986 Aug 2;2(8501):274–276. doi: 10.1016/s0140-6736(86)92085-4. [DOI] [PubMed] [Google Scholar]
  13. Marmot M. G., Shipley M. J., Rose G. Inequalities in death--specific explanations of a general pattern? Lancet. 1984 May 5;1(8384):1003–1006. doi: 10.1016/s0140-6736(84)92337-7. [DOI] [PubMed] [Google Scholar]
  14. Marmot M. G., Smith G. D., Stansfeld S., Patel C., North F., Head J., White I., Brunner E., Feeney A. Health inequalities among British civil servants: the Whitehall II study. Lancet. 1991 Jun 8;337(8754):1387–1393. doi: 10.1016/0140-6736(91)93068-k. [DOI] [PubMed] [Google Scholar]
  15. Payne J. N., Coy J., Milner P. C., Patterson S. Are deprivation indicators a proxy for morbidity? A comparison of the prevalence of arthritis, depression, dyspepsia, obesity and respiratory symptoms with unemployment rates and Jarman scores. J Public Health Med. 1993 Jun;15(2):161–170. doi: 10.1007/BF02959657. [DOI] [PubMed] [Google Scholar]
  16. Phillimore P. R., Morris D. Discrepant legacies: premature mortality in two industrial towns. Soc Sci Med. 1991;33(2):139–152. doi: 10.1016/0277-9536(91)90174-b. [DOI] [PubMed] [Google Scholar]
  17. Pocock S. J., Shaper A. G., Cook D. G., Packham R. F., Lacey R. F., Powell P., Russell P. F. British Regional Heart Study: geographic variations in cardiovascular mortality, and the role of water quality. Br Med J. 1980 May 24;280(6226):1243–1249. doi: 10.1136/bmj.280.6226.1243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Robine J. M., Ritchie K. Healthy life expectancy: evaluation of global indicator of change in population health. BMJ. 1991 Feb 23;302(6774):457–460. doi: 10.1136/bmj.302.6774.457. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Smith G. D., Bartley M., Blane D. The Black report on socioeconomic inequalities in health 10 years on. BMJ. 1990 Aug 18;301(6748):373–377. doi: 10.1136/bmj.301.6748.373. [DOI] [PMC free article] [PubMed] [Google Scholar]

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