Abstract
STUDY OBJECTIVE: To investigate the association between the level of social deprivation in electoral wards and various life events. Life events include mortality, self reported long term illness, and for women: still-birth, underweight birth, birth while a teenager, and sole registered birth. Associations with area deprivation are tested before and after allowing for levels of personal deprivation. DESIGN: Prospective census follow up using the Office for National Statistics Longitudinal Study. SETTING: England and Wales. PARTICIPANTS: A random sample of more than 300,000 people enumerated at the 1981 census, and aged 10 to 64 in 1981. Some analyses are necessarily restricted to certain age/sex groups. OUTCOME MEASURES: Several outcomes in the decade 1981-1992 are investigated: risk of premature death (before age 70, all cause), risk of long term limiting illness in 1991, and risk of inauspicious fertility outcomes in women. MAIN RESULTS: Without adjusting for personal circumstances all outcomes, except risk of stillbirth, show a clear, significant, and approximately linear association with social deprivation of ward of residence in 1981. Associations are much stronger for outcomes where a greater "social" component can be constructed (teenage birth, sole registered birth) than for outcomes that are probably more physiologically determined (mortality, stillbirth, low birth weight). When adjustment is made for personal disadvantage the simple associations with local area deprivation are all attenuated, especially for those living in the more deprived areas. CONCLUSIONS: A variety of adverse or "inauspicious" life events show association with residence in more deprived areas. These are particularly strong for teenage birth and sole registered birth, but are also stronger for long term illness than mortality. These associations seem to be largely because residence in more deprived areas is associated with personal disadvantage, which is more damaging to life chances than area of residence. For some outcomes there is evidence that the personally disadvantaged fare less well if living in relatively advantaged areas, than if living in more homogenously deprived areas.
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Selected References
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- Carstairs V. Deprivation indices: their interpretation and use in relation to health. J Epidemiol Community Health. 1995 Dec;49 (Suppl 2):S3–S8. doi: 10.1136/jech.49.suppl_2.s3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Carstairs V., Morris R. Deprivation and mortality: an alternative to social class? Community Med. 1989 Aug;11(3):210–219. doi: 10.1093/oxfordjournals.pubmed.a042469. [DOI] [PubMed] [Google Scholar]
- Eames M., Ben-Shlomo Y., Marmot M. G. Social deprivation and premature mortality: regional comparison across England. BMJ. 1993 Oct 30;307(6912):1097–1102. doi: 10.1136/bmj.307.6912.1097. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Humphreys K., Carr-Hill R. Area variations in health outcomes: artefact or ecology. Int J Epidemiol. 1991 Mar;20(1):251–258. doi: 10.1093/ije/20.1.251. [DOI] [PubMed] [Google Scholar]
- Morris R., Carstairs V. Which deprivation? A comparison of selected deprivation indexes. J Public Health Med. 1991 Nov;13(4):318–326. [PubMed] [Google Scholar]
- Shouls S., Congdon P., Curtis S. Modelling inequality in reported long term illness in the UK: combining individual and area characteristics. J Epidemiol Community Health. 1996 Jun;50(3):366–376. doi: 10.1136/jech.50.3.366. [DOI] [PMC free article] [PubMed] [Google Scholar]