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. 1995 Feb 18;310(6977):423–427. doi: 10.1136/bmj.310.6977.423

Mortality from cardiovascular disease among interregional migrants in England and Wales.

D P Strachan 1, D A Leon 1, B Dodgeon 1
PMCID: PMC2548815  PMID: 7873946

Abstract

OBJECTIVE--To investigate the extent to which geographical variations in mortality from ischaemic heart disease and stroke in Britain are influenced by factors in early life or in adulthood. DESIGN--Longitudinal study of migrants. SUBJECTS--1% sample of residents in England and Wales born before October 1939 and enumerated at the 1971 census (the Office of Population Censuses and Surveys' longitudinal study). MAIN OUTCOME MEASURE--18,221 deaths from ischaemic heart disease and 9899 deaths from stroke during 1971-88 were analysed by areas of residence in 1939 and 1971. These included 2928 deaths from ischaemic heart disease and 1608 deaths from stroke among individuals moving between 14 areas defined by the major conurbations and nine standard administrative regions of England and Wales. RESULTS--The southeast to northwest gradient in mortality from ischaemic heart disease was related significantly to both the 1939 area (chi 2 = 6.09, df = 1) and area in 1971 (chi 2 = 5.05, df = 1). Geographical variations in mortality from stroke were related significantly to the 1939 area (chi 2 = 4.09, df = 1) but the effect of area in 1971 was greater (chi 2 = 8.07, df = 1). The effect of 1971 area on mortality from stroke was largely due to a lower risk of death from stroke among individuals moving into Greater London compared with migrants to the rest of the South East region (chi 2 = 4.54, df = 1). CONCLUSIONS--Geographical variations in mortality from cardiovascular disease in Britain may be partly determined by genetic factors, environmental exposures, or lifestyle acquired early in life, but the risk of fatal ischaemic heart disease and stroke changes on migration between areas with differing mortality. The low risk of death from stroke associated with residence in Greater London is acquired by individuals who move there.

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Selected References

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  1. Barker D. J., Osmond C. Death rates from stroke in England and Wales predicted from past maternal mortality. Br Med J (Clin Res Ed) 1987 Jul 11;295(6590):83–86. doi: 10.1136/bmj.295.6590.83. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. 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]
  3. Barker D. J., Osmond C., Law C. M. The intrauterine and early postnatal origins of cardiovascular disease and chronic bronchitis. J Epidemiol Community Health. 1989 Sep;43(3):237–240. doi: 10.1136/jech.43.3.237. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Barker D. J., Osmond C., Pannett B. Why Londoners have low death rates from ischaemic heart disease and stroke. BMJ. 1992 Dec 19;305(6868):1551–1554. doi: 10.1136/bmj.305.6868.1551. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Barker D. J., Osmond C., Simmonds S. J., Wield G. A. The relation of small head circumference and thinness at birth to death from cardiovascular disease in adult life. BMJ. 1993 Feb 13;306(6875):422–426. doi: 10.1136/bmj.306.6875.422. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Barker D. J., Winter P. D., Osmond C., Margetts B., Simmonds S. J. Weight in infancy and death from ischaemic heart disease. Lancet. 1989 Sep 9;2(8663):577–580. doi: 10.1016/s0140-6736(89)90710-1. [DOI] [PubMed] [Google Scholar]
  7. 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]
  8. Elford J., Phillips A. N., Thomson A. G., Shaper A. G. Migration and geographic variations in ischaemic heart disease in Great Britain. Lancet. 1989 Feb 18;1(8634):343–346. doi: 10.1016/s0140-6736(89)91722-4. [DOI] [PubMed] [Google Scholar]
  9. Elford J., Phillips A., Thomson A. G., Shaper A. G. Migration and geographic variations in blood pressure in Britain. BMJ. 1990 Feb 3;300(6720):291–295. doi: 10.1136/bmj.300.6720.291. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Law C. M., de Swiet M., Osmond C., Fayers P. M., Barker D. J., Cruddas A. M., Fall C. H. Initiation of hypertension in utero and its amplification throughout life. BMJ. 1993 Jan 2;306(6869):24–27. doi: 10.1136/bmj.306.6869.24. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. 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]
  12. Osmond C., Barker D. J., Winter P. D., Fall C. H., Simmonds S. J. Early growth and death from cardiovascular disease in women. BMJ. 1993 Dec 11;307(6918):1519–1524. doi: 10.1136/bmj.307.6918.1519. [DOI] [PMC free article] [PubMed] [Google Scholar]

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