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Regional inequalities in mortality

R Illsley¹, J Le Grand

¹School of Social Studies, University of Bath.

Journal of Epidemiology and Community Health

|December 1, 1993

Summary

Health inequalities between British regions have converged for younger age groups but persist for older populations. Standardised mortality ratios may obscure these differing trends in regional health.

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Area of Science:

Public Health
Epidemiology
Health Geography

Background:

Persistent health inequalities between British regions have been a long-standing concern.
The use of standardised mortality ratios (SMRs) is common for measuring these disparities.

Purpose of the Study:

To investigate the persistence of health inequalities across British regions.
To evaluate the impact of using standardised mortality ratios on the interpretation of these inequalities.

Main Methods:

Analysis of regional, age-specific death rates from 1931 to 1987-89.
Reconstruction of data to ensure comparability with 1981 regional definitions.
Application of log variance and regional rankings to measure inequality.

Main Results:

Significant convergence in age-specific death rates observed in younger age groups.
The historical north-south gradient in mortality has diminished for younger populations.
This north-south gradient persists in older age groups.

Conclusions:

Standardised mortality ratios can mask variations in the convergence rates of age-specific death rates between regions.
Simple conclusions regarding a persistent north-south health divide are not fully supported by the data.
Distinctive patterns of change in mortality appear to be operating across different age demographics.

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