[show abstract][hide abstract] ABSTRACT: It is accepted that within Britain there are persistent and growing inequalities in mortality between groups of people as defined by their social class. This paper shows that similar persistent and growing inequalities prevail between groups of people defined by district of residence. Although there is some confusion between these two ways of grouping people – there is a slight tendency for people of the same class to live in the same district.This paper reviews the geographical literature which may shed light on why inequalities in mortality are widening between districts in Britain. We present new data for a set of 293 unchanging districts by amalgamating published reports from the 1950s, 60s and 70s with individual postcoded mortality records from the 1980s and 90s, aggregated to the 293 districts using a Geographic Information System and Census data from 1971, 1981 and 1991 (including estimates of the residence of the ‘missing million’). We find that a growing proportion of premature deaths in Britain can be attributed to some aspect of rising spatial inequalities. Changing geographical inequalities in health are not simply a passive reflection of social inequalities. To begin to investigate them, however, we first need to measure them properly.
Sociology of Health & Illness 06/2008; 20(5):694 - 709. · 1.88 Impact Factor
[show abstract][hide abstract] ABSTRACT: This paper presents maps of geographical patterns in mortality for the 160 mainland regions of the 15 countries of the European Union. Standardised mortality ratios (SMRs) for all ages are presented for all causes of death and for lung cancer, ischaemic heart disease, road traffic accidents and suicide. All cause standardised mortality ratios (for deaths under the age of 65) for the years 1990 and 1994 are presented. These data show that while most regions of Europe had decreasing SMRs over this time period, SMRs increased for the 10% of the population with the highest SMRs and the gap between the most and least healthy regions grew. Possible reasons for the observed patterns, the limitations of currently available data and the limitations of studying nation states, are suggested.
Social Science [?] Medicine 05/2000; 50(7-8):1047-58. · 2.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: This paper explores the role of migration in creating geographical inequalities in mortality at the district level in Britain for the British Household Panel Study sample -- a representative sample of 10264 British residents born after 1890 and enumerated in 1991. Analysis of the mortality rates of migrants showed that male migration accounts for nearly all the differences in mortality rates between districts. The BHPS was then utilised to look at the lifetime socio-economic characteristics of these migrants and to compare men and women. It was found that the health of both men and women moving from high mortality districts to low mortality districts could be explained by advantage over their lifetimes. The small proportion of men and women moving from low mortality districts to high mortality districts represent a very mixed group and their contribution, whilst small, is intriguing, as is the very different mortality rates of men and women in this group.
Social Science [?] Medicine 01/2000; 50(6):861-878. · 2.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: This study investigates the extent to which current geographical variations in mortality are influenced by patterns of migration since birth. It is based on a longitudinal study of migrants which consists of a representative sample of 10264 British residents born after 1890 and enumerated as part of the British Household Panel Study in 1991. Between 1991 and 1996, 527 of the study members died and these deaths were analysed by area of residence at birth and in 1991 at both the regional and local district geographical scales. These were compared with findings from the Office for National Statistics Longitudinal Study. The British Household Panel Survey sample replicates the results of work conducted on the Longitudinal Study which finds that geographical variations in age-sex standardised mortality ratios at the regional scale cannot be attributed to selective migration. However, for the British Household Panel Survey sample, the major geographical variations at district level could be attributed to selective migration. Geographical variations in mortality are not well understood. Restrictions on what it is possible to analyse in the Office for National Statistics Longitudinal Study may have resulted in the underestimation of the importance of local lifetime selective migration in producing the contemporary map of mortality variation across Britain. The British Household Panel Survey is a small, recent, but very flexible study, which can be used to investigate the effects of lifetime migration on mortality patterns for all of Britain. This first report of its results on mortality shows that it produces findings which accord with the much larger Longitudinal Study, but which can be taken further to show that selective migration over the whole life-course at the local level does appear to have significantly altered the geographical pattern of mortality seen in Britain today.
Social Science [?] Medicine 11/1999; 49(7):981-8. · 2.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: In this paper new findings on the average life expectancy of the population of Britain are reported according to housing wealth. In addition, estimates of mortality rates for rough sleepers, hostel residents, and bed and breakfast residents are presented. The results indicate that the death rates of bed and breakfast residents are four to five times those of the housed population, death rates for hostel residents are seven times greater, and death rates for rough sleepers are 25 times greater than those of the housed population. At the extremes, people living in the most salubrious housing in Britain (holding over £100 000 of equity in their properties) can expect to live, on average, more than twice as long as those sleeping rough on the streets.
Environment and Planning A. 01/1999; 31(12):2239-2248.