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Inequalities in mortality in Britain today greater than those during 1930s economic depression

July 23, 2010

Research: Inequalities in premature mortality in Britain: Observational study from 1921-2007

The level of inequalities in premature mortality between different areas of Britain has almost surpassed those seen shortly before the economic crash of 1929 and the economic depression of the 1930s, according to a new study published on bmj.com today.

Inequalities continued to rise steadily during the first decade of the twenty first century, UK researchers have found, and could become worse.

Inequalities in mortality in Britain have persisted over many years and recent government efforts to reduce them have not had any great impact as yet. The gap in health inequalities has widened over the past 10 years, reflecting widening inequality in wealth and income.

Researchers from the universities of Sheffield and Bristol have built on previous research looking at socioeconomic differences in mortality, using updated population estimates and a new more accurate way of measuring poverty.

They analysed mortality data for England and Wales, obtained from the Office for National Statistics, and for Scotland, obtained from the General Register Office for Scotland.

The statistics for the entire population aged under 75 from 1990 to 2007 were used and the whole population aged under 65 from 1921-39, 1950-53, 1959-63, 1969-73 and 1981-2007.

The study found that geographical inequalities in age-sex standardised rates of mortality below age 75 have increased every two years from 1990-1 to 2006-7 without exception.

During this period, the poorest people were 1.6 times more likely to die prematurely than the most affluent people in 1990-1, and this difference increased so that by 2006-7, the worst off people were twice as likely to die prematurely than the most affluent people.

There was a small reduction in inequalities around 2001, but this trend quickly reversed and inequalities up to the age of 75 have now reached the highest levels reported since at least 1990.

A slight improvement in inequalities in mortality ratios was also noted in 2001 for people aged under 65, but this pattern has also reversed.

Historical records allow crudely age-sex standardised rates below age 65 to be compared and these reveal that geographical inequalities in mortality are higher in the most recent decade than in any similar time period for which records are available since at least 1921.

This means that the last time that inequalities were almost as high as they are now was in the lead up to the economic crash of 1929 and the economic depression of the 1930s.

The researchers conclude: "Although life expectancy for all people is increasing, the gap between the best and worst districts is continuing to increase. The economic crash of 2008 might precede even greater inequalities in mortality between areas in Britain."

BMJ-British Medical Journal

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