Comparisons between geographies of mortality and deprivation from the 1900s and 2001: spatial analysis of census and mortality statistics.

Full Abstract

OBJECTIVES: To examine the geographical relation between mortality and deprivation in England and Wales at the start of the 20th and 21st centuries. To explore the evidence for a strengthening or weakening of this relation over the century and test for relations between the mortality and deprivation patterns of a century ago and modern mortality and causes of death. DESIGN: Census and mortality data for 634 districts from the 1900s directly compared with interpolated ward level data from 2001. SETTING: Census data and national statistics for England and Wales in the 1900s and 2001. Population Entire population in both periods. MAIN OUTCOME MEASURES: Standardised mortality ratios for all districts for both periods with additional cause specific ratios calculated for 2001. Deprivation (Carstairs) scores for each district in 2001, with comparable measure created for the 1900s. Correlations and partial correlations between deprivation scores and standardised mortality ratios in the 1900s and 2001 for the 614 districts for which all data were available. RESULTS: The was no evidence of a significant change in the strength of the relation between deprivation and mortality between the start and end of the 20th century. Modern patterns of mortality and deprivation remain closely related to the patterns of a century ago. Even after adjustment for modern deprivation, standardised mortality ratios from the 1900s show a significant correlation with modern mortality and most modern causes of death. Conversely, however, there was no significant relation between deprivation in the 1900s and modern mortality for most causes of death after adjustment for modern deprivation. CONCLUSIONS: Despite all the medical, public health, social, economic, and political changes over the 20th century, patterns of poverty and mortality and the relations between them remain firmly entrenched. There is a strong relation between the mortality levels of a century ago and those of today. This goes beyond what would have been expected from the continuing relation between deprivation and mortality and holds true for most major modern causes of death.

Author information

Author/s: Gregory, Ian N (IN);

Affiliation: Faculty of Arts and Social Sciences, Furness College, Lancaster University, Lancaster LA1 4YG. I.Gregory(-atsign-)lancaster.ac.uk

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't

Journal: BMJ (Clinical research ed.) (BMJ), published in England. (Language: eng)

Reference: 2009-; vol 339 (issue ) : pp b3454

Dates: Created 2009/09/11; Completed 2009/09/24;

PMID: 19744974, status: MEDLINE (last retrieval date: 9/24/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.