WIDENING INEQUALITY OF HEALTH IN NORTHERN ENGLAND, 1981-91
WIDENING INEQUALITY OF HEALTH IN NORTHERN ENGLAND, 1981-91
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DOI：
10.1136/bmj.308.6937.1125
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发表时间：
1994-04-30
影响因子：
--
通讯作者：
TOWNSEND, P
中科院分区：
文献类型：
--
作者：
PHILLIMORE, P;BEATTIE, A;TOWNSEND, P
目的：确定1981年至1991年间英格兰北部地区死亡率的相对和绝对变化。1981年设计和1991年人口普查数据被用来对678个区进行物质剥夺指数排名，该指数由四个变量（失业、汽车所有权、住房保有、家庭过度拥挤）组成。对1981年至1991年不同时期和不同年龄组的标准化死亡率（ah原因）进行了计算。设置-克利夫兰、坎布里亚、达勒姆、诺森伯兰和泰恩威尔郡。结果：1981-91年期间，75岁以下所有年龄组中最富裕的五分之一病房和最贫困的五分之一病房之间的死亡率差距扩大。最贫穷地区相对地位的下降尤其显著，其余社会经济阶层的不平等现象没有缩小。按绝对数字计算，最富裕地区所有年龄组的死亡率都有所改善。在最贫穷地区，55-64岁年龄组的改善与15-44岁男子死亡率上升、65-74岁妇女死亡率略有上升以及45-54岁男子死亡率持平相平衡。结论：这些结果再次强调了将死亡率模式与物质条件而非个人行为联系起来的情况。
Objective-To identify relative and absolute changes in mortality in the Northern region of England between 1981 and 1991.Design-1981 and 1991 census data were used to rank 678 wards on an index of material deprivation composed of four variables (unemployment, car ownership, housing tenure, household overcrowding). Standardised mortality ratios (ah causes) were calculated for various periods between 1981 and 1991 and for different age categories.Setting-Counties of Cleveland, Cumbria, Durham, Northumberland, and Tyne and Wear.Results-During 1981-91 mortality differentials widened between the most affluent and deprived fifths of wards in all age categories under 75 years. The decline in the relative position of the poorest areas was particularly great, and there was no narrowing of inequalities across the remainder of the socioeconomic spectrum. In absolute terms, there were improvements in mortality in all age categories in the most affluent areas. In the poorest areas improvements in the 55-64 age group were balanced by increased mortality among men aged 15-44, a slight rise among women aged 65-74, and static rates among men aged 45-54.Conclusions-These results re-emphasise the case for linking mortality patterns with material conditions rather than individual behaviour.