Phillimore P, Beattie A, Townsend P
Department of Social Policy, University of Newcastle, Newcastle upon Tyne.
BMJ. 1994 Apr 30;308(6937):1125-8. doi: 10.1136/bmj.308.6937.1125.
To identify relative and absolute changes in mortality in the Northern region of England between 1981 and 1991.
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 (all causes) were calculated for various periods between 1981 and 1991 and for different age categories.
Counties of Cleveland, Cumbria, Durham, Northumberland, and Tyne and Wear.
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.
These results re-emphasise the case for linking mortality patterns with material conditions rather than individual behaviour.
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。
利用1981年和1991年的人口普查数据，根据由四个变量（失业、汽车拥有量、住房保有形式、家庭过度拥挤）组成的物质匮乏指数对678个选区进行排名。计算了1981年至1991年间不同时期以及不同年龄类别的标准化死亡率（所有原因）。
克利夫兰、坎布里亚、达勒姆、诺森伯兰以及泰恩-威尔郡。
在1981 - 1991年期间，75岁以下所有年龄类别的选区中，最富裕的五分之一选区和最贫困的五分之一选区之间的死亡率差异扩大。最贫困地区相对地位的下降尤为显著，社会经济谱其余部分的不平等现象没有缩小。从绝对意义上讲，最富裕地区所有年龄类别的死亡率都有所改善。在最贫困地区，55 - 64岁年龄组死亡率的改善被15 - 44岁男性死亡率的上升、65 - 74岁女性死亡率的略有上升以及45 - 54岁男性死亡率的稳定所抵消。
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理由。
