Bentham G, Eimermann J, Haynes R, Lovett A, Brainard J
School of Environmental Sciences, University of East Anglia, Norwich, Norfolk.
J Epidemiol Community Health. 1995 Dec;49 Suppl 2(Suppl 2):S57-64. doi: 10.1136/jech.49.suppl_2.s57.
To examine geographical variation in limiting long-term illness in England and Wales and assesses the extent of its similarity with the distribution of mortality rates and of deprivation.
A geographically based study using data from the 1991 census on limiting long term illness. Maps and regression analysis are used to compare the distribution of standardised illness ratios with standardised mortality ratios and indicators of social deprivation.
A total of 401 local authority districts in England and Wales.
The population of England and Wales enumerated in the 1991 census.
The geographical pattern of limiting long term illness shows many similarities with that of mortality but there are also some differences. Both are positively associated with indicators of social deprivation, with limiting long term illness tending to show stronger correlations, particularly in the elderly. Most of Wales and many industrial areas of northern England have higher rates of long term illness than would be expected from their mortality rates, while much of south eastern England has lower than expected rates.
Moves towards using data on limiting long term illness instead of standardised mortality rates would have important implications for NHS resource allocations. Further assessment of the reliability of these data on self reported morbidity is required. in particular, there is a need to assess how much they reflect real differences in ill health rather than the influence of socioeconomic or cultural factors affecting the likelihood of a positive answer to the census question on limiting long term illness.
研究英格兰和威尔士长期慢性病的地理差异，并评估其与死亡率分布及贫困程度的相似程度。
基于地理的研究，使用1991年人口普查中关于长期慢性病的数据。运用地图和回归分析来比较标准化疾病比率与标准化死亡率及社会剥夺指标的分布情况。
英格兰和威尔士的401个地方政府辖区。
1991年人口普查中统计的英格兰和威尔士人口。
长期慢性病的地理分布模式与死亡率的模式有许多相似之处，但也存在一些差异。两者均与社会剥夺指标呈正相关，长期慢性病的相关性往往更强，尤其是在老年人中。威尔士大部分地区和英格兰北部的许多工业区的长期慢性病发病率高于根据其死亡率所预期的水平，而英格兰东南部的许多地区则低于预期水平。
采用长期慢性病数据而非标准化死亡率数据将对国民健康服务体系（NHS）的资源分配产生重要影响。需要进一步评估这些自我报告发病率数据的可靠性。特别是，有必要评估这些数据在多大程度上反映了健康状况的实际差异，而非社会经济或文化因素对普查中关于长期慢性病问题给出肯定回答可能性的影响。
