Drever F, Whitehead M, Roden M
Dept. of Public Health and Sciences, Karolinska Institute, Stockholm, Sweden.
Popul Trends. 1996 Winter(86):15-20.
Every ten years, information from the decennial census is used together with national death registration data to study socio-economic differences in mortality. This article reports the findings of one of the analyses prepared for the latest decennial supplement. This volume is due for publication late in 1997. Over 175,000 deaths of men aged 20-64 in England and Wales were analysed using the Registrar General's Social Class (based on occupation) schema. The social gradient in all-cause mortality observed in earlier decades is still seen in 1991-93. In absolute terms, there has been a fall in mortality rates in England and Wales over the twenty-year period 1970-72 to 1991-93. This is reflected in the falls in mortality rates for each of the social classes I to IV over the two decades. In contrast, the mortality rate of Social Class V rose in the early 1980s. Since then, it has fallen. However, it is still higher than in the early 1970s. Trends in mortality show a relative widening of social differentials developing over this period. This is true for all-cause mortality and for the specific causes investigated in this article. Mortality is almost three times higher in Social Class V (SMR 189) than in Social Class I (SMR 66). Classes IIIM and IV (SMRs 117, 116 respectively) have nearly double the mortality of Class I. Even larger differentials are observed for stroke, lung cancer and suicide.
每十年,十年一次的人口普查信息会与国家死亡登记数据一同用于研究死亡率方面的社会经济差异。本文报告了为最新的十年期增刊所做的一项分析结果。这本书定于1997年末出版。使用总登记官的社会阶层(基于职业)模式,对英格兰和威尔士175,000多名年龄在20至64岁之间男性的死亡情况进行了分析。在1991 - 1993年仍能看到前几十年所观察到的全因死亡率的社会梯度。从绝对数字来看,在1970 - 1972年至1991 - 1993年的二十年期间,英格兰和威尔士的死亡率有所下降。这反映在二十年间社会阶层I至IV中每个阶层的死亡率都在下降。相比之下,社会阶层V的死亡率在20世纪80年代初有所上升。从那时起,它有所下降。然而,它仍然高于20世纪70年代初。死亡率趋势表明,在此期间社会差异在相对扩大。全因死亡率以及本文所研究的特定病因都是如此。社会阶层V的死亡率(标准化死亡比189)几乎是社会阶层I(标准化死亡比66)的三倍。IIIM和IV阶层(标准化死亡比分别为117、116)的死亡率几乎是I阶层的两倍。在中风、肺癌和自杀方面观察到的差异甚至更大。