O'Reilly D, Stevenson M
Health and Health Care Research Unit, Queen's University of Belfast.
J Public Health Med. 1998 Jun;20(2):161-8. doi: 10.1093/oxfordjournals.pubmed.a024737.
The aim of this study was to examine differences in socio-economic standing and ill health between the two communities in Northern Ireland.
This was a descriptive epidemiological study. Deaths from 1991 to 1995 inclusive were used to calculate standardized mortality rates (SMR, under 75 years) at small level using the 1991 Census population estimates. The standardized limiting long-term illness ratios (SIR) were based on the appropriate Census question. Regression models were tested with SMR and SIR as dependent variables and a wide range of socio-economic indicators, including income support and family credit uptake, as independent predictors.
Northern Ireland is a very polarized society. More than 60 per cent of the population live in areas which have more than 80 per cent of one religion. Areas with a preponderance of Catholics tend to be more deprived. Unemployment rates, percentage renting, car availability, and education attainment are all worse in Catholic areas. However, there is considerable heterogeneity between areas with similar levels of religious affiliation and the overall pattern varies with the indicator chosen. SMRs rise stepwise with increasing percentage of Catholics. SIRs increase with increasing polarization of areas, but this is much more marked in those with a predominantly Catholic affiliation. Altogether 46.8 per cent of the variance in SMR and 77.9 per cent of that of SIRs could be explained by socio-economic variables alone. Denomination did not have any residual predictive value.
Policy-makers should continue to periodically monitor for differences between the two communities including any differences in service accessibility and uptake. Efforts should be directed towards reducing the inequalities in health for all sections of the community.
本研究旨在考察北爱尔兰两个社区在社会经济地位和健康不佳状况方面的差异。
这是一项描述性流行病学研究。利用1991年至1995年（含）的死亡数据，根据1991年人口普查的人口估计数，在小区域层面计算75岁以下人群的标准化死亡率（SMR）。标准化长期慢性病比率（SIR）基于适当的人口普查问题。以SMR和SIR作为因变量，以包括收入支持和家庭信贷获取情况在内的一系列社会经济指标作为独立预测因素，对回归模型进行了检验。
北爱尔兰是一个两极分化非常严重的社会。超过60%的人口生活在某一宗教人口占比超过80%的地区。天主教徒占多数的地区往往更加贫困。天主教地区的失业率、租房比例、汽车拥有率和受教育程度都更低。然而，宗教归属水平相似的地区之间存在相当大的异质性，总体模式因所选指标而异。SMR随着天主教徒比例的增加而逐步上升。SIR随着地区两极分化程度的增加而上升，但在以天主教徒为主的地区更为明显。仅社会经济变量就可以解释SMR中46.8%的方差和SIR中77.9%的方差。宗教派别没有任何剩余的预测价值。
政策制定者应继续定期监测两个社区之间的差异，包括服务可及性和利用率方面的任何差异。应努力减少社区各阶层在健康方面的不平等现象。
