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Regional Inequalities in Mortality

Raymond Illsley and Julian Le Grand
Journal of Epidemiology and Community Health (1979-)
Vol. 47, No. 6 (Dec., 1993), pp. 444-449
Published by: BMJ
Stable URL: http://www.jstor.org/stable/25567808
Page Count: 6
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Regional Inequalities in Mortality
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Abstract

Study objective-To examine the hypothesis of sustained and persistent inequalities in health between British regions and to ask how far they are a consequence of using standardised mortality ratios as the tool of measurement. Design, setting and participants-Data are regional, age specific death rates at seven points in time from 1931 to 1987-89 for the British regions, reconstructed to make them comparable with the 1981 regional definitions. Log variance is used to measure inequality; regional rankings are also used. Measurements and main results-There has been a substantial convergence in age specific death rates between regions in younger but not in older age groups. In younger age groups the historic north/south gradient has disappeared; it persists in older groups. Conclusions-Use of standardised mortality ratios obscures differences in the convergence rates of age specific death rates between regions. Simple conclusions about the persistence of a north/south divide are not justified. Different processes of change seem to be at work in different age groups.

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