Are social inequalities in mortality in Britain narrowing? Time trends from 1978 to 2005 in a population-based study of older men

Bibliographic Data

ID11178164
AuthorsSheena E Ramsay (0000-0002-0391-9704, The Royal Free Hospital, corresponding author), Richard Morris (0000-0003-0208-8440, The Royal Free Hospital), R W Morris, Lucy Lennon (0000-0002-1738-1351, The Royal Free Hospital), L T Lennon, Goya Wannamethee (0000-0001-9484-9977, The Royal Free Hospital), S G Wannamethee, Peter H Whincup (0000-0002-5589-4107, St George's, University of London)
Year2008
Volume62
Issue1
Pages75-80
Publication date2008-01-01
Open AccessNo
TypeARTICLE
VenueJournal of Epidemiology and Community Health (JOURNAL)
Journal identifiersISSN: 0143-005X • E-ISSN: 1470-2738
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/jech.2006.053207
PMID18079337
PMCIDPMC2709224
OpenAlexW2095933557
LanguageEN
Citations received4
References cited21

OBJECTIVE: To examine whether social inequalities in all-cause and coronary heart disease (CHD) mortality in Britain have reduced between 1978 and 2005. DESIGN: A prospective study of a socioeconomically representative population. SETTING: 24 British towns. PARTICIPANTS: 7735 Men, aged 40-59 years at recruitment in 1978-1980 and followed up until 2005 through the National Health Service Central Register (164 120 person-years). MAIN OUTCOME MEASURES: Relative hazards and absolute risk differences for all-cause and CHD death comparing manual with non-manual social classes, calculated for different calendar periods. RESULTS: 3009 Deaths from all causes (1003 from CHD) occurred during follow-up. The overall hazard ratio (manual versus non-manual) was 1.56 (95% CI 1.45 to 1.69, p<0.001) for all-cause mortality and 1.54 (95% CI 1.35 to 1.76, p<0.001) for CHD mortality. The relative difference between these social groups tended to increase over time. The overall relative increase in hazard ratio comparing manual with non-manual groups over a 20-year calendar period was 1.22 (95% CI 0.83 to 1.80, p = 0.31) for all-cause mortality and 1.75 (95% CI 0.89 to 3.45, p = 0.11) for CHD mortality. The absolute difference in probability of survival to age 65 years between non-manual and manual groups fell from 29% in 1981 to 19% in 2001 for all-cause mortality and from 17% to 7% for CHD mortality. CONCLUSION: Relative differences in all-cause and CHD mortality between manual and non-manual social class groups persisted and may have increased during this period. Absolute differences in mortality between these social groups decreased as a result of falling overall mortality rates. Greater effort is needed to reduce social inequalities in all-cause and CHD mortality in the new millennium

Absolute risk reduction · Cause of death · Confidence interval · Disease · Environmental health · Hazard ratio · Mortality rate · Population · Proportional hazards model · Relative risk · Social class · Cardiac Health and Mental Health · Demography · Employment and Welfare Studies · Health disparities and outcomes · Internal Medicine · Medicine · Surgery · Gerontology

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