Br Med J (Clin Res Ed) 1988;296:1221-1224 (30 April), doi:10.1136/bmj.296.6631.1221
Inequalities in women's health: looking at mortality differentials using an alternative approach
Kath A Moser,
Helena S Pugh,
Peter O Goldblatt
Data obtained from follow up of the 1971 census sample in the
Office of Population Censuses and Surveys longitudinal study
of England and Wales were used to look at women's mortality
differentials at ages 15-59. Women were grouped by combining
information on marital state, own occupation, husband's occupation
(if married), economic activity, and indicators of household
wealth (housing tenure and access to a car). Large groups were
found with considerable differences in mortality. High mortality
was associated with working in manual occupations and living
in rented housing with no car in the household. In contrast,
low mortality was associated with non-manual occupations and
living in owner occupied housing with a car. Among married housewives
and single women these extreme groups contributed 44% of expected
deaths, the disadvantaged group experiencing death rates two
and a half times that of the advantaged group. Smaller differences
were found among married women with an occupational class.
These findings are further evidence of the "health divide" in England and Wales and show that accurately to reflect the relation between a woman's life circumstances and mortality it is necessary to utilise other measures than those based solely on occupation.

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