North-south divide in social inequalities in Great Britain: Divide in social class inequalities may exist but is small

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7456.52 (Published 01 July 2004) Cite this as: BMJ 2004;329:52
  1. J Martin Bland, professor of health statistics (mb55{at}york.ac.uk)
  1. Department of Health Sciences, University of York, York YO10 5DD

    EDITOR—Doran et al conclude that a northwest-southeast divide in social class inequalities existed in Great Britain at the start of the 21st century.1 They present tables and summary statistics but no analysis to support this statement. Inspection of their tables shows that the differences between the socioeconomic groups are very consistent between the regions.

    Using their data for both men and women, for socioeconomic groups 1 to 7, I found that socioeconomic class was the best predictor of rating health as “not good,” accounting for 74.7% of the variation in rate of reporting poor health, followed by region, which accounted for 18.5%. The extent to which there is regional variation in social class inequalities, as measured by the interaction between socioeconomic class and region, accounted for only 2.5% of the variation (though this was significant, P < 0.0001, the sample being very large). Sex and its interactions accounted for 3.9% of the variability, leaving only 0.4% unaccounted for. Hence we should conclude that socioeconomic class is a far better predictor of reported health than is region and that the differences between socioeconomic classes do not vary much between regions.

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    In addition, this is reported, not actual, health and a fairly crude indicator. Also, association does not necessarily imply causation. Ill health may lead to a slide down the socioeconomic ladder and prevent migration to more affluent areas.


    • Competing interests None declared.


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