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Does the variation in the socioeconomic characteristics of an area affect mortality?

BMJ 1996; 312 doi: (Published 20 April 1996) Cite this as: BMJ 1996;312:1013
  1. Yoav Ben-Shlomo, lecturer in clinical epidemiologya,
  2. Ian R White, lecturer in medical statisticsb,
  3. Michael Marmot, professor of epidemiology and public healtha
  1. a International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, London WC1E 6BT
  2. b Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  1. Correspondence to: Dr Ben-Shlomo.
  • Accepted 23 November 1995

Our research in England has shown that the more deprived an area the greater its incidence of premature mortality.1 Wilkinson has argued that in the developed world income distribution is a more important predictor of life expectancy between countries than simply mean income.2 We aimed to determine whether the risk of mortality in a geographical area was related to the degree of socioeconomic variation within that area as well as the average level of deprivation.

Methods and results

For each of the 8464 wards in England we obtained the Townsend deprivation index from the 1981 census1 and directly standardised all cause mortality for 1981-5. Mortality under the age of 65 was used as an indicator of premature mortality. Male and female mortality rates were averaged for each ward. Twenty four wards were …

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