Intended for healthcare professionals

Rapid response to:

Papers

Vulnerability to winter mortality in elderly people in Britain: population based study

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.38167.589907.55 (Published 16 September 2004) Cite this as: BMJ 2004;329:647

Rapid Response:

Study conundrum

The report by Wilkinson et al (1) that economic deprivation is not a
predictor of winter mortality echoes a finding we made in 2001 that the
social class gap in hospital admissions is narrower in winter (2)

In our paper we discussed a number of possible explanations - for
example that winter excess morbidity and mortality might result not from
increased mortality and morbidity in winter but reduced morbidity and
mortality in summer, which might be experienced most by those with the
resources to use leisure opportunities or protect themselves from the
effects of heat-waves. However we did say that we thought our data was
probably wrong. It was the preparatory study result only and was the
opposite of what we expected. (We only published it out of scientific
integrity.)

We fully expected a better larger study to refute our finding but
instead it has been supported. This is a challenging intellectual
conundrum. The idea that poverty is not a predictor of the likelihood of
succumbing to the consequences of ambient cold is so counterintuitive that
it seems hard to believe.

Competing interests:
None declared

Competing interests: No competing interests

07 October 2004
Stephen J Watkins
Director of Public Health
Marie McDevitt
Stockport PCT, SK4 3DD