Geographical and social class effects on asthma mortality in England and Wales.
To determine whether asthma mortality is influenced by geographical or social factors, a retrospective analysis of deaths from asthma in England and Wales between 1979-1987 was performed. Death rates in the 15 Regional Health Authority areas of England and Wales were stratified by sex, age group (0-4, 5-34, 35-64, and > 64 years), and occupational social class. Detailed analysis was restricted to subjects aged 5-64 years because adequate social class data was only available over this age range. Death rates were higher in manual occupational groups (social class IIIb-V) than in non-manual occupations (social class I-IIIa), but on further analysis this effect was confined to males aged 35-64 years. In younger subjects (5-34 years), mortality was higher in the south of the country, and this difference was significant in males (P < 0.05). In older subjects (35-64 years), mortality in both sexes was significantly higher in the north of the country. This study demonstrates that mortality is not evenly distributed between social classes or regions of the country.
Higgins
B G
BG
Wythenshawe Hospital, Manchester, U.K.
Britton
J R
JR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001249:Asthma / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000401:mortality*; D012189:Retrospective Studies; D017678:Sex Distribution; D012923:Social Class; D014852:Wales / Q000453:epidemiology