Regional inequalities in mortality.
OBJECTIVE
To examine the hypothesis of sustained and persistent inequalities in health between British regions and to ask how far they are a consequence of using standardised mortality ratios as the tool of measurement.


METHODS
Data are regional, age specific death rates at seven points in time from 1931 to 1987-89 for the British regions, reconstructed to make them comparable with the 1981 regional definitions. Log variance is used to measure inequality; regional rankings are also used.


RESULTS
There has been a substantial convergence in age specific death rates between regions in younger but not in older age groups. In younger age groups the historic north/south gradient has disappeared; it persists in older groups.


CONCLUSIONS
Use of standardised mortality ratios obscures differences in the convergence rates of age specific death rates between regions. Simple conclusions about the persistence of a north/south divide are not justified. Different processes of change seem to be at work in different age groups.
Illsley
R
R
School of Social Studies, University of Bath.
Le Grand
J
J
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D017678:Sex Distribution; D006113:United Kingdom / Q000453:epidemiology