Socio-economic disparities in mortality due to pandemic influenza in England.
OBJECTIVE
This study examines variations in mortality between socio-economic groups due to the pandemic Influenza (H1N1) 2009 virus in England.


METHODS
We established a system to identify all deaths related to pandemic (H1N1) 2009 influenza. We collected the postcode of every individual who died, and through this determined the socio-economic deprivation, urban-rural characteristics and region of their residence. Across England, we were therefore able to examine how mortality rates varied by socio-economic group, between urban and rural areas, and between regions.


RESULTS
People in the most deprived quintile of England's population had an age and sex-standardised mortality rate three times that experienced by the least deprived quintile (RR = 3.1, 95% CI 2.2-4.4). Mortality was also higher in urban areas than in rural areas (RR = 1.7, 95% CI 1.2-2.3). Mortality rates were similar between regions of the country.


CONCLUSIONS
Tackling socio-economic health inequalities is a central concept within public health, but has not always been a part of emergency preparedness plans. These data demonstrate the opportunity to reduce the overall impact and narrow inequalities by considering socio-economic disparities in future pandemic planning.
Imperial College, London, UK. p.d.rutter@gmail.com
Paul D
PD
Rutter
Oliver T
OT
Mytton
Matthew
M
Mak
Liam J
LJ
Donaldson
D000293:Adolescent; D000328:Adult; D000368:Aged; D004739:England / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000191:economics / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult