title: A Typology for Charting Socioeconomic Mortality Gradients: "Go Southwest".
abstract: Holistic depiction of time-trends in average mortality rates, and absolute and relative inequalities, is challenging.
  
  
  
  We outline a typology for situations with falling average mortality rates (m↓; e.g., cardiovascular disease), rates stable over time (m-; e.g., some cancers), and increasing average mortality rates (m↑; e.g., suicide in some contexts). If we consider inequality trends on both the absolute (a) and relative (r) scales, there are 13 possible combination of m, a, and r trends over time. They can be mapped to graphs with relative inequality (log relative index of inequality [RII]; r) on the y axis, log average mortality rate on the x axis (m), and absolute inequality (slope index of inequality; SII; a) as contour lines. We illustrate this by plotting adult mortality trends: (1) by household income from 1981 to 2011 for New Zealand, and (2) by education for European countries.
  
  
  
  Types range from the "best" m↓a↓r↓ (average, absolute, and relative inequalities all decreasing; southwest movement in graphs) to the "worst" m↑a↑r↑ (northeast). Mortality typologies in New Zealand (all-cause, cardiovascular disease, nonlung cancer, and unintentional injury) were all m↓r↑ (northwest), but variable with respect to absolute inequality. Most European typologies were m↓r↑ types (northwest; e.g., Finland), but with notable exceptions of m-a↑r↑ (north; e.g., Hungary) and "best" or southwest m↓a↓r↓ for Spain (Barcelona) females.
  
  
  
  Our typology and corresponding graphs provide a convenient way to summarize and understand past trends in inequalities in mortality, and hold potential for projecting future trends and target setting.
authors.affiliation: From the aDepartment of Public Health, University of Otago, Wellington, New Zealand; and bDepartment of Public Health, Erasmus MC, Rotterdam, Netherlands.
authors.forename: Tony
authors.initials: T
authors.lastname: Blakely
authors.forename: George
authors.initials: G
authors.lastname: Disney
authors.forename: June
authors.initials: J
authors.lastname: Atkinson
authors.forename: Andrea
authors.initials: A
authors.lastname: Teng
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009369:Neoplasms / Q000401:mortality*; D009520:New Zealand; D018570:Risk Assessment; D012737:Sex Factors; D012959:Socioeconomic Factors