Spatial and temporal variation of mortality and deprivation 1: widening health inequalities

In this paper we examine the relationship between premature mortality and material deprivation both over time (the intercensal period, 1981 - 91) and over space (for the population in wards and ward groups in Wales). Our focus is on the methods of analysis for small area (ward-based) multiple cross-section mortality data and their application to the substantive issue of the persistent and widening inequalities in Wales. In this paper we examine all-cause deaths and mortality by specific disease classes for groups (quintiles) of wards ranked according to standard measures of material deprivation. Although there have been reductions in premature mortality across all deprivation groups in Wales, over the decade, the gap has widened between the most and least deprived areas. Mortality decline in the largest disease category (circulatory) was found to be significantly lower in the most deprived quintile of wards than in the rest of Wales. Compared with results from the North of England, mortality decline in Wales has been rather greater.