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Changing mortality trends in countries and cities of the UK: a population-based trend analysis
OBJECTIVES: Previously improving life expectancy and all-cause mortality in the UK has stalled since the early 2010s. National analyses have demonstrated changes in mortality rates for most age groups and causes of death, and with deprived populations most affected. The aims here were to establish w...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646340/ https://www.ncbi.nlm.nih.gov/pubmed/33154048 http://dx.doi.org/10.1136/bmjopen-2020-038135 |
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author | Walsh, David McCartney, Gerry Minton, Jon Parkinson, Jane Shipton, Deborah Whyte, Bruce |
author_facet | Walsh, David McCartney, Gerry Minton, Jon Parkinson, Jane Shipton, Deborah Whyte, Bruce |
author_sort | Walsh, David |
collection | PubMed |
description | OBJECTIVES: Previously improving life expectancy and all-cause mortality in the UK has stalled since the early 2010s. National analyses have demonstrated changes in mortality rates for most age groups and causes of death, and with deprived populations most affected. The aims here were to establish whether similar changes have occurred across different parts of the UK (countries, cities), and to examine cause-specific trends in more detail. DESIGN: Population-based trend analysis. PARTICIPANTS/SETTING: Whole populations of countries and selected cities of the UK. PRIMARY AND SECONDARY OUTCOME MEASURES: European age-standardised mortality rates (calculated by cause of death, country, city, year (1981–2017), age group, sex and—for all countries and Scottish cities—deprivation quintiles); changes in rates between 5-year periods; summary measures of both relative (relative index of inequality) and absolute (slope index of inequality) inequalities. RESULTS: Changes in mortality from around 2011/2013 were observed throughout the UK for all adult age groups. For example, all-age female rates decreased by approximately 4%–6% during the 1980s and 1990s, approximately 7%–9% during the 2000s, but by <1% between 2011/2013 and 2015/2017. Equivalent figures for men were 4%–7%, 8%–12% and 1%–3%, respectively. This later period saw increased mortality among the most deprived populations, something observed in all countries and cities analysed, and for most causes of death: absolute and relative inequalities therefore increased. Although similar trends were seen across all parts of the UK, particular issues apply in Scotland, for example, higher and increasing drug-related mortality (with the highest rates observed in Dundee and Glasgow). CONCLUSIONS: The study presents further evidence of changing mortality in the UK. The timing, geography and socioeconomic gradients associated with the changes appear to support suggestions that they may result, at least in part, from UK Government ‘austerity’ measures which have disproportionately affected the poorest. |
format | Online Article Text |
id | pubmed-7646340 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-76463402020-11-10 Changing mortality trends in countries and cities of the UK: a population-based trend analysis Walsh, David McCartney, Gerry Minton, Jon Parkinson, Jane Shipton, Deborah Whyte, Bruce BMJ Open Public Health OBJECTIVES: Previously improving life expectancy and all-cause mortality in the UK has stalled since the early 2010s. National analyses have demonstrated changes in mortality rates for most age groups and causes of death, and with deprived populations most affected. The aims here were to establish whether similar changes have occurred across different parts of the UK (countries, cities), and to examine cause-specific trends in more detail. DESIGN: Population-based trend analysis. PARTICIPANTS/SETTING: Whole populations of countries and selected cities of the UK. PRIMARY AND SECONDARY OUTCOME MEASURES: European age-standardised mortality rates (calculated by cause of death, country, city, year (1981–2017), age group, sex and—for all countries and Scottish cities—deprivation quintiles); changes in rates between 5-year periods; summary measures of both relative (relative index of inequality) and absolute (slope index of inequality) inequalities. RESULTS: Changes in mortality from around 2011/2013 were observed throughout the UK for all adult age groups. For example, all-age female rates decreased by approximately 4%–6% during the 1980s and 1990s, approximately 7%–9% during the 2000s, but by <1% between 2011/2013 and 2015/2017. Equivalent figures for men were 4%–7%, 8%–12% and 1%–3%, respectively. This later period saw increased mortality among the most deprived populations, something observed in all countries and cities analysed, and for most causes of death: absolute and relative inequalities therefore increased. Although similar trends were seen across all parts of the UK, particular issues apply in Scotland, for example, higher and increasing drug-related mortality (with the highest rates observed in Dundee and Glasgow). CONCLUSIONS: The study presents further evidence of changing mortality in the UK. The timing, geography and socioeconomic gradients associated with the changes appear to support suggestions that they may result, at least in part, from UK Government ‘austerity’ measures which have disproportionately affected the poorest. BMJ Publishing Group 2020-11-05 /pmc/articles/PMC7646340/ /pubmed/33154048 http://dx.doi.org/10.1136/bmjopen-2020-038135 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Public Health Walsh, David McCartney, Gerry Minton, Jon Parkinson, Jane Shipton, Deborah Whyte, Bruce Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
title | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
title_full | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
title_fullStr | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
title_full_unstemmed | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
title_short | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
title_sort | changing mortality trends in countries and cities of the uk: a population-based trend analysis |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646340/ https://www.ncbi.nlm.nih.gov/pubmed/33154048 http://dx.doi.org/10.1136/bmjopen-2020-038135 |
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