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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...

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Autores principales: Walsh, David, McCartney, Gerry, Minton, Jon, Parkinson, Jane, Shipton, Deborah, Whyte, Bruce
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
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.
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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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