Are socio-economic inequalities in mortality decreasing in Trent Region, UK? An observational study, 1988-1998

Background There is substantial national interest in the widening gap in socio-economic inequalities. The aim of this study was to examine time trends in age-specific mortality in Trent Region comparing rates by socio-economic deprivation from 1988 to 1998. Methods Mortality rates from 1988 to 1998 were calculated for each of five deprivation categories (derived using 1991-based enumeration district level Townsend scores) for men and women aged 45-54, 55-64, 65-74 and 75-84 years. Rate ratios (95 per cent confidence intervals) were calculated for the years 1988-1990 and 1996-1998, comparing the most deprived with the least deprived categories. Results For men aged 45-54, the rate ratio for the most deprived relative to the least deprived category was 2.42 (2.2-2.67) in 1988-1990 and 2.4 (2.17-2.65) in 1996-1998. Amongst women the ratio fell from 2.14 (1.88-2.42) to 1.67 (1.47-1.88). For men aged 55-64, the rate ratio fell from 2.07 (1.95-2.19) to 1.79 (1.67-1.91). For women the fall was from 1.99 (1.84-2.14) to 1.59 (1.46-1.73). For those aged 65-74, the fall was from 1.65 (1.58-1.72) to 1.33 (1.28-1.39) for men and from 1.55 (1.47-1.63) to 1.37 (1.30-1.45) for women. For people aged 75-84, no clear convergence in rates was seen. Conclusion There appear to be decreases in socio-economic inequalities in mortality between 1988 and 1998 in Trent Region. These trends run counter to those described in the majority of recent literature.