Regional inequalities in premature mortality in Great Britain.

Thomas Plümper,Eric Neumayer,Denise Laroze

doi:10.1371/journal.pone.0193488

Abstract

Premature mortality exhibits strong spatial patterns in Great Britain. Local authorities that are located further North and West, that are more distant from its political centre London and that are more urban tend to have a higher premature mortality rate. Premature mortality also tends to cluster among geographically contiguous and proximate local authorities. We develop a novel analytical research design that relies on spatial pattern recognition to demonstrate that an empirical model that contains only socio-economic variables can eliminate these spatial patterns almost entirely. We demonstrate that socioeconomic factors across local authority districts explain 81 percent of variation in female and 86 percent of variation in male premature mortality in 2012–14. As our findings suggest, policy-makers cannot hope that health policies alone suffice to significantly reduce inequalities in health. Rather, it requires strong efforts to reduce the inequalities in socio-economic factors, or living conditions for short, in order to overcome the spatial disparities in health, of which premature mortality is a clear indication.

Highlights

The probability to die prematurely in Great Britain exhibits strong spatial patterns–stronger than in most other Western European countries [1]
In a cross-sectional analysis of premature mortality in 378 out of 380 local authorities in Great Britain in 2012–14, we find that the local authority characteristics of average income, dependency on welfare benefits, educational qualification, sectoral employment composition, socioeconomic position, and ethnic composition almost completely account for spatial patterns in premature mortality
With the exception of the West-East divide, we find that socioeconomic factors reduce the spatial patterns in premature mortality more for men than for women

Summary

Introduction

The probability to die prematurely in Great Britain exhibits strong spatial patterns–stronger than in most other Western European countries [1]. With the exception of the West-East divide, we find that socioeconomic factors reduce the spatial patterns in premature mortality more for men than for women. Omitted reference categories are ‘not working’, ‘other ethnicity’, ‘entry level educational qualification’ and ‘other sector’, respectively

Findings

Discussion

Conclusion