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ABSTRACT: Objective
To compare the trends in mortality inequalities by educational attainment with trends using area deprivation.Setting
Scotland and England & Wales (E&W).Participants
All people resident in Scotland and E&W between 1981 and 2011 aged 35-79 years.Primary outcome measures
Absolute inequalities (measured using the Slope Index of Inequality (SII)) and relative inequalities (measured using the Relative Index of Inequality (RII)) in all-cause mortality.Results
Relative inequalities in mortality by area deprivation have consistently increased for men and women in Scotland and E&W between 1981-1983 and 2010-2012. Absolute inequalities increased for men and women in Scotland, and for women in E&W, between 1981-1983 and 2000-2002 before subsequently falling. For men in E&W, absolute inequalities were more stable until 2000-2002 before a subsequent decline. Both absolute and relative inequalities were consistently higher in men and in Scotland. These trends contrast markedly with the reported declines in mortality inequalities by educational attainment and apparent improvement of Scotland's inequalities with those in E&W.Conclusions
Trends in health inequalities differ when assessed using different measures of socioeconomic status, reflecting either genuinely variable trends in relation to different aspects of social stratification or varying error or bias. There are particular issues with the educational attainment data in Great Britain prior to 2001 that make these education-based estimates less certain.
SUBMITTER: McCartney G
PROVIDER: S-EPMC5642664 | biostudies-literature | 2017 Jul
REPOSITORIES: biostudies-literature
McCartney Gerry G Popham Frank F Katikireddi Srinivasa Vittal SV Walsh David D Schofield Lauren L
BMJ open 20170721 7
<h4>Objective</h4>To compare the trends in mortality inequalities by educational attainment with trends using area deprivation.<h4>Setting</h4>Scotland and England & Wales (E&W).<h4>Participants</h4>All people resident in Scotland and E&W between 1981 and 2011 aged 35-79 years.<h4>Primary outcome measures</h4>Absolute inequalities (measured using the Slope Index of Inequality (SII)) and relative inequalities (measured using the Relative Index of Inequality (RII)) in all-cause mortality.<h4>Resul ...[more]