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BMJ. 1996 Feb 3;312(7026):287-92.

Deprivation and cause specific morbidity: evidence from the Somerset and Avon survey of health.

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  • 1Department of Social Medicine, University of Bristol.

Abstract

OBJECTIVE:

To investigate the association between cause specific morbidity and deprivation in order to inform the debates on inequalities in health and health services resource allocation.

DESIGN:

Cross sectional postal questionnaire survey ascertaining self reported health status, with validation of a 20% sample through general practitioner and hospital records.

SETTING:

Inner city, urban, and rural areas of Avon and Somerset.

SUBJECTS:

Stratified random sample of 28,080 people aged 35 and over from 40 general practices.

MAIN OUTCOME MEASURES:

Age and sex standardised prevalence of various diseases; Townsend deprivation scores were assigned by linking postcodes to enumeration districts. Relative indices of inequality were calculated to estimate the magnitude of the association between socioeconomic position and morbidity.

RESULTS:

The response rate was 85.3%. The prevalence of most of the conditions rose with increasing material deprivation. The relative index of inequalilty, for both sexes combined, was greater than 1 for all conditions except diabetes. The conditions most strongly associated with deprivation were diabetic eye disease (relative index of inequality 3.21; 95% confidence interval 1.84 to 5.59), emphysema (2.72; 1.67 to 4.43) and bronchitis (2.27; 1.92 to 2.68). The relative index of inequality was significantly higher in women for asthma (P < 0.05) and in men for depression (P < 0.01). The mean reporting of prevalent conditions was 1.07 for the most deprived fifth of respondents and 0.77 in the most affluent fifth (P < 0.001).

CONCLUSIONS:

Material deprivation is strongly linked with many common diseases. NHS resource allocation should be modified to reflect such morbidity differentials.

PMID:
8611787
PMCID:
PMC2349904
[PubMed - indexed for MEDLINE]
Free PMC Article
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