Inequalities in mortality and illness in Trent NHS Region

Natasha HUFF, Christine MACLEOD, David EBDON, David Rosser PHILLIPS, Lindsey DAVIES, Andy NICHOLSON

Research output: Journal PublicationsJournal Article (refereed)peer-review

14 Citations (Scopus)


BACKGROUND:The Department of Health is encouraging health authorities to improve health status by tackling health inequalities. We defined ward level spatial health variations in Trent National Health Service Region, England, investigated urban and rural inequalities, and examined the relationship with deprivation, to identify the extent of small area health inequalities and to establish whether a quantifiable difference exists between urban and rural health as affected by deprivation. METHOD: A small area ecological study design was adopted and ward level (n=591) standardized ratios were calculated (population aged RESULTS: Wide variations in mortality and illness were evident at ward level, being widest for accident mortality (standardized mortality range 0-508). Stroke mortality accounted for the largest proportion of wards with standardized mortality ratios over 125 (36.2 per cent). Relative deprivation correlated strongly with limiting long-term illness (r=0.82) and all-cause mortality (r=0.68) across Trent, and in both urban and rural environments. CONCLUSION: The study set health inequalities within a regional context for Trent as an initiative to coincide with the Government's proposed health strategy for the next few years. Wide health inequalities were evident in Trent and the association between deprivation and health was of a similar magnitude in urban and rural wards. This small area approach allows health authorities access to ward level information in order to inform key debate on tackling health inequalities and distributing resources in relation to need.
Original languageEnglish
Pages (from-to)81-87
Number of pages7
JournalJournal of Public Health Medicine
Issue number1
Publication statusPublished - 1 Mar 1999
Externally publishedYes


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