ArticleBMJ (Clinical research ed.)2012
Impact on health inequalities of rising prosperity in England 1998-2007, and implications for performance incentives: longitudinal ecological study.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Local government funding and life expectancy in England: a longitudinal ecological study.The Lancet. Public health · 2021Article
- Trends in Life Expectancy and Its Association with Economic Factors in the Belt and Road Countries-Evidence from 2000⁻2014.International journal of environmental research and public health · 2018Article
- Investigating the impact of the English health inequalities strategy: time trend analysis.BMJ (Clinical research ed.) · 2017Article
- Healthier central England or North-South divide? Analysis of national survey data on smoking and high-risk drinking.BMJ open · 2017Article
- Desperately seeking reductions in health inequalities: perspectives of UK researchers on past, present and future directions in health inequalities research.Sociology of health & illness · 2016Article
- Article
- Youth unemployment and economic recession in Spain: influence on health and lifestyles in young people (16-24 years old).International journal of public health · 2015Article
- The impact of NHS resource allocation policy on health inequalities in England 2001-11: longitudinal ecological study.BMJ (Clinical research ed.) · 2014Article
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3 authors.
Funding
Abstract
objectiveTo investigate whether the uneven rise in prosperity between 1999 and 2008 accounted for differential increases in life expectancy in English local authorities.
designLongitudinal ecological study.
setting324 local authorities in England, classified by their baseline level of deprivation. M: ain outcome measures Multivariable regression was used to investigate the association between trends in prosperity between 1998 and 2007 and trends in life expectancy. Trends in health inequalities were assessed by comparing the experience of Spearhead local authorities (the 70 most deprived in 1998) with the average for all English local authorities.
resultsThose local authorities that experienced the greatest improvement in prosperity experienced greater increases in life expectancy. With each 1% absolute decline in unemployment, life expectancy increased by 2.2 (95% confidence interval 0.5 to 3.8) months in men and by 1.7 (0.4 to 3.1) months in women. With each £1000 increase in average household income in a local authority, life expectancy increased by 1.4 (0.3 to 2.5) months in men and by 1.1 (0.2 to 1.9) months in women. The more deprived a local authority was in 1998, the lower the rate at which life expectancy improved.
conclusionDecreases in unemployment and increases in average income in an area explained, to a large extent, why some local authorities "performed" better than others. Health inequalities between Spearhead and all local authorities widened during the period of rising prosperity, but they would have widened to an even greater extent had unemployment not fallen at a faster rate in more deprived areas. With worsening economic trends over the next 10 years, this research suggests that increases in life expectancy are likely to be smaller and health inequalities may widen at a faster rate than in the previous decade. Allocating resources to local authorities on the basis of their "performance" at increasing life expectancy is likely to reward more affluent areas rather than disadvantaged areas with greater needs, exacerbating the problem.
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