Evidence map›Paper›PMID 40248460›Full record

ArticleSSM - population health2025

Social determinants of where people die: A study of moderators and mediators using linked UK Census and mortality data.

J M Davies, K C Chua, M Maddocks, F E M Murtagh, K E Sleeman

Abstract read
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Article in SSM - population health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

J M DaviesCicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK.
K C ChuaCentre for Implementation Science, Health Service & Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
M MaddocksCicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK.
F E M MurtaghWolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.
K E SleemanCicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Where people die depends on many factors and is important to the quality of end-of-life care. Many people prefer to avoid end-of-life hospital admissions and yet hospital remains the most common place of death across high-income countries and is more likely for people who live in more deprived areas. This study examines moderators and mediators of socioeconomic inequality in place of death. Methods: We used census data linked to mortality data for people who died in England and Wales between 2011 and 2017 to investigate the association between area-based income deprivation and death in hospital versus home, hospice, and care home. We tested moderators including age, sex, ethnicity, underlying cause of death and region, and mediating pathways through housing deprivation, living alone, and worse health. Results: Among 34,230 decedents, after adjusting for age and sex, the proportion of deaths in hospital was higher in more deprived areas; 52.4 % (95 % CI: 51.2 %-53.6 %) and 46.7 % (45.5 %-48.0 %) for people living in the most and least deprived areas, respectively. This association was moderated by underlying cause of death; a social gradient was observed for deaths from cancer, dementia and 'other' causes but not for people who died from respiratory, cardiovascular, and sudden causes (F = 43.81; df (20), p = 0.0016). In a subsample of people who died from cancer, people living in the most deprived areas were more likely to live alone (36 % (95 % CI 30 %-41 %)) than those in the least deprived areas (19 % (15 %-23 %)), and this partly explained why they were more likely to die in hospital, accounting for 12.2 % of the total effect of income deprivation on death in hospital. Conclusion: This study contributes novel findings that deepen our understanding of socioeconomic inequality in place of death. Improving support for people living alone in more deprived areas is identified as a potential way to reduce inequalities in place of death.

Identifiers

PMID40248460
PMCPMC12005918

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.