Why death in Britain is not a leveller

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Death is no longer the great equaliser - where you live is a better guide to your chance of dying early than at any time for 50 years, according to a major new study.

People living in areas with the highest mortality rates are now almost twice as likely to die prematurely as those who live where mortality rates are lowest - the greatest degree of inequality since local records were first collated in 1951.

And for children the difference in death rates can be as much as eight times between different areas of the country.

While there have been substantial improvements in survival, the research, supported by the Joseph Rowntree Foundation says that one in twelve of the population now live in areas where premature death rates are 15 per cent above the national average.

"Many people think life chances have been getting better all the time, so to learn that we are more unequal than we were in the 1950s may be surprising," said Dr Daniel Dorling, author of the report.

Northern urban cities and towns come out worse, in particular Glasgow, Salford and Oldham recording the largest numbers of premature deaths (defined as deaths before the age of 65).

In comparison living in rural southern areas such as Oxfordshire, Berkshire and Surrey will boost your chances of achieving a ripe old age.

Amongst younger men, inner London boroughs such as Southwark and Hammersmith also came out badly whereas younger women Lambeth and Edinburgh also fared badly.

Using comparable 1951 local authority boundaries the three areas with the highest mortality rates in the 1990s (Oldham, Salford and Greenock) had mortality ratios only a fifth higher than the national average in the early 1950s.

Their rates are now rising towards being a third higher than the national rate. "Almost a thousand deaths a year would be avoided were the mortality rates not excessive in just these three places," the report concludes.

Differences in death rates cannot be blamed on factors such as smoking alone because death rates amongst children show similar divergences, meaning that where a child is born is more important than ever in determining his or her chances of survival.

While nationally infant mortality has seen the most dramatic falls regional divides mimic the adult experience.

An infant girl in Leeds is more than twice as likely to die in the first year of life compared to her peers growing up in a town in Dorset. And eight times as many boys aged between 1 and 4 died in Manchester as compared to rural Gloucestershire between 1990-2.

The researchers concluded that there was a strong link between poverty and premature death, with the worst tenth of areas in Britain also showing up among the most socially disadvantaged areas.

"We are becoming less equal in death," said Dr Dorling. "Where people live in the 1990s has become a more reliable guide to their chances of dying before they reach retirement age than at any time since the Second World War.

"The trend has occurred too quickly - and involves too many deaths - to be explained simply by a changing distribution of wealth, changing causes of death or as a reflection of past health inequalities.

"These patterns of varying life chances need to be investigated - and that is likely to prove a harder task than describing them."

Death in Britain: how local mortality rates have changed 1950s to 1990s is available from York Publishing Services, 64 Hallfield Rd, Layerthorpe, York YO3 7XQ price pounds 13.45