Which areas are healthiest?

Abstract

This article compares mortality rates by geography and over time. This is done by analysing, for England and Wales, mortality data from 1981 to 1992 by cause, local authority, and ward, using the new OPCS area classifications, and the urban/rural categorisation of 1991 Census enumeration districts based on land use. The proportion of babies who in 1990-92 were lightweight at birth was also examined. Urban areas (particularly purpose-built inner city estates and deprived industrial areas) tend to be the least healthy. Rural and prosperous areas are the most healthy, and the biggest health gains have been made in these. Based on 1992 mortality rates, out of every 100 boys born in 'Ports and industry' areas, 16 would survive to age 85 whereas 24 would do so in the 'Most prosperous' areas. The corresponding figures for girls were 33 and 43. The 'Most prosperous' areas also had the most similar male and female life expectancies, with the difference narrowing throughout the period 1981-1992. In 1990-92 people in 'Ports and industry' areas had the highest male mortality levels for malignant neoplasms, lung cancer, circulatory diseases, ischaemic heart disease and cerebrovascular disease. People in 'Inner London' had the highest levels for respiratory diseases and injury and poisoning.