Trends in social inequalities in male mortality, 2001-08. Intercensal estimates for England and Wales.

Abstract

Background: This article presents estimates of mortality rates for men of working age by the National Statistics Socio-economic Classification (NS-SEC). Previously it has been possible to produce such mortality rates only at the time of a census, when populations are enumerated by occupation and NS-SEC. This is the first time that annual intercensal estimates have been produced, enabling the measurement of health inequalities by NS-SEC for the period 2001-08.

Methods: The Labour Force Survey (LFS) was used to provide population denominators by age and NS-SEC for men aged 25-64 for each year between 2001 and 2008. Numbers of deaths for the corresponding period were obtained from death registrations, and age-standardised mortality rates were derived. A number of measures of the inequality in mortality rates across socio-economic classes were compared.

Results: There has been a steady decrease in mortality rates for all NS-SEC classes over the period, 2001-08. Mortality rates for the 'Routine' class declined on average by around 11 deaths per 100,000 population per year, almost double that of the 'Higher managerial and professional' class. Absolute differences between the mortality of the least and most advantaged classes showed a small decline based on three different measures. Relative differences, however, increased over this period. In 2001 the mortality rate of those in routine and manual occupations was 2.0 times that of those in managerial and professional occupations. In 2008 that ratio had risen to 2.3. This pattern of declining absolute but rising relative inequalities is a well known phenomenon in the context of declining overall mortality rates.

Conclusions: The results presented suggest that annual trends in inequalities in mortality at the national level can be effectively monitored using LFS-based measures. This would complement the current measures that are based on area of residence rather than the socio-economic position of the individual.