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The impact of the English national health inequalities strategy on inequalities in mortality at age 65: a time-trend analysis

Lookup NU author(s): Dr Natalie Bennett, Dr Viviana AlbaniORCiD, Dr Andrew KingstonORCiD, Professor Clare BambraORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association. Background: During the 1997–2010 Labour government, several policies were implemented to narrow health inequalities as part of a national health inequalities strategy. Many of these policies are likely to have had a disproportionately large impact on people aged 65 and over. We aimed to understand the association between the health inequalities strategy period and inequalities in mortality at age 65–69. Methods: We use population at risk and mortality data covering 1991–2019 to calculate mortality rate at age 65–69 at the Local Authority level. We use the 2019 Index of Multiple Deprivation to examine geographical inequalities. We employ segmented linear regression models with marginal spline terms for the strategy period and interact these with an indicator of deprivation to understand how inequalities changed before, during and after the strategy. The reporting of this study adheres to STROBE guidelines. Results: Mortality rates in each deprivation quintile improved continuously throughout the period of study. Prior to the programme (1991–9) there was no significant change in absolute inequalities. However, during the strategy (2000–10) there was a significant decrease in absolute inequalities of −9.66 (−17.48 to −1.84). The period following the strategy (2011–19) was associated with a significant increase in absolute inequalities of 12.84 (6.60 to 19.08). Our results were robust to a range of sensitivity tests. Conclusion: The English health inequalities strategy was associated with a significant reduction in absolute inequality in mortality age 65–69. Future strategies to address inequalities in ageing populations may benefit from adopting a similar approach.


Publication metadata

Author(s): Bennett NC, Norman P, Albani V, Kingston A, Bambra C

Publication type: Article

Publication status: Published

Journal: European Journal of Public Health

Year: 2024

Volume: 34

Issue: 4

Pages: 660-665

Print publication date: 01/08/2024

Online publication date: 07/05/2024

Acceptance date: 02/04/2018

Date deposited: 13/08/2024

ISSN (print): 1101-1262

ISSN (electronic): 1464-360X

Publisher: Oxford University Press

URL: https://doi.org/10.1093/eurpub/ckae081

DOI: 10.1093/eurpub/ckae081

Data Access Statement: The data employed in this analysis are freely available to download from the locations linked in the appropriate references. The code for the data preparation, analyses and graphs will be made available in the Supplementary material.

PubMed id: 38715242


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Funding

Funder referenceFunder name
Innovate UK (Reference: 99355)
National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) North East North Cumbria (Reference: NIHR200173)
Nuffield Foundation (grant WEL/FR-000023253)
NIHR (Reference: NIHR204670)
NIHR School of Public Health Research (NIHR204000)
Nuffield Foundation (Reference: OBF/FR-000023817)
Wellcome Trust (221266/Z/20/Z)

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