Shipyards and sectarianism: How do mortality and deprivation compare in Glasgow and Belfast?

Graham, Philip; Walsh, David; McCartney, Gerry

doi:10.1016/j.puhe.2012.01.018

Cited by 16 publications

(11 citation statements)

References 25 publications

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“…It is argued that there are more aspects beyond deprivation that act in different ways in different cities [20]. This factor could also be an explanation for the results in our study: there may be other factors modifying the effect of deprivation in every city.…”

Section: Discussionmentioning

confidence: 65%

Do socioeconomic inequalities in mortality vary between different Spanish cities? a pooled cross-sectional analysis

et al. 2013

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BackgroundThe relationship between deprivation and mortality in urban settings is well established. This relationship has been found for several causes of death in Spanish cities in independent analyses (the MEDEA project). However, no joint analysis which pools the strength of this relationship across several cities has ever been undertaken. Such an analysis would determine, if appropriate, a joint relationship by linking the associations found.MethodsA pooled cross-sectional analysis of the data from the MEDEA project has been carried out for each of the causes of death studied. Specifically, a meta-analysis has been carried out to pool the relative risks in eleven Spanish cities. Different deprivation-mortality relationships across the cities are considered in the analysis (fixed and random effects models). The size of the cities is also considered as a possible factor explaining differences between cities.ResultsTwenty studies have been carried out for different combinations of sex and causes of death. For nine of them (men: prostate cancer, diabetes, mental illnesses, Alzheimer’s disease, cerebrovascular disease; women: diabetes, mental illnesses, respiratory diseases, cirrhosis) no differences were found between cities in the effect of deprivation on mortality; in four cases (men: respiratory diseases, all causes of mortality; women: breast cancer, Alzheimer’s disease) differences not associated with the size of the city have been determined; in two cases (men: cirrhosis; women: lung cancer) differences strictly linked to the size of the city have been determined, and in five cases (men: lung cancer, ischaemic heart disease; women: ischaemic heart disease, cerebrovascular diseases, all causes of mortality) both kinds of differences have been found. Except for lung cancer in women, every significant relationship between deprivation and mortality goes in the same direction: deprivation increases mortality. Variability in the relative risks across cities was found for general mortality for both sexes.ConclusionsThis study provides a general overview of the relationship between deprivation and mortality for a sample of large Spanish cities combined. This joint study allows the exploration of and, if appropriate, the quantification of the variability in that relationship for the set of cities considered.

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Section: Discussionmentioning

confidence: 65%

Do socioeconomic inequalities in mortality vary between different Spanish cities? a pooled cross-sectional analysis

et al. 2013

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“…However, in a study comparing adult mortality , the UK adults' results were the reverse of these children's as the UK significantly did better than 10 other countries, with only five having bigger reductions than the UK (Pritchard and Wallace, ). This suggests that it is the poverty dimension that disproportionately impacts on child mortality, an association found in many clinical studies (Conroy and others, ; Freemantle and others, ; Fritzell and others, ; Graham and others, ; House and others, ; Parslow and others, ; Sengoelge and others, ). This interpretation is supported by the lack of any significant correlation between CMR and % GDPHE and suggests that it is the over‐arching influence of poverty, especially to children that affects CMR.…”

Section: Discussionmentioning

confidence: 89%

“…Relative poverty is associated with worse health outcomes (Conroy and others, ; Freemantle and others, ; Graham and others, ; House and others, ; Mackenbach and others, ; Parslow and others, ; Sengoelge and others, ) and whilst there is a debate about definitions of poverty (Gordon and others, ; IRP, ; Laderichi and others, ), the studies cited are all from Western countries and refer to relative rather than absolute poverty. ‘Income Inequality’, which is based upon World Bank data is claimed to be an indicator of relative poverty (Wilkinson and Pickett, ) and is the gap between the top and bottom 20 per cent of incomes of each nation.…”

Section: Methodsmentioning

confidence: 99%

“…In effect, therefore CMR can be said to be an indicator of comparative and relative levels of ‘neglect’ at a national level in that CMR show the degree to which ‘a nation meets the needs of its children’. It is acknowledged that there are many factors affecting children's health outcomes, in particular children from lower socioeconomic backgrounds have poorer outcomes (Bywaters, ; Conroy and others, ; Freemantle and others, ; Fritzell and others, ; Graham and others, ; House and others, ; Parslow and others, ; Sengoelge and others, ); consequently, we place the study within the context of a measure of relative poverty, namely ‘Income Inequalities’, which is the gap between the top and bottom 20 per cent of incomes (Wilkinson and Pickett, ).…”

Section: Introductionmentioning

confidence: 99%

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Comparing UK and Other Western Countries' Health Expenditure, Relative Poverty and Child Mortality: Are British Children Doubly Disadvantaged?

Pritchard

Wallace²

2014

Children & Society

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We examined the UK's effectiveness in reducing Child Mortality with 20 other Western countries, in the context of their national health expenditures, and, relative poverty — measured by ‘Income Inequality’ the gap between top and bottom 20 per cent of income. W.H.O. Child (0–14) Mortality Rates (CMR) and GDP Expenditure on Health (% GDPHE) were examined and a cost‐effectiveness ratio calculated, which is the reduced CMR over the period divided by average GDPHE. The highest average % GDPHE was USA at 13.2 per cent; the UK's 7.3 per cent was equal lowest. The widest Income Inequality was USA 8.5 times; the UK at 7.2 was third widest. The highest CMR was the USA 2436 per million (pm), the UK's 1630 pm, although representing a fall of 62 per cent was fourth highest. However, UK cost‐effectiveness ratio (1: 350) was eighth best of 21 countries. Only Income Inequality correlated significantly with CMR. UK CMR fell significantly more than five countries but ten others declined more. If UK deaths had been at the average of the 17 countries with lower CMR, there would have been 1827 fewer deaths. British children's poverty and health expenditure means they and their services are doubly disadvantaged although the NHS relatively achieved more with comparatively less.

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“…More profoundly, lower socio-economic status and concomitant health problems among Scottish Catholics relative to Protestants have been attributed to discriminatory employment practices and latent sectarianism (Walls and Williams, 2003;Walls and Williams, 2004). Other authors dispute the importance of sectarianism in modern Scotland and suggestions that it contributes to the Scottish effect (excess mortality in Scotland in comparison with other regions of the UK that is not entirely explained by socio-economic status (SES) at either the individual or area level (Popham and Boyle, 2011)) have received little support (Graham et al, 2012). In our study Scottish Catholics had higher rates of unemployment than all other groups, consistent with our hypothesis that Catholic disadvantage would be more pronounced in Scotland due to the historical lack of explicit legislation banning discrimination by religion.…”

Section: Discussionmentioning

confidence: 99%

Does equality legislation reduce intergroup differences? Religious affiliation, socio-economic status and mortality in Scotland and Northern Ireland: A cohort study of 400,000 people

Wright¹,

Rosato

Raab

et al. 2017

Health & Place

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Religion frequently indicates membership of socio-ethnic groups with distinct health behaviours and mortality risk. Determining the extent to which interactions between groups contribute to variation in mortality is often challenging. We compared socio-economic status (SES) and mortality rates of Protestants and Catholics in Scotland and Northern Ireland, regions in which interactions between groups are profoundly different. Crucially, strong equality legislation has been in place for much longer and Catholics form a larger minority in Northern Ireland. Drawing linked Census returns and mortality records of 404,703 people from the Scottish and Northern Ireland Longitudinal Studies, we used Poisson regression to compare religious groups, estimating mortality rates and incidence rate ratios. We fitted age-adjusted and fully adjusted (for education, housing tenure, car access and social class) models. Catholics had lower SES than Protestants in both countries; the differential was larger in Scotland for education, housing tenure and car access but not social class. In Scotland, Catholics had increased age-adjusted mortality risk relative to Protestants but variation among groups was attenuated following adjustment for SES. Those reporting no religious affiliation were at similar mortality risk to Protestants. In Northern Ireland, there was no mortality differential between Catholics and Protestants either before or after adjustment. Men reporting no religious affiliation were at increased mortality risk but this differential was not evident among women. In Scotland, Catholics remained at greater socio-economic disadvantage relative to Protestants than in Northern Ireland and were also at a mortality disadvantage. This may be due to a lack of explicit equality legislation that has decreased inequality by religion in Northern Ireland during recent decades.

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Shipyards and sectarianism: How do mortality and deprivation compare in Glasgow and Belfast?

Cited by 16 publications

References 25 publications

Do socioeconomic inequalities in mortality vary between different Spanish cities? a pooled cross-sectional analysis

Do socioeconomic inequalities in mortality vary between different Spanish cities? a pooled cross-sectional analysis

Comparing UK and Other Western Countries' Health Expenditure, Relative Poverty and Child Mortality: Are British Children Doubly Disadvantaged?

Does equality legislation reduce intergroup differences? Religious affiliation, socio-economic status and mortality in Scotland and Northern Ireland: A cohort study of 400,000 people

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