4.7 Article Proceedings Paper

Death and deprivation: an exploratory analysis of deaths in the Health and Lifestyle survey

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SOCIAL SCIENCE & MEDICINE
卷 50, 期 7-8, 页码 1059-1079

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PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/S0277-9536(99)00355-X

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mortality; deprivation; area differences; contextual effects; health-related behaviour; multilevel models; survival analysis

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An analysis is undertaken of deaths of respondents in the UK- representative Health and Lifestyle Survey. The sample was originally interviewed in 1984/5 and followed initially until May 1997, Using multilevel logistic and Cox-proportional hazards models, the relationships between death and a wide range of social circumstances and behaviours is explored. It is found that place deprivation interacts with individual social class in accounting for variations in mortality. This is the case even when account is taken of personal health-related behaviour. There appears to be some evidence of a threshold relationship such that the differential effects of social class are only found at high-levels of deprivation. No statistically significant interactions are found for social and behavioural variables, for behavioural and place deprivation variables, and for social and place deprivation variables with the exception of social class. The study is deliberately exploratory and a wide range of models have been fitted which will be subject to more rigorous evaluation as the HALS death study proceeds. (C) 2000 Elsevier Science Ltd. All rights reserved.

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