Inequalities in rates of amenable mortality by individual socioeconomic position
Yates, M., Dundas, R., Pell, J.P. & Leyland, A.H. (2018) CALLS Hub conference, University of St Andrews, UK, 23 March 2018 [SLS]
Background: Mortality amenable to healthcare intervention constitutes premature deaths which should not occur in the presence of timely and effective healthcare. Socioeconomic gradients within rates of amenable mortality (AM) have been explored at the individual level in many European countries, finding increasing inequalities across various measures of socioeconomic position. Inequalities in rates of AM have previously been estimated at the area level in Scotland, but little is known about inequalities at the individual level.
Methods: Socioeconomic patterning of AM was explored across levels of educational attainment, two measures of occupational social class, and household composition for Scottish Longitudinal Study (SLS) members enumerated in the 1991 and 2001 Censuses, with follow-up to 2010. Absolute and relative inequalities within rates of amenable, non-amenable and all-cause mortality were explored using the slope and relative indices of inequality (SII and RII) respectively. The representativeness of the sample to the total population was evaluated by calculating inequalities using area deprivation indices.
Results: Between 1991 and 2010, 6,462 SLS members died of an amenable condition before the age of 75 (16% of all deaths). Despite an overall declining trend in mortality rates, large inequalities in the three mortality groups were found, with no consistent trends. Educational attainment produced the largest RII (Men: 3.4 95%CI (1.9 to 7.5) in 1991-94) and SII, whilst those based on occupational social class were smaller (NS-SEC Men: RII= 1.5 95%CI (1.0 to 2.2) in 1991-94).
Conclusions: Significant, although inconsistent, inequalities within rates of AM were found for all individual measures.