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Biomedical subjects

D Dorling

Publications and source records attributed to D Dorling.

At least 19 recordsLinked to original sources
PubMed2001

Secular trends in antidepressant prescribing in the UK, 1975-1998.

BACKGROUND: We have examined secular trends in age- and sex-specific prescribing of antidepressants to determine whether these mirror changes in other population measures of mental health. METHOD: An analysis was carried out of age- and sex-specific rates of antidepressant prescribing by a representative sample or panel of UK general practitioners (GPs) in the period 1975-1998. RESULTS: The number of antidepressant prescriptions issued increased more than twofold in the period 1975-1998 and, in 1998, a total of 23.4 million antidepressant prescriptions were issued by GPs in the United Kingdom. Rates of antidepressant prescribing increased markedly in all age and sex groups with as much as a threefold increase in the older age groups. With the exception of 12-19-year-olds, these increases have been more marked in males, although absolute levels of prescribing are still at least two times higher in females. CONCLUSIONS: Antidepressant prescribing has increased in all age and sex groups. This indicates either that there have been changes in the presentation, recognition and management of depression in general practice or that the prevalence of depression has increased, or a combination of these two phenomena. The higher prescribing rate in females is in keeping with evidence from psychiatric morbidity surveys suggesting that women experience higher levels of psychiatric morbidity than men. Decreases in the ratio of female to male prescribing, however, support other data indicating that, relative to females, the mental health of young males has declined in recent years. Changes in patterns of help-seeking may also contribute to the observed trends.

Adolescent↗
PubMed2000

Widening inequality in mortality between 160 regions of 15 European countries in the early 1990s.

This paper presents maps of geographical patterns in mortality for the 160 mainland regions of the 15 countries of the European Union. Standardised mortality ratios (SMRs) for all ages are presented for all causes of death and for lung cancer, ischaemic heart disease, road traffic accidents and suicide. All cause standardised mortality ratios (for deaths under the age of 65) for the years 1990 and 1994 are presented. These data show that while most regions of Europe had decreasing SMRs over this time period, SMRs increased for the 10% of the population with the highest SMRs and the gap between the most and least healthy regions grew. Possible reasons for the observed patterns, the limitations of currently available data and the limitations of studying nation states, are suggested.

Accidents, Traffic↗
PubMed2000

Migration and geographical inequalities in health in Britain.

This paper explores the role of migration in creating geographical inequalities in mortality at the district level in Britain for the British Household Panel Study sample--a representative sample of 10264 British residents born after 1890 and enumerated in 1991. Analysis of the mortality rates of migrants showed that male migration accounts for nearly all the differences in mortality rates between districts. The BHPS was then utilised to look at the lifetime socio-economic characteristics of these migrants and to compare men and women. It was found that the health of both men and women moving from high mortality districts to low mortality districts could be explained by advantage over their lifetimes. The small proportion of men and women moving from low mortality districts to high mortality districts represent a very mixed group and their contribution, whilst small, is intriguing, as is the very different mortality rates of men and women in this group.

Adolescent↗
PubMed2000

Increasing mortality differentials by residential area level of poverty: Britain 1981-1997.

This paper considers mortality for ages 15-64 for the period 1981-97 in Britain according to population deciles defined by an area-based poverty measure. Over the study period there has been a polarization of life chances such that by 1994-97 almost one quarter of deaths in this age group can be attributed to unfavourable socioeconomic circumstances. Mortality differentials according to socioeconomic circumstances increased in tandem with increases in income inequality. A commitment to redistributive social policies is necessary if the trend of increasing inequality is to be reversed.

Adolescent↗
PubMed1999

Ecological study of social fragmentation, poverty, and suicide.

OBJECTIVES: To investigate the association between suicide and area based measures of deprivation and social fragmentation. DESIGN: Ecological study. SETTING: 633 parliamentary constituencies of Great Britain as defined in 1991. MAIN OUTCOME MEASURES: Age and sex specific mortality rates for suicide and all other causes for 1981-92. RESULTS: Mortality from suicide and all other causes increased with increasing Townsend deprivation score, social fragmentation score, and abstention from voting in all age and sex groups. Suicide mortality was most strongly related to social fragmentation, whereas deaths from other causes were more closely associated with Townsend score. Constituencies with absolute increases in social fragmentation and Townsend scores between 1981 and 1991 tended to have greater increases in suicide rates over the same period. The relation between change in social fragmentation and suicide was largely independent of Townsend score, whereas the association with Townsend score was generally reduced after adjustment for social fragmentation. CONCLUSIONS: Suicide rates are more strongly associated with measures of social fragmentation than with poverty at a constituency level.

Adult↗
PubMed1999

Mortality and migration in Britain, first results from the British Household Panel Survey.

This study investigates the extent to which current geographical variations in mortality are influenced by patterns of migration since birth. It is based on a longitudinal study of migrants which consists of a representative sample of 10264 British residents born after 1890 and enumerated as part of the British Household Panel Study in 1991. Between 1991 and 1996, 527 of the study members died and these deaths were analysed by area of residence at birth and in 1991 at both the regional and local district geographical scales. These were compared with findings from the Office for National Statistics Longitudinal Study. The British Household Panel Survey sample replicates the results of work conducted on the Longitudinal Study which finds that geographical variations in age-sex standardised mortality ratios at the regional scale cannot be attributed to selective migration. However, for the British Household Panel Survey sample, the major geographical variations at district level could be attributed to selective migration. Geographical variations in mortality are not well understood. Restrictions on what it is possible to analyse in the Office for National Statistics Longitudinal Study may have resulted in the underestimation of the importance of local lifetime selective migration in producing the contemporary map of mortality variation across Britain. The British Household Panel Survey is a small, recent, but very flexible study, which can be used to investigate the effects of lifetime migration on mortality patterns for all of Britain. This first report of its results on mortality shows that it produces findings which accord with the much larger Longitudinal Study, but which can be taken further to show that selective migration over the whole life-course at the local level does appear to have significantly altered the geographical pattern of mortality seen in Britain today.

Age Factors↗
PubMed1999

Where the poor die in a rich city: the case of Oxford.

Research to date has established that there is a relationship between high mortality rates and area deprivation in Britain. However, the majority of this research has looked at the regional level and the few studies that have looked at a smaller area level have tended to focus on London or the North. At a national level a relationship between housing tenure and mortality has also been found. This paper considers the relationship between mortality and place and in particular housing, at ward level in a city in the South East of England. It is found that, in Oxford, there is no straightforward relationship between housing tenure and mortality rates. Rather, it is pockets of poverty within Oxford, expressed in different types of housing, that are associated with high mortality rates. Whilst the very poorest live in the worst quality and least preferred housing, the extent of this relationship is likely to differ in different areas, according to the historical and current patterns of housing provision. A method of identifying such areas nationally is needed, as a reliance on national studies, particular those on tenure, is likely to obscure the true picture and extent of geographical inequalities in health.

Adolescent↗
PubMed1999

Suicide and unemployment in young people. Analysis of trends in England and Wales, 1921-1995.

BACKGROUND: The influence of the macro-economic climate on suicide is unclear. During the recent recession, rates have increased in young males but declined in females. AIMS: To investigate associations between unemployment and suicide in 15- to 44-year-old men and women over a period spanning two major economic recessions (1921-1995). To minimise confounding by changes in method availability, analyses are restricted to suicides using methods other than poisons and gases. METHOD: Time-series analysis using routine mortality and unemployment data. RESULTS: There were significant associations between unemployment and suicide in both males and females. Associations were generally stronger at younger ages. CONCLUSIONS: Secular trends in youth suicide may be influenced by unemployment or other factors associated with changes in the macro-economic climate. These factors appear to affect women to the same extent as men. Although it is not possible to draw firm aetiological conclusions from time-trend data, our findings are in keeping with those of person-based studies.

Adolescent↗
PubMed1998

Mapping and analysing 200 years of the census.

"The 10th of March 2001 will mark the two-hundredth anniversary of the first census of population and should be an opportunity to look back not merely at the history of census-gathering but at the development of the population, economy and society of the British Isles. [We describe] a major university-based project led by ourselves and funded by the Economic and Social Research Council, the Leverhulme Trust and other bodies.... The project is supported by ONS [Office for National Statistics] and one of our central goals is to create an historical social atlas for publication at the bi-centenary."

Censuses↗