STUDY OBJECTIVE--The aim of the study was to examine the relation between place of birth within England and Wales and cause of death. DESIGN--The study was a population survey using data provided by the Office of Population Censuses and Surveys which, for a trial period between 1969 and 1972, coded place of birth on death certificates. SETTING--The survey involved almost 2 million people who died in England and Wales between April 1969 and December 1972. MAIN RESULTS--Persons born in northern counties and industrial towns, and in Wales, had increased risk of ischaemic heart disease and stroke, which persisted whether or not they had moved to other parts of the country. A low risk of cardiovascular disease among people born in and around London went with them when they moved. People born in cities and large towns had an increased and persisting risk of chronic bronchitis. CONCLUSIONS--These findings are evidence that past geographical differences in fetal and infant growth, and in exposure to respiratory infection in early childhood, partly determine today's differences in adult death rates.