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North-South disparities in English mortality1965–2015: longitudinal population study
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  • Published on:
    Absolute Risk Difference is what matters

    This paper makes a number of claims about health in the North relative to the South of England using comparisons of relatively low death rates. When the denominator in such calculations is a very low rate of death, the size of the difference can appear large. However, if we compare the absolute risk of dying, it is relatively close in the North and South and if we were to divide the rate of survival in the South by the rate of survival in the North each year, we would have a very small comparative statistic.

    Abstracts and conclusions can easily be taken out of context and authors of papers like this one should be careful to present appropriate information. For example, the conclusion "...1.2 million northern excess deaths under age 75 over five decades.." implies very high potential death rates, a million! But this figure is presented with no population and reflects experience over 50 years. If we divide by 50, we get 24,000 deaths a year. A further weakness is that no measure of population is provided to put this total number of deaths in context. Using a plausible estimate of 20 million, for example, implies excess deaths at a rate of about 1.2 per 1,000 people. I wonder how many residents of the North are planning to migrate South today to reduce their risk of an early death by just over 1 in 1,000. Yes we should be concerned about all differences in health across regions and social groups but by inflating them with misleading divisions of one small num...

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    Conflict of Interest:
    None declared.