Article Text

Download PDFPDF
Are cities becoming more unhealthy? An analysis of mortality rates in Belfast and Dublin between 1981 and 1991 to illustrate a methodological difficulty with ecological studies
  1. D O'Reillya,
  2. S Brownea,
  3. Z Johnson*,b,
  4. A Kellyc
  1. aHealth and Social Care Research Unit, Queens University of Belfast, Mulhouse Building, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, bERSI Dublin, cSmall Area Health Research Unit, Trinity College, Dublin
  1. Dr O'Reilly (d.oreilly{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Ecological studies are increasingly being used to monitor changes in status over time or as a way of evaluating area based policy interventions1 and as a method of examining for widening inequalities in health.2 The principle is to apply the same assessment instruments to the same areas at two points in time and to compare the changes. However, most of these studies ignore the possible contribution of population change.3This paper aims to compare the inter-censal changes in the mortality experience of the two capital cities in the North and South of Ireland with the rest of the country to see if these changes are related to population movement.


Each country was divided into three areas; capital city, hinterland and the rest of the country. For the South of Ireland the first two of these were respectively Dublin City Borough (which is nested within Dublin County) and the remainder of Dublin County. The equivalent divisions for Northern Ireland were Belfast City (defined by the Belfast …

View Full Text


  • * Zachary Johnson has died since this paper was accepted for publication.

  • Funding: none

  • Conflicts of interest: none.