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Increasing socioeconomic gap between the young and old: temporal trends in health and overall deprivation in England by age, sex, urbanity and ethnicity, 2004–2015
  1. Evangelos Kontopantelis1,2,
  2. Mamas A Mamas3,
  3. Harm van Marwijk1,2,
  4. Iain Buchan1,4,
  5. Andrew M Ryan5,
  6. Tim Doran6
  1. 1 Faculty of Biology Medicine and Health, University of Manchester, Greater Manchester, UK
  2. 2 NIHR School for Primary Care Research, University of Manchester, Greater Manchester, UK
  3. 3 Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK
  4. 4 Healthcare Research, Microsoft Research Cambridge, Cambridge, UK
  5. 5 School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
  6. 6 Department of Health Sciences, University of York, York, UK
  1. Correspondence to Professor Evangelos Kontopantelis, Faculty of Biology Medicine and Health, University of Manchester, Greater Manchester M13 9PL, UK; e.kontopantelis{at}


Background At a low geographical level, little is known about the associations between population characteristics and deprivation, and their trends, which would be directly affected by the house market, labour pressures and government policies. We describe temporal trends in health and overall deprivation in England by age, sex, urbanity and ethnicity.

Methods Repeated cross-sectional whole population study for England, 2004–2015, at a low geographical level (average 1500 residents). We calculated weighted medians of the Index of Multiple Deprivation (IMD) for each subgroup of interest.

Results Over time, we observed increases in relative deprivation for people aged under 30, and aged 30–59, while median deprivation decreased for those aged 60 or over. Subgroup analyses indicated that relative overall deprivation was consistently higher for young adults (aged 20–29) and infants (aged 0–4), with increases in deprivation for the latter. Levels of overall deprivation in 2004 greatly varied by ethnicity, with the lowest levels observed for White British and the highest for Blacks. Over time, small reductions were observed in the deprivation gap between White British and all other ethnic groups. Findings were consistent across overall IMD and its health and disability subdomain, but large regional variability was also observed.

Conclusions Government policies, the financial crisis of 2008, education funding and the increasing cost of houses relative to real wages are important parameters in interpreting our findings. Socioeconomic deprivation is an important determinant of health and the inequalities this work highlights may have significant implications for future fiscal and healthcare policy.

  • deprivation
  • Index of Multiple Deprivation
  • IMD
  • health
  • age
  • sex
  • ethnicity
  • rurality
  • England

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  • Contributors EK designed the study, extracted the data from all sources, performed the analyses and drafted the manuscript. MAM, HM, AMR, IB and TD critically edited the manuscript. EK is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding The MRC Health eResearch Centre (grant MR/K006665/1) supported the time and facilities of EK.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data used in this study are freely available and the authors are happy to share in an organised and cleaned final data set.

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