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Bearing the burden of austerity: how do changing mortality rates in the UK compare between men and women?
  1. David Walsh1,
  2. Ruth Dundas2,
  3. Gerry McCartney3,4,
  4. Marcia Gibson2,
  5. Rosie Seaman2
  1. 1 Glasgow Centre for Population Health, Glasgow, UK
  2. 2 MRC/CSO Social and Public Health Science, University of Glasgow, Glasgow, UK
  3. 3 College of Social Sciences, University of Glasgow, Glasgow, UK
  4. 4 Clinical and Protecting Health, Public Health Scotland Glasgow Office, Glasgow, UK
  1. Correspondence to Dr David Walsh, Glasgow Centre for Population Health, Glasgow, G40 2QH, UK; david.walsh.2{at}glasgow.ac.uk

Abstract

Background Mortality rates across the UK stopped improving in the early 2010s, largely attributable to UK Government’s ‘austerity’ policies. Such policies are thought to disproportionately affect women in terms of greater financial impact and loss of services. The aim here was to investigate whether the mortality impact of austerity—in terms of when rates changed and the scale of excess deaths—has also been worse for women.

Methods All-cause mortality data by sex, age, Great Britain (GB) nation and deprivation quintile were obtained from national agencies. Trends in age-standardised mortality rates were calculated, and segmented regression analyses used to identify break points between 1981 and 2019. Excess deaths were calculated for 2012–2019 based on comparison of observed deaths with numbers predicted by the linear trend for 1981–2011.

Results Changes in trends were observed for both men and women, especially for those living in the 20% most deprived areas. In those areas, mortality increased between 2010/2012 and 2017/2019 among women but not men. Break points in trends occurred at similar time points. Approximately 335 000 more deaths occurred between 2012 and 2019 than was expected based on previous trends, with the excess greater among men.

Conclusions It remains unclear whether there are sex differences in UK austerity-related health effects. Nonetheless, this study provides further evidence of adverse trends in the UK and the associated scale of excess deaths. There is a clear need for such policies to be reversed, and for policies to be implemented to protect the most vulnerable in society.

  • MORTALITY
  • POLICY
  • Health inequalities
  • DEMOGRAPHY

Data availability statement

No data are available.

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Data availability statement

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Footnotes

  • Twitter @gerrymccartney1

  • Contributors The study was conceived by DW. The research questions and analysis plan were agreed by all authors. DW, GM and RD undertook the analyses. DW drafted the manuscript. All authors (DW, GM, RD, MG and RS) provided substantial critical input to improve the manuscript, and all authors approved the final draft. DW is responsible for the overall content as guarantor.

  • Funding No specific funding was obtained for this work. RD, MG and RS are funded by the Medical Research Council (MC_UU_00022/2) and the Chief Scientist Office (SPHSU17).

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.