Area based measures of social and economic circumstances: cause specific mortality patterns depend on the choice of index

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Abstract
As the particular socioeconomic and demographic characteristics of areas that are related to ill health could differ for different diseases we have compared how two indices—the Townsend index of deprivation and a measure developed by Congdon, which has been referred to as an anomie index5 6—relate to cause specific mortality. The first of these indices was developed as a measure of deprivation; the second as a measure of social fragmentation, based on Durkheim's theoretical concept of social integration. As Durkheim's concept of social integration differs from his notion of anomie we refer to the Congdon measure as an index of social fragmentation.7 Mortality data from 1981–1992 for 633 parliamentary consistencies of Great Britain (as defined in 1991) were used. Townsend deprivation score was based on 1981 and 1991 census data regarding unemployment, car ownership, overcrowded housing and housing tenure. The social fragmentation index was derived from 1981 and 1991 census data on private renting, single person households (aged r = 0.7. Table 1 presents correlations between the two indices and death from several illustrative causes, with simple correlations and partial correlations—with each index controlled for the other index—being presented.

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