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

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Abstract
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 Local Authority boundary) and the Belfast hinterland, formed by banding together the five local government districts contiguous with Belfast. The Townsend index was used to assess the relative deprivation of the areas in the North and the SAHRU (Small Area Health Research Unit) index4 was used in the South.