Are social inequalities in mortality in Britain narrowing? Time trends from 1978 to 2005 in a population-based study of older men

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Abstract
Objective: To examine whether social inequalities in all-cause and coronary heart disease (CHD) mortality in Britain have reduced between 1978 and 2005. Design: A prospective study of a socioeconomically representative population. Setting: 24 British towns. Participants: 7735 Men, aged 40–59 years at recruitment in 1978–1980 and followed up until 2005 through the National Health Service Central Register (164 120 person-years). Main outcome measures: Relative hazards and absolute risk differences for all-cause and CHD death comparing manual with non-manual social classes, calculated for different calendar periods. Results: 3009 Deaths from all causes (1003 from CHD) occurred during follow-up. The overall hazard ratio (manual versus non-manual) was 1.56 (95% CI 1.45 to 1.69, pConclusion: Relative differences in all-cause and CHD mortality between manual and non-manual social class groups persisted and may have increased during this period. Absolute differences in mortality between these social groups decreased as a result of falling overall mortality rates. Greater effort is needed to reduce social inequalities in all-cause and CHD mortality in the new millennium.

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