Search

Objectives: To identify areas of Britain whose residents have relatively low age specific mortality, despite experiencing long-term economic adversity. Methods: Longitudinal, ecological study of all residents of Britain from 1971 to 2001. Results: 54 of Britain's 641 parliamentary constituencies were identified as having been persistently economically disadvantaged in the period 1971-2001. Within this group, there was marked variation in age group specific mortality and in the age ranges with relatively high or low mortality. A systematic scoring process identified 18 constituencies as providing strong and consistent evidence of low mortality across a range of age groups, relative to the 54 constituencies as a whole. These 18 were labelled "resilient". Among age groups >24 years, mortality rates in the resilient areas were significantly lower than in the other economically disadvantaged areas. For example, at ages 45-59 years, the average all cause mortality rate in the resilient constituencies was 607 per 100 000 population (95% Cl 574 to 641) and 728 (670 to 787) in the non-resilient constituencies (p=0.013). Conclusions: Areas with similar adverse economic histories do not all have similarly high mortality rates. It is unlikely that a single factor explains these results. Selective migration cannot be discounted as an explanation, but particular sociocultural features of areas (including the political, economic, ethnic and religious characteristics of their population) may also be protective. [ABSTRACT FROM AUTHOR]

Determines the factors associated with complete suicide in young parasuicide patients in Great Britain. Predictors of complete suicide; Prevalence of suicide after parasuicide; Risk factors of suicide.

The article analyzes the Keep Well cardiovascular anticipatory care program in Scotland in an effort to demonstrate the problems associated with the proposal of the British Medical Research Council (MRC) to implement a sequential approach to testing complex interventions in medical care. Keep Well was launched to address the inequalities in cardiovascular morbidity and mortality. The authors argue that Keep Well could have been standardized and better developed to make evaluation easy. They add that no clinical evaluation approach or randomized controlled trial is suited for all patients.