Ten-year trends in all-cause mortality and coronary heart disease mortality in socio-economically diverse neighbourhoods

Objective. Although all-cause mortality and coronary heart disease (CHD) mo rtality is declining in Sweden, as in most other countries in the industria lised world, we have limited information about the distribution and trends of mortality in deprived and affluent neighbourhoods. Design: This study analyses the extent to which the decline in all-cause mo rtality and CHD mortality (over the age range 25-74 y) differs between affl uent and deprived neighbourhoods during the decade 1984-1993. Incidence den sity ratios (IDR). estimated by Poisson regression, were calculated for sma ll areas, grouped into population deciles, by both the care need index (CNI ) and the Townsend deprivation score. On average, there were about 14 500 r esidents and 560 deaths in each decile over the period. Setting. A large Swedish city. Main outcome measures: All-cause mortality and mortality from CHD. Results: The most deprived neighbourhoods had the highest IDR for all-cause mortality and CHD mortality. Over the period from 1984-1988 to 1989-1993 t here was an overall decrease in all-cause mortality and CHD mortality, whic h was significantly higher in the most affluent areas. The mortality ratios for the most deprived neighbourhoods were almost three times higher than t hose of the most affluent areas. Conclusions. People liviing in more affluent neighbourhoods have had the be nefit of most of the last decade's decline in CHD mortality.