Sunday October 19 2008 – The geographical pattern of mortality in Great Britain over the past quarter century has been mapped for the first time, revealing how each of us is most likely to die depending on where we live. The Grim Reaper’s Road Map: An Atlas of Mortality in Britain shows exactly how people’s deaths are affected by where they live, how much money they have, the type of work they do and their lifestyle.
The maps, to be published tomorrow by Policy Press, show patterns that are very different to those created in previous attempts to understand the spread of death across the country. ‘Most maps of mortality simply show that more people die in those towns and cities where more people live, particularly in the places where there are lots of elderly people,’ said co-author Danny Dorling, professor of human geography at the University of Sheffield. ‘But our maps show a person’s chances of dying from a particular cause in a particular place, compared to the national average chance for that cause of death, having standardised for distributions of population and by age and sex in each area.’
The maps show deaths from a range of causes, including heart attack, cancer, murder, electrocution and deaths during surgery.
‘The average age of death since 1981 is 74.4 years; 71.2 for men and 77.4 for women,’ said Dorling. ‘But while in the best neighbourhoods, including Eastbourne West, 42 per cent of those who died were over 80 years old, in others, including Glasgow Easterhouse, 25 per cent were under 60 years of age.
‘Across much of the south of England outside London, and in a few isolated enclaves of prosperity in the north, Wales and Scotland, people’s chances of dying each year have been up to 30 per cent lower than the average since 1981.’
What causes most of the variations shown on these maps are not genetic factors, said Dorling, but environmental issues and whether we smoke, drink and exercise. ‘We hope that many of the maps will encourage readers to reflect on how unfair life is, even in a prosperous country, because we discovered that the most important environmental factor today is relative poverty,’ he said. ‘Death rates are higher where people are poorer. Internal migration is another key factor, making different parts of Britain increasingly home to either the poor or the rich.’
Dorling studied 14,833,696 death records to produce the maps, which show the standardised mortality ratios of every town and city in Britain from 1981 to 2004. The first map in the atlas is of all deaths that have taken place in Britain over the past 24 years. This is then broken down into nine causes, including all cancers and all deaths related to transport. Those maps are then subdivided into 99 categories.
Cervical cancer is most likely to kill those living in a belt stretching across the north of England, from Merseyside to Grimsby. Cancers of the brain, however, are clustered in the south of Aberdeen and around Berwickshire.
There are high clusters of death from asthma in south Wales, Blackpool, Pontefract, Exeter and Coventry, while leukaemia is most commonly found in Wigan, Northampton, Newport Pagnell and Burnley. The highest rates of ovarian cancer are in Ettrick and Lauderdale in the Scottish Borders, Montgomeryshire, north-east Dorset and the rural parts of the Wrekin in Shropshire.
The maps also reveal clusters of more unusual deaths. Most people who die by choking on food live in Morpeth and St Albans East. Rates of accidental drowning are highest in the south-west of England and south Wales, where coastal waters tend to be warmest.
Overall, the maps reveal that 86 million years of life were lost in Britain between 1981 and 2004 due to people dying before they reached the age of 75.
‘Just under a fifth of all years of life lost before age 75 are lost to heart attack and chronic heart disease. Add lung cancer cases and over a quarter of all years are accounted for,’ said Dorling.
Murder accounts for just 7,677 cases a year over the 24-year period: six a week and 0.05 per cent of all deaths, with a concentration on the west coast of Scotland. Most deaths in the first year of life are from respiratory diseases. However, Ellesmere Port West, Hexham West, Keighley North and Meirionnydd Urban have most infants dying of congenital heart defects and other birth defects.
Few youngsters die in childhood, but five- to nine-year-olds living in the north of the country are most likely to die from transport-related deaths. Childhood cancers, however, are the most common causes of death in the same group in the south. Between 10 to 24 years of age, the largest cause of death is transport-related, most commonly road traffic accidents. But for the 15-19 age band there are large geographical differences, with most teenagers in urban areas such as London and parts of Scotland dying from suicide or drug overdoses. In Glasgow, however, murder is the most common cause of death in that age group.
In the 50-54 age group, virtually the whole country has chronic heart disease as the leading cause of death. The one exception is Great Shelford in Cambridgeshire, where the leading cause of death is breast cancer.
guardian.co.uk © Guardian News and Media Limited 2008