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The Lancet: Rates and causes of premature mortality in the United Kingdom

Rates of premature mortality are 2 times higher in the most deprived areas of England compared to the most affluent areas, according to a new comprehensive analysis of health across the United Kingdom.

The study, from the Global Burden of Disease initiative, provides data on premature mortality, disability and risk factors from 1990 to 2016 for 150 local authorities in England, Scotland, Northern Ireland and Wales.

The analysis shows that while overall rates of premature death have improved since 1990, half of all premature deaths in 2016 were linked to modifiable risk factors including tobacco use, diet, alcohol and drug use, obesity and hypertension, pointing to the urgent need for policies and programmes targeting prevention, especially in areas outside the control of the health service.

It reveals the huge burden of disability linked to long-term conditions, such as low back and neck pain, anxiety and depression, highlighting the need for health services to adapt to managing these conditions.

Ischaemic heart disease was the leading cause of premature death in the United Kingdom in 2016, and rates were twice as high in men as in women. Self-harm was the third leading cause of premature death for men.

In England, Wales and Northern Ireland, but not Scotland, years lived with disability exceeded years of life lost. Low back and neck pain, skin and subcutaneous diseases, migraine, depressive and anxiety disorders, and sense organ disorders were the leading causes of disability.

Rates of premature mortality were consistently higher for the 15 most deprived areas of England, compared to the 15 least deprived, and the association with deprivation was particularly strong for lung cancer and chronic obstructive pulmonary disease.

The study is published in the Lancet.


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