Voting Patterns, Mortality, and Health Inequalities in England

Philip Clarke, Charles Rahal, Josh Knight, Veline L' Esperance, Melinda C Mills
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Abstract

Objectives: To replicate an analysis conducted just prior to the 1997 UK General Election on the relationship between voting patterns at the constituency level, correlations between voting patterns, measured inequality, and premature mortality. Design: Observational study using data from the Office of National Statistics. Setting: England, UK. Participants: The health and mortality co-variates come from the English population across multiple publicly available datasets from the Office of National Statistics and are cross-tabulated against members of the public who voted in the 2019 UK General Election in constituencies in England. Main Outcome Measures: Age-standardised mortality rate (ASMR) for premature deaths for 2021, Health Deprivation and Disability (HDD) and Index of Multiple Deprivation (IMD) for 2019, Slope Indices of Inequality (2001-20), Healthy Life Expectancy (2011-20). Results: When observing the proportion of the eligible vote for Labour at the constituency level, there was a strong correlation with higher ASMR in both males (r=0.707, p<0.0001) and females (r=0.6505, p<0.0001). There is a strong correlation between Labour vote share ranks and deprivation, with Spearman's rank correlation coefficients of 𝜌=-0.687 (p<0.0001) for deprivation as measured by the HDD and 𝜌=-0.695 (p<0.0001) for the IMD ranks. Slope indices of inequality (SII) remain high for males and are increasing for females. Healthy life expectancies remain stratified, and differentials across deprivation remain wide and unchanged. Conclusions: Health inequalities across constituencies and socio-economic indicators such as IMD remain high. New approaches are likely to be required to reduce inequalities in the UK. Trial Registration: N/A.
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英格兰的投票模式、死亡率和健康不平等现象
目的:复制 1997 年英国大选前进行的一项分析,研究选区投票模式、投票模式之间的相关性、衡量的不平等程度以及过早死亡率之间的关系。设计:使用国家统计局的数据进行观察研究。地点:英国英格兰:英国英格兰。参与者:英国健康和死亡率协变量来自国家统计局多个公开数据集中的英国人口,并与在 2019 年英国大选中在英格兰选区投票的公众成员进行交叉分析:2021 年过早死亡的年龄标准化死亡率 (ASMR)、2019 年健康贫困与残疾 (HDD) 和多重贫困指数 (IMD)、不平等斜率指数 (2001-20)、健康预期寿命 (2011-20)。结果:在选区层面观察工党的合格选票比例时,男性(r=0.707,p<0.0001)和女性(r=0.6505,p<0.0001)的 ASMR 都与较高的 ASMR 有很强的相关性。工党得票率排名与贫困程度之间存在很强的相关性,以人类发展指数衡量的贫困程度的斯皮尔曼等级相关系数为𝜌=-0.687 (p<0.0001),而 IMD 排名的斯皮尔曼等级相关系数为𝜌=-0.695 (p<0.0001)。男性的不平等斜率指数(SII)仍然很高,而女性的不平等斜率指数正在上升。健康预期寿命仍然是分层的,不同贫困阶层之间的差异仍然很大,没有变化。结论:各选区和 IMD 等社会经济指标之间的健康不平等现象依然严重。英国可能需要新的方法来减少不平等现象。试验注册:不适用。
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