Vulnerability to winter mortality in elderly people in Britain: population based study.


Wilkinson, P; Pattenden, S; Armstrong, B; Fletcher, A; Kovats, RS; Mangtani, P; McMichael, AJ; (2004) Vulnerability to winter mortality in elderly people in Britain: population based study. BMJ (Clinical research ed), 329 (7467). p. 647. ISSN 0959-8138 DOI: 10.1136/bmj.38167.589907.55

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Abstract

OBJECTIVE: To examine the determinants of vulnerability to winter mortality in elderly British people. DESIGN: Population based cohort study (119,389 person years of follow up). SETTING: 106 general practices from the Medical Research Council trial of assessment and management of older people in Britain. PARTICIPANTS: People aged > or = 75 years. MAIN OUTCOME MEASURES: Mortality (10,123 deaths) determined by follow up through the Office for National Statistics. RESULTS: Month to month variation accounted for 17% of annual all cause mortality, but only 7.8% after adjustment for temperature. The overall winter:non-winter rate ratio was 1.31 (95% confidence interval 1.26 to 1.36). There was little evidence that this ratio varied by geographical region, age, or any of the personal, socioeconomic, or clinical factors examined, with two exceptions: after adjustment for all major covariates the winter:non-winter ratio in women compared with men was 1.11 (1.00 to 1.23), and those with a self reported history of respiratory illness had a winter:non-winter ratio of 1.20 (1.08 to 1.34) times that of people without a history of respiratory illness. There was no evidence that socioeconomic deprivation or self reported financial worries were predictive of winter death. CONCLUSION: Except for female sex and pre-existing respiratory illness, there was little evidence for vulnerability to winter death associated with factors thought to lead to vulnerability. The lack of socioeconomic gradient suggests that policies aimed at relief of fuel poverty may need to be supplemented by additional measures to tackle the burden of excess winter deaths in elderly people.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 15315961
Web of Science ID: 224042300016
URI: http://researchonline.lshtm.ac.uk/id/eprint/14491

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