Impact of upward social mobility on population mortality: analysis with routine data

OBJECTIVE: To examine the contribution of changes in the distribution of social class to the mortality of the whole population between 1970-2 and 1991-3. DESIGN: Examination of routine data at two time points: 1970-2 and 1991-3. DATA SOURCE: Data provided by the Office for National Statistics. MAIN OUTCOME MEASURES: Difference for the total population in the number of deaths between 1971 and 1991. Proportion of difference accounted for by change in population size, change in risk of death within each social class, or change in distribution of population across social classes. RESULTS: Reductions in mortality between 1970-2 and 1991-3 among men in England and Wales were partially (16% of all deaths) attributable to increases in the proportion of men in higher social classes, representing 3943 fewer deaths per year or one less death for every 3056 men in 1991-3 compared with 1970-2. CONCLUSION: Some of the observed reduction in mortality seen between 1970-2 and 1991-3 can be accounted for by improved overall socioeconomic status of the population.