Contribution of avoidable mortality to life expectancy inequalities in Wales: a decomposition by age and by cause between 2002 and 2020

Currie, Jonny, Schilling, Hayden T., Evans, Loyd, Boyce, Tammy, Lester, Nathan, Greene, Giles, Little, Kirsty, Humphreys, Ciaran, Huws, Dyfed, Yeoman, Andrew, Lewis, Sally and Paranjothy, Shantini 2023. Contribution of avoidable mortality to life expectancy inequalities in Wales: a decomposition by age and by cause between 2002 and 2020. Journal of Public Health 45 (3) , pp. 762-770. 10.1093/pubmed/fdac133

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Abstract

Objectives To explore the contribution of avoidable mortality to life expectancy inequalities in Wales during 2002–2020. Design Observational study. Setting Wales, 2002–20, including early data from the COVID-19 pandemic. Methods We used routine statistics for 2002–2020 on population and deaths in Wales stratified by age, sex, deprivation quintile and cause of death. We estimated the contribution of avoidable causes of death and specific age-categories using the Arriaga decomposition method to highlight priorities for action. Results Life expectancy inequalities rose 2002–20 amongst both sexes, driven by serial decreases in life expectancy amongst the most deprived quintiles. The contributions of amenable and preventable mortality to life expectancy inequalities changed relatively little between 2002 and 2020, with larger rises in non-avoidable causes. Key avoidable mortality conditions driving the life expectancy gap in the most recent period of 2018–2020 for females were circulatory disease, cancers, respiratory disease and alcohol- and drug-related deaths, and also injuries for males. Conclusions Life expectancy inequalities widened during 2002–20, driven by deteriorating life expectancy in the most deprived quintiles. Sustained investment in prevention post-COVID-19 is needed to address growing health inequity in Wales; there remains a role for the National Health Service in ensuring equitable healthcare access to alongside wider policies that promote equity.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Publisher:	Oxford University Press
ISSN:	1741-3842
Date of First Compliant Deposit:	19 December 2022
Date of Acceptance:	6 October 2022
Last Modified:	12 Sep 2023 12:51
URI:	https://orca.cardiff.ac.uk/id/eprint/155009

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