There will be statisticians out there who can unpack this better than I:
Data released in Parliament show that in the most deprived areas of the country, the mortality rate is as high as 1,500 deaths per 100,000 people in a single year.
By contrast the death rate is 1,427 in Rwanda and 1,452 in Botswana, according to the World Health Organization.
They point out a number of caveats. The areas being discussed are tiny, so simple statistical variation will have a large impact (the national average death rate is some 462 per 100,000).
The presence of a hospital or hospice will alter the figures dramatically (which means, I think, that the figures are drawn from place of death, not place of residence at time of death?).
But do not doubt that this will be taken as proof perfect of the shameful iniquities of the rampant inequality in the country.
And as ever, the elephant will be missed.
Yes, we know there is health inequality. We also know that there is socio-economic inequality. We even know that there is a correlation between the two.
However, in the usual public health discussions it is assumed that the causation runs from socio-economic inequality to health inequality. And I would certainly be open to the argument that some of the correlation does run that way.
However, I would also insist that some of the correlation runs the other way. That health inequality leads to socio-economic inequality. Become ill with some chronic disease and your employment and income prospects simply are going to decline.
And sadly, at least as far as I can see, that\’s not a causation that is allowed to enter into the discussions of inequality and public health. Certainly I looked through the Marmot thing and could not see any evidence at all of it being discussed, even to reject it.
If it is and I missed it please do correct me. But if it isn\’t then we\’ve another one of those lying with numbers things, don\’t we?