{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T09:55:43Z","timestamp":1789638943149,"version":"4.0.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013229","name":"Glasgow Centre for Population Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013229","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Deeply concerning changes to UK health trends have been noted since the early 2010s, including a widening of mortality inequalities. Given the importance of urban areas to national health outcomes, we sought to address gaps in the evidence by examining trends in intra-city mortality inequalities across Britain, including assessing the impact of the peak COVID-19 pandemic period. Age-standardized mortality rates were calculated (for England, Scotland, and 10 major UK cities) by age (all ages, 0\u201364\u2009years), sex, year (1981\u20132020), and country-specific and city-specific area-based quintiles of socio-economic deprivation. Trends in absolute and relative inequalities in mortality by country and city were analysed by means of the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII), respectively. Profound changes to mortality trends and inequalities were observed across both nations and all cities in the decade up to 2020, including increases in death rates among the 20% most deprived populations of almost every city. For deaths at all ages, this was particularly evident in Leeds, Liverpool, Edinburgh, Dundee, and Glasgow. For 0\u201364\u2009years, Scottish cities stood out. With few exceptions, both absolute and relative inequalities increased in the same time period. COVID-19 further increased death rates and inequalities. The analyses provide a hugely concerning picture of worsening mortality and widening inequalities across England and Scotland. When viewed in the context of the evidence for the impact of UK government austerity policies on population health, they represent a wake-up call for both current and future UK governments.<\/jats:p>","DOI":"10.1093\/eurpub\/ckaf008","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T19:33:17Z","timestamp":1739907197000},"page":"235-241","source":"Crossref","is-referenced-by-count":13,"title":["A new era of inequality: profound changes to mortality in England, Scotland, and 10 major British cities"],"prefix":"10.1093","volume":"35","author":[{"given":"Maria Teresa","family":"de Haro Moro","sequence":"first","affiliation":[{"name":"Public Health Scotland , Edinburgh,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Schofield","sequence":"additional","affiliation":[{"name":"Public Health Scotland , Edinburgh,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalia","family":"Munoz-Arroyo","sequence":"additional","affiliation":[{"name":"Public Health Scotland , Edinburgh,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerry","family":"McCartney","sequence":"additional","affiliation":[{"name":"School of Social and Political Sciences, University of Glasgow , Glasgow,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3390-5039","authenticated-orcid":false,"given":"David","family":"Walsh","sequence":"additional","affiliation":[{"name":"School of Health and Wellbeing, University of Glasgow , Glasgow,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"2025042409272555200_ckaf008-B1","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1093\/eurpub\/ckae154","article-title":"Is the period of austerity in the UK associated with increased rates of adverse birth outcomes?","volume":"34","author":"Watson","year":"2024","journal-title":"Eur J Public Health"},{"key":"2025042409272555200_ckaf008-B2","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1136\/jech-2022-219660","article-title":"Trends in psychological distress in Great Britain, 1991-2019: evidence from three representative surveys","volume":"77","author":"Zhang","year":"2023","journal-title":"J Epidemiol Community Health"},{"key":"2025042409272555200_ckaf008-B3","doi-asserted-by":"crossref","first-page":"e038135","DOI":"10.1136\/bmjopen-2020-038135","article-title":"Changing mortality trends in countries and cities of the UK: a population-based trend analysis","volume":"10","author":"Walsh","year":"2020","journal-title":"BMJ Open"},{"key":"2025042409272555200_ckaf008-B4","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.puhe.2021.01.025","article-title":"Life expectancy inequalities in Wales before COVID-19: an exploration of current contributions by age and cause of death and changes between 2002 and 2018","volume":"193","author":"Currie","year":"2021","journal-title":"Public Health"},{"key":"2025042409272555200_ckaf008-B5","doi-asserted-by":"crossref","first-page":"e805","DOI":"10.1016\/S2468-2667(21)00205-X","article-title":"Life expectancy and risk of death in 6791 communities in England from 2002 to 2019: high-resolution spatiotemporal analysis of civil registration data","volume":"6","author":"Rashid","year":"2021","journal-title":"Lancet Public Health"},{"key":"2025042409272555200_ckaf008-B6","volume-title":"Changing Mortality Rates in Scotland and the UK: An Updated Summary","author":"Walsh","year":"2023"},{"key":"2025042409272555200_ckaf008-B7","doi-asserted-by":"crossref","first-page":"e586","DOI":"10.1016\/S2468-2667(18)30214-7","article-title":"Contributions of diseases and injuries to widening life expectancy inequalities in England from 2001 to 2016: a population-based analysis of vital registration data","volume":"3","author":"Bennett","year":"2018","journal-title":"Lancet Public Health"},{"key":"2025042409272555200_ckaf008-B8","doi-asserted-by":"crossref","first-page":"e036529","DOI":"10.1136\/bmjopen-2019-036529","article-title":"How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? 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