Health & place
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Palliative care services in England lack data on the number of children with 'life limiting conditions' (LLCs). Recent research determined that the prevalence of LLCs in children in England was double previous estimates. We build on this by analysing time-trends in the prevalence of LLCs by small area deprivation and geodemographic area types. ⋯ These increases are mirrored by a decrease in all cause mortality for children suggesting improved survival. Rates are highest in more deprived areas and those typified by multicultural populations. Increasing prevalence and number of cases over time may require increased paediatric palliative care service provision in the future.
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The notion that mortality inequalities between differently deprived areas vary by age is logical since not all causes of death increase in risk with age and not all causes of death are related to the gradient of deprivation. In addition to the cause-age and cause-deprivation relationships, population migration may redistribute the population such that the health-deprivation relationship varies by age. We calculate cross-sectional all cause mortality and self-reported limiting long-term illness (LLTI) rate ratios of most to least deprived areas to demonstrate inequalities at different ages. ⋯ Over time there are systematic movements of cohorts between differently deprived areas and associated increases and decreases in the gradient of LLTI across deprivation. It seems likely that population migration does influence inequalities by age. Further work should investigate whether the situation exists for other morbidities and, to better inform public health policy, whether restricting summary measures of area health to ages between 30 and 60 when inequalities are greatest will highlight between area differences.