Changes in socioeconomic inequalities in census measures of health in England and Wales, 1991–2001

Study objectives: To investigate changes in socioeconomic inequalities in census measures of health in England and Wales between 1991 and 2001. Design: Indirect standardisation was used to calculate age standardised rates of limiting long term illness and permanent sickness in men and women in all residential wards in England and Wales in 1991 and 2001. The socioeconomic position of each ward was determined using Townsend deprivation scores. Setting: All residential wards in England and Wales in 1991 and 2001. Participants: All people aged 16–65 who provided census information in the 1991 or 2001 censuses. Main results: There was strong evidence that Townsend deprivation score quintile could predict both logged standardised permanent sickness rate and logged standardised limiting long term illness rate. There was evidence that socioeconomic inequalities in standardised limiting long term illness rates decreased between 1991 and 2001 in both men and women and that socioeconomic inequalities in standardised permanent sickness rates decreased in women but increased in men between 1991 and 2001. Conclusions: As permanent sickness rates seem to reflect labour market accessibility, this study may have found evidence that socioeconomic inequalities in self reported morbidity decreased but inequalities in labour market participation in men increased between 1991 and 2001.