International Journal of Public Health

, Volume 57, Issue 4, pp 745–750 | Cite as

Socio-economic disparities in mortality due to pandemic influenza in England

  • Paul D. Rutter
  • Oliver T. Mytton
  • Matthew Mak
  • Liam J. Donaldson
Original Article



This study examines variations in mortality between socio-economic groups due to the pandemic Influenza (H1N1) 2009 virus in England.


We established a system to identify all deaths related to pandemic (H1N1) 2009 influenza. We collected the postcode of every individual who died, and through this determined the socio-economic deprivation, urban–rural characteristics and region of their residence. Across England, we were therefore able to examine how mortality rates varied by socio-economic group, between urban and rural areas, and between regions.


People in the most deprived quintile of England’s population had an age and sex-standardised mortality rate three times that experienced by the least deprived quintile (RR = 3.1, 95% CI 2.2–4.4). Mortality was also higher in urban areas than in rural areas (RR = 1.7, 95% CI 1.2–2.3). Mortality rates were similar between regions of the country.


Tackling socio-economic health inequalities is a central concept within public health, but has not always been a part of emergency preparedness plans. These data demonstrate the opportunity to reduce the overall impact and narrow inequalities by considering socio-economic disparities in future pandemic planning.


Influenza Pandemic Emergency preparedness Health inequalities Socio-economic deprivation 


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Copyright information

© Swiss School of Public Health 2012

Authors and Affiliations

  • Paul D. Rutter
    • 1
  • Oliver T. Mytton
    • 2
  • Matthew Mak
    • 3
  • Liam J. Donaldson
    • 1
  1. 1.Imperial CollegeLondonUK
  2. 2.University of OxfordOxfordUK
  3. 3.King’s College HospitalLondonUK

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