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This study is a useful addition to the far wider literature regarding the stalling in life expectancy observed in places around the world. May I recommend several avenues of further investigation to the authors and/or others seeking to explore this area.
My own published and unpublished research indicates that the output area classification of social groups gives far greater insight into health behaviours than deprivation [1,2]. Hence the observation in this study that areas of similar deprivation show different life expectancies. Deprivation is merely a crude pointer to social group. In an unpublished study of hospital admission via A&E the role of deprivation completely disappeared after adjusting for social group.
Further research into the role of influenza rates on the expression of excess winter mortality is relevant . This study is about to be published and shows curious spatio-temporal differences between UK local authorities and between countries.
In a series of papers to be published in the Journal of Health Care Finance I have demonstrated an important role for population density in the transmission of infections and this adds a further layer of complexity to the spatio-temporal patterns. Preliminary investigation is available as a multi-series preprint which covered the spread of Covid-19 . Issues relating to population density are profoundly important.
As a final area of interest I have been investigating strange patterns i...
As a final area of interest I have been investigating strange patterns in deaths, which are observed around the world, and which are associated with unexplained patterns of higher medical admissions [See references in 5-10]. These patterns can only be described as shift up and down in deaths which behave in an identical way to an infectious outbreak. These patterns have a profound effect on UK local authority trends in deaths. Sickness absence in NHS workers follows the same patterns.
Hopefully these suggested avenues will yield further clarity.
1. Beeknoo N, Jones R. Using Social Groups to Locate Areas with High Emergency Department Attendance, Subsequent Inpatient Admission and Need for Critical Care. Journal of Advances in Medicine and Medical Research 2016; 18(6): 1-23. http://www.sciencedomain.org/abstract/16693
2. Beeknoo N, Jones R. Using social groups to locate areas of high utilization of critical care. Brit J Healthcare Management 2016; 22(11): 551-560.
3. Jones R. Excess winter mortality (EWM) and stalling international improvements in life expectancy and mortality rates. BJHCM 2020; (in press)
4. Jones R. How many extra deaths have really occurred in the UK due to the Covid-19 outbreak? XVIII. Which communities in the UK are susceptible to the ‘second’ wave. 2020. https://www.researchgate.net/publication/344390361_How_many_extra_deaths...
5. Jones R. Recurring outbreaks of an infection apparently targeting immune function, and consequent unprecedented growth in medical admission and costs in the United Kingdom: A review. Brit J Med and Medical Research 2015; 6(8): 735-770. doi: 10.9734/BJMMR/2015/14845
6. Jones R. A presumed infectious event in England and Wales during 2014 and 2015 leading to higher deaths in those with
neurological and other disorders. Journal of Neuroinfectious Diseases 2016; 7(1): 1000213 doi: 10.4172/2314-7326.1000213
7. Jones R. A reduction in acute thrombotic admissions during a period of unexplained increased deaths and medical admissions in the UK.
European Journal of Internal Medicine 2017; 46: e31-e33 doi: http://dx.doi.org/10.1016/j.ejim.2017.09.007
8. Jones R. Age-specific and year of birth changes in hospital admissions during a period of unexplained higher deaths in England. European Journal of Internal Medicine 45: 2-4. doi: http://dx.doi.org/10.1016/j.ejim.2017.09.039
9. Jones R. Periods of unexplained higher deaths and medical admissions have occurred previously – but were apparently ignored, misinterpreted or not investigated. European Journal of Internal Medicine 40: e18-e20. https://doi.org/10.1016/j.ejim.2017.11.004
10. Jones R. Do outbreaks of ‘Disease X’ regulate NHS beds and costs? Brit J Healthcare Management 24(4): 204-205. http://www.hcaf.biz/2018/Beds_Disease_X.pdf