Insulin dependent diabetes in childhood and material deprivation in northern England, 1977-86

Abstract

Objective - To determine the incidence of insulin dependent diabetes in the Northern region of England in children less than 16 years old in the period 1977 to 1986 and to relate the incidence data to an index of deprivation. Design - Retrospective analysis of hospital case records identified from the regional health authority's computer; validation of the primary source with hospital clinic registers and community paediatric registers. Setting - Northern region, excluding South Cumbria District Health Authority (659300 children under 16 in 1981). Patients - All children diagnosed with insulin dependent diabetes before the age of 16 and resident in the region at time of diagnosis. Main outcome measures - Incidence rates for the 10 year period and analysis of incidence rates within categories of deprivation. Results - 919 incident cases were identified. The validation procedure covered 54% of all cases identified and gave 95% completeness of ascertainment. The average annual incidence over the 10 year period was 14.8/100000 for girls and 13.4/100000 for boys. The annual incidence for the most and least deprived areas of the region was 18.7/100 000 (95% confidence interval 16.2 to 21.5) for boys and 7/100 000 (5.6 to 8.8) for girls. There was a highly significant trend (p<0.001) of decreasing incidence with decreasing level of deprivation. Conclusions - In the north of England the incidence of childhood diabetes is related to material deprivation.