Small-area variation in mortality in the city of Oulu, Finland, during the period 1978--1995.

The aim of the present work was to explore small-area differences in mortality from all causes among males and females within the city of Oulu during the period 1978--1995 and to identify areas where mortality has been persistently high or low. Analyses carried out using Geographical Information System techniques with geo-referenced mortality data produced at a resolution of 1 x 1 km showed significant regional variations in mortality within the city. The differences were wide enough to suggest variations of several years in longevity, and were probably indicative of marked variations in the incidences of diseases. Observed mortality differences may reflect the influence of the rapidly changing urban structure and consequent health effects based on selection, lifestyles, work exposures and deprivation.