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Oportion of total government expenditure spent on the National Health Service (separately measured for the Health Services in England and Wales and Scotland) exerts a substantial beneficial' effect on mortality rates in Britain unlagged and lagged by one year. For both regions total, cerebrovascular and infant mortality show the beneficial effect as does total cardiovascular and heart diseae mortality in England and Wales, and cirrhosis mortality in Scotland. 14. Hospital ped utilization per capita might ordinarily be taken as an indicator of morbidity, except for the presence of general health risk factors in the equations predicting mortality.
The unemployment rate was examined for lagged relations to mortality within the 0-5 year range. A positive relation at zero or one year lag was found for nearly all causes of death except for infant mortality where no relation is found for Scotland, and suicide where the relation is found only for Scotland and at a two-year lag. 41 The quest ion of whether the rates of long duration of unemployment Cover 28 weeks) was a better predictor of the mortality rate than the total unemployment rate without regard to duration was extensively examined.
The werk to date does show, however, wIlich variables would be likely to be effective predictors for most age/sex groups. Knowing this allows the research to continue in a productive direction, without baving to test as many different equations as would need to be tested in the absence of the completed preliminary work. As a result of this work, it is clear that recession and economic growth, as weIl as health-related behaviors and health services, have had important associations over the 22-year period ending in 1976 with mortality rates.