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Article History

Received: 22 May 2025

Accepted: 10 November 2025

First Online: 16 December 2025

Declarations

:

: Dr. Grasic is currently an employee of Amgen, Dr. Cookson reports grants from NIHR during the conduct of the study and personal fees from pharmaceutical companies for advisory work on equity methods outside the submitted work. The remaining of authors do not have conflicts of interest to disclose.

: Not applicable.

: Not applicable.

: Not applicable.

: All data used in this report are publicly available: CCG funding allocations (2018/19) for 195 NHS areas in England: . 2018 mid-year population estimates , from the Office for National Statistics (ONS): . 2018 death counts by sex, age (5-year bands), and 2011 LSOA, from the ONS: . 2019 English Indices of Deprivation , by LSOA, from the Ministry of Housing, Communities and Local Government: . CCG boundary codes (2018/19) for matching LSOAs to CCGs: .

: The code to reproduce the analysis is available from the corresponding author upon reasonable request.

: All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Misael Anaya-Montes and Katja Grašič. The first draft of the manuscript was written by Richard Cookson and Katja Grašič, with contributions from Misael Anaya-Montes and James Lomas. The interpretation of the results were critically appraised and subsequent drafts improved by Laura Anselmi, Miqdad Asaria, Christodoulos Kypridemos and Chris Bentley. The robustness of the empirical methodology and interpretation of results were assessed by Benjamin Barr, Matthew Sutton and Richard Cookson. All authors read and approved the final manuscript.