Mortality, material deprivation and urbanization: exploring the social patterns of a metropolitan area

نویسندگان

  • Paula Santana
  • Claudia Costa
  • Marc Marí-Dell’Olmo
  • Mercè Gotsens
  • Carme Borrell
چکیده

INTRODUCTION Socioeconomic inequalities affecting health are of major importance in Europe. The literature enhances the role of social determinants of health, such as socioeconomic characteristics and urbanization, to achieve health equity. Yet, there is still much to know, mainly concerning the association between cause-specific mortality and several social determinants, especially in metropolitan areas. This study aims to describe the geographical pattern of cause-specific mortality in the Lisbon Metropolitan Area (LMA), at small area level (parishes), and analyses the statistical association between mortality risk and health determinants (material deprivation and urbanization level). Fourteen causes have been selected, representing almost 60% of total mortality between 1995 and 2008, particularly those associated with urbanization and material deprivation. METHODS A cross-sectional ecological study was carried out. Using a hierarchical Bayesian spatial model, we estimated sex-specific smoothed Standardized Mortality Ratios (sSMR) and measured the relative risks (RR), and 95% credible intervals, for cause-specific mortality relative to 1. urbanization level, 2. material deprivation and 3. material deprivation adjusted by urbanization. RESULTS The statistical association between mortality and material deprivation and between mortality and urbanization changes by cause of death and sex. Dementia and MN larynx, trachea, bronchus and lung are the causes of death showing higher relative risk associated with urbanization. Infectious and parasitic diseases, Chronic liver disease and Diabetes are the causes of death presenting higher relative risk associated with material deprivation. Ischemic heart disease was the only cause with a statistical association with both determinants, and MN female breast was the only without any statistical association. Urbanization level reduces the impact of material deprivation for most of the causes of death. Men face a higher impact of material deprivation and urbanization level, than women, in most cause-specific mortality, even when considering the adjusted model. CONCLUSIONS Our findings explore the specific pattern of fourteen causes of death in LMA and reveals small areas with an excess risk of mortality associated with material deprivation, thereby identifying problematic areas that could potentially benefit from public policies effecting social inequalities.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Future Studies Urban bubble in Tehran metropolitan

  Urbanization bubble is a new concept in urban planning issues for examining sustainability at various levels of social, economic, environmental, and management. So far, no common definition provided for urbanization bubble that indicate a lack of research in this field. This research aimed at assessing futures studies of urbanization bubble in Tehran metropolitan with focus on scenario plann...

متن کامل

A deprivation index for health planning in Canada.

Administrative databases in the Canadian health sector do not contain socio-economic information. To facilitate the monitoring of social inequalities for health planning, this study proposes a material and social deprivation index for Canada. After explaining the concept of deprivation, we describe the methodological aspects of the index and apply it to the example of premature mortality (i.e. ...

متن کامل

[Development of composite deprivation index for Korea: the correlation with standardized mortality ratio].

OBJECTIVES The aims of this paper were to develop the composite deprivation index (CDI) for the sub-district (Eup-Myen-Dong) levels based on the theory of social exclusion and to explore the relationship between the CDI and the standardized mortality ratio (SMR). METHODS The paper calculated the age adjusted SMR and we included five dimensions of social exclusion for CDI; unemployment, povert...

متن کامل

دگرگونی سیمای سلامت در ایران

Background and objectives: Data on transitions in health status are among the most important types of information used for promotion of health and social development. Health transition comprises two elements: demographic and epidemiologic transition. This paper depicts the health transition in I.R. Iran over the last few decades. Methods: We used demographic data gathered over the last 45 ye...

متن کامل

Effect of Vegetation Cover on Energy Consumption Optimization due to Reduction of Urban Heat Island intensity: Case of Tehran Metropolitan Area

Urbanization through rapid constructions, is the main cause of high heat absorption in urban centers. In addition, the accumulation of heat energy resulted by removal of vegetation cover, has contributed to formation of urban heat islands (UHIs). The spatial distribution of heat intensity in Tehran Metropolitan Area was studied, and the influence of land use and green cover were analyzed in the...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 14  شماره 

صفحات  -

تاریخ انتشار 2015