Premature mortality due to social and material deprivation in Nova Scotia, Canada

International Journal for Equity in Health

Trevor JB Dummer²  Louise Parker³  Yunsong Cui³  Ron Dewar¹  Nathalie Saint-Jacques³ 

[1] Cancer Care Nova Scotia, Surveillance and Epidemiology Unit, Room 560 Bethune Building, 1276 South Street, Halifax B3H 2Y9, Nova Scotia, Canada;School of Population and Public Health, The University of British Columbia, Room 165-2206 East Mall, Vancouver V6T 1Z3, British Columbia, Canada;Population Cancer Research Program, Department of Pediatrics, Dalhousie University, 1494 Carlton Street, Halifax B3H 4R2, Nova Scotia, Canada

关键词: Health equity;    Public health surveillance;    Deprivation index;    Small-area analysis;    Premature mortality;    Socioeconomic factors;   

Others  :  1137595
DOI  :  10.1186/s12939-014-0094-2

 received in 2014-07-07, accepted in 2014-10-07,  发布年份 2014

【 摘 要 】

Introduction

Inequalities in health attributable to inequalities in society have long been recognized. Typically, those most privileged experience better health, regardless of universal access to health care. Associations between social and material deprivation and mortality from all causes of death— a measure of population health, have been described for some regions of Canada. This study further examines the link between deprivation and health, focusing on major causes of mortality for both rural and urban populations. In addition, it quantifies the burden of premature mortality attributable to social and material deprivation in a Canadian setting where health care is accessible to all.

Methods

The study included 35,266 premature deaths (1995–2005), grouped into five causes and aggregated over census dissemination areas. Two indices of deprivation (social and material) were derived from six socioeconomic census variables. Premature mortality was modeled as a function of these deprivation indices using Poisson regression.

Results

Premature mortality increased significantly with increasing levels of social and material deprivation. The impact of material deprivation on premature mortality was similar in urban and rural populations, whereas the impact of social deprivation was generally greater in rural populations. There were a doubling in premature mortality for those experiencing a combination of the most extreme levels of material and social deprivation.

Conclusions

Socioeconomic deprivation is an important determinant of health equity and affects every segment of the population. Deprivation accounted for 40% of premature deaths. The 4.3% of the study population living in extreme levels of socioeconomic deprivation experienced a twofold increased risk of dying prematurely. Nationally, this inequitable risk could translate into a significant public health burden.

【 授权许可】

   
2014 Saint-Jacques et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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