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Socioeconomic determinants of mortality in two Canadian provinces: Multilevel modelling and neighborhood context


  • Roos, Leslie L.
  • Magoon, Jennifer
  • Gupta, Sumit
  • Chateau, Dan
  • Veugelers, Paul J.


The influence of individual and contextual socioeconomic variables on mortality is compared in two Canadian provinces, Manitoba and Nova Scotia. Although differing substantially in size, ethnic mix, and history, both provinces provide greater access to health and social services as well as fewer income inequalities than the United States. A total of 8032 Manitoba respondents (followed from 1996-97 to 2002) and 2116 Nova Scotia respondents (followed from 1990 to 1999) were linked to the appropriate Canadian census as a source of neighborhood characteristics. Data were analyzed using individual- and multi-level logistic regression. Well-educated and higher income individuals were less likely to die during follow-up. No significant direct effect was found between neighborhood socioeconomic characteristics and mortality. However, both provinces showed an increased importance of individual income vis-à-vis mortality in advantaged neighborhoods relative to disadvantaged neighborhoods. Additional Manitoba analyses showed a "healthy mover" effect among respondents changing place of residence, regardless of whether they moved to more advantaged or more disadvantaged neighborhoods. The findings are discussed in the context of differences in health and health care among Canada, the United States, and other OECD countries.

Suggested Citation

  • Roos, Leslie L. & Magoon, Jennifer & Gupta, Sumit & Chateau, Dan & Veugelers, Paul J., 2004. "Socioeconomic determinants of mortality in two Canadian provinces: Multilevel modelling and neighborhood context," Social Science & Medicine, Elsevier, vol. 59(7), pages 1435-1447, October.
  • Handle: RePEc:eee:socmed:v:59:y:2004:i:7:p:1435-1447

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    Cited by:

    1. van Hooijdonk, Carolien & Droomers, Mariël & van Loon, Jeanne A.M. & van der Lucht, Fons & Kunst, Anton E., 2007. "Exceptions to the rule: Healthy deprived areas and unhealthy wealthy areas," Social Science & Medicine, Elsevier, vol. 64(6), pages 1326-1342, March.
    2. Gulati, Namrata & Ray, Tridip, 2016. "Inequality, neighbourhoods and welfare of the poor," Journal of Development Economics, Elsevier, vol. 122(C), pages 214-228.
    3. Meijer, Mathias & Röhl, Jeannette & Bloomfield, Kim & Grittner, Ulrike, 2012. "Do neighborhoods affect individual mortality? A systematic review and meta-analysis of multilevel studies," Social Science & Medicine, Elsevier, vol. 74(8), pages 1204-1212.
    4. Martin Gächter & Engelbert Theurl, 2010. "Convergence of the Health Status at the Local Level: Empirical Evidence from Austria," NRN working papers 2010-09, The Austrian Center for Labor Economics and the Analysis of the Welfare State, Johannes Kepler University Linz, Austria.
    5. Albor, C. & Uphoff, E.P. & Stafford, M. & Ballas, D. & Wilkinson, R.G. & Pickett, K.E., 2014. "The effects of socioeconomic incongruity in the neighbourhood on social support, self-esteem and mental health in England," Social Science & Medicine, Elsevier, vol. 111(C), pages 1-9.
    6. Roos, Leslie L. & Brownell, Marni & Lix, Lisa & Roos, Noralou P. & Walld, Randy & MacWilliam, Leonard, 2008. "From health research to social research: Privacy, methods, approaches," Social Science & Medicine, Elsevier, vol. 66(1), pages 117-129, January.


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