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Exceptions to the rule: Healthy deprived areas and unhealthy wealthy areas

Listed author(s):
  • van Hooijdonk, Carolien
  • Droomers, Mariël
  • van Loon, Jeanne A.M.
  • van der Lucht, Fons
  • Kunst, Anton E.
Registered author(s):

    In general, inhabitants of low socio-economic areas are unhealthier than inhabitants of high socio-economic areas, but some areas are an exception to this rule. These exceptions imply that other factors besides the socio-economic level of an area contribute to the health of the inhabitants of an area, e.g. environmental factors. In our study we concentrate on areas within the Netherlands that are healthier or unhealthier than could be expected based on their socio-economic level. This study first identifies these areas and secondly determines which area characteristics distinguish these areas from those areas where the level of health is in agreement with their socio-economic level. We used nation-wide data on neighbourhood differences in population composition (gender, age, marital status and ethnicity), urbanisation and two health indicators: mortality and hospitalisation rates. In the Netherlands, many areas are healthier or unhealthier than could be expected based on their income level alone. Areas with higher mortality rates than expected are mainly urban areas with high percentages of elderly people and persons living alone. Similar but opposite associations are observed for areas with lower mortality rates than expected, which are further characterised by a low percentage of non-western immigrants. Areas with lower hospitalisation rates than expected are mainly rural areas with few non-western immigrants. From these results, we conclude that urbanisation and residential segregation based on age, ethnicity and marital status might be important contributors to geographical health inequalities.

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 64 (2007)
    Issue (Month): 6 (March)
    Pages: 1326-1342

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    Handle: RePEc:eee:socmed:v:64:y:2007:i:6:p:1326-1342
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    4. Lochner, Kimberly A. & Kawachi, Ichiro & Brennan, Robert T. & Buka, Stephen L., 2003. "Social capital and neighborhood mortality rates in Chicago," Social Science & Medicine, Elsevier, vol. 56(8), pages 1797-1805, April.
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    6. Cohen, Deborah A. & Farley, Thomas A. & Mason, Karen, 2003. "Why is poverty unhealthy? Social and physical mediators," Social Science & Medicine, Elsevier, vol. 57(9), pages 1631-1641, November.
    7. Senior, Martyn & Williams, Huw & Higgs, Gary, 2000. "Urban-rural mortality differentials: controlling for material deprivation," Social Science & Medicine, Elsevier, vol. 51(2), pages 289-305, July.
    8. 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.
    9. Jeroen Smits & Ingeborg Keij-Deerenberg & Gert Westert, 2005. "Effects of socio-economic status on mortality: separating the nearby from the farther away," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 595-608.
    10. Bentham, Graham, 1988. "Migration and morbidity: Implications for geographical studies of disease," Social Science & Medicine, Elsevier, vol. 26(1), pages 49-54, January.
    11. Huisman, Martijn & Kunst, Anton E. & Mackenbach, Johan P., 2003. "Socioeconomic inequalities in morbidity among the elderly; a European overview," Social Science & Medicine, Elsevier, vol. 57(5), pages 861-873, September.
    12. Haynes, Robin, 1991. "Inequalities in health and health service use: Evidence from the general household survey," Social Science & Medicine, Elsevier, vol. 33(4), pages 361-368, January.
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