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Recent changes in the geography of social disparities in premature mortality in Québec

Listed author(s):
  • Pampalon, Robert
  • Hamel, Denis
  • Gamache, Philippe
Registered author(s):

    Most recent research reveals that social inequalities in premature mortality are widening. Such findings mainly apply to countries as a whole. In this study, we model recent changes in the association between premature mortality and a deprivation index (a small area-based index) in four geographic settings in Québec, namely the Montréal metropolitan area, other Québec metropolitan areas, mid-size cities, and small towns and rural areas. Deaths from all-cause and specific causes of mortality among people under age 75 are considered for the periods 1989-1993 and 1999-2003. Mortality rates are modeled using negative binomial regressions. Models are fitted for the overall population and for men and women, separately, in every geographic setting. Three measures of inequalities are used: mortality rates for different population groups, rate ratios and rate differences. Results show that social inequalities in premature mortality increase everywhere in Québec except in the Montréal metropolitan area. Presently, the highest mortality rates among deprived groups are found in mid-size cities, small towns and rural areas; the highest rate ratios in the Montréal metropolitan area and other metropolitan areas of Québec; and the highest rate differences in the Montréal metropolitan area, other metropolitan areas of Québec and mid-size cities. These results are discussed with reference to possible explanatory factors, namely relative deprivation, smoking, immigration and internal migration. Indications on future research and policy implications are provided.

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

    Volume (Year): 67 (2008)
    Issue (Month): 8 (October)
    Pages: 1269-1281

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    Handle: RePEc:eee:socmed:v:67:y:2008:i:8:p:1269-1281
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    1. Norman, Paul & Boyle, Paul & Rees, Philip, 2005. "Selective migration, health and deprivation: a longitudinal analysis," Social Science & Medicine, Elsevier, vol. 60(12), pages 2755-2771, June.
    2. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    3. 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.
    4. Galea, Sandro & Freudenberg, Nicholas & Vlahov, David, 2005. "Cities and population health," Social Science & Medicine, Elsevier, vol. 60(5), pages 1017-1033, March.
    5. Berkman, Lisa F. & Glass, Thomas & Brissette, Ian & Seeman, Teresa E., 2000. "From social integration to health: Durkheim in the new millennium," Social Science & Medicine, Elsevier, vol. 51(6), pages 843-857, September.
    6. Boyle, Paul & Norman, Paul & Rees, Philip, 2002. "Does migration exaggerate the relationship between deprivation and limiting long-term illness? A Scottish analysis," Social Science & Medicine, Elsevier, vol. 55(1), pages 21-31, July.
    7. Shaw, Mary & Orford, Scott & Brimblecombe, Nicola & Dorling, Daniel, 2000. "Widening inequality in mortality between 160 regions of 15 European countries in the early 1990s," Social Science & Medicine, Elsevier, vol. 50(7-8), pages 1047-1058, April.
    8. Leclerc, Annette & Chastang, Jean-François & Menvielle, Gwenn & Luce, Danièle, 2006. "Socioeconomic inequalities in premature mortality in France: Have they widened in recent decades?," Social Science & Medicine, Elsevier, vol. 62(8), pages 2035-2045, April.
    9. Carpiano, Richard M., 2006. "Toward a neighborhood resource-based theory of social capital for health: Can Bourdieu and sociology help?," Social Science & Medicine, Elsevier, vol. 62(1), pages 165-175, January.
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