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The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal

Author

Listed:
  • Claudia Costa

    (Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal)

  • Angela Freitas

    (Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal)

  • Ricardo Almendra

    (Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal
    Department of Geography and Tourism, University of Coimbra, 3004-530 Coimbra, Portugal)

  • Paula Santana

    (Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal
    Department of Geography and Tourism, University of Coimbra, 3004-530 Coimbra, Portugal)

Abstract

There is considerable evidence pointing to the existence of a socioeconomic gradient in mortality, which tends to be steeper in urban areas. Similar to other European cities, Lisbon is far from homogeneous since considerable geographical inequalities exist between the more advantaged and the more deprived neighborhoods. The main goals of this study are to describe the geographical pattern of premature deaths (before 65 years old), avoidable deaths (preventable and amenable to healthcare) and cause-specific mortality (HIV/AIDS and suicide) in Lisbon, at the lower administrative level (civil parish, in Portuguese: Freguesia), and analyze the statistical association between mortality risk and deprivation, before (1999–2003) and during the economic crisis (2008–2012). Smoothed Standardized Mortality Ratios (sSMR) and Relative Risk (RR) with 95% credible intervals were calculated to identify the association between mortality and deprivation. The analysis of the geographical distribution of cause-specific mortality reveals that civil parishes with high sSMR in the first period continued to present higher mortality rates in the second. Moreover, a significant statistical association was found between all the causes of death and deprivation, except suicide. These findings contribute to understanding how social conditions influence health outcomes and can offer insights about potential policy directions for local government.

Suggested Citation

  • Claudia Costa & Angela Freitas & Ricardo Almendra & Paula Santana, 2020. "The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal," IJERPH, MDPI, vol. 17(22), pages 1-16, November.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:22:p:8517-:d:446409
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    References listed on IDEAS

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    1. Ana Isabel Ribeiro & Ludivine Launay & Elodie Guillaume & Guy Launoy & Henrique Barros, 2018. "The Portuguese version of the European Deprivation Index: Development and association with all-cause mortality," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-13, December.
    2. Legido-Quigley, Helena & Karanikolos, Marina & Hernandez-Plaza, Sonia & de Freitas, Cláudia & Bernardo, Luís & Padilla, Beatriz & Sá Machado, Rita & Diaz-Ordaz, Karla & Stuckler, David & McKee, Martin, 2016. "Effects of the financial crisis and Troika austerity measures on health and health care access in Portugal," Health Policy, Elsevier, vol. 120(7), pages 833-839.
    3. Jason Corburn, 2017. "Urban Place and Health Equity: Critical Issues and Practices," IJERPH, MDPI, vol. 14(2), pages 1-10, January.
    4. Diez Roux, A.V., 2001. "Investigating neighborhood and area effects on health," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1783-1789.
    5. Cairns, Joanne-Marie & Graham, Eva & Bambra, Clare, 2017. "Area-level socioeconomic disadvantage and suicidal behaviour in Europe: A systematic review," Social Science & Medicine, Elsevier, vol. 192(C), pages 102-111.
    6. Perelman, Julian & Felix, Sónia & Santana, Rui, 2015. "The Great Recession in Portugal: Impact on hospital care use," Health Policy, Elsevier, vol. 119(3), pages 307-315.
    7. Julian Besag & Jeremy York & Annie Mollié, 1991. "Bayesian image restoration, with two applications in spatial statistics," Annals of the Institute of Statistical Mathematics, Springer;The Institute of Statistical Mathematics, vol. 43(1), pages 1-20, March.
    8. Håvard Rue & Sara Martino & Nicolas Chopin, 2009. "Approximate Bayesian inference for latent Gaussian models by using integrated nested Laplace approximations," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 71(2), pages 319-392, April.
    9. Iago Lestegás & João Seixas & Rubén-Camilo Lois-González, 2019. "Commodifying Lisbon: A Study on the Spatial Concentration of Short-Term Rentals," Social Sciences, MDPI, vol. 8(2), pages 1-15, January.
    10. Michala Lustigova & Dagmar Dzurova & Claudia Costa & Paula Santana, 2019. "Health Disparities in Czechia and Portugal at Country and Municipality Levels," IJERPH, MDPI, vol. 16(7), pages 1-16, March.
    11. 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.
    12. Ricardo Almendra & Paula Santana & João Vasconcelos, 2017. "Evidence of social deprivation on the spatial patterns of excess winter mortality," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(8), pages 849-856, November.
    13. repec:dau:papers:123456789/10510 is not listed on IDEAS
    14. Adriana Loureiro & Paula Santana & Carla Nunes & Ricardo Almendra, 2019. "The Role of Individual and Neighborhood Characteristics on Mental Health after a Period of Economic Crisis in the Lisbon Region (Portugal): A Multilevel Analysis," IJERPH, MDPI, vol. 16(15), pages 1-16, July.
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    2. Min-Hyeok Choi & Min-Hui Moon & Tae-Ho Yoon, 2022. "Avoidable Mortality between Metropolitan and Non-Metropolitan Areas in Korea from 1995 to 2019: A Descriptive Study of Implications for the National Healthcare Policy," IJERPH, MDPI, vol. 19(6), pages 1-13, March.

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