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Published in: International Journal for Equity in Health 1/2014

Open Access 01-12-2014 | Research

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

Authors: Nathalie Saint-Jacques, Ron Dewar, Yunsong Cui, Louise Parker, Trevor JB Dummer

Published in: International Journal for Equity in Health | Issue 1/2014

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Abstract

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.
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Literature
1.
go back to reference Marmot MG: Understanding social inequalities in health. Perspect Biol Med. 2003, 46 (3 Suppl): S9-S23. 10.1353/pbm.2003.0056.PubMedCrossRef Marmot MG: Understanding social inequalities in health. Perspect Biol Med. 2003, 46 (3 Suppl): S9-S23. 10.1353/pbm.2003.0056.PubMedCrossRef
2.
go back to reference Pickett KE, Pearl M: Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review. J Epidemiol Commun H. 2001, 55: 111-122. 10.1136/jech.55.2.111.CrossRef Pickett KE, Pearl M: Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review. J Epidemiol Commun H. 2001, 55: 111-122. 10.1136/jech.55.2.111.CrossRef
3.
go back to reference Kawachi I, Berkman L: Neighborhoods and Health. 2003, Oxford University Press, New YorkCrossRef Kawachi I, Berkman L: Neighborhoods and Health. 2003, Oxford University Press, New YorkCrossRef
4.
go back to reference Townsend P: Deprivation. Int Soc Pol. 1987, 16: 125-146. Townsend P: Deprivation. Int Soc Pol. 1987, 16: 125-146.
5.
go back to reference Adler NE, Ostrove JM: Socioeconomic status and health: what We know and what We Don´t. Ann NY Acad Sci. 1999, 896: 3-15. 10.1111/j.1749-6632.1999.tb08101.x.PubMedCrossRef Adler NE, Ostrove JM: Socioeconomic status and health: what We know and what We Don´t. Ann NY Acad Sci. 1999, 896: 3-15. 10.1111/j.1749-6632.1999.tb08101.x.PubMedCrossRef
6.
go back to reference Adler NE, Rehkopf DH: U.S. Disparities in health: descriptions, causes, and mechanisms. Annu Rev Publ Health. 2008, 29: 235-252. 10.1146/annurev.publhealth.29.020907.090852.CrossRef Adler NE, Rehkopf DH: U.S. Disparities in health: descriptions, causes, and mechanisms. Annu Rev Publ Health. 2008, 29: 235-252. 10.1146/annurev.publhealth.29.020907.090852.CrossRef
7.
go back to reference Clegg LX, Reichman ME, Miller BA, Hankey BF, Singh GK, Lin YD, Goodman MT, Lynch CF, Schwartz SM, Chen VW, Bernstein L, Gomez SL, Graff JJ, Lin CC, Johnson NJ, Edwards BK: Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. Cancer Causes Control. 2009, 20: 417-435. 10.1007/s10552-008-9256-0.PubMedCrossRef Clegg LX, Reichman ME, Miller BA, Hankey BF, Singh GK, Lin YD, Goodman MT, Lynch CF, Schwartz SM, Chen VW, Bernstein L, Gomez SL, Graff JJ, Lin CC, Johnson NJ, Edwards BK: Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. Cancer Causes Control. 2009, 20: 417-435. 10.1007/s10552-008-9256-0.PubMedCrossRef
8.
go back to reference Sidorchuk A, Agardh EE, Aremu O, Hallqvist J, Allebeck P, Moradi T: Socioeconomic differences in lung cancer incidence: a systematic review and meta-analysis. Cancer Cause Control. 2009, 20: 459-471. 10.1007/s10552-009-9300-8.CrossRef Sidorchuk A, Agardh EE, Aremu O, Hallqvist J, Allebeck P, Moradi T: Socioeconomic differences in lung cancer incidence: a systematic review and meta-analysis. Cancer Cause Control. 2009, 20: 459-471. 10.1007/s10552-009-9300-8.CrossRef
9.
go back to reference Smith LK, Budd JLS, Field DJ, Draper ES: Socioeconomic inequalities in outcome of pregnancy and neonatal mortality associated with congenital anomalies: population based study. BMJ. 2011, 343: d4306-d4306. 10.1136/bmj.d4306.PubMedCentralPubMedCrossRef Smith LK, Budd JLS, Field DJ, Draper ES: Socioeconomic inequalities in outcome of pregnancy and neonatal mortality associated with congenital anomalies: population based study. BMJ. 2011, 343: d4306-d4306. 10.1136/bmj.d4306.PubMedCentralPubMedCrossRef
10.
go back to reference Wu SH, Woo J, Zhang X-H: Worldwide socioeconomic status and stroke mortality: an ecological study. Int J Equity Health. 2013, 12: 42-10.1186/1475-9276-12-42.PubMedCentralPubMedCrossRef Wu SH, Woo J, Zhang X-H: Worldwide socioeconomic status and stroke mortality: an ecological study. Int J Equity Health. 2013, 12: 42-10.1186/1475-9276-12-42.PubMedCentralPubMedCrossRef
11.
go back to reference Feinstein JS: Relationship between socioeconomic status and health: A review of the litterature. Millbank Q. 1993, 71: 279-322. 10.2307/3350401.CrossRef Feinstein JS: Relationship between socioeconomic status and health: A review of the litterature. Millbank Q. 1993, 71: 279-322. 10.2307/3350401.CrossRef
12.
go back to reference Veugelers PJ, Yip AM: Socioeconomic disparities in health care use: Does universal coverage reduce inequalities in health?. J Epidemiol Commun H. 2003, 57: 424-428. 10.1136/jech.57.6.424.CrossRef Veugelers PJ, Yip AM: Socioeconomic disparities in health care use: Does universal coverage reduce inequalities in health?. J Epidemiol Commun H. 2003, 57: 424-428. 10.1136/jech.57.6.424.CrossRef
13.
go back to reference Hayward K, Colman R: The Tides of Changes. Adressing inequity and chronic disease in Atlantic Canada, a discussion paper. Health Canada; 2003. Hayward K, Colman R: The Tides of Changes. Adressing inequity and chronic disease in Atlantic Canada, a discussion paper. Health Canada; 2003.
14.
go back to reference Pampalon R, Hamel D, Gamache P, Raymond G: A deprivation index for health planning in Canada. Chronic Dis Can. 2009, 29: 178-191.PubMed Pampalon R, Hamel D, Gamache P, Raymond G: A deprivation index for health planning in Canada. Chronic Dis Can. 2009, 29: 178-191.PubMed
15.
go back to reference Mackenbach JP: The persistence of health inequalities in modern welfare states: The explanation of a paradox. Soc Sci Med. 2012, 75: 761-769. 10.1016/j.socscimed.2012.02.031.PubMedCrossRef Mackenbach JP: The persistence of health inequalities in modern welfare states: The explanation of a paradox. Soc Sci Med. 2012, 75: 761-769. 10.1016/j.socscimed.2012.02.031.PubMedCrossRef
16.
go back to reference Eames M, Ben-Shlomo Y, Marmot MG: Social deprivation and premature mortality: regional comparison across England. BMJ. 1993, 307: 1097-1102. 10.1136/bmj.307.6912.1097.PubMedCentralPubMedCrossRef Eames M, Ben-Shlomo Y, Marmot MG: Social deprivation and premature mortality: regional comparison across England. BMJ. 1993, 307: 1097-1102. 10.1136/bmj.307.6912.1097.PubMedCentralPubMedCrossRef
17.
go back to reference Exeter DJ, Boyle PJ, Norman P: Deprivation (im)mobility and cause-specific premature mortality in Scotland. Soc Sci Med. 2011, 72: 389-397. 10.1016/j.socscimed.2010.10.009. [13th International Medical Geography Symposium]PubMedCrossRef Exeter DJ, Boyle PJ, Norman P: Deprivation (im)mobility and cause-specific premature mortality in Scotland. Soc Sci Med. 2011, 72: 389-397. 10.1016/j.socscimed.2010.10.009. [13th International Medical Geography Symposium]PubMedCrossRef
18.
go back to reference Borrell C, Marí-Dell´olmo M, Palència L, Gotsens M, Burström BO, Dominguez-Berjón F, Rodriguez-Sanz M, Dzúrová D, Gandarillas A, Hoffmann R, Kovacs K, Marinacci C, Martikainen P, Pikhart H, Corman D, Rosicova K, Saez M, Santana P, Tarkiainen L, Puigpinós R, Morrison J, Pasarin MI, Diez : Socioeconomic inequalities in mortality in 16 European cities. Scand J Public Health. 2014, 42: 245-254. 10.1177/1403494814522556.PubMedCrossRef Borrell C, Marí-Dell´olmo M, Palència L, Gotsens M, Burström BO, Dominguez-Berjón F, Rodriguez-Sanz M, Dzúrová D, Gandarillas A, Hoffmann R, Kovacs K, Marinacci C, Martikainen P, Pikhart H, Corman D, Rosicova K, Saez M, Santana P, Tarkiainen L, Puigpinós R, Morrison J, Pasarin MI, Diez : Socioeconomic inequalities in mortality in 16 European cities. Scand J Public Health. 2014, 42: 245-254. 10.1177/1403494814522556.PubMedCrossRef
19.
go back to reference Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D: Social capital, income inequality, and mortality. Am J Public Health. 1997, 87: 1491-10.2105/AJPH.87.9.1491.PubMedCentralPubMedCrossRef Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D: Social capital, income inequality, and mortality. Am J Public Health. 1997, 87: 1491-10.2105/AJPH.87.9.1491.PubMedCentralPubMedCrossRef
20.
go back to reference Mackenbach JP, Bos V, Andersen O, Cardano M, Costa G, Harding S, Reid A, Hemström , Valkonen T, Kunst AE: Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol. 2003, 32: 830-837. 10.1093/ije/dyg209.PubMedCrossRef Mackenbach JP, Bos V, Andersen O, Cardano M, Costa G, Harding S, Reid A, Hemström , Valkonen T, Kunst AE: Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol. 2003, 32: 830-837. 10.1093/ije/dyg209.PubMedCrossRef
21.
go back to reference Marmot M, Wilkinson RG: Social Determinants of Health. Second. 2008, Oxford University Press, Great Britain Marmot M, Wilkinson RG: Social Determinants of Health. Second. 2008, Oxford University Press, Great Britain
22.
go back to reference Mikkonen J, Raphael DL: Social Determinants of Health: The Canadian Facts. 2010, York University School of Health Policy and Management, Toronto Mikkonen J, Raphael DL: Social Determinants of Health: The Canadian Facts. 2010, York University School of Health Policy and Management, Toronto
23.
go back to reference Menzin J, Marton JP, Menzin JA, Willke RJ, Woodward RM, Federico V: Lost productivity due to premature mortality in developed and emerging countries: an application to smoking cessation. BMC Med Res Methodol. 2012, 12: 87-10.1186/1471-2288-12-87.PubMedCentralPubMedCrossRef Menzin J, Marton JP, Menzin JA, Willke RJ, Woodward RM, Federico V: Lost productivity due to premature mortality in developed and emerging countries: an application to smoking cessation. BMC Med Res Methodol. 2012, 12: 87-10.1186/1471-2288-12-87.PubMedCentralPubMedCrossRef
24.
go back to reference CSDH: Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health. 2008, World Health Organization, Geneva, Switzerland CSDH: Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health. 2008, World Health Organization, Geneva, Switzerland
26.
go back to reference Pampalon R, Hamel D, Gamache P, Simpson A, Philibert D: Valdiation of a deprivation index for public health: a complex exercise illustrated by the Quebec index. Chronic Dis Can. 2014, 34: 12-22. Pampalon R, Hamel D, Gamache P, Simpson A, Philibert D: Valdiation of a deprivation index for public health: a complex exercise illustrated by the Quebec index. Chronic Dis Can. 2014, 34: 12-22.
27.
go back to reference Jarman B: Identification of underprivileged areas. Br Med J (Clin Res Ed). 1983, 287: 130-131. 10.1136/bmj.287.6385.130-c.CrossRef Jarman B: Identification of underprivileged areas. Br Med J (Clin Res Ed). 1983, 287: 130-131. 10.1136/bmj.287.6385.130-c.CrossRef
28.
go back to reference Morris R, Carstairs V: Which deprivation? A comparison of selected deprivation indexes. J Public Health. 1991, 13: 318-326. Morris R, Carstairs V: Which deprivation? A comparison of selected deprivation indexes. J Public Health. 1991, 13: 318-326.
29.
go back to reference Benach J, Yasui Y: Geographical patterns of excess mortality in Spain explained by two indices of deprivation. J Epidemiol Commun H. 1999, 53: 423-431. 10.1136/jech.53.7.423.CrossRef Benach J, Yasui Y: Geographical patterns of excess mortality in Spain explained by two indices of deprivation. J Epidemiol Commun H. 1999, 53: 423-431. 10.1136/jech.53.7.423.CrossRef
30.
go back to reference Salmond C, Crampton P, Sutton F: NZDep91: A New Zealand index of deprivation. Aust N Z J Public Health. 1998, 22: 835-837. 10.1111/j.1467-842X.1998.tb01505.x.PubMedCrossRef Salmond C, Crampton P, Sutton F: NZDep91: A New Zealand index of deprivation. Aust N Z J Public Health. 1998, 22: 835-837. 10.1111/j.1467-842X.1998.tb01505.x.PubMedCrossRef
31.
go back to reference Niggebrugge A, Haynes R, Jones A, Lovett A, Harvey I: The index of multiple deprivation 2000 access domain: a useful indicator for public health?. Soc Sci Med. 2005, 60: 2743-2753. 10.1016/j.socscimed.2004.11.026.PubMedCrossRef Niggebrugge A, Haynes R, Jones A, Lovett A, Harvey I: The index of multiple deprivation 2000 access domain: a useful indicator for public health?. Soc Sci Med. 2005, 60: 2743-2753. 10.1016/j.socscimed.2004.11.026.PubMedCrossRef
32.
go back to reference Bell N, Schuurman N, Oliver L, HAYES MV: Towards the construction of place-specific measures of deprivation: a case study from the Vancouver metropolitan area. Can Geogr-Géogr can. 2007, 51: 444-461. 10.1111/j.1541-0064.2007.00191.x.CrossRef Bell N, Schuurman N, Oliver L, HAYES MV: Towards the construction of place-specific measures of deprivation: a case study from the Vancouver metropolitan area. Can Geogr-Géogr can. 2007, 51: 444-461. 10.1111/j.1541-0064.2007.00191.x.CrossRef
33.
go back to reference Pampalon R, Hamel D, Gamache P, Philibert MD, Raymond G, Simpson A: An area-based material and social deprivation index for public health in Qu´bec and Canada. Can J Public Health. 2012, 103 (8 Suppl 2): S17-S22.PubMed Pampalon R, Hamel D, Gamache P, Philibert MD, Raymond G, Simpson A: An area-based material and social deprivation index for public health in Qu´bec and Canada. Can J Public Health. 2012, 103 (8 Suppl 2): S17-S22.PubMed
34.
go back to reference Testi A, Ivaldi E: Material versus social deprivation and health: a case study of an urban area. Eur J Health Econ. 2009, 10: 323-328. 10.1007/s10198-008-0136-z.PubMedCrossRef Testi A, Ivaldi E: Material versus social deprivation and health: a case study of an urban area. Eur J Health Econ. 2009, 10: 323-328. 10.1007/s10198-008-0136-z.PubMedCrossRef
35.
go back to reference Windenberger F, Rican S, Jougla E, Rey G: Spatiotemporal association between deprivation and mortality: trends in France during the nineties. Eur J Public Health. 2012, 22: 347-353. 10.1093/eurpub/ckr029.PubMedCentralPubMedCrossRef Windenberger F, Rican S, Jougla E, Rey G: Spatiotemporal association between deprivation and mortality: trends in France during the nineties. Eur J Public Health. 2012, 22: 347-353. 10.1093/eurpub/ckr029.PubMedCentralPubMedCrossRef
36.
go back to reference Panczak R, Galobardes B, Voorpostel M, Spoerri A, Zwahlen M, Egger M: A Swiss neighbourhood index of socioeconomic position: development and association with mortality. J Epidemiol Commun H. 2012, 66: 1129-1136. 10.1136/jech-2011-200699.CrossRef Panczak R, Galobardes B, Voorpostel M, Spoerri A, Zwahlen M, Egger M: A Swiss neighbourhood index of socioeconomic position: development and association with mortality. J Epidemiol Commun H. 2012, 66: 1129-1136. 10.1136/jech-2011-200699.CrossRef
37.
go back to reference Torres-Cintrón M, Ortiz A, Ortiz-Ortiz K, Figueroa-Vallés N, Pérez-Irizarry J, Diaz-Medina G: Using a Socioeconomic Position Index to Assess Disparities in Cancer Incidence and Mortality, Puerto Rico, 1995-2004. Prev Chronic Dis. 2012, 9: 1-10. PMC3298767 Torres-Cintrón M, Ortiz A, Ortiz-Ortiz K, Figueroa-Vallés N, Pérez-Irizarry J, Diaz-Medina G: Using a Socioeconomic Position Index to Assess Disparities in Cancer Incidence and Mortality, Puerto Rico, 1995-2004. Prev Chronic Dis. 2012, 9: 1-10. PMC3298767
38.
go back to reference Pampalon R, Raymond G: A deprivation index for health and welfare planning in Quebec. Chronic Dis Can. 2000, 21: 104-113.PubMed Pampalon R, Raymond G: A deprivation index for health and welfare planning in Quebec. Chronic Dis Can. 2000, 21: 104-113.PubMed
39.
go back to reference Blackweel DL: Family structure and children´s health in the United States: findings from the National Health Interview Survey, 2001-2007. Vital Health Statistics. 2010, 246: 1-166. [Data from the National Health Survey Interview Survey] Blackweel DL: Family structure and children´s health in the United States: findings from the National Health Interview Survey, 2001-2007. Vital Health Statistics. 2010, 246: 1-166. [Data from the National Health Survey Interview Survey]
40.
go back to reference Remes H, Martikainen P, Valkonen T: The effects of family type on child mortality. Eur J Public Health. 2011, 21: 688-693. 10.1093/eurpub/ckq159.PubMedCrossRef Remes H, Martikainen P, Valkonen T: The effects of family type on child mortality. Eur J Public Health. 2011, 21: 688-693. 10.1093/eurpub/ckq159.PubMedCrossRef
41.
go back to reference Oleckno B: Essential Epidemiology: Principles and Applications. 2002, Waveland Press, Inc., USA Oleckno B: Essential Epidemiology: Principles and Applications. 2002, Waveland Press, Inc., USA
42.
go back to reference Legendre P, Legendre L: Numerical Ecology. 1998, Elsevier, Amsterdam, Netherlands Legendre P, Legendre L: Numerical Ecology. 1998, Elsevier, Amsterdam, Netherlands
43.
go back to reference Du Plessis V, Beshiri R, Bollman RD, Clemenson H: Rural and Small Town Canada. Government, 17: Statistics Canada. 2001 Du Plessis V, Beshiri R, Bollman RD, Clemenson H: Rural and Small Town Canada. Government, 17: Statistics Canada. 2001
44.
go back to reference Cubbin C, LeClere FB, Smith GS: Socioeconomic status and injury mortality: individual and neighbourhood determinants. J Epidemiol Commun H. 2000, 54: 517-524. 10.1136/jech.54.7.517.CrossRef Cubbin C, LeClere FB, Smith GS: Socioeconomic status and injury mortality: individual and neighbourhood determinants. J Epidemiol Commun H. 2000, 54: 517-524. 10.1136/jech.54.7.517.CrossRef
45.
go back to reference Liu Q, Zhang L, Li J, Zuo D, Kong D, Shen X, Guo Y, Zhang Q: The gap in injury mortality rates between urban and rural residents of Hubei province. China. BMC Public Health. 2012, 12: 180-10.1186/1471-2458-12-180.CrossRef Liu Q, Zhang L, Li J, Zuo D, Kong D, Shen X, Guo Y, Zhang Q: The gap in injury mortality rates between urban and rural residents of Hubei province. China. BMC Public Health. 2012, 12: 180-10.1186/1471-2458-12-180.CrossRef
46.
go back to reference Alexandrescu R, O´Brien SJ, Lecky FE: A review of injury epidemiology in the UK and Europe: some methodological considerations in constructing rates. BMC Public Health. 2009, 9: 226-10.1186/1471-2458-9-226.PubMedCentralPubMedCrossRef Alexandrescu R, O´Brien SJ, Lecky FE: A review of injury epidemiology in the UK and Europe: some methodological considerations in constructing rates. BMC Public Health. 2009, 9: 226-10.1186/1471-2458-9-226.PubMedCentralPubMedCrossRef
47.
go back to reference Woodward A, Kawachi I: Why reduce health inequalities?. J Epidemiol Commun H. 2000, 54: 923-929. 10.1136/jech.54.12.923.CrossRef Woodward A, Kawachi I: Why reduce health inequalities?. J Epidemiol Commun H. 2000, 54: 923-929. 10.1136/jech.54.12.923.CrossRef
48.
go back to reference Richardson EA, Mitchell R, Shortt NK, Pearce J, Dawson TP: Developing summary measures of health-related multiple physical environmental deprivation for epidemiological research. Environ Plann A. 2010, 42: 1650-1668. 10.1068/a42459.CrossRef Richardson EA, Mitchell R, Shortt NK, Pearce J, Dawson TP: Developing summary measures of health-related multiple physical environmental deprivation for epidemiological research. Environ Plann A. 2010, 42: 1650-1668. 10.1068/a42459.CrossRef
50.
go back to reference Pampalon R, Hamel D, Gamache P: Health inequalities in urban and rural Canada: Comparing inequalities in survival according to an individual and area-based deprivation index. Health Place. 2010, 16: 416-420. 10.1016/j.healthplace.2009.11.012.PubMedCrossRef Pampalon R, Hamel D, Gamache P: Health inequalities in urban and rural Canada: Comparing inequalities in survival according to an individual and area-based deprivation index. Health Place. 2010, 16: 416-420. 10.1016/j.healthplace.2009.11.012.PubMedCrossRef
51.
go back to reference Haynes R, Gale S: Deprivation and poor health in rural areas: inequalities hidden by averages. Health Place. 2000, 6: 275-285. 10.1016/S1353-8292(00)00009-5.PubMedCrossRef Haynes R, Gale S: Deprivation and poor health in rural areas: inequalities hidden by averages. Health Place. 2000, 6: 275-285. 10.1016/S1353-8292(00)00009-5.PubMedCrossRef
52.
go back to reference Pampalon R, Hamel D, Gamache P: A comparison of individual and area-based socio-economic data for monitoring social inequalities in health. Health Report. 2009, 20: 85-94. [No. 82-003-X] Pampalon R, Hamel D, Gamache P: A comparison of individual and area-based socio-economic data for monitoring social inequalities in health. Health Report. 2009, 20: 85-94. [No. 82-003-X]
53.
go back to reference Openshaw S: The modifiable areal unit problem. Norwick: Geo Books. OCLC 12052482; 1984. ISBN 0860941345. Openshaw S: The modifiable areal unit problem. Norwick: Geo Books. OCLC 12052482; 1984. ISBN 0860941345.
54.
55.
go back to reference Doubeni C, Schootman M, Major JA, Laiyemo A, Yikyung P, Min L, Messer L, Graubard B, Sinha R, Hollenbeck A, Schatzkin A: Health status, neighborhood socioeconomic context, and premature mortality in the united states: the national institutes of health-AARP diet and health study. Am J Public Health. 2012, 102: 680-688. 10.2105/AJPH.2011.300158.PubMedCentralPubMedCrossRef Doubeni C, Schootman M, Major JA, Laiyemo A, Yikyung P, Min L, Messer L, Graubard B, Sinha R, Hollenbeck A, Schatzkin A: Health status, neighborhood socioeconomic context, and premature mortality in the united states: the national institutes of health-AARP diet and health study. Am J Public Health. 2012, 102: 680-688. 10.2105/AJPH.2011.300158.PubMedCentralPubMedCrossRef
56.
go back to reference Turrell G, Mathers C: Socioeconomic inequalities in all-cause and specific-cause mortality in Australia: 1985-1987 and 1995-1997. Int J Epidemiol. 2001, 30: 231-239. 10.1093/ije/30.2.231.PubMedCrossRef Turrell G, Mathers C: Socioeconomic inequalities in all-cause and specific-cause mortality in Australia: 1985-1987 and 1995-1997. Int J Epidemiol. 2001, 30: 231-239. 10.1093/ije/30.2.231.PubMedCrossRef
58.
go back to reference CPHA: Canadian Public Health Association response to the World Health Organization (WHO) Commissions´s Report-Closing the gap in a generation: Health Equity through action on the social determinants of health. 2008. CPHA: Canadian Public Health Association response to the World Health Organization (WHO) Commissions´s Report-Closing the gap in a generation: Health Equity through action on the social determinants of health. 2008.
Metadata
Title
Premature mortality due to social and material deprivation in Nova Scotia, Canada
Authors
Nathalie Saint-Jacques
Ron Dewar
Yunsong Cui
Louise Parker
Trevor JB Dummer
Publication date
01-12-2014
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2014
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-014-0094-2

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