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

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 de...

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Autores principales: Costa, Claudia, Freitas, Angela, Almendra, Ricardo, Santana, Paula
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698341/
https://www.ncbi.nlm.nih.gov/pubmed/33212953
http://dx.doi.org/10.3390/ijerph17228517
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author Costa, Claudia
Freitas, Angela
Almendra, Ricardo
Santana, Paula
author_facet Costa, Claudia
Freitas, Angela
Almendra, Ricardo
Santana, Paula
author_sort Costa, Claudia
collection PubMed
description 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.
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spelling pubmed-76983412020-11-29 The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal Costa, Claudia Freitas, Angela Almendra, Ricardo Santana, Paula Int J Environ Res Public Health Article 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. MDPI 2020-11-17 2020-11 /pmc/articles/PMC7698341/ /pubmed/33212953 http://dx.doi.org/10.3390/ijerph17228517 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Costa, Claudia
Freitas, Angela
Almendra, Ricardo
Santana, Paula
The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal
title The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal
title_full The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal
title_fullStr The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal
title_full_unstemmed The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal
title_short The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal
title_sort association between material deprivation and avoidable mortality in lisbon, portugal
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698341/
https://www.ncbi.nlm.nih.gov/pubmed/33212953
http://dx.doi.org/10.3390/ijerph17228517
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