An Ecological Study to Identify Census Blocks Supporting a Higher Burden of Disease: Infant Mortality in the Lille Metropolitan Area, France.

In France, reducing social health inequalities has become an explicit goal of health policies over the past few years, one of its objectives is specifically the reduction of the perinatal mortality rate. This study investigates the association between infant mortality and social deprivation categori...

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Published in:Maternal & Child Health Journal Vol. 18; no. 1; pp. 171 - 180
Main Authors: Padilla, Cindy, Lalloué, Benoit, Pies, Cheri, Lucas, Emminarie, Zmirou-Navier, Denis, Séverine, Deguen
Format: equations & formulas pictorial research tables/charts Journal Article
Published: Springer Nature Jan2014
Online Access:View this record in EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: An Ecological Study to Identify Census Blocks Supporting a Higher Burden of Disease: Infant Mortality in the Lille Metropolitan Area, France.
      aug:
        au:
          Padilla, Cindy
          Lalloué, Benoit
          Pies, Cheri
          Lucas, Emminarie
          Zmirou-Navier, Denis
          Séverine, Deguen
        affil: School of Public Health, University of California, Berkeley 94720 USA
      sug:
        subj:
          Infant Mortality Epidemiology
          Poverty
          Poverty Areas
          Social Determinants of Health
          Healthcare Disparities
          Socioeconomic Factors
          Funding Source
          France
          Ecological Research
          Census
          Urban Areas
          Social Environment
          Factor Analysis
          Income
          Educational Status
          Employment Status
          Residence Characteristics
          Family Characteristics
          Data Analysis Software
          Infant, Newborn
          Social Class
          Confidence Intervals
          Relative Risk
          Prenatal Care
          Female
          Pregnancy
          Health Services Accessibility
          Health Resource Utilization
          Human
          Infant, Newborn: birth-1 month
          Female
      ab: In France, reducing social health inequalities has become an explicit goal of health policies over the past few years, one of its objectives is specifically the reduction of the perinatal mortality rate. This study investigates the association between infant mortality and social deprivation categories at a small area level in the Lille metropolitan area, in the north of France, to identify census blocks where public authorities should prioritize appropriate preventive actions. We used census data to establish a neighbourhood deprivation index whose multiple dimensions encompass socioeconomic characteristics. Infant mortality data were obtained from the Lille metropolitan area municipalities to estimate a death rate at the census tract level. We used Bayesian hierarchical models in order to reduce the extra variability when computing relative risks (RR) and to assess the associations between infant mortality and deprivation. Between 2000 and 2009, 668 cases of infant death occurred in the Lille metropolitan area (4.2 per 1,000 live births). The socioeconomic status is associated with infant mortality, with a clear gradient of risk from the most privileged census blocks to the most deprived ones (RR = 2.62, 95 % confidence interval [1.87; 3.70]). The latter have 24.6 % of families who were single parents and 29.9 % of unemployed people in the labor force versus 8.5 % and 7.7 % in the former. Our study reveals socio-spatial disparities in infant mortality in the Lille metropolitan area and highlights the census blocks most affected by the inequalities. Fine spatial analysis may help inform the design of preventive policies tailored to the characteristics of the local communities.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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