Avoidable Mortality Rates Decrease but Inequity Gaps Widen for Marginalized Neighborhoods: A Population-Based Analysis in Ontario, Canada from 1993 to 2014.
Avoidable mortality (AM) is a health indicator used to examine trends in avoidable deaths amenable to public health and medical interventions. AM is more likely amongst marginalized populations. Our objective was to examine trends in AM rates by level of neighborhood marginalization. Decedents under...
| Published in: | Journal of Community Health Vol. 45; no. 3; pp. 579 - 598 |
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| Main Authors: | , , , , , |
| Format: | Article |
| Published: |
Springer Nature
Jun2020
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=142943243&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 142943243 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00945145 JCH jtl: Journal of Community Health issn: 00945145 maglogo: N pubinfo: dt: Jun2020 vid: 45 iid: 3 pid: 237 pub: Springer Nature artinfo: ui: 142943243 10.1007/s10900-019-00778-8 ppf: 579 ppct: 19 formats: fmt: – @attributes: type: T – @attributes: type: P size: 670KB tig: atl: Avoidable Mortality Rates Decrease but Inequity Gaps Widen for Marginalized Neighborhoods: A Population-Based Analysis in Ontario, Canada from 1993 to 2014. aug: au: Zygmunt, Austin Kendall, Claire E. James, Paul Lima, Isac Tuna, Meltem Tanuseputro, Peter affil: School of Epidemiology and Public Health, University of Ottawa, Room 101 – 600 Peter Morand Crescent, K1G 5Z3, Ottawa, ON, Canada Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Canada ICES uOttawa, The Ottawa Hospital, Civic Campus 1053 Carling Avenue, Ottawa, Canada CT Lamont Primary Health Care Research Group, Bruyère Research Institute, Ottawa, Canada Department of Family Medicine, University of Ottawa, Ottawa, Canada Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada Department of Medicine, University Health Network, University of Toronto, Toronto, Canada Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Canada su: Ontario Age distribution Ethnic groups Mortality Sex distribution Social skills Residential patterns Mortality prevention Disease incidence Odds ratio sug: subj: Age distribution Ethnic groups Mortality Sex distribution Social skills Residential patterns Ontario Mortality prevention Disease incidence Odds ratio keyword: Avoidable mortality Dependency Ethnic concentration Marginalization Material deprivation Residential instability Avoidable mortality Dependency Ethnic concentration Marginalization Material deprivation Residential instability ab: Avoidable mortality (AM) is a health indicator used to examine trends in avoidable deaths amenable to public health and medical interventions. AM is more likely amongst marginalized populations. Our objective was to examine trends in AM rates by level of neighborhood marginalization. Decedents under age 75 years in Ontario from 1993 to 2014 (n = 691,453) were assigned to a quintile-level of each Ontario Marginalization (ON-Marg) Index dimension: material deprivation, residential instability, dependency, and ethnic concentration. We calculated ON-Marg Index dimension and quintile specific age- and sex-standardized AM incidence rates. We then calculated annual AM rate ratios between the most (Q5) and least (Q1) marginalized quintiles for each ON-Marg dimension. To describe the inequity gap in AM over time we calculated the absolute difference in the Q5/Q1 rate ratio between 2014 and 1993 for each dimension. AM rates in Ontario were almost halved (48.6%) from 1993 to 2014 (216 vs. 111 per 100,000 population). This decline was greater for treatable AM (75 vs. 36 per 100,000 population) than preventable AM (128 vs. 88 per 100,000 population). The inequity gap in AM Q5/Q1 rate ratios (RR) between 1993 and 2014 widened for all marginalization dimensions: dependency (RR 2.11–2.58), ethnic concentration (RR 0.59–0.48), material deprivation (RR 1.63–2.23), and residential instability (RR 2.01–2.43). To attain further declines in AM, policymakers and governments must address AM due to preventable deaths in neighborhoods highly marginalized by dependency, material deprivation, and residential instability. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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