Proximate and Contextual Socioeconomic Determinants of Mortality: Multilevel Approaches in a Setting with Universal Health Care Coverage Export

@article{veugelers_et_al_2001, abstract = {Investigations of contextual factors (income inequality, cultural disruption, access to health and social services, safety and crime rate, and others) have received little emphasis by epidemiologists, although a few have demonstrated the importance of such factors for mortality, particularly in the United States. To expand current understanding of the importance of contextual factors, the authors evaluated mortality in a longitudinal study in Nova Scotia, Canada, where all residents have greater access to health and social services and where income inequalities are smaller than in the United States. A total of 2,116 participants were followed from 1990 through December 1999, linked to the 1991 Canada Census as a source of neighborhood characteristics, and analyzed using individual-level and multilevel logistic regression. Well-educated and high-earning persons fared better. Neighborhood socioeconomic characteristics (neighborhood income, educational level, unemployment rate), in contrast, were not significantly associated with mortality. However, within advantaged neighborhoods, the importance of individual income and education for mortality was increased relative to disadvantaged neighborhoods. The latter findings may direct health policy aimed at reducing health inequalities. 10.1093/aje/154.8.725}, author = {Veugelers, Paul J. and Yip, Alexandra M. and Kephart, George}, citeulike-article-id = {3463726}, citeulike-linkout-0 = {http://dx.doi.org/10.1093/aje/154.8.725}, citeulike-linkout-1 = {http://aje.oxfordjournals.org/cgi/content/abstract/154/8/725}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/11590085}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=11590085}, day = {15}, doi = {10.1093/aje/154.8.725}, journal = {Am. J. Epidemiol.}, keywords = {area, canada, context, employment, income-inequality, mortality, multilevel, nova-scotia}, month = {October}, number = {8}, pages = {725--732}, posted-at = {2008-10-29 22:01:22}, priority = {2}, title = {Proximate and Contextual Socioeconomic Determinants of Mortality: Multilevel Approaches in a Setting with Universal Health Care Coverage}, url = {http://dx.doi.org/10.1093/aje/154.8.725}, volume = {154}, year = {2001} }

TY - JOUR ID - veugelers_et_al_2001 L3 - citeulike-article-id:3463726 N2 - Investigations of contextual factors (income inequality, cultural disruption, access to health and social services, safety and crime rate, and others) have received little emphasis by epidemiologists, although a few have demonstrated the importance of such factors for mortality, particularly in the United States. To expand current understanding of the importance of contextual factors, the authors evaluated mortality in a longitudinal study in Nova Scotia, Canada, where all residents have greater access to health and social services and where income inequalities are smaller than in the United States. A total of 2,116 participants were followed from 1990 through December 1999, linked to the 1991 Canada Census as a source of neighborhood characteristics, and analyzed using individual-level and multilevel logistic regression. Well-educated and high-earning persons fared better. Neighborhood socioeconomic characteristics (neighborhood income, educational level, unemployment rate), in contrast, were not significantly associated with mortality. However, within advantaged neighborhoods, the importance of individual income and education for mortality was increased relative to disadvantaged neighborhoods. The latter findings may direct health policy aimed at reducing health inequalities. 10.1093/aje/154.8.725 IS - 8 JF - Am. J. Epidemiol. EP - 732 TI - Proximate and Contextual Socioeconomic Determinants of Mortality: Multilevel Approaches in a Setting with Universal Health Care Coverage VL - 154 SP - 725 KW - area KW - canada KW - context KW - employment KW - income-inequality KW - mortality KW - multilevel KW - nova-scotia AU - Veugelers, Paul AU - Yip, Alexandra AU - Kephart, George PY - 2001/10/15/ UR - http://dx.doi.org/10.1093/aje/154.8.725 ER -