Int. J. Environ. Res. Public Health 2013, 10(4), 1378-1391; doi:10.3390/ijerph10041378
Article

The Contribution of Neighbourhood Material and Social Deprivation to Survival: A 22-Year Follow-up of More than 500,000 Canadians

1 Department of Geography, McGill University, 805 Sherbrooke St. West, Montreal, QC H3A 2K6, Canada 2 Health Analysis Division, Statistics Canada, Ottawa, ON K1A 0T6, Canada 3 Population Studies Division, Health Canada, Ottawa, ON K1A 0K9, Canada 4 Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
* Author to whom correspondence should be addressed.
Received: 25 January 2013; in revised form: 25 March 2013 / Accepted: 25 March 2013 / Published: 2 April 2013
(This article belongs to the Special Issue Social and Economical Determinants of Health)
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Abstract: Background: We examined the incremental influence on survival of neighbourhood material and social deprivation while accounting for individual level socioeconomic status in a large population-based cohort of Canadians. Methods: More than 500,000 adults were followed for 22 years between 1982 and 2004. Tax records provided information on sex, income, marital status and postal code while a linkage was used to determine vital status. Cox models were used to estimate hazard ratios (HR) for quintiles of neighbourhood material and social deprivation. Results: There were 180,000 deaths over the follow-up period. In unadjusted analyses, those living in the most materially deprived neighbourhoods had elevated risks of mortality (HRmales 1.37, 95% CI: 1.33–1.41; HRfemales 1.20, 95% CI: 1.16–1.24) when compared with those living in the least deprived neighbourhoods. Mortality risk was also elevated for those living in socially deprived neighbourhoods (HRmales 1.15, CI: 1.12–1.18; HRfemales 1.15, CI: 1.12–1.19). Mortality risk associated with material deprivation remained elevated in models that adjusted for individual factors (HRmales 1.20, CI: 1.17–1.24; HRfemales 1.16, CI: 1.13–1.20) and this was also the case for social deprivation (HRmales 1.12, CI: 1.09–1.15; HRfemales 1.09, CI: 1.05–1.12). Immigrant neighbourhoods were protective of mortality risk for both sexes. Being poor and living in the most socially advantageous neighbourhoods translated into a survival gap of 10% over those in the most socially deprived neighbourhoods. The gap for material neighbourhood deprivation was 7%. Conclusions: Living in socially and materially deprived Canadian neighbourhoods was associated with elevated mortality risk while we noted a “healthy immigrant neighbourhood effect”. For those with low family incomes, living in socially and materially deprived areas negatively affected survival beyond their individual circumstances.
Keywords: neighbourhood deprivation; mortality; survival analysis; immigrant neighbourhoods; Canada

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MDPI and ACS Style

Ross, N.A.; Oliver, L.N.; Villeneuve, P.J. The Contribution of Neighbourhood Material and Social Deprivation to Survival: A 22-Year Follow-up of More than 500,000 Canadians. Int. J. Environ. Res. Public Health 2013, 10, 1378-1391.

AMA Style

Ross NA, Oliver LN, Villeneuve PJ. The Contribution of Neighbourhood Material and Social Deprivation to Survival: A 22-Year Follow-up of More than 500,000 Canadians. International Journal of Environmental Research and Public Health. 2013; 10(4):1378-1391.

Chicago/Turabian Style

Ross, Nancy A.; Oliver, Lisa N.; Villeneuve, Paul J. 2013. "The Contribution of Neighbourhood Material and Social Deprivation to Survival: A 22-Year Follow-up of More than 500,000 Canadians." Int. J. Environ. Res. Public Health 10, no. 4: 1378-1391.

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