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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,* , 2
 and 3,4
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 neighbourhood deprivation; mortality; survival analysis; immigrant neighbourhoods; Canada
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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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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