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Int. J. Environ. Res. Public Health 2014, 11(2), 1776-1793; doi:10.3390/ijerph110201776
Article

Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008

1,*  and 2
Received: 26 November 2013; in revised form: 10 January 2014 / Accepted: 17 January 2014 / Published: 5 February 2014
(This article belongs to the Special Issue Spatial Epidemiology)
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Abstract: The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result.
Keywords: urbanization; avoidable mortality; health disparities; Taiwan; breast cancer; lung cancer; ischemic heart disease urbanization; avoidable mortality; health disparities; Taiwan; breast cancer; lung cancer; ischemic heart disease
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

Chen, B.K.; Yang, C.-Y. Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008. Int. J. Environ. Res. Public Health 2014, 11, 1776-1793.

AMA Style

Chen BK, Yang C-Y. Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008. International Journal of Environmental Research and Public Health. 2014; 11(2):1776-1793.

Chicago/Turabian Style

Chen, Brian K.; Yang, Chun-Yuh. 2014. "Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008." Int. J. Environ. Res. Public Health 11, no. 2: 1776-1793.


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