Int J Health Geogr - Cumulative disadvantage? Exploring relationships between neighbourhood deprivation trends (1991 to 2006) and mortality in New Zealand.


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CKGROUND: Area-level socioeconomic deprivation has been shown to exert an independent effect on both individual and population health outcomes and health-related behaviours. Evidence also suggests that health and economic inequalities in many countries are increasing in some areas but may be on the decline in others. While area-level deprivation at a single point in time is known to influence health, the literature relating to longitudinal deprivation of communities and associated health impacts is sparse. This research makes a methodological contribution to this literature.METHODS: Using a Latent Class Growth Model, we identified 12 deprivation trends (1991-2006) for small areas (n=1621) in New Zealand. We then fitted regression models to assess the effects of trends of relative deprivation on a) all-cause mortality, and b) cardiovascular mortality (2005-2007) by census area unit. For comparison, we also fitted regression models to assess the effect of deprivation deciles (in 2006) on outcomes a) and b).RESULTS: Using trends, we found a positive association between deprivation and mortality, except for two trends for both all-cause and CVD-related mortality. When comparing trends and deciles of deprivation, we observed similar patterns. However, we found that AIC values were slightly lower for the model including deciles, indicating better model fit.CONCLUSION: While we found that current deprivation was a slightly better predictor of mortality, the approach used here offers a potentially useful alternative. Future deprivation research must consider the possible loss of information about health benefits of living in areas where relative deprivation has improved in cross-sectional analyses.

Resumo Limpo

ckground arealevel socioeconom depriv shown exert independ effect individu popul health outcom healthrel behaviour evid also suggest health econom inequ mani countri increas area may declin other arealevel depriv singl point time known influenc health literatur relat longitudin depriv communiti associ health impact spars research make methodolog contribut literaturemethod use latent class growth model identifi depriv trend small area n new zealand fit regress model assess effect trend relat depriv allcaus mortal b cardiovascular mortal census area unit comparison also fit regress model assess effect depriv decil outcom bresult use trend found posit associ depriv mortal except two trend allcaus cvdrelat mortal compar trend decil depriv observ similar pattern howev found aic valu slight lower model includ decil indic better model fitconclus found current depriv slight better predictor mortal approach use offer potenti use altern futur depriv research must consid possibl loss inform health benefit live area relat depriv improv crosssect analys

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