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Community-level income inequality and mortality in Québec, Canada.
Public Health. 2009 Jun; 123(6):438-43.PH

Abstract

OBJECTIVES

Evidence of the association between income inequality and mortality for small rather than large areas is conflicting. This study evaluated community-level income inequality in relation to age- and cause-specific mortality.

STUDY DESIGN

Ecological analysis.

METHODS

Mortality data were extracted from the Québec, Canada registry for 1999-2003. For Québec communities (n=143), directly standardized mortality rates were calculated for all-cause (overall, working-age and post-working-age), suicide, alcohol, tobacco and cardiovascular mortality. Using 2001 Canada Census data, the tertiles of income inequality measured as the decile ratio, coefficient of variation and median share were calculated. The relative risk (RR) of death was determined using Poisson regression, accounting for median community income, family structure and rural-urban area.

RESULTS

Income inequality was most strongly associated with alcohol-related mortality (RR(CoefficientVariation) 0.85, 95% confidence interval 0.77-0.94), followed by statistically significant but weaker inverse associations with tobacco-related and age-specific all-cause mortality.

CONCLUSIONS

Income inequality in Québec communities is inversely associated with mortality outcomes, particularly alcohol-related mortality. These associations contrast with positive or null associations observed in studies of larger US and Canadian metropolitan areas, respectively. Community-level studies accounting for individual-level covariates are necessary to clarify the relationship between income inequality and mortality.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Auger N
Unité Etudes et analyses de l'état de santé de la population, Institut national de santé publique du Québec, Montréal, Québec, Canada. nathalie.auger@inspq.qc.ca
Zang G
No affiliation info available
Daniel M
No affiliation info available

MeSH

AdolescentAdultAge FactorsAgedAlcohol DrinkingChildChild, PreschoolFemaleHealth Status DisparitiesHumansIncomeInfantMaleMiddle AgedMortalityQuebecResidence CharacteristicsSocial Class

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19482322

Citation

Auger, N, et al. "Community-level Income Inequality and Mortality in Québec, Canada." Public Health, vol. 123, no. 6, 2009, pp. 438-43.
Auger N, Zang G, Daniel M. Community-level income inequality and mortality in Québec, Canada. Public Health. 2009;123(6):438-43.
Auger, N., Zang, G., & Daniel, M. (2009). Community-level income inequality and mortality in Québec, Canada. Public Health, 123(6), 438-43. https://doi.org/10.1016/j.puhe.2009.04.012
Auger N, Zang G, Daniel M. Community-level Income Inequality and Mortality in Québec, Canada. Public Health. 2009;123(6):438-43. PubMed PMID: 19482322.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Community-level income inequality and mortality in Québec, Canada. AU - Auger,N, AU - Zang,G, AU - Daniel,M, Y1 - 2009/05/30/ PY - 2008/10/29/received PY - 2009/04/01/revised PY - 2009/04/29/accepted PY - 2009/6/2/entrez PY - 2009/6/2/pubmed PY - 2009/8/7/medline SP - 438 EP - 43 JF - Public health JO - Public Health VL - 123 IS - 6 N2 - OBJECTIVES: Evidence of the association between income inequality and mortality for small rather than large areas is conflicting. This study evaluated community-level income inequality in relation to age- and cause-specific mortality. STUDY DESIGN: Ecological analysis. METHODS: Mortality data were extracted from the Québec, Canada registry for 1999-2003. For Québec communities (n=143), directly standardized mortality rates were calculated for all-cause (overall, working-age and post-working-age), suicide, alcohol, tobacco and cardiovascular mortality. Using 2001 Canada Census data, the tertiles of income inequality measured as the decile ratio, coefficient of variation and median share were calculated. The relative risk (RR) of death was determined using Poisson regression, accounting for median community income, family structure and rural-urban area. RESULTS: Income inequality was most strongly associated with alcohol-related mortality (RR(CoefficientVariation) 0.85, 95% confidence interval 0.77-0.94), followed by statistically significant but weaker inverse associations with tobacco-related and age-specific all-cause mortality. CONCLUSIONS: Income inequality in Québec communities is inversely associated with mortality outcomes, particularly alcohol-related mortality. These associations contrast with positive or null associations observed in studies of larger US and Canadian metropolitan areas, respectively. Community-level studies accounting for individual-level covariates are necessary to clarify the relationship between income inequality and mortality. SN - 1476-5616 UR - https://www.unboundmedicine.com/medline/citation/19482322/Community_level_income_inequality_and_mortality_in_Québec_Canada_ DB - PRIME DP - Unbound Medicine ER -