scholarly journals Social inequalities in mortality: a problem of cognitive function?

2009 ◽  
Vol 30 (15) ◽  
pp. 1819-1820 ◽  
Author(s):  
M. Marmot ◽  
M. Kivimaki
2011 ◽  
Vol 27 (suppl 2) ◽  
pp. s298-s308 ◽  
Author(s):  
Luiz Antonio Chaves Viana ◽  
Maria da Conceição Nascimento Costa ◽  
Jairnilson Silva Paim ◽  
Ligia Maria Vieira-da-Silva

An ecological study was carried out using information zones as units of analysis in order to assess the evolution of socio-spatial inequalities in mortality due to external causes and homicides in Salvador, Bahia State, Brazil, in 2000 and 2006. The Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE) and the City Health Department (Secretaria Municipal de Saúde) provided the data sources, and causes of death were reviewed and reclassified based on reports from the Institute of Legal Medicine (Instituto Médico Legal). The information zones were classified into four social strata according to income and schooling. The ratio between mortality rates (inequality ratio) was calculated and confirmed a rise of 98.5% in the homicide rate. In 2000, the risk of death due to external causes and murders in the stratum with the worst living conditions was respectively 1.40 and 1.94 times greater than in the reference stratum. In 2006 these figures were 2.02 and 2.24. The authors discuss the implications for inter-sectoral public policies, based on evidence from the study's findings.


2021 ◽  
pp. e1-e10
Author(s):  
Marciane Kessler ◽  
Elaine Thumé ◽  
Michael Marmot ◽  
James Macinko ◽  
Luiz Augusto Facchini ◽  
...  

Objectives. To investigate the role of the Family Health Strategy (FHS) in reducing social inequalities in mortality over a 9-year follow-up period. Methods. We carried out a population-based cohort study of individuals aged 60 years and older from the city of Bagé, Brazil. Of 1593 participants at baseline (2008), 1314 (82.5%) were included in this 9-year follow-up (2017). We assessed type of primary health care (PHC) coverage and other variables at baseline. In 2017, we ascertained 579 deaths through mortality registers. Hazard ratios and their 95% confidence intervals modeled time to death estimated by Cox regression. We also tested the effect modification between PHC and wealth. Results. The FHS had a protective effect on mortality among individuals aged 60 to 64 years, a result not found among those not covered by the FHS. Interaction analysis showed that the FHS modified the effect of wealth on mortality. The FHS protected the poorest from all-cause mortality (hazard ratio [HR] = 0.59; 95% confidence interval [CI] = 0.36, 0.96) and avoidable mortality (HR = 0.46; 95% CI = 0.25, 0.85). Conclusions. FHS coverage reduced social inequalities in mortality among older adults. Our findings highlight the need to guarantee universal health coverage in Brazil by expanding and strengthening the FHS to promote health equity. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306146 )


2006 ◽  
Vol 6 (1) ◽  
Author(s):  
Maria Rosvall ◽  
Basile Chaix ◽  
John Lynch ◽  
Martin Lindström ◽  
Juan Merlo

2021 ◽  
pp. 1-12
Author(s):  
Regina Silva Paradela ◽  
Naomi Vidal Ferreira ◽  
Mariana Penteado Nucci ◽  
Brenno Cabella ◽  
Luiza Menoni Martino ◽  
...  

Background: Socioeconomic factors are important contributors to brain health. However, data from developing countries (where social inequalities are the most prominent) are still scarce, particularly about hypertensive individuals. Objective: To evaluate the relationship between socioeconomic index, cognitive function, and cortical brain volume, as well as determine whether white matter hyperintensities are mediators of the association of the socioeconomic index with cognitive function in hypertensive individuals. Methods: We assessed 92 hypertensive participants (mean age = 58±8.6 years, 65.2%female). Cognitive evaluation and neuroimaging were performed and clinical and sociodemographic data were collected using questionnaires. A socioeconomic index was created using education, income, occupation (manual or non-manual work), and race. The associations of the socioeconomic index with cognitive performance and brain volume were investigated using linear regression models adjusted for age, sex, time of hypertension since diagnosis, and comorbidities. A causal mediation analysis was also conducted. Results: Better socioeconomic status was associated with better visuospatial ability, executive function, and global cognition. We found associations between a better socioeconomic index and a higher parietal lobe volume. White matter hyperintensities were also not mediators in the relationship between the socioeconomic index and cognitive performance. Conclusion: Socioeconomic disadvantages are associated with worse cognitive performance and brain volume in individuals with hypertension.


2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Joséphine Bryere ◽  
◽  
Laure Tron ◽  
Gwenn Menvielle ◽  
Guy Launoy

Abstract Background To determine relevant public health actions and to guide intervention priorities, it is of great importance to assess the relative contribution of incidence and lethality to social inequalities in cancer mortality. Methods The study population comprised 185,518 cases of cancer diagnosed between 2006 and 2009 recorded in the French registries. Survival was known for each patient (endpoint: 30/06/2013). Deprivation was assessed using the European Deprivation Index. We studied the influence of deprivation on mortality, incidence and lethality rates and quantified the respective proportions of incidence and lethality in social inequalities in mortality by calculating attributable deaths. Results For cancers with social inequalities both in incidence and lethality, excess mortality in deprived was mainly caused by social inequalities in incidence (e.g. men lung cancer: 87% of excess deaths in the deprived caused by inequalities in incidence). Proportions were more balanced for some cancer sites (e.g. cervical cancer: 56% incidence, 44% lethality). For cancer sites with a higher incidence in the least deprived (e.g. breast cancer), the excess-lethality in deprived leads entirely the higher mortality among the deprived. Conclusions Most of the excess mortality in deprived is due to the excess incidence of tobacco-dependent cancers and the excess lethality of screenable cancers.


2015 ◽  
Vol 25 (5) ◽  
pp. 849-856 ◽  
Author(s):  
Rasmus Hoffmann ◽  
Terje A. Eikemo ◽  
Ivana Kulhánová ◽  
Margarete C. Kulik ◽  
Caspar Looman ◽  
...  

2008 ◽  
Vol 37 (3) ◽  
pp. 591-602 ◽  
Author(s):  
H. Nabi ◽  
M. Kivimaki ◽  
M. G Marmot ◽  
J. Ferrie ◽  
M. Zins ◽  
...  

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