The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal

Claudia Costa, Angela Freitas, Ricardo Almendra and Paula Santana
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Claudia Costa: Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal
Angela Freitas: Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal
Ricardo Almendra: Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal
Paula Santana: Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal

IJERPH, 2020, vol. 17, issue 22, 1-16

Abstract: There is considerable evidence pointing to the existence of a socioeconomic gradient in mortality, which tends to be steeper in urban areas. Similar to other European cities, Lisbon is far from homogeneous since considerable geographical inequalities exist between the more advantaged and the more deprived neighborhoods. The main goals of this study are to describe the geographical pattern of premature deaths (before 65 years old), avoidable deaths (preventable and amenable to healthcare) and cause-specific mortality (HIV/AIDS and suicide) in Lisbon, at the lower administrative level (civil parish, in Portuguese: Freguesia), and analyze the statistical association between mortality risk and deprivation, before (1999–2003) and during the economic crisis (2008–2012). Smoothed Standardized Mortality Ratios (sSMR) and Relative Risk (RR) with 95% credible intervals were calculated to identify the association between mortality and deprivation. The analysis of the geographical distribution of cause-specific mortality reveals that civil parishes with high sSMR in the first period continued to present higher mortality rates in the second. Moreover, a significant statistical association was found between all the causes of death and deprivation, except suicide. These findings contribute to understanding how social conditions influence health outcomes and can offer insights about potential policy directions for local government.

Keywords: inequalities; area deprivation; avoidable deaths; premature mortality; preventable deaths; amenable deaths due to healthcare; HIV/AIDS; suicide; urban health; cities; geography (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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