An ecological study to identify census blocks supporting a higher burden of disease: infant mortality in the Lille metropolitan area, France

Cindy Padilla (), Benoit Lalloué (), Cheri Pies, Emminarie Lucas, Denis Zmirou-Navier () and Séverine Deguen ()
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Cindy Padilla: Irset - Institut de recherche en santé, environnement et travail - UA - Université d'Angers - UR - Université de Rennes - EHESP - École des Hautes Études en Santé Publique - INSERM - Institut National de la Santé et de la Recherche Médicale - Biosit : Biologie - Santé - Innovation Technologique - Structure Fédérative de Recherche en Biologie et Santé de Rennes
Benoit Lalloué: IECL - Institut Élie Cartan de Lorraine - UL - Université de Lorraine - CNRS - Centre National de la Recherche Scientifique, Irset - Institut de recherche en santé, environnement et travail - UA - Université d'Angers - UR - Université de Rennes - EHESP - École des Hautes Études en Santé Publique - INSERM - Institut National de la Santé et de la Recherche Médicale - Biosit : Biologie - Santé - Innovation Technologique - Structure Fédérative de Recherche en Biologie et Santé de Rennes, EHESP - École des Hautes Études en Santé Publique
Cheri Pies: UC Berkeley - University of California [Berkeley] - UC - University of California
Emminarie Lucas: EHESP - École des Hautes Études en Santé Publique
Denis Zmirou-Navier: Irset - Institut de recherche en santé, environnement et travail - UA - Université d'Angers - UR - Université de Rennes - EHESP - École des Hautes Études en Santé Publique - INSERM - Institut National de la Santé et de la Recherche Médicale - Biosit : Biologie - Santé - Innovation Technologique - Structure Fédérative de Recherche en Biologie et Santé de Rennes
Séverine Deguen: Irset - Institut de recherche en santé, environnement et travail - UA - Université d'Angers - UR - Université de Rennes - EHESP - École des Hautes Études en Santé Publique - INSERM - Institut National de la Santé et de la Recherche Médicale - Biosit : Biologie - Santé - Innovation Technologique - Structure Fédérative de Recherche en Biologie et Santé de Rennes

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Abstract: In France, reducing social health inequalities has become an explicit goal of health policies over the past few years, one of its objectives is specifically the reduction of the perinatal mortality rate. This study investigates the association between infant mortality and social deprivation categories at a small area level in the Lille metropolitan area, in the north of France, to identify census blocks where public authorities should prioritize appropriate preventive actions. We used census data to establish a neighbourhood deprivation index whose multiple dimensions encompass socioeconomic characteristics. Infant mortality data were obtained from the Lille metropolitan area municipalities to estimate a death rate at the census tract level. We used Bayesian hierarchical models in order to reduce the extra variability when computing relative risks (RR) and to assess the associations between infant mortality and deprivation. Between 2000 and 2009, 668 cases of infant death occurred in the Lille metropolitan area (4.2 per 1,000 live births). The socioeconomic status is associated with infant mortality, with a clear gradient of risk from the most privileged census blocks to the most deprived ones (RR = 2.62, 95 % confidence interval [1.87; 3.70]). The latter have 24.6 % of families who were single parents and 29.9 % of unemployed people in the labor force versus 8.5 % and 7.7 % in the former. Our study reveals socio-spatial disparities in infant mortality in the Lille metropolitan area and highlights the census blocks most affected by the inequalities. Fine spatial analysis may help inform the design of preventive policies tailored to the characteristics of the local communities.

Keywords: Census tracts; Social health inequalities; Infant mortality; Small-area analysis; Bayesian models; Deprivation index (search for similar items in EconPapers)
Date: 2013-03-12
Note: View the original document on HAL open archive server: https://hal.science/hal-00876255v1
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Published in Maternal and Child Health Journal, 2013, 18 (1), pp.171-179. ⟨10.1007/s10995-013-1251-8⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-00876255

DOI: 10.1007/s10995-013-1251-8

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