Relative deprivation between neighbouring wards is predictive of coronary heart disease mortality after adjustment for absolute deprivation of wards

Allender, Steven, Scarborough, Peter, Keegan, Thomas and Rayner, Mike 2012, Relative deprivation between neighbouring wards is predictive of coronary heart disease mortality after adjustment for absolute deprivation of wards, Journal of epidemiology & community health, vol. 66, no. 9, pp. 803-808.

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Title Relative deprivation between neighbouring wards is predictive of coronary heart disease mortality after adjustment for absolute deprivation of wards
Author(s) Allender, Steven
Scarborough, Peter
Keegan, Thomas
Rayner, Mike
Journal name Journal of epidemiology & community health
Volume number 66
Issue number 9
Start page 803
End page 808
Total pages 6
Publisher B M J Group
Place of publication London, England
Publication date 2012-09
ISSN 0143-005X
1470-2738
Keyword(s) coronary heart disease
mortality rates
Summary Background The aims of this study were to assess whether deprivation inequality at small area level in England is associated with coronary heart disease (CHD) mortality rates and to assess whether this provides evidence of an association between area-level and individual-level risk.

Methods Mortality rates for all wards in England were calculated using all CHD deaths between 2001 and 2006. Ward-level deprivation was measured using the Carstairs Index. Deprivation inequality within local authorities (LAs) was measured by the IQR of deprivation for wards within the LA. Relative deprivation for wards was measured as the modulus of the difference between deprivation for the ward and average deprivation for all neighbouring wards.

Results Deprivation inequality within LAs was positively associated with CHD mortality rates per 100 000 (eg, all men β; 95% CI=2.7; 1.1 to 4.3) after adjustment for absolute deprivation (p<0.001 for all models). Relative deprivation for wards was positively associated with CHD mortality rates per 100 000 (eg, all men 1.4; 0.7 to 2.1) after adjustment for absolute deprivation (p<0.001 for all models). Subgroup analyses showed that relative deprivation was independently associated with CHD mortality rates in both affluent and deprived wards.

Conclusions
Rich wards surrounded by poor areas have higher CHD mortality rates than rich wards surrounded by rich areas, and poor wards surrounded by rich areas have worse CHD mortality rates than poor wards surrounded by poor areas. Local deprivation inequality has a similar adverse impact on both rich and poor areas, supporting the hypothesis that income inequality of an area has an impact on individual-level health outcomes.
Notes Published Online First 28 June 2011
Language eng
Field of Research 110201 Cardiology (incl Cardiovascular Diseases)
Socio Economic Objective 920103 Cardiovascular System and Diseases
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2011, B M J Group
Persistent URL http://hdl.handle.net/10536/DRO/DU:30035975

Document type: Journal Article
Collections: Faculty of Health
WHO Collaborating Centre on Obesity Prevention
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Created: Wed, 20 Jul 2011, 10:33:00 EST by Jane Moschetti

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