Dataset Information

Gender inequalities in the association between area deprivation and perceived social support: a cross-sectional multilevel analysis at the municipality level in Germany.

ABSTRACT:

Objectives

To investigate the association between area deprivation at municipality level with low perceived social support, independent of individual socioeconomic position and demographic characteristics. To assess whether there are gender inequalities in this association.

Design

Cross-sectional multilevel analysis of survey data.

Setting

Germany.

Participants

3350 men and 3665 women living in 167 municipalities throughout Germany participating in the 'German Health Interview and Examination Survey for Adults' (DEGS1 2008-2011) as part of the national health monitoring.

Outcome

Perceived social support as measured by Oslo-3 Social Support Scale.

Results

Prevalence of low perceived social support was 11.4% in men and 11.1% in women. Low social support was associated in men and women with sociodemographic characteristics that indicate more disadvantaged living situations. Taking these individual-level characteristics into account, municipal-level deprivation was independently associated with low perceived social support in men (OR for the most deprived quintile: 1.80 (95% CI 1.14 to 2.84)), but not in women (OR 1.22 (95% CI 0.78 to 1.90)).

Conclusion

The results of our multilevel analysis suggest that there are gender inequalities in the association of municipal-level deprivation with the prevalence of low perceived social support in Germany independent of individual socioeconomic position. Community health interventions aiming at promotion of social support among residents might profit from a further understanding of the observed gender differences.

SUBMITTER: Mena E

PROVIDER: S-EPMC5898354 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Publications

Gender inequalities in the association between area deprivation and perceived social support: a cross-sectional multilevel analysis at the municipality level in Germany.

Mena Emily E Kroll Lars Eric LE Maier Werner W Bolte Gabriele G

BMJ open 20180412 4

<h4>Objectives</h4>To investigate the association between area deprivation at municipality level with low perceived social support, independent of individual socioeconomic position and demographic characteristics. To assess whether there are gender inequalities in this association.<h4>Design</h4>Cross-sectional multilevel analysis of survey data.<h4>Setting</h4>Germany.<h4>Participants</h4>3350 men and 3665 women living in 167 municipalities throughout Germany participating in the 'German Health ...[more]

PMID: 29654020

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Project description:BackgroundPeople living in more deprived areas of high-income countries have lower cancer survival than those in less deprived areas. However, associations between individual-level socio-economic circumstances and cancer survival are relatively poorly understood. Moreover, few studies have addressed contextual effects, where associations between individual-level socio-economic status and cancer survival vary depending on area-based deprivation.MethodsUsing 9276 individual-level observations from a longitudinal study in England and Wales, we examined the association with cancer survival of area-level deprivation and individual-level occupation, education, and income, for colorectal, prostate and breast cancer patients aged 20-99 at diagnosis. With flexible parametric excess hazard models, we estimated excess mortality across individual-level and area-level socio-economic variables and investigated contextual effects.ResultsFor colorectal cancers, we found evidence of an association between education and cancer survival in men with Excess Hazard Ratio (EHR) = 0.80, 95% Confidence Interval (CI) = 0.60;1.08 comparing "degree-level qualification and higher" to "no qualification" and EHR = 0.74 [0.56;0.97] comparing "apprenticeships and vocational qualification" to "no qualification", adjusted on occupation and income; and between occupation and cancer survival for women with EHR = 0.77 [0.54;1.10] comparing "managerial/professional occupations" to "manual/technical," and EHR = 0.81 [0.63;1.06] comparing "intermediate" to "manual/technical", adjusted on education and income. For breast cancer in women, we found evidence of an association with income (EHR = 0.52 [0.29;0.95] for the highest income quintile compared to the lowest, adjusted on education and occupation), while for prostate cancer, all three individual-level socio-economic variables were associated to some extent with cancer survival. We found contextual effects of area-level deprivation on survival inequalities between occupation types for breast and prostate cancers, suggesting wider individual-level inequalities in more deprived areas compared to least deprived areas. Individual-level income inequalities for breast cancer were more evident than an area-level differential, suggesting that area-level deprivation might not be the most effective measure of inequality for this cancer. For colorectal cancer in both sexes, we found evidence suggesting area- and individual-level inequalities, but no evidence of contextual effects.ConclusionsFindings highlight that both individual and contextual effects contribute to inequalities in cancer outcomes. These insights provide potential avenues for more effective policy and practice.

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Dataset Information

Gender inequalities in the association between area deprivation and perceived social support: a cross-sectional multilevel analysis at the municipality level in Germany.

Objectives

Design

Setting

Participants

Outcome

Results

Conclusion

Publications

Gender inequalities in the association between area deprivation and perceived social support: a cross-sectional multilevel analysis at the municipality level in Germany.

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