Dataset Information

Social differences in avoidable mortality between small areas of 15 European cities: an ecological study.

ABSTRACT: BACKGROUND: Health and inequalities in health among inhabitants of European cities are of major importance for European public health and there is great interest in how different health care systems in Europe perform in the reduction of health inequalities. However, evidence on the spatial distribution of cause-specific mortality across neighbourhoods of European cities is scarce. This study presents maps of avoidable mortality in European cities and analyses differences in avoidable mortality between neighbourhoods with different levels of deprivation. METHODS: We determined the level of mortality from 14 avoidable causes of death for each neighbourhood of 15 large cities in different European regions. To address the problems associated with Standardised Mortality Ratios for small areas we smooth them using the Bayesian model proposed by Besag, York and Mollié. Ecological regression analysis was used to assess the association between social deprivation and mortality. RESULTS: Mortality from avoidable causes of death is higher in deprived neighbourhoods and mortality rate ratios between areas with different levels of deprivation differ between gender and cities. In most cases rate ratios are lower among women. While Eastern and Southern European cities show higher levels of avoidable mortality, the association of mortality with social deprivation tends to be higher in Northern and lower in Southern Europe. CONCLUSIONS: There are marked differences in the level of avoidable mortality between neighbourhoods of European cities and the level of avoidable mortality is associated with social deprivation. There is no systematic difference in the magnitude of this association between European cities or regions. Spatial patterns of avoidable mortality across small city areas can point to possible local problems and specific strategies to reduce health inequality which is important for the development of urban areas and the well-being of their inhabitants.

SUBMITTER: Hoffmann R

PROVIDER: S-EPMC4007807 | biostudies-other | 2014

REPOSITORIES: biostudies-other

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Social differences in avoidable mortality between small areas of 15 European cities: an ecological study.

Hoffmann Rasmus R Borsboom Gerard G Saez Marc M Mari Dell'Olmo Marc M Burström Bo B Corman Diana D Costa Claudia C Deboosere Patrick P Domínguez-Berjón M Felicitas MF Dzúrová Dagmar D Gandarillas Ana A Gotsens Mercè M Kovács Katalin K Mackenbach Johan J Martikainen Pekka P Maynou Laia L Morrison Joana J Palència Laia L Pérez Gloria G Pikhart Hynek H Rodríguez-Sanz Maica M Santana Paula P Saurina Carme C Tarkiainen Lasse L Borrell Carme C

International journal of health geographics 20140312

<h4>Background</h4>Health and inequalities in health among inhabitants of European cities are of major importance for European public health and there is great interest in how different health care systems in Europe perform in the reduction of health inequalities. However, evidence on the spatial distribution of cause-specific mortality across neighbourhoods of European cities is scarce. This study presents maps of avoidable mortality in European cities and analyses differences in avoidable mort ...[more]

PMID: 24618273

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Project description:Marine protected areas (MPAs) are a primary tool for the stewardship, conservation, and restoration of marine ecosystems, yet 69% of global MPAs are only partially protected (i.e., are open to some form of fishing). Although fully protected areas have well-documented outcomes, including increased fish diversity and biomass, the effectiveness of partially protected areas is contested. Partially protected areas may provide benefits in some contexts and may be warranted for social reasons, yet social outcomes often depend on MPAs achieving their ecological goals to distinguish them from open areas and justify the cost of protection. We assessed the social perceptions and ecological effectiveness of 18 partially protected areas and 19 fully protected areas compared with 19 open areas along 7000 km of coast of southern Australia. We used mixed methods, gathering data via semistructured interviews, site surveys, and Reef Life (underwater visual census) surveys. We analyzed qualitative data in accordance with grounded theory and quantitative data with multivariate and univariate linear mixed-effects models. We found no social or ecological benefits for partially protected areas relative to open areas in our study. Partially protected areas had no more fish, invertebrates, or algae than open areas; were poorly understood by coastal users; were not more attractive than open areas; and were not perceived to have better marine life than open areas. These findings provide an important counterpoint to some large-scale meta-analyses that conclude partially protected areas can be ecologically effective but that draw this conclusion based on narrower measures. We argue that partially protected areas act as red herrings in marine conservation because they create an illusion of protection and consume scarce conservation resources yet provide little or no social or ecological gain over open areas. Fully protected areas, by contrast, have more fish species and biomass and are well understood, supported, and valued by the public. They are perceived to have better marine life and be improving over time in keeping with actual ecological results. Conservation outcomes can be improved by upgrading partially protected areas to higher levels of protection including conversion to fully protected areas.

Dataset Information

Social differences in avoidable mortality between small areas of 15 European cities: an ecological study.

Publications

Social differences in avoidable mortality between small areas of 15 European cities: an ecological study.

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