Samenvatting
Aims. This study probes into the evolution in social inequalities in mortality among adolescents and young adults according to urbanicity level. In Belgium, substantial regional differences in life expectancy have been found. Yet, little information exists on the rural-urban divide in young-adult mortality. Previous research in the Brussels-Capital Region (BCR) identified a large drop in mortality among the young in the 1990s compared to the 2000s, and showed persisting social inequalities, especially among men. This study expands this research, by adding a comparison with the other Belgian large urban areas, and identifies if the drop in mortality in the BCR is a general phenomenon in Belgium or specific for a metropolitan context.
Design & Setting. Individual record-linked data between the Belgian censuses of 1991 and 2001 and register data on death and emigrations is used. Five large cities can be identified: Brussels, Antwerp, Ghent, Liège and Charleroi. Age-standardised Mortality Rates (ASMR) and the Relative Index of Inequality are measured.
Participants. Analyses were restricted to young adults aged 19 to 34 years at baseline. The young population comprised 2,458,637 persons in 1991, and 2,174,384 in 2001.
Results. There is a positive evolution towards lower mortality among the young, with the strongest declines in large cities, especially in the BCR and Liège (e.g. ASMR BCR men 1991= 34.9 [95%CI 32.5-37.4]; 2001: 20.4 [18.6-22.3]). Mortality remains highest in the Walloon Region, while the highest social inequalities have been found both in smaller urban areas. In most large cities declines were similar in all educational groups, resulting in a small but statistically non-significant decline in relative social inequalities over time (e.g. RII Antwerp 1991= 3.60 [2.30-5.61], RII 2001=3.30 [1.83-5.98]). The case of Charleroi stands out, with only a small decline in mortality over time and increasing social inequalities.
Conclusions. This study showed that young-adult mortality declines are strongest in large cities, except one highly-deprived large city, and that social inequalities are steady or less strong over time compared to smaller urban areas. With these results we hope to contribute to research that does not only look at the urban health penalty, but also shows the advantages of living and growing up in large urban areas.
Design & Setting. Individual record-linked data between the Belgian censuses of 1991 and 2001 and register data on death and emigrations is used. Five large cities can be identified: Brussels, Antwerp, Ghent, Liège and Charleroi. Age-standardised Mortality Rates (ASMR) and the Relative Index of Inequality are measured.
Participants. Analyses were restricted to young adults aged 19 to 34 years at baseline. The young population comprised 2,458,637 persons in 1991, and 2,174,384 in 2001.
Results. There is a positive evolution towards lower mortality among the young, with the strongest declines in large cities, especially in the BCR and Liège (e.g. ASMR BCR men 1991= 34.9 [95%CI 32.5-37.4]; 2001: 20.4 [18.6-22.3]). Mortality remains highest in the Walloon Region, while the highest social inequalities have been found both in smaller urban areas. In most large cities declines were similar in all educational groups, resulting in a small but statistically non-significant decline in relative social inequalities over time (e.g. RII Antwerp 1991= 3.60 [2.30-5.61], RII 2001=3.30 [1.83-5.98]). The case of Charleroi stands out, with only a small decline in mortality over time and increasing social inequalities.
Conclusions. This study showed that young-adult mortality declines are strongest in large cities, except one highly-deprived large city, and that social inequalities are steady or less strong over time compared to smaller urban areas. With these results we hope to contribute to research that does not only look at the urban health penalty, but also shows the advantages of living and growing up in large urban areas.
Originele taal-2 | English |
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Titel | The International Conference on Urban Health |
Plaats van productie | Manchester, UK |
Status | Published - 4 mrt 2014 |
Evenement | 11th International Conference on Urban Health - Manchester, United Kingdom Duur: 4 mrt 2014 → 7 mrt 2014 |
Conference
Conference | 11th International Conference on Urban Health |
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Land/Regio | United Kingdom |
Stad | Manchester |
Periode | 4/03/14 → 7/03/14 |