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This cross-sectional study examines the population prevalence of blood lead levels (BLLs) greater than the sample median of 0.76 [micro]g/dl in the U.S. population and investigates demographic factors associated with higher BLLs using data from the 2017-2018 National Health and Nutrition Examination Survey. Logistic regression models were used to assess the impact of poverty status on BLLs, with adjustments for factors such as race, age, gender, and lifetime smoking history. This study found that individuals living in or near poverty had significantly higher odds of having a BLL >0.76 [micro]g/dl when compared with individuals not in poverty, with. an adjusted OR of 1.824 (95% CI [1.324, 2.513]) and 1.744 (95% CI [1.388, 2.190]), respectively. This nationally representative study has important implications for understanding the demographic and socioeconomic factors that affect BLLs in the U.S. population. Keywords: blood lead level, lead, poverty, environmental justice, environment, regression, Introduction Lead is a toxic heavy metal that has been recognized for many decades as a significant environmental and public health hazard. Lead is present in the environment as a [...]

Rats are a common problem in cities worldwide. Impoverished urban neighborhoods are disproportionately affected because factors associated with poverty promote rat infestations and rat-human contact. In public health, most studies have focused on disease transmission, but little is known about the nonphysical consequences of this environmental exposure. Mental health often is neglected but is receiving increasing attention in public health research and practice. The objective of this study was to use a systematic review and narrative synthesis of the published literature to explore the effect of rat exposure on mental health among residents in impoverished urban neighborhoods. Although the literature addressing this topic was sparse, the results of this review suggest that rat exposure consistently has a negative impact on mental health. These effects can be elicited directly (e.g., fear of rat bites) or indirectly (e.g., feeling of disempowerment from inability to tackle rat problems). By developing a better understanding of potential rat-related health risks, both mental and physical, public health officials can better evaluate, refine, and develop their policies regarding rats., Introduction Society has a negative perception of rats (Rattus spp.). From a health perspective, they are the source of a number of zoonoses (diseases transmitted to people from animals) that [...]

Spanning more than a decade, dedicated international efforts to eradicate extreme poverty and achieve the United Nations Millennium Development Goals (MDGs) have yielded extraordinary successes. Buoyed by the dramatic reductions [...]

The concept of food insecurity that encompasses both the physical sensation of hunger and compensatory behavior used to avoid hunger and emerging epidemics of obesity and diet-sensitive chronic disease in developing and newly industrialized countries are reviewed. New programs should be developed and implemented to encourage and provide incentives for shifting dietary intake toward more healthful foods that could reduce food insecurity and widening socioeconomic disparities in chronic disease.

Insecure access to food and water are experienced by millions of people around the world. Not only does insecure access to food and water represent a violation of basic human fights, it is a major threat to the physical and mental health of individuals and communities. There is, therefore, great need for tools to identify those who are food and water insecure and the severity of their insecurity. We argue here that measures of food and water insecurity must not only reflect biological requirements but also the biocultural nature of food and water needs. In this paper, we present case studies from Tanzania and Bolivia that detail the steps used to adapt or create experience-based measures and validate these measures using a suite of established approaches. We also show that, by broadening our understanding of insecurity to include respondents' experiences, the full range of health impacts--including psychosocial stress and mental health--become apparent. We conclude by noting limitations of the biocultural approach and offer suggestions for future research. Key words: Bolivia, Tanzania, measurement, poverty, nutrition, health, scarcity, public health

Montreal, the poverty capital of Canada! For decades, Montreal has held this sad distinction, as year in year out, one third of its population falls below the Statistics Canada low-income [...]

Although there has been global decline in Infant and Child Mortality rates, sub-Sahara African countries still bear the greatest burden in the world. Many of these deaths occur as a result of preventable diseases such as pneumonia, malaria, measles and malnutrition. This has been witnessed in the six partnership districts of the study. With the introduction of a dialogue model, the study aimed at investigating the characteristics associated with the affected households. The overall result in the six partnership districts is a reversal of the recent child mortality trends in Kenya. The study aimed to determine the child mortality rates in six partnership districts and their distribution by socio-economic characteristics and health seeking behaviour. Mortality and population data were derived from a complete household census of 27 sub-locations within the partnership districts (Nyando 7, Kisumu 2, Bondo 7, Suba 7, Siaya 2 and Rachuonyo 2 sub-locations). Child mortality and its relationship to specific variables relating to background and proximate factors were considered. Between 2006 and 2007, proportions of households with child deaths declined in all the districts with Rachuonyo and Suba district sub-locations having the greatest decline from 38% to 12% and 15% to 0.1%, respectively. Proportions of health facility deliveries decreased in households that experienced under-five deaths in all the other 5 districts except Nyando sub- locations with an increase of (18%). Measles vaccination coverage was lower among households with child deaths. Use of Insecticide Treated Nets (ITNs) was lower among households with child deaths in Kisumu and Bondo unlike in Rachuonyo where a large proportion of the households experiencing child deaths were using ITNs. Child mortality declined by type of housing and level of education. Households living in mud houses and had mothers with primary education experienced the highest proportions of child mortality while households living in permanent houses with mothers having secondary education and above, the lowest. Education of mothers remains a significant determinant of child mortality along with health facility delivery. No difference in child mortality was realized between mothers having primary education and those that had none. Better health seeking behavior should, therefore, be encouraged to help stem the high child mortality rates. Keywords: Child mortality, distribution, partnership, districts, INTRODUCTION Infant and child mortality rates in many parts of the world have been decreasing in recent decades, but still remain among the highest in the world in sub- Saharan [...]

The Undernutrition Prevention Center (UPC) of the Corporation for Childhood Nutrition (CONIN) assists children from 0-3 years of age who present with primary or secondary undenutrition. The aim of the retrospective study reported here was to complete a nutritional, cognitive, and social evaluation of UPC children in Mendoza, Argentina, from 1995 to 2005. During the study period, a total of 478 schoolchildren aged 5-17 years (185 in the CONIN group and 292 in the non-CONIN group) were evaluated. Although no differences in weight and height were found between the groups, the percentage of children below the cutoff level for the maturity test was significantly lower in the CONIN group (70.8% versus 17.6%; P = 0.043). CONIN provides important social support to families through work qualification programs and health education.

The cost to developing countries, for current and future generations, of not eradicating hunger and poverty--in terms of recurrent conflicts and emergencies, widening inequalities, depleted resources, ill health, and premature death--is enormous. Although strategies are underway to address certain problems in Africa and the Middle East, much remains to be done. Breaking the poverty cycle in these regions demands both local and international attention. Nutrition transition is a key factor, since many countries in the region also suffer the consequences of the excessive and unbalanced diets that are typical of developed countries. This paper reviews the experiences with facing malnutrition in Sub-Saharan and North Africa and the Middle East.

The income-achievement gap is a formidable societal problem, but little is known about either neurocognitive or biological mechanisms that might account for income-related deficits in academic achievement. We show that childhood poverty is inversely related to working memory in young adults. Furthermore, this prospective relationship is mediated by elevated chronic stress during childhood. Chronic stress is measured by allostatic load, a biological marker of cumulative wear and tear on the body that is caused by the mobilization of multiple physiological systems in response to chronic environmental demands.

Objectives. We estimated associations between poverty in early, middle, and later childhood and adult body mass index to further elucidate the effects of socioeconomic status on health. Methods. We conducted secondary analyses of data from men and women (N=885) born between 1968 and 1975 who were tracked between their prenatal and birth years and adulthood in the nationally representative Panel Study of Income Dynamics. We used multivariate regression techniques and spline models to estimate the relationship between income in different stages of childhood and adult body mass index, overweight, and obesity. We controlled for other family characteristics, including income in other periods of childhood. Results. Mean annual family income in the prenatal and birth years for children whose annual family incomes averaged less than $25 000 was significantly associated with increased adult body mass index, but mean annual family income between 1 and 5 years of age and between 6 and 15 years of age was not. Conclusions. Our results indicated that economic conditions in the earliest period of life (during the prenatal and birth years) may play an important role in eventual anthropometric measures. (doi: 10.2105/AJPH.2007.130575)

This study contributes to literature examining the salience of ecological variables by investigating relationships between stress, coping, community resources, and residential nature. One hundred thirty-three low-income women in mid-Michigan reported on institutional resource availability, recent stressful events, and preferred coping styles. Research assistants rated yards surrounding respondents' homes for the presence of natural features. African American mothers reported greater usage of both emotion-focused and active coping strategies compared to European American mothers. Availability of community resources was found to predict significantly to the use of active and emotion-focused coping strategies, and stress intensity and natural resources predicted significantly to avoidant coping strategies. Further development of the Residential Natural Resources Inventory and investigation of the variance of environmental stressors, resources, and coping responses within racial, ethnic, and socioeconomic groups are recommended. Keywords: women; mothers; low income; coping; stress; natural environment; community resources; poverty

Background. We examined age differences in levels of biological risk factors in the U.S. population by poverty status. It is not clear how socioeconomic status differentials in biological risk change with age because of mortality. Methods. We used two nationally representative samples (National Health and Nutrition Examination Survey [NHANES] III, 1988-1994, and NHANES, 1999-2004) with data for more than 12,000 people aged 20 and older in each data set to examine biological risk for persons in families with incomes below and close to poverty level and those with higher income. We examined how mortality and life expectancy in the earlier sample are related to poverty status and biological risk. We examined life table survivorship to clarify how mortality differentially removes those who are poor and those with high biological risk from the population. Results. Differences in biological risk by poverty status are larger before old age and become insignificant at older ages. Life expectancy at age 20 differs markedly by biological risk and poverty status. Conclusions. Population differentials in health at older ages result from a lifetime of differences. Socioeconomic differences in health in old age disappear because of health and mortality differentials at earlier ages. Poorer people 'age' earlier and this affects the age pattern of social differentials. Key Words: Poverty--Biological risk---Mortality--Gender--Life expectancy--NHAHES--SES differentials.

Objective: We consider associations between individual, household and area-level characteristics and self-reported health. Method: Data is taken from baseline surveys undertaken in 13 socio-economically disadvantaged neighbourhoods in Victoria (n=3,944). The neighbourhoods are sites undergoing Neighbourhood Renewal (NR), a State government initiative redressing place-based disadvantage. Analysis: This focused on the relationship between area and compositional factors and self-reported health. Area was coded into three categories; LGA, NR residents living in public housing (NRPU) and NR residents who lived in private housing (NRPR). Compositional factors included age, gender, marital status, identifying as a person with a disability, level of education, unemployment and receipt of pensions/benefits. Results: There was a gradient in socioeconomic disadvantage on all measures. People living in NR public housing were more disadvantaged than people living in NR private housing who, in turn, were more disadvantaged than people in the same LGA. NR public housing residents reported the worst health status and LGA residents reported the best. Conclusions: Associations between compositional characteristics of disability, educational achievement and unemployment income and poorer self-reported health were shown. They suggested that area characteristics, with housing policies, may be contributing to differences in self-reported health at the neighbourhood level. Implications: The clustering of socioeconomic disadvantage and health outcomes requires the integration of health and social support interventions that address the circumstances of people and places. Key words: Socio-economic factors, family characteristics, health status, public policy, public housing, residential mobility

Objective: This paper explores associations between residents' perceptions of social incivilities and physical disorders in local environments and self-reported health status. Method: Surveys were conducted with 4,029 residents from 13 Neighbourhood Renewal sites and 1,857 residents of corresponding Local Government Areas in Victoria. An open-ended question asked respondents to nominate the worst things about living in their neighbourhood and this qualitative data was analysed for the range of perceptions of incivilities. Quantitative data analysis considered associations between incivilities in neighbourhood environments and self-reported health status. Results: Issues conceptualised as social incivilities (drug and alcohol use, dangerous driving, the behaviour of other people, feeling unsafe, noise, racism) accounted for 58% of issues nominated. Quantitative analyses suggested that increased exposure to issues related to aspects of neighbourhood safety were associated with living in a disadvantaged neighbourhood. Perceptions of lower levels of neighbourhood safety were, in turn, associated with poorer health. Conclusions: Cumulative and compounding aspects of local environments that heighten feelings of insecurity and anxiety may be mechanisms through which places affect health. Implications: While the characteristics of populations are important determinants of health outcomes, the findings endorse the value of incorporating complementary place-based approaches for addressing mechanisms that contribute to health inequalities in local environments. Key words: Social environment, social conditions, environment and public health, socio-economic factors, health status.

To address the childhood obesity epidemic, numerous national agencies have outlined specific school policy recommendations for nutrition and physical activity. The extent to which current policies differ by socioeconomic status and geographic location is yet to be determined. This cross-sectional study examined select school nutrition and physical activity policies by markers for poverty among 209 middle and high schools in Utah (82% response rate). The results show that students' opportunities to establish healthful dietary and physical activity patterns differed by economic circumstances and geographic location. Schools with the highest percentage of free and reduced-price lunch enrollment and schools in rural areas were both less likely to offer a variety of healthful foods outside of the school meal program (ie, competitive foods and drinks) and intramural activities or physical activity clubs. Schools with highest free and reduced-price lunch enrollment were more likely to allow the purchase of unhealthful snacks during lunchtimes than schools with low enrollment (28.4% vs 7.6%, P=0.01). Schools in rural communities were less likely to promote walking and bicycling to school compared with other locations (47.4% rural vs 67.1% urban and 63.6% suburban, P=0.06). Current school policies related to nutrition and physical activity may not be conducive to reducing the childhood overweight problem among children attending schools in areas with increased risk factors due to poverty or rural location in Utah.

In contrast to the most industrialized Western nations, the United States faces great social and economic disparities and a deep gap between the socioeconomic strata. The child poverty rate is almost three times higher than in any other industrialized Western country, and single mother families represent 60% of all poor families in the United States. Concentrating on the situation of single mothers in impoverished Buffalo, New York, the authors argue that similar to the underdeveloped world, the fate of single mothers in the United States is tied to the global economy. This project seeks to understand how systemic (social location) and idiosyncratic (individual) factors interactively affect the health and well-being of female-headed, single-parent families. The quantitative analyses are supported by an examination of a case study of a transitional housing program, called Gerard Place. We examine the impact of this comprehensive program offered to poor mothers, including housing, counseling, education, child care, and financial support. These support systems assist female-headed families to rebuild self-sufficiency, sustainable income, and economic independence. The call to approach welfare programs as a synthesis of systemic and idiosyncratic factors concludes the study. KEYWORDS. Family policy, globalization and poverty, impoverished city of Buffalo, welfare reform

The life course perspective emphasizes that past economic experiences and stage in the life course influence a family's ability to cope with negative life events such as poor health. However, traditional analytic approaches are not well-suited to examine how the impact of negative life events differs based on a family's past economic experiences, nor do they typically account for the potentially spurious association between negative life events and family economic well-being. We use finite mixture modeling to examine how changes in parental health affect children 's exposure to poverty. We find that for some children the association between family head's health and children's exposure to poverty is spurious, while for other children family head's poor health is associated with increased risk of economic deprivation. The extent to which a family head's poor health alters children's economic well-being depends on a child's family's underlying economic trajectory and past history of exposure to disadvantage.

The release of the new WHO guidelines on HIV and infant feeding, in a global context of widespread impoverishment, requires countries to re-examine their infant-feeding policies in relation to broader socioeconomic issues. This widening scope is necessitated by compelling new reports on the scale of global underdevelopment in developing countries. This paper explores these issues by addressing feeding choices made by HIV-infected mothers and programmes supplying free formula milks within a global environment of persistent poverty. Accumulating evidence on the increase in malnutrition, morbidity and mortality associated with the avoidance or early cessation of breastfeeding by HIV-infected mothers, and the unanticipated hazards of formula feeding, demand a deeper assessment of the measures necessary for optimum policies on infant and child nutrition and for the amelioration of poverty. Piecemeal interventions that increase resources directed at only a fraction of a family's impoverishment, such as basic materials for preparation of hygienic formula feeds and making flawed decisions on choice of infant feeding, are bound to fail. These are not alternatives to taking fundamental steps to alleviate poverty. The economic opportunity costs of such programmes, the equity costs of providing resources to some and not others, and the leakages due to temptation to sell capital goods require careful evaluation. Providing formula to poor populations with high HIV prevalence cannot be justified by the evidence, by humanitarian considerations, by respect for local traditions or by economic outcomes. Exclusive breastfeeding, which is threatened by the HIV epidemic, remains an unfailing anchor of child survival, Bulletin of the World Health Organization 2008;86:210-214. Resume Dans le contexte mondial actuel d'appauvrissement generalise, les nouvelles directives de I'OMS sur le VIH et l'alimentation du nourrisson recemment publies demandent aux pays de reexaminer leurs politiques d'alimentation du nourrisson en tenant compte d'aspects socioeconomiques plus larges. Cet elargissement de la perspective est motive par de nouveaux rapports convaincants sur l'ampleur a l'echelle mondiale du sous-developpement dans les pays en developpement. Le present article etudie ces aspects en examinant les choix en matiere d'alimentation du nourrisson faits par les meres infectees par le VIH et les programmes fournissant gratuitement du lait pour nourrisson dans un contexte mondial de pauvrete persistante. Les preuves qui s'accumulent d'une augmentation de la malnutrition, de la morbidite et de la mortalite liee a l'abstention ou a l'arret precoce de l'alimentation au sein par les meres infectees et les dangers imprevus de l'alimentation artificielle exigent une evaluation plus approfondie des mesures necessaires pour optimiser les politiques en matiere d'alimentation du nourrisson et de l'enfant et pour faire reculer la pauvrete. Les interventions fragmentaires pour augmenter les ressources qui ne compensent qu'une partie de l'appauvrissement familial (fourniture de matieres de base pour preparer des aliments pour nourrissons conformes a l'hygiene par exemple) et prennent de mauvaises decisions concernant l'alimentation du nourrisson, sont condamnees a echouer. Il n'existe pas d'alternative a la prise de mesures fondamentales pour attenuer la pauvrete. Les couts d'opportunite de tels programmes, les couts en matiere d'equite de la fourniture selective de ressources et les pertes dues aux tentations de vendre des biens en capital doivent etre soigneusement evalues. La fourniture de preparations pour nourrissons a des populations pauvres subissant une forte prevalence du VIH ne peut se justifier par des elements factuels, des considerations humanitaires, le respect des traditions locales ou des resultats economiques. L'alimentation exclusivement au sein, menacee par l'epidemie de VIH, reste la base inebranlable de la survie de l'enfant. Resumen La publicacion de las nuevas directrices de la OMS sobre el VIH y la alimentacion del lactante, en un contexto mundial de empobrecimiento generalizado, obliga a los paises a revisar sus politicas de alimentacion del lactante en relacion con algunos aspectos socioeconomicos mas amplios. Esta perspectiva mas amplia es imprescindible a la vista de la contundencia de los ultimos datos sobre la magnitud del subdesarrollo global en los paises en desarrollo. En este articulo se analizan esas cuestiones centrando la atencion en las decisiones de alimentacion de sus hijos que toman las madres infectadas por el VIH y en los programas que suministran leche artificial gratuita en un contexto mundial de pobreza persistente. La creciente evidencia de un aumento de la malnutricion, la morbilidad y la mortalidad asociadas a la evitacion o la interrupcion temprana de la lactancia materna por las madres infectadas por el VIH y los riesgos imprevisibles de las preparaciones para lactantes exigen una evaluacion mas profunda de las medidas necesarias para formular politicas optimas sobre la nutricion del lactante y del nino y para mitigar la pobreza. Las intervenciones fragmentarias de incremento de los recursos con miras a paliar solo una parte del empobrecimiento de las familias, como productos basicos para la elaboracion higienica de las preparaciones y algunas decisiones desacertadas en materia de alimentacion del lactante, estan destinadas a fracasar. No son esas alternativas que puedan suplir medidas fundamentales de mitigacion de la pobreza. Los cestos de oportunidad economicos de esos programas, la inequidad que supone proporcionar recursos a unos y no a otros, y las perdidas debidas a la tentacion de vender los bienes de capital exigen una detenida evaluacion. El suministro de preparaciones a las poblaciones pobres con alta prevalencia de infeccion por VIH no puede justificarse aduciendo la evidencia disponible, consideraciones humanitarias, el respeto de las tradiciones locales o los erectos economicos. La lactancia materna exclusiva, amenazada por la epidemia de VIH, sigue siendo un arma fundamental para la supervivencia infantil., WHO Consensus Statement on HIV and Infant Feeding The new WHO Consensus Statement on HIV and Infant Feeding (1) highlights critical issues in the continuing debate on whether the HIV [...]

Race- and poverty-related disparities in physical function are well documented, though little is known about effects of race and poverty on functional decline and the progression of disability. We examined cross-sectional and longitudinal relationships between race, poverty and lower extremity function using data from moderately to severely disabled women in the U.S. Women's Health and Aging Study. Severity of lower extremity functional limitation was determined from scaled responses of reported difficulty walking 1/4 mile, walking across a room, climbing stairs, and stooping, crouching or kneeling. Usual walking speed assessed over 4 m was our objective measure of function. Of the 996 women who described themselves as black or white, 284 (29%) were black and 367 (37%) were living at or below 100% of the federal poverty level. Independent of demographic and health-related factors, among white women, the poor exhibited consistently worse lower extremity function than the non-poor; this association, however, was not observed in black women. Among the non-poor, black women had slower walking speeds, and reported more limitation in lower extremity function than their non-poor white counterparts, even after adjusting for demographic variables and health-related characteristics. After 3 years, accounting for baseline function, demographic and health-related factors, race and poverty status were unrelated to functional decline. Thus, while race and poverty status were associated with functional deficits in old age, they do not appear to impact the rate of functional decline or progression of disability over 3 years. Keywords: Health disparities; Poverty status; Functional decline; Race; Functional status; Lower extremity functioning; Women; USA

Aims: To describe the socio-economic background and physical health status of young offenders in custody in New South Wales (Australia). Design: Cross-sectional survey of all young offenders held at nine juvenile detention centres across New South Wales (NSW) (eight male and one female) between January and March 2003. Methods: Demographic and health information was collected by nurse interviewers and psychologists using a face-to-face interview. Blood and urine samples were collected to screen for blood-borne viruses and sexually transmissible infections. Results: The final sample comprised 242 young people (223 males and 19 females). Overall, 90% of those assessed rated their general health as 'excellent', 'very good' or 'good'. Sixty-nine (30%) young offenders reported that they had been previously diagnosed with asthma. Two young women reported a past diagnosis of diabetes with the results of the random blood glucose testing indicating that a further six young people required testing for possible diabetes. None of those tested were positive for HIV, 9% tested positive for hepatitis C antibody, and 11% tested positive for hepatitis B core-antibody. Conclusions: Our findings indicate that young offenders in New South Wales have backgrounds characterised by extreme disadvantage (poor educational attainment, unemployment, and care placements) and poor physical health. Parental incarceration was common to 43% of the sample. Our findings reinforce the concept that for marginalised groups, contact with the criminal justice system represents an important opportunity to detect illness, initiate treatment, and promote contact with health services. Keywords: Adolescent; prisoners; bloodborne pathogens; health status; Australia. doi:10.1111/j.1753-6405.2008.00169.x

We examined health and social outcomes among children related to parental disposable income and receipt of social assistance. Swedish national registry data were used in a longitudinal design. We estimated relative risks and odds ratios for health and social outcomes in Poisson and logistic regressions among 1.2 million children between 1993 and 2002, and adjusted for factors that might affect the associations. Children in families receiving long-term social assistance showed considerably less satisfactory future prospects regarding health-related outcomes--all-cause mortality, suicide attempt, alcohol and drug misuse. Also, and to an even greater extent, the children experienced low educational attainment and social assistance in young adulthood compared with the rest of the population, and also in comparison with other low-income families. Low income was also associated with risk increases, but to a lesser extent. After taking into account the greater proportion of social-assistance recipients in low-income groups, attenuated risk increases remained only regarding future prospects of low education and social assistance. Regarding both low income and months receiving social assistance there was a gradient, at least in the age-adjusted analyses; there were greater risk increases among long-term recipients and among those with low incomes, and lower risk increases among short-term recipients and among those with high incomes. The results indicate that growing up in a family on long-term social assistance is a robust risk marker for compromised long-term development. A policy whereby children and parents receiving long-term assistance are offered access to evidence-based prevention programs in the areas of health, education and skills training appears to be important. Keywords: Sweden; Health inequalities; Poverty; Social assistance; Children; Adolescents; Child health and development; Longitudinal

A study examining the effects of poverty and malnutrition on dental caries, periodontal disease, oral cancer and tooth loss is presented.

This paper considers the spatial characteristics of the relationship between deprivation and mortality rates in Scotland. Scotland not only has higher average mortality rates than England and Wales but the greatest spatial concentrations of the poorest health areas in Britain. Recent analysis has suggested that degree of deprivation alone cannot explain the majority of Scotland's 'excess' poor health relative to England and Wales, a finding referred to as the 'Scottish effect'. This analysis considers if the spatial patterning of deprivation could be significant to understanding of high mortality in Scotland. Exploratory spatial data analysis methods are implemented to study the spatial relationships between deprivation and standardised mortality ratios (SMRs) in post-code sectors in Scotland. Deprivation was measured using the 2001 Carstairs score, and the total number of deaths during a 3-year period around the 2001 census was used to calculate SMRs. A strong spatial relationship is observed between deprivation and mortality. Deprivation impacts mortality levels not only within the same areas but also in spatially proximate areas. It is concluded that, further research on the 'Scottish effect' can benefit from new methodological approaches which assess the variation in both the extent and spatial arrangement of deprivation and mortality in small areas. Keywords: Deprivation: Mortality rates: Exploratory spatial data analysis: Scottish effect: Scotland: UK