Scientific Programme – Proffered Papers

Objectives: To analyze whether there is an association between neighbourhood deprivation and morbidity and mortality of lung cancer, beyond individual level characteristics. Design: The entire Swedish population aged over 50, a total of 3.2 million individuals, was followed from January 1, 2000, until admission due to morbidity or mortality of lung cancer during the study period, or the end of the study on December 31, 2010. Multilevel logistic regression was used in the analysis with individual level characteristics (age, marital status, family income, education, immigration status, urban/rural status, mobility, and comorbidities) at the first level and level of neighbourhood deprivation at the second level. Neighbourhood deprivation was measured at small area market statistics level the use of Care Need Index, combining low educational status, low income, unemployment, and social welfare assistance. Results: There was a strong association between level of neighbourhood deprivation and morbidity and mortality of lung cancer. In the full model, which took account of individual level characteristics, the risk of morbidity of lung cancer was 1.31 and 1.36 for mortality in the most deprived neighbourhood than in the most affluent neighbourhoods. The variance at neighbourhood level was over twice the standard error, indicating significant difference in morbidity and mortality of lung cancer risk between neighbourhoods. Conclusions: This study is the largest to date of the influences of neighbourhood deprivation on morbidity and mortality of lung cancer. Results suggest that characteristics of neighbourhood affect risk of morbidity and mortality of lung cancer independently of individual level sociodemographic characteristics. Both individual and neighborhood level approaches are important in health care policies.