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Socioeconomic status and injury mortality: individual and neighbourhood determinants
- Source :
- Journal of Epidemiology & Community Health. 54:517-524
- Publication Year :
- 2000
- Publisher :
- BMJ, 2000.
-
Abstract
- STUDY OBJECTIVE—This study examined both individual and neighbourhood correlates of injury mortality to better understand the contribution of socioeconomic status to cause specific injury mortality. Of particular interest was whether neighbourhood effects remained after adjusting for individual demographic characteristics and socioeconomic status. DESIGN—Census tract data (measuring small area socioeconomic status, racial concentration, residential stability, urbanisation, and family structure) was merged with the National Health Interview Survey (NHIS) and a file that links the respondents to subsequent follow up of vital status and cause of death data. Cox proportional hazards models were specified to determine individual and neighbourhood effects on homicide, suicide, motor vehicle deaths, and other external causes. Variances are adjusted for the clustered sample design of the NHIS. SETTING—United States, 1987-1994, with follow up to the end of 1995. PARTICIPANTS—From a sample of 472 364 persons ages 18-64, there were 1195 injury related deaths over the follow up period. MAIN RESULTS—Individual level effects were generally robust to the inclusion of neighbourhood level variables in the models. Neighbourhood characteristics had independent effects on the outcome even after adjustment for individual variability. For example, there was approximately a twofold increased risk of homicide associated with living in a neighborhood characterised by low socioeconomic status, after adjusting for individual demographic and socioeconomic characteristics. CONCLUSIONS—Social inequalities in injury mortality exist for both persons and places. Policies or interventions aimed at preventing or controlling injuries should take into account not only the socioeconomic characteristics of people but also of the places in which they live. Keywords: socioeconomic status; injury; neighborhood
- Subjects :
- Adult
Male
Research Report
Gerontology
Adolescent
Epidemiology
Poison control
Social class
Residence Characteristics
Cause of Death
Injury prevention
Humans
Medicine
National Health Interview Survey
Social inequality
Socioeconomic status
Neighbourhood (mathematics)
business.industry
Accidents, Traffic
Public Health, Environmental and Occupational Health
Middle Aged
United States
Suicide
Social Class
Data Interpretation, Statistical
Population Surveillance
Vital Status
population characteristics
Wounds and Injuries
Female
Homicide
business
Demography
Subjects
Details
- ISSN :
- 0143005X
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Journal of Epidemiology & Community Health
- Accession number :
- edsair.doi.dedup.....8ec483739ea82e3a29a11f6ef88c154c