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Assessing the effect of regional deprivation on mortality avoiding compositional bias

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Assessing the effect of regional deprivation on mortality avoiding compositional bias : a natural experiment. / Reiss, Katharina; Berger, Ursula; Winkler, Volker; Voigtländer, Sven; Becher, Heiko; Razum, Oliver.

in: J EPIDEMIOL COMMUN H, Jahrgang 67, Nr. 3, 01.03.2013, S. 213-8.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Reiss, K, Berger, U, Winkler, V, Voigtländer, S, Becher, H & Razum, O 2013, 'Assessing the effect of regional deprivation on mortality avoiding compositional bias: a natural experiment', J EPIDEMIOL COMMUN H, Jg. 67, Nr. 3, S. 213-8. https://doi.org/10.1136/jech-2012-201336

APA

Reiss, K., Berger, U., Winkler, V., Voigtländer, S., Becher, H., & Razum, O. (2013). Assessing the effect of regional deprivation on mortality avoiding compositional bias: a natural experiment. J EPIDEMIOL COMMUN H, 67(3), 213-8. https://doi.org/10.1136/jech-2012-201336

Vancouver

Reiss K, Berger U, Winkler V, Voigtländer S, Becher H, Razum O. Assessing the effect of regional deprivation on mortality avoiding compositional bias: a natural experiment. J EPIDEMIOL COMMUN H. 2013 Mär 1;67(3):213-8. https://doi.org/10.1136/jech-2012-201336

Bibtex

@article{573fce1b168a433ba7677247cd4296d8,
title = "Assessing the effect of regional deprivation on mortality avoiding compositional bias: a natural experiment",
abstract = "BACKGROUND AND OBJECTIVE: We assessed the effect of regional deprivation on individual mortality by making use of a natural experiment: we followed up ethnic German resettlers from Former Soviet Union countries who were quasi-randomly distributed across the socioeconomically heterogeneous counties of Germany's federal state North Rhine-Westphalia (NRW).METHODS: We used data from the retrospective cohort study 'AMOR' on the mortality of resettlers in NRW (n=34 393). Based on the postcode of the last known residence we linked study participants to the 54 counties of NRW, which were aggregated in six deprivation clusters. Mortality rates and standardised mortality ratios (SMRs) were calculated for each cluster. After a mean follow-up of 10 years, 2580 resettlers were deceased.RESULTS: For male and female cohort members, mortality rates and SMRs were highest in the cluster 'poverty poles' (SMR men: 1.21, 95% CI 1.04 to 1.41; SMR women: 1.17, 95% CI 0.99 to 1.37), whereas they were lowest in the cluster 'prospering regions and suburban counties' (SMR women: 0.86, 95% CI 0.70 to 1.05) as well as in the cluster 'heterogeneous counties' (SMR men: 0.73, 95% CI 0.61 to 0.88).CONCLUSIONS: The population which was quasi-randomly distributed to counties of differing socioeconomic status experienced different levels of mortality. It was highest in regions with the highest level of regional deprivation. Previous studies describing this positive relationship between mortality and regional deprivation could not differentiate between compositional and contextual effects. Thus, our findings indicate that in terms of mortality, regional deprivation does matter.",
keywords = "Adolescent, Adult, Age Distribution, Aged, Bias (Epidemiology), Cluster Analysis, Cultural Deprivation, Female, Germany, Healthcare Disparities, Humans, Male, Middle Aged, Mortality, Poverty Areas, Proportional Hazards Models, Residence Characteristics, Retrospective Studies, Sensitivity and Specificity, Sex Distribution, Socioeconomic Factors, Suburban Population, Transients and Migrants, Young Adult",
author = "Katharina Reiss and Ursula Berger and Volker Winkler and Sven Voigtl{\"a}nder and Heiko Becher and Oliver Razum",
year = "2013",
month = mar,
day = "1",
doi = "10.1136/jech-2012-201336",
language = "English",
volume = "67",
pages = "213--8",
journal = "J EPIDEMIOL COMMUN H",
issn = "0143-005X",
publisher = "BMJ PUBLISHING GROUP",
number = "3",

}

RIS

TY - JOUR

T1 - Assessing the effect of regional deprivation on mortality avoiding compositional bias

T2 - a natural experiment

AU - Reiss, Katharina

AU - Berger, Ursula

AU - Winkler, Volker

AU - Voigtländer, Sven

AU - Becher, Heiko

AU - Razum, Oliver

PY - 2013/3/1

Y1 - 2013/3/1

N2 - BACKGROUND AND OBJECTIVE: We assessed the effect of regional deprivation on individual mortality by making use of a natural experiment: we followed up ethnic German resettlers from Former Soviet Union countries who were quasi-randomly distributed across the socioeconomically heterogeneous counties of Germany's federal state North Rhine-Westphalia (NRW).METHODS: We used data from the retrospective cohort study 'AMOR' on the mortality of resettlers in NRW (n=34 393). Based on the postcode of the last known residence we linked study participants to the 54 counties of NRW, which were aggregated in six deprivation clusters. Mortality rates and standardised mortality ratios (SMRs) were calculated for each cluster. After a mean follow-up of 10 years, 2580 resettlers were deceased.RESULTS: For male and female cohort members, mortality rates and SMRs were highest in the cluster 'poverty poles' (SMR men: 1.21, 95% CI 1.04 to 1.41; SMR women: 1.17, 95% CI 0.99 to 1.37), whereas they were lowest in the cluster 'prospering regions and suburban counties' (SMR women: 0.86, 95% CI 0.70 to 1.05) as well as in the cluster 'heterogeneous counties' (SMR men: 0.73, 95% CI 0.61 to 0.88).CONCLUSIONS: The population which was quasi-randomly distributed to counties of differing socioeconomic status experienced different levels of mortality. It was highest in regions with the highest level of regional deprivation. Previous studies describing this positive relationship between mortality and regional deprivation could not differentiate between compositional and contextual effects. Thus, our findings indicate that in terms of mortality, regional deprivation does matter.

AB - BACKGROUND AND OBJECTIVE: We assessed the effect of regional deprivation on individual mortality by making use of a natural experiment: we followed up ethnic German resettlers from Former Soviet Union countries who were quasi-randomly distributed across the socioeconomically heterogeneous counties of Germany's federal state North Rhine-Westphalia (NRW).METHODS: We used data from the retrospective cohort study 'AMOR' on the mortality of resettlers in NRW (n=34 393). Based on the postcode of the last known residence we linked study participants to the 54 counties of NRW, which were aggregated in six deprivation clusters. Mortality rates and standardised mortality ratios (SMRs) were calculated for each cluster. After a mean follow-up of 10 years, 2580 resettlers were deceased.RESULTS: For male and female cohort members, mortality rates and SMRs were highest in the cluster 'poverty poles' (SMR men: 1.21, 95% CI 1.04 to 1.41; SMR women: 1.17, 95% CI 0.99 to 1.37), whereas they were lowest in the cluster 'prospering regions and suburban counties' (SMR women: 0.86, 95% CI 0.70 to 1.05) as well as in the cluster 'heterogeneous counties' (SMR men: 0.73, 95% CI 0.61 to 0.88).CONCLUSIONS: The population which was quasi-randomly distributed to counties of differing socioeconomic status experienced different levels of mortality. It was highest in regions with the highest level of regional deprivation. Previous studies describing this positive relationship between mortality and regional deprivation could not differentiate between compositional and contextual effects. Thus, our findings indicate that in terms of mortality, regional deprivation does matter.

KW - Adolescent

KW - Adult

KW - Age Distribution

KW - Aged

KW - Bias (Epidemiology)

KW - Cluster Analysis

KW - Cultural Deprivation

KW - Female

KW - Germany

KW - Healthcare Disparities

KW - Humans

KW - Male

KW - Middle Aged

KW - Mortality

KW - Poverty Areas

KW - Proportional Hazards Models

KW - Residence Characteristics

KW - Retrospective Studies

KW - Sensitivity and Specificity

KW - Sex Distribution

KW - Socioeconomic Factors

KW - Suburban Population

KW - Transients and Migrants

KW - Young Adult

U2 - 10.1136/jech-2012-201336

DO - 10.1136/jech-2012-201336

M3 - SCORING: Journal article

C2 - 23093522

VL - 67

SP - 213

EP - 218

JO - J EPIDEMIOL COMMUN H

JF - J EPIDEMIOL COMMUN H

SN - 0143-005X

IS - 3

ER -