11 research outputs found
Demographic and Social Correlates of Suicide in the Czech Republic
In this article the authors review the trends & differentials in mortality from self-inflicted injury & poisoning in the Czech Republic between the early 1970s & the present in terms of their socio-economic & demographic associations. They describe the sources of data on suicide & explore the possible extent of under-reporting of deaths from suicide, & they examine the differences in suicide incidence by age & sex. With the decline in mortality from suicide, the male/female ratio of suicide rates increased from about 2.6 in the early 1970s to around 4.0 in recent years. Suicide rates increase steadily with age, & this pattern did not noticeably change during the period reviewed. The age specific suicide rates of older men & women declined more than the rates for younger people. As in other societies, married men & women have the lowest suicide rates; in contrast, divorce puts both men & women at the greatest risk of suicide. The authors attempt to investigate the social correlates of suicide by analysing the variation in suicide rates among districts in the Czech Republic & selected socio-economic & demographic characteristics of the district populations. Stepwise regression analysis is used to identify three independent variables that explain 50% of the variation in suicide rates among districts: the abortion ratio, the percentage of locally born population, & the percentage of adults with limited education
socioeconomic inequalities in suicide mortality in european urban areas before and during the economic recession
Abstract
Background
Few studies have assessed the impact of the financial crisis on inequalities in suicide mortality in European urban areas. The objective of the study was to analyse the trend in area socioeconomic inequalities in suicide mortality in nine European urban areas before and after the beginning of the financial crisis.
Methods
This ecological study of trends was based on three periods, two before the economic crisis (2000–2003, 2004–2008) and one during the crisis (2009–2014). The units of analysis were the small areas of nine European cities or metropolitan areas, with a median population ranging from 271 (Turin) to 193 630 (Berlin). For each small area and sex, we analysed smoothed standardized mortality ratios of suicide mortality and their relationship with a socioeconomic deprivation index using a hierarchical Bayesian model.
Results
Among men, the relative risk (RR) comparing suicide mortality of the 95th percentile value of socioeconomic deprivation (severe deprivation) to its 5th percentile value (low deprivation) were higher than 1 in Stockholm and Lisbon in the three periods. In Barcelona, the RR was 2.06 (95% credible interval: 1.24–3.21) in the first period, decreasing in the other periods. No significant changes were observed across the periods. Among women, a positive significant association was identified only in Stockholm (RR around 2 in the three periods). There were no significant changes across the periods except in London with a RR of 0.49 (95% CI: 0.35–0.68) in the third period.
Conclusions
Area socioeconomic inequalities in suicide mortality did not change significantly after the onset of the crisis in the areas studied
Social differences in avoidable mortality between small areas of 15 European cities : an ecological study
Peer reviewe
Health Disparities in Czechia and Portugal at Country and Municipality Levels
This article investigates the health outcomes and determinants between two different European populations, Portuguese and Czech, on two hierarchical levels: country and metropolitan area. At first, the decomposition method of age and cause of death were compared on the country level, and then health was examined based on a factor analysis at the municipality level of Prague and Lisbon. The results clearly indicate problematic diabetes mortality among the Portuguese population, and especially in the Lisbon Metropolitan Area, and confirm the dominant role of circulatory mortality and cancer mortality among Czech, especially the Prague population. The social and economic deprivations were revealed as the major drivers for both metropolitan areas, although with differences between them, requiring interventions that go beyond the health sector
Socioeconomic Inequalities in Chronic Liver Diseases and Cirrhosis Mortality in European Urban Areas before and after the Onset of the 2008 Economic Recession
Objective: To analyse the trends in chronic liver diseases and cirrhosis
mortality, and the associated socioeconomic inequalities, in nine
European cities and urban areas before and after the onset of the 2008
financial crisis. Methods: This is an ecological study of trends in
three periods of time: two before (2000-2003 and 2004-2008), and one
after (2009-2014) the onset of the economic crisis. The units of
analysis were the geographical areas of nine cities or urban areas in
Europe. We analysed chronic liver diseases and cirrhosis standardised
mortality ratios, smoothing them with a hierarchical Bayesian model by
each city, area, and sex. An ecological regression model was fitted to
analyse the trends in socioeconomic inequalities, and included the
socioeconomic deprivation index, the period, and their interaction.
Results: In general, chronic liver diseases and cirrhosis mortality
rates were higher in men than in women. These rates decreased in all
cities during the financial crisis, except among men in Athens (rates
increased from 8.50 per 100,000 inhabitants during the second period to
9.42 during the third). Socioeconomic inequalities in chronic liver
diseases and cirrhosis mortality were found in six cities/metropolitan
areas among men, and in four among women. Finally, in the periods
studied, such inequalities did not significantly change. However, among
men they increased in Turin and Barcelona and among women, several
cities had lower inequalities in the third period. Conclusions: There
are geographical socioeconomic inequalities in chronic liver diseases
and cirrhosis mortality, mainly among men, that did not change during
the 2008 financial crisis. These results should be monitored in the long
term
Population Health Inequalities Across and Within European Metropolitan Areas through the Lens of the EURO-HEALTHY Population Health Index
The different geographical contexts seen in European metropolitan areas
are reflected in the uneven distribution of health risk factors for the
population. Accumulating evidence on multiple health determinants point
to the importance of individual, social, economic, physical and built
environment features, which can be shaped by the local authorities. The
complexity of measuring health, which at the same time underscores the
level of intra-urban inequalities, calls for integrated and
multidimensional approaches. The aim of this study is to analyse
inequalities in health determinants and health outcomes across and
within nine metropolitan areas: Athens, Barcelona, Berlin-Brandenburg,
Brussels, Lisbon, London, Prague, Stockholm and Turin. We use the
EURO-HEALTHY Population Health Index (PHI), a tool that measures health
in two components: Health Determinants and Health Outcomes. The
application of this tool revealed important inequalities between
metropolitan areas: Better scores were found in Northern cities when
compared with their Southern and Eastern counterparts in both
components. The analysis of geographical patterns within metropolitan
areas showed that there are intra-urban inequalities, and, in most
cities, they appear to form spatial clusters. Identifying which urban
areas are measurably worse off, in either Health Determinants or Health
Outcomes, or both, provides a basis for redirecting local action and for
ongoing comparisons with other metropolitan areas
Population health inequalities across and within european metropolitan areas through the lens of the EURO-HEALTHY Population Health Index
The different geographical contexts seen in European metropolitan areas are reflected in the uneven distribution of health risk factors for the population. Accumulating evidence on multiple health determinants point to the importance of individual, social, economic, physical and built environment features, which can be shaped by the local authorities. The complexity of measuring health, which at the same time underscores the level of intra-urban inequalities, calls for integrated and multidimensional approaches. The aim of this study is to analyse inequalities in health determinants and health outcomes across and within nine metropolitan areas: Athens, Barcelona, Berlin-Brandenburg, Brussels, Lisbon, London, Prague, Stockholm and Turin. We use the EURO-HEALTHY Population Health Index (PHI), a tool that measures health in two components: Health Determinants and Health Outcomes. The application of this tool revealed important inequalities between metropolitan areas: Better scores were found in Northern cities when compared with their Southern and Eastern counterparts in both components. The analysis of geographical patterns within metropolitan areas showed that there are intra-urban inequalities, and, in most cities, they appear to form spatial clusters. Identifying which urban areas are measurably worse off, in either Health Determinants or Health Outcomes, or both, provides a basis for redirecting local action and for ongoing comparisons with other metropolitan areas.This research was conducted under the EURO-HEALTHY project, which was funded by the European Union’s Horizon 2020 research and innovation programme, Grant Agreement No 643398, and received support from the Centre of Studies in Geography and Spatial Planning (CEGOT), funded by national funds through the Foundation for Science and Technology (FCT) under the reference UID/GEO/04084/2013
Socioeconomic inequalities in suicide mortality in European urban areas before and during the economic recession
Background: Few studies have assessed the impact of the financial crisis on inequalities in suicide mortality in European urban areas. The objective of the study was to analyse the trend in area socioeconomic inequalities in suicide mortality in nine European urban areas before and after the beginning of the financial crisis. Methods: This ecological study of trends was based on three periods, two before the economic crisis (2000-2003, 2004-2008) and one during the crisis (2009-2014). The units of analysis were the small areas of nine European cities or metropolitan areas, with a median population ranging from 271 (Turin) to 193 630 (Berlin). For each small area and sex, we analysed smoothed standardized mortality ratios of suicide mortality and their relationship with a socioeconomic deprivation index using a hierarchical Bayesian model. Results: Among men, the relative risk (RR) comparing suicide mortality of the 95th percentile value of socioeconomic deprivation (severe deprivation) to its 5th percentile value (low deprivation) were higher than 1 in Stockholm and Lisbon in the three periods. In Barcelona, the RR was 2.06 (95% credible interval: 1.24-3.21) in the first period, decreasing in the other periods. No significant changes were observed across the periods. Among women, a positive significant association was identified only in Stockholm (RR around 2 in the three periods). There were no significant changes across the periods except in London with a RR of 0.49 (95% CI: 0.35-0.68) in the third period. Conclusions: Area socioeconomic inequalities in suicide mortality did not change significantly after the onset of the crisis in the areas studied.This study is a part of the EURO-HEALTHY project (Shaping EUROpean policies to promote HEALTH equity) and has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement No 643398. Michala Lustigova was supported by Charles University (UNCE/HUM 018, too)