Regional variation of premature mortality in Ontario, Canada: a spatial analysis.
Adolescent
Adult
Aged
Alcohol Drinking
/ epidemiology
Bayes Theorem
Diet
/ statistics & numerical data
Economic Status
Female
Fruit
Humans
Male
Middle Aged
Mortality, Premature
Ontario
/ epidemiology
Overweight
/ epidemiology
Risk Factors
Sedentary Behavior
Smoking
/ epidemiology
Social Class
Spatial Analysis
Vegetables
Young Adult
Epidemiology
Geography
Health policy
Premature mortality
Public health
Journal
Population health metrics
ISSN: 1478-7954
Titre abrégé: Popul Health Metr
Pays: England
ID NLM: 101178411
Informations de publication
Date de publication:
31 07 2019
31 07 2019
Historique:
received:
05
08
2018
accepted:
24
07
2019
entrez:
2
8
2019
pubmed:
2
8
2019
medline:
14
5
2020
Statut:
epublish
Résumé
Premature mortality is a meaningful indicator of both population health and health system performance, which varies by geography in Ontario. We used the Local Health Integration Network (LHIN) sub-regions to conduct a spatial analysis of premature mortality, adjusting for key population-level demographic and behavioural characteristics. We used linked vital statistics data to identify 163,920 adult premature deaths (deaths between ages 18 and 74) registered in Ontario between 2011 and 2015. We compared premature mortality rates, population demographics, and prevalence of health-relevant behaviours across 76 LHIN sub-regions. We used Bayesian hierarchical spatial models to quantify the contribution of these population characteristics to geographic disparities in premature mortality. LHIN sub-region premature mortality rates ranged from 1.7 to 6.6 deaths per 1000 per year in males and 1.2 to 4.8 deaths per 1000 per year in females. Regions with higher premature mortality had fewer immigrants and higher prevalence of material deprivation, excess body weight, inadequate fruit and vegetable consumption, sedentary behaviour, and ever-smoked status. Adjusting for all variables eliminated close to 90% of geographic variation in premature mortality, but did not fully explain the spatial pattern of premature mortality in Ontario. We conducted the first spatial analysis of mortality in Ontario, revealing large geographic variations. We demonstrate that well-known risk factors explain most of the observed variation in premature mortality. The result emphasizes the importance of population health efforts to reduce the burden of well-known risk factors to reduce variation in premature mortality.
Sections du résumé
BACKGROUND
Premature mortality is a meaningful indicator of both population health and health system performance, which varies by geography in Ontario. We used the Local Health Integration Network (LHIN) sub-regions to conduct a spatial analysis of premature mortality, adjusting for key population-level demographic and behavioural characteristics.
METHODS
We used linked vital statistics data to identify 163,920 adult premature deaths (deaths between ages 18 and 74) registered in Ontario between 2011 and 2015. We compared premature mortality rates, population demographics, and prevalence of health-relevant behaviours across 76 LHIN sub-regions. We used Bayesian hierarchical spatial models to quantify the contribution of these population characteristics to geographic disparities in premature mortality.
RESULTS
LHIN sub-region premature mortality rates ranged from 1.7 to 6.6 deaths per 1000 per year in males and 1.2 to 4.8 deaths per 1000 per year in females. Regions with higher premature mortality had fewer immigrants and higher prevalence of material deprivation, excess body weight, inadequate fruit and vegetable consumption, sedentary behaviour, and ever-smoked status. Adjusting for all variables eliminated close to 90% of geographic variation in premature mortality, but did not fully explain the spatial pattern of premature mortality in Ontario.
CONCLUSIONS
We conducted the first spatial analysis of mortality in Ontario, revealing large geographic variations. We demonstrate that well-known risk factors explain most of the observed variation in premature mortality. The result emphasizes the importance of population health efforts to reduce the burden of well-known risk factors to reduce variation in premature mortality.
Identifiants
pubmed: 31366354
doi: 10.1186/s12963-019-0193-9
pii: 10.1186/s12963-019-0193-9
pmc: PMC6670187
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
9Subventions
Organisme : CIHR
ID : FRN-142498
Pays : Canada
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