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Geographical Epidemiology of Health and Deprivation: a Population-Based, Spatio-Temporal Analysis of Health and Social Inequality in Nova Scotia, Canada

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dc.contributor.author Terashima, Mikiko
dc.date.accessioned 2011-05-02T12:07:13Z
dc.date.available 2011-05-02T12:07:13Z
dc.date.issued 2011-05-02
dc.identifier.uri http://hdl.handle.net/10222/13496
dc.description.abstract Narrowing the gap in health inequality is vital not only from an equity point of view but also from an economic cost point of view. Small-area level investigations of health inequalities can play an important role in this effort. This research is an attempt to produce evidence of within-province social and health inequality. This cross-sectional, ecological study examines the geographical distribution of life expectancy at birth (LE) and its relationships with two domains of deprivation—material and social—at two time periods (1995-1999 and 2003-2007) across 182 ‘communities.’ The deprivation measures were derived from a set of indices now widely used in Quebec. Five community types assigned to the communities represented relative levels of rurality. A general pattern was observed that material deprivation became more prominent as ‘rurality’ increased. The pattern of social deprivation by rurality was more ‘flat’ where other levels of rurality than the most urban type had similar deprivation scores and rankings. LE was patterned by a relative degree of deprivation but not by rurality per se, though high socioeconomic deprivation tends to be observed in ‘rural areas.’ The gaps in LEs between the most and least deprived were wider for males than for females. Inequalities in LE by material deprivation of the communities appear to have widened over time. The regression models indicated the presence of an interaction effect—material and social deprivation together exacerbate the risk of low LE. The study also observed some regional clustering of unaccounted factors, which requires further investigation to determine what potential regional phenomena account for this effect. Lastly, the deprivation scores left more variations in LE in rural communities unexplained than variations in urban communities, leading us to suspect that the indices employed might be less sensitive for health inequalities in rural communities than in urban communities. Further research efforts are necessary to tackle many questions this research could not address, which would more fully inform policy related to the reduction of health and social inequality in Nova Scotia and elsewhere. en_US
dc.language.iso en en_US
dc.subject Geographical Epidemiololgy, health inequality, deprivation, life expectancies, small-area analysis, rural, urban en_US
dc.title Geographical Epidemiology of Health and Deprivation: a Population-Based, Spatio-Temporal Analysis of Health and Social Inequality in Nova Scotia, Canada en_US
dc.date.defence 2011-04-04
dc.contributor.department Interdisciplinary PhD Programme en_US
dc.contributor.degree Interdisciplinary PhD en_US
dc.contributor.external-examiner Dr. Susan Elliott en_US
dc.contributor.graduate-coordinator Dr. Michael Lee en_US
dc.contributor.thesis-reader Dr. Pantelis Andreou, Dr. Robert Maher, Dr. Victor Thiessen en_US
dc.contributor.thesis-supervisor Dr. Judith Read Guernsey en_US
dc.contributor.ethics-approval Received en_US
dc.contributor.manuscripts Not Applicable en_US
dc.contributor.copyright-release Not Applicable en_US


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