Neighbourhood-level marginalization and avoidable mortality in Ontario, Canada: a population-based study

Zygmunt, Austin; Tanuseputro, Peter; James, Paul D.; Lima, Isac; Tuna, Meltem; Kendall, Claire

doi:10.17269/s41997-019-00270-9

Cited by 25 publications

(25 citation statements)

References 37 publications

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“…The Ontario Marginalization Index was developed using 42 variables from the Canadian Census and has been associated with health outcomes. 31 It includes 4 dimensions, measured in quintiles: material deprivation (based on income, parental status, education, and employment), ethnic concentration (proportion of individuals self-identifying as a visible minority and recent immigrants), dependency (proportion of individuals aged 0-14 and 65 years and older or unemployed/ unpaid), and residential instability (based on the type and density of dwellings, families, and individuals).…”

Section: Study Cohortmentioning

confidence: 99%

“Bring the Hoses to Where the Fire Is!”: Differential Impacts of Marginalization and Socioeconomic Status on COVID-19 Case Counts and Healthcare Costs

et al. 2022

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Section: Study Cohortmentioning

confidence: 99%

“Bring the Hoses to Where the Fire Is!”: Differential Impacts of Marginalization and Socioeconomic Status on COVID-19 Case Counts and Healthcare Costs

et al. 2022

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“…For example, individuals experiencing homelessness in Toronto have been reported to face greater unmet healthcare needs compared to the city's general population, 23 and wide disparities in avoidable mortality rates have been demonstrated between the least and most marginalized neighbourhoods in Ontario. 24,25 In particular, we found only one study that focused on Indigenous populations, which could suggest a research gap in this area. Future studies should explore the association between physician characteristics and population served in a Canadian setting in order to optimize health human resources in a way that contributes to a more equitable health care system.…”

Section: Discussionmentioning

confidence: 91%

Characteristics of Canadian physicians and their associations with practice patterns: a scoping review

et al. 2022

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Background: Physician characteristics such as education and sociodemographic attributes are associated with particular practice patterns, such as practice in rural settings. Understanding the Canadian context of such associations can inform medical school recruitment and health workforce decision-making. Objective: The objective of this scoping review was to report the nature and extent of the literature on associations between characteristics of physicians in Canada and physicians’ practice patterns. Eligibility criteria: We included studies reporting associations between 1) the education or sociodemographic attributes of practicing physicians or residents in Canada and 2) practice patterns, including career choice, practice setting, and populations served. Methods: We searched five electronic databases (MEDLINE (R) ALL, Embase, ERIC, Education Source and Scopus) for quantitative primary studies and reviewed reference lists of included studies for additional studies. Data were extracted using a standardized data charting form. Results: Our search yielded 80 studies. Sixty-two examined education, evenly divided between undergraduate and postgraduate. Fifty-eight examined physicians’ attributes, most focusing on sex/gender. The majority of studies focused on the outcome of practice setting. We found no studies examining race/ethnicity or socioeconomic status. Conclusion: Many studies in our review found positive associations between (i) rural training or rural background and rural practice setting and (ii) location of training or physicians’ origin and practice in that location, consistent with previous literature. Associations for sex/gender were mixed, suggesting it may be a less useful target for workforce planning or recruitment aiming to address gaps in health care provision. More research is needed on the association of characteristics, particularly race/ethnicity and socioeconomic status, with career choice and populations served.

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“…Evaluations of interventions to reduce the impacts of neighbourhood deprivation on SRB risk are needed, which include programs aimed at improving neighbourhood services and opportunities (employment, education, living conditions, etc.) (85). For instance, regional economic and transit developments that help to connect residents to employment opportunities and services may be investigated regarding its impact on SRB risk (86).…”

Section: Policy Implicationsmentioning

confidence: 99%

Suicide-related behaviours across sexual orientation and neighbourhood deprivation levels: a retrospective cohort study using linked health administrative data

Azra¹,

Nielsen²,

Kim³

et al. 2022

Preprint

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BackgroundThere have been no studies examining how neighbourhood deprivation modifies the effects of sexual minority status on suicide-related behaviours (SRB). Sexual minority individuals in deprived areas may face unique challenges and stressors that exacerbate their risk of SRB. This study aims to investigate the association between sexual minority status and clinical SRB, and examine whether the effect of neighbourhood deprivation differs across sexual orientation. MethodsA population-representative survey sample (weighted n= 8,778,120) was linked to administrative health data in Ontario, Canada to measure SRB-related events (emergency department visits, hospitalizations, and deaths) from 2007 to 2017. Neighbourhood-level deprivation was measured using the Ontario Marginalisation index measure of material deprivation at the dissemination area level. Discrete-time survival analysis models, stratified by sex, tested the effects of neighbourhood deprivation and sexual minority status, while controlling for individual-level covariates. ResultsSexual minority men had 2.79 times higher odds of SRB compared to their heterosexual counterparts (95% CI 1.66 to 4.71), while sexual minority women had 2.14 time higher odds (95% CI 1.54 to 2.98). Additionally, neighbourhood deprivation was associated with higher odds of SRB: men in the most deprived neighbourhoods (Q5) had 2.01 times higher odds (95% CI 1.38 to 2.92) of SRB compared to those in the least deprived (Q1), while women had 1.75 times higher odds (95% CI 1.28 to 2.40). No significant interactions were observed between sexual minority status and neighbourhood deprivation levels. ConclusionIn both men and women, sexual minority status and neighbourhood deprivation are independent risk factors for SRB. Despite the lack of effect modification, sexual minorities living in the most deprived neighbourhoods have the highest chances of SRB. Future investigations should evaluate interventions and policies to improve sexual minority mental health and address neighbourhood deprivation.

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Neighbourhood-level marginalization and avoidable mortality in Ontario, Canada: a population-based study

Cited by 25 publications

References 37 publications

“Bring the Hoses to Where the Fire Is!”: Differential Impacts of Marginalization and Socioeconomic Status on COVID-19 Case Counts and Healthcare Costs

“Bring the Hoses to Where the Fire Is!”: Differential Impacts of Marginalization and Socioeconomic Status on COVID-19 Case Counts and Healthcare Costs

Characteristics of Canadian physicians and their associations with practice patterns: a scoping review

Suicide-related behaviours across sexual orientation and neighbourhood deprivation levels: a retrospective cohort study using linked health administrative data

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