"Spatial segregation and socioeconomic inequalities in health in Brazilian cities: combining spatial and social epidemiology"
Prof Tarani Chandola, Cathie Marsh Centre for Census and Survey Research, The University of Manchester
Date: Wednesday 12th December 2012
Time: 15.30-17.00 (Tea and coffee will be served from 15:30, with the AGM and seminar beginning at 16:00).
Venue: Room G.207, Alan Turing Building, The University of Manchester
Abstract:
Spatial and socioeconomic inequalities in health are well-documented across the world, with poorer people, areas and regions experiencing poorer health and higher mortality risks than richer people, areas and regions. Furthermore, greater income inequality has also been linked to higher mortality rates. However, there has been less work on the spatial dimension of such socioeconomic inequalities in relation to inequalities in health. The UN-Habitat 2010-11 report on the state of the world's cities identified the spatial isolation of poor people in cities (the "spatial poverty trap") as one of the major challenges in developing countries. As people and cities in the developing world get richer, the worry is that the spatial socioeconomic segregation of poor people increases, which in turn may increase their risks of mortality and poor health.
Data from 15 major Brazilian cities were analysed, with spatial measures of socioeconomic segregation estimated for Brazilian districts within cities. The association of the spatial segregation with district level mortality rates was examined using multiple membership multilevel Poisson regression models to take account of the multilevel (districts within cities) and spatial nature of the data. Increasing spatial segregation tends to be associated with higher mortality rates, with an interaction between income and spatial segregation. Spatial socioeconomic segregation is not associated with mortality within rich districts, whereas there is an increase of around 2 deaths per 1000 population among poor districts with the lowest segregation compared to poor districts with the greatest segregation.
As cities in the developing world get richer, there is a risk that this leads to increasing spatial socioeconomic segregation of the poor within those cities. The results from this study suggests that the spatial dimension of poverty within cities may be just as important to health as poverty levels.
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Dr Richard Emsley
Lecturer in Biostatistics
Centre for Biostatistics
Institute of Population Health
The University of Manchester
4.304 Jean McFarlane Building
Oxford Road
Manchester
M13 9PL
0161 306 8002
Chairman, Royal Statistical Society Manchester Local Group
http://www.medicine.manchester.ac.uk/staff/RichardEmsley
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