Deprivation-specific life tables using multivariable flexible modelling - trends from 2000-2002 to 2010-2012, Portugal

BMC Public Health. 2019 Mar 7;19(1):276. doi: 10.1186/s12889-019-6579-6.

Abstract

Background: Completing mortality data by information on possible socioeconomic inequalities in mortality is crucial for policy planning. The aim of this study was to build deprivation-specific life tables using the Portuguese version of the European Deprivation Index (EDI) as a measure of area-level socioeconomic deprivation, and to evaluate mortality trends between the periods 2000-2002 and 2010-2012.

Methods: Statistics Portugal provided the counts of deaths and population by sex, age group, calendar year and area of residence (parish). A socioeconomic deprivation level was assigned to each parish according to the quintile of their national EDI distribution. Death counts were modelled within the generalised linear model framework as a function of age, deprivation level and calendar period. Mortality Rate Ratios (MRR) were estimated to evaluate variations in mortality between deprivation groups and periods.

Results: Life expectancy at birth increased from 74.0 and 80.9 years in 2000-2002, for men and women, respectively, and to 77.6 and 83.8 years in 2010-2012. Yet, life expectancy at birth differed by deprivation, with, compared to least deprived population, a deficit of about 2 (men) and 1 (women) years among most deprived in the whole study period. The higher mortality experienced by most deprived groups at birth (in 2010-2012, mortality rate ratios of 1.74 and 1.29 in men and women, respectively) progressively disappeared with increasing age.

Conclusions: Persistent differences in mortality and life expectancy were observed according to ecological socioeconomic deprivation. These differences were larger among men and mostly marked at birth for both sexes.

Keywords: Deprivation; Health inequalities; Life-tables; Multivariable modelling; Socioeconomic factors.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Life Expectancy / trends*
  • Life Tables*
  • Linear Models
  • Male
  • Middle Aged
  • Mortality / trends*
  • Portugal / epidemiology
  • Poverty / statistics & numerical data*
  • Residence Characteristics / statistics & numerical data
  • Sex Distribution
  • Socioeconomic Factors
  • Young Adult