Propensity score matching approach to test the association of income inequality and mortality in Sao Paulo, Brazil


Autoria(s): Chiavegatto Filho, Alexandre Dias Porto; Kawachi, Ichiro; Gotlieb, Sabina Lea Davidson
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

06/11/2013

06/11/2013

2012

Resumo

Background Support for the adverse effect of high income inequality on population health has come from studies that focus on larger areas, such as the US states, while studies at smaller geographical areas (eg, neighbourhoods) have found mixed results. Methods We used propensity score matching to examine the relationship between income inequality and mortality rates across 96 neighbourhoods (distritos) of the municipality of Sao Paulo, Brazil. Results Prior to matching, higher income inequality distritos (Gini >= 0.25) had slightly lower overall mortality rates (2.23 per 10 000, 95% CI -23.92 to 19.46) compared to lower income inequality areas (Gini <0.25). After propensity score matching, higher inequality was associated with a statistically significant higher mortality rate (41.58 per 10 000, 95% CI 8.85 to 73.3). Conclusion In Sao Paulo, the more egalitarian communities are among some of the poorest, with the worst health profiles. Propensity score matching was used to avoid inappropriate comparisons between the health status of unequal (but wealthy) neighbourhoods versus equal (but poor) neighbourhoods. Our methods suggest that, with proper accounting of heterogeneity between areas, income inequality is associated with worse population health in Sao Paulo.

Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)

Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)

Identificador

JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, LONDON, v. 66, n. 1, supl. 1, Part 2, pp. 14-17, JAN, 2012

0143-005X

http://www.producao.usp.br/handle/BDPI/42516

10.1136/jech.2010.108852

http://dx.doi.org/10.1136/jech.2010.108852

Idioma(s)

eng

Publicador

B M J PUBLISHING GROUP

LONDON

Relação

JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH

Direitos

restrictedAccess

Copyright B M J PUBLISHING GROUP

Palavras-Chave #POPULATION HEALTH #PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Tipo

article

original article

publishedVersion