Epidemiology & Public Health

Biography

Biography: Luce Yemadje-Menudier

Abstract

Reducing health disparities is a major public health issue. This paper proposes methods on the deprivation index research and spatial analyses, to address health inequalities. The purpose of this study was to analyze mortality data from 2002 to 2010 by major causes of death in Centre-Val de Loire (CVL) region, France, there spatial variations at district level and the links between mortality and deprivation indexes. Deprivation indexes were built from socio-demographic factors and from medical and social care provision factors. Association between the observed mortality and social deprivation indexes were then analyzed. Comparative mortality rate were used for regional and departmental analyses. Standardized mortality ratios were used for district analyses. Regional comparative mortality rate in CVL region is higher than nationwide rate in France. Men's comparative mortalities rates are higher than women's (p-value <0.0001). Mortality excess was mainly identified in south-east of region Centre (SMR> 1.30). Major causes of deaths show marked spatial differences. For example, cancer mortality is high among men in the south-eastern. Mortality excess is found for tumors associated with alcohol/tobacco consumption or more generally for diseases related to alcohol/tobacco in the south-eastern part of the CVL region. The mortality excess for tumors observed in the south-east region does not affect hormone-dependent cancers. The link between socio-demographic index and mortality was significant (p-value <0.0001) for both overall mortality and mortality by tumor. This study highlights the link between territorial and social inequalities in health and mortality. Furthermore it raises questions regarding the role of environment and individual behavior