Διερεύνηση γεωγραφικών κοινωνικοοικονομικών ανισοτήτων στη θνησιμότητα – συσχέτιση του δείκτη πρόωρης θνησιμότητας σε επίπεδο κοινοτήτων στην Κύπρο με δείκτες κοινωνικοοικονομικού μειονεκτήματος

Abstract

Introduction: Social inequalities are seriously threatening social cohesion. The inadequate access to essential health services and the increase of poverty rate in the European population, constitute reality with large negative impacts on social welfare. Therefore, the need to pay attention to social inequalities and unequal health outcomes is greater today, than it has been for many years. Aim: Investigation of geographical socio-economic inequalities and the correlation between premature mortality and indicators of socio-economic disadvantage, at a community level in Cyprus.

Material and Method: Data were taken from the record of population census (Cyprus Statistical Service) and from the Monitoring Unit of Cyprus Ministry of Health. The initial number of variables is twenty-six. They were chosen based on literature review (previous studies), on the dimensions of the Index of Multiple Deprivation in England, as well as on the availability of data. The sample consisted of the 370 communities of Cyprus (communities in occupied Cyprus were excluded). The variables were transformed using the natural log transformation and standardization (z-scores). Correlations performed using Pearson and Spearman statistical tests. Exploratory factor analysis, with varimax rotation (orthogonal rotation of the factor axes), was performed to indicate the factors. Standardized Mortality Rate and Standardized Mortality per 10 000, were calculated according to each factor’s levels, as to communities’ quartiles, but also to population quartiles.

Results: Factor analysis was conducted with twenty-two variables and led to in four indicators (socio-economic disadvantage, social environment, economic environment, structural environment). Alongside, another indicator for urban areas only, was calculated. The phenomenon of social gradient is most clearly reflected in the first index, with the most deprived areas to have higher rates of mortality. The specific index for urban areas only, shows the advantage of the least deprived urban areas in comparison to others.

Conclusions: Indicators of socio-economic disadvantage are very good tools for identifying areas in disadvantage. It is, however, necessary to investigate the degradation of rural areas, in relation to the causes that might cause it.