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. 2017 Nov;62(8):849-856.
doi: 10.1007/s00038-017-0964-7. Epub 2017 Mar 30.

Evidence of social deprivation on the spatial patterns of excess winter mortality

Ricardo Almendra  1   2 , Paula Santana  3   4 , João Vasconcelos  5
Affiliations

Evidence of social deprivation on the spatial patterns of excess winter mortality

Ricardo Almendra et al. Int J Public Health. 2017 Nov.

Abstract

Objectives: The aims of this study are to identify the patterns of excess winter mortality (due to diseases of the circulatory system) and to analyse the association between the excess winter deaths (EWD) and socio-economic deprivation in Portugal.

Methods: The number of EWD in 2002-2011 was estimated by comparing the number of deaths in winter months with the average number in non-winter months. The EWD ratio of each municipality was calculated by following the indirect standardization method and then compared with two deprivation indexes (socio-material and housing deprivation index) through ecological regression models.

Results: This study found that: (1) the EWD ratio showed considerable asymmetry in its geography; (2) there are significant positive associations between the EWD ratio and both deprivation indexes; and (3) at the higher level of deprivation, housing conditions have a stronger association with EWD than socio-material conditions.

Conclusions: The significant association between two deprivation dimensions (socio-material and housing deprivation) and EWDs suggests that EWD geographical pattern is influenced by deprivation.

Keywords: Environmental vulnerability; Excess winter deaths; Socio-economic deprivation.

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Conflict of interest statement

Funding

This study was funded by FCT doctoral fellowship SFRH/BD/92568/2013 and by CEGOT group Cities, competitiveness, and well-being (UID/GEO/04084/2013).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Figures

Fig. 1
Fig. 1
Annual average mean temperature in Portugal, 1971–2001 (normal climate data are provided via the climate web portal of the Portuguese Meteorological Institute’s web map service)
Fig. 2
Fig. 2
Smoothed excess winter death ratio by diseases of the circulatory system and probability of smoothed excess winter death ratio higher than 100 in Portugal, 2002–2011
Fig. 3
Fig. 3
Socio-material and housing deprivation index in Portugal, 2011
Fig. 4
Fig. 4
Excess winter death rate ratios between the first deprivation index quintile and the others deprivation quintiles in Portugal
See this image and copyright information in PMC

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