Avoidable mortality by neighbourhood income in Canada: 25 years after the establishment of universal health insurance

• DOI: 10.1136/jech.2006.047092
• Publication Date: 2007-03-19T22:14:13Z
• Authors: P. D James; R. Wilkins; A. S Detsky; P. Tugwell; D. G Manuel
• Keywords: Neighbourhood (mathematics); Census tract

<b>Aim:</b> To examine neighbourhood income differences in deaths amenable to medical care and public health over a 25-year period after the establishment of universal insurance for doctors hospital services Canada. <b>Methods:</b> Data census metropolitan areas were obtained from Canadian Mortality Database population censuses years 1971, 1986, 1991 1996. Deaths care, health, ischaemic heart disease other causes considered. on grouped into quintiles basis tract percentage below Canada's low-income cut-offs. <b>Results:</b> From 1971 1996, between richest poorest age-standardised expected life lost decreased 60% (p&lt;0.001) men 78% women, those increased 0.7% (p = 0.94) 20% 0.55) 58% 38% 15% 9% women. Changes difference significantly larger than or both women (p&lt;0.001). <b>Conclusions:</b> Reductions rates made largest contribution narrowing socioeconomic mortality disparities. Continuing disparities suggest that initiatives have potentially important, but yet unrealised, role further reducing