Cumulative deprivation and cause specific mortality. A census based study of life course influences over three decades.
OBJECTIVE
To examine whether increasing cumulative deprivation has an incremental effect on total as well as cause specific mortality.


METHODS
Census data on housing conditions as indicators of deprivation from 1960, 1970, and 1980 were linked to 1990-98 death registrations. Relative indices of inequalities were computed for housing conditions to measure the cumulative impact of differences in social conditions.


METHODS
97 381 (71.1%) 30-49 year old and 70701 (80.0%) 50-69 year old inhabitants of Oslo, Norway, in 1990 with census information on housing conditions and recorded length of education.


RESULTS
Mortality risk was increased when all censuses' housing conditions were summed in both age groups and sex. The cause specific analysis indicated such an effect particularly for coronary heart disease, chronic obstructive lung disease, and smoking related cancers. Violent deaths were essentially associated with housing conditions closer to the time of death in men in both age groups and in young women.


CONCLUSIONS
To fully account for socially mediated risk of death, a full life course approach should be adopted. The relative importance of each stage seems to vary by cause of death.
Naess
Øyvind
Ø
Institute of General Practice and Community Medicine, Oslo, Norway. oyvind.nass@samfunnsmed.uio.no
Claussen
Bjørgulf
B
Thelle
Dag S
DS
Davey Smith
George
G
D000328:Adult; D000368:Aged; D002423:Cause of Death / Q000639:trends*; D019352:Censuses; D005260:Female; D006798:Housing / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011203:Poverty / Q000706:statistics & numerical data* / Q000639:trends; D012923:Social Class; D012959:Socioeconomic Factors