title: Cumulative disadvantage? Exploring relationships between neighbourhood deprivation trends (1991 to 2006) and mortality in New Zealand.
abstract: BACKGROUND
  Area-level socioeconomic deprivation has been shown to exert an independent effect on both individual and population health outcomes and health-related behaviours. Evidence also suggests that health and economic inequalities in many countries are increasing in some areas but may be on the decline in others. While area-level deprivation at a single point in time is known to influence health, the literature relating to longitudinal deprivation of communities and associated health impacts is sparse. This research makes a methodological contribution to this literature.
  
  
  METHODS
  Using a Latent Class Growth Model, we identified 12 deprivation trends (1991-2006) for small areas (n = 1621) in New Zealand. We then fitted regression models to assess the effects of trends of relative deprivation on a) all-cause mortality, and b) cardiovascular mortality (2005-2007) by census area unit. For comparison, we also fitted regression models to assess the effect of deprivation deciles (in 2006) on outcomes a) and b).
  
  
  RESULTS
  Using trends, we found a positive association between deprivation and mortality, except for two trends for both all-cause and CVD-related mortality. When comparing trends and deciles of deprivation, we observed similar patterns. However, we found that AIC values were slightly lower for the model including deciles, indicating better model fit.
  
  
  CONCLUSIONS
  While we found that current deprivation was a slightly better predictor of mortality, the approach used here offers a potentially useful alternative. Future deprivation research must consider the possible loss of information about health benefits of living in areas where relative deprivation has improved in cross-sectional analyses.
authors: Department of Public Health, University of Otago, PO Box 7343, Mein Street, Newtown, Wellington 6242, New Zealand. amber.pearson@otago.ac.nz
authors: Amber L
authors: AL
authors: Pearson
authors: Philippe
authors: P
authors: Apparicio
authors: Mylène
authors: M
authors: Riva
mesh_terms: D003467:Cultural Deprivation; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D009026:Mortality / Q000208:ethnology* / Q000639:trends*; D009520:New Zealand / Q000208:ethnology; D012111:Residence Characteristics / Q000706:statistics & numerical data
references: J Epidemiol Community Health. 2012 Oct;66(10):919-26
references: 22473585
references: J Prim Prev. 2009 Nov;30(6):677-96
references: 19949869
references: J Epidemiol Community Health. 2009 May;63(5):386-90
references: 19211590
references: J Epidemiol Community Health. 2007 Sep;61(9):802-9
references: 17699536
references: J Public Health (Oxf). 2011 Jun;33(2):234-45
references: 20884643
references: PLoS Med. 2008 Apr 22;5(4):e66
references: 18433290
references: Health Place. 2011 May;17(3):793-800
references: 21421335
references: Health Educ Res. 2008 Oct;23(5):753-62
references: 18024978
references: Soc Sci Med. 2004 Jan;58(1):57-74
references: 14572921
references: J Epidemiol Community Health. 2003 Nov;57(11):844-8
references: 14600107
references: Soc Sci Med. 2009 Oct;69(8):1252-60
references: 19713021