Health Inequities in Manitoba: Is the Socioeconomic Gap

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Chapter 3: Mortality 32 University of Manitoba • With the exception of T3, there was very little difference in the PYLL among R2 to R5 residents at all times. The rate ratio of R1 compared to R5 showed no statistically significant change. The absolute difference gap of PYLL comparing R1 to R5 statistically significantly increased by 17% over time, from 53.77 more potential years of life lost per 1,000 in the first time period to 62.93 more potential years of life lost per 1,000 in the last time period. Urban: • From T1 to T5, the PYLL of urban neighbourhood income quintile groups U2 to U5 decreased steadily, whereas the PMR of the lowest urban neighbourhood income quintile U1 decreased in T2, increased slightly in T3, and plateaued after that. • In the urban areas, it appears that there is a greater spread by neighbourhood income quintile between all quintiles, compared to little spread in the R2 to R5 categories. • The disparity between U1 and U5 increased substantially. The rate ratio of U1 compared to U5 was 2.32 in the first time period and 3.59 in the last time period, for a statistically significant increase of 55%. The absolute difference of PYLL comparing U1 to U5 also statistically significantly increased by 19% over time, from 61.19 more potential years of life lost in the first time period to 72.82 more potential years of life lost per 1,000 in the last time period. Lorenz Curves: Rural over time: • In T1, 30.4% of the PYLL occurred in the 20.0% of the population in the lowest neighbourhood income quintile group R1, with the Gini coefficient of 0.103 indicating a statistically significant disparity. • In T5, 33.0% of the PYLL occurred in the 20.0% of the population in the lowest neighbourhood income quintile group R1, with the Gini coefficient of 0.168 indicating a statistically significant disparity. • The change in Gini coefficient from the first to the last time period was statistically significant (p=.00023), indicating that the inequality across rural neighbourhood income quintiles increased over that time period. Urban over time: • In T1, 29.7% of the PYLL occurred in the 19.3% of the population in the lowest neighbourhood income quintile group U1, with the Gini coefficient of 0.169 indicating a statistically significant disparity. • In T5, 38.5% of the PYLL occurred in the 19.5% of the population in the lowest neighbourhood income quintile group U1, with the Gini coefficient of 0.255 indicating a statistically significant disparity. • The Gini coefficient increased from the first to the last time period, showing a statistically significant increase in inequality over that time period (p
Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time? Disparity measures over time by rural and urban: • The disparity rate ratios (i.e., the ratio of the PYLL of the lowest compared to the highest neighbourhood income group) are increasing over time for urban Manitoba, but not for rural Manitoba. The ratios are consistently higher in urban, indicating a larger rate ratio between lowest and highest neighbourhood income groups in urban Manitoba. • The disparity rate differences (i.e., the absolute difference of PYLL between the lowest and highest neighbourhood income group) are increasing in both rural and urban Manitoba. Once again, the absolute differences are consistently higher in urban, with the exception of T4 (1999–2003), indicating a larger rate difference between lowest and highest neighbourhood income groups in urban Manitoba. What is this telling us? • The socioeconomic gap in PYLL is widening over time for both rural and urban Manitobans, particularly for urban Manitobans. • By all measures, the socioeconomic gap is larger in urban than in rural Manitoba. • The lowest neighbourhood income group in urban Manitoba appears to show no improvement over time, in contrast with the overall patterns shown by all other neighbourhood income groups. • The largest socioeconomic gap in PYLL is seen in the most recent time period of 2004–2007 for urban Manitoba, where over one–third of the PYLL is experienced by lowest urban neighbourhood income group representing around one–fifth of the urban population. Where to from here? • Causes of potential years of life lost in the lowest urban and rural neighbourhood income quintiles need further exploration, in order to target appropriate interventions. Manitoba Centre for Health Policy 33
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HEALTH INEQUITIES IN MANITOBA: Is t
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About the Manitoba Centre For Healt
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Dr. Patricia Martens acknowledges t
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Key findings: High School Completio
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List of Figures Figure 1.1 Distribu
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Figure 4.27 Adjusted Lorenz Curve f
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Health Inequities in Manitoba: Is t
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Figure 5.2: Diabetes Prevalence Ove
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Figure 5.10: Amputations Among Figu
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Figure 5.18: Ischemic Heart Disease
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Figure 5.26: Multiple Sclerosis Pre
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References: Health Inequities in Ma
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Figure 6.2: Continuity of Care Prev
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Figure 7.2: Prevalence of Cumulativ
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Dementia Health Inequities in Manit
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Figure 7.10: Dementia Prevalence Ov
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Figure 7.18: Prevalence of Complete
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Reference Health Inequities in Mani
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Reference Health Inequities in Mani
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Table 9.1: Continued Indicator RURA
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Table 9.1: Continued Health Inequit
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Table A2.3: Crude Numbers of Mortal
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Table A2.5: Crude Numbers for High
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Table A2.7: Crude Numbers for Denta
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Table A2.11: Crude Numbers for Isch
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Table A2.17: Crude Numbers for Cumu
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Figure A3.2: High School Appendix C
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Health Inequities in Manitoba: Is the Socioeconomic Gap

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