Health Inequities in Manitoba: Is the Socioeconomic Gap

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Chapter 3: Mortality 40 University of Manitoba • The disparity between U1 and U5 was unchanged over the study period. The rate ratio of U1 compared to U5 was 2.19 in the first time period and 2.32 in the last time period, which was not statistically significantly different. The absolute difference of U1 compared to U5 went from 1.74 more deaths per 1,000 in the first time period to 1.20 more deaths per 1,000 in the second time period, which was also not statistically significant. Lorenz Curves: Rural over time: • In T1, 35.2% of the deaths to infants and children under age five occurred in the 22.9% of the population in the lowest neighbourhood income quintile group R1, with the Gini coefficient of 0.155 indicating a statistically significant disparity. • In T5, 31.2% of the deaths to infants and children under age five occurred in the 26.2% of the population in the lowest neighbourhood income quintile group R1, with the Gini coefficient of 0.110 indicating a statistically significant disparity. • The Gini coefficients from the first to the last time period were not statistically significantly different from each other, indicating similar socioeconomic inequality for under age five mortality over the study period. Urban over time: • In T1, 32.0% of the deaths to infants and children under age five occurred in the 22.0% of the population in the lowest neighbourhood income quintile group U1, with the Gini coefficient of 0.160 indicating a statistically significant disparity. • In T5, 37.7% of the premature deaths occurred in the 24.0% of the population in the lowest neighbourhood income quintile group U1, with the Gini coefficient of 0.129 indicating a statistically significant disparity. The substantial decrease in deaths per 1,000 in U2 is shown by the “dip” in the Lorenz curve. • The Gini coefficients from the first to the last time period were not statistically significantly different from each other, indicating similar socioeconomic inequality for under age five mortality over the study period. Rural compared to urban in most recent time period: • In the most recent time period T5, there is no statistically significant difference in the Gini coefficient in urban compared to rural, indicating a similar level of inequality in urban and rural Manitoba for under age five mortality. Disparity measures over time by rural and urban: • The disparity rate ratios (i.e., the ratio of the under age five mortality rates of the lowest compared to the highest neighbourhood income group) showed no statistically significant change over time for either rural or urban Manitoba. There was also no difference between rural and urban areas of the province in the rate ratio between lowest and highest neighbourhood income groups. • The disparity rate differences (i.e., the absolute difference of under age five mortality rates between the lowest and highest neighbourhood income group) showed no statistically significant change over the study period for urban Manitoba. In rural Manitoba, the disparity rate differences decreased significantly over time indicating that the rate difference between lowest and highest neighbourhood income groups in rural Manitoba has narrowed.
Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time? What is this telling us? • There is a substantial socioeconomic gap in under age five mortality in both rural and urban Manitoba. • The socioeconomic gap in under age five mortality has remained fairly stable across the study period, with some signs of a decrease in rural Manitoba. • By all measures, the socioeconomic gap is similar in urban and rural Manitoba. • All neighbourhood income groups in both rural and urban Manitoba showed improvement in this measure; under age five mortality rates decreased over time. Where to from here? • The decrease in under age five mortality over time is a positive finding, but the existing and sustained gap between the lowest and highest neighbourhood income quintiles remains a concern. Causes of deaths to infants and children under age five in the lowest urban and two lowest rural neighbourhood income quintiles need further exploration so as to target appropriate interventions. Manitoba Centre for Health Policy 41
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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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Figure 6.15 Hospitalization Due to
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List of Tables Table E.1 Changes in
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Figure A3.6 Adjusted Lorenz Curve f
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Executive Summary Health status and
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Health Inequities in Manitoba: Is t
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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 6.10: Hospitalization Due to
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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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Figure 8.2: Post-AMI Care: Beta-Blo
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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 A2.13: Crude Numbers for Cont
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CONFIDENTIAL ‐‐ NOT FOR DISTRIB
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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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