Effects of area deprivation on health risks and outcomes: a multilevel, cross-sectional, Australian population study
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Our aim was to examine the effect of local area socio-economic disadvantage after accounting for individual socio-economic status (SES), and to determine if these differ between various health and risk factor variables.
The North West Adelaide Health Study (NWAHS) is a biomedical representative population study of adults. The Index of Relative Socio-Economic Disadvantage (IRSD), produced from the Australian Bureau of Statistics (ABS) Census data at the level of Collector Districts (200 dwellings) was used as an indicator of local area disadvantage. Multi-level modeling techniques examined the effects of IRSD level on a variety of health outcomes and risk factors, after accounting for individual socio-economic factors.
Significant, independent associations were seen between IRSD and obesity, smoking, and health-related quality of life, with 5 % to 7.2 % of the variance located at the neighborhood level. No independent associations were seen between IRSD and estimated cardiovascular disease risk, diabetes, physical activity, or at-risk alcohol use.
Aggregated area-level characteristics make modest, but significant independent contributions to smoking, obesity and quality of life, but not for other health outcomes.
Keywords:Socio-economic disadvantage Multilevel modeling Obesity Health-related quality of life Social determinants of health
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