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People living in the poorest neighbourhoods in Ontario more likely to suffer avoidable deaths than those living in the richest neighbourhoods


Ontario residents living in the most deprived neighbourhoods had the highest risk of avoidable deaths compared to the most well-off neighbourhoods, according to researchers at ICES, a non-profit research institute that uses population-based health information to produce knowledge on a broad range of health care issues.

The study, published today in Canadian Journal of Public Health, found that there were 124,000 avoidable deaths in the most materially deprived areas of Ontario versus 66,000 avoidable deaths in the most well-off areas between 1993 and 2014. These rates were generally two to two and a half times higher than the least marginalized neighbourhoods, and these amounts increased through the study periods.
The researchers from ICES, The Ottawa Hospital, and Bruyère Research Institute looked at the trends in avoidable deaths in Ontario over the 20-year study period. They divided the deaths into those that are avoidable through: 
  1. Prevention such as by curbing alcohol and tobacco use or increasing vaccination uptake
  2. Treatment of diseases like pneumonia, high blood pressure, and breast cancer
Between 1993 and 2014, avoidable deaths in Ontario decreased by almost half, mostly from advances in medical treatment of diseases.
“Despite our universal health care system, we were concerned to find that not everyone benefited equally from advances in treatment of diseases over the past 20 years,” says lead author Dr. Austin Zygmunt, family physician in Ottawa and Public Health & Preventive Medicine resident at the University of Ottawa.
The authors also found that avoidable deaths were highest for people living in areas of greatest material deprivation and residential instability. Material deprivation refers to income and education, as well as neighbourhood vulnerability which considers the number of single parent families, the number of people requiring government transfer payments, and the rate of unemployment. Residential instability includes factors such as low social supports and housing burdens like living alone, frequent moving, and overcrowding.
In addition, the researchers found that living in an ethnically diverse neighbourhood in Ontario was protective against having a death from an avoidable cause.
“Our research confirms that where Ontarians live and the conditions of their neighbourhood impact their health, which has implications for future public health efforts to reduce inequities in avoidable deaths,” says senior author Dr. Claire Kendall, adjunct scientist at ICES, clinical investigator at the Bruyère Research Institute, and family physician at the Bruyère Family Health Team in Ottawa.
The study “Neighbourhood-level marginalization and avoidable mortality in Ontario, Canada: a population-based study,” was published by Canadian Journal of Public Health.

Author block: Austin Zygmunt (Twitter: @AustinZygmunt), Peter Tanuseputro (@PTanuseputro), Paul James, Isac Lima, Meltem Tuna, Claire E. Kendall.