Evidence map›Paper›PMID 31722048›Full record

ArticleJournal of community health2020

Avoidable Mortality Rates Decrease but Inequity Gaps Widen for Marginalized Neighborhoods: A Population-Based Analysis in Ontario, Canada from 1993 to 2014.

Austin Zygmunt, Claire E Kendall, Paul James, Isac Lima, Meltem Tuna, Peter Tanuseputro

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of community health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Self-study tool for integrating health equity into Health in All Policies (HiAP) initiatives.Canadian journal of public health = Revue canadienne de sante publique · 2026
    Article
  2. Article
  3. Association of marginalization and PSMA-PET in prostate cancer An analysis of the Ontario PSMA-PET Registry for Recurrent Prostate Cancer.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2025
    Article
  4. Article
  5. Article
  6. Article
  7. Influence of the Social Environment on Ideal Cardiovascular Health.Journal of the American Heart Association · 2023
    Article
  8. Disparities in years of potential life lost among racial and ethnic groups in Washington state.Archives of public health = Archives belges de sante publique · 2022
    Article
  9. Article
  10. Trends in socioeconomic inequalities in premature and avoidable mortality in Canada, 1991-2016.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020
    Article
  11. The mirage of universality: Canada's failure to act on social policy and health care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Austin ZygmuntSchool of Epidemiology and Public Health, University of Ottawa, Room 101 - 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada. azygm025@uottawa.ca.ORCID 0000-0002-4219-6887
Claire E KendallOttawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Canada.
Paul JamesICES uOttawa, The Ottawa Hospital, Civic Campus 1053 Carling Avenue, Ottawa, Canada.
Isac LimaOttawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Canada.
Meltem TunaOttawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Canada.
Peter TanuseputroOttawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Avoidable mortality (AM) is a health indicator used to examine trends in avoidable deaths amenable to public health and medical interventions. AM is more likely amongst marginalized populations. Our objective was to examine trends in AM rates by level of neighborhood marginalization. Decedents under age 75 years in Ontario from 1993 to 2014 (n = 691,453) were assigned to a quintile-level of each Ontario Marginalization (ON-Marg) Index dimension: material deprivation, residential instability, dependency, and ethnic concentration. We calculated ON-Marg Index dimension and quintile specific age- and sex-standardized AM incidence rates. We then calculated annual AM rate ratios between the most (Q5) and least (Q1) marginalized quintiles for each ON-Marg dimension. To describe the inequity gap in AM over time we calculated the absolute difference in the Q5/Q1 rate ratio between 2014 and 1993 for each dimension. AM rates in Ontario were almost halved (48.6%) from 1993 to 2014 (216 vs. 111 per 100,000 population). This decline was greater for treatable AM (75 vs. 36 per 100,000 population) than preventable AM (128 vs. 88 per 100,000 population). The inequity gap in AM Q5/Q1 rate ratios (RR) between 1993 and 2014 widened for all marginalization dimensions: dependency (RR 2.11-2.58), ethnic concentration (RR 0.59-0.48), material deprivation (RR 1.63-2.23), and residential instability (RR 2.01-2.43). To attain further declines in AM, policymakers and governments must address AM due to preventable deaths in neighborhoods highly marginalized by dependency, material deprivation, and residential instability.

Indexed as

Healthcare DisparitiesResidence CharacteristicsAdultEthnicityFemaleHumansIncidenceMaleMiddle AgedMortalityOntarioAvoidable mortalityDependencyEthnic concentrationMarginalizationMaterial deprivationResidential instability

Identifiers

PMID31722048

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.