Evidence map›Paper›PMID 32462460›Full record

ArticleCanadian journal of public health = Revue canadienne de sante publique2020

Association between the regional variation in premature mortality and immigration in Ontario, Canada.

Laura C Rosella, Kathy Kornas, Tristan Watson, Emmalin Buajitti, Catherine Bornbaum, David Henry, Adalsteinn Brown

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of public health = Revue canadienne de sante publique, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 43% of its field
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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

7 authors at 2 institutions in 1 country.

Laura C RosellaDalla Lana School of Public Health, Health Sciences Building, University of Toronto, 6th floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada. laura.rosella@utoronto.ca.ORCID 0000-0003-4867-869X
Kathy KornasDalla Lana School of Public Health, Health Sciences Building, University of Toronto, 6th floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
Tristan WatsonICES, Toronto, ON, Canada.
Emmalin BuajittiDalla Lana School of Public Health, Health Sciences Building, University of Toronto, 6th floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
Catherine BornbaumDalla Lana School of Public Health, Health Sciences Building, University of Toronto, 6th floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
David HenryDalla Lana School of Public Health, Health Sciences Building, University of Toronto, 6th floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
Adalsteinn BrownDalla Lana School of Public Health, Health Sciences Building, University of Toronto, 6th floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
University of Toronto · CAWestern University · CA

Funding

CIHR 142498
6 · The paper itself

Abstract

objectivesHealth region differences in immigration patterns and premature mortality rates exist in Ontario, Canada. This study used linked population-based databases to describe the regional proportion of immigrants in the context of provincial health region variation in premature mortality.

methodsWe analyzed all adult premature deaths in Ontario from 1992 to 2012 using linked population files, Canadian census, and death registry databases. Geographic boundaries were analyzed according to 14 health service regions, known as Local Health Integration Networks (LHINs). We assessed the role of immigrant status and regional proportion of immigrants in the context of these health region variations and assessed the contribution using sex-specific multilevel negative binomial models, accounting for age, individual- and area-level immigration, and area-level material deprivation.

resultsWe observed significant premature mortality variation among health service regions in Ontario between 1992 and 2012. Average annual rates ranged across LHINs from 3.03 to 6.40 per 1000 among males and 2.04 to 3.98 per 1000 among females. The median rate ratio (RR) decreased for men from 1.14 (95% CI 1.06, 1.19) to 1.07 (95% CI 1.00, 1.11) after adjusting for year, age, area-based material deprivation, and individual- and area-level immigration, and among females reduced from 1.13 (95% CI 1.05, 1.18) to 1.04 (95% CI 1.00, 1.05). These adjustments explained 84.1% and 94.4% of the LHIN-level variation in males and females respectively. Reduced premature mortality rates were associated with immigrants compared with those for long-term residents in the fully adjusted models for both males 0.43 (95% CI 0.42, 0.44) and females 0.45 (0.44, 0.46).

conclusionThe findings demonstrate that health region differences in premature mortality in Ontario are in part explained by individual-level effects associated with the health advantage of immigrants, as well as contextual area-level effects that are associated with regional differences in the immigrant population. These factors should be considered in addition to health system factors when looking at health region variation in premature deaths.

Indexed as

Health Status DisparitiesAdolescentAdultAgedDatabases, FactualEmigrants and ImmigrantsFemaleGeographyHumansMaleMiddle AgedMortality, PrematureOntarioYoung AdultHealthy immigrant effectImmigrantsPremature mortalityRegional variation

Identifiers

PMID32462460
PMCPMC7351932
OpenAlexW3032431674

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.