Causes of death contributing to urban socioeconomic mortality differences in Amsterdam.

Abstract

Socioeconomic mortality differences exist between parts of many cities. This study aims to identify causes of death associated with such mortality differences and which preventive or curative interventions can modify. Associations were compared between socioeconomic status and age-standardized mortality by borough of Amsterdam, The Netherlands (n = 22) for causes of death grouped by feasible interventions. In men, mortality due to external and ill-defined causes occurs more frequently in low-income boroughs. In women, this holds for smoking-related and ill-defined causes. AIDS-related mortality is higher in boroughs with a high educational level. Mortality in low-income boroughs is generally higher for those causes of death which explain the relatively high urban mortality. Interventions to decrease urban socioeconomic mortality differences should be targeted on violence and accidents in men and smoking in women. Incomplete notification of deaths in low-income boroughs obscures some differences but also indicates problems in urban general practice and specific risks for immigrant residents. AIDS reduces the size of mortality differences among men, probably temporarily. Both feasibility and type of interventions are relevant for many urban areas.