Age-standardized All-cause Mortality Rates Research Articles

Cluster pattern analysis of environmental stressors and quantifying their impact on all-cause mortality in Belgium

Environmental stress represents an important burden on health and leads to a considerable number of diseases, hospitalisations, and excess mortality. Our study encompasses a representative sample size drawn from the Belgian population in 2016 (n = 11.26 million, with a focus on n = 11.15 million individuals). The analysis is conducted at the geographical level of statistical sectors, comprising a total of n = 19,794 sectors, with a subset of n = 18,681 sectors considered in the investigation. We integrated multiple parameters at the finest spatial level and constructed three categories of environmental stress through clustering: air pollution, noise stress and stress related to specific land-use types. We observed identifiable patterns in the spatial distribution of stressors within each cluster category. We assessed the relationship between age-standardized all-cause mortality rates (ASMR) and environmental stressors. Our research found that especially very high air pollution values in areas where traffic is the dominant local component of air pollution (ASMR + 14,8%, 95% CI: 10,4 – 19,4%) and presence of industrial land (ASMR + 14,7%, 95% CI: 9,4 – 20,2%) in the neighbourhood are associated with an increased ASMR. Cumulative exposure to multiple sources of unfavourable environmental stress (simultaneously high air pollution, high noise, presence of industrial land or proximity of primary/secondary roads and lack of green space) is associated with an increase in ASMR (ASMR + 26,9%, 95% CI: 17,1 – 36,5%).

Effects of long-term exposure to ambient fine particulate air pollution on all-cause mortality in Taiwan

ABSTRACT According to the US Environmental Protection Agency’s Integrated Science Assessment (ISA), there is a causal relationship between fine particulate matter (PM2.5) exposure and increased mortality rates. A similar association was also reported by the International Agency for Research on Cancer (IARC). While many studies are available on this relationship between PM exposure and elevated mortality frequency in Europe and North America, there are limited investigations in Asia. Thus, the aim of this study was to perform an ecological investigation to determine the relationship between exposure to ambient PM2.5 levels and all-cause mortality in 66 in Taiwan municipalities. To undertake this investigation, annual PM2.5 levels and age-standardized all-cause mortality rates were calculated for male and female residents of these areas from 2010 to 2020. Weighted-multiple regression analyses were used to obtain adjusted risk ratio (RR) controlling for possible confounding by urbanization level, physician density, and annual mean household income. Annual PM2.5 levels of each municipality were divided into tertiles. Data demonstrated that men residing in areas with intermediate tertile PM2.5 levels (21.06 to 27.29 µg/m3) and the highest tertiles levels (27.30–33.11 µg/m3) exhibited adjusted RRs of 1.06 (95% CI = 1.03–1.08) and 1.13 (95% CI = 1.10–1.16), respectively. Women in these locations displayed a similar risk, 1.03 (0.99–1.06) and 1.07 (1.04–1.11), respectively. These findings indicate that ambient exposure to PM2.5 increased risk for all-cause mortality rates in both men and women in Taiwan during this time period.

The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis

BackgroundTaxation increases which reduce the affordability of alcohol are expected to reduce mortality inequalities. A recent taxation increase in Lithuania offers the unique possibility to test this hypothesis.MethodsCensus-linked mortality data between 2011 and 2019 were used to calculate monthly sex- and education-stratified age-standardized mortality rates for the population aged 40 to 70 years. As primary outcome, we analysed the difference in age-standardized all-cause mortality rates between the population of lowest versus highest educational achievement. The impact of the 2017 taxation increase was evaluated using interrupted time series analyses. To identify whether changes in alcohol use can explain the observed effects on all-cause mortality, the education-based mortality differences were then decomposed into n = 16 cause-of-death groupings.ResultsBetween 2012 and 2019, education-based all-cause mortality inequalities in Lithuania declined by 18% among men and by 14% among women. Following the alcohol taxation increase, we found a pronounced yet temporary reduction of mortality inequalities among Lithuanian men (− 13%). Subsequent decomposition analyses suggest that the reduction in mortality inequalities between lower and higher educated men was mainly driven by narrowing mortality differences in injuries and infectious diseases.ConclusionsA marked increase in alcohol excise taxation was associated with a decrease in mortality inequalities among Lithuanian men. More pronounced reductions in deaths from injuries and infectious diseases among lower as compared to higher educated groups could be the result of differential changes in alcohol use in these populations.

Are we really all in this together? The social patterning of mortality during the first wave of the COVID-19 pandemic in Belgium

BackgroundBelgium was one of the countries that was struck hard by COVID-19. Initially, the belief was that we were ‘all in it together’. Emerging evidence showed however that deprived socioeconomic groups suffered disproportionally. Yet, few studies are available for Belgium. The main question addressed in this paper is whether excess mortality during the first COVID-19 wave followed a social gradient and whether the classic mortality gradient was reproduced.MethodsWe used nationwide individually linked data from the Belgian National Register and the Census 2011. Age-standardized all-cause mortality rates were calculated during the first COVID-19 wave in weeks 11-20 in 2020 and compared with the rates during weeks 11-20 in 2015-2019 to calculate absolute and relative excess mortality by socioeconomic and -demographic characteristics. For both periods, relative inequalities in total mortality between socioeconomic and -demographic groups were calculated using Poisson regression. Analyses were stratified by age, gender and care home residence.ResultsExcess mortality during the first COVID-19 wave was high in collective households, with care homes hit extremely hard by the pandemic. The social patterning of excess mortality was rather inconsistent and deviated from the usual gradient, mainly through higher mortality excesses among higher socioeconomic groups classes in specific age-sex groups. Overall, the first COVID-19 wave did not change the social patterning of mortality, however. Differences in relative inequalities between both periods were generally small and insignificant, except by household living arrangement.ConclusionThe social patterning during the first COVID-19 wave was exceptional as excess mortality did not follow the classic lines of higher mortality in lower classes and patterns were not always consistent. Relative mortality inequalities did not change substantially during the first COVID-19 wave compared to the reference period.

Social factors tend to decline age-standardized all-cause mortality rates in China during 2005–2015: evidence from an ecological study

ObjectivesIt is important to understand the factors that can substantially decrease mortality rates, as multiple strategies have been implemented to improve economic development and national health in China. We aimed to describe the geographic variations and changes in the all-cause mortality rates in 2005–2015 and to investigate the social factors that tend to decline age-standardized all-cause mortality rates. Study designEcological study. MethodsThe data used came from China’s National Census Survey in 2005, 2010 and 2015 and China National Statistical Yearbooks. We conducted provincial-level thematic mapping of age-standardized all-cause mortality rate trajectory groups in 2005–2015 by using ArcGIS. Generalized estimating equation (GEE) models were used to clarify the social factors that may have long-term relevance to declining age-standardized all-cause mortality rates. We compared the characteristics of the three provinces with the lowest mortality rates and the three provinces with the highest mortality rates to further understand the health disparities. ResultsThe age-standardized mortality rates declined from 2000 to 2006 and from 2008 to 2019. Provinces in the low-trajectory tended to be located in the Northeast and Southeast China. The GEE results revealed that the greater the proportion of the population with senior high school education or above, the more families with flushing or pumping toilets that are not shared with other households, the more nurses per 1000 people and a stable economic growth rate were inclined to low age-standardized all-cause mortality rates (P < 0.05). ConclusionsHealth disparities between different regions were still in existence even in 2015. Thus, it is critical to improve equality in economic and educational development, the distribution of healthcare professionals, and sanitation facilities, to ensure the equality of opportunities in terms of healthy lives and well-being for all. Furthermore, for developing countries, the improvement of national health urgently needs to prevent the health risks relevant to rapid industrialization and urbanization.

A population-based study on mortality among Belgian immigrants during the first COVID-19 wave in Belgium. Can demographic and socioeconomic indicators explain differential mortality?

IntroductionBelgium has noted a significant excess mortality during the first COVID-19 wave. Research in other countries has shown that people with migrant origin are disproportionally affected. Belgium has an ethnically diverse and increasingly ageing population and is therefore particularly apt to study differential mortality by migrant group during this first wave of COVID-19.Data and methodsWe used nationwide individually-linked data from the Belgian National Register providing sociodemographic indicators and mortality; and the administrative census of 2011 providing indicators of socioeconomic position. Age-standardized all-cause mortality rates (ASMRs) were calculated during the first COVID-19 wave (weeks 11–20 in 2020) and compared with ASMRs during weeks 11–20 in 2019 to calculate excess mortality by migrant origin, age and gender. For both years, relative inequalities were calculated by migrant group using Poisson regression, with and without adjustment for sociodemographic and socioeconomic indicators.ResultsAmong the middle-aged, ASMRs revealed increased mortality in all origin groups, with significant excess mortality for Belgians and Sub-Saharan African men. At old age, excess mortality up to 60% was observed for all groups. In relative terms, most male elderly migrant groups showed higher mortality than natives, as opposed to 2019 and to women. Adding the control variables decreased this excess mortality.DiscussionThis study underlined important inequalities in overall and excess mortality in specific migrant communities, especially in men. Tailor-made policy measures and communication strategies should be set-up taking into account the particular risks to which groups are exposed.

Positive Effects of Declining Age-Standardized All-Cause Mortality Rates in China During 2005-2015

Background: It is important to understand which factors can substantially decrease mortality rates, as multiple strategies have been implemented to improve economic development and national health in China. We aimed to describe the geographic variations and changes in the all-cause mortality rates in 2005-2015, and to investigate the positive effects of declining age-standardized all-cause mortality rates. Methods: The data used came from China’s National Census Survey in 2005, 2010 and 2015 and China National Statistical Yearbooks. We conducted provincial-level thematic mapping of age-standardized all-cause mortality rate trajectory groups in 2005-2015 by using ArcGIS. Generalized estimating equation (GEE) models were used to clarify the possible long-term effects of declining age-standardized all-cause mortality rates. We compared the characteristics of the three provinces with the lowest mortality rates and the three provinces with the highest mortality rates to further understand the associated health disparities. Results: The age-standardized mortality rates declined from 2000 to 2006 and from 2008 to 2019. Provinces in the low-trajectory tended to be located in the Northeast and Southeast China. The GEE results revealed that the greater the proportion of the population with senior high school education or above, the more families with flushing or pumping toilets that are not shared with other households, the more nurses per 1000 people and a stable economic growth rate can substantially decrease age-standardized all-cause mortality rates (p < 0·05). Interpretation: Regional disparities in population health still exist. Thus, it is critical to improve equality in economic and educational development, the distribution of healthcare professionals, and sanitation facilities, as well as people’s policy literacy, to ensure the equality of opportunities in terms of healthy lives and well-being for all. Furthermore, for developing countries, the improvement of national health urgently needs to prevent the health risks caused by rapid industrialization and urbanization. Funding: Natural Science Foundation of Fujian Province of China (No. 2018J01129). Conflict of Interest: We declare no competing interests.

Severe intimate partner violence is associated with all-cause mortality among women living with HIV.

To examine the independent association between intimate partner violence (IPV) severity and all-cause mortality among women living with HIV (WLHIV). Cross-sectional questionnaire linked to longitudinal vital statistics data. We examined the lifetime prevalence of IPV and age-standardized all-cause mortality rates by IPV severity reported by WLHIV. Lifetime IPV (emotional/verbal, physical, or sexual) severity was assessed as a categorical variable: no history of any IPV (none); experienced one or two forms of IPV (moderate); or experienced all three forms of IPV (severe IPV). Two separate logistic regression models examined associations between any IPV (vs. none) as well as IPV severity (none vs. moderate, severe) and all-cause mortality. At the time of interview (2007-2010), 260 participants self-identified as women with a median (Q1-Q3) age of 41 years (35-46). Of these women, the majority were unemployed (85%), 59% reported any IPV and 24% reported severe IPV. Of the 252 women followed until 31 December 2017, 25% (n = 63) died. Age-standardized all-cause mortality rates for WLHIV who experienced severe IPV were two-times higher than women with no history of IPV (44.7 per 1000 woman-years vs. 20.9 per 1000 woman-years). After adjustment for confounding, experiences of severe IPV (vs. none) were significantly associated with all-cause mortality (aOR = 2.42, 95% CI = 1.03-5.70). Although we found that any lifetime experience of IPV was not associated with all-cause mortality, women ever experiencing severe IPV were significantly more likely to die during the study period. This may suggest a need for increased trauma- and violence-aware approaches.

5191Recurrent coronary heart disease in the year following myocardial infarction among US men and women between 2008 and 2015

Abstract Background Although the risk of recurrent events among adults with coronary heart disease (CHD) has declined considerably from the 1970's in the US and many Western countries, studies from the 2000's show that rates remain high. Women have lower rates of incident CHD but little is known about sex differences in recurrent events in adults with CHD. Purpose To examine trends in rates of recurrent myocardial infarction (MI), recurrent CHD, and all-cause mortality following a MI hospitalization between 2008 and 2015 among US men and women. Also, we compared sex differences in event rates among individuals with a MI hospitalization versus their counterparts without a history of CHD. Methods Data were used from 1,232,024 (53% women) US adults &lt;65 years of age with commercial health insurance in the MarketScan database and US adults ≥66 years of age with government health insurance through Medicare who had a MI hospitalization between January 1, 2008 and December 31, 2015. For each calendar year, age-standardized sex-specific rates of recurrent MI, recurrent CHD (i.e., recurrent MI or coronary revascularization), and all-cause mortality (in Medicare only) were calculated through 365 days following the hospital discharge date for MI. In a secondary analyses, we assessed the rate of recurrent MI, CHD events and all-cause mortality among women versus men with a history of MI (n=324,283) and without a history of CHD (n=1,297,132) in 2014–2015. For these analyses, adjusted hazard ratios (95% confidence intervals) were calculated using follow-up through December 31, 2016. Results From 2008 to 2015, age-standardized rates over 365 days of follow-up for recurrent MI declined by 15%, from 94 to 80 per 1000 person-years, in men and by 14%, from 89 to 77 per 1000 person-years, in women. Age-standardized recurrent CHD rates decreased by 16%, from 163 to 138 per 1000 person-years, in men and by 17%, from 142 to 118 per 1000 person-years, in women. In the Medicare population, age-standardized all-cause mortality rates following MI decreased by 6%, from 446 to 421 per 1000 person-years, in men and by 3%, from 412 to 398 per 1000 person-years, in women. In the secondary analyses, the women-to-men hazard ratios for those with a history of MI and those without prior CHD were 0.97 (0.94–0.99) and 0.67 (0.65–0.69), respectively, for MI, 0.89 (0.87–0.91) and 0.52 (0.51–0.54), respectively, for CHD, and 0.84 (0.83–0.85) and 0.74 (0.73–0.75) respectively, for all-cause mortality. Conclusion Reductions in rates of recurrent MI, recurrent CHD, and all-cause mortality within 365 days after hospitalization for MI have been similar for US women and men. The lower risk for events comparing women versus men without prior CHD is attenuated after a MI. Acknowledgement/Funding The design and conduct of the study was supported through a research grant from Amgen, Inc.

Educational inequalities in all-cause and cause-specific mortality among patients with osteoarthritis in southern Sweden

Purpose: To assess the association between socioeconomic status, measured by education, and all-cause and cause-specific mortality among patients with osteoarthritis (OA) in southern Sweden. Methods: A register-based open cohort study was conducted. The Region of Skåne, which is the southeast part of Sweden, was the geographical area of interest. All residents aged ≥45 years in the region with doctor-diagnosed OA (ICD-10 codes: M15-M19) between the 1st of January 1998 and the 31st of December 2013 (n=123,981) were followed until death, relocation outside the Skåne region, or the end of 2014, whichever occurred first. Individual-level data was obtained from the Skåne Healthcare Register (SHR), Statistics Sweden and the National Board of Health and Welfare´s Cause of Death Register. The Slope index of inequality (SII) and the Relative index of inequality (RII), which measure the absolute and relative educational inequality, respectively, were estimated. The Aalen´s additive hazard model was used to estimate the SII and Cox model was used to estimate the RII. Two cause-of-death attribution approaches were used to estimate the RIIs: “underlying cause” and “weighted multiple-cause”. All estimates were adjusted for age, sex, marital status and whether the subject had a Swedish or foreign background. Results: During a mean follow-up of 7.1 years, we identified 24,493 deaths. Age-standardized all-cause mortality rates increased as the educational level decreased (Figure 1). The RII showed that all-cause mortality rate was 1.54 (95% CI: 1.47, 1.62) times higher in low vs. high educated OA patients (Table 1). Among causes of death, the greatest relative inequality was seen in deaths caused by diseases in circulatory system (RII 1.88, 95% CI: 1.73, 2.04). Higher mortality rates were observed in low educated for all causes except for mental and behavioural disorders & diseases of the nervous system. Regarding the results for the subgroups based on sex, age and OA-type, there were a higher all-cause mortality in low educated patients. A higher cause-specific mortality in favour of high educated was also generally seen in these groups.Table 1Relative index of inequality (RII) and slope index of inequality (SII) in mortality.Disease group (ICD-10 codes)All (≥45 years)SexesAge groupsOA-typeMenWomen45-74 years≥75 yearsKnee OA (M17)Hip OA (M16)RIISII*RIISII*RIISII*RIISII*RIISII*RIISII*RIISII*All-cause1.54 ( 1.47, 1.62)904 (779, 1030)1.55 (1.44, 1.67)1270 (1060, 1480)1.54 (1.44, 1.65)924 (767, 1080)1.72 (1.59, 1.86)700 (600, 800)1.44 (1.35, 1.54)1350 (1050, 1650)1.52 (1.41, 1.64)874 (680, 1070)1.53 (1.39, 1.67)1300 (990, 1610)Diseases of the circulatory system (I00-I99)1.88 (1.73, 2.04)555 (475, 635)1.85 (1.64, 2.08)732 (596, 868)1.86 (1.67, 2.08)542 (443, 641)2.25 (1.94, 2.60)325 (269, 381)1.68 (1.53, 1.85)981 (775, 1190)1.78 (1.58, 2.01)515 (389, 641)1.90 (1.64, 2.19)840 (642, 1040)Malignant neoplasms (C00-C97)1.20 (1.09, 1.32)77.6 (11.7, 143)1.30 (1.13, 1.49)193 (80.7, 305)1.19 (1.04, 1.37)86 (5.1, 167)1.27 (1.12, 1.45)127 (64.5, 190)1.11 (0.96, 1.29)-4.7 (-136, 127)1.19 (1.02, 1.39)66.3 (-32.3, 165)1.21 (1.01, 1.45)137 (-21.6, 296)Mental and behavioural disorders (F00-F99) & Diseases of the nervous system (G00-G99)1.12 (0.93, 1.34)4.8 (-30.8, 40.5)0.98 (0.71, 1.35)-6.7 (-59.5, 46)1.17 (0.93, 1.47)7.6 (-40.3, 55.4)1.47 (1.04, 2.08)24.7 (0.59, 48.8)0.97 (0.78, 1.20)-31.5 (-123, 60.4)1.14 (0.85, 1.52)0.8 (-54.1, 55.6)0.95 (0.69, 1.32)-38.3 (-125, 48.7)Diseases of the respiratory system (J00-J99)1.58 (1.28, 1.93)53 (20.3, 85.7)1.70 (1.25, 2.32)101 (44, 158)1.54 (1.16 2.06)55.1 (15.5, 94.7)2.45 (1.73, 3.48)63.9 (40.2, 87.6)1.30 (1.01, 1.68)42.9 (-38.4, 124)1.66 (1.18, 2.34)51.5 (4.7, 98.3)1.48 (1.01, 2.19)63.6 (-13.4, 141)Other causes1.70 (1.52, 1.91)234 (178, 290)1.55 (1.31, 1.84)258 (164, 352)1.81 (1.55, 2.12)258 (187, 329)1.93 (1.61, 2.32)163 (119, 207)1.60 (1.38, 1.85)375 (239, 511)1.69 (1.42, 2.01)228 (141, 315)1.68 (1.35, 2.09)327 (191, 463)* per 100,000 person-years. 95 % Confidence intervals are shown in parenthesis. Models were adjusted for sex, marital status, and background. Open table in a new tab There were 904 (95% CI: 779, 1030) more all-cause deaths per 100,000 person-years in the low educated compared with high educated OA patients (Table 1). Diseases of the circulatory system and mental and behavioural disorders & diseases of the nervous system contributed the most and least, respectively, to the absolute inequalities in all-cause mortality in the whole study population and all subgroups (Table 2).Table 2Contribution (%) of specific causes of death to the absolute inequality in mortality.Disease group (ICD-10 codes)All (≥45years)SexesAge groupsOA-typeDiseases of the circulatory system (I00-I99)MenWomen45-74 years≥75 yearsKneeHipDiseases of the circulatory system (I00-I99)60.057.357.146.272.059.863.2Malignant neoplasms (C00-C97)8.415.19.118.1-0.37.710.3Mental and behavioural disorders (F00-F99) & Diseases of the nervous system (G00-G99)0.5-0.50.83.5-2.30.1-2.9Diseases of the respiratory system (J00-J99)5.77.95.89.13.16.04.8Other causes25.320.227.223.227.526.524.6Total mortality99.9100.0100.0100.1100.0100.1100.0 Open table in a new tab When we used the weighted multiple-cause approach, the RII for diseases of the circulatory system increased, while the RII for malignant neoplasms decreased. In addition, the RII for respiratory system was no longer statistically significant when the weighted multiple-cause approach was used. Conclusions: We found an inverse association between educational level and all-cause mortality in OA-patients. The cause-of-death attribution approaches generally led to similar conclusion. These findings suggest that educational level is an important factor to consider in OA-patients, especially if they suffer from cardiovascular diseases. Further studies are required to explain the inequality observed in our study.

The effect of women in government on population health: An ecological analysis among Canadian provinces, 1976–2009

Previous research finds connections between women in government, promotion of women’s issues, and government spending. However, the connection between female politicians and population health warrants more significant attention. This study takes advantage of differences among Canadian provinces to evaluate the effect of women in government on age-standardized all-cause mortality rates, to assess the potential mediating role of government spending, and to determine the role played by political partisanship. Time-series cross-sectional data are retrieved from the Canadian Socio-Economic Information Management System II Tables for 1976–2009 (10 provinces and 34 years = 340 cases). Cumulative women in government is measured as the cumulative seats held by female politicians as a percentage of provincial seats since 1960. Political partisanship is measured as the cumulative seats held by female politicians in left-wing, centre, and right-wing parties as a percentage of provincial seats since 1960. Government spending is measured as the average of standard scores of four provincial expenditures: medical care, preventive care, other social services, and post-secondary education. Health is measured as total, male and female age-standardized mortality rates per 1000 population (all causes of death). Estimation techniques include the Prais-Winsten regressions with panel-corrected SEs, a first-order autocorrelation correction model, and fixed-unit effects, adjusted for alternative factors. We find that as the cumulative average percentage of women in government has historically risen, total, male, and female mortality rates tend to be lower, net of alternative explanations. Government spending partially mediates the effect of women in government on mortality rates. Moreover, increases in female politicians from left-wing, centre, and right-wing parties are all significantly associated with decreases in mortality rates. Women in government can bring about desirable changes in population health. Our work encourages more debate and research about quotas and other measures designed to level the political playing field for women.

Corruption and use of antibiotics in regions of Europe

The aim of this article is to investigate the association between corruption and antibiotic use at sub-national level. We explore the correlation between, on the one hand, two measures of corruption (prevalence of corruption in the health sector and prevalence of bribes in the society) at regional level from the European Quality of Government Index; and, on the other, the consumption of antibiotics in those European regions from a 2009 Special Euro Barometer. In a multivariate regression model, we control for potential confounders: purchasing power of standardized regional gross domestic product, inhabitants per medical doctor and age-standardized all-cause mortality rates. We find that there is a strong positive association between both measures of corruption (i.e. in the health sector, and in the society at large) and antibiotics use; and that this association is robust to the introduction of the control variables. These results support previous findings in the literature linking corruption to higher antibiotic use at cross-national level. We show that corruption does seem to account for some of the remarkable between-region variation in antibiotic consumption in Europe.

Secular changes in mortality disparities in New York City: a reexamination.

Previously published analyses showed that inequalities in mortality rates between residents of poor and wealthy neighborhoods in New York City (NYC) narrowed between 1990 and 2000, but these trends may have been influenced by population in-migration and gentrification. The NYC public housing population has been less subject to these population shifts than those in other NYC neighborhoods. We compared changes in mortality rates (MRs) from 1989-1991 to 1999-2001 among residents of NYC census blocks consisting entirely of public housing residences with residents of nonpublic housing low-income and higher-income blocks. Public housing and nonpublic housing low-income blocks were those in census block groups with > or =50% of residents living at <1.5 times the federal poverty level (FPL); nonpublic housing higher-income blocks were those in census block groups with <50% of residents living at <1.5 times the FPL. Information on deaths was obtained from NYC's vital registry, and US Census data were used for denominators. Age-standardized all-cause MRs in public housing, low-income, and higher-income residents decreased between the decades by 16%, 28%, and 22%, respectively. While mortality rate ratios between low-income and higher-income residents narrowed by 8%, the relative disparity between public housing and low-income residents widened by 21%. Diseases amenable to prevention including malignancies, diabetes, and chronic lung disease contributed to the increased overall mortality disparity between public housing and lower-income residents. These findings temper previous findings that inequalities in the health of poor and wealthier NYC neighborhood residents have narrowed. NYC public housing residents should be a high-priority population for efforts to reduce health disparities.