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Bosakova L, Rosicova K, Filakovska Bobakova D. Association of socioeconomic disadvantage and ethnicity with perinatal neonatal, and infant mortality in Slovakia. BMC Public Health 2024; 24:1142. [PMID: 38658885 PMCID: PMC11040926 DOI: 10.1186/s12889-024-18645-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/18/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Infant mortality rates are reliable indices of the child and general population health status and health care delivery. The most critical factors affecting infant mortality are socioeconomic status and ethnicity. The aim of this study was to assess the association between socioeconomic disadvantage, ethnicity, and perinatal, neonatal, and infant mortality in Slovakia before and during the COVID-19 pandemic. METHODS The associations between socioeconomic disadvantage (educational level, long-term unemployment rate), ethnicity (the proportion of the Roma population) and mortality (perinatal, neonatal, and infant) in the period 2017-2022 were explored, using linear regression models. RESULTS The higher proportion of people with only elementary education and long-term unemployed, as well as the higher proportion of the Roma population, increases mortality rates. The proportion of the Roma population had the most significant impact on mortality in the selected period between 2017 and 2022, especially during the COVID-19 pandemic (2020-2022). CONCLUSIONS Life in segregated Roma settlements is connected with the accumulation of socioeconomic disadvantage. Persistent inequities between Roma and the majority population in Slovakia exposed by mortality rates in children point to the vulnerabilities and exposures which should be adequately addressed by health and social policies.
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Affiliation(s)
- Lucia Bosakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Tr. SNP 1, Kosice, 040 01, Slovak Republic.
- Olomouc University Social Health Institute (OUSHI), Palacky University in Olomouc, Univerzitni 22, 771 11, Olomouc, Czech Republic.
| | - Katarina Rosicova
- Department of Regional Development, Land-Use Planning and Environment, Kosice Self-Governing Region, Nam. Maratonu Mieru 1, 042 66, Kosice, Slovakia
| | - Daniela Filakovska Bobakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Tr. SNP 1, Kosice, 040 01, Slovak Republic
- Olomouc University Social Health Institute (OUSHI), Palacky University in Olomouc, Univerzitni 22, 771 11, Olomouc, Czech Republic
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Morrison J, Bosakova L, Dzurova D, Rosicova K, Lustigova M, Santana P, Pikhart H. Regional mortality in countries of Central and Eastern Europe: findings from Euro-Healthy project. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - D Dzurova
- Charles University, Prague, Czech Republic
| | - K Rosicova
- Department of Regional Development, Kosice, Slovakia
| | | | - P Santana
- University of Coimbra, Coimbra, Portugal
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Rosicova K, Bosakova L, Madarasova Geckova A, Rosic M, Andrejkovic M, Žežula I, Groothoff JW, van Dijk JP. Regional mortality by socioeconomic factors in Slovakia: a comparison of 15 years of changes. Int J Equity Health 2016; 15:115. [PMID: 27435090 PMCID: PMC4952279 DOI: 10.1186/s12939-016-0404-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 07/11/2016] [Indexed: 12/01/2022] Open
Abstract
Background Like most Central European countries Slovakia has experienced a period of socioeconomic changes and at the same time a decline in the mortality rate. Therefore, the aim is to study socioeconomic factors that changed over time and simultaneously contributed to regional differences in mortality. Methods The associations between selected socioeconomic indicators and the standardised mortality rate in the population aged 20–64 years in the districts of the Slovak Republic in the periods 1997–1998 and 2012–2013 were analysed using linear regression models. Results A higher proportion of inhabitants in material need, and among males also lower income, significantly contributed to higher standardised mortality in both periods. The unemployment rate did not contribute to this prediction. Between the two periods no significant changes in regional mortality differences by the selected socioeconomic factors were found. Conclusions Despite the fact that economic growth combined with investments of European structural funds contributed to the improvement of the socioeconomic situation in many districts of Slovakia, there are still districts which remain “poor” and which maintain regional mortality differences.
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Affiliation(s)
- Katarina Rosicova
- Kosice Self-governing Region, Department of Regional Development, Land-use Planning and Environment, Nam. Maratonu mieru 1, 042 66, Kosice, Slovakia. .,Graduate School Kosice Institute for Society and Health, Pavol Jozef Safarik University, Kosice, Slovakia. .,Department of Health Psychology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.
| | - Lucia Bosakova
- Department of Health Psychology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Faculty of Business Economics, Department of Quantitative Methods, University of Economics in Bratislava, Kosice, Slovakia.,Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Andrea Madarasova Geckova
- Graduate School Kosice Institute for Society and Health, Pavol Jozef Safarik University, Kosice, Slovakia.,Department of Health Psychology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Martin Rosic
- Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovakia
| | - Marek Andrejkovic
- Faculty of Business Economics, Department of Quantitative Methods, University of Economics in Bratislava, Kosice, Slovakia
| | - Ivan Žežula
- Institute of Mathematical Sciences, Faculty of Science, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Johan W Groothoff
- Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.,Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Rosicova K, Reijneveld SA, Madarasova Geckova A, Stewart RE, Rosic M, Groothoff JW, van Dijk JP. Inequalities in mortality by socioeconomic factors and Roma ethnicity in the two biggest cities in Slovakia: a multilevel analysis. Int J Equity Health 2015; 14:123. [PMID: 26541416 PMCID: PMC4635593 DOI: 10.1186/s12939-015-0262-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 11/01/2015] [Indexed: 11/29/2022] Open
Abstract
Background The socioeconomic and ethnic composition of urban neighbourhoods may affect mortality, but evidence on Central European cities is lacking. The aim of this study was to assess the associations between socioeconomic and ethnic neighbourhood indicators and the mortality of individuals aged 20–64 years old in the two biggest cities of the Slovak Republic. Methods We obtained data on the characteristics of neighbourhoods and districts (educational level, unemployment, income and share of Roma) and on individual mortality of residents aged 20–64 years old, for the two largest cities in the Slovak Republic (Bratislava and Kosice) in the period 2003–2005. We performed multilevel Poisson regression analyses adjusted for age and gender on the individual (mortality), neighbourhood (education level and share of Roma in population) and district levels (unemployment and income). Results The proportions of Roma and of low-educated residents were associated with mortality at the neighbourhood level in both cities. Mutually adjusted, only the association with the proportion of Roma remained in the model (risk ratio 1.02; 95 % confidence interval 1.01–1.04). The area indicators – high education, income and unemployment – were not associated with mortality. Conclusion The proportion of Roma is associated with early mortality in the two biggest cities in the Slovak Republic.
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Affiliation(s)
- Katarina Rosicova
- Kosice Self-governing Region, Department of Regional Development, Land-use Planning and Environment, Nam. Maratonu mieru 1, 042 66, Kosice, Slovakia. .,Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia. .,Institute of Public Health - Department of Health Psychology, Medical Faculty, Safarik University, Kosice, Slovakia.
| | - Sijmen A Reijneveld
- Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Andrea Madarasova Geckova
- Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia. .,Institute of Public Health - Department of Health Psychology, Medical Faculty, Safarik University, Kosice, Slovakia. .,Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.
| | - Roy E Stewart
- Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Martin Rosic
- Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovakia.
| | - Johan W Groothoff
- Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia. .,Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.
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Borrell C, Marí-Dell'olmo M, Palència L, Gotsens M, Burström BO, Domínguez-Berjón F, Rodríguez-Sanz M, Dzúrová D, Gandarillas A, Hoffmann R, Kovacs K, Marinacci C, Martikainen P, Pikhart H, Corman D, Rosicova K, Saez M, Santana P, Tarkiainen L, Puigpinós R, Morrison J, Pasarín MI, Díez È. Socioeconomic inequalities in mortality in 16 European cities. Scand J Public Health 2014; 42:245-54. [PMID: 24567425 DOI: 10.1177/1403494814522556] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS To explore inequalities in total mortality between small areas of 16 European cities for men and women, as well as to analyse the relationship between these geographical inequalities and their socioeconomic indicators. METHODS A cross-sectional ecological design was used to analyse small areas in 16 European cities (26,229,104 inhabitants). Most cities had mortality data for a period between 2000 and 2008 and population size data for the same period. Socioeconomic indicators included an index of socioeconomic deprivation, unemployment, and educational level. We estimated standardised mortality ratios and controlled for their variability using Bayesian models. We estimated relative risk of mortality and excess number of deaths according to socioeconomic indicators. RESULTS We observed a consistent pattern of inequality in mortality in almost all cities, with mortality increasing in parallel with socioeconomic deprivation. Socioeconomic inequalities in mortality were more pronounced for men than women, and relative inequalities were greater in Eastern and Northern European cities, and lower in some Western (men) and Southern (women) European cities. The pattern of excess number of deaths was slightly different, with greater inequality in some Western and Northern European cities and also in Budapest, and lower among women in Madrid and Barcelona. CONCLUSIONS In this study, we report a consistent pattern of socioeconomic inequalities in mortality in 16 European cities. Future studies should further explore specific causes of death, in order to determine whether the general pattern observed is consistent for each cause of death.
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Affiliation(s)
- Carme Borrell
- 1Agència de Salut Pública de Barcelona, Barcelona, Spain
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Gotsens M, Marí-Dell'Olmo M, Pérez K, Palència L, Martinez-Beneito MA, Rodríguez-Sanz M, Burström B, Costa G, Deboosere P, Domínguez-Berjón F, Dzúrová D, Gandarillas A, Hoffmann R, Kovacs K, Marinacci C, Martikainen P, Pikhart H, Rosicova K, Saez M, Santana P, Riegelnig J, Schwierz C, Tarkiainen L, Borrell C. Socioeconomic inequalities in injury mortality in small areas of 15 European cities. Health Place 2013; 24:165-72. [PMID: 24112963 DOI: 10.1016/j.healthplace.2013.09.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 08/30/2013] [Accepted: 09/10/2013] [Indexed: 11/26/2022]
Abstract
This study analysed socioeconomic inequalities in mortality due to injuries in small areas of 15 European cities, by sex, at the beginning of this century. A cross-sectional ecological study with units of analysis being small areas within 15 European cities was conducted. Relative risks of injury mortality associated with the socioeconomic deprivation index were estimated using hierarchical Bayesian model. The number of small areas varies from 17 in Bratislava to 2666 in Turin. The median population per small area varies by city (e.g. Turin had 274 inhabitants per area while Budapest had 76,970). Socioeconomic inequalities in all injury mortality are observed in the majority of cities and are more pronounced in men. In the cities of northern and western Europe, socioeconomic inequalities in injury mortality are found for most types of injuries. These inequalities are not significant in the majority of cities in southern Europe among women and in the majority of central eastern European cities for both sexes. The results confirm the existence of socioeconomic inequalities in injury related mortality and reveal variations in their magnitude between different European cities.
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Affiliation(s)
- Mercè Gotsens
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.
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Rosicova K, Madarasova Geckova A, van Dijk JP, Kollarova J, Rosic M, Groothoff JW. Regional socioeconomic indicators and ethnicity as predictors of regional infant mortality rate in Slovakia. Int J Public Health 2011; 56:523-31. [PMID: 20976517 PMCID: PMC3174369 DOI: 10.1007/s00038-010-0199-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 04/29/2010] [Accepted: 09/12/2010] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Exploring the associations of regional differences in infant mortality with selected socioeconomic indicators and ethnicity could offer important clues for designing public health policy measures. METHODS Data included perinatal and infant mortality in the 79 districts of the Slovak population in 2004. Linear regression was used to analyse the contribution of education, unemployment, income and proportion of Roma population on regional differences in perinatal and infant mortality rates. RESULTS All the explored socioeconomic indicators and ethnicity individually contributed significantly to both perinatal and infant mortality, with the exception of income. In the model exploring the influence of all these variables together on perinatal and infant mortality, only the effect of the proportion of Roma population remained significant. This model explained 34.9% of the variance for perinatal and 36.4% of the variance for infant mortality. CONCLUSIONS Living in Roma settlements indicates an accumulation of socioeconomic disadvantage. Health literacy, health-related behaviour and many other factors might contribute to the explanation of the differences in infant mortality, and a better understanding of these processes might help us to design tailored interventions.
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Affiliation(s)
- Katarina Rosicova
- Kosice Self-Governing Region, Department of Regional Development and Land-Use Planning, Kosice, Slovakia.
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Rosicova K, Geckova AM, van Dijk JP, Rosic M, Zezula I, Groothoff JW. Socioeconomic indicators and ethnicity as determinants of regional mortality rates in Slovakia. Int J Public Health 2009; 54:274-82. [PMID: 19234672 DOI: 10.1007/s00038-009-7108-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES Regional differences in mortality might reflect socioeconomic and ethnic differences between regions. The present study examines the relationship between education, unemployment, income, Roma population and regional mortality in the Slovak Republic. METHODS Separately for males and females, data on standardised mortality in the Slovak population aged 20-64 years in the year 2002 were calculated for each of the 79 districts. Similarly the proportions of respondents with tertiary education, unemployed status, Roma ethnicity and income data were calculated per district. A linear regression model was used to analyse the data. RESULTS Socioeconomic differences in regional mortality were found among males, but not among females. While education and unemployment rate significantly contributed to mortality differences between regions, income and the proportion of Roma population did not. The model explained 32.9% of the variance in standardised mortality rate among districts for males and 7.6% for females. CONCLUSION Low education and high unemployment rate seems to be an indicator of regions with high mortality of male and therefore should be targeted by policy measures aimed at decreasing mortality in productive age.
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Affiliation(s)
- Katarina Rosicova
- Kosice Self-Governing Region, Land-Use Planning Department, Namestie Maratonu mieru 1, 040 01 Kosice, Slovakia.
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