Territorial inequalities in premature mortality in Józsefváros (district VIII. of Capital City Budapest), 2006-2008 (level of blocks of flat)

*Aranka Kovács¹, Csilla Nagy², Attila Juhász², Zoltán Papp³

Summary
Background: It is well known that the state of health of the population in Józsefváros is extremely bad. The literature already mentioned in the mid-80′s that the average life expectancy at birth in Józsefváros was 12 years less than in District XII, on the right bank of Danube. Unfortunately, the situation today is still similar, but the district is not homogeneous at all: the state of health of inhabitant groups with different historical and socio-economic background within the district differs at least as much from each other as the indicators of the whole district VIII differ from the capital′s typical results.
Method: In our study we used the Rapid Inquire Facility and for the cluster analysis we used the SatScan program. We reviewed the demographic data of district′s VIII population and – using Standardised Mortality Ratio – the mortality rate of the population aged 30-69 between 2006 and 2008. The effects of the well-known distorting factor (the large number of deaths, homeless shelters in certain areas and among the residents registered at the same address) were eliminated from the study.
Results: The results of the analysis performed by residential quarters showed a significant 1.5 fold excess mortality in Magdolna, Szigony and Orczy quarters compared to the rate of the entire city of Budapest. The significantly high mortality rates in the blocks of Magdolna and Orczy quarters were confirmed by the inspection on the level of blocks and by the results of cluster analysis as well.
Conclusions: The results of this study clearly define areas with a high death-risk in district VIII, even on the level of blocks, which constitutes a targeted information to the local decision-makers for developing a health promotion plan in order to reduce the existing disparities.

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