Population density, socioeconomic environment and all-cause mortality: A multilevel survival analysis of 2.7 million individuals in Denmark

Associations of All-Cause Mortality with Census-Based Neighbourhood Deprivation and Population Density in Japan: A Multilevel Survival Analysis

“…Thus, they [11] examined whether areal socio-economic status and population density affected cardiovascular mortality in a prospective study of a Swedish parish; results showed that after controlling for individual factors, population density had the dominant effect on mortality. A similar prospective study on all-cause mortality was replicated for all of Denmark [12]: findings suggested that population density was a more consistent contextual indicator than was areal socio-economic variables after controlling for individual factors through multilevel survival analysis. In both cases, higher population density was associated with higher mortality, supporting the ‘urban penalty’ hypothesis that life characteristics in urbanised areas, such as higher exposure to environmental pollution, individualistic lifestyles, and unhealthy behaviours (e.g.…”

“…The health disparities between urban and rural areas have also been considered an important aspect of contextual differences in health [11], [12]. Urbanicity/rurality is often measured using a simple census variable, such as population density [11], [12], or through administratively defined regional divisions [13], [14].…”

“…Urbanicity/rurality is often measured using a simple census variable, such as population density [11], [12], or through administratively defined regional divisions [13], [14]. Chaix et al [11] noted the lack of multilevel studies that compared urbanicity (population density) and deprivation simultaneously by controlling for individual socio-economic status.…”

“…Thus, in the present study, we examined the simultaneous effects of neighbourhood deprivation and population density on all-cause mortality in a Japanese population by using multilevel models that controlled for individual socio-economic factors, just as the Swedish and Danish studies did [11], [12]. Using the cohort dataset of middle-aged Japanese population in non-metropolitan areas, our primary aim was to examine whether living in more deprived and crowded neighbourhoods increased mortality risk.…”

How much of the variation in mortality across Norwegian municipalities is explained by the socio-demographic characteristics of the population?

“…In supplementary analysis, we included the number of persons living in the municipality, which is the only indicator of the environment that was available in the data. The population size, or rather the closely related population density, might be expected to affect the socio-demographic characteristics as well as mortality (Chaix et al, 2006;Meijer et al, 2012b). However, it turned out to be a completely unimportant control variable.…”