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Neighborhood Deprivation and Risks of Autoimmune Disorders: A National Cohort Study in Sweden

Author

Listed:
  • Xinjun Li

    (Center for Primary Health Care Research, Lund University, 205 02 Malmö, Sweden)

  • Jan Sundquist

    (Center for Primary Health Care Research, Lund University, 205 02 Malmö, Sweden
    Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10001, USA
    Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Izumo 690-2406, Japan)

  • Tsuyoshi Hamano

    (Department of Sports Sociology and Health Sciences, Kyoto Sangyo University, Kyoto 520-0461, Japan
    Department of Functional Pathology, Shimane University School of Medicine, Izumo 690-2406, Japan)

  • Kristina Sundquist

    (Center for Primary Health Care Research, Lund University, 205 02 Malmö, Sweden
    Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10001, USA
    Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Izumo 690-2406, Japan)

Abstract

Background: No study to date, as far as we know, has analyzed the potential effect of neighborhood-level deprivation on autoimmune disorders (ADs), when adjusted for individual-level characteristics. Methods: A total of 5.4 million individuals from 8363 neighborhoods, comprising the whole Swedish population (ages 25–74 years), were followed for the period 1 January 2000, until admission due to diagnosis of ADs during the period of the study, or the conclusion of the study (31 December 2010). We used a neighborhood deprivation index, constructed from variables such as low education, low income, unemployment, and social welfare assistance, to assess the level of neighborhood deprivation. Multilevel logistic regression was used in the analysis with individual level characteristics at the first level and level of neighborhood deprivation at the second level. Results: A significant association between level of neighborhood deprivation and ADs was found. The crude odds were 1.32 (95% confidence interval 1.27–1.36) for those residing in the high-deprived neighborhoods compared to those living in low-deprivation neighborhoods. In the full model, where individual level characteristics were taken into account, the odds of ADs were 1.18 (1.14–1.22) in the most deprived neighborhoods. Certain Ads—angiitis hypersensitive (5.14), ankylosing spondylitis (1.66), celiac disease (1.65), Crohn’s disease (1.21), diabetes mellitus type 1 (1.45), Graves’s disease (1.13), Hashimoto thyroiditis (1.51), psoriasis (1.15), rheumatoid arthritis (1.15), sarcoidosis (1.20), and systemic sclerosis (1.27)—remained significantly associated with high level of neighborhood deprivation after adjustment for the individual-level variables. Conclusion: This study is the largest to date analyzing the potential influence of neighborhood deprivation on ADs. Our results indicate that neighborhood deprivation may affect risk of ADs, independent of individual level sociodemographic characteristics. For health care policies, both individual and neighborhood level approaches seem to be of importance.

Suggested Citation

  • Xinjun Li & Jan Sundquist & Tsuyoshi Hamano & Kristina Sundquist, 2019. "Neighborhood Deprivation and Risks of Autoimmune Disorders: A National Cohort Study in Sweden," IJERPH, MDPI, vol. 16(20), pages 1-14, October.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:20:p:3798-:d:274591
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    References listed on IDEAS

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    1. John Lynch & George Smith & Marianne Hillemeier & Trivellore Raghunathan & George Kaplan & Mary Shaw, 2001. "Income Inequality, the Psycho-social Environment and Health Comparisons of Wealthy Nations," LIS Working papers 269, LIS Cross-National Data Center in Luxembourg.
    2. Sundquist, Jan & Johansson, Sven-Erik & Yang, Min & Sundquist, Kristina, 2006. "Low linking social capital as a predictor of coronary heart disease in Sweden: A cohort study of 2.8 million people," Social Science & Medicine, Elsevier, vol. 62(4), pages 954-963, February.
    3. Anne Mette Bender & Ichiro Kawachi & Torben Jørgensen & Charlotta Pisinger, 2015. "Neighborhood Deprivation Is Strongly Associated with Participation in a Population-Based Health Check," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-10, June.
    4. Lochner, K. & Pamuk, E. & Makuc, D. & Kennedy, B.P. & Kawachi, I., 2001. "State-level income inequality and individual mortality risk: A prospective, multilevel study," American Journal of Public Health, American Public Health Association, vol. 91(3), pages 385-391.
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