Area-based socioeconomic conditions and urban malaria and diarrhea mortalities in Accra, Ghana

Julius N. Fobil, Wibke Loag, Norbert Schwarz, Frederick Rodrigues, Christian G. Meyer, Alexander Kraemer, Juergen May

Research output: Contribution to journalArticlepeer-review

Abstract

Health inequalities are linked to inequalities in Socioeconomic Status (SES). While infant malaria/diarrhea mortality is widely studied, not very much is known about the influence of area-based measures of SES and all age urban malaria and diarrhea mortalities. To assess the relationship between area-based SES and malaria/diarrhea mortalities and whether these differed across SE-classes in an urban area in a low income country. Proportional mortality rates, computed from 24716 reported death records, collected from Accra over the period 1998-2002 were compared with area-based socioeconomic data in multivariate linear regression analyses in an ecological study design. While malaria mortality showed strong evidence of significant differences across the SE-quintiles (Mean PMR fd = 0.030; 95% CI = 0.010 0.049 p = 0.0008), no such differences in diarrhea mortality were observed (Mean PMR fd = 0.027; 95% CI = 0.014 0.040; p = 0.288). Analyses showed weaker associations between area-based SE-conditions and diarrhea mortality than that observed for malaria mortality. We conclude that all age urban malaria mortalities were more sensitive to changing area-based SE-conditions than diarrhea mortalities suggesting perhaps that social interventions were more effective in diarrhea control compared to malaria.

Original languageEnglish
Pages (from-to)6-16
Number of pages11
JournalInternational Journal of Tropical Medicine
Volume7
Issue number1
DOIs
Publication statusPublished - 2012
Externally publishedYes

Keywords

  • Accra
  • Area-based SES
  • Germany
  • Health inequalities
  • Proportional mortality ratio
  • SE-quintiles

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