CAUSES OF DEATH CONTRIBUTING TO URBAN SOCIOECONOMIC MORTALITY DIFFERENCES IN AMSTERDAM

Background. Socioeconomic mortality differences exist between parts of many cities. This study aims to identity causes of death associated w ith such mortality differences and which preventive or curative interv entions can modify. Methods. Associations were compared between socioe conomic status and age-standardized mortality by borough of Amsterdam, The Netherlands (n = 22) for causes of death grouped by feasible inte rventions. Results. In men, mortality due to external and ill-defined causes occurs more frequently in low-income boroughs. In women, this h olds for smoking-related and ill-defined causes. AIDS-related mortalit y is higher in boroughs with a high educational level. Mortality in lo w-income boroughs is generally higher for those causes of death which explain the relatively high urban mortality. Conclusions. Intervention s to decrease urban socioeconomic mortality differences should be targ eted on violence and accidents in men and smoking in women. Incomplete notification of deaths in low-income boroughs obscures some differenc es but also indicates problems in urban general practice and specific risks for immigrant residents. AIDS reduces the size or mortality diff erences among men, probably temporarily. Both feasibility and type of interventions are relevant for many urban areas.