Area disadvantage, individual socio-economic position, and premature cancer mortality in Australia 1998 to 2000: a multilevel analysis

Cancer Causes Control. 2008 Mar;19(2):183-93. doi: 10.1007/s10552-007-9084-7. Epub 2007 Nov 20.


Objective: To examine associations between area and individual socio-economic characteristics and premature cancer mortality using multilevel analysis.

Methods: We modeled cancer mortality among 25-64-year-old men and women (n = 16,340) between 1998 and 2000 in Australia. Socio-economic characteristics of Statistical Local Areas (n = 1,317) were measured using an Index of Relative Socio-economic Disadvantage (quintiles), and individual socio-economic position was measured by occupation (professionals, white and blue collar).

Results: After adjustment for within-area variation in age and occupation, the probability of premature cancer mortality was highest in the most disadvantaged areas for all-cancer mortality for men (RR 1.48 95% CI 1.35-1.63) and women (RR 1.30 95% CI 1.18-1.43) and for lung cancer mortality for men (1.91 95% CI 1.63-2.25) and women (1.51 95% CI 1.04-2.18). Men in blue collar occupations had a higher rate of cancer mortality (RR 1.57 95% CI 1.50-1.65) and lung cancer mortality (RR 2.31 95 % CI 2.09-2.56), whereas men in white collar occupations had a lower all-cancer mortality rate (RR 0.78 95% CI 0.72-0.85). Compared with professionals, women in white collar occupations had an all-cancer mortality rate that was lower (RR 0.85 95% CI 0.80-0.90). When deaths from breast cancer were excluded, women in blue collar occupations had a significantly higher all-cancer mortality rate than professionals (RR 1.12 95% CI 1.02-1.22).

Conclusions: Area disadvantage and individual socio-economic position were independently associated with premature cancer mortality, suggesting that interventions to reduce inequalities should focus on places and people.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Australia / epidemiology
  • Female
  • Healthcare Disparities*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Mortality
  • Neoplasms / mortality*
  • Occupations
  • Sex Factors
  • Social Class
  • Socioeconomic Factors*