Moving beyond the residential neighbourhood to explore social inequalities in exposure to area-level disadvantage: Results from the Interdisciplinary Study on Inequalities in Smoking
Article [Accepted Manuscript]
Abstract(s)
The focus, in place and health research, on a single, residential, context overlooks the fact that
individuals are mobile and experience other settings in the course of their daily activities. Socioeconomic
characteristics are associated with activity patterns, as well as with the quality of places
where certain groups conduct activities, i.e. their non-residential activity space. Examining how
measures of exposure to resources, and inequalities thereof, compare between residential and nonresidential
contexts is required. Baseline data from 1,890 young adults (18 to 25 years-old)
participating in the Interdisciplinary Study of Inequalities in Smoking, Montreal, Canada (2011-
2012), were analyzed. Socio-demographic and activity location data were collected using a
validated, self-administered questionnaire. Area-level material deprivation was measured within
500-meter road-network buffer zones around participants’ residential and activity locations.
Deprivation scores in the residential area and non-residential activity space were compared
between social groups. Multivariate linear regression was used to estimate associations between
individual- and area-level characteristics and non-residential activity space deprivation, and to
explore whether these characteristics attenuated the education-deprivation association. Participants
in low educational categories lived and conducted activities in more disadvantaged areas than
university students/graduates. Educational inequalities in exposure to area-level deprivation were
larger in the non-residential activity space than in the residential area for the least educated, but
smaller for the intermediate group. Adjusting for selected covariates such as transportation
resources and residential deprivation did not significantly attenuate the education-deprivation
associations. Results support the existence of social isolation in residential areas and activity
locations, whereby less educated individuals tend to be confined to more disadvantaged areas than
their more educated counterparts. They also highlight the relevance of investigating both residential
and non-residential contexts when studying inequalities in health-relevant exposures.
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