Enigmatic geographical differences: A study of contextual determinants of health inequalities in Norway

In current international public health research, prominent themes are the significance of area-level income inequality and contextual influences (ie, place effects) on population health. The starting point for the project is previous findings indicating c onsiderably higher mortality in the Metropolitan Oslo region, compared to the large, contiguous Rural West/Mid-Norway area, after adjustments for a series of individual-level mortality predictors. The mortality differential was particularly clear as regar ds lower social strata. The mortality differential corresponds to differences in income inequality between these two large regions, but whether this association is causal or spurious is not evident. This project will analyse various aspects of these two g eographical areas which constitute the opposite ends of the variation within the Norwegian setting both as to levels of mortality and income inequality. The project will utilise existing health surveys, surveys of level of living, and administrative data on the municipal level. The project will seek to explore whether life styles, working conditions, social participation, social investments, and mobility patterns etc. can be considered as causal factors for the mortality differences. On the theoretical si de, the project will discuss the meaning of the concept of place in health inequality research, and furthermore explore the distinctions between area-level and individual-level determinants.