Forgotten Inequality: Social Disparities in Mortality Associated with Neurodegeneration, a Population-Based Study in Belgium

Neurodegenerative diseases (NDDs), including dementias, parkinsonism, and motor neuron diseases, pose a mounting public health challenge. This study delves into the socioeconomic intricacies of NDD mortality in Belgium, a nation significantly impacted by these disorders. While existing evidence indicates a negative correlation between socioeconomic position (SEP) and general mortality, the specific link between SEP and NDD mortality is less explored. Investigating social determinants in NDDs is crucial for targeted preventive interventions. This research aims to provide a comprehensive framework elucidating the interplay between SEP and mortality associated with major NDDs in Belgium over time and across multiple levels, also considering the influence of registration practices. Quantitative analyses will assess the relationship between SEP – more specifically education, income, and occupation – and NDD deaths, utilizing record linkage between the 1981/1991/2001/2011/2021 censuses and mortality data from 1981-2022. Additionally, a multilevel analysis will explore the interplay between individual- and aggregated -level SEP (measured through neighbourhood deprivation), and air pollution in relation to NDD mortality. The qualitative analysis will focus on the mechanisms behind these relations through in-depth interviews with medical experts, fostering a comprehensive understanding of the multifaceted dynamics surrounding NDD mortality in Belgium.