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Ochoa Sangrador C, Garmendia Leiza JR, Pérez Boillos MJ, Pastrana Ara F, Lorenzo Lobato MDP, Andrés de Llano JM. [Impact of COVID-19 on mortality in the autonomous community of Castilla y León (Spain)]. GACETA SANITARIA 2021; 35:459-464. [PMID: 32446595 PMCID: PMC7198174 DOI: 10.1016/j.gaceta.2020.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/27/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To estimate the increase in mortality associated with the SARS-CoV-2 coronavirus pandemic in the autonomous community of Castilla y León (Spain). METHOD Ecological study based on population and death data for the months of March 2016 to 2020 in Castilla y León. The general and provincial standardized rates, the relative risks of the year 2020 with respect to previous years and the risks adjusted by sex, periods and province, using Poisson regression, were calculated. Trend analysis was performed using joinpoint linear regression. RESULTS An increase in mortality was observed in March 2020 with respect to previous years, with an increase of 39% for men (relative risk [RR]: 1.39; 95% confidence interval [95%CI]: 1.32-1.47) and 28% for women (RR: 1.28; 95%CI: 1.21-1.35). The model predicts excess mortality of 775 deaths. In the trend analysis there is a significant turning point in 2019 in men, globally and for almost all provinces. The increase in mortality is general, although heterogeneous by sex, age group and province. CONCLUSIONS Although the observed increase in mortality cannot be totally attributed to the disease, it is the best estimate we have of the real impact on deaths directly or indirectly related to it. The number of declared deaths only reaches two thirds of the increase in mortality observed.
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Affiliation(s)
- Carlos Ochoa Sangrador
- Servicio de Pediatría, Oficina de Apoyo a la Investigación Clínico-Epidemiológica, Complejo Asistencial de Zamora, Zamora, España.
| | - José Ramón Garmendia Leiza
- Dirección General de Sistema de Información, Calidad y Prestación Farmacéutica, Gerencia Regional de Salud de Castilla y León, Sacyl, Valladolid, España
| | | | - Fernando Pastrana Ara
- Dirección General de Sistema de Información, Calidad y Prestación Farmacéutica, Gerencia Regional de Salud de Castilla y León, Sacyl, Valladolid, España
| | - María Del Pilar Lorenzo Lobato
- Dirección General de Sistema de Información, Calidad y Prestación Farmacéutica, Gerencia Regional de Salud de Castilla y León, Sacyl, Valladolid, España
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Cirera L, Ballesta M, Márquez-Calderón S, Chirlaque MD, Saez M, Salmerón D. Partial contributions and temporal trends of leading causes of death during the last four decades in Spain. Public Health 2020; 189:81-90. [PMID: 33188998 DOI: 10.1016/j.puhe.2020.08.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/18/2020] [Accepted: 08/23/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The study was conducted to assess time trend shifts of leading causes of death and their partial contributions over the years 1975-2016 in Spain. STUDY DESIGN A longitudinal ecological epidemiologic design was conducted to analyse linear trend period shifts using joinpoint regression as the annual percentage of change (APC) in the period 1975-2016. The partial contributions were illustrated as the rate ratio of a singular-cause to their major-cause shift periods. RESULTS HIV/AIDS shaped the increasing trend period of infectious diseases in 1989-1995 (APC = 25.3, P < 0.05) and the decreasing trend in 1995-1999 and 1999-2016. Lung cancer fell gradually from 1994 in men (-0.4, P < 0.05); however, in women, the condition continued increasing from 1990 (P < 0.05). Dementia types influenced mental and neurological disease drifts. The recent trend for circulatory periods (1980-2016) was mainly modulated by cardiac ischaemia, with increased partial contributions (25%, 32% and 30%). Traffic accidents defined the descending tendency of external causes. CONCLUSIONS Spain showed a Western pattern in descended rates, including non-decreasing trends in mental and neurological diseases, pancreatic cancer, drug abuse and suicide. Trend shifts and partial contributions illustrated targets for further mortality reduction.
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Affiliation(s)
- L Cirera
- Department of Epidemiology, Regional Health Council of Murcia, Ronda de Levante, 11, 30011, Murcia, Spain; IMIB-Arrixaca, Murcia, Spain; Department of Health & Social Sciences, Murcia University, Campus de Espinardo, 30100, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - M Ballesta
- Department of Epidemiology, Regional Health Council of Murcia, Ronda de Levante, 11, 30011, Murcia, Spain; IMIB-Arrixaca, Murcia, Spain; Department of Health & Social Sciences, Murcia University, Campus de Espinardo, 30100, Murcia, Spain.
| | - S Márquez-Calderón
- Andalusian Ministry of Heatlh - Institute of Statistics and Cartography of Andalusia, Calle Leonardo da Vinci, 21, 41092, Seville, Spain.
| | - M-D Chirlaque
- Department of Epidemiology, Regional Health Council of Murcia, Ronda de Levante, 11, 30011, Murcia, Spain; IMIB-Arrixaca, Murcia, Spain; Department of Health & Social Sciences, Murcia University, Campus de Espinardo, 30100, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - M Saez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Carrer Universitat de Girona, 10, 17071, Girona, Spain; Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain.
| | - D Salmerón
- IMIB-Arrixaca, Murcia, Spain; Department of Health & Social Sciences, Murcia University, Campus de Espinardo, 30100, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Pereyra-Zamora P, Copete JM, Oliva-Arocas A, Caballero P, Moncho J, Vergara-Hernández C, Nolasco A. Changes in Socioeconomic Inequalities in Amenable Mortality after the Economic Crisis in Cities of the Spanish Mediterranean Coast. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186489. [PMID: 32899994 PMCID: PMC7559182 DOI: 10.3390/ijerph17186489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022]
Abstract
Several studies have described a decreasing trend in amenable mortality, as well as the existence of socioeconomic inequalities that affect it. However, their evolution, particularly in small urban areas, has largely been overlooked. The aim of this study is to analyse the socioeconomic inequalities in amenable mortality in three cities of the Valencian Community, namely, Alicante, Castellon, and Valencia, as well as their evolution before and after the start of the economic crisis (2000–2007 and 2008–2015). The units of analysis have been the census tracts and a deprivation index has been calculated to classify them according to their level of socioeconomic deprivation. Deaths and population were also grouped by sex, age group, period, and five levels of deprivation. The specific rates by sex, age group, deprivation level, and period were calculated for the total number of deaths due to all causes and amenable mortality and Poisson regression models were adjusted in order to estimate the relative risk. This study confirms that the inequalities between areas of greater and lesser deprivation in both all-cause mortality and amenable mortality persisted along the two study periods in the three cities. It also shows that these inequalities appear with greater risk of death in the areas of greatest deprivation, although not uniformly. In general, the risks of death from all causes and amenable mortality have decreased significantly from one period to the other, although not in all the groups studied. The evolution of death risks from before the onset of the crisis to the period after presented, overall, a general pro-cyclical trend. However, there are population subgroups for which the trend was counter-cyclical. The use of the deprivation index has made it possible to identify specific geographical areas with vulnerable populations in all three cities and, at the same time, to identify the change in the level of deprivation (ascending or descending) of the geographical areas throughout the two periods. It is precisely these areas where more attention is needed in order to reduce inequalities.
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Affiliation(s)
- Pamela Pereyra-Zamora
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (J.M.C.); (A.O.-A.); (P.C.); (J.M.); (A.N.)
- Correspondence:
| | - José M. Copete
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (J.M.C.); (A.O.-A.); (P.C.); (J.M.); (A.N.)
| | - Adriana Oliva-Arocas
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (J.M.C.); (A.O.-A.); (P.C.); (J.M.); (A.N.)
| | - Pablo Caballero
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (J.M.C.); (A.O.-A.); (P.C.); (J.M.); (A.N.)
| | - Joaquín Moncho
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (J.M.C.); (A.O.-A.); (P.C.); (J.M.); (A.N.)
| | - Carlos Vergara-Hernández
- Área de Desigualdades en Salud, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46035 Valencia, Spain;
| | - Andreu Nolasco
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (J.M.C.); (A.O.-A.); (P.C.); (J.M.); (A.N.)
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