1
|
Zelenina A, Shalnova S, Maksimov S, Drapkina O. Classification of Deprivation Indices That Applied to Detect Health Inequality: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10063. [PMID: 36011694 PMCID: PMC9408665 DOI: 10.3390/ijerph191610063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Many studies around the world are undertaken to establish the association between deprivation and public health indicators. Both separate indicators (e.g., income, education, occupation, public security and social support) and complex models (indices) include several indicators. Deprivation indices are actively used in public health since the mid 1980s. There is currently no clear classification of indices. METHODS In the current review, data related to deprivation indices are combined and analyzed in order to create a taxonomy of indices based on the results obtained. The search was carried out using two bibliographic databases. After conducting a full-text review of the articles and searching and adding relevant articles from the bibliography, and articles that were already known to the authors, sixty studies describing the use of sixty deprivation indices in seventeen countries were included in the narrative synthesis, resulting in development of a taxonomy of indices. When creating the taxonomy, an integrative approach was used that allows integrating new classes and sub-classes in the event that new information appears. RESULTS In the review, 68% (41/60) of indices were classified as socio-economic, 7% (4/60) of indices as material deprivation, 5% (3/60) of indices as environmental deprivation and 20% (12/60) as multidimensional indices. CONCLUSIONS The data stimulates the use of a competent approach, and will help researchers and public health specialist in resolving conflicts or inconsistencies that arise during the construction and use of indices.
Collapse
Affiliation(s)
- Anastasia Zelenina
- National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Petroverigskiy per. 10, 101990 Moscow, Russia
| | | | | | | |
Collapse
|
2
|
Navas Martín MÁ. [Influence of social inequalities in health on the mortality of the rural and urban population in Spain, 2007-2013]. Semergen 2020; 46:331-338. [PMID: 31889661 DOI: 10.1016/j.semerg.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/24/2019] [Accepted: 10/30/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Describe patterns of cause of death by gender, age and territory. The causes of mortality and their possible relationships with health inequalities in the rural and urban population in Spain. MATERIAL AND METHODS An ecological study of the mortality data of the Spanish population between 2007 and 2013 was carried out. Mortality data were obtained from the National Statistics Institute (INE). To be able to present the data in the grouped and simplified form, the ICD-10 classification detected by the INE was coded with the classification of Disease Load defined by Murray and López (1996), reduced to 21 categories of diseases. The territory variable has been determined: rural / urban, taking as a reference the cut that establishes that populations over 10,000 inhabitants are urban environments and those that are below rural environments. The chi-square test and the Bonferroni-corrected z test for qualitative factors and the Student's t-test for quantitative factors were considered. RESULTS The results showed than the main causes of death were cardiovascular diseases with 31% (844,010) and malignant tumors with 26.7% (724,889), neuropsychiatric with 8.8% (238,330) and respiratory with 8.7% (235,448). In the rural setting, for the male gender, 52.7% (366,053) died, while 51.3% (995,470) died in the urban environment. Regarding the female gender, the cases of deaths were 47.3% (329,063) in the rural environment and 48.7% (9545.188) in the urban. Related to age, the means of the ages associated with a later death were nutritional conditions with 85.62 years. As for the earliest ages, obviating those related to the deaths of newborns, were the congenital anomalies with 25.37 years of means. CONCLUSIONS Mortality differences were found between the 3axes of social inequality in health-age, gender and territory. Therefore, we can say that social determinants condition our life expectancy.
Collapse
Affiliation(s)
- M Á Navas Martín
- Grado en Sociología y Máster en Comunicación y Educación en la Red, Instituto de Salud Carlos III, Madrid, España.
| |
Collapse
|
3
|
Tornero Patricio S, Charris-Castro L, Granero Asencio M, Daponte Codina A. Influence of postcode on paediatric admissions in Seville. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.anpede.2016.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
4
|
Tornero Patricio S, Charris-Castro L, Granero Asencio M, Daponte Codina A. [Influence of postcode on paediatric admissions in Seville]. An Pediatr (Barc) 2017; 87:320-329. [PMID: 28063821 DOI: 10.1016/j.anpedi.2016.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/23/2016] [Accepted: 12/01/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The postcode (where the home is situated) is an indicator of socioeconomic status and is associated with morbidity, mortality, and the use of health services. The aim of this study was to analyse its effects on paediatric admissions and to determine the rates of the most common causes of paediatric admissions in Seville. MATHERIAL AND METHODS An observational cross-sectional study with two analysis units: under 15 year-old "admissions" in public hospitals in Seville (n=2,660) and "city districts" of Seville (n=11). The independent variable analysed was whether the postcode of the admitted patients was within a Regional Government designated "area with social transformation needs". The analysis of the admissions was performed using X2-test, Fisher test and Student-t test, with the description of rates using the calculation of crude and specific rates, and by rate ratio. RESULTS Children living in districts with a lower socioeconomic status were on average 7 months younger (P<.001), and they were significantly more likely to be admitted via the emergency department (P<.001). There was no statistical difference detected in either the length of hospital stay or mortality. The crude admission rate ratio was higher in districts with a lower socioeconomic status (1.8), with a higher specific rate ratio detected in admissions due to asthma, respiratory infections, inguinal hernia, and epilepsy/convulsions. CONCLUSIONS Paediatric hospital admission rates of the main diagnoses were higher in districts with a lower socioeconomic status. Children living in these districts were more likely to be admitted younger and via the emergency department.
Collapse
Affiliation(s)
- Sebastián Tornero Patricio
- Pediatría Atención Primaria, Distrito Sevilla de Atención Primaria, Servicio Andaluz de Salud, Sevilla, España.
| | - Liliana Charris-Castro
- Unidad de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Servicio Andaluz de Salud, Sevilla, España
| | - Mercedes Granero Asencio
- Unidad de Neonatología, Hospital Universitario Virgen Macarena, Servicio Andaluz de Salud, Sevilla, España
| | - Antonio Daponte Codina
- Ciber de Epidemiología y Salud Pública (CIBERESP), Observatorio de Salud y Medio Ambiente de Andalucía (OSMAN), Escuela Andaluza de Salud Pública, Campus Universitario de la Cartuja, Granada, España
| |
Collapse
|
5
|
Marí-Dell’Olmo M, Gotsens M, Palència L, Rodríguez-Sanz M, Martinez-Beneito MA, Ballesta M, Calvo M, Cirera L, Daponte A, Domínguez-Berjón F, Gandarillas A, Goñi NI, Martos C, Moreno-Iribas C, Nolasco A, Salmerón D, Taracido M, Borrell C. Trends in socioeconomic inequalities in mortality in small areas of 33 Spanish cities. BMC Public Health 2016; 16:663. [PMID: 27473140 PMCID: PMC4966571 DOI: 10.1186/s12889-016-3190-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 06/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Spain, several ecological studies have analyzed trends in socioeconomic inequalities in mortality from all causes in urban areas over time. However, the results of these studies are quite heterogeneous finding, in general, that inequalities decreased, or remained stable. Therefore, the objectives of this study are: (1) to identify trends in geographical inequalities in all-cause mortality in the census tracts of 33 Spanish cities between the two periods 1996-1998 and 2005-2007; (2) to analyse trends in the relationship between these geographical inequalities and socioeconomic deprivation; and (3) to obtain an overall measure which summarises the relationship found in each one of the cities and to analyse its variation over time. METHODS Ecological study of trends with 2 cross-sectional cuts, corresponding to two periods of analysis: 1996-1998 and 2005-2007. Units of analysis were census tracts of the 33 Spanish cities. A deprivation index calculated for each census tracts in all cities was included as a covariate. A Bayesian hierarchical model was used to estimate smoothed Standardized Mortality Ratios (sSMR) by each census tract and period. The geographical distribution of these sSMR was represented using maps of septiles. In addition, two different Bayesian hierarchical models were used to measure the association between all-cause mortality and the deprivation index in each city and period, and by sex: (1) including the association as a fixed effect for each city; (2) including the association as random effects. In both models the data spatial structure can be controlled within each city. The association in each city was measured using relative risks (RR) and their 95 % credible intervals (95 % CI). RESULTS For most cities and in both sexes, mortality rates decline over time. For women, the mortality and deprivation patterns are similar in the first period, while in the second they are different for most cities. For men, RRs remain stable over time in 29 cities, in 3 diminish and in 1 increase. For women, in 30 cities, a non-significant change over time in RR is observed. However, in 4 cities RR diminishes. In overall terms, inequalities decrease (with a probability of 0.9) in both men (RR = 1.13, 95 % CI = 1.12-1.15 in the 1st period; RR = 1.11, 95 % CI = 1.09-1.13 in the 2nd period) and women (RR = 1.07, 95 % CI = 1.05-1.08 in the 1st period; RR = 1.04, 95 % CI = 1.02-1.06 in the 2nd period). CONCLUSIONS In the future, it is important to conduct further trend studies, allowing to monitoring trends in socioeconomic inequalities in mortality and to identify (among other things) temporal factors that may influence these inequalities.
Collapse
Affiliation(s)
- Marc Marí-Dell’Olmo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023 Barcelona, Spain
- Institut d’Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
- Universitat Rovira i Virgili, Tarragona, Spain
| | - Mercè Gotsens
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023 Barcelona, Spain
- Institut d’Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Laia Palència
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023 Barcelona, Spain
- Institut d’Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Maica Rodríguez-Sanz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023 Barcelona, Spain
- Institut d’Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Miguel A. Martinez-Beneito
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Fundación para el fomento de la investigación sanitaria y biomédica de la Comunidad Valenciana (FISABIO), Valencia, Spain
| | - Mónica Ballesta
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Montse Calvo
- Estudios e investigación Sanitaria, Departamento de Sanidad y Consumo, Gobierno Vasco, Vitoria-Gasteiz, Spain
| | - Lluís Cirera
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Antonio Daponte
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Observatorio de Salud y Medio Ambiente de Andalucía (OSMAN), Escuela Andaluza de Salud Pública (EASP), Granada, Spain
| | | | - Ana Gandarillas
- Subdirección de Promoción de la Salud y Prevención, Consejería de Sanidad, Comunidad de Madrid, Spain
| | - Natividad Izco Goñi
- Registro de Mortalidad, Consejería de Salud y Servicios Sociales, La Rioja, Spain
| | - Carmen Martos
- Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
| | - Conchi Moreno-Iribas
- Instituto de Salud Pública de Navarra, Departamento de Salud, Gobierno de Navarra, Pamplona, Navarra Spain
| | - Andreu Nolasco
- Unidad de Investigación en Análisis de la Mortalidad y Estadísticas Sanitarias, Universidad de Alicante, San Vicente del Raspeig, Spain
| | - Diego Salmerón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Margarita Taracido
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Carme Borrell
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023 Barcelona, Spain
- Institut d’Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| |
Collapse
|
6
|
Salgado-Barreira Á, Estany-Gestal A, Figueiras A. [Effect of socioeconomic status on mortality in urban areas: a systematic critical review]. CAD SAUDE PUBLICA 2015; 30:1609-21. [PMID: 25210902 DOI: 10.1590/0102-311x00152513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 04/01/2014] [Indexed: 11/21/2022] Open
Abstract
Socioeconomic inequalities cause more disease and death than most risk factors, especially in cities. This systematic review of the scientific evidence included articles in English, Spanish, Portuguese, and Italian and excluded studies with low levels of evidence and those that did not analyze associations between mortality and socioeconomic status in urban settings. Articles were selected by two independent reviewers, and data extraction used evidence tables. A total of 1,509 records were obtained, and 24 were included. All the studies showed higher mortality rates in poorer areas. Six studies showed an association with cardiovascular diseases, four with lung diseases, and three with AIDS, infectious and parasitic diseases, and cirrhosis. The selected studies showed low consistency in the results and important methodological limitations that prevented comparisons between studies or the extraction of relevant conclusions.
Collapse
Affiliation(s)
| | - Ana Estany-Gestal
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, España
| | - Adolfo Figueiras
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, España
| |
Collapse
|
7
|
Gotsens M, Marí-Dell'Olmo M, Martínez-Beneito MÁ, Pérez K, Pasarín MI, Daponte A, Puigpinós-Riera R, Rodríguez-Sanz M, Audicana C, Nolasco A, Gandarillas A, Serral G, Domínguez-Berjón F, Martos C, Borrell C. Socio-economic inequalities in mortality due to injuries in small areas of ten cities in Spain (MEDEA Project). ACCIDENT; ANALYSIS AND PREVENTION 2011; 43:1802-1810. [PMID: 21658508 DOI: 10.1016/j.aap.2011.04.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 04/08/2011] [Accepted: 04/10/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To analyse socio-economic inequalities in mortality due to injuries among census tracts of ten Spanish cities by sex and age in the period 1996-2003. METHODS This is a cross-sectional ecological study where the units of analysis are census tracts. The study population consisted of people residing in the cities during the period 1996-2003. For each census tract we obtained an index of socio-economic deprivation, and estimated standardized mortality ratios using hierarchical Bayesian models which take into account the spatial structure of the data. RESULTS In the majority of the cities, the geographical pattern of total mortality from injuries is similar to that of the socio-economic deprivation index. There is an association between mortality due to injuries and the deprivation index in the majority of the cities which is more important among men and among those younger than 45 years. In these groups, traffic injuries and overdoses are the causes most often associated with deprivation in the cities. The percentage of excess mortality from injuries related to socio-economic deprivation is higher than 20% in the majority of the cities, the cause with the highest percentage being drug overdose. CONCLUSIONS In most cities, there are socio-economic inequalities in mortality due to overdose and traffic injuries. In contrast, few cities have found association between suicide mortality and deprivation. Finally, no association was found between deprivation and deaths due to falls. Inequalities are higher in men and those under 45 years of age. These results highlight the importance of intra-urban inequalities in mortality due to injuries.
Collapse
|
8
|
Desigualdades y mortalidad por cirrosis en varones (Zaragoza, 1996-2003). GACETA SANITARIA 2011; 25:139-45. [DOI: 10.1016/j.gaceta.2010.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Revised: 10/20/2010] [Accepted: 11/22/2010] [Indexed: 11/24/2022]
|
9
|
Puigpinós-Riera R, Marí-Dell'Olmo M, Gotsens M, Borrell C, Serral G, Ascaso C, Calvo M, Daponte A, Domínguez-Berjón FM, Esnaola S, Gandarillas A, López-Abente G, Martos CM, Martínez-Beneito MA, Montes-Martínez A, Montoya I, Nolasco A, Pasarín IM, Rodríguez-Sanz M, Sáez M, Sánchez-Villegas P. Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities. Int J Health Geogr 2011; 10:6. [PMID: 21232096 PMCID: PMC3033786 DOI: 10.1186/1476-072x-10-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 01/13/2011] [Indexed: 11/10/2022] Open
Abstract
Background Intra-urban inequalities in mortality have been infrequently analysed in European contexts. The aim of the present study was to analyse patterns of cancer mortality and their relationship with socioeconomic deprivation in small areas in 11 Spanish cities. Methods It is a cross-sectional ecological design using mortality data (years 1996-2003). Units of analysis were the census tracts. A deprivation index was calculated for each census tract. In order to control the variability in estimating the risk of dying we used Bayesian models. We present the RR of the census tract with the highest deprivation vs. the census tract with the lowest deprivation. Results In the case of men, socioeconomic inequalities are observed in total cancer mortality in all cities, except in Castellon, Cordoba and Vigo, while Barcelona (RR = 1.53 95%CI 1.42-1.67), Madrid (RR = 1.57 95%CI 1.49-1.65) and Seville (RR = 1.53 95%CI 1.36-1.74) present the greatest inequalities. In general Barcelona and Madrid, present inequalities for most types of cancer. Among women for total cancer mortality, inequalities have only been found in Barcelona and Zaragoza. The excess number of cancer deaths due to socioeconomic deprivation was 16,413 for men and 1,142 for women. Conclusion This study has analysed inequalities in cancer mortality in small areas of cities in Spain, not only relating this mortality with socioeconomic deprivation, but also calculating the excess mortality which may be attributed to such deprivation. This knowledge is particularly useful to determine which geographical areas in each city need intersectorial policies in order to promote a healthy environment.
Collapse
Affiliation(s)
- Rosa Puigpinós-Riera
- Servei de Sistemes d'Informació Sanitaria, Agència de Salut Pública de Barcelona, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Antònia Barceló M, Saez M, Cano-Serral G, Ángel Martínez-Beneito M, Miguel Martínez J, Borrell C, Ocaña-Riola R, Montoya I, Calvo M, López-Abente G, Rodríguez-Sanz M, Toro S, Tomás Alcalá J, Saurina C, Sánchez-Villegas P, Figueiras A. Métodos para la suavización de indicadores de mortalidad: aplicación al análisis de desigualdades en mortalidad en ciudades del Estado español (Proyecto MEDEA). GACETA SANITARIA 2008; 22:596-608. [DOI: 10.1016/s0213-9111(08)75362-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
Grau M, García-Altés A, Pasarín MI, Arribas P, Borrell C, Brugal T. [Utility of an information system for primary care]. Aten Primaria 2008; 40:167-73. [PMID: 18405580 DOI: 10.1157/13118058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To know the usefulness and applicability of an information system for basic health areas put into operation 16 years ago. DESIGN Descriptive study of selected indicators registered in 1994 and 2004. SETTING Basic health areas of Barcelona, Spain. PARTICIPANTS Population living in Barcelona, Spain, during 1994 and 2004. MEASUREMENTS The following indicators were described, and standardized taking the Barcelona 2004 population as reference: proportion of foreign population, proportion of unemployment, number of mothers less than 20 years old, AIDS incidence rate, tuberculosis incidence rate, and traffic accident, ischaemic disease, lung cancer (for men), breast cancer (for women), and total mortality rates. Results were presented for one basic health area, its corresponding district, and Barcelona. Moreover, users of the information system were interviewed about their level of knowledge, and the adequacy, usefulness, and limitations of the system. RESULTS Disaggregated annual information allows comparing indicators between different fields and years. The information system was found useful to users to describe the level of health of the community and to design preventive interventions. CONCLUSIONS Although some of the indicators did not show the desired level of accuracy, the information system for basic health areas showed to be useful to know the level of health of the population assigned to primary healthcare teams.
Collapse
Affiliation(s)
- María Grau
- Servei de Sistemes d'Informació Sanitària, Agència de Salut Pública de Barcelona, Barcelona, España
| | | | | | | | | | | |
Collapse
|
12
|
Ruiz-Ramos M, Escolar Pujolar A, Sánchez Perea J, Garrucho Rivero G. Evolución de las desigualdades sociales en la mortalidad general de la ciudad de Sevilla (1994-2002). GACETA SANITARIA 2006; 20:303-10. [PMID: 16942718 DOI: 10.1157/13091146] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To know trends of social inequalities in general mortality in Seville (Spain) between 1997 and 2002. MATERIAL AND METHOD Socioeconomic level of its the residential census tracts was assigned for each death, taken from the Socio-economic Synthetic Index built up after applying a principal components analysis from 2001 census variables. Using mortality indicators its magnitude and trend was described according socio-economic level. RESULTS General mortality standardized rates by age in the census tracts of lowest socio-economic level were 1.32 and 1.25 times greater than in the highest census tracts in men and 1.19 and 1.08 in women respectively in each periods. The truncated rates ratio and potential years of lost life in men went from 1.66 to 2.28 in men and 1.74 to 2.10 in women, respectively. The four years difference in life expectancy at birth between the census tracts of highest and lower level remained unchanged in men, and fell from 1.90 to 0.82 in women. The population attributable risk (all ages) went from 13.18% to 10.46% in men and 10.02% to 2.58% in women. CONCLUSIONS Social inequalities in mortality for the general population decreased mainly in women. The inequalities increased in the early death and between 35-64 years old in men, basically due to a reduced mortality in higher socio-economic level census tracts.
Collapse
|
13
|
Domínguez-Berjón MF, Borrell C. Mortalidad y privación socioeconómica en las secciones censales y los distritos de Barcelona. GACETA SANITARIA 2005; 19:363-9. [PMID: 16242094 DOI: 10.1157/13080134] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To analyze the association between socioeconomic deprivation and mortality in the census tracts of Barcelona and the distinct patterns of this association in the districts. METHODS We performed an ecological, cross sectional study based on the 1,812 census tracts and the 10 districts of Barcelona, using socioeconomic variables obtained from the 1991 census and mortality data for 1987-1995. A deprivation index was created through component analysis. Descriptive analyses were performed and multivariate Poisson regression models were adjusted. RESULTS The greater the socioeconomic deprivation in the census tracts, the higher the mortality. The quartile with the greatest deprivation had a relative risk (RR) of mortality of 1.24 (95% confidence interval [CI], 1.22-1.27) in males and an RR of 1.05 (95% CI, 1.02-1.07) in females (compared with the quartile of census tracts with the lowest deprivation). This association varied according to district: in the old inner-city district (district 1), which had the highest mortality and the greatest deprivation, the RR was 1.57 (95% CI, 1.21-2.05) for males, while in district 8, which also has considerable deprivation, mortality was lower. CONCLUSIONS Analysis of socioeconomic inequalities in mortality in census tracts in an urban area highlights special areas of risk not observed in analysis of districts.
Collapse
|
14
|
|