Trends in mortality inequalities in an urban area: the influence of immigration.
Adult
Cross-Sectional Studies
Emigrants and Immigrants
/ statistics & numerical data
Emigration and Immigration
/ statistics & numerical data
Female
Health Status Disparities
Humans
Male
Middle Aged
Mortality
/ trends
Mortality, Premature
/ trends
Residence Characteristics
/ statistics & numerical data
Socioeconomic Factors
Spain
/ epidemiology
Urban Population
/ statistics & numerical data
Epidemiology
Health equity
Journal
International journal for equity in health
ISSN: 1475-9276
Titre abrégé: Int J Equity Health
Pays: England
ID NLM: 101147692
Informations de publication
Date de publication:
26 02 2019
26 02 2019
Historique:
received:
23
10
2018
accepted:
14
02
2019
entrez:
28
2
2019
pubmed:
28
2
2019
medline:
25
7
2019
Statut:
epublish
Résumé
Nearly 20% of the population in Barcelona is foreign-born and this percentage rises to up to 40% in some neighborhoods. Consequently, migration health patterns may play an important role in trends in socioeconomic geographical inequalities in mortality. The objective of this study was to analyze the trend in socioeconomic inequalities in mortality between neighborhoods in Barcelona during the period 2001-2012 in the foreign-born and Spanish-born population. Repeated cross-sectional design of the population aged 25-64 years in Barcelona between 2001 and 2012. Hierarchical data consisted of yearly mortality linked-population. The variables analyzed were age, sex, education, and country of birth (Spanish-born, foreign-born), neighborhood of residence, and the socioeconomic level of the neighborhoods using quartiles of unemployment rates. Age-standardized mortality rates were estimated, and mixed Poisson regressions were applied using generalized linear mixed models, including two random effects to consider the intracorrelation within neighborhoods and across years. The number of foreign-born residents aged 25-64 increased notably in disadvantaged neighborhoods. Approximately 9% of premature deaths occurred in foreign-born individuals. Premature mortality rates were higher in disadvantaged neighborhoods and in the Spanish-born population in all periods. Despite the stabilized socioeconomic inequalities in mortality in the Spanish-born population, no inequalities were found between neighborhoods in foreign-born men and women. Evidence of the 'healthy migrant' effect in mortality and socioeconomic inequalities in mortality was found in Barcelona, which seems to alter the distribution of mortality through time and space, related to the low levels of premature mortality and the selective residence of immigrants in socioeconomically disadvantaged neighborhoods.
Sections du résumé
BACKGROUND
Nearly 20% of the population in Barcelona is foreign-born and this percentage rises to up to 40% in some neighborhoods. Consequently, migration health patterns may play an important role in trends in socioeconomic geographical inequalities in mortality. The objective of this study was to analyze the trend in socioeconomic inequalities in mortality between neighborhoods in Barcelona during the period 2001-2012 in the foreign-born and Spanish-born population.
METHODS
Repeated cross-sectional design of the population aged 25-64 years in Barcelona between 2001 and 2012. Hierarchical data consisted of yearly mortality linked-population. The variables analyzed were age, sex, education, and country of birth (Spanish-born, foreign-born), neighborhood of residence, and the socioeconomic level of the neighborhoods using quartiles of unemployment rates. Age-standardized mortality rates were estimated, and mixed Poisson regressions were applied using generalized linear mixed models, including two random effects to consider the intracorrelation within neighborhoods and across years.
RESULTS
The number of foreign-born residents aged 25-64 increased notably in disadvantaged neighborhoods. Approximately 9% of premature deaths occurred in foreign-born individuals. Premature mortality rates were higher in disadvantaged neighborhoods and in the Spanish-born population in all periods. Despite the stabilized socioeconomic inequalities in mortality in the Spanish-born population, no inequalities were found between neighborhoods in foreign-born men and women.
CONCLUSIONS
Evidence of the 'healthy migrant' effect in mortality and socioeconomic inequalities in mortality was found in Barcelona, which seems to alter the distribution of mortality through time and space, related to the low levels of premature mortality and the selective residence of immigrants in socioeconomically disadvantaged neighborhoods.
Identifiants
pubmed: 30808362
doi: 10.1186/s12939-019-0939-9
pii: 10.1186/s12939-019-0939-9
pmc: PMC6390301
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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