Effect of the Financial Crisis on Socioeconomic Inequalities in Mortality in Small Areas in Seven Spanish Cities.
inequalities
mortality
small areas
socioeconomic factors
trends
urban areas
Journal
International journal of environmental research and public health
ISSN: 1660-4601
Titre abrégé: Int J Environ Res Public Health
Pays: Switzerland
ID NLM: 101238455
Informations de publication
Date de publication:
04 02 2020
04 02 2020
Historique:
received:
09
12
2019
revised:
23
01
2020
accepted:
30
01
2020
entrez:
9
2
2020
pubmed:
9
2
2020
medline:
28
8
2020
Statut:
epublish
Résumé
The aim of this study was to analyze the trend in socioeconomic inequalities in mortality in small areas due to several specific causes before (2001-2004, 2005-2008) and during (2009-2012) the economic crisis in seven Spanish cities. This ecological study of trends, with census tracts as the areas of analysis, was based on three periods. Several causes of death were studied. A socioeconomic deprivation index was calculated for each census tract. For each small area, we estimated standardized mortality ratios, and controlled for their variability using Bayesian models (sSMR). We also estimated the relative risk of mortality according to deprivation in the different cities, periods, and sexes. In general, a similar geographical pattern was found for the socioeconomic deprivation index and sSMR. For men, there was an association in all cities between the deprivation index and all-cause mortality that remained stable over the three periods. For women, there was an association in Barcelona, Granada, and Sevilla between the deprivation index and all-cause mortality in the third period. Patterns by causes of death were more heterogeneous. After the start of the financial crisis, socioeconomic inequalities in total mortality in small areas of Spanish cities remained stable in most cities, although several causes of death showed a different pattern.
Sections du résumé
BACKGROUND
The aim of this study was to analyze the trend in socioeconomic inequalities in mortality in small areas due to several specific causes before (2001-2004, 2005-2008) and during (2009-2012) the economic crisis in seven Spanish cities.
METHODS
This ecological study of trends, with census tracts as the areas of analysis, was based on three periods. Several causes of death were studied. A socioeconomic deprivation index was calculated for each census tract. For each small area, we estimated standardized mortality ratios, and controlled for their variability using Bayesian models (sSMR). We also estimated the relative risk of mortality according to deprivation in the different cities, periods, and sexes.
RESULTS
In general, a similar geographical pattern was found for the socioeconomic deprivation index and sSMR. For men, there was an association in all cities between the deprivation index and all-cause mortality that remained stable over the three periods. For women, there was an association in Barcelona, Granada, and Sevilla between the deprivation index and all-cause mortality in the third period. Patterns by causes of death were more heterogeneous.
CONCLUSIONS
After the start of the financial crisis, socioeconomic inequalities in total mortality in small areas of Spanish cities remained stable in most cities, although several causes of death showed a different pattern.
Identifiants
pubmed: 32033162
pii: ijerph17030958
doi: 10.3390/ijerph17030958
pmc: PMC7037194
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Déclaration de conflit d'intérêts
The authors declare no conflict of interest
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