Socioeconomic inequalities in mortality in Pamplona and Logroño (cities in the North of Spain) in the 1996-2007 period
Keywords:
Mortality. Socioeconomic factors. Small area analysis. MEDEAAbstract
Background. The objective of this study was to describe inequalities in mortality in the cities of Logroño and Pamplona, using a socioeconomic privation data by census tract.
Methods. Deaths were geocoded using the mailing address of the Death Statistics Bulletin and, in its absence, that of the Spanish Municipal Register or the Spanish Health Card were considered. The socioeconomic variables used to construct the deprivation index were obtained from the Spanish Population and Housing Census of 2001. Census tracts were grouped by socioeconomic deprivation quintiles. In each quintile, age-adjusted mortality rates were computed divided by sex and age group (0-64, ≥ 65).
Results. In both cities, higher mortality rates were observed in the geographical areas with higher socio-economic deprivation. This was particularly evident among men under 65 for whom a positive gradient between mortality and the deprivation index was observed. The areas with higher deprivation reached a relative risk (RR) of 1.61 (CI 95%, 1, 33-1, 92) and 1.77 (CI 95%, 1, 55-2 01) in Pamplona and Logroño respectively. Among women under 65, a RR of 1.44 (CI 95%, 1, 18-1, 74) and 1.48 (CI 95%, 1, 10-1, 95) were shown for the most depressed areas of Pamplona and Logroño respectively.
Conclusions. The study highlighted inequalities in mortality associated with socioeconomic deprivation in the cities of Logroño and Pamplona. Also shown was the utility of analysing socio-economic indicators and mortality by small areas in order to identify inequality in health.
Downloads
References
1. STRINGHINI S, SABIA S, SHIPLEY M, BRUNNER E, NABI H, KIVIMAKI M et al. Association of socioeconomic position with health behaviors and mortality. JAMA 2010; 303: 1159-1166.
https://doi.org/10.1001/jama.2010.297
2. HUMMER RA, ROGERS RG, EBERSTEIN IW. Sociodemographic differentials in adult mortality: a review of analytic approaches. Popul Dev Rev, 1998; 24: 553-578.
https://doi.org/10.2307/2808154
3. RUIZ-RAMOS M, SÁNCHEZ J, GARRUCHO G, VICIANA F. Desigualdades en mortalidad en la ciudad de Sevilla. Gac Sanit 2004; 18: 16-23.
https://doi.org/10.1016/S0213-9111(04)71994-9
4. MACKENBACH JP, STIRBU I, ROSKAM AJ, SCHAAP MM, MENVIELLE G, LEINSALU M et al. Socioeconomic inequalities in health in 22 European countries. N Engl J Med 2008; 358: 2468-881.
https://doi.org/10.1056/NEJMsa0707519
5. GALLO V, MACKENBACH JP, EZZATI M, MENVIELLE G, KUNST AE, ROHRMANN S et al. Social Inequalities and Mortality in Europe - Results from a Large Multi-National Cohort, 2012 PLoS ONE 7(7): e39013. doi:10.1371/journal.pone.0039013.
https://doi.org/10.1371/journal.pone.0039013
6. CARSTAIRS V. Small area analysis and health service research. Community Med 1981; 3: 131-139.
https://doi.org/10.1093/oxfordjournals.pubmed.a043414
7. CARSTAIRS V, MORRIS R. Deprivation and mortality: an alternative to social class? Community Med 1989; 11: 210-219.
https://doi.org/10.1093/oxfordjournals.pubmed.a042469
8. CARSTAIRS V, MORRIS R. Deprivation: explaining differences in mortality between Scotland and England and Wales. BMJ 1989; 299: 886-889.
https://doi.org/10.1136/bmj.299.6704.886
9. ESNAOLA S, ALDASORO E, RUIZ R, AUDICANA C, PÉREZ Y, CALVO M. Desigualdades socioeconómicas en la mortalidad en la Comunidad Autónoma del País Vasco. Gac Sanit 2006; 20: 16-24.
https://doi.org/10.1157/13084123
10. MACINTYRE S, ELLAWAY A. Neighborhoods and Health: An Overview. En: Kawachi BL, Oxford I. (Eds), University Press, Oxford, 2003: 20-42.
https://doi.org/10.1093/acprof:oso/9780195138382.003.0002
11. MACINTYRE S, ELLAWAY A, CUMMINS S. Place effects on health: how can we conceptualise, operationalise and measure them? Soc Sci Med 2002; 55: 125-139.
https://doi.org/10.1016/S0277-9536(01)00214-3
12. KJELLSTROM, T. Our cities, our health, our future. WHO Commission on socialdeterminants of health from the knowledge network on urban settings acting on social determinants for health equity in urban settings, Kobe (Japan), 2008.
https://doi.org/10.1177/0956247808096128
13. BORRELL C, MARÍ-DELL'OLMO M, SERRAL G, MARTÍNEZ-BENEITO M, GOTSENS M, MEDEA Members: Inequalities in mortality in small areas of eleven Spanish cities (the multicenter MEDEA project). Health Place 2010; 16:703-711.
https://doi.org/10.1016/j.healthplace.2010.03.002
14. DOMÍNGUEZ-BERJÓN MF, BORRELL C, CANO-SERRAL G, ESNAOLA S, NOLASCO A, PASARÍN MA et al. Construcción de un índice de privación a partir de datos censales en grandes ciudades españolas (Proyecto MEDEA). Gac Sanit 2008; 22: 179-187.
https://doi.org/10.1157/13123961
15. CHIANG CL. The life table and its applications. Malabar: Robert E. Krieger; 1984.
16. BESAG J, YORK J, MOLLIE A: Bayesian image restoration, with two applications in spatial statistics. Ann Inst Statist Math 1991, 43: 59.
https://doi.org/10.1007/BF00116466
17. CASI CASANELLAS A, MORENO IRIBAS C. Desigualdad ante la muerte: Estudio comparativo entre comunidades de Navarra en el segmento de población de 25 a 74 años. Aten Primaria 1992; 10: 543-548.
18. UGARTE MD, ARTIEDA L, IBAÑEZ B, MILITINO AF, LEZAUN M, LOPEZ-SAGASETA M, MORENO-IRIBAS C. A cohort study to estimate occupational mortality risks in Navarra. Eur J Public Health 2005; 5: 305-312.
https://doi.org/10.1093/eurpub/cki083
19. Population statistics at regional level - Statistics Explained (2013/1/4) Disponible en: http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Population_statistics_at_regional_level
Published
How to Cite
Issue
Section
License
Copyright (c) 2013 Anales del Sistema Sanitario de Navarra

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
La revista Anales del Sistema Sanitario de Navarra es publicada por el Departamento de Salud del Gobierno de Navarra (España), quien conserva los derechos patrimoniales (copyright ) sobre el artículo publicado y favorece y permite la difusión del mismo bajo licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (CC BY-SA 4.0). Esta licencia permite copiar, usar, difundir, transmitir y exponer públicamente el artículo, siempre que siempre que se cite la autoría y la publicación inicial en Anales del Sistema Sanitario de Navarra, y se distinga la existencia de esta licencia de uso.


