Socioeconomic inequalities in chronic liver diseases and cirrhosis mortality in european urban areas before and after the onset of the 2008 economic recession
Borrell i Thió, Carme (Institut d'Investigació Biomèdica Sant Pau)
Palència, Laia (Institut d'Investigació Biomèdica Sant Pau)
Bosakova, L. (Olomouc University Social Health Institute (OUSHI). Palacky University in Olomouc)
Gotsens, Mercè (Institut d'Investigació Biomèdica Sant Pau)
Morrison, J. (Institute of Health Equity at the Research Department of Epidemiology and Public Health. University College London)
Costa, C. (Centre of Studies in Geography and Spatial Planning (CEGOT). University of Coimbra)
Dzurova, Dagmar (Faculty of Science. Charles University)
Deboosere, P. (Department of Sociology. Interface Demography. Vrije Universiteit Brussel)
Lustigova, Michala (Faculty of Science. Charles University)
Marí-Dell'Olmo, Marc 1978- (Institut d'Investigació Biomèdica Sant Pau)
Rodopoulou, S. (Department of Hygiene. Epidemiology and Medical Statistics. Medical School. National and Kapodistrian University of Athens)
Santana, Paula (Department of Geography and Tourism. University of Coimbra)

Date:	2021
Abstract:	Objective: To analyse the trends in chronic liver diseases and cirrhosis mortality, and the associated socioeconomic inequalities, in nine European cities and urban areas before and after the onset of the 2008 financial crisis. Methods: This is an ecological study of trends in three periods of time: two before (2000-2003 and 2004-2008), and one after (2009-2014) the onset of the economic crisis. The units of analysis were the geographical areas of nine cities or urban areas in Europe. We analysed chronic liver diseases and cirrhosis standardised mortality ratios, smoothing them with a hierarchical Bayesian model by each city, area, and sex. An ecological regression model was fitted to analyse the trends in socioeconomic inequalities, and included the socioeconomic deprivation index, the period, and their interaction. Results: In general, chronic liver diseases and cirrhosis mortality rates were higher in men than in women. These rates decreased in all cities during the financial crisis, except among men in Athens (rates increased from 8. 50 per 100,000 inhabitants during the second period to 9. 42 during the third). Socioeconomic inequalities in chronic liver diseases and cirrhosis mortality were found in six cities/metropolitan areas among men, and in four among women. Finally, in the periods studied, such inequalities did not significantly change. However, among men they increased in Turin and Barcelona and among women, several cities had lower inequalities in the third period. Conclusions: There are geographical socioeconomic inequalities in chronic liver diseases and cirrhosis mortality, mainly among men, that did not change during the 2008 financial crisis. These results should be monitored in the long term.
Grants:	European Commission. Horizon 2020 643398
Note:	Altres ajuts: CEGOT, Foundation for Science and Technology UIDB/04084/2020
Note:	Altres ajuts: Fundação para a Ciência e a Tecnologia (SFRH/BD/132218/2017, UIDB/04084/2020)
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Chronic liver diseases ; Liver cirrhosis ; Mortality ; Inequalities ; Urban areas ; Financial crisis
Published in:	International journal of environmental research and public health, Vol. 18 Núm. 16 (february 2021) , p. 8801, ISSN 1660-4601

DOI: 10.3390/ijerph18168801
PMID: 34444557

11 p, 1.2 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles