Trends in socioeconomic inequalities in preventable mortality in urban areas of 33 Spanish cities, 1996-2007 (MEDEA project)
Nolasco, A. (Universidad de Alicante)
Moncho, Joaquin (Universidad de Alicante)
Quesada, José Antonio (Universidad de Alicante)
Melchor, Inmaculada (Universidad de Alicante)
Pereyra-Zamora, Pamela (Universidad de Alicante)
Tamayo-Fonseca, Nayara (Universidad de Alicante)
Martínez-Beneito, Miguel Ángel (Instituto de Salud Carlos III)
Zurriaga, Oscar (Instituto de Salud Carlos III)
Ballesta, Mónica (Consejo Regional de Salud (Múrcia))
Daponte, Antonio (Escuela Andaluza de Salud Pública)
Gandarillas, Ana (Consejeria de Sanidad de Madrid. Dirección General de Atención Primaria)
Domínguez-Berjón, M. Felicitas (Consejeria de Sanidad de Madrid. Dirección General de Atención Primaria)
Marí-Dell'Olmo, Marc 1978- (Institut d'Investigació Biomèdica Sant Pau)
Gotsens, Mercè (Institut d'Investigació Biomèdica Sant Pau)
Izco, Natividad (Dirección General de Salud Pública y Consumo (La Rioja))
Moreno, M. Concepción (Instituto de Salud Carlos III)
Sáez, Marc (Universitat de Girona)
Martos, Carmen (Instituto de Salud Carlos III)
Sánchez-Villegas, Pablo (Escuela Andaluza de Salud Pública)
Borrell i Thió, Carme (Instituto de Salud Carlos III)
Universitat Autònoma de Barcelona

Data:	2015
Resum:	Background: Preventable mortality is a good indicator of possible problems to be investigated in the primary prevention chain, making it also a useful tool with which to evaluate health policies particularly public health policies. This study describes inequalities in preventable avoidable mortality in relation to socioeconomic status in small urban areas of thirty three Spanish cities, and analyses their evolution over the course of the periods 1996-2001 and 2002-2007. Methods: We analysed census tracts and all deaths occurring in the population residing in these cities from 1996 to 2007 were taken into account. The causes included in the study were lung cancer, cirrhosis, AIDS/HIV, motor vehicle traffic accidents injuries, suicide and homicide. The census tracts were classified into three groups, according their socioeconomic level. To analyse inequalities in mortality risks between the highest and lowest socioeconomic levels and over different periods, for each city and separating by sex, Poisson regression were used. Results: Preventable avoidable mortality made a significant contribution to general mortality (around 7. 5%, higher among men), having decreased over time in men (12. 7 in 1996-2001 and 10. 9 in 2002-2007), though not so clearly among women (3. 3% in 1996-2001 and 2. 9% in 2002-2007). It has been observed in men that the risks of death are higher in areas of greater deprivation, and that these excesses have not modified over time. The result in women is different and differences in mortality risks by socioeconomic level could not be established in many cities. Conclusions: Preventable mortality decreased between the 1996-2001 and 2002-2007 periods, more markedly in men than in women. There were socioeconomic inequalities in mortality in most cities analysed, associating a higher risk of death with higher levels of deprivation. Inequalities have remained over the two periods analysed. This study makes it possible to identify those areas where excess preventable mortality was associated with more deprived zones. It is in these deprived zones where actions to reduce and monitor health inequalities should be put into place. Primary healthcare may play an important role in this process.
Drets:	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.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Causes of death ; Inequalities in health ; Preventable avoidable mortality ; Small area analysis
Publicat a:	International Journal for Equity in Health, Vol. 14 Núm. 1 (2015) , p. 33, ISSN 1475-9276

DOI: 10.1186/s12939-015-0164-0
PMID: 25879739

15 p, 2.6 MB

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