Do socioeconomic inequalities in mortality vary between different Spanish cities? A pooled cross-sectional analysis
Martinez-Beneito, Miguel A. (Instituto de Salud Carlos III)
Zurriaga, Oscar (Dirección General de Salud Pública. Conselleria de Sanitat. Generalitat Valenciana)
Botella-Rocamora, Paloma (Universidad CEU Cardenal Herrera)
Marí-Dell'Olmo, Marc 1978- (Institut d'Investigació Biomèdica Sant Pau)
Nolasco, Andreu (Universidad de Alicante)
Moncho, Joaquín (Universidad de Alicante)
Daponte, Antonio (Campus Universitario de Cartuja)
Domínguez-Berjón, M.Felicitas (Consejeria de Sanidad de Madrid. Dirección General de Atención Primaria)
Gandarillas, Ana (Consejeria de Sanidad de Madrid. Dirección General de Atención Primaria)
Martos, Carmen (Instituto de Salud Carlos III)
Montoya, Imanol (Gobierno Vasco. Departamento de Sanidad)
Sánchez-Villegas, Pablo (Campus Universitario de Cartuja)
Taracido, Margarita (Universidade de Santiago de Compostela)
Borrell i Thió, Carme (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Data:	2013
Resum:	Background: The relationship between deprivation and mortality in urban settings is well established. This relationship has been found for several causes of death in Spanish cities in independent analyses (the MEDEA project). However, no joint analysis which pools the strength of this relationship across several cities has ever been undertaken. Such an analysis would determine, if appropriate, a joint relationship by linking the associations found. Methods. A pooled cross-sectional analysis of the data from the MEDEA project has been carried out for each of the causes of death studied. Specifically, a meta-analysis has been carried out to pool the relative risks in eleven Spanish cities. Different deprivation-mortality relationships across the cities are considered in the analysis (fixed and random effects models). The size of the cities is also considered as a possible factor explaining differences between cities. Results: Twenty studies have been carried out for different combinations of sex and causes of death. For nine of them (men: prostate cancer, diabetes, mental illnesses, Alzheimer's disease, cerebrovascular disease; women: diabetes, mental illnesses, respiratory diseases, cirrhosis) no differences were found between cities in the effect of deprivation on mortality; in four cases (men: respiratory diseases, all causes of mortality; women: breast cancer, Alzheimer's disease) differences not associated with the size of the city have been determined; in two cases (men: cirrhosis; women: lung cancer) differences strictly linked to the size of the city have been determined, and in five cases (men: lung cancer, ischaemic heart disease; women: ischaemic heart disease, cerebrovascular diseases, all causes of mortality) both kinds of differences have been found. Except for lung cancer in women, every significant relationship between deprivation and mortality goes in the same direction: deprivation increases mortality. Variability in the relative risks across cities was found for general mortality for both sexes. Conclusions: This study provides a general overview of the relationship between deprivation and mortality for a sample of large Spanish cities combined. This joint study allows the exploration of and, if appropriate, the quantification of the variability in that relationship for the set of cities considered. © 2013 Martinez-Beneito et al. ; licensee BioMed Central Ltd.
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 de revisió ; recerca ; Versió publicada
Matèria:	Deprivation ; Meta-analysis ; Mortality ; Pooled cross-sectional analysis ; Spain ; Urban areas
Publicat a:	BMC public health, Vol. 13 Núm. 1 (2013) , p. 480, ISSN 1471-2458

DOI: 10.1186/1471-2458-13-480
PMID: 23679869

11 p, 287.9 KB

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