Trends in socioeconomic inequalities in preventable mortality in urban areas of 33 Spanish cities, 1996-2007 (MEDEA project)

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...

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Detalles Bibliográficos
Autores: Nolasco A., Moncho J., Quesada J.A., Melchor I., Pereyra-Zamora P., Tamayo-Fonseca N., Martínez-Beneito M.A., Zurriaga O., Ballesta M., Daponte A., Gandarillas A., Domínguez-Berjón M.F., Marí-Dell'Olmo M., Gotsens M., Izco N., Moreno M.C., Sáez M., Martos C., Sánchez-Villegas P., Borrell C.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p10573
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=10573
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84927930689&doi=10.1186%2fs12939-015-0164-0&partnerID=40&md5=5aa785bc0f3f6f9334a74cc656b36355
Access Level:acceso abierto
Palabra clave:cause of death
census
equity
health policy
health risk
public health
regression analysis
socioeconomic status
spatiotemporal analysis
urban area
acquired immune deficiency syndrome
adolescent
adult
Article
child
city
controlled study
female
health disparity
homicide
human
human rights
infant
injury
liver cirrhosis
lung cancer
male
middle aged
mortality
newborn
preventable mortality
priority journal
social status
Spain
suicide
traffic accident
trend study
aged
epidemiology
health
population research
preschool child
sex ratio
socioeconomics
trends
young adult
Adolescent
Adult
Aged
Cause of Death
Censuses
Child
Child, Preschool
Cities
Female
Health Status Disparities
Humans
Infant
Male
Middle Aged
Mortality
Sex Distribution
Socioeconomic Factors
Urban Health
Young Adult
Descripción
Sumario: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. © 2015 Nolasco et al.; licensee BioMed Central.