Do socioeconomic inequalities in mortality vary between different Spanish cities? a pooled cross-sectional analysis
Por:
Martinez-Beneito, MA, Zurriaga, O, Botella-Rocamora, P, Mari-Dell'Olmo, M, Nolasco, A, Moncho, J, Daponte, A, Dominguez-Berjon, MF, Gandarillas, A, Martos, C, Montoya, I, Sanchez-Villegas, P, Taracido, M, Borrell, C
Publicada:
16 may 2013
Resumen:
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.
Filiaciones:
Martinez-Beneito, MA:
Ctr Super Invest Salud Publ, Valencia 46020, Spain
Inst Salud Carlos III, CIBERESP, Madrid 28029, Spain
Zurriaga, O:
Ctr Super Invest Salud Publ, Valencia 46020, Spain
Inst Salud Carlos III, CIBERESP, Madrid 28029, Spain
Generalitat Valenciana, Conselleria Sanitat, Direcc Gen Salud Publ, Valencia 46020, Spain
Botella-Rocamora, P:
Univ CEU Cardenal Herrera, Dept Ciencias Fis Matemat & Comp, Alfara Del Patriarca 46115, Spain
Mari-Dell'Olmo, M:
Inst Salud Carlos III, CIBERESP, Madrid 28029, Spain
Agencia Salut Publ Barcelona, Barcelona, Spain
Inst Recerca Biomed St Pau IIB St Pau, Barcelona, Spain
Nolasco, A:
Univ Alicante, Dept Enfermeria Comunitaria Med Prevent & Salud P, Unidad Invest Anal Mortalidad & Estadist Sanitari, E-03080 Alicante, Spain
Moncho, J:
Univ Alicante, Dept Enfermeria Comunitaria Med Prevent & Salud P, Unidad Invest Anal Mortalidad & Estadist Sanitari, E-03080 Alicante, Spain
Daponte, A:
Inst Salud Carlos III, CIBERESP, Madrid 28029, Spain
Escuela Andaluza Salud Publ, Observ Salud & Medio Ambiente Andalucia OSMAN, Cuesta Observ, Granada 18080, Spain
Dominguez-Berjon, MF:
Comunidad Madrid, Consejeria Sanidad, Direcc Gen Atenc Primaria, Subdirecc Promoc Salud & Prevenc, Madrid 28037, Spain
Gandarillas, A:
Comunidad Madrid, Consejeria Sanidad, Direcc Gen Atenc Primaria, Subdirecc Promoc Salud & Prevenc, Madrid 28037, Spain
Martos, C:
Ctr Super Invest Salud Publ, Valencia 46020, Spain
Inst Salud Carlos III, CIBERESP, Madrid 28029, Spain
Montoya, I:
Dept Sanidad Gobierno Vasco, Vitoria 01001, Alava, Spain
Sanchez-Villegas, P:
Inst Salud Carlos III, CIBERESP, Madrid 28029, Spain
Escuela Andaluza Salud Publ, Observ Salud & Medio Ambiente Andalucia OSMAN, Cuesta Observ, Granada 18080, Spain
Taracido, M:
Inst Salud Carlos III, CIBERESP, Madrid 28029, Spain
Univ Santiago de Compostela, Dept Med Prevent & Salud Publ, Santiago De Compostela 15782, Spain
Borrell, C:
Inst Salud Carlos III, CIBERESP, Madrid 28029, Spain
Agencia Salut Publ Barcelona, Barcelona, Spain
Inst Recerca Biomed St Pau IIB St Pau, Barcelona, Spain
Univ Pompeu Fabra, Barcelona, Spain
Gold, Green Published, All Open Access, Green
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