Socioeconomic inequalities in cause-specific mortality in 15 European cities
Por:
Marí-Dell'Olmo M., Gotsens M., Palència L., Burström B., Corman D., Costa G., Deboosere P., Díez E., Domínguez-Berjón F., Dzúrová D., Gandarillas A., Hoffmann R., Kovács K., Martikainen P., Demaria M., Pikhart H., Rodríguez-Sanz M., Saez M., Santana P., Schwierz C., Tarkiainen L., Borrell C.
Publicada:
1 ene 2015
Resumen:
Background: Socioeconomic inequalities are increasingly recognised as an important public health issue, although their role in the leading causes of mortality in urban areas in Europe has not been fully evaluated. In this study, we used data from the INEQCITIES study to analyse inequalities in cause-specific mortality in 15 European cities at the beginning of the 21st century. Methods: A cross-sectional ecological study was carried out to analyse 9 of the leading specific causes of death in small areas from 15 European cities. Using a hierarchical Bayesian spatial model, we estimated smoothed Standardized Mortality Ratios, relative risks and 95% credible intervals for cause-specific mortality in relation to a socioeconomic deprivation index, separately for men and women. Results: We detected spatial socioeconomic inequalities for most causes of mortality studied, although these inequalities differed markedly between cities, being more pronounced in Northern and Central-Eastern Europe. In the majority of cities, most of these causes of death were positively associated with deprivation among men, with the exception of prostatic cancer. Among women, diabetes, ischaemic heart disease, chronic liver diseases and respiratory diseases were also positively associated with deprivation in most cities. Lung cancer mortality was positively associated with deprivation in Northern European cities and in Kosice, but this association was non-existent or even negative in Southern European cities. Finally, breast cancer risk was inversely associated with deprivation in three Southern European cities. Conclusions: The results confirm the existence of socioeconomic inequalities in many of the main causes of mortality, and reveal variations in their magnitude between different European cities.
Filiaciones:
Marí-Dell'Olmo M.:
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Agència de Salut Pública de Barcelona, Barcelona, Spain
Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
Gotsens M.:
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Agència de Salut Pública de Barcelona, Barcelona, Spain
Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
Palència L.:
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Agència de Salut Pública de Barcelona, Barcelona, Spain
Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
Burström B.:
Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
Corman D.:
Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
Costa G.:
Department of Clinical and Biological Science, University of Turin, Turin, Italy
Deboosere P.:
Department of Social Research, Vrije Universiteit Brussel, Brussels, Belgium
Díez E.:
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Agència de Salut Pública de Barcelona, Barcelona, Spain
Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
Domínguez-Berjón F.:
Subdirección de Promoción de la Salud y Prevención, Consejería de Sanidad, Comunidad de Madrid, Spain
Dzúrová D.:
Department of Social Geography and Regional Development, Faculty of Science, Charles University in Prague, Prague, Czech Republic
Gandarillas A.:
Subdirección de Promoción de la Salud y Prevención, Consejería de Sanidad, Comunidad de Madrid, Spain
Hoffmann R.:
Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
Kovács K.:
Demographic Research Institute, Budapest, Hungary
Martikainen P.:
Department of Social Research, University of Helsinki, Helsinki, Finland
Demaria M.:
Department of Epidemiology and Environmental Health, Regional Environmental Protection Agency, Piedmont, Italy
Pikhart H.:
Department of Epidemiology and Public Health, University College London, London, United Kingdom
Rodríguez-Sanz M.:
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Agència de Salut Pública de Barcelona, Barcelona, Spain
Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
Saez M.:
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
Santana P.:
Centro de Estudos de Geografia e de Ordenamento do Territorio (CEGOT), Departamento de Geografia, Colégio de S. Jerónimo, Universidade de Coimbra, Coimbra, Portugal
Schwierz C.:
Statistik Stadt Zürich, Zürich, Switzerland
Tarkiainen L.:
Department of Social Research, University of Helsinki, Helsinki, Finland
Borrell C.:
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Agència de Salut Pública de Barcelona, Barcelona, Spain
Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
Universitat Pompeu Fabra, Barcelona, Spain
All Open Access; Green
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