Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities
Por:
Puigpinos-Riera, R, Mari-Dell'Olmo, M, Gotsens, M, Borrell, C, Serral, G, Ascaso, C, Calvo, M, Daponte, A, Dominguez-Berjon, FM, Esnaola, S, Gandarillas, A, Lopez-Abente, G, Martos, CM, Martinez-Beneito, MA, Montes-Martinez, A, Montoya, I, Nolasco, A, Pasarin, IM, Rodriguez-Sanz, M, Saez, M, Sanchez-Villegas, P
Publicada:
13 ene 2011
Resumen:
Background: Intra-urban inequalities in mortality have been infrequently analysed in European contexts. The aim of the present study was to analyse patterns of cancer mortality and their relationship with socioeconomic deprivation in small areas in 11 Spanish cities.
Methods: It is a cross-sectional ecological design using mortality data (years 1996-2003). Units of analysis were the census tracts. A deprivation index was calculated for each census tract. In order to control the variability in estimating the risk of dying we used Bayesian models. We present the RR of the census tract with the highest deprivation vs. the census tract with the lowest deprivation.
Results: In the case of men, socioeconomic inequalities are observed in total cancer mortality in all cities, except in Castellon, Cordoba and Vigo, while Barcelona (RR = 1.53 95% CI 1.42-1.67), Madrid (RR = 1.57 95% CI 1.49-1.65) and Seville (RR = 1.53 95% CI 1.36-1.74) present the greatest inequalities. In general Barcelona and Madrid, present inequalities for most types of cancer. Among women for total cancer mortality, inequalities have only been found in Barcelona and Zaragoza. The excess number of cancer deaths due to socioeconomic deprivation was 16,413 for men and 1,142 for women.
Conclusion: This study has analysed inequalities in cancer mortality in small areas of cities in Spain, not only relating this mortality with socioeconomic deprivation, but also calculating the excess mortality which may be attributed to such deprivation. This knowledge is particularly useful to determine which geographical areas in each city need intersectorial policies in order to promote a healthy environment.
Filiaciones:
Puigpinos-Riera, R:
Agencia Salut Publ Barcelona, Serv Sistemes Informacio Sanitaria, Barcelona, Spain
CIBERESP, Barcelona, Spain
Univ Barcelona, Fac Med, Dept Salt Publ, Barcelona 7, Spain
Mari-Dell'Olmo, M:
Agencia Salut Publ Barcelona, Serv Sistemes Informacio Sanitaria, Barcelona, Spain
CIBERESP, Barcelona, Spain
Gotsens, M:
Agencia Salut Publ Barcelona, Serv Sistemes Informacio Sanitaria, Barcelona, Spain
CIBERESP, Barcelona, Spain
Borrell, C:
Agencia Salut Publ Barcelona, Serv Sistemes Informacio Sanitaria, Barcelona, Spain
CIBERESP, Barcelona, Spain
Univ Pompeu Fabra, Barcelona, Spain
Serral, G:
Agencia Salut Publ Barcelona, Serv Sistemes Informacio Sanitaria, Barcelona, Spain
CIBERESP, Barcelona, Spain
Ascaso, C:
Univ Barcelona, Fac Med, Dept Salt Publ, Barcelona 7, Spain
Calvo, M:
Dept Sanidad & Consumo Gobierno Vasco, Vitoria, Spain
Daponte, A:
CIBERESP, Barcelona, Spain
OSMAN, Escuela Andaluza Salud Publ, Area Salud Publ & Protecc Salud, Granada, Spain
Dominguez-Berjon, FM:
Inst Salud Publ, Direcc Gen Salud Publ & Alimentac, Serv Informes Salud & Estudios, Comunidad De Madrid, Spain
Esnaola, S:
Dept Sanidad & Consumo Gobierno Vasco, Vitoria, Spain
Gandarillas, A:
Direcc Gen Atenc Primaria, Serv Epidemiol, Comunidad De Madrid, Spain
Lopez-Abente, G:
Ctr Nacl Epidemiol, Area Epidemiol Ambiental & Canc, Madrid, Spain
Martos, CM:
Ctr Super Invest Salud Publ Valencia, Area Desigualdades Salud, Valencia, Spain
Inst Aragones Ciencias Salud, Aragon, Spain
Martinez-Beneito, MA:
Ctr Super Invest Salud Publ Valencia, Area Desigualdades Salud, Valencia, Spain
Montes-Martinez, A:
CIBERESP, Barcelona, Spain
Univ Santiago de Compostela, Dept Med Prevent & Saude Publ, Santiago De Compostela, Spain
Montoya, I:
Dept Sanidad & Consumo Gobierno Vasco, Vitoria, Spain
Pasarin, IM:
Agencia Salut Publ Barcelona, Serv Sistemes Informacio Sanitaria, Barcelona, Spain
CIBERESP, Barcelona, Spain
Univ Pompeu Fabra, Barcelona, Spain
Rodriguez-Sanz, M:
Agencia Salut Publ Barcelona, Serv Sistemes Informacio Sanitaria, Barcelona, Spain
CIBERESP, Barcelona, Spain
Saez, M:
CIBERESP, Barcelona, Spain
Univ Pompeu Fabra, Barcelona, Spain
Univ Girona, Res Grp Stat Appl Econ & Hlth GRECS, Girona, Spain
Sanchez-Villegas, P:
OSMAN, Escuela Andaluza Salud Publ, Area Salud Publ & Protecc Salud, Granada, Spain
Gold, Green Published
|