Socioeconomic Inequalities in Chronic Liver Diseases and Cirrhosis Mortality in European Urban Areas before and after the Onset of the 2008 Economic Recession
Por:
Borrell, C, Palencia, L, Bosakova, L, Gotsens, M, Morrison, J, Costa, C, Dzurova, D, Deboosere, P, Lustigova, M, Mari-Dell'Olmo, M, Rodopoulou, S, Santana, P
Publicada:
1 ago 2021
Resumen:
Objective: To analyse the trends in chronic liver diseases and cirrhosis mortality, and the associated socioeconomic inequalities, in nine European cities and urban areas before and after the onset of the 2008 financial crisis. Methods: This is an ecological study of trends in three periods of time: two before (2000-2003 and 2004-2008), and one after (2009-2014) the onset of the economic crisis. The units of analysis were the geographical areas of nine cities or urban areas in Europe. We analysed chronic liver diseases and cirrhosis standardised mortality ratios, smoothing them with a hierarchical Bayesian model by each city, area, and sex. An ecological regression model was fitted to analyse the trends in socioeconomic inequalities, and included the socioeconomic deprivation index, the period, and their interaction. Results: In general, chronic liver diseases and cirrhosis mortality rates were higher in men than in women. These rates decreased in all cities during the financial crisis, except among men in Athens (rates increased from 8.50 per 100,000 inhabitants during the second period to 9.42 during the third). Socioeconomic inequalities in chronic liver diseases and cirrhosis mortality were found in six cities/metropolitan areas among men, and in four among women. Finally, in the periods studied, such inequalities did not significantly change. However, among men they increased in Turin and Barcelona and among women, several cities had lower inequalities in the third period. Conclusions: There are geographical socioeconomic inequalities in chronic liver diseases and cirrhosis mortality, mainly among men, that did not change during the 2008 financial crisis. These results should be monitored in the long term.
Filiaciones:
Borrell, C:
Agencia Salut Publ Barcelona, Barcelona 08023, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid 20029, Spain
Inst Invest Biomed IIB St Pau, Barcelona 08003, Spain
Univ Pompeu Fabra, Dept Expt Sci & Hlth, Barcelona 08003, Spain
Palencia, L:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid 20029, Spain
Inst Invest Biomed IIB St Pau, Barcelona 08003, Spain
Agencia Salut Publ Barcelona, Serv Hlth Informat Syst, Barcelona 08023, Spain
Bosakova, L:
PJ Safarik Univ Kosice, Med Fac, Dept Hlth Psychol & Res Methodol, Kosice 04180, Slovakia
Palacky Univ Olomouc, Olomouc Univ Social Hlth Inst OUSHI, CZ-77900 Olomouc, Czech Republic
Gotsens, M:
Inst Invest Biomed IIB St Pau, Barcelona 08003, Spain
Agencia Salut Publ Barcelona, Serv Prevent & Care Drug Addict, Barcelona 08023, Spain
Morrison, J:
UCL, Res Dept Epidemiol & Publ Hlth, Inst Hlth Equ, London WC1E 6BT, England
Costa, C:
Univ Coimbra, Ctr Studies Geog & Spatial Planning CEGOT, P-3000370 Coimbra, Portugal
Dzurova, D:
Charles Univ Prague, Fac Sci, Prague 11636, Czech Republic
Deboosere, P:
Vrije Univ Brussel, Dept Sociol, Interface Demog, B-1050 Brussels, Belgium
Lustigova, M:
Charles Univ Prague, Fac Sci, Prague 11636, Czech Republic
Mari-Dell'Olmo, M:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid 20029, Spain
Inst Invest Biomed IIB St Pau, Barcelona 08003, Spain
Agencia Salut Publ Barcelona, Serv Environm Qual & Intervent, Barcelona 08023, Spain
Rodopoulou, S:
Natl & Kapodistrian Univ Athens, Med Sch, Dept Hyg Epidemiol & Med Stat, Athens 10679, Greece
Santana, P:
Univ Coimbra, Ctr Studies Geog & Spatial Planning CEGOT, P-3000370 Coimbra, Portugal
Univ Coimbra, Dept Geog & Tourism, P-3000370 Coimbra, Portugal
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