Inequalities in mortality in small areas of eleven Spanish cities (the multicenter MEDEA project)
Inequalities in mortality in small areas of eleven Spanish cities (the multicenter MEDEA project)
复制标题
DOI：
10.1016/j.healthplace.2010.03.002
复制
发表时间：
2010-07-01
期刊：
影响因子：
4.8
通讯作者：
Gotsens, Merce
中科院分区：
文献类型：
--
作者：
Borrell, Carme;Mari-Dell'Olmo, Marc;Gotsens, Merce
本研究的目的是确定 1996 年至 2003 年期间西班牙 11 个城市人口普查区的死亡率不平等现象，并分析这些地理不平等与社会经济贫困之间的关系。这是一项横断面生态研究，分析单位是人口普查区。我们使用考虑了空间结构的分层贝叶斯模型获得了社会经济剥夺指数并估计了每个人口普查区的 SMR。在大多数城市中，男女总死亡率的地理模式都存在，这与社会经济剥夺指数的地理模式相似。在男性中，四种特定死因（肺癌、缺血性心脏病、呼吸系统疾病和肝硬化）与大多数城市的贫困呈正相关。在女性中，糖尿病和肝硬化的具体原因呈正相关，而肺癌则与剥夺呈负相关。与剥夺相关的超额死亡率为男性 59,445 人，女性 23,292 人。这些结果凸显了城市内健康不平等的重要性。 (C) 2010 Elsevier Ltd. 保留所有权利。
The objectives of this study are to identify inequalities in mortality among census tracts of 11 Spanish cities in the period 1996-2003 and to analyse the relationship between these geographical inequalities and socioeconomic deprivation. It is a cross-sectional ecological study where the units of analysis are census tracts. We obtained an index of socioeconomic deprivation and estimated SMR by each census tract using hierarchical Bayesian models which take into account the spatial structure. In the majority of the cities geographical patterns in total mortality were found in both sexes, which were similar to those for the index of socioeconomic deprivation. Among men, four specific causes of death (lung cancer, ischemic heart diseases, respiratory diseases and cirrhosis) were positively associated with deprivation in the majority of cities. Among women the specific causes diabetes and cirrhosis were positively associated, while lung cancer was negatively associated with deprivation. The excess of mortality related with deprivation was 59,445 deaths among men and 23,292 among women. These results highlight the importance of intra-urban inequalities in health. (C) 2010 Elsevier Ltd. All rights reserved.