Diabetes mellitus mortality in Spanish cities: Trends and geographical inequalities

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Title: Diabetes mellitus mortality in Spanish cities: Trends and geographical inequalities
Authors: Aguilar-Palacio, Isabel | Martínez-Beneito, Miguel A. | Rabanaque, María José | Borrell, Carme | Cirera, Lluís | Daponte, Antonio | Domínguez Berjón, María Felicitas | Gandarillas, Ana | Gotsens, Mercè | Lorenzo, Pedro | Marí-Dell'Olmo, Marc | Nolasco, Andreu | Sáez, Marc | Sánchez-Villegas, Pablo | Saurina, Carme | Martos, Carmen
Research Group/s: Grupo Balmis de Investigación en Salud Comunitaria e Historia de la Ciencia
Center, Department or Service: Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia
Keywords: Diabetes mellitus | Mortality | Geographical inequalities | Urban areas
Knowledge Area: Enfermería
Issue Date: 13-Jun-2017
Publisher: Elsevier
Citation: Primary Care Diabetes. 2017, 11(5): 453-460. doi:10.1016/j.pcd.2017.05.006
Abstract: Aim: To analyze the geographical pattern of diabetes mellitus (DM) mortality and its association with socioeconomic factors in 26 Spanish cities. Methods: We conducted an ecological study of DM mortality trends with two cross-sectional cuts (1996–2001; 2002–2007) using census tract (CT) as the unit of analysis. Smoothed standardized mortality rates (sSMR) were calculated using Bayesian models, and a socioeconomic deprivation score was calculated for each CT. Results: In total, 27,757 deaths by DM were recorded, with higher mortality rates observed in men and in the period 1996–2001. For men, a significant association between CT deprivation score and DM mortality was observed in 6 cities in the first study period and in 7 cities in the second period. The highest relative risk was observed in Pamplona (RR, 5.13; 95% credible interval (95%CI), 1.32–15.16). For women, a significant association between CT deprivation score and DM mortality was observed in 13 cities in the first period and 8 in the second. The strongest association was observed in San Sebastián (RR, 3.44; 95%CI, 1.25–7.36). DM mortality remained stable in the majority of cities, although a marked decrease was observed in some cities, including Madrid (RR, 0.67 and 0.64 for men and women, respectively). Conclusions: Our findings demonstrate clear inequalities in DM mortality in Spain. These inequalities remained constant over time are were more marked in women. Detection of high-risk areas is crucial for the implementation of specific interventions.
Sponsor: This work was partially supported by FIS (PI0426, PI081488, PI080330, PI081017, PI081713), the DGA (PI126/08), FUNCIS (PI84/07), Fundación Caja Murcia (FFIS/CM10/27), and by CIBER Epidemiología y Salud Pública (CIBERESP).
URI: http://hdl.handle.net/10045/67308
ISSN: 1751-9918 (Print) | 1878-0210 (Online)
DOI: 10.1016/j.pcd.2017.05.006
Language: eng
Type: info:eu-repo/semantics/article
Rights: © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd.
Peer Review: si
Publisher version: http://dx.doi.org/10.1016/j.pcd.2017.05.006
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