Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities

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Title: Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities
Authors: Puigpinós-Riera, Rosa | Marí-Dell'Olmo, Marc | Gotsens, Mercè | Borrell, Carme | Serral, Gemma | Ascaso, Carlos | Calvo, Montse | Daponte, Antonio | Domínguez Berjón, María Felicitas | Esnaola, Santiago | Gandarillas, Ana | López-Abente, Gonzalo | Martos, Carmen | Martínez-Beneito, Miguel A. | Montes-Martínez, Agustín | Montoya, Imanol | Nolasco, Andreu | Pasarín, Isabel M. | Rodríguez-Sanz, Maica | Sáez, Marc | Sánchez-Villegas, Pablo
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: Cancer mortality | Inequalities | Socioeconomic deprivation | Urban areas | Spain
Knowledge Area: Enfermería
Issue Date: 13-Jan-2011
Publisher: BioMed Central
Citation: PUIGPINÓS-RIERA, Rosa, et al. “Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities”. International Journal of Health Geographics 2011, 10:6. doi:10.1186/1476-072X-10-6
Abstract: 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.
Sponsor: This article was partially supported by Fondo de Investigaciones Ssanitarias (FIS) projects numbers PI042013, PI040041, PI040170, PI040069, PI042602 PI040388, PI040489, PI042098 , PI041260, PI040399, PI081488 and by the CIBER en Epidemiología y Salud Pública (CIBERESP), Spain and by the program of “Intensificación de la Actividad Investigadora (Carme Borrell)” funded by the “Instituto de Salud Carlos III” and “Departament de Salut. Generalitat de Catalunya”.
ISSN: 1476-072X
DOI: 10.1186/1476-072X-10-6
Language: eng
Type: info:eu-repo/semantics/article
Rights: © 2011 Puigpinós-Riera et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Peer Review: si
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