Do socioeconomic inequalities in mortality vary between different Spanish cities? a pooled cross-sectional analysis

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Title: Do socioeconomic inequalities in mortality vary between different Spanish cities? a pooled cross-sectional analysis
Authors: Martínez-Beneito, Miguel A. | Zurriaga, Óscar | Botella-Rocamora, Paloma | Marí-Dell'Olmo, Marc | Nolasco, Andreu | Moncho, Joaquin | Daponte, Antonio | Domínguez Berjón, María Felicitas | Gandarillas, Ana | Martos, Carmen | Montoya, Imanol | Sánchez-Villegas, Pablo | Taracido, Margarita | Borrell, Carme
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: Deprivation | Mortality | Urban areas | Pooled cross-sectional analysis | Meta-analysis | Spain
Knowledge Area: Enfermería
Issue Date: 16-May-2013
Publisher: BioMed Central
Citation: MARTINEZ-BENEITO, Miguel A., et al. “Do socioeconomic inequalities in mortality vary between different Spanish cities? a pooled cross-sectional analysis”. BMC Public Health 2013, 13:480. doi:10.1186/1471-2458-13-480
Abstract: Background: The relationship between deprivation and mortality in urban settings is well established. This relationship has been found for several causes of death in Spanish cities in independent analyses (the MEDEA project). However, no joint analysis which pools the strength of this relationship across several cities has ever been undertaken. Such an analysis would determine, if appropriate, a joint relationship by linking the associations found. Methods: A pooled cross-sectional analysis of the data from the MEDEA project has been carried out for each of the causes of death studied. Specifically, a meta-analysis has been carried out to pool the relative risks in eleven Spanish cities. Different deprivation-mortality relationships across the cities are considered in the analysis (fixed and random effects models). The size of the cities is also considered as a possible factor explaining differences between cities. Results: Twenty studies have been carried out for different combinations of sex and causes of death. For nine of them (men: prostate cancer, diabetes, mental illnesses, Alzheimer’s disease, cerebrovascular disease; women: diabetes, mental illnesses, respiratory diseases, cirrhosis) no differences were found between cities in the effect of deprivation on mortality; in four cases (men: respiratory diseases, all causes of mortality; women: breast cancer, Alzheimer’s disease) differences not associated with the size of the city have been determined; in two cases (men: cirrhosis; women: lung cancer) differences strictly linked to the size of the city have been determined, and in five cases (men: lung cancer, ischaemic heart disease; women: ischaemic heart disease, cerebrovascular diseases, all causes of mortality) both kinds of differences have been found. Except for lung cancer in women, every significant relationship between deprivation and mortality goes in the same direction: deprivation increases mortality. Variability in the relative risks across cities was found for general mortality for both sexes. Conclusions: This study provides a general overview of the relationship between deprivation and mortality for a sample of large Spanish cities combined. This joint study allows the exploration of and, if appropriate, the quantification of the variability in that relationship for the set of cities considered.
Sponsor: This article was partially funded by Ministerio de Economia y Competitividad via the research grant MTM2010-19528 (jointly financed with European Regional Development Fund), the FIS-FEDER projects: PI042013, PI040041, PI040170, PI040069, PI042602, PI040388, PI040489, PI042098, PI041260, PI040399, PI08/1488, PI08/0330 and by the CIBER Epidemiología y Salud Publica (CIBERESP), Spain.
URI: http://hdl.handle.net/10045/33243
ISSN: 1471-2458
DOI: 10.1186/1471-2458-13-480
Language: eng
Type: info:eu-repo/semantics/article
Rights: © 2013 Martinez-Beneito et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Peer Review: si
Publisher version: http://dx.doi.org/10.1186/1471-2458-13-480
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