Trends in socioeconomic inequalities in preventable mortality in urban areas of 33 Spanish cities, 1996–2007 (MEDEA project)

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Title: Trends in socioeconomic inequalities in preventable mortality in urban areas of 33 Spanish cities, 1996–2007 (MEDEA project)
Authors: Nolasco, Andreu | Moncho, Joaquin | Quesada, José Antonio | Melchor-Alós, Inmaculada | Pereyra-Zamora, Pamela | Tamayo Fonseca, Nayara | Martínez-Beneito, Miguel A. | Zurriaga, Óscar | Ballesta, Mónica | Daponte, Antonio | Gandarillas, Ana | Domínguez Berjón, María Felicitas | Marí-Dell'Olmo, Marc | Gotsens, Mercè | Izco, Natividad | Moreno, María Concepción | Sáez, Marc | Martos, Carmen | Sánchez-Villegas, Pablo | 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: Preventable avoidable mortality | Causes of death | Inequalities in health | Small area analysis
Knowledge Area: Enfermería
Issue Date: 1-Apr-2015
Publisher: BioMed Central
Citation: International Journal for Equity in Health 2015, 14:33. doi:10.1186/s12939-015-0164-0
Abstract: Background: Preventable mortality is a good indicator of possible problems to be investigated in the primary prevention chain, making it also a useful tool with which to evaluate health policies particularly public health policies. This study describes inequalities in preventable avoidable mortality in relation to socioeconomic status in small urban areas of thirty three Spanish cities, and analyses their evolution over the course of the periods 1996–2001 and 2002–2007. Methods: We analysed census tracts and all deaths occurring in the population residing in these cities from 1996 to 2007 were taken into account. The causes included in the study were lung cancer, cirrhosis, AIDS/HIV, motor vehicle traffic accidents injuries, suicide and homicide. The census tracts were classified into three groups, according their socioeconomic level. To analyse inequalities in mortality risks between the highest and lowest socioeconomic levels and over different periods, for each city and separating by sex, Poisson regression were used. Results: Preventable avoidable mortality made a significant contribution to general mortality (around 7.5%, higher among men), having decreased over time in men (12.7 in 1996–2001 and 10.9 in 2002–2007), though not so clearly among women (3.3% in 1996–2001 and 2.9% in 2002–2007). It has been observed in men that the risks of death are higher in areas of greater deprivation, and that these excesses have not modified over time. The result in women is different and differences in mortality risks by socioeconomic level could not be established in many cities. Conclusions: Preventable mortality decreased between the 1996–2001 and 2002–2007 periods, more markedly in men than in women. There were socioeconomic inequalities in mortality in most cities analysed, associating a higher risk of death with higher levels of deprivation. Inequalities have remained over the two periods analysed. This study makes it possible to identify those areas where excess preventable mortality was associated with more deprived zones. It is in these deprived zones where actions to reduce and monitor health inequalities should be put into place. Primary healthcare may play an important role in this process.
Sponsor: This work was partly supported by the FIS-FEDER projects PI080330, PI081713, PI081978, PI0463/2010, PI081017, PI081785, PI081058, PI080142, and the FUNDACIÓN CAJAMURCIA project FFIS/CM10/27.
ISSN: 1475-9276
DOI: 10.1186/s12939-015-0164-0
Language: eng
Type: info:eu-repo/semantics/article
Rights: © 2015 Nolasco et al.; licensee BioMed Central. 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 credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Peer Review: si
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