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Article

Effect of the Financial Crisis on Socioeconomic Inequalities in Mortality in Small Areas in Seven Spanish Cities

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Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
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Institut d’Investigació Biomèdica (IIB Sant Pau), 08041 Barcelona, Spain
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CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, 28035 Madrid, Spain
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Observatorio de Salud y Medio Ambiente de Andalucía, Escuela Andaluza de Salud Pública, 18080 Granada, Spain
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Department of Health of the Basque Country, 01006 Vitoria-Gasteiz, Spain
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Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08002 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(3), 958; https://doi.org/10.3390/ijerph17030958
Received: 9 December 2019 / Revised: 23 January 2020 / Accepted: 30 January 2020 / Published: 4 February 2020
(This article belongs to the Section Public Health Statistics and Risk Assessment)
Background: The aim of this study was to analyze the trend in socioeconomic inequalities in mortality in small areas due to several specific causes before (2001–2004, 2005–2008) and during (2009–2012) the economic crisis in seven Spanish cities. Methods: This ecological study of trends, with census tracts as the areas of analysis, was based on three periods. Several causes of death were studied. A socioeconomic deprivation index was calculated for each census tract. For each small area, we estimated standardized mortality ratios, and controlled for their variability using Bayesian models (sSMR). We also estimated the relative risk of mortality according to deprivation in the different cities, periods, and sexes. Results: In general, a similar geographical pattern was found for the socioeconomic deprivation index and sSMR. For men, there was an association in all cities between the deprivation index and all-cause mortality that remained stable over the three periods. For women, there was an association in Barcelona, Granada, and Sevilla between the deprivation index and all-cause mortality in the third period. Patterns by causes of death were more heterogeneous. Conclusions: After the start of the financial crisis, socioeconomic inequalities in total mortality in small areas of Spanish cities remained stable in most cities, although several causes of death showed a different pattern. View Full-Text
Keywords: socioeconomic factors; trends; mortality; inequalities; urban areas; small areas socioeconomic factors; trends; mortality; inequalities; urban areas; small areas
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MDPI and ACS Style

Gotsens, M.; Ferrando, J.; Marí-Dell’Olmo, M.; Palència, L.; Bartoll, X.; Gandarillas, A.; Sanchez-Villegas, P.; Esnaola, S.; Daponte, A.; Borrell, C. Effect of the Financial Crisis on Socioeconomic Inequalities in Mortality in Small Areas in Seven Spanish Cities. Int. J. Environ. Res. Public Health 2020, 17, 958. https://doi.org/10.3390/ijerph17030958

AMA Style

Gotsens M, Ferrando J, Marí-Dell’Olmo M, Palència L, Bartoll X, Gandarillas A, Sanchez-Villegas P, Esnaola S, Daponte A, Borrell C. Effect of the Financial Crisis on Socioeconomic Inequalities in Mortality in Small Areas in Seven Spanish Cities. International Journal of Environmental Research and Public Health. 2020; 17(3):958. https://doi.org/10.3390/ijerph17030958

Chicago/Turabian Style

Gotsens, Mercè, Josep Ferrando, Marc Marí-Dell’Olmo, Laia Palència, Xavier Bartoll, Ana Gandarillas, Pablo Sanchez-Villegas, Santi Esnaola, Antonio Daponte, and Carme Borrell. 2020. "Effect of the Financial Crisis on Socioeconomic Inequalities in Mortality in Small Areas in Seven Spanish Cities" International Journal of Environmental Research and Public Health 17, no. 3: 958. https://doi.org/10.3390/ijerph17030958

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