[Geographic Patterns of Mortality and Socioeconomic Inequalities in Mortality in Spain]

Rev Esp Salud Publica. 2015 Apr;89(2):137-47. doi: 10.4321/S1135-57272015000200003.
[Article in Spanish]

Abstract

Background: Estimates of socioeconomic inequalities in mortality coming from individual data sources were only available from Madrid, the Basque Country and the city of Barcelona. The aim of this study was to show the geographical pattern of mortality in different socio-economic groups, as well as that of inequalities in mortality in the whole Spanish territory.

Methods: All people aged 25 and older in the 2001 census were followed for seven years and two months to determine their vital status (196 470 401 person-years at risk and 2,379,558 deaths). The socioeconomic variable was educational level. Age-adjusted mortality rate was estimated for women and men in every province and in each category of educational level. Inequalities in mortality in each province have been estimated by the ratio of mortality in subjects with primary or lower level of education compared to subjects with university education.

Results: In women, the lowest rate ratios -between 1.06 and 1.16- are observed in Palencia, Segovia, Guadalajara, Avila and Castellon and the highest -between 1.53 and 1,75- in Malaga, Las Palmas, Ceuta, Melilla and Toledo. In men, the lowest rate ratios -between 1.00 and 1.12- are observed in Guadalajara, Teruel, Cuenca, La Rioja and Ávila and the highest -between 1.47 and 1,73- in Las Palmas, Cantabria, Murcia, Melilla and Ceuta.

Conclusions: The geographical pattern of mortality rates in Spain varies by educational level. Inequalities in mortality by education have the lowest magnitude in central peninsular provinces.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Educational Status
  • Female
  • Health Status Disparities*
  • Humans
  • Male
  • Middle Aged
  • Mortality*
  • Sex Distribution
  • Social Class*
  • Socioeconomic Factors
  • Spain / epidemiology