Variation in mortality inequalities in the autonomous communities of Spain: a matter of mortality in people with less education

Rev Esp Salud Publica. 2015 Nov-Dec;89(6):563-73. doi: 10.4321/S1135-57272015000600004.
[Article in English, Spanish]

Abstract

Background: Given the importance of mortality rates in each socioeconomic group, as explanation for the variation in mortality inequalities across populations, the objective of the present study is to evaluate whether regional variation in mortality inequalities in Spain is related to the mortality rates in different socioeconomic groups.

Methods: The study included all persons aged 30-74 years living in Spain in 2001 and followed up for mortality over 7 years. In each of the 17 autonomous communities of Spain mortality rates were estimated for those with low and high education, as well as two measures of mortality inequality according to education: mortality rate difference and mortality rate ratio. Median value of mortality inequalities was calculated for the regions with the highest and lowest mortality rates and for those with intermediate mortality rates. And the Pearson correlation coefficient was used to estimate the relation between mortality rates and the measures of mortality inequality.

Results: The correlation coefficients between mortality rate in low education and mortality rate difference and mortality rate ratio were 0.87 and 0.78 in women and 0.81 and 0.73 in men, respectively. The correlation coefficients between mortality rate in high education and mortality rate difference and mortality rate ratio were -0.07 and -0.24 in women and 0.10 and -0.06 in men, respectively.

Conclusion: Regions with the lowest and highest mortality rates in low education people generally had the lowest and highest inequalities in mortality. The variation in the magnitude of inequalities in mortality from one place to another can be explained by the variation in mortality in low education people. No relation was observed between mortality rate in high education and mortality inequality.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Health Status Disparities*
  • Humans
  • Male
  • Middle Aged
  • Mortality*
  • Socioeconomic Factors
  • Spain / epidemiology