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

Mercè Gotsens, Josep Ferrando, Marc Marí-Dell’Olmo, Laia Palència, Xavier Bartoll, Ana Gandarillas, Pablo Sanchez-Villegas, Santi Esnaola, Antonio Daponte and Carme Borrell
Additional contact information
Mercè Gotsens: Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
Josep Ferrando: Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
Marc Marí-Dell’Olmo: Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
Laia Palència: Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
Xavier Bartoll: Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
Ana Gandarillas: Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, 28035 Madrid, Spain
Pablo Sanchez-Villegas: CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
Santi Esnaola: Department of Health of the Basque Country, 01006 Vitoria-Gasteiz, Spain
Antonio Daponte: CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
Carme Borrell: Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain

IJERPH, 2020, vol. 17, issue 3, 1-16

Abstract: 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.

Keywords: socioeconomic factors; trends; mortality; inequalities; urban areas; small areas (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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