Geographical Variability in Mortality in Urban Areas: A Joint Analysis of 16 Causes of Death

Miguel A. Martinez-Beneito, Carlos Vergara-Hernández, Paloma Botella-Rocamora, Francisca Corpas-Burgos, Jordi Pérez-Panadés, Óscar Zurriaga, Elena Aldasoro, Carme Borrell, Elena Cabeza, Lluís Cirera, Josu Delfrade Osinaga, Ana Fernández-Somoano, Ana Gandarillas, Pedro L. Lorenzo Ruano, Marc Marí-Dell’Olmo, Andreu Nolasco, M. Dolores Prieto-Salceda, Rebeca Ramis, Maica Rodríguez-Sanz, Pablo Sánchez-Villegas and the MEDEA3 Project Group
Additional contact information
Miguel A. Martinez-Beneito: Departament d’Estadística e Investigaciò Opertiva, Universitat de València, 46100 Burjassot, Spain
Carlos Vergara-Hernández: FISABIO Foundation, 46020 Valencia, Spain
Paloma Botella-Rocamora: Dirección General de Salut Pública i Adiccions, Conselleria de Sanitat Universal y Salut Pública, 46020 Valencia, Spain
Francisca Corpas-Burgos: CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain
Jordi Pérez-Panadés: Dirección General de Salut Pública i Adiccions, Conselleria de Sanitat Universal y Salut Pública, 46020 Valencia, Spain
Óscar Zurriaga: CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain
Elena Aldasoro: Dirección de Salud Pública y Adicciones, 48013 Bilbao, Spain
Carme Borrell: CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain
Elena Cabeza: Institut d’investigació sanitària de les Illes Balears, 07120 Palma de Mallorca, Spain
Lluís Cirera: CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain
Josu Delfrade Osinaga: CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain
Ana Fernández-Somoano: CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain
Ana Gandarillas: Consejeria de Sanidad, 28035 Madrid, Spain
Pedro L. Lorenzo Ruano: Servicio Canario de Salud, 35018 Las Palmas de Gran Canaria, Spain
Marc Marí-Dell’Olmo: CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain
Andreu Nolasco: Universidad de Alicante, 03690 San Vicente del Raspeig, Spain
M. Dolores Prieto-Salceda: Fundación Marqués de Valdecilla-Observatorio de Salud Pública de Cantabria, 39008 Santander, Spain
Rebeca Ramis: CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain
Maica Rodríguez-Sanz: CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain
Pablo Sánchez-Villegas: Escuela Andaluza de Salud Pública, 18011 Granada, Spain
the MEDEA3 Project Group: Membership of the MEDEA3 Project Group is provided in the Acknowledgments.

IJERPH, 2021, vol. 18, issue 11, 1-15

Abstract: The geographical distribution of mortality has frequently been studied. Nevertheless, those studies often consider isolated causes of death. In this work, we aim to study the geographical distribution of mortality in urban areas, in particular, in 26 Spanish cities. We perform an overall study of 16 causes of death, considering that their geographical patterns could be dependent and estimating the dependence between the causes of death. We study the deaths in these 26 cities during the period 1996–2015 at the census tract level. A multivariate disease mapping model is used in order to solve the potential small area estimation problems that these data could show. We find that most of the geographical patterns found show positive correlations. This suggests the existence of a transversal geographical pattern, common to most causes of deaths, which determines those patterns to a higher/lower extent depending on each disease. The causes of death that exhibit that underlying pattern in a more prominent manner are chronic obstructive pulmonary disease (COPD), lung cancer, and cirrhosis for men and cardiovascular diseases and dementias for women. Such findings are quite consistent for most of the cities in the study. The high positive correlation found between geographical patterns reflects the existence of both high and low-risk areas in urban settings, in general terms for nearly all the causes of death. Moreover, the high-risk areas found often coincide with neighborhoods known for their high deprivation. Our results suggest that dependence among causes of death is a key aspect to be taken into account when mapping mortality, at least in urban contexts.

Keywords: mortality; urban areas; geographical inequalities; multivariate disease mapping (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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