Service of Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain.
J Epidemiol Community Health. 2009 Oct;63(10):832-8. doi: 10.1136/jech.2008.080986. Epub 2009 Jul 1.
Within Europe, women in the southern regions have the lowest inequalities in mortality. This study evaluates inequalities in mortality from different causes by educational level and their contribution to total mortality inequalities in adult women in one of these regions.
The 2001 population census in the Region of Madrid was linked with deaths in the following 20 months according to the mortality registry. The population of women was stratified into three age groups, and the mortality rate ratio and mortality rate difference by educational level were estimated in each age group. The contribution of each cause of death to total mortality inequality was estimated based on the absolute index of inequality.
In women aged 45-64 years, no significant relation was observed between educational level and mortality from the leading causes of death. In women aged 25-44 years and in those aged 65 and over, the mortality rate ratios and differences from the leading causes of death gradually increased from the highest to the lowest educational level. AIDS, respiratory diseases and digestive diseases, in young adult women, and cardiovascular diseases, in older women, were the causes of death that contributed most to inequality in mortality.
At the beginning of the twenty-first century, mortality inequalities by educational level were not seen in middle-aged adult women in the Region of Madrid. In contrast, mortality inequalities were found in young women and in older women, although the main causes of death that contributed to these inequalities were different in each group.
在欧洲,南部地区的女性在死亡率方面的不平等程度最低。本研究评估了该地区的女性死亡率不平等的原因,这些不平等是按教育程度划分的,并评估了它们对成年女性总死亡率不平等的贡献。
马德里地区 2001 年的人口普查与随后 20 个月的死亡率登记数据相关联。将女性人口分为三个年龄组,在每个年龄组中按教育水平估计死亡率比和死亡率差异。根据绝对不平等指数来估计每种死因对总死亡率不平等的贡献。
在 45-64 岁的女性中,教育水平与主要死因的死亡率之间没有显著关系。在 25-44 岁和 65 岁及以上的女性中,从最高到最低教育水平,主要死因的死亡率比和差异逐渐增加。在年轻成年女性中,艾滋病、呼吸道疾病和消化系统疾病,以及老年女性中的心血管疾病是导致死亡率不平等的主要原因。
在 21 世纪初,马德里地区中年女性的死亡率不平等程度与教育程度无关。相比之下,在年轻女性和老年女性中发现了死亡率不平等现象,尽管导致这些不平等的主要死因在每个群体中有所不同。