Agència de Salut Pública de Barcelona, Lesseps, 1, 08023, Barcelona, Spain.
Institut d'Investigacio Biomedica (IIB Sant Pau), Barcelona, Spain.
Int J Equity Health. 2019 Feb 26;18(1):37. doi: 10.1186/s12939-019-0939-9.
Nearly 20% of the population in Barcelona is foreign-born and this percentage rises to up to 40% in some neighborhoods. Consequently, migration health patterns may play an important role in trends in socioeconomic geographical inequalities in mortality. The objective of this study was to analyze the trend in socioeconomic inequalities in mortality between neighborhoods in Barcelona during the period 2001-2012 in the foreign-born and Spanish-born population.
Repeated cross-sectional design of the population aged 25-64 years in Barcelona between 2001 and 2012. Hierarchical data consisted of yearly mortality linked-population. The variables analyzed were age, sex, education, and country of birth (Spanish-born, foreign-born), neighborhood of residence, and the socioeconomic level of the neighborhoods using quartiles of unemployment rates. Age-standardized mortality rates were estimated, and mixed Poisson regressions were applied using generalized linear mixed models, including two random effects to consider the intracorrelation within neighborhoods and across years.
The number of foreign-born residents aged 25-64 increased notably in disadvantaged neighborhoods. Approximately 9% of premature deaths occurred in foreign-born individuals. Premature mortality rates were higher in disadvantaged neighborhoods and in the Spanish-born population in all periods. Despite the stabilized socioeconomic inequalities in mortality in the Spanish-born population, no inequalities were found between neighborhoods in foreign-born men and women.
Evidence of the 'healthy migrant' effect in mortality and socioeconomic inequalities in mortality was found in Barcelona, which seems to alter the distribution of mortality through time and space, related to the low levels of premature mortality and the selective residence of immigrants in socioeconomically disadvantaged neighborhoods.
巴塞罗那近 20%的人口是外国出生的，在某些街区这一比例上升到 40%。因此，移民健康模式可能在死亡率的社会经济地理不平等趋势中发挥重要作用。本研究的目的是分析 2001-2012 年期间巴塞罗那出生的外国人和西班牙出生的人群在不同街区的死亡率的社会经济不平等趋势。
2001 年至 2012 年期间，巴塞罗那年龄在 25-64 岁的人群重复横断面设计。分层数据由每年与人口相关的死亡率组成。分析的变量包括年龄、性别、教育程度和出生国（西班牙出生、外国出生）、居住街区以及使用失业率四分位法的街区的社会经济水平。估计了年龄标准化死亡率，并使用广义线性混合模型应用混合泊松回归，包括两个随机效应，以考虑街区内和年份间的相关性。
处于不利地位街区的外国出生居民人数显著增加。大约 9%的过早死亡发生在外国出生的人身上。在所有时期，弱势街区和西班牙出生的人群的过早死亡率都较高。尽管西班牙出生的人群的死亡率的社会经济不平等已经稳定，但在外国出生的男性和女性之间没有发现街区间的不平等。
在巴塞罗那发现了死亡率和社会经济不平等的“健康移民”效应的证据，这似乎通过时间和空间改变了死亡率的分布，与低水平的过早死亡率和移民在社会经济劣势街区的选择性居住有关。
