Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain.
Institut d'Investigació Biomèdica (IIB Sant Pau), 08041 Barcelona, Spain.
Int J Environ Res Public Health. 2020 Feb 4;17(3):958. doi: 10.3390/ijerph17030958.
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.
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.
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.
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.
本研究旨在分析在西班牙七个城市经历经济危机之前（2001-2004 年，2005-2008 年）和期间（2009-2012 年），由于多种特定原因导致的小范围（街区）死亡的社会经济不平等趋势。
本研究为趋势的生态研究，以街区为分析区域，基于三个时期。研究了几种死因。为每个街区计算了一个社会经济剥夺指数。对于每个小范围，我们根据标准化死亡率比值进行了估计，并使用贝叶斯模型（sSMR）对其变异性进行了控制。我们还根据不同城市、时期和性别，估计了死亡率与贫困之间的相对风险。
一般来说，社会经济剥夺指数和 sSMR 的地理模式相似。对于男性，所有城市的剥夺指数与全因死亡率之间均存在关联，且这种关联在三个时期均保持稳定。对于女性，在巴塞罗那、格拉纳达和塞维利亚，在第三个时期，剥夺指数与全因死亡率之间存在关联。死因模式的异质性更大。
在金融危机开始后，西班牙城市小范围的总死亡率的社会经济不平等在大多数城市中保持稳定，尽管一些死因的模式有所不同。
