Trends in socioeconomic inequalities in preventable mortality in urban areas of 33 Spanish cities, 1996-007 (MEDEA project)

详细信息    查看全文

• 作者：Andreu Nolasco ; Joaquin Moncho…
• 关键词：Preventable avoidable mortality ; Causes of death ; Inequalities in health ; Small area analysis
• 刊名：International Journal for Equity in Health
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：14
• 期：1
• 全文大小：2,666 KB
• 参考文献：1. Rutstein, DD, Berenberg, W, Chalmers, TC, Child, CG, Fishman, AP, Perrin, EB (1976) Measuring the quality of medical care. A clinical method. N Engl J Med 294: pp. 582-8 CrossRef
  2. Charlton, JR, Hartley, RM, Silver, R, Holland, WW (1983) Geographical variation in mortality from conditions amenable to medical intervention in England and Wales. Lancet 1: pp. 691-6 CrossRef
  3. Holland, WW (1988) European community atlas of avoidable death - report No 3. Oxford University Press, Brussels
  4. Mackenbach, JP, Kunst, AE, Looman, CW, Habbema, JD, Maas, PJ (1988) Regional differences in mortality from conditions amenable to medical intervention in The Netherlands: a comparison of four time periods. J Epidemiol Community Health 42: pp. 325-32 CrossRef
  5. Nolte, E, McKee, M (2004) Does Health Care save lives? Avoidable mortality revisited. The Nuffield Trust, London
  6. Gispert, R, Bares, MA, Puigdefabregas, A (2006) Avoidable mortality: a consensus list of causes to update the indicator in Spain. Gac Sanit 20: pp. 184-93 CrossRef
  7. Nolte, E, McKee, CM (2008) Measuring the health of nations: updating an earlier analysis. Health Aff (Millwood ) 27: pp. 58-71 CrossRef
  8. Tobias, M, Yeh, LC (2007) How much does health care contribute to health inequality in New Zealand?. Aust N Z J Public Health 31: pp. 207-10 CrossRef
  9. Hoffmann, R, Plug, I, Khoshaba, B, McKee, M, Mackenbach, JP (2013) Amenable mortality revisited: the AMIEHS study. Gac Sanit 27: pp. 199-206 CrossRef
  10. Holland, WW (1991) European community atlas of avoidable death - report No 6. Oxford University Press, Brussels
  The world health report 2000 - health systems: improving performance. World Health Organization, Geneva
  11. Stevens, G, Mathers, C (2010) Avoidable mortality–a tool for policy evaluation in developing countries?. Eur J Public Health 20: pp. 241-2 CrossRef
  12. James, PD, Wilkins, R, Detsky, AS, Tugwell, P, Manuel, DG (2007) Avoidable mortality by neighbourhood income in Canada: 25?years after the establishment of universal health insurance. J Epidemiol Community Health 61: pp. 287-96 CrossRef
  13. Mackenbach, JP, Stirbu, I, Roskam, AJ, Schaap, MM, Menvielle, G, Leinsalu, M (2008) Socioeconomic inequalities in health in 22 European countries. N Engl J Med 358: pp. 2468-81 CrossRef
  14. Cano-Serral, G, Azlor, E, Rodriguez-Sanz, M, Pasarin, MI, Martinez, JM, Puigpinos, R (2009) Socioeconomic inequalities in mortality in Barcelona: a study based on census tracts (MEDEA Project). Health Place 15: pp. 186-92 CrossRef
  15. Stirbu, I, Kunst, AE, Bopp, M, Leinsalu, M, Regidor, E, Esnaola, S (2010) Educational inequalities in avoidable mortality in Europe. J Epidemiol Community Health 64: pp. 913-20 CrossRef
  16. Baburin, A, Aareleid, T, Padrik, P, Valvere, V, Innos, K (2014) Time trends in population-based breast cancer survival in Estonia: analysis by age and stage. Acta Oncol 53: pp. 226-34 CrossRef
  17. Regidor, E, Fuente, L, Calle, ME, Navarro, P, Dominguez, V (2003) Unusually strong association between education and mortality in young adults in a community with a high rate of injection-drug users. Eur J Public Health 13: pp. 334-9 CrossRef
  18. Borrell, C, Rodriguez-Sanz, M, Pasarin, MI,
• 刊物主题：Public Health; Development Economics; Quality of Life Research; Social Policy;
• 出版者：BioMed Central
• ISSN：1475-9276

文摘

Background Preventable mortality is a good indicator of possible problems to be investigated in the primary prevention chain, making it also a useful tool with which to evaluate health policies particularly public health policies. This study describes inequalities in preventable avoidable mortality in relation to socioeconomic status in small urban areas of thirty three Spanish cities, and analyses their evolution over the course of the periods 1996-001 and 2002-007. Methods We analysed census tracts and all deaths occurring in the population residing in these cities from 1996 to 2007 were taken into account. The causes included in the study were lung cancer, cirrhosis, AIDS/HIV, motor vehicle traffic accidents injuries, suicide and homicide. The census tracts were classified into three groups, according their socioeconomic level. To analyse inequalities in mortality risks between the highest and lowest socioeconomic levels and over different periods, for each city and separating by sex, Poisson regression were used. Results Preventable avoidable mortality made a significant contribution to general mortality (around 7.5%, higher among men), having decreased over time in men (12.7 in 1996-001 and 10.9 in 2002-007), though not so clearly among women (3.3% in 1996-001 and 2.9% in 2002-007). It has been observed in men that the risks of death are higher in areas of greater deprivation, and that these excesses have not modified over time. The result in women is different and differences in mortality risks by socioeconomic level could not be established in many cities. Conclusions Preventable mortality decreased between the 1996-001 and 2002-007 periods, more markedly in men than in women. There were socioeconomic inequalities in mortality in most cities analysed, associating a higher risk of death with higher levels of deprivation. Inequalities have remained over the two periods analysed. This study makes it possible to identify those areas where excess preventable mortality was associated with more deprived zones. It is in these deprived zones where actions to reduce and monitor health inequalities should be put into place. Primary healthcare may play an important role in this process.