Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

The role of population change in the increased economic differences in mortality: a study of premature death from all causes and major groups of causes of death in Spain, 1980–2010

Authors: David Martínez, Carolina Giráldez-García, Estrella Miqueleiz, María E Calle, Juana M Santos, Enrique Regidor

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

An increase has been observed in differences in mortality between the richest and poorest areas of rich countries. This study assesses whether one of the proposed explanations, i.e., population change, might be responsible for this increase in Spain.

Methods

Observational study based on average income, population change and mortality at provincial level. The premature mortality rate (ages 0–74 years) was estimated for all causes and for cancer, cardiovascular disease and external causes across the period 1980–2010. In the years analysed, provinces were grouped into tertiles based on provincial income, with the mortality rate ratio (MMR) being estimated by taking the tertile of highest-income provinces as reference. Population change was then controlled for to ascertain whether it would modify the rate ratio.

Results

In all-cause mortality, the magnitude of the MRR for provinces in the poorest versus the richest tertile was 1.01 in 1980 and 1.12 in 2010; in cardiovascular mortality, the MMRs for these same years were 1.08 and 1.31 respectively; and in the case of cancer and external-cause mortality, MMR magnitude was similar in 1980 and 2010. The magnitude of the MMR remained unchanged in response to adjustment for population change, with the single exception of 1980, when it increased in all-cause and cardiovascular mortality.

Conclusion

The increase in the difference in premature mortality between the richest and poorest areas in Spain is due to the increased difference in cardiovascular mortality. This increase is not accounted for by population change. In rich countries, more empirical evidence is thus needed to test other alternative explanations for the increase in economic differences in mortality.
Literature
1.
2.
Thomas B, Dorling D, Davey Smith G. Inequalities in premature mortality in Britain: observational study from 1921 to 2007. BMJ. 2010;41:c3639.CrossRef
3.
Singh GK, Siahpush M. Increasing inequalities in all-cause and cardiovascular mortality among US adults aged 25–64 years by area socioeconomic status, 1969–1998. Int J Epidemiol. 2002;31:600–13.CrossRefPubMed
4.
Pearce J, Dorling D. Increasing geographical inequalities in health in New Zealand, 1980–2001. Int J Epidemiol. 2006;35:597–603.CrossRefPubMed
5.
Harper S. Commentary What explains widening geographic differences in life expectancy in New Zealand. Int J Epidemiol. 2006;35:604–6.CrossRefPubMed
6.
Brimblecombe N, Dorling D, Shaw M. Migration and geographical inequalities in health in Britain. Soc Sci Med. 2000;50:861–78.CrossRefPubMed
7.
Davey Smith G, Shaw M, Dorling D. Shrinking areas and mortality. Lancet. 1998;352:1439–30.CrossRef
8.
9.
Davey Smith G, Shaw M, Dorling D. Population change and mortality in men and women. J Epidemiol Community Health. 2001;55:9.CrossRefPubMed
10.
Regidor E, Calle ME, Domínguez V, Navarro P. Inequalities in mortality in shrinking and growing areas. J Epidemiol Community Health. 2002;56:919–21.CrossRefPubMedPubMedCentral
11.
Connolly S, O'Reilly D, Rosato M. Increasing inequalities in health: is it an artefact caused by the selective movement of people? Soc Sci Med. 2007;64:2008–15.CrossRefPubMed
12.
Boyle P, Exeter D, Flowerdew R. The role of population change in widening the mortality gap in Scotland. Area. 2004;36(2):164–73.CrossRef
13.
Regidor E, Santos JM, Ortega P, Calle ME, Astasio P, Martínez D. Decreasing income inequality and emergence of the association between income and premature mortality: Spain, 1970–2010. Health Place. 2014;27:30–7.CrossRefPubMed
14.
Fundación BBV. Renta nacional de España y su distribución provincial. Serie homogénea. Años 1955 a 1993 y avances 1994 a 1997. Bilbao: Fundación BBV; 1999.
15.
16.
Mahoney MC, LaBrie DS, Nasca PC, Wolfgang PE, Burnett WS. Population density and cancer mortality differentials in New York State, 1978–1982. Int J Epidemiol. 1990;19:483–90.CrossRefPubMed
17.
Chaix B, Rosvall M, Lynch J, Merlo J. Disentangling contextual effects on cause-specific mortality in a longitudinal 23-year follow-up study: impact of population density or socioeconomic environment? Int J Epidemiol. 2006;35:633–43.CrossRefPubMed
18.
19.
Eurostat. Europe in figures. Eurostat Yearbook 2005. Luxembourg: Office for Official Publications of the European Communities; 2005.
20.
Regidor E, de La Fuente L, Martínez D, Calle ME, Domínguez V. Heterogeneity in cause-specific mortality according to birthplace in immigrant men residing in Madrid, Spain. Ann Epidemiol. 2008;18:605–13.CrossRefPubMed
21.
Krieger N, Rehkopf DH, Chen JT, Waternan PD, Marcelli E, Kennedy M. The fall and rise of US inequities in premature mortality: 1960–2002. PLoS Med. 2008;5:e46.CrossRefPubMedPubMedCentral
22.
Leyland AH, Dundas R, McLoone P, Boddy FA. Cause-specific inequalities in mortality in Scotland: two decades of change A population-based study. BMC Public Health. 2007;7:112.CrossRef
23.
Ezzati M, Friedman AB, Kulkarni SC, Murray CJL. The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States. PLoS Med. 2008;5:e66.CrossRefPubMedPubMedCentral
24.
Connolly S, O'Reilly D. The contribution of migration to changes in the distribution of health over time: five-year follow-up study in Northern Ireland. Soc Sci Med. 2007;65:1004–11.CrossRefPubMed
25.
Reques L, Giráldez-García C, Miqueleiz E, Belza MJ, Regidor E. Educational differences in mortality and the relative importance of different causes of death: a 7-year follow-up study of Spanish adults. J Epidemiol Community Health. 2014;68:1151–60.CrossRefPubMed
26.
Wing S, Casper M, Riggan W, Hayes C, Tyroler HA. Socioenvironmental characteristics associated with the onset of decline of ischemic heart disease mortality in the United States. Am J Public Health. 1988;78:923–6.CrossRefPubMedPubMedCentral
27.
Grau M, Elosua R, Cabrera de León A, Guembe MJ, Baena-Díez JM, Alonso T, et al. Cardiovascular risk factors in Spain in the first decade of the 21st century, a pooled analysis with individual data from 11 population-based studies: the DARIOS study. Rev Esp Cardiol. 2011;64:295–304.CrossRefPubMed
28.
Exeter DJ, Feng Z, Flowerdew R, Boyle PJ. Shrinking areas and mortality: an artefact of deprivation effects? J Epidemiol Community Health. 2005;59:924–6.CrossRefPubMedPubMedCentral
29.
Exeter DJ, Boyle PJ, Feng Z, Boyle M. Shrinking areas and mortality: an artefact of deprivation effects in the West of Scotland? Health Place. 2009;15:399–401.CrossRefPubMed
Metadata
Title
The role of population change in the increased economic differences in mortality: a study of premature death from all causes and major groups of causes of death in Spain, 1980–2010
Authors
David Martínez
Carolina Giráldez-García
Estrella Miqueleiz
María E Calle
Juana M Santos
Enrique Regidor
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1678-5

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue

Research article

Non-fatal overdoses and related risk factors among people who inject drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia

Research article

Replication of a whole school ethos-changing intervention: different context, similar effects, additional insights

Research article

Economic considerations and health in all policies initiatives: evidence from interviews with key informants in Sweden, Quebec and South Australia

Research article

Predictors of marked weight gain in a population of health care and industrial workers following smoking cessation

Research article

Socioeconomic inequalities in non-communicable diseases and their risk factors: an overview of systematic reviews

Research article

Information and communication technologies for approaching smokers: a descriptive study in primary healthcare