IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v141y2015icp142-150.html
   My bibliography  Save this article

Area-level socioeconomic context, total mortality and cause-specific mortality in Spain: Heterogeneous findings depending on the level of geographic aggregation

Author

Listed:
  • Regidor, Enrique
  • Vallejo, Fernando
  • Reques, Laura
  • Cea, Lucía
  • Miqueleiz, Estrella
  • Barrio, Gregorio

Abstract

The objective of this study was to estimate the association between area-level socioeconomic context and mortality in Spain, using two different geographic aggregations. Nation-wide prospective study covering all persons living in Spain in 2001. Mortality was analysed in Spanish citizens by province of residence and in citizens of Madrid by neighbourhood of residence. Provinces and neighbourhoods were grouped into quartiles according to two socioeconomic indicators: percentage of the population with university education and unemployment rate. The measure of association was the rate ratio for total mortality and cause-specific mortality, by each socioeconomic indicator in two age groups, 25–64 years (adult population) and 65 years and over (elderly population). After adjustment for all individual socioeconomic variables, the rate ratio for total mortality among residents in the provinces with the worst versus best socioeconomic context was 0.92 (95% CI 0.88–0.97) when the indicator was percentage of university population and 0.89 (0.85–0.93) when it was unemployment rate in the adult population, and 1.05 (1.00–1.11) and 1.08 (1.03–1.13), respectively, in the elderly population. No significant differences in mortality were observed between adults residing in neighbourhoods with the worst versus best socioeconomic context, but in the elderly population the mortality rate ratios for the two socioeconomic indicators were 1.04 (1.01–1.07) and 1.06 (1.03–1.09), respectively. Residents in provinces with the worst socioeconomic context had the lowest mortality from cancer and external causes and the highest mortality from cardiovascular diseases, while residents in neighbourhoods with the worst socioeconomic context had the highest mortality from respiratory and digestive diseases. Further research should find out the reasons for the lower total mortality in adult population residing in the Spanish provinces with the most adverse socioeconomic context and the reasons for excess mortality from digestive diseases and respiratory diseases among residents in neighbourhoods with the worst socioeconomic context.

Suggested Citation

  • Regidor, Enrique & Vallejo, Fernando & Reques, Laura & Cea, Lucía & Miqueleiz, Estrella & Barrio, Gregorio, 2015. "Area-level socioeconomic context, total mortality and cause-specific mortality in Spain: Heterogeneous findings depending on the level of geographic aggregation," Social Science & Medicine, Elsevier, vol. 141(C), pages 142-150.
    • Handle: RePEc:eee:socmed:v:141:y:2015:i:c:p:142-150
    DOI: 10.1016/j.socscimed.2015.07.030
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953615300460
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2015.07.030?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Jacqueline M Major & Chyke A Doubeni & Neal D Freedman & Yikyung Park & Min Lian & Albert R Hollenbeck & Arthur Schatzkin & Barry I Graubard & Rashmi Sinha, 2010. "Neighborhood Socioeconomic Deprivation and Mortality: NIH-AARP Diet and Health Study," PLOS ONE, Public Library of Science, vol. 5(11), pages 1-6, November.
    2. Waitzman, N.J. & Smith, K.R., 1998. "Erratum: Phantom of the area: Poverty-area residence and mortality in the United States (American Journal of Public Health (1998) 88 (973-976))," American Journal of Public Health, American Public Health Association, vol. 88(7), pages 1122-1122.
    3. Maria T Sánchez-Santos & Marco Mesa-Frias & Minkyoung Choi & Eveline Nüesch & Angel Asunsolo-Del Barco & Antoinette Amuzu & George Davey Smith & Shah Ebrahim & David Prieto-Merino & Juan P Casas, 2013. "Area-Level Deprivation and Overall and Cause-Specific Mortality: 12 Years’ Observation on British Women and Systematic Review of Prospective Studies," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
    4. Meijer, Mathias & Röhl, Jeannette & Bloomfield, Kim & Grittner, Ulrike, 2012. "Do neighborhoods affect individual mortality? A systematic review and meta-analysis of multilevel studies," Social Science & Medicine, Elsevier, vol. 74(8), pages 1204-1212.
    5. Waitzman, N.J. & Smith, K.R., 1998. "Phantom of the area: Poverty-area residence and mortality in the United States," American Journal of Public Health, American Public Health Association, vol. 88(6), pages 973-976.
    6. Petrelli, Alessio & Gnavi, Roberto & Marinacci, Chiara & Costa, Giuseppe, 2006. "Socioeconomic inequalities in coronary heart disease in Italy: A multilevel population-based study," Social Science & Medicine, Elsevier, vol. 63(2), pages 446-456, July.
    7. Merlo, Juan & Viciana-Fernández, Francisco J. & Ramiro-Fariñas, Diego, 2012. "Bringing the individual back to small-area variation studies: A multilevel analysis of all-cause mortality in Andalusia, Spain," Social Science & Medicine, Elsevier, vol. 75(8), pages 1477-1487.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Justin T. Denney & Jarron M. Saint Onge & Jeff A. Dennis, 2018. "Neighborhood Concentrated Disadvantage and Adult Mortality: Insights for Racial and Ethnic Differences," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 37(2), pages 301-321, April.
    2. Nancy A. Ross & Lisa N. Oliver & Paul J. Villeneuve, 2013. "The Contribution of Neighbourhood Material and Social Deprivation to Survival: A 22-Year Follow-up of More than 500,000 Canadians," IJERPH, MDPI, vol. 10(4), pages 1-14, April.
    3. Islam, M. Kamrul & Gerdtham, Ulf-G. & Gullberg, Bo & Lindström, Martin & Merlo, Juan, 2008. "Social capital externalities and mortality in Sweden," Economics & Human Biology, Elsevier, vol. 6(1), pages 19-42, March.
    4. Jacob, Brian A. & Ludwig, Jens & Miller, Douglas L., 2013. "The effects of housing and neighborhood conditions on child mortality," Journal of Health Economics, Elsevier, vol. 32(1), pages 195-206.
    5. Mamelund, Svenn-Erik, 2006. "A socially neutral disease? Individual social class, household wealth and mortality from Spanish influenza in two socially contrasting parishes in Kristiania 1918-19," Social Science & Medicine, Elsevier, vol. 62(4), pages 923-940, February.
    6. Do, D. Phuong & Finch, Brian Karl & Basurto-Davila, Ricardo & Bird, Chloe & Escarce, Jose & Lurie, Nicole, 2008. "Does place explain racial health disparities? Quantifying the contribution of residential context to the Black/white health gap in the United States," Social Science & Medicine, Elsevier, vol. 67(8), pages 1258-1268, October.
    7. Votruba, Mark Edward & Kling, Jeffrey R., 2009. "Effects of neighborhood characteristics on the mortality of black male youth: Evidence from Gautreaux, Chicago," Social Science & Medicine, Elsevier, vol. 68(5), pages 814-823, March.
    8. Wen, Ming & Cagney, Kathleen A. & Christakis, Nicholas A., 2005. "Effect of specific aspects of community social environment on the mortality of Individuals diagnosed with serious illness," Social Science & Medicine, Elsevier, vol. 61(6), pages 1119-1134, September.
    9. Scribner, Richard Allen & Theall, Katherine P. & Simonsen, Neal R. & Mason, Karen E. & Yu, Qingzhao, 2009. "Misspecification of the effect of race in fixed effects models of health inequalities," Social Science & Medicine, Elsevier, vol. 69(11), pages 1584-1591, December.
    10. van Hooijdonk, Carolien & Droomers, Mariël & van Loon, Jeanne A.M. & van der Lucht, Fons & Kunst, Anton E., 2007. "Exceptions to the rule: Healthy deprived areas and unhealthy wealthy areas," Social Science & Medicine, Elsevier, vol. 64(6), pages 1326-1342, March.
    11. Francois Beland & Steve Birch & Greg Stoddart, 1999. "Health and Individual and Community Characteristics: A Research Protocol," Social and Economic Dimensions of an Aging Population Research Papers 7, McMaster University.
    12. Seth Feinberg, 2009. "Preventable Mortality as a Predictor of Community Social Organisation: Examining Reverse Causality," Urban Studies, Urban Studies Journal Limited, vol. 46(9), pages 1829-1858, August.
    13. Chiara Acquati & Tzuan A. Chen & Isabel Martinez Leal & Shahnjayla K. Connors & Arooba A. Haq & Anastasia Rogova & Stephanie Ramirez & Lorraine R. Reitzel & Lorna H. McNeill, 2021. "The Impact of the COVID-19 Pandemic on Cancer Care and Health-Related Quality of Life of Non-Hispanic Black/African American, Hispanic/Latina and Non-Hispanic White Women Diagnosed with Breast Cancer ," IJERPH, MDPI, vol. 18(24), pages 1-16, December.
    14. Zick, Cathleen D. & Smith, Ken R. & Fan, Jessie X. & Brown, Barbara B. & Yamada, Ikuho & Kowaleski-Jones, Lori, 2009. "Running to the Store? The relationship between neighborhood environments and the risk of obesity," Social Science & Medicine, Elsevier, vol. 69(10), pages 1493-1500, November.
    15. McGrath, Jennifer J. & Matthews, Karen A. & Brady, Sonya S., 2006. "Individual versus neighborhood socioeconomic status and race as predictors of adolescent ambulatory blood pressure and heart rate," Social Science & Medicine, Elsevier, vol. 63(6), pages 1442-1453, September.
    16. Nazeem Muhajarine & Ronald Labonte & Allison Williams & James Randall, 2008. "Person, Perception, and Place: What Matters to Health and Quality of Life," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 85(1), pages 53-80, January.
    17. Maria T Sánchez-Santos & Marco Mesa-Frias & Minkyoung Choi & Eveline Nüesch & Angel Asunsolo-Del Barco & Antoinette Amuzu & George Davey Smith & Shah Ebrahim & David Prieto-Merino & Juan P Casas, 2013. "Area-Level Deprivation and Overall and Cause-Specific Mortality: 12 Years’ Observation on British Women and Systematic Review of Prospective Studies," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
    18. Zhang, Wei & McCubbin, Hamilton & McCubbin, Laurie & Chen, Qi & Foley, Shirley & Strom, Ida & Kehl, Lisa, 2010. "Education and self-rated health: An individual and neighborhood level analysis of Asian Americans, Hawaiians, and Caucasians in Hawaii," Social Science & Medicine, Elsevier, vol. 70(4), pages 561-569, February.
    19. Macintyre, Sally & Macdonald, Laura & Ellaway, Anne, 2008. "Do poorer people have poorer access to local resources and facilities? The distribution of local resources by area deprivation in Glasgow, Scotland," Social Science & Medicine, Elsevier, vol. 67(6), pages 900-914, September.
    20. Zimmer, Zachary & Wen, Ming & Kaneda, Toshiko, 2010. "A multi-level analysis of urban/rural and socioeconomic differences in functional health status transition among older Chinese," Social Science & Medicine, Elsevier, vol. 71(3), pages 559-567, August.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:141:y:2015:i:c:p:142-150. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.