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Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe

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dc.contributor.author Palència Fernàndez, Laia, 1980-
dc.contributor.author Gotsens Miquel, Mercè, 1983-
dc.contributor.author Marí Dell'Olmo, Marc, 1978-
dc.contributor.author Bosakova, Lucia
dc.contributor.author Burström, Bo
dc.contributor.author Costa, Claudia
dc.contributor.author Deboosere, Patrick
dc.contributor.author Dzúrová, Dagmar
dc.contributor.author Lustigova, Michala
dc.contributor.author Morrison Esteve, Joana, 1977-
dc.contributor.author Santana, Paula
dc.contributor.author Borrell i Thió, Carme
dc.date.accessioned 2021-02-23T06:58:21Z
dc.date.available 2021-02-23T06:58:21Z
dc.date.issued 2020
dc.identifier.citation Palència L, Gotsens M, Marí-Dell'Olmo M, Bosakova L, Burström B, Costa C, Deboosere P, Dzurova D, Lustigova M, Morrison J, Santana P, Borrell C. Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe. Gac Sanit. 2020; 34(3):253-60. DOI: 10.1016/j.gaceta.2019.11.001
dc.identifier.issn 0213-9111
dc.identifier.uri http://hdl.handle.net/10230/46569
dc.description.abstract Objective: To analyse socioeconomic inequalities in all-cause mortality among men and women in nine European urban areas during the recent economic crisis, and to compare the results to those from two periods before the crisis. Method: This is an ecological study of trends based on three time periods (2000-2003, 2004-2008 and 2009-2014). The units of analysis were the small areas of nine European urban areas. We used a composite deprivation index as a socioeconomic indicator, along with other single indicators. As a mortality indicator, we used the smoothed standardized mortality ratio, calculated using the hierarchical Bayesian model proposed by Besag, York and Mollié. To analyse the evolution of socioeconomic inequalities, we fitted an ecological regression model that included the socioeconomic indicator, the period of time, and the interaction between these terms. Results: We observed significant inequalities in mortality among men for almost all the socioeconomic indicators, periods, and urban areas studied. However, no significant changes occurred during the period of the economic crisis. While inequalities among women were less common, there was a statistically significant increase in inequality during the crisis period in terms of unemployment and the deprivation index in Prague and Stockholm, respectively. Conclusions: Future analyses should also consider time-lag in the effect of crises on mortality and specific causes of death, and differential effects between genders.
dc.description.abstract Objetivo: Analizar las desigualdades socioeconómicas en la mortalidad por todas las causas en hombres y mujeres de nueve áreas urbanas europeas durante la reciente crisis económica, y comparar los resultados con dos periodos previos a la crisis. Método: Estudio ecológico de tendencias basado en tres periodos (2000-2003, 2004-2008 y 2009-2014). Las unidades de análisis fueron las áreas pequeñas de nueve zonas urbanas europeas. Se utilizaron un índice compuesto de privación socioeconómica como indicador socioeconómico y otros indicadores simples. Como indicador de mortalidad se usó la razón de mortalidad estandarizada suavizada, calculada utilizando el modelo jerárquico bayesiano propuesto por Besag, York y Mollié. Para analizar la evolución de las desigualdades socioeconómicas se utilizó un modelo de regresión ecológico que incluía el indicador socioeconómico, el periodo y la interacción de ambos. Resultados: Se observaron desigualdades significativas en la mortalidad en los hombres para casi todos los indicadores socioeconómicos, periodos y áreas urbanas. Sin embargo, no hubo cambios significativos en las desigualdades en el periodo de crisis. Aunque las desigualdades entre las mujeres fueron menos comunes, hubo un incremento significativo en las desigualdades en mortalidad en el periodo de crisis en términos de desempleo y del índice de privación en Praga y Estocolmo, respectivamente. Conclusiones: Futuros análisis deberán tener en cuenta el tiempo transcurrido entre la crisis y su efecto en la mortalidad, así como diferentes causas de mortalidad y el efecto diferencial entre géneros.
dc.description.sponsorship This study is a part of the EURO-HEALTHY project (Shaping EUROpean policies to promote HEALTH equity) and has received funding from the European Union's Horizon 2020 research and innovation programme (Grant Agreement No 643398). Dagmar Dzúrová and Michala Lustigova were also supported by Charles University (UNCE/HUM 018).
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Gac Sanit. 2020; 34(3):253-60
dc.rights © 2019 SESPAS. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.title Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe
dc.title.alternative Efecto de la reciente crisis económica en las desigualdades socioeconómicas en la mortalidad en nueve áreas urbanas europeas
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.gaceta.2019.11.001
dc.subject.keyword All-cause mortality
dc.subject.keyword Crisis económica
dc.subject.keyword Desigualdades socioeconómicas
dc.subject.keyword Economic crisis
dc.subject.keyword Europa
dc.subject.keyword Europe
dc.subject.keyword Mortalidad por todas las causas
dc.subject.keyword Small areas
dc.subject.keyword Socioeconomic inequalities
dc.subject.keyword Áreas pequeñas
dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/643398
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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