Int J Health Geogr - Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities.


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CKGROUND: Intra-urban inequalities in mortality have been infrequently analysed in European contexts. The aim of the present study was to analyse patterns of cancer mortality and their relationship with socioeconomic deprivation in small areas in 11 Spanish cities.METHODS: It is a cross-sectional ecological design using mortality data (years 1996-2003). Units of analysis were the census tracts. A deprivation index was calculated for each census tract. In order to control the variability in estimating the risk of dying we used Bayesian models. We present the RR of the census tract with the highest deprivation vs. the census tract with the lowest deprivation.RESULTS: In the case of men, socioeconomic inequalities are observed in total cancer mortality in all cities, except in Castellon, Cordoba and Vigo, while Barcelona (RR = 1.53 95%CI 1.42-1.67), Madrid (RR = 1.57 95%CI 1.49-1.65) and Seville (RR = 1.53 95%CI 1.36-1.74) present the greatest inequalities. In general Barcelona and Madrid, present inequalities for most types of cancer. Among women for total cancer mortality, inequalities have only been found in Barcelona and Zaragoza. The excess number of cancer deaths due to socioeconomic deprivation was 16,413 for men and 1,142 for women.CONCLUSION: This study has analysed inequalities in cancer mortality in small areas of cities in Spain, not only relating this mortality with socioeconomic deprivation, but also calculating the excess mortality which may be attributed to such deprivation. This knowledge is particularly useful to determine which geographical areas in each city need intersectorial policies in order to promote a healthy environment.

Resumo Limpo

ckground intraurban inequ mortal infrequ analys european context aim present studi analys pattern cancer mortal relationship socioeconom depriv small area spanish citiesmethod crosssect ecolog design use mortal data year unit analysi census tract depriv index calcul census tract order control variabl estim risk die use bayesian model present rr census tract highest depriv vs census tract lowest deprivationresult case men socioeconom inequ observ total cancer mortal citi except castellon cordoba vigo barcelona rr ci madrid rr ci sevill rr ci present greatest inequ general barcelona madrid present inequ type cancer among women total cancer mortal inequ found barcelona zaragoza excess number cancer death due socioeconom depriv men womenconclus studi analys inequ cancer mortal small area citi spain relat mortal socioeconom depriv also calcul excess mortal may attribut depriv knowledg particular use determin geograph area citi need intersectori polici order promot healthi environ

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