Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe
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 period...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-05-01
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| Series: | Gaceta Sanitaria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0213911119302614 |
| _version_ | 1811286881423327232 |
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| author | Laia Palència Mercè Gotsens Marc Marí-Dell’Olmo Lucia Bosakova Bo Burström Cláudia Costa Patrick Deboosere Dagmar Dzurova Michala Lustigova Joana Morrison Paula Santana Carme Borrell |
| author_facet | Laia Palència Mercè Gotsens Marc Marí-Dell’Olmo Lucia Bosakova Bo Burström Cláudia Costa Patrick Deboosere Dagmar Dzurova Michala Lustigova Joana Morrison Paula Santana Carme Borrell |
| author_sort | Laia Palència |
| collection | DOAJ |
| description | 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. Resumen: 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. |
| first_indexed | 2024-04-13T03:08:51Z |
| format | Article |
| id | doaj.art-88f49a64ff244e8496daa67a8288b839 |
| institution | Directory Open Access Journal |
| issn | 0213-9111 |
| language | English |
| last_indexed | 2024-04-13T03:08:51Z |
| publishDate | 2020-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gaceta Sanitaria |
| spelling | doaj.art-88f49a64ff244e8496daa67a8288b8392022-12-22T03:05:10ZengElsevierGaceta Sanitaria0213-91112020-05-01343253260Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in EuropeLaia Palència0Mercè Gotsens1Marc Marí-Dell’Olmo2Lucia Bosakova3Bo Burström4Cláudia Costa5Patrick Deboosere6Dagmar Dzurova7Michala Lustigova8Joana Morrison9Paula Santana10Carme Borrell11Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d’Investigació Biomèdica Sant Pau, Barcelona, Spain; Corresponding author.Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d’Investigació Biomèdica Sant Pau, Barcelona, SpainAgència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d’Investigació Biomèdica Sant Pau, Barcelona, SpainDepartment of Health Psychology, Medical Faculty, P.J. Safarik University in Kosice, Kosice, Slovak Republic; Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czech RepublicDepartment of Public Health Sciences, Equity and Health Policy Research Group, Karolinska Institutet, Stockholm, SwedenCentre of Studies in Geography and Spatial Planning, University of Coimbra, Coimbra, PortugalInterface Demography, Section Social Research, Vrije Universiteit Brussels, Brussels, BelgiumDepartment of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czech RepublicDepartment of Social Geography and Regional Development, Faculty of Science, Charles University, Prague, Czech RepublicResearch Department of Epidemiology and Public Health, University College London, London, United KingdomCentre of Studies in Geography and Spatial Planning, University of Coimbra, Coimbra, Portugal; Department of Geography and Tourism, Humanities Faculty, University of Coimbra, Coimbra, PortugalAgència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut d’Investigació Biomèdica Sant Pau, Barcelona, SpainObjective: 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. Resumen: 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.http://www.sciencedirect.com/science/article/pii/S0213911119302614Desigualdades socioeconómicasMortalidad por todas las causasÁreas pequeñasEuropaCrisis económica |
| spellingShingle | Laia Palència Mercè Gotsens Marc Marí-Dell’Olmo Lucia Bosakova Bo Burström Cláudia Costa Patrick Deboosere Dagmar Dzurova Michala Lustigova Joana Morrison Paula Santana Carme Borrell Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe Gaceta Sanitaria Desigualdades socioeconómicas Mortalidad por todas las causas Áreas pequeñas Europa Crisis económica |
| title | Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe |
| title_full | Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe |
| title_fullStr | Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe |
| title_full_unstemmed | Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe |
| title_short | Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe |
| title_sort | effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in europe |
| topic | Desigualdades socioeconómicas Mortalidad por todas las causas Áreas pequeñas Europa Crisis económica |
| url | http://www.sciencedirect.com/science/article/pii/S0213911119302614 |
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