Widening social inequalities in mortality: the case of Barcelona, a southern European city.

An ecological study was carried out using information zones as units of analysis in order to assess the evolution of socio-spatial inequalities in mortality due to external causes and homicides in Salvador, Bahia State, Brazil, in 2000 and 2006. The Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE) and the City Health Department (Secretaria Municipal de Saúde) provided the data sources, and causes of death were reviewed and reclassified based on reports from the Institute of Legal Medicine (Instituto Médico Legal). The information zones were classified into four social strata according to income and schooling. The ratio between mortality rates (inequality ratio) was calculated and confirmed a rise of 98.5% in the homicide rate. In 2000, the risk of death due to external causes and murders in the stratum with the worst living conditions was respectively 1.40 and 1.94 times greater than in the reference stratum. In 2006 these figures were 2.02 and 2.24. The authors discuss the implications for inter-sectoral public policies, based on evidence from the study's findings.

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Family Health Strategy, Primary Health Care, and Social Inequalities in Mortality Among Older Adults in Bagé, Southern Brazil

American Journal of Public Health ◽

10.2105/ajph.2020.306146 ◽

2021 ◽

pp. e1-e10

Author(s):

Marciane Kessler ◽

Elaine Thumé ◽

Michael Marmot ◽

James Macinko ◽

Luiz Augusto Facchini ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Primary Health Care ◽

Social Inequalities ◽

Family Health ◽

Primary Health ◽

Health Strategy ◽

Family Health Strategy ◽

Inequalities In Mortality

Objectives. To investigate the role of the Family Health Strategy (FHS) in reducing social inequalities in mortality over a 9-year follow-up period. Methods. We carried out a population-based cohort study of individuals aged 60 years and older from the city of Bagé, Brazil. Of 1593 participants at baseline (2008), 1314 (82.5%) were included in this 9-year follow-up (2017). We assessed type of primary health care (PHC) coverage and other variables at baseline. In 2017, we ascertained 579 deaths through mortality registers. Hazard ratios and their 95% confidence intervals modeled time to death estimated by Cox regression. We also tested the effect modification between PHC and wealth. Results. The FHS had a protective effect on mortality among individuals aged 60 to 64 years, a result not found among those not covered by the FHS. Interaction analysis showed that the FHS modified the effect of wealth on mortality. The FHS protected the poorest from all-cause mortality (hazard ratio [HR] = 0.59; 95% confidence interval [CI] = 0.36, 0.96) and avoidable mortality (HR = 0.46; 95% CI = 0.25, 0.85). Conclusions. FHS coverage reduced social inequalities in mortality among older adults. Our findings highlight the need to guarantee universal health coverage in Brazil by expanding and strengthening the FHS to promote health equity. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306146 )

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Are social inequalities in mortality in Britain narrowing? Time trends from 1978 to 2005 in a population-based study of older men

Journal of Epidemiology & Community Health ◽

10.1136/jech.2006.053207 ◽

2008 ◽

Vol 62 (1) ◽

pp. 75-80 ◽

Cited By ~ 12

Author(s):

S E Ramsay ◽

R W Morris ◽

L T Lennon ◽

S G Wannamethee ◽

P H Whincup

Keyword(s):

Time Trends ◽

Social Inequalities ◽

Older Men ◽

Population Based ◽

Population Based Study ◽

Inequalities In Mortality

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Social inequalities in mortality in older women cannot be explained by biological and health behavioural factors — results from a Norwegian health survey (the HUNT Study)

Scandinavian Journal of Public Health ◽

10.1177/1403494809102777 ◽

2009 ◽

Vol 37 (4) ◽

pp. 401-408 ◽

Cited By ~ 8

Author(s):

Berit Rostad ◽

Berit Schei ◽

Tom Ivar Lund Nilsen

Keyword(s):

Older Women ◽

Health Survey ◽

Social Inequalities ◽

Hunt Study ◽

Behavioural Factors ◽

Inequalities In Mortality

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Contribution of main causes of death to social inequalities in mortality in the whole population of Scania, Sweden

BMC Public Health ◽

10.1186/1471-2458-6-79 ◽

2006 ◽

Vol 6 (1) ◽

Cited By ~ 24

Author(s):

Maria Rosvall ◽

Basile Chaix ◽

John Lynch ◽

Martin Lindström ◽

Juan Merlo

Keyword(s):

Causes Of Death ◽

Social Inequalities ◽

Inequalities In Mortality

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Social inequalities in mortality: a problem of cognitive function?

European Heart Journal ◽

10.1093/eurheartj/ehp264 ◽

2009 ◽

Vol 30 (15) ◽

pp. 1819-1820 ◽

Cited By ~ 12

Author(s):

M. Marmot ◽

M. Kivimaki

Keyword(s):

Cognitive Function ◽

Social Inequalities ◽

Inequalities In Mortality

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The respective parts of incidence and lethality in socioeconomic differences in cancer mortality. An analysis of the French network Cancer registries (FRANCIM) data

International Journal for Equity in Health ◽

10.1186/s12939-019-1087-y ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Joséphine Bryere ◽

◽

Laure Tron ◽

Gwenn Menvielle ◽

Guy Launoy

Keyword(s):

Cancer Mortality ◽

Excess Mortality ◽

Social Inequalities ◽

Cancer Registries ◽

Relative Contribution ◽

Mortality Incidence ◽

Study Population ◽

Inequalities In Mortality ◽

Excess Incidence ◽

Guide Intervention

Abstract Background To determine relevant public health actions and to guide intervention priorities, it is of great importance to assess the relative contribution of incidence and lethality to social inequalities in cancer mortality. Methods The study population comprised 185,518 cases of cancer diagnosed between 2006 and 2009 recorded in the French registries. Survival was known for each patient (endpoint: 30/06/2013). Deprivation was assessed using the European Deprivation Index. We studied the influence of deprivation on mortality, incidence and lethality rates and quantified the respective proportions of incidence and lethality in social inequalities in mortality by calculating attributable deaths. Results For cancers with social inequalities both in incidence and lethality, excess mortality in deprived was mainly caused by social inequalities in incidence (e.g. men lung cancer: 87% of excess deaths in the deprived caused by inequalities in incidence). Proportions were more balanced for some cancer sites (e.g. cervical cancer: 56% incidence, 44% lethality). For cancer sites with a higher incidence in the least deprived (e.g. breast cancer), the excess-lethality in deprived leads entirely the higher mortality among the deprived. Conclusions Most of the excess mortality in deprived is due to the excess incidence of tobacco-dependent cancers and the excess lethality of screenable cancers.

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