Age-period-cohort analysis of lung cancer mortality inequalities in Southern Spain: missed opportunities for implementing equitable tobacco control policies.

Background: Lung cancer mortality in European countries shows different epidemiological patterns according to sex and socioeconomic variables. Some countries show decreasing rates in both sexes, while others show a delayed profile, with increasing mortality in women, inconsistently influenced by socioeconomic status. Our aim was to evaluate the effect of age, period and birth cohort on lung cancer mortality inequalities in men and women in Andalusia, the southernmost region in Spain.

Industrial pollution and mortality from digestive cancers at the small area level in a Spanish industrialized province.

The province of Cadiz, Spain, is a highly industrialized area with numerous registered industrial plants, which has led to major concern regarding the possible influence of these facilities on the high rate of cancer-related mortality observed. Our objective was to evaluate the association between digestive cancer mortality and proximity to industrial installations in the province of Cadiz over the period 1992-2014 and to analyse this risk according to different categories of carcinogenic substances. An ecological study at the census tract level was carried out.

Geographical variations in cancer mortality and social inequalities in southern Spain (Andalusia). 2002-2013.

Introduction: Geographical variations in cancer mortality can be explained, in part, by their association with social inequalities. The objective of our study was to analyse the spatial pattern of mortality in relation to the most common causes of cancer in the Spanish autonomous community of Andalusia and its possible association with social inequalities.

Materials And Methods: A small area cross-sectional study in Andalusia, with census tracts as units of spatial analysis, for the period 2002-2013.

Cancer Mortality and Deprivation in the Proximity of Polluting Industrial Facilities in an Industrial Region of Spain.

Residential proximity to industrial facilities that release pollutants is a source of exposure to a high number of toxics, many of them known or suspected carcinogens. The objective of the study was to analyze the association between lung, larynx, bladder, and kidney cancer mortality and deprivation in areas proximate to polluting industrial facilities in Cadiz, a highly industrialized province in Spain. An ecological study at census tract level was carried out to estimate the mortality rates associated with deprivation and proximity to polluting industrial facilities (1-5 km) using the Besag-York-Mollié model.

Withstanding austerity: Equity in health services utilisation in the first stage of the economic recession in Southern Spain.

Scant research is available on the impact of the current economic crisis and austerity policies on inequality in health services utilisation in Europe. This study aimed to describe the trends in horizontal inequity in the use of health services in Andalusia, Spain, during the early years of the Great Recession, and the contribution of demographic, economic and social factors. Consultation with a general practitioner (GP) and specialist, hospitalisation and emergency care were studied through the Andalusian Health Survey 2007 (pre-crisis) and 2011-2012 (crisis), using a composite income index as socioeconomic status (SES) indicator.

The effect of marital status on social and gender inequalities in diabetes mortality in Andalusia.

Objective: To assess the modifying effect of marital status on social and gender inequalities in mortality from diabetes mellitus (DM) in Andalusia.

Material And Methods: A cross-sectional study was conducted using the Andalusian Longitudinal Population Database. DM deaths between 2002 and 2013 were analyzed by educational level and marital status.

[Family, socioeconomic status and health services: Clues to health care in diabetic patients with lower limb amputations in Andalusia. A qualitative study].

Aim: To examine the experience of diabetic care in patients undergoing lower limb amputation.

Design: A qualitative study using the phenomenological approach.

Setting: Cadiz Health District.

How are the employed and unemployed affected by the economic crisis in Spain? Educational inequalities, life conditions and mental health in a context of high unemployment.

Background: Despite an increasing number of studies on the factors mediating the impact of the economic recession on mental health, research beyond the individual employment status is scarce. Our objectives were to investigate in which ways the mental health of employed and unemployed populations is differently affected by the current economic recession along the educational scale and to examine whether financial strain and social support explain these effects of the crisis.

Methods: A repeated cross-sectional study, using two waves of the Andalusian Health Survey in 2007 (pre-crisis) and 2011-2012 (crisis).

The impact of economic crises on social inequalities in health: what do we know so far?

Since 2008, Western countries are going through a deep economic crisis whose health impacts seem to be fundamentally counter-cyclical: when economic conditions worsen, so does health, and mortality tends to rise. While a growing number of studies have presented evidence on the effect of crises on the average population health, a largely neglected aspect of research is the impact of crises and the related political responses on social inequalities in health, even if the negative consequences of the crises are primarily borne by the most disadvantaged populations. This commentary will reflect on the results of the studies that have analyzed the effect of economic crises on social inequalities in health up to 2013.

[Trends in socioeconomic inequalities in general mortality in the city of Cadiz, Spain (1992-2007)].

Objective: To analyze trends in socioeconomic inequality in mortality in the city of Cadiz (Spain) from 1992 to 2007.

Methods: An ecological study was performed of trends over 3 cross-sections, with the census tract as the unit of analysis. Deaths were grouped into three periods: 1992-1996, 1997-2001 and 2002-2007 and were then classified according to a deprivation index of the census tract.

[The economic crisis at the beginning of the XXI century and mortality in Spain. Trend and impact on social inequalities. SESPAS Report 2014].

This study aimed to assess the impact of the current economic crisis on mortality trends in Spain and its effect on social inequalities in mortality in Andalusia. We used data from vital statistics and the Population Register for 1999 to 2011, as provided by the Spanish Institute of Statistics, to estimate general and sex- and age-specific mortality rates. The Longitudinal Database of the Andalusian Population (2001 census cohort) was used to estimate general mortality rates and ratios by educational level.

[Social determinants vs. lifestyle in type 2 diabetes mellitus in Andalusia (Spain): difficulty in making ends meet or obesity?].

Objective: To assess the relationship between difficulty in making ends meet and obesity and type 2 diabetes mellitus in Andalusia.

Methods: We performed a cross-sectional survey based on the Andalusian Health Survey-2003. Measures of the prevalence and odds ratios (OR) of type 2 diabetes mellitus were calculated according to lifestyle variables, obesity and type 2 diabetes mellitus according to self-perceived difficulties in making ends meet.

[Constructing a deprivation index based on census data in large Spanish cities(the MEDEA project)].

Objectives: a) To describe the methodology used to construct a deprivation index by census tract in cities, to identify the tracts with the least favorable socioeconomic conditions, and b) to analyze the association between this index and overall mortality.

Methods: Several socioeconomic indicators (Census 2001) were defined by the census tracts of the following cities: Barcelona, Bilbao, Madrid, Seville and Valencia. The correlations with the standardized mortality ratio (1996-2003), and the dimensionality of the socioeconomic indicators were studied.

[Trends in social inequalities in mortality in the city of Seville [Spain] [1994-2002]].

Objectives: To know trends of social inequalities in general mortality in Seville (Spain) between 1997 and 2002.

Material And Method: Socioeconomic level of its the residential census tracts was assigned for each death, taken from the Socio-economic Synthetic Index built up after applying a principal components analysis from 2001 census variables. Using mortality indicators its magnitude and trend was described according socio-economic level.

[Diabetes mellitus in Spain: death rates, prevalence, impact, costs and inequalities].

Objective: Describing the situation of diabetes mellitus (DM) in Spain from a public health perspective.

Material And Method: manual review of books and other documents on diabetes mellitus in Spain was conducted. In addition, a specific research of articles published using MeSH terms diabetes mortality, prevalence, incidence, cost, inequalities and Spain was conducted in Medline through Internet (PubMed).

[Trends in preventive drug prescription in the Primary Care District of Seville [2000-2003]].

Objectives: To describe trends in prescription rates for biphosphonates, raloxifene, calcitonin, statins and hormone replacement therapy (HRT) between 2000 and 2003 and to assess the impact of mass media information on the interruption of the Women's Health Initiative trial on HRT prescription rates.

Methodology: We performed a descriptive, ecological study, with time (month) as the observation unit. Monthly rates of bisphosphonate, calcitonin, raloxifene, statins and HRT prescription, in defined daily doses per 1000 persons, were measured in the population assigned to 249 family physicians in 27 health centers in Seville.

Municipal distribution of bladder cancer mortality in Spain: possible role of mining and industry.

Background: Spain shows the highest bladder cancer incidence rates in men among European countries. The most important risk factors are tobacco smoking and occupational exposure to a range of different chemical substances, such as aromatic amines.

Methods: This paper describes the municipal distribution of bladder cancer mortality and attempts to "adjust" this spatial pattern for the prevalence of smokers, using the autoregressive spatial model proposed by Besag, York and Molliè, with relative risk of lung cancer mortality as a surrogate.