"Evolution of the socioeconomic inequalities in mortality in small areas of the Basque Autonomous Community" (Evolución de las desigualdades socioeconómicas en la mortalidad en áreas pequeñas de la Comunidad Autónoma del País Vasco) is the title of the PhD thesis written up by Imanol Montoya in the Department of Applied Economics III (Econometrics and Statistics) of the UPV/EHU's Faculty of Economics and Business Sciences. In Montoya's view, "the analysis of the geographical distribution of health indicators is very important to be able to develop suitable public policies that will enable the inequalities in health to be reduced".

To do this, he studied the association between mortality and socioeconomic deprivation according to place of residence during two periods of time (1996-2001 and 2002-2007) for men and women in 1,645 census tracts of the BAC. Both general mortality and the main causes of mortality were analysed. The socioeconomic level of each geographical area was characterised using an index that takes five socioeconomic indicators into consideration: percentage of manual workers, unemployment, seasonal employees, insufficient education and insufficient education among young people. Complex statistical methods were used, such as spatial models that take into consideration the correlation between neighbouring geographical areas and the Bayesian methodology, to estimate the association between mortality and socioeconomic deprivation.

The main conclusion of this work "is that there are highly significant socioeconomic inequalities in mortality in general and in several of the main causes between the census tracts of the BAC during the 1996-2001 and 2002-2007 periods," explained Montoya, "and that these results are more evident for men than for women. In the more socially disadvantaged areas the mortality risk is clearly higher than that of the more advantaged areas". According to the researcher, there are various hypotheses that could explain the reason why the results are not so evident in the case of women; one of them is the way in which the indicator used to characterise the tracts was set up: the researcher acknowledged that the socioeconomic indicators used (percentage of manual workers, unemployment, etc.) may not truly reflect the case of women.

Another of the contributions of this work is that "the impact that these inequalities exert on general mortality and on the main causes of mortality has been quantified for the first time in the BAC", he added. According to data provided by the researcher, in the case of men the total number of deaths that can be attributed to inequalities has been shown to be significant: 5,278 deaths in the 1996-2001 period and 4,475 in the 2002-2007 period; "this accounts for practically 10% of the total of deaths in the men", explained Montoya. This signifies, according to the researcher, that for men in the BAC there is a daily average of two deaths that can be attributed to the social inequalities in health relating to the place of residence.

In men, "when analysing the main causes of mortality, there is a greater risk of mortality in the more disadvantaged areas of the BAC in practically all the causes analysed", affirmed the author. According to the data provided in the research, 25% of mortality due to cirrhosis or cancer of the respiratory and digestive tract can be attributed to socioeconomic inequalities of the place of residence; and between 10% and 20% of the deaths that can be attributed to socioeconomic inequalities of the place of residence in the case of suicide, external causes, chronic obstructive pulmonary disease, lung cancer, stomach cancer and malignant tumours.

Study before the economic crisis

The study, carried out over two periods, has produced results that persist over time: "the results are practically the same in both periods," concluded Montoya. However, he highlights the fact that since 2008 the BAC has been enduring a significant economic downturn and that this work analyses mortality only up to 2007, so "in the future these results could be valuable in analysing the effect that the downturn could exert on the socioeconomic inequalities in mortality in the BAC," said the researcher.

As Montoya explained, "pieces of work like this and others produced by the Department of Health of the BAC Government have highlighted the fact that there are significant differences in the mortality risk in the BAC depending on where one lives. So it is necessary to go on monitoring and investigating in this respect". Finally, he added that it is necessary "to intensify the policies that can reduce these social inequalities in the BAC".

Additional information

Imanol Montoya-Arroniz (Vitoria-Gasteiz, 1977) is a Graduate in Economics (Statistics and Econometrics) at the UPV/EHU and has a Master's in Statistics (London School of Economics). His PhD thesis was written up under the supervision of Petr Mariel Chladkova and in collaboration with the Healthcare Studies and Research Service of the Department of Health of the BAC Government.

Photos: Nuria González. UPV/EHU.

Subscribe to Directory
Write an Article

Recent News

El diagnóstico genético neonatal mejor...

Un estudio con datos de los últimos 35 años, ind...

Más de 1.500 cambios epigenéticos en e...

Un equipo de investigadores de la Universidad Juli...

Tuneable reverse photochromes in the sol...

A new technique allows the design of solid materia...

Highlight

Eosinófilos. ¿Qué significa tener val...

by Labo'Life

​En nuestro post hablamos sobre este interesante tipo de célula del...

Un estudio de INCLIVA muestra el efecto ...

by INCLIVA

Han desarrollado un estudio para evaluar la correlación entre el teji...

Photos Stream