Mortality

Both socioeconomic and environmental inequalities occur in all health outcome variables, both in morbidity and mortality.

Although it is true that we will all die eventually, the causes of such mortality can differ greatly and it has been seen that these causes can exhibit differences per geographical region, time period, and different variables, such as sex.

In Spain, the general mortality rate (per 1000 inhabitants) still differs greatly among the different Autonomous Regions. In 2018, the Autonomous Regions with the lowest mortality rates were Madrid and the Balearic Islands, whereas those with the highest mortality rates were Asturias and Castile and Leon. In the case of Asturias and Castile and Leon, this increased rate is probably explained by the greater aging of the population. Furthermore, and as expected, mortality among men continues to be higher than among women, and has gradually increased in both sexes over the years.

We observed that mortality due to pneumonia and influenza has increased, probably due to the greater mean age of the population, as these diseases are associated with much higher mortality rates among the elderly and people with concomitant diseases.

It should be noted that the Autonomous Regions with a lower per capita gross domestic product (GDP) are characterized by a lower life expectancy and higher mortality rates, both overall and from different causes. In some cases, a notable inequality can be observed within the Autonomous Regions themselves, a fact that should be addressed together with the impact of socioeconomic level on these inequalities.

Studying the distribution of both mortality and morbidity is of great value for prevention, as it reflects the distribution of the risk factors affecting the studied causes.

Thus, nowadays there is still a need to reduce inequalities, in both life expectancy and mortality, which have proven to continue to be very important, and to consider them in the prevention and treatment of different health events, such as in the highly predictable outbreaks of COVID-19.

Projects

Socioeconomic Inequalities in Mortality: Evidence and Policies in Cities of Europe (INEQ-CITIES). Project DG-SANCO A/101156 VII Framework EU Project, Second Program of Community Action in the Field of Health (2008-2013). Main Coordinator: Carme Borrell, Public Health Agency of Barcelona (Agència de Salut Pública de Barcelona). Principal investigator of the GRECS (partner): Marc Saez. Collaborators: Maria Antònia Barceló among others (2009-2012).

Evolution of Socioeconomic, Environmental, and Health inequalities in Small Areas of the Barcelona Metropolitan Region, Camp de Tarragona, and the Girona Health Region (Original title: Evolución de las desigualdades socioeconómicas, medioambientales y en salud, en áreas pequeñas de la Región Metropolitana de Barcelona, del Camp de Tarragona y de la Región Sanitaria Girona). Project 08/0142 of the FIS of the Spanish Ministry of Health and Consumer Affairs. Principal investigator: María Antonia Barceló (GRECS, UdG) (2009-2011).

Survival as an Outcome and Equity Measure of Health Interventions in Cancer Patients. Geographical Analysis in the Assessment of Relative Survival (Original title: La supervivencia como medida de resultado y de equidad de las intervenciones sanitarias en pacientes con cáncer. Análisis geográfico en la estimación de la supervivencia relativa). Project 06/90553 on Health Care Technology Assessment, FIS. Principal investigator: María Antonia Barceló (GRECS, UdG) (2007-2009).

Socioeconomic and Environmental Health Inequalities in Catalonian Cities (Original title: Desigualdades socioeconómicas y medioambientales en salud en ciudades de Cataluña). Project PI040399 of the FIS of the Spanish Ministry of Health and Consumer Affairs. Principal investigator: María Antonia Barceló (GRECS, UdG) (2005 - 2007).

Survival as an Outcome and Equity Measure of Health Interventions in Cancer Patients. Geographic Analysis in the Assessment of Relative Survival (Original title: La supervivència com a mesura de resultat i equitat de les intervencions en salut en pacients amb càncer. Anàlisi geogràfica en l’estimació de la supervivència relativa). Principal investigator: Marc Saez, Project 006/01/2006 of the Catalonian Health Service's AATRM of the Regional Government of Catalonia. Collaborators: Maria Antònia Barceló among others (2007-2009).

Atlas of Mortality in the Provincial Capitals of Catalonia, 1992-1999 (Original title: Atlas de mortalidad de las capitales de provincia de Cataluña, 1992-1999). Principal investigator: Marc Saez, Project PI020735 of the FIS of the Spanish Ministry of Health and Consumer Affairs. Collaborators: Maria Antònia Barceló among others (2003-2005).

Multicenter Study of the Short-Term Effects of Air Pollution on Health (EMECAS project) (Original title: Estudio multicéntrico de los efectos a corto plazo de la contaminación atmosférica en la salud [proyecto EMECAS]). Project 00/0010-02 of the FIS of the Spanish Ministry of Health and Consumer Affairs. Principal investigator: Marc Saez. Collaborators: Maria Antònia Barceló among others (2000-2002).

Meta-Analysis of the Relationship Between Urban Pollutants and Mortality in the Cities Participating in the EMECAM Study (Original title: Meta-análisis de la relación entre contaminantes urbanos y mortalidad en las ciudades participantes en el estudio EMECAM). Project 97/0051-02 of the FIS of the Spanish Ministry of Health and Consumer Affairs. Principal investigator: Marc Saez. Collaborators: Maria Antònia Barceló among others (1997-1998).

Featured Articles

Blood-based biomarkers in centenarians and non-centenarians: a matched, population-based retrospective cohort study using primary care records in Catalonia, Spain

Moreno MA, Vidal-Alaball J, Saez M, Barceló MA. Biogerontology 2025; 26:115. doi: 10.1007/s10522-025-10258-3 (Impact Factor: 4.100, GERIATRICS & GERONTOLOGY 19/73 Q2).

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Long term effects of traffic noise on mortality in the city of Barcelona, 2004-2007

Barceló MA, Varga D, Tobías A, Díaz J, Linares C, Saez M. Environmental Research 2016; 147:193-206. doi: 10.1016/j.envres.2016.02.010 (Impact Factor: 5.026, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, 14/185 Q1)

Environmental epidemiology Environmental inequalities Method:Space-time models Mortality Q1 Selection on observables:Matching Socioeconomic inequalities

Spatial variability in relative survival from female breast cancer

Saez M, Barceló MA, Martos C, Saurina C, Marcos-Gragera R, Renart G, Ocaña-Riola R, Feja C, Alcalá T. Journal of the Royal Statistical Society, Series A 2012; 175(1):107-134. doi: 10.1111/j.1467-985X.2011.00720 (Impact Factor: 1.785, PUBLIC, STATISTICS & PROBABILITY 32/123 Q2)

Cancer epidemiology Method:Space-time models Method:Survival analysis Mortality Q2 Relative survival Selection on unobservables:Mixed models Socioeconomic inequalities

Inequalities in mortality in small areas of eleven spanish cities (The multicenter MEDEA Project)

Borrell C, Marí-Dell’Olmo M, Serral G, Martínez-Beneito M, Gotsens M, other MEDEA members - Barceló MA (pos 21), Saez M (pos 22). Health & Place, 2010; 16:703-711. doi: 10.1016/j.healthplace.2010.03.002 (Impact Factor: 3.202, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH 39/185 Q1)

Environmental epidemiology Environmental inequalities Method:Space-time models Mortality Q1 Selection on unobservables:Space-time models Socioeconomic inequalities

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