Examining geographic patterns of mortality: the atlas of mortality in small areas in Spain (1987-1995).
BACKGROUND
Small-area mortality atlases have been demonstrated to be a useful tool for both showing general geographical patterns in mortality data and identifying specific high-risk locations. In Spain no study has so far systematically examined geographic patterns of small-area mortality for the main causes of death. This paper presents the main features, contents and potential uses of the Spanish Atlas of Mortality in small areas (1987-1995).


METHODS
Population data for 2,218 small areas were drawn from the 1991 Census. Aggregated mortality data for 14 specific causes of death for the period 1987-1995 were obtained for each small area. Empirical Bayes-model-based estimates of age-adjusted relative risk were displayed in small-area maps for each cause/gender/age group (0-64 or 65 and over) combination using the same range of values (i.e. septiles) and colour schemes.


RESULTS
The 'Spanish Atlas of Mortality' includes multiple choropleth (area-shaded) small-area maps and graphs to answer different questions about the data. The atlas is divided into three main sections. Section 1 includes the methods and comments on the main maps. Section 2 presents a two-page layout for each leading cause of death by gender including 1) a large map with relative risk estimates, 2) a map that indicates high- and low-risk small areas, 3) a graph with median and interquartile range of relative risk estimates for 17 large regions of Spain, and 4) relative-risk maps for two age groups. Section 3 provides specific information on the geographical units of analysis, statistical methods and other supplemental maps.


CONCLUSIONS
The 'Spanish Atlas of Mortality' is a useful tool for examining geographical patterns of mortality risk and identifying specific high-risk areas. Mortality patterns displayed in the atlas may have important implications for research and social/health policy planning purposes.
Benach
Joan
J
Department of Experimental Sciences and Health, Occupational Health Research Unit, Universitat Pompeu Fabra, Barcelona, Spain. joan.benach@cexs.upf.es
Yasui
Yutaka
Y
Borrell
Carme
C
Rosa
Elisabeth
E
Pasarín
M Isabel
MI
Benach
Núria
N
Español
Esther
E
Martínez
José Miguel
JM
Daponte
Antonio
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001271:Atlases as Topic; D001943:Breast Neoplasms / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D005843:Geography; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D017062:Small-Area Analysis; D013030:Spain / Q000453:epidemiology