[Avoidable and nonavoidable mortality: geographical distribution in small areas in Spain (1990-2001)].
OBJECTIVE
Comparison of mortality amenable to medical intervention (avoidable mortality) in small geographical areas provides a useful tool to analyse quality of health care services. Currently there are no studies that analyse avoidable mortality by geographical distribution in small areas for the whole of Spain. The aim of this study is to describe the geographical distribution of avoidable and non-avoidable mortality in small areas in Spain by sex for the period 1990-2001.


METHODS
The 2.218 small areas considered consisted of municipalities or aggregated municipalities in the entirety of the Spanish territory. Avoidable deaths were analysed for the period 1990-2001. Empirical Bayes model-based estimates of age-adjusted relative risk were displayed in small-area maps for each group of causes of death by sex.


RESULTS
There is an heterogeneous geographical distribution of avoidable mortality for both sexes. Areas with greater mortality are located in the south and northwest of Spain. Especially for hypertension, cerebrovascular disease and ischaemic heart disease in men there is a clear aggregation of deaths in these areas. Geographical distribution of non avoidable mortality in both sexes is similar to that described for these three causes.


CONCLUSIONS
Geographical study of avoidable mortality in small areas for the whole of Spain permits the identification of areas with elevated mortality. Further research is necessary to clarify those factors related to avoidable mortality distribution.
Vergara Duarte
Montse
M
Grup de Recerca de Desigualtats en Salut, Unitat de Recerca en Salut Laboral, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, España. montse.vergara@upf.edu
Benach
Joan
J
Martínez
José Miguel
JM
Buxó Pujolràs
Maria
M
Yasui
Yutaka
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D013030:Spain / Q000453:epidemiology; D055815:Young Adult