title: [Men inequalities and liver cirrhosis mortality (Zaragoza, Spain, 1996-2003)].
abstract: OBJECTIVE
  The aim of this study was to identify geographical differences in mortality from liver cirrhosis in men living in the province of Zaragoza, Spain, as well as its possible association with socioeconomic factors. The utility of the MEDEA project's deprivation index in rural areas was also explored.
  
  
  METHODS
  Census tracts were used in Zaragoza city as analysis units and municipalities were used for the rest of the province. Crude and smoothed standardized mortality ratios were calculated for each analysis unit through a Bayesian generalized mixed linear model. A deprivation index was obtained and was included in the model in quartiles. An exploratory analysis was also conducted, including a rural index in the province of Zaragoza.
  
  
  RESULTS
  In Zaragoza city, mortality from liver cirrhosis and other chronic liver diseases [code 571 of the 9th International Classification of Diseases (ICD) and K70, K72.1, K73, K74, K76.1.9 of the ICD-10] increased as the deprivation index increased. Mortality in the most deprived areas was twice that in the less deprived areas (relative risk [RR] 2.09, credible interval (CI): 1.53-2.83). In the rest of the province, geographical differences in mortality could not be explained by the deprivation index used. Nevertheless, municipalities with the highest values in the rural index showed a RR of 0.47 (CI: 0.18-0.92) compared with those with the lowest values.
  
  
  CONCLUSIONS
  In Zaragoza city, mortality from liver cirrhosis and other chronic liver diseases was higher in the most deprived census tracts than in the most affluent areas. This association was not found in the rest of the province, probably because of the low variability explained by the deprivation index. Municipalities with high rural values had the lowest risk of death from these diseases.
authors.affiliation: Unidad Docente de Medicina Preventiva y Salud Pública de Aragón, Zaragoza, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Aguilar
authors.forename: Cristina
authors.initials: C
authors.lastname: Feja
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Compés
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Rabanaque
authors.forename: Mariano
authors.initials: M
authors.lastname: Esteban
authors.forename: Tomás
authors.initials: T
authors.lastname: Alcalá
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Martos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D006801:Humans; D007223:Infant; D008103:Liver Cirrhosis / Q000401:mortality*; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D012423:Rural Health; D012737:Sex Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult