title: Monitoring the cluster of high-risk mortality areas in the southwest of Spain.
abstract: Inspired by a previous study showing a striking geographical mortality clustering, not attributable to chance, in the south-western region of Spain in 1987-1995, the authors have conducted an ecological study of time trends in all-cause mortality risk between 1987-1995 and 1996-2004 in 2,218 small areas of Spain. To identify high-risk areas, age-adjusted relative risks for each area, stratified by sex and time period, were computed using a Bayesian approach. Areas of high-risk in both periods, or in the second period only, were identified. Annual excess mortality and percentage of people living in these high-risk areas, again stratified by sex and time period, were estimated. The cluster of high mortality risk areas identified in the southwest of Spain during 1987-1995 persisted in the period 1996-2004 with an increase in the number of high-risk areas and in annual excess of mortality. These increases showed a gender difference, being more pronounced in women.
authors.affiliation: Health Inequalities Research Group - Employment Conditions Knowledge Network (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain. maria.buxo@upf.edu
authors.forename: Maria
authors.initials: M
authors.lastname: Buxó-Pujolràs
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Martínez
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Martín
authors.forename: Montserrat
authors.initials: M
authors.lastname: Vergara
authors.forename: Marta
authors.initials: M
authors.lastname: Cervantes
authors.forename: Joan
authors.initials: J
authors.lastname: Benach
mesh_terms: D001499:Bayes Theorem; D002423:Cause of Death; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D061213:Mortality, Premature; D016012:Poisson Distribution; D012307:Risk Factors; D017678:Sex Distribution; D017062:Small-Area Analysis; D012959:Socioeconomic Factors; D013029:Space-Time Clustering; D013030:Spain / Q000453:epidemiology