title: Commentary: approaches, strengths, and limitations of avoidable mortality.
abstract: Publication of recent papers such as the one by Schoenbaum and colleagues entitled 'Mortality Amenable to Health Care in the United States: The Roles of Demographics and Health Systems Performance' has stimulated this commentary. We discuss strengths and limitations of amenable and avoidable mortality in health-care systems' performance and their contribution to health inequalities. To illustrate, we present a case study of avoidable and amenable mortality in Spain over 27 years. We conclude that amenable mortality is not a good indicator of health-care systems' performance, or for determining whether it could give rise to health inequalities. To understand health problems and to assess the impact of interventions affecting health requires good, basic, and routine monitoring of health indicators and of socioeconomic determinants of health.
authors.affiliation: 1] Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, Barcelona 08023, Spain [2] Universitat Pompeu Fabra, Barcelona, Spain [3] CIBER Epidemiología y Salud Pública (CIBERESP), Spain [4] Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
authors.forename: Glòria
authors.initials: G
authors.lastname: Pérez
authors.affiliation: 1] Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, Barcelona 08023, Spain [2] CIBER Epidemiología y Salud Pública (CIBERESP), Spain [3] Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
authors.forename: Maica
authors.initials: M
authors.lastname: Rodríguez-Sanz
authors.affiliation: 1] CIBER Epidemiología y Salud Pública (CIBERESP), Spain [2] Universitat de Vic, Vic, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Cirera
authors.affiliation: 1] Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, Barcelona 08023, Spain [2] CIBER Epidemiología y Salud Pública (CIBERESP), Spain [3] Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
authors.forename: Katherine
authors.initials: K
authors.lastname: Pérez
authors.affiliation: 1] Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, Barcelona 08023, Spain [2] CIBER Epidemiología y Salud Pública (CIBERESP), Spain [3] Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Puigpinós
authors.affiliation: 1] Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, Barcelona 08023, Spain [2] Universitat Pompeu Fabra, Barcelona, Spain [3] CIBER Epidemiología y Salud Pública (CIBERESP), Spain [4] Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
mesh_terms: D002423:Cause of Death / Q000639:trends*; D003695:Delivery of Health Care / Q000639:trends*; D005544:Forecasting; D006297:Health Services Accessibility / Q000639:trends*; D006301:Health Services Needs and Demand / Q000639:trends*; D054625:Healthcare Disparities / Q000639:trends*; D006801:Humans; D008017:Life Expectancy / Q000639:trends; D009026:Mortality / Q000639:trends*; D058996:Quality Improvement / Q000639:trends*; D064890:Social Determinants of Health / Q000639:trends; D012959:Socioeconomic Factors; D013030:Spain