title: Has the economic crisis widened the intraurban socioeconomic inequalities in mortality? The case of Barcelona, Spain.
abstract: BACKGROUND
  There is considerable evidence demonstrating socioeconomic inequalities in mortality, some of which focuses on intraurban inequalities. However, all the studies assume that the spatial variation of inequalities is stable over the time. We challenge this assumption and propose two hypotheses: (i) have spatial variations in socioeconomic inequalities in mortality at an intraurban level changed over time? and (ii) as a result of the economic crisis, has the gap between such disparities widened? In this paper, our objective is to assess the effect of the economic recession on the spatio-temporal variation of socioeconomic inequalities in mortality in Barcelona (Catalonia, Spain).
  
  
  METHODS
  We used a spatio-temporal ecological design to analyse mortality inequalities at small area level in Barcelona. Mortality data and socioeconomic indicators correspond to the years 2005 and 2008-2011. We specified spatio-temporal ecological mixed regressions for both men and women using two indicators, neighbourhood and year. We allowed the coefficients of the socioeconomic variables to differ according to the levels and explicitly took into account spatio-temporal adjustment.
  
  
  RESULTS
  For men and women both absolute and, above all, relative risks for mortality have increased since 2009. In relative terms, this means that the risk of dying has increased much more in the most economically deprived neighbourhoods than in the more affluent ones.
  
  
  CONCLUSIONS
  Although the geographical pattern in relative risks for mortality in neighbourhoods in Barcelona remained very stable between 2005 and 2011, socioeconomic inequalities in mortality at an intraurban level have surged since 2009.
authors.affiliation: Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Laia
authors.initials: L
authors.lastname: Maynou
authors.affiliation: Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Saez
authors.affiliation: Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain Department of Economics and Business, Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Guillem
authors.initials: G
authors.lastname: Lopez-Casasnovas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D012923:Social Class; D013030:Spain / Q000453:epidemiology; D014504:Urban Health / Q000639:trends; D055815:Young Adult
keywords: Health inequalities; SOCIO-ECONOMIC; SPATIAL ANALYSIS; STATISTICS