title: [Use of area-level socioeconomic indicators in epidemiological research: experience in Spain and advancement opportunities].
abstract: OBJECTIVE
  To determine the use of area-level socioeconomic indicators in epidemiological studies in Spain.
  
  
  METHODS
  We included studies analyzing the association of area-level socioeconomic indicators and health indicators in Spain published in peer-reviewed journals. An electronic search was conducted in PubMed-Medline, SCI-Expanded, SSCI, Embase, and the Spanish Medical Index (until December 31, 2012). A manual search was also conducted of the references of the selected studies. Each of the articles initially selected on the basis of the title and abstract was reviewed by two investigators. Information was obtained on the publication and methodology (design and study areas, information sources, health and socioeconomic indicators, and statistical analysis).
  
  
  RESULTS
  We included 142 studies published since 1988 (58.4% since 2005). More than half (59.9%) were in English. The level of analysis was ecological in 73.2% and multilevel in 19.0%. The areas most frequently analyzed were census tracts (35 studies), especially within cities or autonomous regions, followed by the provinces (30 studies), mostly concerning Spain overall. The dependent variable most frequently analyzed was mortality and the socioeconomic dimension most commonly used was employment (71.1%).
  
  
  CONCLUSIONS
  In the last decade in Spain, there has been an increase in the number of studies examining the association of area-level socioeconomic and health indicators, as well as in the complexity of design and analysis.
authors.affiliation: Subdirección de Promoción de la Salud y Prevención, Consejería de Sanidad, Comunidad de Madrid, Madrid, España. Electronic address: felicitas.dominguez@salud.madrid.org.
authors.forename: María Felicitas
authors.initials: MF
authors.lastname: Domínguez-Berjón
authors.affiliation: Agència de Salut Pública de Barcelona, Barcelona, España; Institut d'Investigació Biomèdica Sant Pau, Barcelona, España; Doctorado en Biomedicina, Universitat Pompeu Fabra, Barcelona, España.
authors.forename: Maica
authors.initials: M
authors.lastname: Rodríguez-Sanz
authors.affiliation: Agència de Salut Pública de Barcelona, Barcelona, España; Institut d'Investigació Biomèdica Sant Pau, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
authors.forename: Marc
authors.initials: M
authors.lastname: Marí-Dell'Olmo
authors.affiliation: Estudios e Investigación Sanitaria, Dirección de Planificación, Ordenación y Evaluación, Departamento de Salud, Gobierno Vasco, Vitoria (Álava), España.
authors.forename: Santiago
authors.initials: S
authors.lastname: Esnaola
authors.affiliation: Observatorio de Salud Pública de Cantabria, Fundación Marqués de Valdecilla, Consejería de Sanidad, Santander, España.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Prieto-Salceda
authors.affiliation: Subdirección General de Tecnologías de la Información y las Comunicaciones, Instituto Nacional de Estadística, Madrid, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Duque
authors.affiliation: Dirección General de Salud Pública, Departamento de Sanidad, Bienestar Social y Familia, Gobierno de Aragón, Zaragoza, España.
authors.forename: María Pilar
authors.initials: MP
authors.lastname: Rodrigo
mesh_terms: D016021:Epidemiologic Studies; D006801:Humans; D012959:Socioeconomic Factors; D013030:Spain; D013997:Time Factors
keywords: Areas; Desigualdades; Epidemiología/salud; España; Factores socioeconómicos; Health/epidemiology; Indicadores; Indicators; Inequalities; Socioeconomic factors; Spain; Áreas