title: What is happening to health in the economic downturn? A view of the Lisbon Metropolitan Area, Portugal.
abstract: BACKGROUND
  The economic downturn has introduced new social risks in the most affected countries with foreseeable negative consequences for health.
  
  
  OBJECTIVE
  To analyse changes in health and its socioeconomic inequalities between 2001-2011 in the Lisbon Metropolitan Area (LMA), Portugal.
  
  
  METHODS
  This study, conducted in the LMA neighbourhoods (n = 207), examines the association between deprivation and premature mortality using standardised premature mortality ratios and a composite index of socioeconomic deprivation. The association was observed by analysing the whole range of values, quintiles and deciles of the LMA population. Pearson coefficients and ANOVA were used to assess associations and variability between quintiles/deciles.
  
  
  RESULTS
  The findings show that people living in extreme deprivation conditions increased (5.45%) and that increasing deprivation is associated with health degradation in specific groups. Between 2001-2011, premature mortality became more unequally distributed, increasing in the richest (1%) and median (12%) areas, even though socioeconomic inequalities in mortality decreased.
  
  
  CONCLUSIONS
  Health degradation is selective, affecting mainly the middle class living in LMA; these 'newly deprived' people experience an increased risk, while the 'traditionally deprived' show no decrease in premature mortality. Therefore, social inequalities in health tend to decrease, but without health gains.
authors: a Geography Department , Research Centre for Anthropology and Health (CIAS), University of Coimbra , Coimbra , Portugal.
authors: Helena
authors: H
authors: Nogueira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002947:Cities; D057172:Economic Recession; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature; D011174:Portugal; D011203:Poverty / Q000706:statistics & numerical data; D012111:Residence Characteristics; D055815:Young Adult
keywords: Economic crisis; Portugal; health inequalities; premature mortality