Medea

Acción Estratégica Medea

Background

Over the last decade, there has been an increase in interest and research into the effects of area of residence on the health of the population, particularly at small-area level. This interest arises because individual factors are not sufficient to explain the causes of disease and ill-health: contextual factors of the area of residence, such as unemployment level, must also be taken into account. Furthermore, the characteristics of the area of residence may contribute to socio-economic and environmental inequalities in health. Finally, the study of health inequalities in small urban areas allows those areas susceptible of intervention to be identified. The recent use of specific methods to analyse information of this type such as Geographical Information Systems or hierarchical Bayesian models for spatial epidemiology enables this research.

There are currently still very few studies of inequalities based on cities in Spain which have used the census tract as the unit of analysis; one such study is the MEDEA I project which analysed socio-economic and environmental inequalities in mortality.

The trends in mortality inequalities in terms of socio-economic level, whether at individual or at area level, have been studied in many countries since the 1990s. The majority of these studies have found an increase in such inequalities over time. However, very few studies have analysed trends in these inequalities in the context of cities, and at the same time employed a level of desegregation as small as the census tract.

The present project aims to achieve advances by analysing the evolution of mortality inequalities in small areas of various cities in Spain, including new causes of death and applying new methods of analysis.