The public health burden of material deprivation: excess mortality in leading causes of death in Spain

Abstract

Objective: The aim of the study is to investigate the burden of deprivation-associated excess of deaths by 10 leading causes of death in each gender and two age groups.

Design: A small-area ecological study using two indices of material deprivation drawn from 1991 census and mortality data aggregated for 1987-1995 was undertaken.

Setting: 2218 small areas in Spain. Data are presented by region.

Main outcome measures: The 10 leading causes of death in each gender and two age groups were determined.

Results: The deprivation-associated excess mortality in the top 10 leading causes of death was 14.4 and 11% for males and females, respectively. Excess mortality in the 9-year period studied accounted for more than 222,000 deaths. A large proportion of excess deaths was found in causes related to smoking and alcohol consumption among males and diet-related causes of death among females. The most deprived regions within the country showed the highest mortality risk.

Conclusions: Material deprivation appears to be manifested in high mortality rates differently by gender and region. It imposes a significant public health burden that demands urgently attention and action by health policy-makers.