Trends in socioeconomic inequalities in general mortality in the city of Cadiz, Spain (1992-2007)

Objective: To analyze trends in socioeconomic inequality in mortality in the city of Cadiz (Spain) from 1992 to 2007. Methods: An ecological study was performed of trends over 3 cross-sections, with the census tract as the unit of analysis. Deaths were grouped into three periods: 1992-1996, 1997-2001 and 2002-2007 and were then classified according to a deprivation index of the census tract. We calculated adjusted rates by the direct method and three measures of health inequality. Results: Of 18,586 deaths, 96.7% was geocoded to a census tract. The population-attributable risk decreased in men and women, respectively, from 15.4% and 12.2% in 1992-1996 to 9.3% and 5.6% in 2002-2007. The other measures, slope index and the relative index also showed a decline in inequality but only among women. Conclusions: Despite a decreasing trend, social inequalities are a substantial component in the distribution of overall mortality in the city of Cadiz. Titel på spanska: Evolución de las desigualdades sociales en la mortalidad general de la ciudad de Cádiz (1992–2007)