Search

Resumen: Las encuestas de salud son una herramienta clave para la toma de decisiones en políticas de salud y para la planificación de los servicios de salud. El uso de métodos estadísticos para áreas pequeñas que utilizan información de diferentes ámbitos geográficos puede resultar útil para estimar indicadores de salud a una escala geográfica menor que la originalmente considerada en el diseño de una encuesta. Abstract: Health surveys are a key tool for decision-making in health policies and health services planning. The use of small-area statistical methods that use information at different geographic levels may be useful for estimating health indicators at a lower geographical level than originally considered in the survey design. Palabras clave: Análisis de áreas pequeñas, Encuesta de salud, Estadística espacial, Keywords: Small area analysis, Health survey, Spatial statistics

Health surveys are a key tool for decision-making in health policies and health services planning. The use of small-area statistical methods that use information at different geographic levels may be useful for estimating health indicators at a lower geographical level than originally considered in the survey design.

Introduction and objectives Infectious diseases are one of the major causes of sudden death, but data of sudden unexpected death from infectious diseases (SUDID) are sparse in children and young people. The aim of this study is to analyse their epidemiological, clinical, pathological and microbiological characteristics. Methods Population observational study of all deaths due to infectious diseases in people aged 0–34 years in Biscay between 1991 and 2010. The data of Mortality Register and Forensic Pathology Service were analysed. The SUDID cases in which a forensic autopsy was performed were identified. Results There were 56 SUDID cases (16% of the all sudden deaths). Myocarditis ( n = 20) and acute bacterial bronchopneumonia/pneumonia ( n = 18) were the most frequent causes, followed by meningococcemia ( n = 5) and viral pneumonia ( n = 4). A chronic co-morbid condition (mainly drug abuse in young people and moderate low birth weight in infants) was recorded in one-third and prodromal symptoms in two-thirds. Seventeen young people had consumed illegal drugs and/or methadone. In 17 of the 23 autopsies where microbiological analyses were performed, the organism responsible was identified. The incidence of SUDID was 0.6/100 000 inhabitants/year, representing 5% of all deaths from infectious diseases. SUDID rate was 1.87 times higher in males than in females. The highest incidence occurred in infants (3.7). Conclusions SUDID is infrequent, but it represents a significant proportion of all sudden deaths in children and young people. The relationship between methadone and bronchopneumonia is noticeable. This article stresses the importance of microbiological analyses in SUDID. Investigation based on forensic pathology provides useful epidemiologic, clinico-pathological and microbiological information for prevention of infectious diseases.

Background: The study is aimed at assessing social inequities in the location of polluting industries in the Basque Country, and at exploring if the effect on mortality of living near air polluting industries is modified by economic deprivation. Methods: This is a cross-sectional ecological study that uses the census sections as analysis units. Mortality from all causes, lung cancer, respiratory diseases and ischaemic heart disease were studied. Ordinal logistic regression models were fitted to assess if proximity of census sections to polluting industries is associated with deprivation. Bayesian Poisson regression models were used to explore if the association between proximity to polluting industries and mortality is modified by socio-economic deprivation. Results: Proximity to a polluting industry and deprivation are positively associated, showing a clear gradient across deprivation quintiles. In women, the risk associated with proximity to metal-processing industries grows as the deprivation of the area increases in the case of total and lung cancer mortality. In men, the interaction terms between proximity and deprivation are positive for total, ischaemic heart disease mortality, with a credibility level approaching 90%. High levels of deprivation are associated with greater risk of mortality, excepting lung cancer in women. Conclusion: There is a higher proportion of more deprived census sections around polluting industries in the Basque Country. Risks of mortality associated with proximity to polluting industries tend to be higher in more deprived areas.

Objective: To estimate the incidence and 28-day and 5-year survival rates after a first acute myocardial infarction (AMI) in relation to socioeconomic status in the Basque Country (Spain) between 1999 and 2000. Methods: Data from a population-based registry of AMI were used. The study included 3,619 patients to calculate age-standardized incidence by the direct method and 2,003 patients (out-of-hospital deaths were excluded) to calculate observed and relative survival using the Kaplan-Meier and Hakulinen methods, respectively. Socioeconomic status was quantified using a deprivation index ecologically assigned to each patient according to the census tract of residence at diagnosis of AMI and was categorized into quintiles. Results: Among men, the risk of AMI was higher in the lowest socioeconomic group than in the highest socioeconomic group (RR=1.17; 95%CI: 1.02-1.34). In men, a higher risk of death was observed in the middle (Q3; HR=1.60; 95%CI: 1.02-2.51) and low (Q5; HR=1.65; 95%CI: 1.02-2.69) quintiles compared with the least deprived group for age-adjusted survival during the acute phase. In the fully adjusted model, this effect was attenuated and no significant differences were observed in long-term survival. Among women, no significant differences were observed either in incidence or in short- and long-term survival. Conclusions: Socioeconomic inequalities were only observed in men in incidence and in survival during the acute phase after an AMI.

Resumen Introduccion y objetivos Existen pocos trabajos sobre muerte subita cardiovascular extrahospitalaria en adultos de mediana edad. El objetivo de este estudio es analizar sus caracteristicas epidemiologicas y clinico-patologicas. Metodos Estudio poblacional de mortalidad cardiovascular en personas de 35-49 anos en Vizcaya entre 2003 y 2008. Se analizaron los datos del Registro de Mortalidad y del Servicio de Patologia Forense. Se identifico a los fallecidos por muerte subita extrahospitalaria sometidos a autopsia forense. Resultados De 465 muertes cardiovasculares, 216 fueron subitas. La principal causa fue la cardiopatia isquemica (n = 140/216). Otras fueron enfermedades del miocardio (n = 32), enfermedades cerebrovasculares (n = 19) y muerte subita arritmica en corazon estructuralmente normal (n = 10). Las causas variaron significativamente en razon del sexo y la edad. El 10% tenia antecedentes de enfermedad cardiovascular en vida; el 66%, factores de riesgo cardiovascular, y el 27% habia consumido recientemente etanol y/o drogas de abuso. La incidencia fue de 13,2 residentes/100.000 habitantes/ano. La incidencia fue 3,77 veces superior en varones que en mujeres y se incrementaba con la edad. Conclusiones La incidencia de muerte subita en Vizcaya fue menor que en otros paises industrializados. La mitad de las muertes cardiovasculares en adultos de mediana edad son muertes subitas extrahospitalarias, que afectan principalmente a sujetos sin enfermedad conocida en vida. El desarrollo de estrategias para identificar a las personas con mayor riesgo dentro de la poblacion general con bajo riesgo es esencial en la prevencion. Los estudios basados en autopsias forenses mejoran los conocimientos sobre mortalidad cardiovascular.

Census track level socioeconomic inequalities in mortality are described in the Basque Country and its three main cities in the 1996-2003 period. An ecological crosssectional study of small areas was performed. Using principal component analysis a socioeconomic deprivation index was calculated. The mortality risk for each census track and the relation between mortality and socioeconomic deprivation were studied by means of hierarchical Bayesian models. Geographical patterns of the mortality risk and the deprivation index were similar, with higher mortality in more deprived areas. In the Basque Country as a whole the magnitude of the association between mortality and deprivation was higher in men than in women. In the cities, the association was only apparent for men. These results are useful to guide health policies and identify geographical areas with greater needs., Se describen las desigualdades socioeconómicas en la mortalidad por secciones censales en el País Vasco y en sus tres capitales durante el período 1996-2003. Se realizó un estudio ecológico transversal de áreas pequeñas. Mediante el análisis de componentes principales se calculó un índice de privación socioeconómica. El riesgo de mortalidad de cada sección censal, y la relación entre la mortalidad y la privación socioeconómica se estudiaron mediante modelos Bayesianos jerárquicos. Los patrones geográficos del riesgo de mortalidad y del índice de privación fueron similares, con mayor mortalidad en las áreas de mayor privación. En el conjunto del País Vasco la magnitud de la asociación entre la privación y la mortalidad fue mayor en los hombres que en las mujeres. En las capitales esa asociación sólo se evidenció para los hombres. Estos resultados son útiles para orientar las políticas de salud e identificar las áreas geográficas que precisan una mayor atención. [fr] On décrit les inégalités socio-économiques dans la mortalité par sections de recensement au Pays Basque et ses trois capitales pendant la période 1996-2003. Une étude écologique transversale d’aires petites a été accomplie. Au moyen de l’analyse de composantes principales, on a calculé un index de privation socio-économique. Le risque de mortalité de chaque section, et le rapport entre la mortalité et la privation socioéconomique ont été étudiés utilisant des modèles Bayesians hiérarchiques. Les patrons géographiques du risque de mortalité et de l’index de privation étaient semblables, étant la mortalité plus grande dans les aires avec une plus grande privation. Dans l’ensemble du Pays Basque la grandeur de l’association entre la privation et la mortalité était plus grande chez les hommes que chez les femmes. Dans les capitales l’association était evidente seulement chez les hommes. Ces résultats sont utiles pour orienter les politiques de santé et pour identifier les aires géographiques qui ont besoin d’une plus grande attention.

Fundamento y objetivo Diferencias en la presentacion clinica del infarto agudo de miocardio (IAM), como la edad, la comorbilidad y la frecuencia de sintomas atipicos, podrian condicionar un proceso de cuidados hospitalarios distinto segun el sexo. Este estudio analiza la magnitud y los determinantes de las diferencias entre sexos en la revascularizacion precoz en personas ingresadas por IAM. Pacientes y metodo Se estudio a 2.836 pacientes con IAM que accedieron a cuidados hospitalarios (IBERICA-Pais Vasco). Se estimo el riesgo relativo (RR) de revascularizacion precoz en los varones respecto a las mujeres teniendo en cuenta la edad, la presentacion clinica, los antecedentes y la demora extrahospitalaria. Se aplico la metodologia de descomposicion de efectos y el analisis de regresion log-binomial. Resultados El 29% de los pacientes eran mujeres y su edad mediana, de 77 anos. El RR de revascularizacion de los varones respecto a las mujeres fue distinto segun la edad. Tras ajustar por hipertension arterial, diabetes, Killip III-IV al ingreso y sintomas atipicos, no se apreciaban diferencias significativas a los 45 anos (RR = 0,91; intervalo de confianza [IC] del 95%, 0,77-1,07), mientras que para los mayores de 64 anos, el RR de revascularizacion fue de 1,24 (IC del 95%, 1,05-1,47). Al ajustar por la demora extrahospitalaria, las diferencias por sexo y la interaccion del sexo con la edad no eran significativas. Conclusiones El retraso en el acceso a la atencion sanitaria de las mujeres mayores es causa de las diferencias por sexo en la revascularizacion precoz. Es necesario analizar las razones de esta demora.

Fundamento y objetivo El estudio de la mortalidad poblacional del infarto agudo de miocardio (IAM), que incluye las muertes ocurridas antes de llegar al hospital, ofrece una vision mas completa sobre la magnitud del problema que la obtenida estudiando unicamente la mortalidad de los casos que reciben atencion hospitalaria. Pacientes y metodo Los datos provienen del estudio IBERICA (Investigacion, Busqueda Especifica y Regis-tro de Isquemia Coronaria Aguda). Se describe la mortalidad en los primeros 28 dias desde el inicio de los sintomas de los episodios de IAM registrados, durante 1997 y 1998, en la poblacion de 25 a 74 anos residente en 7 comunidades autonomas espanolas: Castilla-La Mancha (Toledo y Albacete), Cataluna (Girona), Comunidad Valenciana (Valencia), Islas Baleares (Mallorca), Murcia, Navarra y Pais Vasco. Ademas, se estudia la relacion entre mortalidad y otras variables como el sexo, la edad y el area geografica. Resultados Se registraron 10.654 casos de IAM de los que 4.105 fallecieron durante los 28 primeros dias (38,5%; intervalo de confianza [IC] del 95%, 37,6–39,4%). La mortalidad fue del 37,0% (IC del 95%, 35,9–38,0%) en los varones y del 44,3% (IC del 95%, 42,3–46,4%) en las mujeres. La muerte se produjo fuera del hospital en 2.869 (69,9%) casos. La mayor mortalidad en mujeres estuvo relacionada fundamentalmente con una mayor mortalidad hospitalaria (45% superior a la registrada en los varones), siendo menor la diferencia en la proporcion de casos que fallecieron fuera del hospital. La sintomatologia tipica de presentacion del episodio fue mas frecuente en varones (el 82,7 frente al 77,6%) (p Conclusiones La mortalidad poblacional por IAM en estas 7 areas espanolas es muy elevada aunque inferior a la de otros paises industrializados. Aproximadamente dos de cada tres muertes ocurren antes de llegar al hospital. Estos datos refuerzan el papel prioritario de la prevencion primaria y secundaria, ya que los cuidados hospitalarios tienen un impacto limitado en el control de la mortalidad poblacional por IAM. Tambien indican que una forma de reducir la mortalidad deberia incluir el acceso rapido a la desfibrilacion y a las maniobras de resucitacion de los pacientes que presenten una muerte subita.

Fundamento Estudio epidemiologico, clinico y patologico de la muerte subita (MS) en ninos y jovenes. Sujetos, material y metodo Estudio sobre la poblacion general de todas las MS en personas de 1 a 35 anos de edad desde 1991 hasta 1998 en Bizkaia. En cada caso se realizaron una autopsia completa y estudios histopatologicos, toxicologicos y, ocasionalmente, microbiologicos, y se recogio informacion sobre antecedentes patologicos. Resultados Hubo 107 casos de MS en personas de 1 a 35 anos, siendo la tasa de mortalidad de 2,4/100.000/ano. El riesgo de MS en varones triplico al de mujeres. Las tasas fueron mas altas en jovenes que en ninos. Solo un pequeno porcentaje de las muertes naturales son subitas (4,5%). El 43% de las MS fueron cardiacas, predominando la enfermedad ateromatosa coronaria a partir de los 30 anos, y las enfermedades del miocardio y las anomalias del sistema de conduccion en los jovenes de 15 a 29 anos. El 39% fueron extracardiacas, sobresaliendo las enfermedades infecciosas en ninos, y la epilepsia y el asma en jovenes de 15 a 29 anos. Otro proceso patologico importante fue la hemorragia intracraneal. Un 18% de los casos fueron MS inexplicadas, siendo el porcentaje mas alto entre los ninos. Las causas de muerte difirieron significativamente con relacion al sexo y la edad. Conclusiones La MS es muy infrecuente en ninos y jovenes y responde a una gran variedad de causas. Este estudio pone de manifiesto la importancia de la realizacion de autopsias forenses completas con el fin de estimular estudios epidemiologicos y preventivos de la MS.

Background: Mortality studies of multiple sclerosis (MS) patients are scarce. Objective: To assess mortality of MS patients included in a large MS cohort from the county of Bizkaia in Spain. Methods: Patients were collected from a dynamic population-based cohort of patients with MS from the county of Bizkaia (named the ‘Bizkaia cohort') in the Basque Country (Spain). Data from official registries were used for estimating mortality indicators. Results: During a 24-year period (1987-2011), a total of 1,283 patients were included in the Bizkaia cohort. Eighty-nine patients (6.9%) had died before December 31, 2011. The standardized mortality ratio was 2.78 for the whole group (3.26 for men and 2.73 for women), with a decreased life expectancy of 6.53 years. The mean survival from the onset of MS in deceased patients was 22.4 years. Death was related directly or indirectly to MS in 57 patients and unrelated in 27, while the cause of death was unknown in the remaining 5. Respiratory infection and sepsis were the most frequent MS-related causes of death. Differences in survival according to gender or disease course were not observed. Conclusion: Patients with MS included in the ‘Bizkaia cohort' had an almost threefold increase in the risk for death. Life expectancy is reduced by 6-10 years.

The estimation of the impact of morbidity on health is essential to health planning. The objective was to estimate this impact using disability free life expectancy, and to analyze whether the hypothetical elimination of various diseases would have led to a compression or expansion of morbidity.Cross-sectional study on the population of the Basque Country. Data on mortality (2002-2006), health survey data (2007) and population based data were used. The impact of different groups of diseases on mortality rates, years of life and potential years of life lost (PYLL) and disability (absolute number and rates) were calculated. An integrated analysis was also done, using disability free life expectancy (DFLE), using the Sullivan method.The diseases causing the greatest impact on mortality were tumours among men (35,2% and 39,3% of deaths and PYLL respectively), and circulatory diseases (34,5% of deaths) and tumours (43,6% of PYLL) among women. Osteomuscular diseases had a major impact on disability, causing the 26,6% and the 45,2% of the total cases in men and women). Circulatory diseases had the highest impact as a whole (4.2 years of DFLE in men and 3.8 in women). However, osteomuscular diseases had the highest influence on years of life with disability.The diseases which caused the overall greatest impact on mortality and disability were circulatory system related ones, tumors, and osteomuscular diseases. The elimination of this last group of diseases would have led to a morbidity compression, meaning the greatest reduction in life years with disability among all the causes.

Objectives To analyse socio-economic inequalities in mortality due to injuries among census tracts of ten Spanish cities by sex and age in the period 1996–2003. Methods This is a cross-sectional ecological study where the units of analysis are census tracts. The study population consisted of people residing in the cities during the period 1996–2003. For each census tract we obtained an index of socio-economic deprivation, and estimated standardized mortality ratios using hierarchical Bayesian models which take into account the spatial structure of the data. Results In the majority of the cities, the geographical pattern of total mortality from injuries is similar to that of the socio-economic deprivation index. There is an association between mortality due to injuries and the deprivation index in the majority of the cities which is more important among men and among those younger than 45 years. In these groups, traffic injuries and overdoses are the causes most often associated with deprivation in the cities. The percentage of excess mortality from injuries related to socio-economic deprivation is higher than 20% in the majority of the cities, the cause with the highest percentage being drug overdose. Conclusions In most cities, there are socio-economic inequalities in mortality due to overdose and traffic injuries. In contrast, few cities have found association between suicide mortality and deprivation. Finally, no association was found between deprivation and deaths due to falls. Inequalities are higher in men and those under 45 years of age. These results highlight the importance of intra-urban inequalities in mortality due to injuries.

Introduction and objectives: The data of mortality of out-of-hospital sudden cardiovascular death in middle-aged adults have been poorly characterized. The aim of this study is to analyze their epidemiological, clinical and pathological characteristics. Methods: Population observational study of all cardiovascular deaths in people 35–49 years old in Vizcaya between 2003 and 2008. The data of Mortality Register and Forensic Pathology Service were analyzed. The out-of-hospital sudden deaths subjected to forensic autopsy were identified. Results: 216 of the 465 cardiovascular deaths were sudden deaths. The main cause was ischemic heart disease (N = 140/216). Other conditions were: cardiomyopathies (N = 32), cerebrovascular diseases (N = 19) and sudden arrhythmic death in structurally normal hearts (N = 10). The causes varied significantly in relation to gender and age. Ten percent had been diagnosed in life of a cardiovascular disease; 66% had cardiovascular risk factors and 27% had recently consumed ethanol and/or abuse drugs. The incidence of sudden death was 13.2/100,000 inhabitants/year, representing 46% of cardiovascular deaths. The incidence was 3.77 times higher in males than in females and increased with the age. Conclusions: The incidence of sudden death in Vizcaya was lower than in other industrialized countries. In middle-aged adults out-of-hospital sudden cardiac death is the first manifestation of disease in half of all cardiovascular deaths. One challenge in prevention is the development of strategies to identify the highest risk people within the general population at low risk. Studies based on forensic autopsies improve our understanding of cardiovascular mortality.

Clinical variability in myocardial infarction (MI) regarding age, comorbidities and atypical symptoms could determine gender differences in inhospital care. This study analyzes the magnitude and determinants of differences between men and women in early reperfusion therapy in people hospitalized after MI.2,836 patients who arrived to hospital with MI were studied (IBERICA-Basque Country study). The relative risk (RR) of receiving early reperfusion for men versus women, adjusted by age, clinical characteristics, risk factors, and pre-hospital delay was estimated. The effect decomposition methodology and the log binomial regression were applied.29% of patients were women with a median age of 77 years. The RR of revascularization in men compared to women was different according to age. When factors such as hypertension diabetes, Killip III-IV at admission and atypical symptoms were taken into account, statistically significant differences between sexes were not detected at 45 years old (RR=0.91; 95% CI=0.77-1.07). However, for 64 years old and over, the RR of reperfusion was 1.24 (95% CI=1.05-1.47). Both the differences by sex and the sex-age interaction were no longer statistically significant after adjusting by pre-hospital delay.The delay to receive medical care in elderly women is responsible of gender differences in early reperfusion. It is necessary to analyze the reasons for treatment-seeking delay.

To describe socioeconomic inequalities in mortality in the Basque Country, using mortality and socioeconomic data by census sections.Mortality and population data were obtained from the Basque Institute of Statistics. Socioeconomic characteristics of the census sections were assigned to each death and a deprivation index combining information from four socioeconomic indicators was computed. Age-adjusted mortality rates by sex, age group (0-64or = 65) and cause of death were calculated for each quintile of the deprivation index. Poisson regression models were fitted to estimate age-adjusted rate ratios and excess mortality attributable to inequalities.Mortality showed a gradient according to the deprivation index in men and women. Mortality was greater in the most deprived sections. Mortality inequalities were observed in men younger than 65 years. A total of 9.3% of deaths in men and 4.9% of those in women were attributable to socioeconomic inequalities. The relative importance of the cause of death differed according to the inequality measure used. Lifestyle-related causes of death were notable.This study illustrates the potential utility of census section socioeconomic indicators both to describe socioeconomic inequalities in mortality and to identify priorities for interventions.

The magnitude of the problem of myocardial infarction (MI) is better understood by assessing the population case-fatality than by analyzing only the number of patients attending hospitals.Our data come from the IBERICA Study (Investigation, Specific Search and Registry of Acute Myocardial Ischemic Syndrome). Twenty eight-day MI population case-fatality is described in the population aged 25 to 74 years during 1997 and 1998 in the following Spanish autonomous communities: Castilla-La Mancha (Toledo and Albacete), Catalonia (Girona), Valencia Community (Valencia), Balearic Islands (Majorca), Murcia, Navarra and Basque Country. The relationship between case-fatality and other variables such as sex, age and geographic area is also analyzed.A total of 10,660 MI cases were registered, 4,106 of whom died within the period of 28 days following the onset of symptoms (38.5%; CI 95%, 37.6-39.4%). The overall case-fatality was 37.0% (CI 95%, 35.9-38.0%) in men and 44.3% (CI 95%, 42.3-46.4%) in women. Death occurred out of hospitals in 2,869 (69.9%) cases. An increased case-fatality in women was associated with a higher in-hospital case-fatality (45% higher than men). The proportion of patients who died before reaching a hospital was similar in both genders. Classical symptoms of MI were more common among men than women (82.7% vs. 77.6%, p0,001). The interval between symptoms' onset and hospitalization was 30 minute longer among hospitalized women as compared with men (p0,001).Population MI case-fatality is high in the seven Spanish autonomous communities studied. Approximately 2 out of 3 deaths occur without patients being able to reach a hospital. These results emphasize the importance of primary and secondary prevention measures and the necessity to design ready-access systems to defibrillation and resuscitation manoeuvres for patients with cardiopulmonary arrest.

ResumenObjetivosDescribir las desigualdades socioeconómicas en la mortalidad en la Comunidad Autónoma del País Vasco, utilizando datos de mortalidad y socioeconómicos por secciones censales.MétodosLos datos sobre las defunciones y sobre la población fueron obtenidos del Instituto Vasco de Estadística. Se asignó a cada defunción las características socioeconómicas de su sección censal y se construyó un índice de privación que combinaba cuatro indicadores socioeconómicos. Se estimaron tasas de mortalidad ajustadas por edad para cada quintil del índice de privación por sexo, grupo de edad (0-64, ≥ 65 años) y causa de defunción. Mediante modelos de regresión de Poisson se estimaron las razones de tasas ajustadas por edad y el exceso de mortalidad atribuible a las desigualdades.ResultadosLa mortalidad mostró un gradiente según el índice de privación en ambos sexos, siendo la mortalidad mayor en las secciones más desfavorecidas. Las mayores desigualdades se observaron en los varones menores de 65 años. Un 9,3 y un 4,9% de las defunciones en los varones y en las mujeres, respectivamente, fueron atribuibles a las desigualdades socioeconómicas. La importancia relativa de las causas de muerte fue distinta según la medida de desigualdad utilizada, y destacaron las causas relacionadas con los estilos de vida.ConclusionesEste estudio ilustra la utilidad de los datos por sección censal para describir las desigualdades en la mortalidad y para identificar prioridades de intervención.AbstractObjectivesTo describe socioeconomic inequalities in mortality in the Basque Country, using mortality and socioeconomic data by census sections.MethodsMortality and population data were obtained from the Basque Institute of Statistics. Socioeconomic characteristics of the census sections were assigned to each death and a deprivation index combining information from four socioeconomic indicators was computed. Age-adjusted mortality rates by sex, age group (0-64 ≥ 65) and cause of death were calculated for each quintile of the deprivation index. Poisson regression models were fitted to estimate age-adjusted rate ratios and excess mortality attributable to inequalities.ResultsMortality showed a gradient according to the deprivation index in men and women. Mortality was greater in the most deprived sections. Mortality inequalities were observed in men younger than 65 years. A total of 9.3% of deaths in men and 4.9% of those in women were attributable to socioeconomic inequalities. The relative importance of the cause of death differed according to the inequality measure used. Lifestyle-related causes of death were notable.ConclusionThis study illustrates the potential utility of census section socioeconomic indicators both to describe socioeconomic inequalities in mortality and to identify priorities for interventions.