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Background Prior studies have identified a decrease in ischaemic heart disease mortality during the recent economic recession. The Spanish population was severely affected by the Great Recession, however, there is little evidence on its effects on socioeconomic inequalities in ischaemic heart disease mortality. This study examines trends in socioeconomic inequalities in mortality due to ischaemic heart disease (IHD). Methods We used linked census records with mortality registers available from the Basque Country and Barcelona city for population above 25 years, between 2001 and 04, the accelerated economic growth period of 2005–08, and 2009–12, with the last period coinciding with the Great Recession. Applying Poisson models, we calculated relative and absolute indexes of inequalities by education level for each period, age group, gender, and site. Results We found moderate age-adjusted inequalities in IHD with a gradient of increasing rates through less educational level, but no significant evidence of increasing trends in socioeconomic inequalities in IHD mortality, rather an inverted U-shape time trend in some groups below 75 years in relative inequalities. Absolute inequalities decrease in the last period except for women from 50 to 64 years. Conclusions This study shows that the economic crisis has not increased socioeconomic inequalities in IHD mortality in two geographical settings in Spain.

An increase in suicide mortality is often observed in economic recessions. The objective of this study was to analyse trends in socioeconomic inequalities in suicide mortality before and during the economic recession in two geographical settings in Spain.This study analyses inequalities in mortality according to educational level during 3 different time periods based on individual data from the Basque Country and Barcelona city. We analysed suicide mortality data for all residents over 25 years of age from 2001 to 2012. Two periods before the crisis (2001-2004 and 2005-2008) and another during the crisis (2009-2012) were studied. We performed independent analyses for sex, age group, and for the two geographical settings. We fit Poisson regression models to study the relationship between educational level and mortality, and calculated the relative index of inequality (RII) and the slope index of inequality (SII) as comparative measures.For men in the Basque Country, all RII values for the three time periods were similar and almost all were greater than 2; in Barcelona the RII values were generally lower. The SII values for Barcelona tended to decrease over time, whereas in the Basque Country they showed a U-shaped pattern. Among women aged 25-44 years we found an association between educational level and suicide mortality during the first time period; however, we found no clear association for other age groups or time periods.This study within two geographical settings in Spain shows that trends in inequalities in suicide mortality according to educational level remained stable among men before and during the economic recession.

Background: In Spain, several ecological studies have analyzed trends in socioeconomic inequalities in mortality from all causes in urban areas over time. However, the results of these studies are quite heterogeneous finding, in general, that inequalities decreased, or remained stable. Therefore, the objectives of this study are: (1) to identify trends in geographical inequalities in all-cause mortality in the census tracts of 33 Spanish cities between the two periods 1996–1998 and 2005–2007; (2) to analyse trends in the relationship between these geographical inequalities and socioeconomic deprivation; and (3) to obtain an overall measure which summarises the relationship found in each one of the cities and to analyse its variation over time. Methods: Ecological study of trends with 2 cross-sectional cuts, corresponding to two periods of analysis: 1996– 1998 and 2005–2007. Units of analysis were census tracts of the 33 Spanish cities. A deprivation index calculated for each census tracts in all cities was included as a covariate. A Bayesian hierarchical model was used to estimate smoothed Standardized Mortality Ratios (sSMR) by each census tract and period. The geographical distribution of these sSMR was represented using maps of septiles. In addition, two different Bayesian hierarchical models were used to measure the association between all-cause mortality and the deprivation index in each city and period, and by sex: (1) including the association as a fixed effect for each city; (2) including the association as random effects. In both models the data spatial structure can be controlled within each city. The association in each city was measured using relative risks (RR) and their 95 % credible intervals (95 % CI). Results: For most cities and in both sexes, mortality rates decline over time. For women, the mortality and deprivation patterns are similar in the first period, while in the second they are different for most cities. For men, RRs remain stable over time in 29 cities, in 3 diminish and in 1 increase. For women, in 30 cities, a non-significant change over time in RR is observed. However, in 4 cities RR diminishes. In overall terms, inequalities decrease (with a probability of 0.9) in both men (RR = 1.13, 95 % CI = 1.12–1.15 in the 1st period; RR = 1.11, 95 % CI = 1.09–1.13 in the 2nd period) and women (RR = 1.07, 95 % CI = 1.05–1.08 in the 1st period; RR = 1.04, 95 % CI = 1.02–1.06 in the 2nd period). Conclusions: In the future, it is important to conduct further trend studies, allowing to monitoring trends in socioeconomic inequalities in mortality and to identify (among other things) temporal factors that may influence these inequalities This article was partially funded by Plan Nacional de I + D + I 2008–2011 and Instituto de Salud Carlos III (ISCIII) –Subdirección General de Evaluación y Fomento de la Investigación- (Award numbers: PI081488, PI081978, PI080367, PI08/1017, PI080330, P08/0142, PI081785, PI080662, PI081713, PI081058, PI081340, PI080803, PI126/08), Fundación Canaria de Investigación Sanitaria FUNCIS 84/07 and by CIBER Epidemiología y Salud Pública (CIBERESP) SI

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.

Objectives To study the association between proximity to air polluting industrial facilities and mortality in the Basque Country (Spain) in the 1996e2003 period. Methods A cross-sectional ecological study with 1465 census sections (CS) as units of analysis with a mean population of 1257 inhabitants. Association of CS mortality with proximity of industries of the European Pollutant Emission Register was studied by type of industrial activity and adjusted for social deprivation. Two distance thresholds (1 km and 2 km) were used as proxies for exposure in a ‘near versus far’ analysis. Causes of mortality studied were: all causes; tracheal, bronchial, and lung cancer; haematological tumours; ischaemic heart disease; cerebrovascular diseases; chronic diseases of the lower respiratory tract; and breast cancer (in women). Poisson’s generalised linear mixed models (GLMM) with two random effects (heterogeneity and structured spatial variability) were used in a fully Bayesian environment. Results Men living in sections within 1 km from energy production industries had greater mortality from tracheal, bronchial, and lung cancer [CI90% 6% to 53%] as compared with people living further. Women had greater mortality from ischaemic heart disease [CI90% 1% to 17%] and respiratory illness [CI90% 1% to 24%] within 2 km from metal-processing industries. On the contrary, within the 1 km buffer from mineral industries, mortality was lower for all causes [CI90% � 20% to � 6%] and for ischaemic heart disease [CI90% � 40% to � 10%] in women, and from respiratory diseases in men [CI90% � 39% to � 4%], while it was greater for breast cancer in women [CI90% 2% to 28%] within the 2 km buffer. Conclusions Analysis of mortality by census sections is a helpful exploratory tool for investigating environmental risk factors and directing actions to sites and risk factors with a greater impact on health. Further epidemiological andenvironmentalinvestigationsaroundmetal-processing and energy-producing plants are required.

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.

Background: While it is known that a variety of factors (biological, behavioural and interventional) play a major role in the health of individuals and populations, the importance of the role of social determinants is less clear. The effect of social inequality on population-based screening for colorectal cancer (CRC) could limit the value of such programmes. The present study aims to determine whether such inequalities exist. Methods: Data was obtained from the population-based screening programme administered in the Autonomous Community of the Basque Country, Spain, with a target population aged 50 to 69, first invited to participate between 2009 and 2011. The magnitude of inequality was analysed using the odds ratio (taking the least disadvantaged socioeconomic quintile as the reference population), the population attributable risk and the relative index of inequality, based on the regression, which is the ratio of the rates in the most and least disadvantaged socioeconomic groups. Results: The target population comprised 242,394 people, with the test kit successfully sent to 95.1 % (230,510). The overall response rate was 64.3 % (67.1 in women and 61.4 % men). Among women, the highest participation was in the third quintile (71.5 %) and the lowest in the first - the least disadvantaged (65.7 %). The lowest and highest rates of people with identified lesions were in the second and fourth quintiles (14.7/1000 and 17.0/1000 respectively). Among men, the response rate was lowest in the fifth - most disadvantaged - quintile (60.2 %). The highest rate of identified lesions was in the fifth quintile; 38 % higher than the first (55.7/1000 compared to 41.0/1000). Conclusions: Sex and socioeconomic group influence the rate of participation in the CRC programme and the rate of lesions found in the participants. Any public health programme is morally and ethically obliged to strive for equity and effectiveness. Improving participation of men and socially disadvantaged groups should be taken in account.

Although there is some experience in the study of mortality inequalities in Spanish cities, there are large urban centers that have not yet been investigated using the census tract as the unit of territorial analysis. The coordinated projectSocioeconomic and environmental inequalities in mortality in Spanish cities. The MEDEA projectwas designed to fill this gap, with the participation of 10 groups of researchers in Andalusia, Aragon, Catalonia, Galicia, Madrid, Valencia, and the Basque Country. The MEDEA project has four distinguishing features: a) the census tract is used as the basic geographical area; b) statistical methods that include the geographical structure of the region under study are employed for risk estimation; c) data are drawn from three complementary data sources (information on air pollution, information on industrial pollution, and the records of mortality registrars), and d) a coordinated, large-scale analysis, favored by the implantation of coordinated research networks, is carried out. The main objective of the present study was to explain the methods for smoothing mortality indicators in the context of the MEDEA project. This study focusses on the methodology and the results of the Besag, York and Mollié model (BYM) in disease mapping. In the MEDEA project, standardized mortality ratios (SMR), corresponding to 17 large groups of causes of death and 28 specific causes, were smoothed by means of the BYM model; however, in the present study this methodology was applied to mortality due to cancer of the trachea, bronchi and lung in men and women in the city of Barcelona from 1996 to 2003. As a result of smoothing, a different geographical pattern for SMR in both genders was observed. In men, a SMR higher than unity was found in highly deprived areas. In contrast, in women, this pattern was observed in more affluent areas.

Aunque la experiencia en el estudio de las desigualdades en la mortalidad en las ciudades españolas es amplia, quedan grandes núcleos urbanos que no han sido investigados utilizando la sección censal como unidad de análisis territorial. En este contexto se sitúa el proyecto coordinado «Desigualdades socioeconómicas y medioambientales en la mortalidad en ciudades de España. Proyecto MEDEA», en el cual participan 10 grupos de investigadores de Andalucía, Aragón, Cataluña, Galicia, Madrid, Comunitat Valenciana y País Vasco. Cabe señalar cuatro particularidades: a) se utiliza como área geográfica básica la sección censal; b) se emplean métodos estadísticos que tienen en cuenta la estructura geográfica de la región de estudio para la estimación de riesgos; c) se aprovechan las oportunidades que ofrecen 3 fuentes de datos complementarias (información sobre contaminación atmosférica, información sobre contaminación industrial y registros de mortalidad), y d) se emprende un análisis coordinado de gran alcance, favorecido por la implantación de la redes temáticas de investigación. El objetivo de este trabajo es explicar los métodos para la suavización de indicadores de mortalidad en el proyecto MEDEA. El artículo se centra en la metodología y los resultados del modelo de mapa de enfermedades de Besag, York y Mollié (BYM). Aunque en el proyecto se han suavizado, mediante el modelo BYM, las rezones de mortalidad estandarizadas (RME) correspondientes a 17 grandes grupos de causas de defunción y 28 causas específicas, aquí se aplica esta metodología a la mortalidad por cáncer de tráquea, de bronquios y de pulmón en ambos sexos en la ciudad de Barcelona durante el período 1996-2003. Como resultado se aprecia un diferente patrón geográfico en las RME suavizadas en ambos sexos. En los hombres se observan unas RME mayores que la unidad en los barrios con mayor privación socioeconómica. En las mujeres este patron se observa en las zonas con un mayor nivel socioeconómico Although there is some experience in the study of mortality inequalities in Spanish cities, there are large urban centers that have not yet been investigated using the census tract as the unit of territorial analysis. The coordinated project «Socioeconomic and environmental inequalities in mortality in Spanish cities. The MEDEA project» was designed to fill this gap, with the participation of 10 groups of researchers in Andalusia, Aragon, Catalonia, Galicia, Madrid, Valencia, and the Basque Country. The MEDEA project has four distinguishing features: a) the census tract is used as the basic geographical area; b) statistical methods that include the geographical structure of the region under study are employed for risk estimation; c) data are drawn from three complementary data sources (information on air pollution, information on industrial pollution, and the records of mortality registrars), and d) a coordinated, large-scale analysis, favored by the implantation of coordinated research networks, is carried out. The main objective of the present study was to explain the methods for smoothing mortality indicators in the context of the MEDEA project. This study focusses on the methodology and the results of the Besag, York and Mollié model (BYM) in disease mapping. In the MEDEA project, standardized mortality ratios (SMR), corresponding to 17 large groups of causes of death and 28 specific causes, were smoothed by means of the BYM model; however, in the present study this methodology was applied to mortality due to cancer of the trachea, bronchi and lung in men and women in the city of Barcelona from 1996 to 2003. As a result of smoothing, a different geographical pattern for SMR in both genders was observed. In men, a SMR higher than unity was found in highly deprived areas. In contrast, in women, this pattern was observed in more affluent areas Estudio parcialmente financiado por el proyecto «Mortalidad en áreas pequeñas Españolas y Desigualdades socio-Económicas y Ambientales (MEDEA)»: PI04/0399 (GRECS, Universitat de Girona), PI04/2013 (ASPB, Barcelona), PI04/0388 (Departamento de Sanidad y Servicio Vasco de Salud, Gobierno Vasco), PI04/0041 (CNE, ISCIII), PI04/0170 (Conselleria de Sanitat, València); por la Red de Centros de Epidemiología y Salud Pública (FISS C03/09); y por el CIBER de Epidemiología y Salud Pública (CIBERESP) SI

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.

incluye "Erratum to: Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities" BACKGROUND: Intra-urban inequalities in mortality have been infrequently analysed in European contexts. The aim of the present study was to analyse patterns of cancer mortality and their relationship with socioeconomic deprivation in small areas in 11 Spanish cities. METHODS: It is a cross-sectional ecological design using mortality data (years 1996-2003). Units of analysis were the census tracts. A deprivation index was calculated for each census tract. In order to control the variability in estimating the risk of dying we used Bayesian models. We present the RR of the census tract with the highest deprivation vs. the census tract with the lowest deprivation. RESULTS: In the case of men, socioeconomic inequalities are observed in total cancer mortality in all cities, except in Castellon, Cordoba and Vigo, while Barcelona (RR = 1.53 95%CI 1.42-1.67), Madrid (RR = 1.57 95%CI 1.49-1.65) and Seville (RR = 1.53 95%CI 1.36-1.74) present the greatest inequalities. In general Barcelona and Madrid, present inequalities for most types of cancer. Among women for total cancer mortality, inequalities have only been found in Barcelona and Zaragoza. The excess number of cancer deaths due to socioeconomic deprivation was 16,413 for men and 1,142 for women. CONCLUSION: This study has analysed inequalities in cancer mortality in small areas of cities in Spain, not only relating this mortality with socioeconomic deprivation, but also calculating the excess mortality which may be attributed to such deprivation. This knowledge is particularly useful to determine which geographical areas in each city need intersectorial policies in order to promote a healthy environment. This article was partially supported by Fondo de Investigaciones Ssanitarias (FIS) projects numbers PI042013, PI040041, PI040170, PI040069, PI042602 PI040388, PI040489, PI042098 , PI041260, PI040399, PI081488 and by the CIBER en Epidemiología y Salud Pública (CIBERESP), Spain and by the program of "Intensificación de la Actividad Investigadora (Carme Borrell)" funded by the "Instituto de Salud Carlos III" and "Departament de Salut. Generalitat de Catalunya". Sí

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.