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.

Trends in socioeconomic inequalities in amenable mortality in urban areas of Spanish cities, 1996-2007

Background: While research continues into indicators such as preventable and amenable mortality in order to evaluate quality, access, and equity in the healthcare, it is also necessary to continue identifying the areas of greatest risk owing to these causes of death in urban areas of large cities, where a large part of the population is concentrated, in order to carry out specific actions and reduce inequalities in mortality. This study describes inequalities in amenable mortality in relation to socioeconomic status in small urban areas, and analyses their evolution over the course of the periods 1996–99, 2000–2003 and 2004–2007 in three major cities in the Spanish Mediterranean coast (Alicante, Castellón, and Valencia). Methods: All deaths attributed to amenable causes were analysed among non-institutionalised residents in the three cities studied over the course of the study periods. Census tracts for the cities were grouped into 3 socioeconomic status levels, from higher to lower levels of deprivation, using 5 indicators obtained from the 2001 Spanish Population Census. For each city, the relative risks of death were estimated between socioeconomic status levels using Poisson’s Regression models, adjusted for age and study period, and distinguishing between genders. Results: Amenable mortality contributes significantly to general mortality (around 10%, higher among men), having decreased over time in the three cities studied for men and women. In the three cities studied, with a high degree of consistency, it has been seen that the risks of mortality are greater in areas of higher deprivation, and that these excesses have not significantly modified over time. Conclusions: Although amenable mortality decreases over the time period studied, the socioeconomic inequalities observed are maintained in the three cities. Areas have been identified that display excesses in amenable mortality, potentially attributable to differences in the healthcare system, associated with areas of greater deprivation. Action must be taken in these areas of greater inequality in order to reduce the health inequalities detected. The causes behind socioeconomic inequalities in amenable mortality must be studied in depth.

Trends in socioeconomic inequalities in preventable mortality in urban areas of 33 Spanish cities, 1996–2007 (MEDEA project)

Background: Preventable mortality is a good indicator of possible problems to be investigated in the primary prevention chain, making it also a useful tool with which to evaluate health policies particularly public health policies. This study describes inequalities in preventable avoidable mortality in relation to socioeconomic status in small urban areas of thirty three Spanish cities, and analyses their evolution over the course of the periods 1996–2001 and 2002–2007. Methods: We analysed census tracts and all deaths occurring in the population residing in these cities from 1996 to 2007 were taken into account. The causes included in the study were lung cancer, cirrhosis, AIDS/HIV, motor vehicle traffic accidents injuries, suicide and homicide. The census tracts were classified into three groups, according their socioeconomic level. To analyse inequalities in mortality risks between the highest and lowest socioeconomic levels and over different periods, for each city and separating by sex, Poisson regression were used. Results: Preventable avoidable mortality made a significant contribution to general mortality (around 7.5%, higher among men), having decreased over time in men (12.7 in 1996–2001 and 10.9 in 2002–2007), though not so clearly among women (3.3% in 1996–2001 and 2.9% in 2002–2007). It has been observed in men that the risks of death are higher in areas of greater deprivation, and that these excesses have not modified over time. The result in women is different and differences in mortality risks by socioeconomic level could not be established in many cities. Conclusions: Preventable mortality decreased between the 1996–2001 and 2002–2007 periods, more markedly in men than in women. There were socioeconomic inequalities in mortality in most cities analysed, associating a higher risk of death with higher levels of deprivation. Inequalities have remained over the two periods analysed. This study makes it possible to identify those areas where excess preventable mortality was associated with more deprived zones. It is in these deprived zones where actions to reduce and monitor health inequalities should be put into place. Primary healthcare may play an important role in this process.

Spatial Distribution of Marine Epibenthic Communities in the Hola Trough (Vesterålen, Northern Norway)

The Lofoten-Vesterålen marine shelf is one of the most geologically diverse coast and offshore margin areas in Norway. This leads to huge heterogeneity in marine environments, and often high biodiversity. However, little is known yet about the benthic communities in this region. Within the ARCTOS LoVe MarineEco project the epibenthic communities of the Hola trough (Vesterålen) are analysed to give a first description of their spatial distribution. In this trough both a complex hydrodynamic system and varied topographic submarine elements occur. Trawling samples were collected for two different approaches: one in a meso-scale and another in a small-scale. For the broad scale a transect consisting in three stations was developed, while for the fine scale a small area on a sand wave field, consisting in five stations called HolaBox, was sampled. All organisms were intended to be identified to species level and colonial fauna was discarded for the analysis. Different diversity indexes were assessed (Shannon index (H’) and Pielou’s eveness (J’)). Clustering and nMDS analyses identified four statistically significant groups in terms of abundance (ind./100m2). A total amount of 211 different taxa were found within all stations. The more outer part of the transect (close to the shelf edge) presented a huge abundance of organisms and was dominated by the hemi sessile tube-builder polychaetes Nothria conchylega and Eunice dubitata and the sea urchin Gacilechinus acutus, while the more inner parts presented less abundance of individuals. Probably some upwelling produced by the Norwegian Atlantic Current (NWAC) is influencing the shelf edge increasing the primary production and, therefore, enriching the seafloor in this region. The sand wave field presented two different groups with few amount of individuals. Small-scale variability could be produced by the high heterogeneity within the different types of sand waves, while the scarce abundance of animals can be produced by the permanent changing environment that movable sand waves produce. Here more active and mobile fauna was found such as brittle stars and hermit crabs (among others). Finally, a fourth group was found in the most inner station of the transect, laying on a ridge in the central part of the trough. This station, with coarse substrate, was mainly dominated again by brittle stars and sea urchins. We can conclude that this is a really heterogeneous trough in environments and therefore in communities (even in a local scale). More detailed studies that focus in the local environmental drivers have to be carried out to get an integrated understanding of the structure of benthic communities in this system.

Synthesis of high surface area TiO2 nanoparticles by mild acid treatment with HCl or HI for photocatalytic propene oxidation

Nanostructured TiO2 photocatalysts with small crystalline sizes have been synthesized by sol-gel using the amphiphilic triblock copolymer Pluronic P123 as template. A new synthesis route, based on the treatment of TiO2 xerogels with acid-ethanol mixtures in two different steps, synthesis and extraction-crystallization, has been investigated, analyzing two acids, hydrochloric and hydriodic acid. As reference, samples have also been prepared by extraction-crystallization in ethanol, being these TiO2 materials amorphous and presenting higher porosities. The prepared materials present different degrees of crystallinity depending on the experimental conditions used. In general, these materials exhibit high surface areas, with an important contribution of microporosity and mesoporosity, and with very small size anatase crystals, ranging from 5 to 7 nm. The activity of the obtained photocatalysts has been assessed in the oxidation of propene in gas phase at low concentration (100 ppmv) under a UVA lamp with 365 nm wavelength. In the conditions studied, these photocatalysts show different activities in the oxidation of propene which do not depend on their surface areas, but on their crystallinity and band gap energies, being sample prepared with HCl both during synthesis and in extraction-crystallizations steps, the most active one, with superior performance than Evonik P25.

Presencia del olmo temblón o negrillo, Ulmus laevis Pall. en Ibi (Alicante, Comunidad Valenciana)

Se ha localizado en la Rambla de la Gavarnera en Ibi, Alicante una pequeña población de Ulmus laevis Pall., que no había sido citado expresamente en localidades valencianas, ni en las floras locales, regionales, ni nacionales, en unos casos por no haberse localizado, en otros por considerar a este árbol alóctono en España. Desde hace una década un equipo de la ETSIA de Montes de la Universidad Politécnica de Madrid, viene realizando diversos proyectos y tesis doctorales que han dado como resultado la puesta en valor de esta especie, a través de su localización a nivel nacional, estudio ecológico, fisiológico y genético, que arrojan numerosas pruebas a favor de la autoctonía de esta especie en España. Según los autores de este dilatado proyecto, U. laevis habría tenido en España uno de su principales refugios cuaternarios, aunque en la actualidad se encuentre fragmentado en poblaciones dispersas, con pocos individuos y problemas para su conservación y supervivencia. No obstante esta especie ha demostrado mayores tasas de supervivencia a la enfermedad de los olmos, que otros de sus congéneres como Ulmus minor y U. glabra. En cuanto a su presencia en Alicante, son precisamente estos autores los que localizan un primer ejemplar en Ibi, al que ahora añadimos dos ejemplares más repartidos en tres puntos muy próximos y situados a lo largo de la Rambla de la Gavarnera. Este es un cauce irregular pero con nivel freático permanente, como lo atestiguan la existencia de pozos, azudes, albercas que abastecieron a los pequeños regadíos de la zona, muchos de ellos abandonados en la actualidad. Dada la rareza de esta especie a nivel nacional y la excepcionalidad de su presencia en Ibi, consideramos que el ejemplar de mayor porte merece la consideración de árbol singular para la Comunidad Valenciana y por otra parte, los otros ejemplares merecen su protección y multiplicación, para incrementar la población existente. Es necesario desarrollar un mayor esfuerzo de localización en este paraje y zonas próximas de la Comarca, para conocer su potencial distribución en la provincia y determinar un estatus de protección adecuado.