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.

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.

Chebanov law and Vakar formula in mathematical models of complex systems

Ecological models written in a mathematical language L(M) or model language, with a given style or methodology can be considered as a text. It is possible to apply statistical linguistic laws and the experimental results demonstrate that the behaviour of a mathematical model is the same of any literary text of any natural language. A text has the following characteristics: (a) the variables, its transformed functions and parameters are the lexic units or LUN of ecological models; (b) the syllables are constituted by a LUN, or a chain of them, separated by operating or ordering LUNs; (c) the flow equations are words; and (d) the distribution of words (LUM and CLUN) according to their lengths is based on a Poisson distribution, the Chebanov's law. It is founded on Vakar's formula, that is calculated likewise the linguistic entropy for L(M). We will apply these ideas over practical examples using MARIOLA model. In this paper it will be studied the problem of the lengths of the simple lexic units composed lexic units and words of text models, expressing these lengths in number of the primitive symbols, and syllables. The use of these linguistic laws renders it possible to indicate the degree of information given by an ecological model.

Elección de la duración del viaje vacacional: una aproximación con modelos de recuento

La duración del viaje vacacional es una decisión del turista con unas implicaciones fundamentales para las organizaciones turísticas, pero que ha recibido una escasa atención por la literatura. Además, los escasos estudios se han centrado en los destinos costeros, cuando el turismo de interior se está erigiendo como una alternativa importante en algunos países. El presente trabajo analiza los factores determinantes de la elección temporal del viaje turístico, distinguiendo el tipo de destino elegido -costa e interior-, y proponiendo varias hipótesis acerca de la influencia de las características de los individuos relacionadas con el destino, de las restricciones personales y de las características sociodemográficas. La metodología aplicada estima, como novedad en este tipo de decisiones, un Modelo Binomial Negativo Truncado que evita los sesgos de estimación de los modelos de regresión y el supuesto restrictivo de igualdad media-varianza del Modelo de Poisson. La aplicación empírica realizada en España sobre una muestra de 1.600 individuos permite concluir, por un lado, que el Modelo Binomial Negativo es más adecuado que el de Poisson para realizar este tipo de análisis. Por otro lado, las dimensiones determinantes de la duración del viaje vacacional son, para ambos destinos, el alojamiento en hotel y apartamento propio, las restricciones temporales, la edad del turista y la forma de organizar el viaje; mientras que el tamaño de la ciudad de residencia y el atributo “precios baratos” es un aspecto diferencial de la costa; y el alojamiento en apartamentos alquilados lo es de los destinos de interior.

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.

Nuevas herramientas para el estudio de la interacción entre especies en el espacio y en el tiempo

Las funciones de segundo orden son cada vez más empleadas en el análisis de procesos ecológicos. En este trabajo presentamos dos funciones de 2º orden desarrolladas recientemente que permiten analizar la interacción espacio-temporal entre dos especies o tipos funcionales de individuos. Estas funciones han sido desarrolladas para el estudio de interacciones entre especies en masas forestales a partir de la actual distribución diamétrica de los árboles. La primera de ellas es la función bivariante para procesos de puntos con marca Krsmm, que permite analizar la correlación espacial de una variable entre los individuos pertenecientes a dos especies en función de la distancia. La segunda es la función de reemplazo , que permite analizar la asociación entre los individuos pertenecientes a dos especies en función de la diferencia entre sus diámetros u otra variable asociada a dichos individuos. Para mostrar el comportamiento de ambas funciones en el análisis de sistemas forestales en los que operan diferentes procesos ecológicos se presentan tres casos de estudio: una masa mixta de Pinus pinea L. y Pinus pinaster Ait. en la Meseta Norte, un bosque de niebla de la Región Tropical Andina y el ecotono entre las masas de Quercus pyrenaica Willd. y Pinus sylvestris L. en el Sistema Central, en los que tanto la función Krsmm como la función r se utilizan para analizar la dinámica forestal a partir de parcelas experimentales con todos los árboles localizados y de parcelas de inventario.

Determinant factors of senior tourists’ length of stay

The current tendency to undertake more trips, but of shorter duration, throughout the year, has meant that the tourist industry has started to show greater interest in attracting those market segments that opt for more prolonged stays, as they are especially profitable. One of these segments is that of seniors. Given the aging demographic of the population worldwide, which is particularly noticeable in Spain, the object of this study is to identify the variables that determine the length of stay of Spanish seniors at their destination. The Negative Binomial model was adapted to the context of length of stay by Spanish seniors and the determinant factors identified were: age, travel purpose, climate, type of accommodation, group size, trip type and the activities carried out at the destination. This study is a contribution to this field from an empirical point of view, given the scarcity of studies of this type and their eminently descriptive character; as well as from a practical level, with interesting implications for the sector.