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Economic Crisis and Amenable Mortality in Spain

Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, Campus de San Vicente del Raspeig s/n, Ap. 99-03080 Alicante, Spain
Mortality Register of the Valencian Community, section of Epidemiological Studies and Health Statistics, General Sub-directorate of Epidemiology and Health Monitoring, General Directorate of Public Health, Health Ministry of the Valencian Government, 03010 Alicante, Spain
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(10), 2298;
Received: 6 September 2018 / Revised: 9 October 2018 / Accepted: 16 October 2018 / Published: 19 October 2018
(This article belongs to the Special Issue Health Care Equity)
Background: Both overall mortality and avoidable mortality have decreased in recent years in most European countries. It has become clear that less privileged socioeconomic groups have an increased risk of death. In 2008, most countries went into a severe economic recession, whose effects on the health of the population are still ongoing. While on the one hand, some evidence associates the economic crisis with positive health outcomes (pro-cyclical effect), on the other hand, some other evidence suggests that the economic crisis may pose serious public health problems (counter-cyclical effect), which has given rise to controversy. Objectives: To describe the evolution of overall mortality and amenable mortality in Spain between 2002–2007 (before the economic crisis) and 2008–2013 (during the economic crisis), nationally and by province, as well as to analyse trends in the risks of death and their association with indicators of the impact of the crisis. Methods: Ecological study of overall mortality and amenable mortality describing the evolution of the risks of death between 2002–2007 and 2008–2013. Age Standardised Rates were calculated, as well as their percentage change between periods. The association between percentage changes and provincial indicators of the impact of the crisis was analysed. Amenable mortality was studied both overall and categorised into five groups. Results: Amenable mortality represented 8.25% of overall mortality in 2002–2007, and 6.93% in 2008–2013. Age Standardised Rates for overall mortality and global amenable mortality generally declined, with the sharpest decline in amenable mortality. Decreases in overall mortality and amenable mortality were directly related to vulnerability indicators. The most significant decreases were registered in ischaemic heart disease, cerebrovascular disease, and other amenable causes. The relationship with vulnerability indices varied from direct (cancer) to inverse (hypertensive disease). Conclusions: Amenable mortality shows a more significant decrease than overall mortality between both study periods, albeit unevenly between provinces causes of death. Higher vulnerability indicators entail greater declines, although this trend varied for different causes. Mortality trends and their relationship with socioeconomic indicators in a situation of crisis must be conducted cautiously, taking into consideration a possible pro-cyclical effect. View Full-Text
Keywords: mortality; amenable mortality; economic recession; socioeconomic factors; Spain mortality; amenable mortality; economic recession; socioeconomic factors; Spain
MDPI and ACS Style

Nolasco, A.; Pereyra-Zamora, P.; Sanchis-Matea, E.; Tamayo-Fonseca, N.; Caballero, P.; Melchor, I.; Moncho, J. Economic Crisis and Amenable Mortality in Spain. Int. J. Environ. Res. Public Health 2018, 15, 2298.

AMA Style

Nolasco A, Pereyra-Zamora P, Sanchis-Matea E, Tamayo-Fonseca N, Caballero P, Melchor I, Moncho J. Economic Crisis and Amenable Mortality in Spain. International Journal of Environmental Research and Public Health. 2018; 15(10):2298.

Chicago/Turabian Style

Nolasco, Andreu, Pamela Pereyra-Zamora, Elvira Sanchis-Matea, Nayara Tamayo-Fonseca, Pablo Caballero, Inmaculada Melchor, and Joaquín Moncho. 2018. "Economic Crisis and Amenable Mortality in Spain" International Journal of Environmental Research and Public Health 15, no. 10: 2298.

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