Affiliation:
1. Nursing Directorate Consorci Sanitari del Maresme Barcelona Spain
2. Research Unit Consorci Sanitari del Maresme Barcelona Spain
3. Centre for Networked Biomedical Research Liver and Digestive Diseases (CIBER‐EHD) Madrid Spain
4. Methodology, Methods Models and Outcomes of Health and Social Sciences Research Group (M3O) Faculty of Health Sciences and Welfare Centre for Health and Social Care Research (CESS) University of Vic‐Central University of Catalonia Vic Spain
5. Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS‐CC) Vic Spain
6. Management Consorci Sanitari del Maresme Barcelona Spain
Abstract
AbstractObjectiveHealth inequalities are universal, but their magnitude and determinants vary according to geographic areas, and understanding variations is essential to designing and implementing preventive and corrective policies. Our objective was to evaluate health inequalities in the Maresme region (Catalonia, Spain) and the relationship with socioeconomic indicators.DesignCross‐sectional ecological study (2017).SiteMaresme region.ParticipantsPopulation assigned to any of the Maresme's 21 basic health areas (BHAs).MeasuresSociodemographic, socioeconomic, health, and health resource use indicators published by the Catalan Health Service's Information and Knowledge Unit.ResultsDifferences observed between BHAs were 49% in mortality, 266% in diabetes incidence, 348% in stroke incidence, and 89% in hospitalizations. In the most compared to the least disadvantaged BHAs, socioeconomic deprivation, as measured by the socioeconomic index (SEI), was 4.6 times greater and the percentage population with low educational attainment (EA) was 3.7 times higher. Greater deprivation was associated with greater prevalence of diabetes, chronic obstructive pulmonary disease, and high blood pressure, and greater incidence of diabetes, ischemic heart disease, and cancer. Likewise, a greater percentage population with low EA was associated with higher premature mortality and avoidable hospitalizations.ConclusionGreat variation exists in socioeconomic, health, and health resource use between the different Maresme BHAs. Socioeconomic deprivation is strongly correlated with the prevalence and incidence of certain chronic diseases, and low EA is correlated with premature mortality and avoidable hospitalizations. Our findings point to the urgency of taking health inequalities into account in designing and implementing healthcare strategies, programs, and policies.