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The Association of Geographic Coordinates with Mortality in People with Lower and Higher Education and with Mortality Inequalities in Spain

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  • Enrique Regidor
  • Laura Reques
  • Carolina Giráldez-García
  • Estrella Miqueleiz
  • Juana M Santos
  • David Martínez
  • Luis de la Fuente

Abstract

Objective: Geographic patterns in total mortality and in mortality by cause of death are widely known to exist in many countries. However, the geographic pattern of inequalities in mortality within these countries is unknown. This study shows mathematically and graphically the geographic pattern of mortality inequalities by education in Spain. Methods: Data are from a nation-wide prospective study covering all persons living in Spain's 50 provinces in 2001. Individuals were classified in a cohort of subjects with low education and in another cohort of subjects with high education. Age- and sex-adjusted mortality rate from all causes and from leading causes of death in each cohort and mortality rate ratios in the low versus high education cohort were estimated by geographic coordinates and province. Results: Latitude but not longitude was related to mortality. In subjects with low education, latitude had a U-shaped relation to mortality. In those with high education, mortality from all causes, and from cardiovascular, respiratory and digestive diseases decreased with increasing latitude, whereas cancer mortality increased. The mortality-rate ratio for all-cause death was 1.27 in the southern latitudes, 1.14 in the intermediate latitudes, and 1.20 in the northern latitudes. The mortality rate ratios for the leading causes of death were also higher in the lower and upper latitudes than in the intermediate latitudes. The geographic pattern of the mortality rate ratios is similar to that of the mortality rate in the low-education cohort: the highest magnitude is observed in the southern provinces, intermediate magnitudes in the provinces of the north and those of the Mediterranean east coast, and the lowest magnitude in the central provinces and those in the south of the Western Pyrenees. Conclusion: Mortality inequalities by education in Spain are higher in the south and north of the country and lower in the large region making up the central plateau. This geographic pattern is similar to that observed in mortality in the low-education cohort.

Suggested Citation

  • Enrique Regidor & Laura Reques & Carolina Giráldez-García & Estrella Miqueleiz & Juana M Santos & David Martínez & Luis de la Fuente, 2015. "The Association of Geographic Coordinates with Mortality in People with Lower and Higher Education and with Mortality Inequalities in Spain," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-16, July.
    • Handle: RePEc:plo:pone00:0133765
    DOI: 10.1371/journal.pone.0133765
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    References listed on IDEAS

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    1. Montez, J.K. & Berkman, L.F., 2014. "Trends in the educational gradient of mortality among US adults aged 45 to 84 years: Bringing regional context into the explanation," American Journal of Public Health, American Public Health Association, vol. 104(1), pages 82-90.
    2. Mark R Cullen & Clint Cummins & Victor R Fuchs, 2012. "Geographic and Racial Variation in Premature Mortality in the U.S.: Analyzing the Disparities," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-13, April.
    3. Fabio Divino & Viviana Egidi & Michele Antonio Salvatore, 2009. "Geographical mortality patterns in Italy," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 20(18), pages 435-466.
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    2. Vanessa Santos S�nchez & Gabriele Ruiu & Lucia Pozzi & Marco Breschi & Giovanna Gonano, 2020. "Geographical variations in mortality and unemployment in Italy," RIEDS - Rivista Italiana di Economia, Demografia e Statistica - The Italian Journal of Economic, Demographic and Statistical Studies, SIEDS Societa' Italiana di Economia Demografia e Statistica, vol. 74(2), pages 109-120, April-Jun.
    3. Clemente López, Jesús & García Castrillo, Pedro & González-Álvarez , María A., 2019. "Mortalidad y estatus socioeconómico en la España de principios del siglo XXI," INVESTIGACIONES REGIONALES - Journal of REGIONAL RESEARCH, Asociación Española de Ciencia Regional, issue 45, pages 227-240.
    4. Sieds, 2020. "Complete Volume LXXIV n. 1 2020," RIEDS - Rivista Italiana di Economia, Demografia e Statistica - The Italian Journal of Economic, Demographic and Statistical Studies, SIEDS Societa' Italiana di Economia Demografia e Statistica, vol. 74(2), pages 1-123, April-Jun.

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