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dc.contributor.authorRegidor, Enrique
dc.contributor.authorReques, Laura 
dc.contributor.authorGiráldez-García, Carolina
dc.contributor.authorMiqueleiz, Estrella
dc.contributor.authorSantos, Juana M
dc.contributor.authorMartínez, David
dc.contributor.authorFuente, Luis de la
dc.identifier.citationPLoS One. 2015 Jul 24;10(7):e0133765.es_ES
dc.description.abstractOBJECTIVE: 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.es_ES
dc.description.sponsorshipThis study was funded by UCM-Banco de Santander (GR3/14). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.es_ES
dc.publisherPublic Library of Science (PLOS) es_ES
dc.subject.meshCause of Death es_ES
dc.subject.meshFemale es_ES
dc.subject.meshGeography es_ES
dc.subject.meshHumans es_ES
dc.subject.meshMale es_ES
dc.subject.meshModels, Statistical es_ES
dc.subject.meshProspective Studies es_ES
dc.subject.meshSocioeconomic Factors es_ES
dc.subject.meshSpain es_ES
dc.subject.meshMortality es_ES
dc.subject.meshPopulation Surveillance es_ES
dc.titleThe Association of Geographic Coordinates with Mortality in People with Lower and Higher Education and with Mortality Inequalities in Spaines_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderBanco Santander 
dc.identifier.journalPloS onees_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.repisalud.centroISCIII::Escuela Nacional de Sanidades_ES
dc.rights.accessRightsopen accesses_ES

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