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00925njm 22002777a 4500 dc Martinez-Beneito, Miguel A author Vergara-Hernández, Carlos author Botella-Rocamora, Paloma author Corpas-Burgos, Francisca author Pérez-Panadés, Jordi author Zurriaga, Óscar author Aldasoro, Elena author Borrell, Carme author Cabeza, Elena author Cirera, Lluís author Delfrade Osinaga, Josu author Fernández-Somoano, Ana author Gandarillas, Ana author Lorenzo Ruano, Pedro L author Marí-Dell'Olmo, Marc author Nolasco, Andreu author Prieto-Salceda, M Dolores author Ramis, Rebeca author Rodríguez-Sanz, Maica author Sánchez-Villegas, Pablo author MEDEA3 Project Group author 2021-05-25 The geographical distribution of mortality has frequently been studied. Nevertheless, those studies often consider isolated causes of death. In this work, we aim to study the geographical distribution of mortality in urban areas, in particular, in 26 Spanish cities. We perform an overall study of 16 causes of death, considering that their geographical patterns could be dependent and estimating the dependence between the causes of death. We study the deaths in these 26 cities during the period 1996-2015 at the census tract level. A multivariate disease mapping model is used in order to solve the potential small area estimation problems that these data could show. We find that most of the geographical patterns found show positive correlations. This suggests the existence of a transversal geographical pattern, common to most causes of deaths, which determines those patterns to a higher/lower extent depending on each disease. The causes of death that exhibit that underlying pattern in a more prominent manner are chronic obstructive pulmonary disease (COPD), lung cancer, and cirrhosis for men and cardiovascular diseases and dementias for women. Such findings are quite consistent for most of the cities in the study. The high positive correlation found between geographical patterns reflects the existence of both high and low-risk areas in urban settings, in general terms for nearly all the causes of death. Moreover, the high-risk areas found often coincide with neighborhoods known for their high deprivation. Our results suggest that dependence among causes of death is a key aspect to be taken into account when mapping mortality, at least in urban contexts. Int J Environ Res Public Health. 2021 May 25;18(11):5664. 10.3390/ijerph18115664 1660-4601 International Journal of Environmental Research and Public Health https://hdl.handle.net/20.500.13003/18824 34070635 L2007320567 2-s2.0-85106415481 http://hdl.handle.net/20.500.12105/13874 660002300001 Geographical inequalities Mortality Multivariate disease mapping Urban areas Geographical Variability in Mortality in Urban Areas: A Joint Analysis of 16 Causes of Death