Citation

Regidor E, Mateo A, Barrio G, Fuente L. Am. J. Public Health 2019; 109(7): 1043-1049.

Affiliation

Enrique Regidor is with the Department of Public Health and Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid. Alberto Mateo is with the National Epidemiology Center, Instituto de Salud Carlos III, Madrid, and the School of Public Health, Health Education North West, Manchester, UK. Gregorio Barrio is with the National School of Public Health, Instituto de Salud Carlos III, Madrid. Luis de la Fuente is with the National Epidemiology Center, Instituto de Salud Carlos III, Madrid, and CIBERESP, Madrid.

Copyright

(Copyright © 2019, American Public Health Association)

DOI

10.2105/AJPH.2019.305075

PMID

31095411

Abstract

Objectives. To analyze the mortality trend in Spain before, during, and after the economic crisis and austerity policies.

Methods. We calculated age-standardized annual mortality rates in 2001 through 2016 and estimated linear trends in mortality rates during 4 periods (2001-2007, 2008-2010, 2011-2013, and 2014-2016) using the annual percentage change (APC).

Results. All-cause mortality rate decreased during the period 2001 to 2016, although we found increases over the previous year. After adjusting for increased influenza activity (P = .743) and heat waves (P = .473), we found the greatest declines during the economic crisis (2008-2010) and the smallest in the period 2014 to 2016, in which the APC in mortality rates was -2.9 and -0.6, respectively. The APC before the crisis (2001-2007) and during austerity (2011-2013) was -2.0 and -2.2, respectively. We observed similar results in mortality from cardiovascular, respiratory, and digestive diseases and motor vehicle accidents. Mortality from cancer showed the smallest decline during the crisis and the austerity period, whereas suicide increased in the period 2011 to 2013.

Conclusions. Lifestyle changes could explain the decline in mortality during the economic crisis. Increased influenza activity and the 2015 heat wave may prevent identifying a possible delayed effect of austerity policies in the slowing down of mortality decline in the period 2014 to 2016.

(Am J Public Health. Published online ahead of print May 16, 2019: e1-e7. doi:10.2105/AJPH.2019.305075).

Language: en