Geographic clustering of cardiovascular diseases in Madrid City

GOMEZ-BARROSO, D.; PRIETO FLORES, M.E.; VIDAL DOMINGUEZ, M.J.; MORENO-JIMÉNEZ, A.

Congreso; 11th International Conference on Urban Health; 2014

lntroduction: This work has been conducted within the context of a wider research project on environmental justice in Spain (Spanish Ministry of Science and lnnovation, Ref. Project CS02011-26177). The aim of this study is to identify the spatial patters of mortality from cardiovascular diseases for men, women and both sexes, and to find clusters of these diseases in  Madrid city, during 2010. Material and methods: An ecological study was conducted in Madrid city,  using age-adjusted data of mortality from cardiovascular diseases of men, women and both sexes  combined, by census tract level, during 2010. The information was obtained from the Statistics Institute of the Community of Madrid and the Spanish National Statistics lnstitute. Standardized mortality ratios (SMR) were calculated for each census tract, followed by smoothed relative risks (RRs) of cardiovascular disease mortality and the posterior probability (PP) of relative risks, being greater than 1, using the Besag, York and Mollie autoregressive spatial models. Moran's lndex was used to assess spatial autocorrelation of SMR globally. To calculate  local rates or hotspots, the Local Moran's lndex [known as local indicator of spatial association (LlSA)] was applied. Results: All the results by sex and both sexes were mapped. There were differences between   men and women in the distribution of the diseases. The map of SMR, RR and PP for women and for both sexes showed some geographical variations in disease pattern, with higher risks in the peripheral census tracts. The Moran lndex was 0.03 for men, 0.12 for women and 0.05 for both sexes. LlSA maps also showed differences between sexes and significant clusters (p< 0.05) in peripheral areas too, for women and for both sexes. Conclusion: These results emphasize the value of spatial statistical techniques to identify health inequalities. Explanations for the spatial patterns of cardiovascular disease mortality in Madrid city might be associated with socioeconomic and environmental factors, which could have important implications of environmental justice for public health. ln a next step, this factors will be examined by our research group.