The rich live two years longer than the poor in Tarragona

The residents of the Barri dels Músics live statistically longer than those of Campclar. And, in turn, those of Almoster also have a increased life expectancy than those of Batea, if we compare the income extremes in the province, between census sections or between municipalities. they are just quantitative averages but they x-ray numerically inequality in health by territory and its impact on mortality according to socioeconomic level.

Being healthier is not just a matter of genetic chance. The richest people from Tarragona live on average two years more than the poor. This is the conclusion of a study led by several groups from the Epidemiology and Public Health Area (CIBERESP) of the Network Biomedical Research Center Consortium (CIBER-ISCIII). The report has been published in the journal Scientific Reports, by 'Nature', and has received funding from the Carlos III Health Institute (ISCIII) and the Spanish Association Against Cancer (AECC). A team from the ISCIII National Epidemiology Center (CNE) has also collaborated in the study.

The research has made it possible to draw the first life tables in Spain by socioeconomic levela material that is emerging useful for studying the survival of different diseases, including cancer.

differences at birth

in Tarragona, men in the wealthiest 20% of the population live 1.8 years longer than those who are in the bottom 20%. In women, the difference is less and is located in eight months. But where this imbalance is most visible is in life expectancy at birth.

The lower class triples in respiratory infections to the upper-middle class in the Camp de Tarragona

A child from Tarragona who is born into a wealthy environment has a life expectancy of 79.6 years while, at the other extreme, in the part of the population with fewer resources, the age is 77 years. They are 2.6 years apart. Among women, life expectancy at birth ranges from 84.7 years in the richest settings to 83.4 in the poorest, 1.3 years.

Tarragona is not among the provinces with a greater gap between classes. Soria, Guadalajara, Segovia or Teruel are among those with the greatest gap. In fact, Tarragona is better than the Spanish average. Analyzing the relationship between the level and life expectancy at birth, the authors have determined that women and men living in the poorest areas live between 3.2 and 3.8 years less, respectively, than in the richest areas. In addition, it has been calculated that, on average, women live 5.6 years longer than men (82.9 years for women compared to 77.3 for men).

In a provincial key, the study shows that life expectancy at birth was higher in the northern half of the peninsula, in both sexes, and in the capitals compared to rural areas. Factors such as lifestyle, having a less healthy eating and coexistencethe environment. Having to share a flat for financial reasons or not being able to telework These are factors that can explain a greater predisposition to contagion, something that has been seen during Covid.

public health programs

According to Daniel Redondo, a researcher at CIBERESP and the Andalusian School of Public Health, "understanding the association between life expectancy and socioeconomic status could help develop appropriate public health programs and in this line, life tables are necessary to estimate the cancer-specific survival measures according to social status.

The food or the type of housing influence when it comes to getting sick or spreading a contagion

CNE researcher Pablo Fernández highlights «the significant gap that we have found in life expectancy in Spain according to geographic variation, by sex and by socioeconomic status", differences that are more pronounced among men than among women: "A better understanding of the association between life expectancy and socioeconomic status can eitheroptimize the development of public health programs».​

The recently published data refer to the years 2011-2013, but much more recent estimates tied to the pandemic they also show that imbalance in health according to the standard of living.

The latest figures from the Department of Health in Tarragona are eloquent: in the last two months the lower class has accumulated 6,464 acute respiratory infections in the Camp. That includes Covid, flu or colds. It is almost triple the balance of those of a medium-high level (2,387).

"There is a significant gap according to geographic variation or socioeconomic status," says Pablo Fernández, one of the researchers

In turn, in the same period, the lower-middle class added 9,557 cases, four times more than the upper-middle class. It is true that there are more infections at an absolute level among the lower or lower-middle classes, because they have a greater volume, but the rate of patients per 100,000 inhabitants also reflects significant differences.

Fewer resources, more infections. The low socioeconomic level has a rate of 686.74 infections, above the medium-low (615.35) and 18% higher than the medium-high stratum (580.4).

Risk and response capacity

That distance has also been reproduced only taking into account the Covid and during the hardest times of the pandemic. There have been waves with very diverse cases that have been infecting a large part of the population, but the coronavirus was raging, especially in the first year, with profiles living in more modest environments. "The socioeconomic level is important to establish who is at higher risk because they are more exposed but also because of the ability to respond», explained Israel Rodríguez, professor of Psychology and Educational Sciences at the UOC. Rodriguez.

"In times of restrictions, teleworking was a form of privilege," admits Israel Rodríguez, professor of Psychology and Educational Sciences at the UOC

The teacher added in recent times of restrictions: «Teleworking, in a certain way, becomes a form of privilege. The physical distance of the periphery also influences because it entails greater mobility, as well as housing and the possibility of doing quarantines well done. If you can't do it, there tends to be more risk." Elisa Alegre, anthropologist and professor at the UOC and the URV, also stressed a similar line: «In some cases it coincides that the most precarious jobs are those that cannot be done remotely. In the most impoverished neighborhoods, the type of work that is usually had is not virtualizable ».

That imbalance clearly occurred, for example, two years ago. In the second wave of Covid, in autumn 2020, the neighborhoods of Ponent, on the outskirts of Tarragona, and also other more vulnerable districts such as Sant Salvador, showed a higher incidence that in the center. It has been that way for many times.

Elisa Alegre and other researchers have been claiming for years «include social indicators as a perspective in public healthfor the sake of concepts such as the sociology of health”, since “it is something that appears in any study of social sciences that works with health”.

Tables to study inequality in cancer survival

Obtaining, for the first time in Spain, life tables by socioeconomic level is a starting point for studying survival in cancer and other chronic diseases applying the perspective of economic inequality. This should contribute to a better understanding of the factors that influence the prognosis of certain ailments.

"Inequalities in cancer persist and have an impact on health costs", acknowledges María José Sánchez, researcher

For María José Sánchez, head of the research group, "the tables are essential for calculating life expectancy and estimating survival from cancer." Sánchez indicates that in terms of tumors "inequalities persist and have an economic impact on health costs." The same 'Nature' study indicates that these investigations “they are important for cancer control in Spain”.

To carry out this research deaths from any cause of death of the 35,960 census sections of Spain were analyzed in the period 2011-13, and mortality was modeled by sex, age group and socioeconomic level.

The level of wealth or poverty in each area was measured with an index developed by the Spanish Society of Epidemiology, which includes information on six indicators related to employment and education: percentage of manual workers (with and without employment), occasional employees, Percentage of the population without secondary education and households without internet.

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