[Deprivation index by enumeration district in Spain, 2011]. / Índice de privación en España por sección censal en 2011.

OBJECTIVE: To present the methodology used in the design and implementation of a deprivation index by enumeration district, and to describe the socioeconomic situation of Spain in 2011. METHOD: The unit of analysis was the enumeration district (N=35,960). Data came from the 2011 Population and Housing Census of Spain. Given both the sampling nature of the Census and the regulatory limitations of data confidentiality, variables were calculated indirectly by using the complement of the available variables. Checks were made to ensure reliability. The selection of the indicators took into account comparability with the MEDEA index. The inclusion of additional information was explored. A deprivation index was built using Principal Component Analysis. Sensitivity analysis of the index was performed for urban areas and the rest of the regions. RESULTS: Using the census information, 22 indicators were calculated for 35,917 enumeration districts. The deprivation index was based on six indicators: manual and temporary workers, unemployment, insufficient education overall and in young people (aged 16 to 29 years), and dwellings without access to the internet. The map of Spain shows a gradient of decreasing deprivation from south-west to north-east. CONCLUSIONS: The socioeconomic information of the 2011 census by enumeration district was used systematically. The drafted index, similar to the MEDEA, will facilitate the updated study of health inequalities for Spain overall following the economic recession that began in 2008.

[Use of area-level socioeconomic indicators in epidemiological research: experience in Spain and advancement opportunities]. / Uso de indicadores socioeconómicos del área de residencia en la investigación epidemiológica: experiencia en España y oportunidades de avance.

OBJECTIVE: To determine the use of area-level socioeconomic indicators in epidemiological studies in Spain. METHODS: We included studies analyzing the association of area-level socioeconomic indicators and health indicators in Spain published in peer-reviewed journals. An electronic search was conducted in PubMed-Medline, SCI-Expanded, SSCI, Embase, and the Spanish Medical Index (until December 31, 2012). A manual search was also conducted of the references of the selected studies. Each of the articles initially selected on the basis of the title and abstract was reviewed by two investigators. Information was obtained on the publication and methodology (design and study areas, information sources, health and socioeconomic indicators, and statistical analysis). RESULTS: We included 142 studies published since 1988 (58.4% since 2005). More than half (59.9%) were in English. The level of analysis was ecological in 73.2% and multilevel in 19.0%. The areas most frequently analyzed were census tracts (35 studies), especially within cities or autonomous regions, followed by the provinces (30 studies), mostly concerning Spain overall. The dependent variable most frequently analyzed was mortality and the socioeconomic dimension most commonly used was employment (71.1%). CONCLUSIONS: In the last decade in Spain, there has been an increase in the number of studies examining the association of area-level socioeconomic and health indicators, as well as in the complexity of design and analysis.