Atlas interactivo de mortalidad en Andalucía (AIMA)

Abstract

Until now, mortality atlases have been static. Most of them describe the geographical distribution of mortality using count data aggregated over time and standardized mortality rates. However, this methodology has several limitations. Count data aggregated over time produce a bias in the estimation of death rates. Moreover, this practice difficult the study of temporal changes in geographical distribution of mortality. On the other hand, using standardized mortality hamper to check differences in mortality among groups. The Interactive Mortality Atlas in Andalusia (AIMA) is an alternative to conventional static atlases. It is a dynamic Geographical Information System that allows visualizing in web-site more than 12.000 maps and 338.00 graphics related to the spatio-temporal distribution of the main death causes in Andalusia by age and sex groups from 1981. The objective of this paper is to describe the methods used for AIMA development, to show technical specifications and to present their interactivity. The system is available from the link products in www.demap.es. AIMA is the first interactive GIS that have been developed in Spain with these characteristics. Spatio-temporal Hierarchical Bayesian Models were used for statistical data analysis. The results were integrated into web-site using a PHP environment and a dynamic cartography in Flash. Thematic maps in AIMA demonstrate that the geographical distribution of mortality is dynamic, with differences among year, age and sex groups. The information nowadays provided by AIMA and the future updating will contribute to reflect on the past, the present and the future of population health in Andalusia.

Bringing the individual back to small-area variation studies: A multilevel analysis of all-cause mortality in Andalusia, Spain

“…Our conclusion critically questions previous ecological/spatial studies of small-area variation published hitherto in Spain (Benach et al, 2003;Benach et al, 2004;Borrell et al, 2010;Collaboration, 2010;Ocana-Riola & Mayoral-Cortes, 2010;Ocana-Riola et al, 2008a). These ecological/spatial studies of small-area variation are only justified if we implicitly assume that the geographical variation between municipalities and between census tracts represents an important factor for understanding individual inequalities in mortality risk.…”

“…However, many multilevel analyses performed so far have been mainly focused on the study of associations between contextual variables and individual health, considering the analysis of variance as secondary information (Blakely & Woodward, 2000;Diez Roux, 2008). In contrast, others scholars have explicitly concluded that the analysis of variance provides indispensable information for understanding place effects on health (Boyle MH & Willms JD, 1999;Clarke P & Wheaton B, 2007;Duncan et al, 1993;Merlo, 2003;Merlo et al, 2004;Merlo et al, 2009;Riva et al, 2007) Moreover, all around the world, a persistent amount of observational information on place effects is still being obtained from ecological/spatial studies of "small-area variations" , frequently in the form of coloured atlases and disease maps (Benach et al, 2003;Benach et al, 2004;Borrell et al, 2010;Collaboration, 2010;MacNab & Dean, 2002;Middleton et al, 2008;Ocana-Riola & Mayoral-Cortes, 2010;Ocana-Riola et al, 2008a;Pickle et al, 1999;Shaw, 2008;Turrell & Mengersen, 2000). From an empirical perspective, the advantages of multilevel versus ecological regression analyses were clearly identified by the seminal work performed by Aitkins and Longford (Aitkin M & Longford N, 1986) as well as by Jones,4 Duncan, Moon, Subramanian and colleagues (Bullen et al, 1996;Duncan et al, 1993Duncan et al, , 1995Duncan et al, , 1996Duncan et al, , 1998Duncan et al, , 1999Jones et al, 1991;Subramanian et al, 2009;Twigg et al, 2000).…”

Geographical and Temporal Variations in Female Breast Cancer Mortality in the Municipalities of Andalusia (Southern Spain)

“…Dynamic mortality maps are able to provide up-to-date understanding of the geographical variation and evolution over time of mortality from breast cancer and other causes of death, substantially improving on the information provided by conventional static atlases [32]. However, a systematic validation of the information sources, a careful statistical analysis and a thorough interpretation of mortality maps are all still needed in epidemiological research.…”

“…The reader interested in the published studies on other causes of death in Andalusia, or methodological aspects related to disease mapping, can obtain additional information from the references at the end of this paper [9,23,30,31,32], as well as at the DEMAP web site [33]. The conclusions of these studies have been cited, in part, during the discussion of this paper and together can help to understand the evolution of mortality in Andalusia over both space and time.…”

Efectos de la edad, el periodo de defunción y la cohorte de nacimiento en la mortalidad por enfermedad isquémica del corazón en el sur de España

“…El Atlas Interactivo de Mortalidad en Andalucía se implementó en esta regió n con fines de vigilancia epidemioló gica 14 . Los aná lisis de los datos actualizados anualmente del Atlas Interactivo de Mortalidad en Andalucía aportan una perspectiva respecto a la distribució n geográ fica de la mortalidad por cardiopatía isqué mica a lo largo del tiempo en el sur de Españ a. Estudios recientes basados en esos datos indican que, actualmente, en má s del 95% de los municipios andaluces las tasas de mortalidad de varones y mujeres de los grupos de menos de 65 añ os de edad son similares o significativamente inferiores a las correspondientes tasas españ olas.…”