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      Desigualdades en el daño en salud: Evidencia en menores de 5 años residentes en municipios del centro sur de Chile Translated title: Inequalities in damage of health: Evidence in children under 5 years residents of municipalities of central-south Chile

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          Abstract

          El objetivo es evaluar el comportamiento de las desigualdades presentes en el daño en salud de la población en su lugar de residencia. Se trata de un estudio ecológico longitudinal, no experimental, que utiliza los registros oficiales de admisión hospitalaria para enfermedades respiratorias en menores de cinco años. La identificación de grupos socioeconómico (GSE) se obtiene utilizando categorías de beneficiarios del sistema de salud chileno. La desigualdad se evalúa por medio de tres medidas: la tasa específica de admisión hospitalaria, la Razón de Tasas de los grupos de menores ingresos en comparación al de ingreso económico más alto, y la gradiente de desigualdad. Los resultados muestran desigualdad e inequidad en el daño en la salud de los residentes en todos los municipios bajo estudio. El riesgo de enfermar y requerir cuidados hospitalarios, aumenta a medida que disminuye el GSE.

          Translated abstract

          The objective is to evaluate the behavior of inequalities present in health damage of the population in their place of residence. It is an ecological longitudinal non-experimental study using records of hospital admissions for respiratory diseases in children under five years. The identification of socio-economic groups (GSE) is obtained using categories of beneficiaries of the Chilean health system. Inequality is evaluated by three measures: the specific rate of hospital admission, the rate ratio for lower income groups compared to the highest income and inequality gradient. The results show inequality and inequity in damage to the health of residents in all municipalities under study. The risk of becoming ill and require hospital care increases with decreasing the GSE.

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          Most cited references32

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          Psychosocial and material pathways in the relation between income and health: a response to Lynch et al.

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            Socioeconomic status, particulate air pollution, and daily mortality: differential exposure or differential susceptibility.

            Short-term increases in particulate air pollution are linked with increased daily mortality and morbidity. Socioeconomic status (SES) is a determinant of overall health. We investigated whether social class is an effect modifier of the PM(10) (particulate matter with diameter <10 micron)-daily mortality association, and possible mechanisms for this effect modification. Area-based traffic emissions, income, and SES were available for each resident in Rome. All natural deaths (83,253 subjects) occurring in Rome among city residents (aged 35+ years) during the period 1998-2001 were identified. For each deceased individual, all the previous hospitalizations within 2 years before death were available via a record linkage procedure. PM(10) daily data were available from two urban monitoring sites. A case-crossover analysis was utilized in which control days were selected according to the time stratified approach (same day of the week during the same month). Conditional logistic regression was used. Due to the social class distribution in the city, exposure to traffic emissions was higher among those with higher area-based income and SES. Meanwhile, people of lower social class had suffered to a larger extent from chronic diseases before death than more affluent residents, especially diabetes mellitus, hypertension, heart failure, and chronic obstructive pulmonary diseases. Overall, PM(10) (lag 0-1) was strongly associated with mortality (1.1% increase, 95%CI = 0.7-1.6%, per 10 microg/m(3)). The effect was more pronounced among persons with lower income and SES (1.9% and 1.4% per 10 microg/m(3), respectively) compared to those in the upper income and SES levels (0.0% and 0.1%, respectively). The results confirm previous suggestions of a stronger effect of particulate air pollution among people in low social class. Given the uneven geographical distributions of social deprivation and traffic emissions in Rome, the most likely explanation is a differential burden of chronic health conditions conferring a greater susceptibility to less advantaged people. (c) 2007 Wiley-Liss, Inc.
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              Environmental justice and health: the implications of the socio-spatial distribution of multiple environmental deprivation for health inequalities in the United Kingdom

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                Author and article information

                Journal
                esso
                Estudios Socioterritoriales
                Estudios Socioterritoriales
                Centro de Investigaciones Geográficas CIG-Instituto de Geografía, Historia y Ciencias Sociales CIG-IGEHCS CONICET/UNCPBA (Tandil, , Argentina )
                1853-4392
                December 2015
                : 18
                Article
                S1853-43922015000200007 S1853-4392(15)01800000007
                0ac3a3c6-254c-4dee-b239-fa515df389ad

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 30 April 2015
                : 02 October 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 0
                Product

                SciELO Argentina

                Categories
                Artículos Científicos

                Socioeconomic status,Health damage,Health Inequalities,Chile,Desigualdades en Salud,Estatus socioeconómico,Daño en salud

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