Inequalities in mortality by social class in men in Barcelona, Spain

Most of the studies of inequalities in mortality carried out in Spain have been ecological, due to the difficulty of obtaining good quality socioecono mic information at individual level. The objective of this study was to des cribe inequalities in mortality by social class, based on occupation, among men residents of Barcelona in 1993. A representative sample was obtained o f men residents of Barcelona who died during the year 1993, aged between 15 and 65 years. It was a retrospective interview given to relatives of the d eceased, or other closely related persons. The variables analysed were: age , education level, underlying cause of death, and social class based on occ upation (manual and non-manual workers). Rates, relative risks (RRs) and th eir 95% confidence intervals (95% CIs) are presented by age groups and caus e of death. The main results show that among young people, the excess of mo rtality due to infectious diseases is notable (RR: 1.9; 95% CI: 1.6-2.2), a nd also due to external causes (RR: 2.1; 95% CI: 1.8-2.4) among manual work ers with respect to non-manual workers, mainly due to AIDS and drug overdos e. No significant differences were found in mortality due to tumours. For r espiratory and cardiovascular causes, there is an increase in mortality in the less favoured social classes, as also occurs for mortality due to disea ses of the digestive system, particularly among young manual workers, with an RR: 2.6 (95% CI: 1.5-3.6) compared to non-manual workers. This study sho ws that it is necessary to continue exploring inequalities in health, but a bove all it is necessary to implement efficient preventive measures address ed mainly at young people in situations of disadvantage, in order to avoid the excess of avoidable mortality which is found.