Power relations and premature mortality in Spain's autonomous communities

Maica Rodríguez-Sanz, Carme Borrell, Rosa Urbanos, M. Isabel Pasarín, Ana Rico, Marta Fraile, Xavier Ramos, Vicente Navarro

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


This trends ecological study analyzes, across 17 autonomous communities of Spain from 1989 to 1998, the relationship between mortality (total and by main causes of death) and power relations (type of government: social democratic (SDP), conservative (CDP), and others), labor market variables, welfare state variables, income inequality, absolute income, poverty, and number of civil associations. The authors conducted a descriptive analysis; a bivariate analysis (Pearson correlation coefficients) between mortality and each of the independent variables; and a multivariate analysis, adjusting multilevel linear regression models. All dimensions of the conceptual power relations model were related to premature mortality in the direction hypothesized. The cross-pooled multilevel regression models show that total premature mortality in males, male and female cerebrovascular mortality, male and female cirrhosis mortality, and male lung cancer mortality decreased somewhat more in communities where primary health care reform was implemented more quickly. Premature mortality decreased somewhat more in SDP than in CDP communities for male and female total premature mortality, cerebrovascular mortality, and cirrhosis mortality, and male lung cancer mortality. These results are in accord with earlier studies that found a relationship among health indicators and variables related to labor market, welfare state, income inequalities, civil associations, and power relations.

Original languageEnglish (US)
Pages (from-to)687-722
Number of pages36
JournalInternational Journal of Health Services
Issue number4
StatePublished - Dec 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy


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