Background and aims: In recent years, mortality from ischemic heart disease and diabetes has decreased. There is an inequality in mortality reduction between urban and non-urban areas. This study aims to estimate the trend in mortality from ischemic heart disease and diabetes mellitus in urban and non-urban areas in Italy and Spain, throughout the first two decades of the 21st century.
Methods: Deaths and population data by age and sex, according to the area de residence, were obtained from the National Institutes of Statistics. Annual age-standardized mortality rates from ischemic heart disease and diabetes mellitus were calculated from 2003 to 2019, in each of the two areas of residence in both countries. The average annual percentage change (APC) in the mortality rate in each area was estimated using linear regression models and taking age-standardized mortality rates as dependent variable.
Results: Mortality rates from both causes of death decreased between the beginning and the end of the period analysed. In Italy, the APC in was -4.0% and -3.6% in mortality rate from ischemic heart disease and -1.5% and -1.3% in mortality rate from diabetes mellitus, in urban and non-urban areas, respectively. In Spain, the APC in was -4.4% and -3.7% in mortality rate from ischemic heart disease and -3.3% and -2.0% in mortality rate from diabetes mellitus, in urban and non-urban areas, respectively.
Conclusion: Mortality from ischemic heart disease and mortality from diabetes have shown a greater reduction in urban than in non-urban areas since the first years of the 21st century in Spain and Italy.
Keywords: Italy; Spain; diabetes; ischemic heart disease; mortality; non-urban; urban.
This study evaluated the trend in mortality from ischemic heart disease and diabetes in urban and non-urban areas in two Southern European countries, Italy and Spain, throughout the first two decades of the 21st century.A reduction in mortality from diabetes and ischemic heart disease was observed in both urban and non-urban areas in both countries.Residents in urban areas showed a greater reduction in mortality than residents in non-urban areas. The mortality advantage found in non-urban areas at the beginning of the study disappeared at the end of it or even mortality became higher in non-urban areas.
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