Trends in age-sex-specific mortality in Spain (1981-2016). Changes associated with the economic crisis

Objective: To analyze trends in age-sex-specific mortality in Spain, and to identify if there have been changes following the onset of economic crisis. Method: A study of trends in mortality rates by sex and quinquennial groups of age was carried out, from 1981 to 2016. Time trends were established by joint-point regression models. The results of the last two periods identified in the regressions are presented in detail, identifying changes after the onset of the economic crisis. When slowdown or stagnation of the mortality trends were identified in several successive age groups, an analysis of trends by causes was carried out. Results: Mortality was significantly reduced between 1981 and 2016. After the beginning of the economic crisis, the trend in total age-standardized mortality did not change for men, but it stagnated for women from 2013 to 2016. In the analysis by quinquennial age groups, the downward trend in mortality suffered a stagnation in men in all the groups between 15 and 39 years, which started between 2011 and 2014, and lasted until 2016. In both women and men, in the four groups between 60 and 79 years, the previous decline in mortality suffered a slowdown or stagnation, which began between 2009 and 2014, and continued until 2016. Negative changes in mortality trends were mainly influenced by external causes(in 15-39 years men) and diseases of the circulatory and respiratory systems (in 60-79 years men and women). Conclusions: The downward trend of mortality suffered stagnation or deceleration after the onset of the economic crisis in young men and 60-79 years old men and women. (C) 2019 SESPAS. Published by Elsevier Espana, S.L.U.