The socioeconomic situation of individuals takes its toll on their health. So much, that even conditions their life expectancy. According a study published in the scientific journal Preventive Medicine, a Catalan of high socioeconomic status has a life expectancy similar to that of a Swiss citizen. However, a low-income Catalan has a life expectancy similar to that of a person from Rwanda. The research, which has crossed socio-economic, diagnostic and mortality data of six million Catalans, suggests that life expectancy is up to 12 years higher in high incomes than in low ones.
"We found a strong social pattern of Life expectancy and mortality, "says the study, which has crossed the health and socioeconomic data of all residents in Catalonia over 18 years. This research crystallizes the gap in life expectancy that exists in Catalonia according to the socioeconomic status of citizens. The study points out that Catalans identified with the lowest incomes have a life expectancy up to 12 years less than those who have a high socioeconomic status. By gender, the gap between women is nine years and between men, 12. "The lower the socioeconomic status, the higher the chances of death, regardless of age and sex, "says the research.
Through an anonymized database of the Catalan Health Service (CatSalut), the researchers studied the income of all Catalans included in the study and disaggregated socioeconomic status into four groups according to their income: from more than 100,000 euros per year -The high rents- up to less than 18,000 euros per year-low socioeconomic status. The "very low" income indicator corresponded to those individuals who receive aid or social assistance from the Administration.
66% of the sample were people of low socioeconomic status, the largest group; 28% were middle level; 4%, of very low status; and only 1% corresponded to high incomes. The results showed that life expectancy at 18 years old is 64.9 in men of high class and 70.2 in women of the same social status -to these figures we must add the age of 18 from which part the population analyzed-. In the lower class Catalans, however, life expectancy at 18 years decreases to 52.9 years in men and 60.8 in women.
To give context to the data analyzed, the researchers argue that the life expectancy of Catalan men of high class (64.9 years) is higher than that of Switzerland -In 2016, when the data was collected, it was the country with the highest life expectancy at 18 years. In contrast, the group of men of lower socioeconomic status have a life expectancy (52.9 years) similar to that of Rwanda or El Salvador. Among women, high-income Catalans live as long (70.2 years) as Japanese women, while women from Catalonia with a more disadvantaged socio-economic level have a life expectancy (60.8 years) similar to that of Sri Lanka. u Honduras, "two countries with the lowest life expectancy in the world," qualify the scientists. "These differences have also been reported in the United States, where the lower strata have a life expectancy similar to that of Pakistan or Sudan," the study adds.
The results of this research follow the line taken long ago by the World Health Organization (WHO) about the influence of social determinants on health: according to the WHO, parameters such as housing, work, income or the social environment, among others, are behind most health inequities. However, cardiologist Miguel Caínzos-Achirica, a cardiovascular epidemiologist at the Bellvitge hospital in Barcelona and author of the study, points out that there are elements that "attract attention". "In an environment like this, with all the protective factors such as the highest life expectancy in the world and universal access to health, there is a difference of 10 years. It's a very big difference, "warns the cardiologist.
The team of Caínzos-Achirica has already studied the influence of socioeconomic factors on other occasions and, in specific pathologies, such as heart failure, the gap is triggered. "People with less income develop more diseases and their evolution is worse," he says. In a study published a few months ago, the cardiologist showed that, in patients with heart failure, the lowest rents were associated with a shorter life expectancy at 50 years (of 22.2 years in upper classes and 12.8 in low rents).
The team of Caínzos-Achirica has already studied the influence of socioeconomic factors on other occasions and, in specific pathologies, such as cardiac insufficiency, the gap goes up. "People with less income develop more diseases and their evolution is worse," he says. In a study published a few months ago, the cardiologist showed that, in patients with heart failure, the lowest rents were associated with a shorter life expectancy at 50 years (of 22.2 years in upper classes and 12.8 in low rents).
Researchers admit being conservative with the data and, in fact, the mortality in the lowest incomes could be much higher than what is exposed in the study. This is explained, experts say, by the "salmon effect": "Immigrants get sick and return to their countries of origin, which can bias mortality estimates in this subpopulation."
Scientists claim that this population subgroup is generally among the lowest income individuals, where mortality is already higher, so the number of deaths would be underestimated.
However, despite an eventual conservative bias, experts argue that the life expectancy gap characterized in the study opens the door to reviewing political agendas "in which the protection of highly vulnerable groups, such as people with low socioeconomic status. , should be a priority ", they point.