<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112020000300005</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2019.03.007</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tendencia de la mortalidad por edad y sexo en España (1981-2016). Cambios asociados a la crisis económica]]></article-title>
<article-title xml:lang="en"><![CDATA[Trends in age-sex-specific mortality in Spain (1981-2016). Changes associated with the economic crisis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Márquez-Calderón]]></surname>
<given-names><![CDATA[Soledad]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez Velasco]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Viciana-Fernández]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernández Merino]]></surname>
<given-names><![CDATA[Juan Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Consejería de Salud de la Junta de Andalucía  ]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Estadística y Cartografía de Andalucía  ]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Universitario Virgen del Rocío  ]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>34</volume>
<numero>3</numero>
<fpage>230</fpage>
<lpage>237</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112020000300005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112020000300005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112020000300005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Objetivo: Analizar la tendencia de las tasas de mortalidad por edad y sexo en España e identificar si se han producido cambios tras el comienzo de la crisis económica.  Método: Estudio de tendencias de las tasas de mortalidad por grupos quinquenales de edad y sexo en el periodo 1981-2016, mediante regresión joint-point. Se detallan los resultados de los dos últimos periodos identificados en las regresiones, que permiten identificar cambios ocurridos después del inicio de la crisis. En caso de ralentización o estancamiento de la tendencia de mortalidad en varios grupos de edad sucesivos, se realizó un análisis de tendencias por causas.  Resultados: La mortalidad se redujo de forma significativa entre 1981 y 2016. Tras el inicio de la crisis económica, la tendencia de la mortalidad total estandarizada no cambió en los hombres, y sufrió un estancamiento en las mujeres entre 2013 y 2016. En el análisis por grupos quinquenales de edad, la tendencia descendente de la mortalidad sufrió un estancamiento en los hombres en todos los grupos entre los 15 y 39 años, que se inició entre 2011 y 2014 y duró hasta 2016. En ambos sexos, en los cuatro grupos de edad entre 60 y 79 años, la reducción previa de la mortalidad sufrió una ralentización o estancamiento, que se inició entre 2009 y 2014, y continuó hasta 2016. Las causas que más contribuyeron al cambio de tendencia fueron las causas externas en hombres de 15-39 años, y las enfermedades del sistema circulatorio y respiratorio en las personas de 60-79 años.  Conclusión: La tendencia descendente de la mortalidad ha sufrido una ralentización o un estancamiento después del inicio de la crisis económica, principalmente en hombres jóvenes, y en hombres y mujeres de 60-79 años.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Mortalidad]]></kwd>
<kwd lng="es"><![CDATA[Tendencias]]></kwd>
<kwd lng="es"><![CDATA[Crisis económica]]></kwd>
<kwd lng="en"><![CDATA[Mortality]]></kwd>
<kwd lng="en"><![CDATA[Trends]]></kwd>
<kwd lng="en"><![CDATA[Economic recession]]></kwd>
</kwd-group>
</article-meta>
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