Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study
Abstract
:1. Introduction
2. Materials and Methods
3. Statistical Methods
4. Results
5. Discussion
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | Almassora | Benicarló | Borriana | Castelló | Onda | Vall d’Uixó | Vila- Real | Vinaròs |
---|---|---|---|---|---|---|---|---|
Socio-economic indicators | ||||||||
Health departments | 2 | 1 | 3 | 2 | 3 | 3 | 3 | 1 |
Population 1 | 17,384 | 21,015 | 27,385 | 150,444 | 20,021 | 29,638 | 42,961 | 22,960 |
Population aged 65 years and above % | 14.2 | 17.8 | 17.1 | 17.8 | 15.7 | 19.1 | 15.8 | 18.1 |
Foreign-born % | 14.8 | 21.2 | 15.9 | 15.9 | 12.5 | 7.1 | 11.8 | 17.8 |
Household income in euros | 14,064 | 13,824 | 14,077 | 15,519 | 13,815 | 13,754 | 14,436 | 14,198 |
Unemployment % | 18.1 | 15.3 | 16.8 | 17.9 | 21.2 | 18.67 | 19.6 | 15.3 |
Illiteracy % | 32.1 | 22.6 | 22.4 | 20.4 | 23.3 | 24.0 | 24.4 | 22.9 |
Occupation % | ||||||||
Agriculture % | 3.2 | 8.8 | 10.0 | 2.7 | 5.9 | 8.6 | 4.8 | 8.7 |
Industrial % | 22.1 | 18.7 | 22.7 | 17.2 | 33.1 | 20.5 | 26.6 | 16.7 |
Construction % | 11.8 | 10.1 | 7.8 | 6.6 | 8.7 | 9.3 | 8.6 | 8.2 |
Services % | 62.9 | 62.4 | 59.5 | 73.5 | 52.3 | 61.7 | 60.0 | 66.4 |
Agriculture production Ha 2 | ||||||||
Agriculture 2 | 104.3 | 181.0 | 130.7 | 46.0 | 404.0 | 189.1 | 88.8 | 335.9 |
Herbaceous 2 | 8.7 | 58.9 | 4.7 | 7.5 | 14.6 | 4.3 | 4.7 | 37.0 |
Woody plants 2 | 90.0 | 105.8 | 122.9 | 29.2 | 242.2 | 77.9 | 80.2 | 281.5 |
Pastures 2 | 5.8 | 15.8 | 3.1 | 8.1 | 69.9 | 106.0 | 3.9 | 16.3 |
Forest species 2 | 0.15 | 1.2 | 0.01 | 1.21 | 89.4 | 0.02 | 0.0 | 1.04 |
Vegetables 3 | 1.1 | 64.0 | 0.9 | 0.2 | 0.2 | 0.3 | 0.0 | 10.3 |
Artichoke 3 | 0.5 | 27.4 | 0.2 | 0.1 | 0.0 | 0.03 | 0.0 | 2.8 |
Citrus 3 | 94.4 | 52.3 | 111.7 | 21.7 | 182.7 | 70.9 | 76.2 | 204.6 |
Environmental indicators | ||||||||
Water hardness in French degrees 4 | 35.8° | 35.5° | 45.8° | 49.5° | 48.9° | 28.9° | 45.0° | 30.4° |
Coastal distance in km | 5.0 | 0.10 | 5.7 | 5.0 | 10.6 | 20.0 | 8.4 | 0.10 |
PM10 mg/m3 5 | 36.58 | 16.03 | 27.38 | 29.08 | 21.93 | 19.0 6 | 31.64 | 16.03 |
NO2 mg/m3 5 | 22.7 | 6.25 | 16.22 | 21.49 | 9.0 | 6.5 6 | 19.20 | 6.25 |
Variables | (a) | (b) | (c) | (d) | (e) | (f) | (g) | (h) | (i) | (j) | (k) | (l) | (m) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Population aged 65 years and above % (a) | 1.0 | ||||||||||||
Household income in euros (b) | −0.06 | 1.0 | |||||||||||
Foreign-born % (c) | 0.16 | 0.38 | 1.0 | ||||||||||
Illiteracy % (d) | −0.41 | −0.33 | −0.71 | 1.0 | |||||||||
Agriculture Production 1 (e) | 0.22 | −0.69 | −0.17 | 0.10 | 1.0 | ||||||||
Vegetables 1 (f) | 0.22 | 0.33 | 0.52 | 0.10 | 0.40 | 1.0 | |||||||
Artichoke 1 (g) | 0.25 | 0.04 | 0.75 | −0.29 | 0.05 | 0.91 | 1.0 | ||||||
Citrus 1 (h) | −0.25 | −0.12 | −0.22 | 0.24 | 0.62 | 0.21 | −0.01 | 1.0 | |||||
Unemployment % (i) | −0.44 | −0.57 | −0.83 | −0.57 | 0.05 | −0.43 | −0.92 | 0.01 | 1.0 | ||||
Coastal distance in km (j) | −0.11 | −0.42 | −0.88 | 0.36 | 0.14 | −0.66 | 0.87 | 0.02 | 0.84 | 1.0 | |||
PM10 mg/m3/(k) | −0.70 | 0.40 | −0.31 | 0.37 | −0.72 | −0.56 | −0.41 | −0.14 | 0.49 | 0.25 | 1.0 | ||
NO2 mg/m3 (l) | −0.64 | 0.42 | −0.19 | 0.23 | −0.74 | −0.54 | −0.35 | −0.22 | 0.42 | 0.19 | 0.98 | 1.0 | |
Water hardness 2 (m) | −0.54 | 0.45 | 0.19 | −0.40 | 0.40 | −0.57 | −0.41 | −0.10 | 0.29 | 0.11 | 0.51 | 0.59 | 1.0 |
Municipality | All-Cause Mortality | Cardiovascular Disease (CVD) | Cerebrovascular Disease (CED) | Ischaemic Heart Disease (IHD) | CED + IHD | |||||
---|---|---|---|---|---|---|---|---|---|---|
Males | Females | Males | Females | Males | Females | Males | Females | Males | Females | |
Almassora | 101.2 | 103.8 | 99.2 | 115.5 | 98.2 | 98.5 | 110.2 | 101.1 | 103.8 | 99.1 |
Benicarló | 104.7 | 111.8 | 94.9 | 97.7 | 75.5 | 71.4 | 94.1 | 82.1 | 83.3 | 73.9 |
Borriana | 95.4 | 101.0 | 120.6 | 116.3 | 137.0 | 141.6 | 113.4 | 97.6 | 126.5 | 129.3 |
Castelló | 98.1 | 107.1 | 106.4 | 106.5 | 100.6 | 98.9 | 108.1 | 117.9 | 104.1 | 104.3 |
Onda | 115.2 | 109.1 | 111.3 | 120.2 | 119.3 | 133.1 | 107.2 | 87.0 | 104.1 | 120.1 |
Vall d’Uixó | 108.2 | 111.7 | 105.0 | 116.1 | 103.8 | 106.4 | 107.2 | 88.2 | 114.0 | 101.0 |
Vila-real | 104.1 | 106.2 | 113.7 | 121.0 | 128.3 | 138.4 | 101.3 | 96.2 | 115.9 | 126.4 |
Vinaròs | 100.7 | 103.0 | 100.6 | 102.0 | 85.4 | 101.7 | 109.0 | 90.9 | 96.3 | 98.5 |
Municipality | All-Cause Mortality | Cardiovascular Disease (CVD) | Cerebrovascular Disease (CED) | Ischaemic Heart Disease (IHD) | CED + IHD | |||||
---|---|---|---|---|---|---|---|---|---|---|
Males | Females | Males | Females | Males | Females | Males | Females | Males | Females | |
Almassora | 952.2 | 866.2 | 287.7 | 382.5 | 80.8 | 109.8 | 80.2 | 46.4 | 161.1 | 156.1 |
Benicarló | 891.9 | 812.0 | 274.8 | 335.5 | 60.7 | 78.5 | 68.0 | 36.2 | 128.7 | 114.7 |
Borriana | 1082.9 | 894.8 | 350.8 | 399.0 | 114.7 | 159.2 | 82.5 | 44.8 | 197.2 | 203.4 |
Castelló | 976.5 | 834.2 | 378.3 | 365.8 | 83.5 | 110.9 | 78.5 | 53.2 | 162.0 | 164.1 |
Onda | 977.7 | 929.0 | 323.0 | 414.4 | 99.2 | 151.5 | 77.6 | 38.5 | 176.7 | 190.0 |
Vall d’Uixó | 948.0 | 885.3 | 303.7 | 399.0 | 85.6 | 118.6 | 71.2 | 39.3 | 159.9 | 157.7 |
Vila-real | 1027.0 | 925.3 | 331.2 | 414.1 | 106.9 | 155.7 | 73.2 | 43.8 | 180.1 | 198.8 |
Vinaròs | 996.4 | 853.6 | 292.4 | 350.2 | 69.5 | 113.7 | 79.5 | 41.0 | 148.9 | 154.6 |
SMRs | Moran’s I Index | Z | p-Value |
---|---|---|---|
All-cause mortality | −0.013 | 0.620 | 0.268 |
Cardiovascular (CVD) mortality | 0.110 | 2.015 | 0.022 |
Cerebrovascular (CED) mortality | 0.073 | 1.596 | 0.055 |
Ischaemic heart disease (IHD) mortality | −0.008 | 0.741 | 0.229 |
CED + IHD mortality | 0.110 | 2.052 | 0.020 |
AMRs | |||
All-cause mortality | 0.006 | 0.699 | 0.242 |
Cardiovascular (CVD) mortality | 0.046 | 1.292 | 0.098 |
Cerebrovascular (CED) mortality | 0.073 | 1.199 | 0.115 |
Ischaemic heart disease (IHD) mortality | 0.006 | 0.817 | 0.207 |
CED + IHD mortality | 0.113 | 2.083 | 0.019 |
Factors | SMRs | AMR | ||||
---|---|---|---|---|---|---|
RC 1(95% CI 2) | p-Value | ICC 3 (95% CI) | RC 1 (95% CI 2) | p-Value | ICC 3 (95% IC) | |
All-cause mortality | ||||||
Agriculture 4 | −0.01 (−0.04 to 0.43) | 0.726 | 0.24(0.01 to 0.92) 5 | −0.04 (−0.27 to 0.20) | 0.761 | 0.25 (0.00–0.91) |
Vegetables 4 | −0.19 (−0.31 to −0.07) | 0.003 | NC 6 | −1.76 (−2.88 to −0.63) | 0.002 | NC 6 |
Artichokes 4 | −0.42 (−0.62 to −0.11) | 0.003 | NC 6 | −3.92 (−6.41 to −1.42) | 0.002 | NC 6 |
Citrus 4 | 0.03 (−0.01 to 0.07) | 0.196 | 0.16 (0.00 to 0.97) 5 | 0.25 (−0.11 to 0.61) | 0.178 | 0.15 (0.00 to 0.97) |
Cardiovascular disease (CVD) mortality | ||||||
Agriculture 4 | −0.02 (−0.05 to 0.01) | 0.169 | 0.23 (0.01 to 0.92) | −0.05 (−0.17 to 0.06) | 0.376 | NC 6 |
Vegetables 4 | −0.20 (−0.36 to −0.03) | 0.017 | 0.07(0.00 to 0.99) | −0.58 (−1.33 to 0.16) | 0.126 | NC 6 |
Artichokes 4 | −0.42 (−0.79 to −0.04) | 0.028 | 0.10 (0.00 to 0.99) | −1.20 (−2.88 to 0.48) | 0.161 | NC 6 |
Citrus 4 | 0.02 (−0.01 to 0.06) | 0.137 | 0.88 (0.50 to 0.98) | −0.02 (−0.22 to 0.18) | 0.862 | NC 6 |
Cerebrovascular disease (CED) mortality | ||||||
Agriculture 4 | −0.05 (−0.14 to 0.04) | 0.309 | 0.82 (0.54 to 0.96) | −0.04 (−0.14 to 0.05) | 0.372 | 0.62 (0.21 to 0.90) |
Vegetables 4 | −0.68 (−1.16 to −0.19) | 0.006 | 0.72 (0.33 to 0.93) | −0.71 (−1.18 to −0.24) | 0.003 | 0.39 (0.05 to 0.88) |
Artichokes 4 | −1.47 (−2.57 to −0.36) | 0.000 | 0.73 (0.35 to 0.93) | −1.54 (−2.16 to −0.47) | 0.005 | 0.41 (0.06 to 0.88) |
Citrus 4 | 0.04 (−0.13 to 0.21) | 0.623 | 0.84 (0.54 to 0.96) 5 | 0.05 (−0.12 to 0.22) | 0.544 | 0.64 (0.23 to 0.99) |
Ischaemic heart disease (IHD) mortality | ||||||
Agriculture 4 | 0.01 (−0.05 to 0.07) | 0.771 | NC 6 | 0.01 (−0.02 to 0.03) | 0.651 | 0.19 (0.0 to 0.95) |
Vegetables 4 | −0.36 (−0.76 to 0.03) | 0.067 | NC 6 | −0.21 (−0.31 to −0.12) | 0.000 | NC 6 |
Artichokes 4 | −0.78 (−1.65 to 0.10) | 0.083 | NC 6 | −0.46 (−0.68 to −0.25) | 0.000 | NC 6 |
Citrus 4 | 0.30 (−0.07 to 0.14) | 0.548 | NC 6 | 0.03 (−0.01 to 0.06) | 0.104 | 0.06 (0.00 to 0.99) |
Cerebrovascular disease (CED) and ischaemic heart disease (IHD) mortality | ||||||
Agriculture 4 | −0.02 (−0.10 to 0.05) | 0.509 | 0.80 (0.47 to 0.95) 5 | −0.04 (0.15 to 0.08) | 0.528 | 0.80 (0.45 to 0.95) 5 |
Vegetables 4 | −0.57 (−0.89 to −0.26) | 0.000 | 0.59 (0.18 to 0.90) | −0.92 (−1.41 to −0.42) | 0.000 | 0.56(0.16 to 0.90) |
Artichokes 4 | −1.24 (−1.97 to −0.52) | 0.001 | 0.61 (0.20 to 0.91) | −2.00 (−3.14 to −0.86) | 0.001 | 0.58 (0.17 to 0.90) |
Citrus 4 | 0.05 (−0.07 to 0.17) | 0.434 | 0.80 (0.47 to 0.95) 5 | 0.08 (−0.12 to 0.28) | 0.421 | 0.79 (0.44 to 0.95) 5 |
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Arnedo-Pena, A.; Puig-Barberà, J.; Bellido-Blasco, J.; Romeu-Garcia, M.; Pac-Sa, M.R.; Guillen-Grima, F. Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study. Int. J. Environ. Res. Public Health 2020, 17, 6583. https://doi.org/10.3390/ijerph17186583
Arnedo-Pena A, Puig-Barberà J, Bellido-Blasco J, Romeu-Garcia M, Pac-Sa MR, Guillen-Grima F. Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study. International Journal of Environmental Research and Public Health. 2020; 17(18):6583. https://doi.org/10.3390/ijerph17186583
Chicago/Turabian StyleArnedo-Pena, Alberto, Joan Puig-Barberà, Juan Bellido-Blasco, MªAngeles Romeu-Garcia, Mª Rosario Pac-Sa, and Francisco Guillen-Grima. 2020. "Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study" International Journal of Environmental Research and Public Health 17, no. 18: 6583. https://doi.org/10.3390/ijerph17186583