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[[File:Logo MonografíaSpain_Human-settlements_2020_map_18023_eng.jpg|left|thumb|300px|MapaMap: Human settlementessettlements. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_Entidades-deSpain_Human-poblacion_2020_mapa_18023_spasettlements_2020_map_18023_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_Entidades-deSpain_Human-poblacion_2020_mapa_18023_spasettlements_2020_map_18023_eng.zip Data] . [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_109_t.r_109_t&i2=c_108_t.c_108_t&s=2020&s2=2020&t=A02&t2=A02&view=map9 Versión interactivaInteractive version].]]
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[[File:Logo MonografíaSpain_Population-living-in-scattered-villages-by-municipality_2020_map_18026_eng.jpg|left|thumb|300px|Map: Population living in scattered villages by provincemunicipality. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-living-in-scattered-villages-enby-diseminado_2020_mapa_18024_spamunicipality_2020_map_18026_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-living-enin-diseminado_2020_mapa_18024_spascattered-villages-by-municipality_2020_map_18026_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_111_t.r_111_t&i2=c_110_t.c_110_t&s=2020&s2=2020&t=A02&t2=A02&view=map9 Versión interactivaInteractive version].]]]
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The maps showing human settlements throughout the Spanish territory seem to be very explanatory. At first glance, there is an outstanding number of human settlements in the Northwest in relation to the rest of the country (see the map on Human settlements). However, a more detailed analysis could conclude that certain differences may be observed in the rest of the country as the map on Density of human settlements, which shows a more detailed unit of anaysis as it moves from a provincial level to a municipal division, reveals areas with a significant density of human settlements such as the outskirts of the Metropolitan Area of Madrid, central and northern Catalonia (Catalunya/Cataluña), some areas in the Region of Valencia (Comunitat Valenciana), the southeast of the Region of Murcia (Región de Murcia), eastern Andalusia (Andalucía), the central area of the province of Salamanca as well as some of the Canary Islands (Canarias).
Besides, the maps showing the population living in scattered villages ([[:File:Population Spain_Population-living -in -scattered villages by province-villages_2020_map_18024_eng.jpg| ''by province'']] and [[:File:Population Spain_Population-living -in -scattered -villages -by municipality-municipality_2020_map_18026_eng.jpg| ''by municipality'']] ), i.e. villages different to the capital town of the municipality, reveal a sharp contrast between the periphery [especially Galicia, western Asturias, the Basque Country (Euskadi/País Vasco), northwestern Navarre (Navarra), the district called Maestrazgo/Maestrat between the regions of Aragón and Valencia, as well as a long strip that goes from Alicante/Alacant to Cádiz], where more people live in scattered villages, and the Spanish hinterland, where lower figures are shown on both maps since more people live in the capital town of the municipality. In short, population distribution is more scattered along the coast, whether for geographical, historical or functional reasons. In the hinterland, by contrast, a greater concentration in terms of human settlements may be observed, yet certain differences shall be pointed out, i.e. human settlements are closer to each other although smaller in size in the Northern Plateau, whereas a smaller number of settlements that are more distant from each other and which have municipalities larger in size may be observed in the Southern Plateau.
Certain features of population distribution and human concentration have been described so far. Three further aspects are analysed in the following paragraphs, i.e. age structure, levels of household overcrowding and healthy life years.
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[[File:Logo MonografíaSpain_Population-under-60-years-of-age_2020_map_17748_eng.jpg|left|thumb|300px|Map: Population under 60 years of age. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-under-menor60-deyears-60of-anos_2020_mapa_17748_spaage_2020_map_17748_eng.pdf PDF]. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Population-under-60-years-of-age_2020_map_17748_eng.zip Data]. [ Versión interactiva//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r12111.r12111&i2=c12112.v12112&t=A03&t2=A03&view=map9 Interactive version].]]
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<li style="display: inline-block">[[File:Logo MonografíaSpain_Population-from-60-to-85-years-of-age_2020_map_17749_eng.jpg|right|thumb|300px|Map: Population from 60 to 85 years of age. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-entrefrom-60-yto-85-anos_2020_mapa_17749_spayears-of-age_2020_map_17749_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-entrefrom-60-yto-85-anos_2020_mapa_17749_spayears-of-age_2020_map_17749_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r12124.v12124&i2=c12125.c12125&t=A02&t2=A02&view=map9 Versión interactivaInteractive version].]]
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[[File:Logo MonografíaSpain_Population-over-85-years-of-age_2020_map_17750_eng.jpg|rightleft|thumb|300px|Map: Population over 85 years of age. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-over-mayor85-deyears-85of-anos_2020_mapa_17750_spaage_2020_map_17750_eng.pdf PDF]. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Population-over-85-years-of-age_2020_map_17750_eng.zip Data]. [ Versión interactiva//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r12114.r12114&i2=c12115.c12115&t=A02&t2=A02&view=map9 Interactive version].]]
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[[File:Logo MonografíaSpain_Households-with-5-or-more-members_2019_map_17763_eng.jpg|left|thumb|300px|Map: Households with 5 or more members. 2019. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_HogaresSpain_Households-conwith-cinco5-oor-masmore-personas_2019_mapa_17763_spamembers_2019_map_17763_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_HogaresSpain_Households-conwith-cinco5-oor-masmore-personas_2019_mapa_17763_spamembers_2019_map_17763_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s17763.s17763&i2=c12131.c12131&t=A01&t2=A01&view=map9 Versión interactivaInteractive version].]]
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[[File:Logo MonografíaSpain_Healthy-life-years_2007-2018_map_18147_eng.jpg|left|thumb|300px|Map: Healthy life years. 2007-2018. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_EsperanzaSpain_Healthy-de-vida-enlife-buenayears_2007-salud_2007-2018_mapa_18147_spa2018_map_18147_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_EsperanzaSpain_Healthy-de-vida-en-buenalife-salud_2007years_2007-2018_mapa_18147_spa2018_map_18147_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12628.c12628&t=A02&view=map10 Versión interactivaInteractive version].]]
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The national average of households with five or more members out of the total amount of households lies by 5.7% (see the map on [[:File:Households Spain_Households-with -5 -or -more members-members_2019_map_17763_eng.jpg| ''Households with 5 or more members'']]). The provinces of Almería and Murcia stand out as their figures rise to around 9%, whilst on the other end of the scale some provinces on the Northern Plateau, next to the Portuguese border as well as Asturias fall to around 4%. Figures in the rest of the country are similar to the national average.
The region is used as spatial unit of analysis on the map on [[:File:Healthy Spain_Healthy-life years-years_2007-2018_map_18147_eng.jpg| ''Healthy life years'']]. A double point of view is taken into account, i.e. healthy life years at birth and at the age of 65. In the first case, a graph shows the evolution from 2007 to 2018 with very contrasting profiles that do not allow deducing well-defined spatial behaviours. In the second case, however, a larger extension of healthy life at the age of 65 seems to be detected in the northern hinterland as well as in Galicia, the Basque Country (Euskadi/País Vasco) and the Balearic Islands (Illes Balears).
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'''COPD'''[[File:Logo MonografíaSpain_Reported-prevalence-of-COPD-in-the-population-over-15-years-of-age_2017_map_17860_eng.jpg|left|thumb|300px|Map: Reportered Reported prevalence of COPD in the population over 15 years of age. 2017. Spain . [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PrevalenciaSpain_Reported-prevalence-of-deCOPD-obesidadin-enthe-lapopulation-poblacionover-mayor15-deyears-18of-anos_2017_mapa_17861_spaage_2017_map_17860_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PrevalenciaSpain_Reported-deprevalence-obesidadof-enCOPD-in-the-lapopulation-poblacionover-mayor15-deyears-18of-anos_2017_mapa_17861_spaage_2017_map_17860_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_122_tc12329.r_122_tc12329&st=TotalA02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12328.c12328&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional.ign. es/index.php#c=indicator&i=c12327.c12327&t=A02&view=map10 3]. ]]
Chronic Obstructive Pulmonary Disease (COPD) does not appear to be a predisposing factor for SARS-CoV-2 infection. However, once infection occurs and the disease develops, there is an increased risk of hospital admission, admission to intensive care unit (ICU) and death. Furthermore, the respiratory symptoms of COVID-19 may sometimes be confused with COPD exacerbations, which may delay diagnosis and affect the clinical course. The underlying pathophysiological mechanism would be an increased expression of ACE2 receptors (to which the virus binds to penetrate the cell) in the bronchial epithelium, amongst others.
'''HYPERTENSION'''
[[File:Logo MonografíaSpain_Reported-prevalence-of-hypertension-in-the-population-over-15-years-of-age_2017_map_17862_eng.jpg|left|thumb|300px|Map: Reportered Reported prevalence of hypertension in the population over 15 yearsof age. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Reported-prevalence-of-hypertension-in-the-population-over-15-years-of-age_2017_map_17862_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Reported-prevalence-of-hypertension-in-the-population-over-15-years-of-age_2017_map_17862_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12332.r_123_tc12332&st=TotalA02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12331.c12331&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12333. c12333&t=A02&view=map10 3]. ]]
Hypertension is an important risk factor that has been discovered in 19% of patients with COVID-19 in Spain. The biological concept is based on its effect on the renin-angiotensin-aldosterone system and on angiotensin-converting enzyme 2 (ACE-2) overexpression.
'''OBESITY'''
[[File:Logo MonografíaSpain_Prevalence-of-obesity-in-the-population-over-18-years-of-age_2017_map_17861_eng.jpg|left|thumb|300px|Map: Prevalence of obesity in the population over 18 years of age. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-obesity-in-the-population-over-18-years-of-age_2017_map_17861_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-obesity-in-the-population-over-18-years-of-age_2017_map_17861_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12363.r_123_tc12363&t=A02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&si=Totalc12362.c12362&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional. ign.es/index.php#c=indicator&i=c12364.c12364&t=A02&view=map10 3].]]
Obesity is considered the epidemic of the 21st century, as its numbers are increasing in the adult population and, what is more worrying, in children. Being overweight/obese has been identified in numerous studies as a predictor of hospital admission and admission to the ICU, especially in patients under 65 years of age. The SEMI-COVID-19 registry shows its presence in 21% of patients.
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'''DIABETES'''[[File:Logo MonografíaSpain_Reported-prevalence-of-diabetes-in-the-population-over-15-years-of-age_2017_map_17863_eng.jpg|left|thumb|300px|Map: Reportered Reported prevalence of diabetes in the population over 15 yearsof age. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Reported-prevalence-of-diabetes-in-the-population-over-15-years-of-age_2017_map_17863_eng.pdf PDF]. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Reported-prevalence-of-diabetes-in-the-population-over-15-years-of-age_2017_map_17863_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12369.r_123_tc12369&t=A02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&si=Totalc12368.c12368&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional. ign.es/index.php#c=indicator&i=c12370.c12370&t=A02&view=map10 3].]]
This risk factor has been identified in 17% of the cases reported (8.9% of hospital admissions in Spain). It is clearly a higher risk factor for hospital admission, admission to the ICU and death. The biological mechanism on which this risk factor is based is that described for hypertension.
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'''HEART FAILURE'''[[File:Logo MonografíaSpain_Prevalence-of-heart-failure_2017_map_17868_eng.jpg|left|thumb|300px|Map: Prevalence of heart failure. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-heart-failure_2017_map_17868_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-heart-failure_2017_map_17868_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12546.c12546&t=A02&view=map10 1] [//interactivo-atlasnacional.r_123_tign.es/index.php#c=indicator&si=Totalc12545.c12545&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional. ign.es/index.php#c=indicator&i=c12547.c12547&t=A02&view=map10 3].]]
Heart failure has been described, either under this term or as a cardiovascular disease, as the most prevalent risk factor in the population diagnosed with COVID-19 (up to 30%) and is present in more than 50% of COVID-19 patients admitted to the ICU in Spain, according to several studies. Its mechanism of action is the same as for diabetes and hypertension.
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'''CHRONIC KIDNEY DISEASE'''[[File:Logo MonografíaSpain_Prevalence-of-chronic-kidney-disease_2019_map_18373_eng.jpg|left|thumb|300px|Map: Prevalence of chronic kidney disease. 2019. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-chronic-kidney-disease_2019_map_18373_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-chronic-kidney-disease_2019_map_18373_eng.zip Data]. Interactive version [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12867.c12867&t=A02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.r_123_tphp#c=indicator&si=Totalc12866.c12866&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12868. c12868&t=A02&view=map10 3].]]
Chronic Kidney Disease (CKD) is included in the range of comorbidities that are associated with worse COVID-19 outcomes. Kidneys have ACE-2 receptors and are primarily involved in the renin-angiotensin-aldosterone system that regulates blood pressure. These are usually patients with added comorbidities, such as diabetes and hypertension, who have a weakened immune system.
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'''HIV-AIDS'''[[File:Logo MonografíaSpain_Prevalence-of-HIV-and-AIDS_2017_map_17869_eng.jpg|left|thumb|300px|Map: Prevalence of HIV and AIDS. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-HIV-and-AIDS_2017_map_17869_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-HIV-and-AIDS_2017_map_17869_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12549.c12549&t=A02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.r_123_tphp#c=indicator&si=Totalc12548.c12548&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12550. c12550&t=A02&view=map10 3].]]
HIV infection and AIDS diagnosis is not usually listed as a risk factor in most studies as such; immunodeficiency is. However, this term is very broad and difficult to define. So a pathology like VIH-AIDS, with a well-established information system and a clear impact on the immune system, especially cell-mediated immunity, was opted for in this study.
