For those of you interested in using geographical differences in prevalence rates to try to get a greater understanding of PD, the paper by Pedro-Cuesta et al. is a must. It does for Spain what the paper by Willis does for the US.

Highlights:
- north bad, south good;
- identifies hot-spots.

"Spatial distribution of Parkinson's disease mortality in Spain, 1989-1998, as a guide for focused aetiological research or health-care intervention"
Jesús de Pedro-Cuesta, Eduard Rodríguez-Farré and Gonzalo Lopez-Abente
BMC Public Health, vol 9, Dec 2009.
http://www.biomedcentral.com/1471-2458/9/445

John

Fascinating study.
One reason there are not enough resources devoted to PD. It is under-reported:
…”the proportion of PD sufferers whose death certificates made no mention of the disease ranged from 68% in Iceland to 81% in Rochester; and 2) in those cases where PD was reported, the annual proportion recorded as the underlying cause of death in Sweden ranged from 46% to 81%, and varied by county…..”
…”excess mortality registered in many towns in Catalonia, the Basque Country, Huesca, Asturias and Tarragona is consistent with the traditional, well-documented industrial toxic emissions reported in these places….. emissions from multiple industrial plants near the city of Tarragona, in which lead, cadmium and other organic and inorganic industrial chemicals are included…”
(and yet there are other towns with the same level of pollution, but lower than average PD)
There was a similar map of the USA somewhere here on Neurotalk – showing the frequency county by county
And this north-south thing – northern spain has a lot more PD than southern Spain. In Canada, there is a high rate of PD among the Inuit in the Arctic.
Whassup with that, doc?

Bob - That is exactly why I made certain when Kevin died that the death certificate indicated Parkinson's as the cause. The tendency is to list the secondary cause which is really an effect of the underlying PD. The immediate cause was would not have occurred except for PD. I think it is important for caregivers to understand the implication and have PD listed whenever appropriate.

North-south thing - in Spain the north is more an industrial/agricultural mix, south is more agricultural/tourism mix. Both areas enjoy good weather, high sunlight levels, etc, though temperatures are higher in the south overall as a southern european country the winters are shorter than northern europe. Inland is in general less populated, and south as area with high tourism has high level of transitory population, with both northern-european expatriates, and tourist industry populations fluctuating throughout the year, with many of the latter returning to their homes further north in the country for the off-season winter months.

It would be interesting to have data for France which has a more general spread of population, but similar occupational conditions, but further north.

Something which may be of interest is that both countries have Mediterranean and Atlantic coastlines, affecting diet, environment, agriculture etc similarly. If both countries followed a similar pattern of north-south incidence of PD, some inference may be possible.