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Using annual mortality rates at the provincial level for men and women, we construct a Gini index to estimate changes in regional health inequalities since 1860 in Spain. We find a long steady decline in health inequality across provinces from 1860 until today, interrupted by World War I and the Spanish Civil War. Over the 40 years of Franco's rule, health inequality stopped its downward trend and rose. Today, regional differences across provinces are at their lowest historical levels.

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