Maria Luisa Rodero-Cosano

The Impact of Socio-Economic Status on Self-Rated Health: Study of 29 Countries Using European Social Surveys (2002-2008)

Studies show that the association between socio-economic status (SES) and self-rated health (SRH) varies in different countries, however there are not many country-comparisons that examine this relationship over time. The objective of the present study is to determine the effect of three SES measures on SRH in 29 countries according to findings in European Social Surveys (2002–2008), in order to study how socio-economic inequalities can vary our subjective state of health. In line with previous studies, income inequalities seem to be greater not only in Anglo-Saxon and Scandinavian countries, but especially in Eastern European countries. The impact of education is greater in Southern countries, and this effect is similar in Eastern and Scandinavian countries, although occupational status does not produce significant differences in southern countries. This study shows the general relevance of socio-educational factors on SRH. Individual economic conditions are obviously a basic factor contributing to a good state of health, but education could be even more relevant to preserve it. In this sense, policies should not only aim at reducing income inequalities, but should also further the education of people who are in risk of social exclusion.

Changes in socioeconomic determinants of health: comparing the effect of social and economic indicators through European welfare state regimes

AimThis study is aimed at comparing the effect of different measures of socioeconomic status on self-rated health throughout European welfare state regimes during the period 2002–2008, in order to study how diverse socioeconomic inequalities can vary our health over time.Subjects and methodsThis study uses the European Social Survey to compare the impact of three specific socioeconomic measures (income, education and occupational status) on self-rated health.ResultsThe main finding to be highlighted is that the importance of education-related inequalities surpasses differences in income and occupational status, especially in southern and eastern countries. The relationship between income and self-rated health is stronger in liberal and social-democratic regimes, where labour market regulation is characterized by its flexibility and high liberalization. The impact of occupational status is moderate among liberal, social-democratic and conservative regimes, but lower in southern and eastern ones.ConclusionThese findings support the existence of a contextual effect among welfare states that varies the impact of social and economic indicators in self-rated health over time.

Methodological barriers to studying the association between the economic crisis and suicide in Spain

BackgroundThe hypothetical relationship between economic recession and the increase in suicides in Spain is subject to various arguments. In addition to the inherent complexity of capturing and explaining the underlining mechanisms that could describe this causal link, different points of contention have been be identified. The period of this association and its possible starting points, the socioeconomic determinants that may explain the variation in suicide rate, and the data sources available are the main focus of controversy. The present study aims to identify the phases of association between different periods of economic recession and suicide rates, and compare the effect of different social determinants of health that have been mentioned in previous studies.MethodsWe have used interrupted time series analyses to assess the impact of economic recession on national rates of suicide mortality provided by the Spanish Statistical Office (1980–2014). In an attempt to consider the factors that have affected the study of suicide in Spain, different data sources/periods, predictors, and regions in Spain were analysed.ResultsThe analysis revealed a positive and significant relationship between the Great Recession and suicide rates during the second period of economic recession (2011–2014), while appeared to decrease during the first recession period. However, the first decreasing trend was not statistically significant in the global analysis of the evolution of monthly suicide rates for the entire country. Both unemployment and per capita GDP were positively related to suicide trends. Finally, the regional analysis demonstrates a similar pattern in different Spanish areas.ConclusionAlthough previous studies have mentioned the double-dip in the suicide rate associated with the corresponding period of double recession, our study only identify a positive relationship during the second recession period. These results points out that the major impact of economic problems might have had a delayed effect due to initial protection policies.

Online sustainability information in European local governments: An explicative model to improve transparency

Purpose – The purpose of this paper is to propose an analytical model that shows causal relationships between the amount and nature of information on strategies and the governance of city councils, as well as the contents of different dimensions of sustainability that are disclosed on the websites of local governments in big European cities. This model could reveal if the information is disseminated in a homogeneous and coordinated way and could improve the quality of the information, its coherence and its comparability. Design/methodology/approach – The authors have designed a questionnaire with 75 variables from the Global Reporting Initiative proposal to specify information disclosed on sustainability. The level of information about each of these variables has been gathered by consulting the contents published on the websites of the 142 local governments in the sample. Finally the authors propose a model about the cause-effect relationships between the amount and nature of the information in different ...

Applying an Evolutionary Algorithm for the Analysis of Mental Disorders in Macro-urban Areas: The Case of Barcelona

Abstract Spatial analysis is widely used to study geographic patterns of diseases. To locate groups of close spatial units where the treated prevalence is significantly high or low, the latest contribution is a tool based on a Multi-objective Evolutionary Algorithm, which has not yet been used in macro-urban areas: this study is the first attempt for this purpose. To do so, spatial distribution of the treated prevalence of mental disorders in basic health areas was analysed within the Barcelona metropolitan zone during 2009. The results highlight inequitable zones that need further attention, and geographically weighted regression shows that socio-economic factors influence treated prevalence although there may be additional factors involved.

The Relationships between Depression Spatial Clusters and Mental Health Planning in Catalonia (Spain)

This study aims to analyse potential risk factors which could influence the occurrence of hot spots of depression. They cannot only be explained through municipal socio-demographic characteristics and which is why causes at catchment area level should also be studied. Indicators at both spatial levels were analysed by a multi-level regression model. The analysis included various socio-demographic, geographical and service allocation indicators. According to scientific literature, unemployment and rurality were identified as risk factors for depression and, therefore, for hot spots. On the other hand, low educational levels and poor accessibility showed little relationship here while other studies indicated otherwise. Preliminary results described diverse risk factors at two levels which were related to a high likelihood of hot spots, although more in-depth analysis will be needed.

La carga de enfermedad en España: resultados del Estudio de la Carga Global de las Enfermedades 2016

BACKGROUND AND OBJECTIVES The global burden of disease (GBD) project measures the health of populations worldwide on an annual basis, and results are available by country. We used the estimates of the GBD to summarise the state of health in Spain in 2016 and report trends in mortality and morbidity from 1990 to 2016. MATERIAL AND METHODS GBD 2016 estimated disease burden due to 333 diseases and injuries, and 84 risk factors. The GBD list of causes is hierarchical and includes 3 top level categories, namely: 1) communicable, maternal, neonatal, and nutritional diseases; 2) non-communicable diseases (NCDs), and 3) injuries. Mortality and disability-adjusted life-years (DALYs), risk factors, and progress towards the sustainable development goals (SDGs) are presented based on the GBD 2016 data in Spain. RESULTS There were 418,516 deaths in Spain in 2016, from a total population of 46.5 million, and 80.5% of them occurred in those aged 70 years and older. Overall, NCDs were the main cause of death: 388,617 (95% uncertainty interval 374,959-402,486), corresponding to 92.8% of all deaths. They were followed by 3.6% due to injuries with 15,052 (13,902-17,107) deaths, and 3.5% communicable diseases with 14,847 (13,208-16,482) deaths. The 5 leading specific causes of death were ischaemic heart disease (IHD, 14.6% of all deaths), Alzheimer disease and other dementias (13.6%), stroke (7.1%), chronic obstructive pulmonary disease (6.9%), and lung cancer (5.0%). Remarkable increases in mortality from 1990 to 2016 were observed in other cancers, lower respiratory infections, chronic kidney disease, and other cardiovascular disease, among others. On the contrary, road injuries moved down from 8th to 32nd position, and diabetes from 6th to 10th. Low back and neck pain became the number one cause of DALYs in Spain in 2016, just surpassing IHD, while Alzheimer disease moved from 9th to 3rd position. The greatest changes in DALYs were observed for road injuries dropping from 4th to 16th position, and congenital disorders from 17th to 35th; conversely, oral disorders rose from 25th to 17th. Overall, smoking is by far the most relevant risk factor in Spain, followed by high blood pressure, high body mass index, alcohol use, and high fasting plasma glucose. Finally, Spain scored 74.3 of 100 points in the SDG index classification in 2016, and the main national drivers of detrimental health in SDGs were alcohol consumption, smoking and child obesity. An increase to 80.3 points is projected in 2030. CONCLUSION Low back and neck pain was the most important contributor of disability in Spain in 2016. There has seen a remarkable increase in the burden due to Alzheimer disease and other dementias. Tobacco remains the most important health issue to address in Spain.

A multi-level analysis of the relationship between spatial clusters of outpatient-treated depression, risk factors and mental health service planning in Catalonia (Spain).

BACKGROUND Previous research identified high/low clusters of prevalence of outpatient-treated depression at municipal level in Catalonia (Spain). This study aims to analyse potential risk factors, both socioeconomic and related to the mental health service planning, which could influence the occurrence of hot/cold spots of depressed outpatients at two geographical levels: municipalities and service catchment areas. METHOD Hot/cold spots were examined in relation to socioeconomic indicators at municipal level, such as population density, unemployment, university education, personal income, and also those related to service planning at catchment area level, such as adequacy of healthcare, urbanicity, accessibility and the availability of mental health community centres. The analysis has been carried out through multilevel logistic regression models in order to consider the two different scales. RESULTS Hot spots are related to high population density, unemployment, urbanicity, the adequacy of provision of mental health services, and accessibility to mental health community centres at both study levels. On the other hand, the multilevel model weakly explains cold spots, associating them with high personal incomes. LIMITATIONS The dependent variables of the multi-level models are binary. This limits the interpretation of the results, since they cannot provide information about the variance of the dependent variables explained by the models. CONCLUSIONS The results described diverse risk factors at two levels which are related to a high likelihood of hot and cold spots of depression. The findings show the relevance of health planning in the distribution of diseases and the utilisation of healthcare services.