Pilar García Gómez

Regional Differences in Socio-Economic Health Inequalities in Spain

This paper reports an analysis of income related health inequalities at the Autonomous Community level in Spain using the self assessed health measure in the 2001 edition of the Encuesta Nacional de Salud. We use recently developed methods in order to cardinalise and model self assessed health within a regression framework, decompose the sources of inequality and explain the observed differences across regions. Pais Vasco, Navarra, and La Rioja are the regions with the highest levels of mean health and simultaneously enjoy the lowest degree of income related health inequality. By contrast, Murcia is the least favoured region in that its population report one of the lowest levels of mean health and suffers the greatest degree of income related health inequality. Other territories where income related health inequality is high relative to País Vasco include rich regions such as Madrid, Baleares and Catalonia. The main feature characterizing regions where income related health inequality is low is the absence of a positive gradient between income and health. In turn, the regions where income related health inequality is greater are characterized by a strong and significant positive gradient between health and income. Thus policies aimed at eliminating the gradient between health and income can potentially lead to greater reductions in socio-economic health inequalities than policies aimed at redistributing income.

Trade-off entre cuidados formales e informales en Europa

OBJECTIVE To study the relationship between formal and informal care for the dependent population in a number of European countries. METHOD Data from the Survey of Health, Aging and Retirement in Europe for 2004 were used and a bivariate probit model was estimated. Unlike other studies, the present analysis includes the institutional features of the various long-term care systems, in addition to the demographic, health and environmental characteristics of the individual receiving care. RESULTS A significant correlation was found between the two options, which reveals that, conditional on receiving care, there was a preference for the combination of both types of care. The results show the importance of health status and living arrangements for defining the combination of formal and informal care. There were substantial differences in the likelihood of the two types of care among European countries. A notable finding was the importance of informal care in Spain in comparison with other countries. CONCLUSIONS The probability of receiving formal or informal care is higher in countries where families have a legal obligation to look after dependent relatives and where institutionalization rates are higher. This finding should be considered in the design of long-term care policies. Therefore, to control growth of public expenditure and, at the same time, improve caregiver satisfaction, policies that combine distinct formal services should be promoted over the implementation of care allowances.

Investigación de una toxiinfección alimentaria en un centro penitenciario de alta ocupación

Background: On September 25 2005, more than 100 inmates (almost 5% of the 1,800 prison population) experienced sudden onset gastroenteritis. This outbreak was the largest foodborne outbreak described in a prison population in Spain. Our objective was to confirm the outbreak, identify risk factors, implement control measures, and provide recommendations. Methods: We conducted a cohort analysis of a stratified random sample of all the inmates, a cohort analysis of the one of the prison blocks, and an environmental investigation. Results: A total of 221 inmates were selected, of which 196 were interviewed. Twenty-eight percent had gastroenteritis and the main symptoms were abdominal pain (85%) and diarrhea (71%). All foods consumed caused similar attack rates. Factors associated with the risk of illness were eating the entire portion of seafood cocktail at lunch or all of the fried shrimp at dinner on September 24 (RR = 2; 95% CI, 1.1-3.8, and RR = 1.8; 95% CI, 1.1-3.1). Analysis of one of the prison blocks yielded results similar to those of the random sample. Clostridium perfringens, Bacillus cereus and Escherichia coli were isolated from a sample of the seafood cocktail. Conclusion: A gastroenteritis outbreak caused by several pathogens was confirmed. Both the reported symptoms and the calculated incubation periods corresponded to the pathogens isolated. Preparation of food in prison facilities should meet minimum safety standards, including refrigeration and training of food handlers.

[Investigation of a foodborne intoxication in a high-density penitentiary center].

BACKGROUND On September 25 2005, more than 100 inmates (almost 5% of the 1,800 prison population) experienced sudden onset gastroenteritis. This outbreak was the largest foodborne outbreak described in a prison population in Spain. Our objective was to confirm the outbreak, identify risk factors, implement control measures, and provide recommendations. METHODS We conducted a cohort analysis of a stratified random sample of all the inmates, a cohort analysis of the one of the prison blocks, and an environmental investigation. RESULTS A total of 221 inmates were selected, of which 196 were interviewed. Twenty-eight percent had gastroenteritis and the main symptoms were abdominal pain (85%) and diarrhea (71%). All foods consumed caused similar attack rates. Factors associated with the risk of illness were eating the entire portion of seafood cocktail at lunch or all of the fried shrimp at dinner on September 24 (RR = 2; 95% CI, 1.1-3.8, and RR = 1.8; 95% CI, 1.1-3.1). Analysis of one of the prison blocks yielded results similar to those of the random sample. Clostridium perfringens, Bacillus cereus and Escherichia coli were isolated from a sample of the seafood cocktail. CONCLUSION A gastroenteritis outbreak caused by several pa-thogens was confirmed. Both the reported symptoms and the calculated incubation periods corresponded to the pathogens isolated. Preparation of food in prison facilities should meet minimum safety standards, including refrigeration and training of food handlers.

Hypothesis on Immigration and Welfare

The number of hypothesis trying to explain which are the reasons behind the decision to migrate to work into a developed country are diverse and at the same time, difficult to test due to the multiplicity of factors which affect it. This papers attempts to move forward trying to disentangle which are the socio-economic factors that explain the differences in the figures of immigrants in the OECD countries. We show empirical evidence about the determinants of the migratory flows to 17 OECD countries from 65 countries in the 1980-2000 period. Our results reveal the importance to differentiate the inflows composition by at least income in the origin countries. Thus, regarding inflows from non-high-income countries, the results suggest that there is a pull effect from monetary and not real income, and then, the welfare magnets hypothesis should be rejected. This group reacts more to the migratory policy than the inflows coming from high-income countries, although those policies designed to slow down the inflows have not been able, in the aggregate, to reduce them.