Inequalities in mortality in small areas of eleven Spanish cities (the multicenter MEDEA project)
The objectives of this study are to identify inequalities in mortality among census tracts of 11 Spanish cities in the period 1996-2003 and to analyse the relationship between these geographical inequalities and socioeconomic deprivation. It is a cross-sectional ecological study where the units of analysis are census tracts. We obtained an index of socioeconomic deprivation and estimated SMR by each census tract using hierarchical Bayesian models which take into account the spatial structure. In the majority of the cities geographical patterns in total mortality were found in both sexes, which were similar to those for the index of socioeconomic deprivation. Among men, four specific causes …
Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities
incluye "Erratum to: Cancer mortality inequalities in urban areas: a Bayesian small area analysis in Spanish cities" BACKGROUND: Intra-urban inequalities in mortality have been infrequently analysed in European contexts. The aim of the present study was to analyse patterns of cancer mortality and their relationship with socioeconomic deprivation in small areas in 11 Spanish cities. METHODS: It is a cross-sectional ecological design using mortality data (years 1996-2003). Units of analysis were the census tracts. A deprivation index was calculated for each census tract. In order to control the variability in estimating the risk of dying we used Bayesian models. We present the RR of the censu…
Socio-economic inequalities in mortality due to injuries in small areas of ten cities in Spain (MEDEA Project).
Abstract Objectives To analyse socio-economic inequalities in mortality due to injuries among census tracts of ten Spanish cities by sex and age in the period 1996–2003. Methods This is a cross-sectional ecological study where the units of analysis are census tracts. The study population consisted of people residing in the cities during the period 1996–2003. For each census tract we obtained an index of socio-economic deprivation, and estimated standardized mortality ratios using hierarchical Bayesian models which take into account the spatial structure of the data. Results In the majority of the cities, the geographical pattern of total mortality from injuries is similar to that of the soc…
Is recession bad for your mental health? The answer could be complex: evidence from the 2008 crisis in Spain
Abstract Background We explored the impact of 2008 recession on the prevalence of mental health problems in Spain. Methods Repeated cross-sectional survey design. Datasets from 2006 and 2011 were used, and temporal change was examined. The study was conducted on the economically active population (16–64 years old). The two surveys included 29,478 and 21,007 people, obtaining a 96 and 89.6% response rate, respectively. Multiple logistic regression models were adjusted to identify poor mental health risk factors. A standardisation analysis was performed to estimate the prevalence of people at risk of poor mental health (GHQ+). Results The prevalence of GHQ+ following the crisis increased in m…
The spatial distribution of population exposure to outdoor air pollution in Valencia (Spain) and its association with a privation index
Objetivo: Evaluar la variación espacial de la exposición a dióxido de nitrógeno (NO2) en la ciudad de Valencia y su relación con la privación socioeconómica y la edad. Métodos: La población por sección censal (SC) procede del Instituto Nacional de Estadística. Los niveles de NO2 se midieron en 100 puntos del área de estudio, mediante captadores pasivos, en tres campañas entre 2002 y 2004. Se utilizó regresión por usos del suelo (LUR) para obtener el mapa de los niveles de NO2. Las predicciones del LUR se compararon con las proporcionadas por: a) el captador más cercano de la red de vigilancia, b) el captador pasivo más cercano, c) el conjunto de captadores en un entorno y d) kriging. Se asi…
Cross-cultural adaptation, reliability and validity of the Spanish version of the Neonatal Skin Risk Assessment Scale.
Aim: To adapt the Neonatal Skin Risk Assessment Scale to the Spanish context and to test its validity and reliability. Background: Currently, in Spain there are no validated scales to evaluate the risk of pressure ulcers in infants. Method: The research was performed in 10 neonatal units. Overall, we use an observational study design, but divided it in to three stages. In the first stage, the transcultural adaptation of the scale and its content validation was performed. For the second stage, the inter‐rater/intra‐rater agreement and construct validity were evaluated using a cross‐sectional design. Finally, in the third stage, a cohort study to analyse pressure ulcers’ incidence, diagnostic…
Socioeconomic Inequalities in Mortality among Foreign-Born and Spanish-Born in Small Areas in Cities of the Mediterranean Coast in Spain, 2009–2015
Many studies have analysed socioeconomic inequalities and its association with mortality in urban areas. However, few of them have differentiated between native and immigrant populations. This study is an ecological study of mortality by overall mortality and analyses the inequalities in mortality in these populations according to the level of deprivation in small areas of large cities in the Valencian Community, from 2009 to 2015. The census tract was classified into five deprivation levels using an index based on socioeconomic indicators from the 2011 census. Rates and relative risks of death were calculated by sex, age, level of deprivation and country of birth. Poisson regression models…
Factores asociados a la predisposición a vacunarse contra la gripe pandémica A/H1N1 en población adulta del Departamento de Salud de Elche (España): Influencia de las fuentes de información
Psychometric behaviour of the strengths and difficulties questionnaire (SDQ) in the Spanish national health survey 2006
Abstract Background The Strengths and Difficulties Questionnaire (SDQ) is a tool to measure the risk for mental disorders in children. The aim of this study is to describe the diagnostic efficiency and internal structure of the SDQ in the sample of children studied in the Spanish National Health Survey 2006. Methods A representative sample of 6,773 children aged 4 to 15 years was studied. The data were obtained using the Minors Questionnaire in the Spanish National Health Survey 2006. The ROC curve was constructed and calculations made of the area under the curve, sensitivity, specificity and the Youden J indices. The factorial structure was studied using models of exploratory factorial ana…
Iron deficiency risk factors in infants at one year: A cross-sectional study
A cross-sectional study was performed to assess the relative importance of well-known risk factors for iron deficiency in one-year-old children and to detect new ones. Serum ferritin, erythrocyte protoporphyrin and haemoglobin were used as diagnostic tools to screen for iron deficiency. Epidemiologic analysis of data included measures of association, potential impact and a log-linear model to obtain adjusted measures. Socioeconomic variables show a strong association with iron deficiency (low income, odds ratio = 5.07, UCL = 16.08, LCL = 1.60; unemployed father, odds ratio = 4.16, UCL = 14.94, LCL = 1.16; emigration, odds ratio = 9.14, UCL = 54.56, LCL = 1.53). Some errors in feeding practi…
Contribution of the Economic Crisis to the Risk Increase of Poor Mental Health in a Region of Spain
Previous research suggests that the economic crisis can affect mental health. The purpose of this study was to analyse the association of risk of poor mental health with various socioeconomic, demographic, health, quality of life, and social support variables
Self-reported chronic mental health problems and mental health service use in Spain.
Objectives: To determine the prevalence of self-reported chronic mental health problems (MHPs) and mental health service use and their determinants, among the Spanish population over 14 years of age. Methods: Data from the 1999 Spanish Survey on Disabilities, Deficiencies, and State of Health were used. The survey is a cross-sectional study based on a multi-stage stratified sample of all the non-institutionalized Spanish population aged over 14 years (n=59,101, 11% non-responders). Multivariate logistic regression analysis were used. Results: 10.7% of the Spanish population suffer from an MHP. The highest prevalences were found in women, divorced/separated persons, those with a lower level…
Geographical Variability in Mortality in Urban Areas: A Joint Analysis of 16 Causes of Death.
The authors acknowledge the support of the research grants PI16/00670, PI16/00755, PI16/01004, PI16/01187, PI16/01273, PI16/01281, and PI18/01313 of Instituto de Salud Carlos III, co-funded with FEDER grants.
Anaemia during pregnancy as a risk factor for infant iron deficiency: report from the Valencia Infant Anaemia Cohort (VIAC) study.
A prospective cohort study with a 1-year follow-up of 156 neonates was carried out specifically designed to test the hypothesis that there is a positive relationship between iron deficiency during pregnancy and the development of the same disease in newborn infants. Exposure was defined as being born of a mother with ferropenic anaemia at delivery, and cases as the infants who developed iron deficiency during their first year of life. A statistically significant positive association was detected with an odds ratio of 6.57 (95% confidence limits 1.81-25.97). A stratified analysis was also performed to control the effect of potential confounders such as socio-economic variables, feeding pract…
Variación espacial de la exposición a contaminación atmosférica en la ciudad de Valencia y su relación con un índice de privación The spatial distribution of population exposure to outdoor air pollution in Valencia (Spain) and its association with a privation index
Objetivo: Evaluar la variación espacial de la exposición a dióxido de nitrógeno (NO2) en la ciudad de Valencia y su relación con la privación socioeconómica y la edad. Métodos: La población por sección censal (SC) procede del Instituto Nacional de Estadística. Los niveles de NO2 se midieron en 100 puntos del área de estudio, mediante captadores pasivos, en tres campañas entre 2002 y 2004. Se utilizó regresión por usos del suelo (LUR) para obtener el mapa de los niveles de NO2. Las predicciones del LUR se compararon con las proporcionadas por: a) el captador más cercano de la red de vigilancia, b) el captador pasivo más cercano, c) el conjunto de captadores en un entorno y d) kriging. Se asi…
Efficacy and effectiveness of individual family intervention on social and clinical functioning and family burden in severe schizophrenia: a 2-year randomized controlled study
BackgroundEmpirical evidence of the efficacy and effectiveness of psychosocial family intervention and of the specificity of its effects on the course of schizophrenia is limited. The aim was to study the efficacy and effectiveness of psychosocial family intervention with regard to clinical and social functioning and family burden after controlling for compliance and several prognostic factors.MethodA 2-year randomized controlled trial with blind assessments. Fifty patients with DSM-IV schizophrenia and persistent positive symptoms and/or previous clinical relapse were allocated to psychosocial family intervention, individual counselling and standard treatment versus individual counselling …
Adherence and concordance of vaccination coverage against influenza and pertussis in Spain.
Background: Pregnant women should receive two vaccines during pregnancy due to maternal-foetal complications and risks as well as the influenza and pertussis vaccinations. The goal was to evaluate vaccination coverage against influenza and pertussis in pregnant women, following midwife professional advice during the pregnancy follow-up; Methods: Prospective cohort study of 1017 pregnancies during the vaccination campaign in 2015-2016. To estimate the degree of consistency between the coverage declared by mothers and that registered in the Nominal Vaccination Registry (NVR), we used the Cohen's kappa index (k); Results: 95.4% were registered in the NVR. Vaccination coverage recorded against …