Infección por el VIH e inmigración

Los inmigrantes representan en torno a un tercio de los nuevos diagnósticos de VIH en España y constituyen una población especialmente vulnerable a sus consecuencias negativas debido al contexto sociocultural, económico, laboral, administrativo y legal. Los inmigrantes se diagnostican más tardíamente, lo que empeora su pronóstico individual y facilita el mantenimiento de la epidemia en la población. A pesar de las diferentes barreras que experimentan para acceder a los servicios sanitarios en general, y a los relacionados con el VIH en particular, el acceso al tratamiento antirretroviral se ha producido en condiciones similares a la población autóctona. Sin embargo, los beneficios obtenidos del mismo han sido inferiores, siendo los subsaharianos y las mujeres los grupos con peor respuesta. Es necesaria una actitud proactiva para el diagnóstico precoz de la infección, la adopción de medidas preventivas para evitar nuevos casos y proporcionar una atención sanitaria accesible, adaptada y de alta calidad.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-04-08

Informal employment and health status in Central America

Background: Informal employment is assumed to be an important but seldom studied social determinant of health, affecting a large number of workers around the world. Although informal employment arrangements constitute a permanent, structural pillar of many labor markets in low- and middle-income countries, studies about its relationship with health status are still scarce. In Central America more than 60 % of non-agricultural workers have informal employment. Therefore, we aimed to assess differences in self-perceived and mental health status of Central Americans with different patterns of informal and formal employment. Methods: Employment profiles were created by combining employment relations (employees, self-employed, employers), social security coverage (yes/no) and type of contract -only for employees- (written, oral, none), in a cross-sectional study of 8,823 non-agricultural workers based on the I Central American Survey of Working Conditions and Health of 2011. Using logistic regression models, adjusted odds ratios (aOR) by country, age and occupation, of poor self-perceived and mental health were calculated by sex. Different models were first fitted separately for the three dimensions of employment conditions, then for employment profiles as independent variables. Results:Poor self-perceived health was reported by 34 % of women and 27 % of men, and 30 % of women and 26 % of men reported poor mental health. Lack of social security coverage was associated with poor ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-02-08

Impact of tobacco prices and smoke-free policy on smoking cessation, by gender and educational group: Spain, 1993-2012

BACKGROUND:To evaluate the effect of tobacco prices and the implementation of smoke-free legislation on smoking cessation in Spain, by educational level, across the period 1993-2012.METHODS:National Health Surveys data for the above two decades were used to calculate smoking cessation in people aged 25-64 years. The relationship between tobacco prices and smoking quit-ratio was estimated using multiple linear regression adjusted for time and the presence of smoke-free legislation. The immediate as well as the longer-term impact of the 2006 smoke-free law on quit-ratio was estimated using segmented linear regression analysis. The analyses were performed separately in men and women with high and low education, respectively.RESULTS:No relationship was observed between tobacco prices and smoking quit-ratio, except in women having a low educational level, among whom a rise in price was associated with a decrease in quit-ratio. The smoke-free law altered the smoking quit-ratio in the short term and altered also pre-existing trends. Smoking quit-ratio increased immediately after the ban - though this increase was significant only among women with a low educational level - and then decreased in subsequent years except among men with a high educational level.CONCLUSION:A clear relationship between tobacco prices and smoking quit-ratio was not observed in a recent period. After the implementation of smoke-free legislation the trend in the quit ratio in most of the socio-economic groups ...

Categoría:Clase Social
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-07-29

Inequalities in health: definitions, concepts and theories

Inequalities in health: definitions, concepts and theories Individuals from different backgrounds, social groups, and countries enjoy different levels of health. This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. We describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behavior, environmental, and selection explanations. Concepts of relative versus absolute; dose-response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. We close by reflecting on what conditions make health inequalities unjust, and to consider the merits of policies that prioritize the elimination of health disparities versus those that focus on raising the overall standard of health in a population.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-07-13

Intimate partner violence among women in Spain: the impact of regional-level male unemployment and income inequality

Intimate partner violence among women in Spain: the impact of regional-level male unemployment and income inequality Background:Intimate partner violence (IPV) against women is a complex worldwide public health problem. There is scarce research on the independent effect on IPV exerted by structural factors such as labour and economic policies, economic inequalities and gender inequality.Objective: To analyse the association, in Spain, between contextual variables of regional unemployment and income inequality and individual women’s likelihood of IPV, independently of the women’s characteristics.Method: We conducted multilevel logistic regression to analyse cross-sectional data from the 2011 Spanish Macrosurvey of Gender-based Violence which included 7898 adult women. The first level of analyses was the individual women’ characteristics and the second level was the region of residence.Results: Of the survey participants, 12.2% reported lifetime IPV. The region of residence accounted for 3.5% of the total variability in IPV prevalence. We determined a direct association between regional male long-term unemployment and IPV likelihood (P= 0.007) and between the Gini Index for the regional income inequality and IPV l

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-07-10

Injury-Related Mortality Over 12 Years in a Cohort of Patients with Alcohol Use Disorders: Higher Mortality Among Young People and Women

Background:The goal of this study was to estimate excess death due to external causes among 18- to 64-year-olds with alcohol use disorder (AUD) who were treated at public outpatient treatment centers, and the time elapsed from treatment initiation to death. Methods:We conducted a retrospective longitudinal study among 7,012 outpatients aged 18 to 64 years who began treatment for AUD between 1997 and 2007. Deaths due to external causes (intentional and unintentional injuries) were monitored until the end of 2008. Person-years (PY) of follow-up and crude mortality rates (CMRs) were calculated for all study variables, for each sex, and for 2 age groups (18 to 34 and 35 to 64 years). Standardized mortality ratios (SMRs) were estimated by age group and sex. Survival was analyzed using the Kaplan–Meier method and Cox regression.Results: We recorded 114 deaths due to external causes. The CMR was 2.7 per 1,000 PY (95% confidence interval [CI]: 2.2 to 3.2), with significant gender differences only among younger individuals (CMR for males = 3.9 per 1,000 PY [95% CI: 2.2 to 5.5] and CMR for females = 2.8 per 1,000 PY [95% CI: 0.1 to 5.6]). Unintentional injury was the most common cause of death (n = 65), of which acute poisoning (n = 25; 38.5%) and traffic accidents (n = 15; 23.1%) were the most prevalent. Suicide accounted for 91.8% (n = 49) of deaths from intentional injuries. The excess of mortality between the AUD group and the general population (SMR) was 9.5 higher than in ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-25

Inequities in the freedom to lead a flourishing and healthy life: issues for healthy public policy

There are many reasons for the health inequities that we see around the world today. Public policy and the way society organises its affairs affects the economic, social and physical factors that influence the conditions in which people are born, grow, live, work and age - the social determinants of health. Tackling health inequities is a political issue that requires leadership, political courage, progressive public policy, social struggle and action, and a sound evidence base.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-17

In It Together: Why less Inequality Benefits All

In It Together: Why less Inequality Benefits All The gap between rich and poor keeps widening. Growth, if any, has disproportionally benefited higher income groups while lower income households have been left behind. This long-run increase in income inequality not only raises social and political concerns, but also economic ones. It tends to drag down GDP growth, due to the rising distance of the lower 40% from the rest of society. Lower income people have been prevented from realising their human capital potential, which is bad for the economy as a whole. This book highlights the key areas where inequalities are created and where new policies are required, including: the consequences of current consolidation policies; structural labour market changes with rising non-standard work and job polarization; persisting gender gaps; the challenge of high wealth concentration, and the role for redistribution policies.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-02

Impacto de la Crisis Económica en la Salud y en el Sistema Sanitario en España

Impacto de la Crisis Económica en la Salud y en el Sistema Sanitario en España Este informe aporta información sobre este programa de seguimiento del impacto de la crisis económica sobre el sistema sanitario y sobre la salud en España. En el capítulo inicial se definen las grandes áreas de información que se han seguido a partir de una determinada categorización para los Determinantes sociales de la salud, la Salud y las desigualdades, dando un énfasis especial a los Servicios sanitarios, vistos tanto como determinantes de la salud y también como variable dependiente. Además, se analiza el Contexto Institucional, político y social en el que se produce la crisis económica española y sus características esenciales, la Estructura social, las Condiciones de vida y de trabajo, los Estilos de vida y las conductas de los ciudadanos, los Factores psicosociales, la Cohesión social y la exclusión e integración social. Se detiene en los Servicios Sanitarios, analizando las políticas sociales, los ingresos del Estado y la capacidad adquisitiva de los ciudadanos, el modelo de prestación de servicios, analizando la cobertura, los costes y la utilización de los servicios sanitarios. La Salud y las desigualdades de salud se estudian a partir de bases de datos nacionales e internacionales y, en este primer informe, se hace una comparación con otros países de nuestro entorno socioeconómico. Para cada área de información, see han seleccionado indicadores que están disponibles en general para los países de la Unión Europea, algunos otros países de la Organización para l ...

Categoría:Servicios de salud
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-05-13

Indicators of Gender Equality

Indicators of Gender Equality Statistics and indicators that reflect the realities of the lives of women and men are needed to describe women’s and men’s role in the society, economy and family, to formulate and monitor policies and plans, monitor changes, and inform the public. In 2010, the Conference of European Statisticians (CES) established the Task Force on Indicators of Gender Equality, to improve the monitoring of gender equality in the UNECE region by consolidating and systematizing gender-relevant statistical indicators. This publication contains the result of the work of that Task Force, which was endorsed by CES in October 2014. It presents a set of 115 gender equality indicators recommended for use in countries participating in the work of CES.The indicators are grouped in eight thematic domains inspired by the Beijing Platform for Action and categorized into 42 headline indicators and 73 supporting indicators. The selection is based on the consideration of policy needs, main existing international indicator frameworks, relevance to the measurement of gender equality and international availability.

Publicado en ODS2015-01-11

Income inequality and health: A casual review

Income inequality and health: A casual review There is a very large literature examining income inequality in relation to health. Early reviews came to different interpretations of the evidence, though a large majority of studies reported that health tended to be worse in more unequal societies. More recent studies, not included in those reviews, provide substantial new evidence. Our purpose in this paper is to assess whether or not wider income differences play a causal role leading to worse health. We conducted a literature review within an epidemiological causal framework and inferred the likelihood of a causal relationship between income inequality and health (including violence) by considering the evidence as a whole. The body of evidence strongly suggests that income inequality affects population health and wellbeing. The major causal criteria of temporality, biological plausibility, consistency and lack of alternative explanations are well supported. Of the small minority of studies which find no association, most can be explained by income inequality being measured at an inappropriate scale, the inclusion of mediating variables as controls, the use of subjective rather than objective measures of health, or follow up periods which are too short. The evidence that large income differences have damaging health and social consequences is strong and in most countries inequality is increasing. Narrowing the gap will improve the health and wellbeing of populations.

Categoría:Clase Social
TipoRevisiones Bibliográficas
Publicado en ODS2015-01-19

Informe Mundial sobre Salarios 2014/2015

Informe Mundial sobre Salarios 2014/2015 En la edición de 2014/2015 se examina la relación entre los salarios y la desigualdad a nivel de los hogares. Se demuestra que en la mayoría de los países los salarios constituyen la mayor fuente de ingresos de las familias con al menos un miembro en edad de trabajar, y se señalan las variaciones de los salarios y del empleo remunerado como principales factores determinantes de las tendencias recientes de la desigualdad. El informe también examina las disparidades salariales entre determinados grupos; por ejemplo, entre mujeres y hombres; migrantes y nacionales; y trabajadores de la economía informal y de la economía formal. La desigualdad puede tratarse mediante políticas que incidan directa o indirectamente en la distribución salarial, y también mediante la distribución fiscal. Sin embargo, la creciente desigualdad en el mercado laboral impone una carga mayor a las iniciativas para reducir la desigualdad a través de los impuestos y las transferencias. Así pues, el informe pone de manifiesto la necesidad de combinar medidas de política que contemplen el salario mínimo, la potenciación de la negociación colectiva, intervenciones para eliminar las disparidades salariales, la promoción del empleo remunerado y la redistribución mediante impuestos y transferencias.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-12-24

Incorporating Intersectionality in Evaluation of Policy Impacts on Health Equity

Socio-economic position (including indicators of social stratification and social class) is the most studied form of social inequality when describing health inequalities and analysing policies to tackle them (CSDH, 2008). However, there are other social relations that generate health inequalities such as, for example, gender, ethnicity or migration status (Solar and Irwin 2007). These axes, or dimensions of social inequality, can be seen as intertwined power relations interacting among each other in creating health inequalities. Therefore, not only research on health inequalities but also the design of policies and the study of the impact of a policy on health equity needs to take into consideration all these dimensions, as well as their intersections (Schulz and Mullings 2006). This guide aims to raise this issue, by introducing central concepts of intersectionality theory and questions to consider in an intersectionality-based policy analyses and by showing examples of how one-dimensional analyses of population health and health inequalities can mask evidence of true health effects.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-11-07