Mortalidad y principales causas de muerte en la población inmigrante residente en España, 2001-2005 Destacadoextranjeros.mtin.es/es/ObservatorioPermanenteInmigracion/Pub
Este recurso, realizado por el Grupo de Estudio sobre Inmigración y Salud, del Departamento de Medicina Preventiva, Salud Pública e Historia de la Ciencia de la Universidad Complutense de Madrid, analiza la mortalidad de la población inmigrante que reside en España y su comparación con el patrón de mortalidad de la población autóctona, con el fin de destacar las similitudes y diferencias.
Measuring healh inequities in low and middle income countries for the devolpment of observatoires on inequities and social determinants of health
Background: Almost seven years after the publication of the final report of the World Health Organization's Commission on Social Determinants of Health (CSDH), its third recommendation has not been attended to properly. Measuring health inequities (HI) within countries and globally, in order to develop and evaluate evidence-based policies and actions aimed at the social determinants of health (SDH), is still a pending task in most low and middle income countries (LMIC) in the Latin American region. In this paper we discuss methodological and conceptual issues to measure HI in LMIC and suggest a three-stage methodology for the creation of observatories on health inequities (OHI) and social determinants of health, based on the experience of the Brazilian Observatory on Health Inequities (BOHI) that has been successfully operating since 2010 at the Fundaçao Oswaldo Cruz (FIOCRUZ). Methods: A three-stage methodology for the creation of an OHI was developed based on a literature review on the following topics: SDH, HI measurement, and the process of setting-up of health observatories; followed by semi-structured interviews with key informants from the BOHI. We describe the three stages and discuss the replicability of this methodology in other Latin American countries. We also carried out a search of suitable national information systems to feed an OHI in Mexico, along with an outline of the institutional infrastructure to sustain it. Results: When implementing the methodology f ...
Measuring healh inequities in low and middle income countries for the devolpment of observatoires on inequities and social determinants of health
Background: Almost seven years after the publication of the final report of the World Health Organization’s Commission on Social Determinants of Health (CSDH), its third recommendation has not been attended to properly. Measuring health inequities (HI) within countries and globally, in order to develop and evaluate evidence-based policies and actions aimed at the social determinants of health (SDH), is still a pending task in most low and middle income countries (LMIC) in the Latin American region. In this paper we discuss methodological and conceptual issues to measure HI in LMIC and suggest a three-stage methodology for the creation of observatories on health inequities (OHI) and social determinants of health, based on the experience of the Brazilian Observatory on Health Inequities (BOHI) that has been successfully operating since 2010 at the Fundação Oswaldo Cruz (FIOCRUZ). Methods: A three-stage methodology for the creation of an OHI was developed based on a literature review on the following topics: SDH, HI measurement, and the process of setting-up of health observatories; followed by semi-structured interviews with key informants from the BOHI. We describe the three stages and discuss the replicability of this methodology in other Latin American countries. We also carried out a search of suitable national information systems to feed an OHI in Mexico, along with an outline of the institutional infrastructure to sustain it. Results: ...
The study of migrant populations poses unique challenges owing to the mobility of these groups, which may be further complicated by cultural, educational, and linguistic diversity as well as the legal status of their members. These barriers limit the usefulness of both traditional survey sampling methods and routine public health surveillance systems. Since nearly 1 in 7 people in the world is a migrant, appropriate methodological approaches must be designed and implemented to capture health data from populations. This effort is particularly important because migrant populations, in comparison to other populations, typically suffer disparities related to limited access to health care, greater exposure to infectious diseases, more occupational injuries, and fewer positive outcomes for mental health and other health conditions. This path-breaking handbook is the first to engage with the many unique issues that arise in the study of migrant communities. It offers a comprehensive description of quantitative and qualitative methodologies useful in work with migrant populations. By providing information and practical tools, the editors fill existing gaps in research methods and enhance opportunities to address the health and social disparities migrant populations face in the United States and around the world.
The Millennium Development Goals focused on poverty and development and reducing inequalities between countries.1 Progress was monitored through national averages without adequate attention to within-country inequality. The post-2015 sustainable development goals (SDG) stress “leaving no one behind” – with goal 10 specifically calling for the reduction of inequality, within and among countries. Monitoring of inequalities within countries focuses on indicators and dimensions of inequality that are particularly relevant to each country. Drawing upon the outputs of within-country inequality monitoring, policies can be tailored to be maximally effective in reducing inequalities.3 At the same time, having comparable disaggregated data across countries is important to track within-country inequality at a regional or global level. One of the SDG targets specifically addresses the importance of disaggregated data, calling on countries to increase “…the availability of high-quality, timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographic location and other characteristics relevant in national contexts”. Such disaggregated data are vital to identify where and why inequalities exist and ensure that policies, programmes and practices are successful in reaching the most vulnerable. Many countries have made major progress in monitoring health inequalities through household surveys such a ...
Moving Towards a Better Understanding of Socioeconomic Inequalities in Preventive Health Care Use: A Life Course Perspective
The aim of this book chapter is to outline how the life course perspective can move forward the debate on socioeconomic inequalities in preventive health care use. Recent theoretical developments in medical sociology, including health lifestyle theory and cultural health capital theory, have implicitly encapsulated a longer-term view of an individual’s life, in order to develop a better understanding of the social causes of good health and conversely illness. I will elaborate more explicitly on how the five central principles of the life course perspective apply to preventive health care use, using the empirical example of mammography screening. Central and unanswered questions pertain to (i) the life stages that are important in the development of cultural health capital or a healthy lifestyle (life-span development); (ii) the temporality of socioeconomic inequalities in preventive health care (timing); (iii) the impact of different socialization contexts for healthy lifestyles or cultural health capital (structure-agency debate); (iv) the change in preventive health care use across policy implementations (time and place); and (v) the role of significant others for health care use (linked lives).
Mortality, material deprivation and urbanization: exploring the social patterns of a metropolitan area
Introduction:Socioeconomic inequalities affecting health are of major importance in Europe. The literature enhances the role of social determinants of health, such as socioeconomic characteristics and urbanization, to achieve health equity. Yet, there is still much to know, mainly concerning the association between cause-specific mortality and several social determinants, especially in metropolitan areas.This study aims to describe the geographical pattern of cause-specific mortality in the Lisbon Metropolitan Area (LMA), at small area level (parishes), and analyses the statistical association between mortality risk and health determinants (material deprivation and urbanization level). Fourteen causes have been selected, representing almost 60 % of total mortality between 1995 and 2008, particularly those associated with urbanization and material deprivation. Methods:A cross-sectional ecological study was carried out. Using a hierarchical Bayesian spatial model, we estimated sex–specific smoothed Standardized Mortality Ratios (sSMR) and measured the relative risks (RR), and 95 % credible intervals, for cause-specific mortality relative to 1. urbanization level, 2. material deprivation and 3. material deprivation adjusted by urbanization. Results:The statistical association between mortality and material deprivation and between mortality and urbanization changes by cause of death and sex. Dementia and MN larynx, trachea, bronchus and lung are the causes of death showin ...
Women and men are not the same, and the jobs they do, their working conditions and circumstances and how society treats them are not the same. All these factors can affect the risks they face at work and the approach that needs to be taken to prevent these risks. More widespread recognition of the importance of taking account of gender differences in occupational safety and health (OSH) is relatively recent, although the number of initiatives seen in this area is increasing. However, especially because it is not always a very well understood area, practice needs to be exchanged and experiences shared. This report presents examples of policies, programmes and practices from across the EU and worldwide to illustrate gender approaches in OSH.
The study of migrant populations poses unique challenges owing to the mobility of these groups, which may be further complicated by cultural, educational, and linguistic diversity as well as the legal status of their members. These barriers limit the usefulness of both traditional survey sampling methods and routine public health surveillance systems. Since nearly 1 in 7 people in the world is a migrant, appropriate methodological approaches must be designed and implemented to capture health data from populations. This effort is particularly important because migrant populations, in comparison to other populations, typically suffer disparities related to limited access to health care, greater exposure to infectious diseases, more occupational injuries, and fewer positive outcomes for mental health and other health conditions.
This booklet communicates fundamental concepts about the importance of health inequality monitoring, using text, figures, maps and videos. Following a brief summary of main messages, four general principles pertaining to health inequalities are highlighted:1. health inequalities are widespread;2. health inequality is multidimensional;3. benchmarking puts changes in inequality in context and 4. health inequalities inform policy. Each of the four principles is accompanied by figures or maps that illustrate the concept, a question that is posed as an extension and application of the material, and a link to a video, demonstrating the use of interactive visuals to answer the question. The videos are accessible online by scanning a QR code (a URL is also provided). The next section of the booklet outlines essential steps forward for achieving health equity, including the strengthening and equity orientation of health information systems through data collection, data analysis and reporting practices. The use of visualization technologies as a tool to present data about health inequality is promoted, accompanied by a link to a video demonstrating how health inequality data can be presented interactively. Finally, the booklet announces the upcoming State of inequality report, and refers readers to the Health Equity Monitor homepage on the WHO Global Health Observatory.The accompanying video clips illustrate fundamental concepts of monitoring health inequality and can be foundhere.
Mortality inequality among older adults in Mexico: the combined role of infectious and chronic diseaseswww.paho.org/journal/index.php?option=com_content&view=artic
OBJECTIVE: To assess the effects of education and chronic and/or infectious disease, and the interaction between both variables, on the risk of dying among Mexicans 60 years and older. METHODS: Using data from the Mexican Health and Aging Study (MHAS), logistic regressions were performed to estimate the risk of mortality for older Mexicans between 2001 and 2003. Estimated mortality risks associated with chronic disease, infectious disease, and a combination of both were used to estimate additional life expectancy at age 60. RESULTS: Compared to the group with some schooling, the probability of dying over the twoyear inter-wave period was 26% higher among those with no schooling. Not having at least one year of formal education translated into a shorter additional life expectancy at age 60 by 1.4-2.0 years. Having chronic and/or infectious disease also increased the risk of mortality during the same period CONCLUSIONS: These results indicate that 1) a mixed epidemiological regime (the presence of both chronic and infectious disease) adds to the mortality health burden experienced by older people, and 2) there are persistent inequalities in mortality risks based on socioeconomic status.&l
Mental health and poor recovery in female nursing workers: a contribution to the study of gender inequitieswww.scielosp.org/scielo.php?script=sci_serial&pid=1020-4989&
Objective:To address the association between work and mental health from a gender perspective by investigating the combination of domestic work and adverse aspects of professional work (night shifts and psychosocial stress) with regard to minor psychiatric disorders (MPD) and poor recovery from work. MethodsA cross-sectional study was carried out at three public hospitals in Rio de Janeiro, Brazil, in 2006 (n = 1 122). Data collection was based on a census of all female nurses, technicians, and auxiliary nurses. A multidimensional instrument containing information about health, professional work, and the domestic work was used. The domestic work hours (longer or shorter than 10 hours per week) were combined with the work schedule (day or night shifts) and with psychosocial stress (absence or presence of effort-reward imbalance [ERI]). These combinations were tested with regard to the association with MPD and poor recovery from work. The adjusted odds ratios (OR) and their confidence intervals were calculated using multiple regression models. Results: The combination of long domestic work hours with night work was significantly associated with MPD (OR=1,94) and poor recovery (OR= 2,67). Long domestic work hours combined with the presence of ERI resulted in significantly higger odds ratios (OR= 4.37 and OR=5,33 respectively). In all analyses, greater odds ratios were observed in groups with long domestic work hours, compared to short work hours. ConclusionsThese findings sugges ...
Background: European city councils are increasingly developing interventions against health inequalities. There is little knowledge about how they are perceived. This study describes and analyses good practices and challenges for local interventions on inequalities in health through the narratives of European city managers. Methods: A qualitative study was conducted. Each participating city (Amsterdam, Barcelona, Cluj-Napoca, Helsinki, Lisbon, London, Madrid, Rotterdam) selected interventions following these criteria: at least 6 months of implementation; an evaluation performed or foreseen; the reduction of health inequalities among their objectives, and only one of the interventions selected could be based on health care. Managers of these local interventions were interviewed following an outline. Eleven individual in-depth interviews describing nine local interventions were obtained. A thematic content analysis was performed. Results: One or more local interventions against health inequalities were identified in each city. Most relied on quantitative data and were linked to national strategies. Few interventions addressed socio-economic determinants. Health care, employment and education were the main determinants addressed. With variable depth, evidence-base, participation and intersectorality were regular components of the interventions. Half of them targeted the city and half some deprived neighbourhoods. Few interventions had been evaluated. Scarcity of fundin ...
Measuring employment precariousness in the European working conditions survey: The social distribution in Europeiospress.metapress.com/content/x276pvp181608518/
BACKGROUND: Precarious employment is becoming an increasingly important social determinant of health inequalities among workers. The way in which contemporary employment arrangements and their health consequences are addressed in empirical research is mostly based on the contract-related or employment instability dimension. A broader conceptual approach including various important characteristics of the degrading of employment conditions and relations is needed. OBJECTIVE: The general objective of this paper is to empirically test a new multidimensional construct for measuring precarious employment in an existing database. Special focus is on the social distribution of precarious employment. METHODS: A subsample of 21,415 participants in the EU-27 from the Fourth European Working Conditions Survey-2005 was analysed. A cross-sectional study of the social distribution of precarious employment was conducted through the analysis of proportional differences according to gender, social class and credentials for the European Union as a whole and within each country. The 8 dimensions of the Employment Precariousness Construct were represented by 11 indicators. RESULTS: In general, women, workers without supervisory authority, those with fewer credentials, and those living in Eastern and Southern European countries suffer the highest levels of precarious employment. Exceptionally, men, workers with supervisory authority and those with the highest credentials suffer the highest le ...
La finalidad de esta publicación es ofrecer, desde una perspectiva de género, una selección de los indicadores más relevantes en el momento actual que permitan analizar la situación de hombres y mujeres, en determinadas áreas sociales y económicas como educación, empleo, salarios e inclusión social, salud, ciencia y tecnología, etc. La publicación se ha organizado en ocho grandes temas que contienen fichas asociadas a diferentes indicadores. Cada ficha es independiente del resto y consta de: introducción, definiciones, comentarios, fuentes y un apartado de más información en el que se proporcionan los enlaces de interés. Cada indicador dispone de una selección de tablas que el usuario puede descargar en formato Excel o PC-axis y algún gráfico. Aparte de la opción de descargar las tablas y el acceso a las fuentes de información el usuario puede editar el contenido de cada indicador en un fichero PDF.
OBJETIVOS: Comparar la mortalidad de autóctonos e inmigrantes en Andalucía entre 2006 y 2010, y caracterizarla por causas. MATERIALES Y MÉTODOS: Con las defunciones registradas en las estadísticas de mortalidad por causas y las poblaciones de los padrones de habitantes agregadas por países de nacimiento en autóctonos e inmigrantes, y los inmigrantes en seis zonas de procedencia geográfica, se calcularon las tasas brutas y estandarizadas por edad de mortalidad general y sus causas, para las edades de 0 a 39 años, 40 a 65 años, y 65 años y más, en hombres y mujeres. RESULTADOS: En el grupo de 0 a 39 años de edad, los inmigrantes tuvieron mayor mortalidad que los autóctonos debido a causas externas; destacaron los africanos, con tasas estandarizadas de 142 y 145 defunciones por 100.000 en mujeres y hombres, respectivamente. En especial fueron importantes las muertes por causas maternas entre las africanas. En el grupo de 40 a 64 años de edad, las mujeres inmigrantes tuvieron mayor mortalidad que las autóctonas y los hombres menos, y sobresalieron las mujeres africanas y los hombres procedentes de Europa y Norteamérica. En el grupo de 65 años y más, la población autóctona tuvo mayor mortalidad que la inmigrante en ambos sexos, debido a los cánceres y las causas cardiovasculares. CONCLUSIONES: Las diferencias en la mortalidad entre la población inmigrante y la autóctona dependen de la edad, el sexo, las causas y la zona geográfica de nacimiento. Se observa una mayor mortali ...
Monitoring social well-being to support policies on the social determinants of health: the case of New Zealand's "Social Reports/Te Purongo Oranga Tangata"whqlibdoc.who.int/publications/2010/9789241500869_eng.pdf
Este documento es el tercero de una colección sobre determinantes sociales de la salud que la Organización Mundial de la Salud ha publicado. El presente número tiene como objetivo contribuir a la bibliografía existente sobre los indicadores sociales y el monitoreo de la equidad en la salud a partir de un estudio de caso, en concreto el de Nueva Zelanda y sus informes sobre indicadores sociales.
En este monográfico web el Portal Mayores, un portal científico de acceso libre y gratuito especializado en Gerontología y Geriatría, ofrece una recopilación de los principales documentos a texto completo, bibliografía y enlaces sobre mujer y envejecimiento desde una perspectiva de género.
Meeting of the Expert Group on Social Determinants and Health Inequalities Luxembourg, 12-13 October 2010ec.europa.eu/health/social_determinants/events/ev_101012_en.
Esta página web permite el acceso a los documentos producidos por la Reunión del Grupo de Personas Expertas en Determinantes Sociales y Desigualdades en Salud de la Unión Europea que tuvo lugar en Luxemburgo del 12 al 13 de Octubre de 2010. Entre los temas que se trataron destacan las experiencias de Hungría, Bélgica y Suecia, y el proyecto EuroHealthNet.
Este Eurobarómetro, publicado por la Comisión Europea a través del departamento de Salud Pública y de Salud Mental trata sobre la autopercepción del estado de salud mental de los y las europeas. Esta encuesta se llevó a cabo durante febrero y marzo de 2010 en los 27 Estados miembros de la Unión Europea. De acuerdo con los resultados, el estigma que acompaña a los trastornos mentales todavía persiste.