Recursos

The impact of the Great Recession on mental health and its inequalities: the case of a Southern European region, 1997-2013

The impact of the Great Recession on mental health and its inequalities: the case of a Southern European region, 1997-2013 Background: Numerous studies have shown that macroeconomic changes have a great influence on health, prompting different concerns in recent literature about the effects of the current recession. The objetive of the study was to assess the changes in the mental health of the working-age population in the Basque Country (Spain) and its social inequalities following the onset of the 2008 recession, with special focus on the role of unemployment. Methods: Repeated cross-sectional study on the population aged 16-64, using four Basque Health Surveys (1997-2013). Age-adjusted prevalences of poor mental health and incremental prevalence ratios (working status and social class adjusted) between years were calculated. Absolute/relative measures of social inequalities were also calculated. Results: From 2008, there was a clear deterioration in the mental health, especially among men. Neither changes in employment status nor social class accounted for these changes. In men, the deterioration affected all working status categories, except the retired but significant changes occurred only among the employed. In women, poor mental health significantly increased among the unemployed. Students were also especially affected. Relative inequalities increased only in men. Conclusions: The Great Recession is being accompanied by adverse effects on mental health, which cannot be fully explained by the increase of unemployment. Public health professionals should closely monitor the medium and lon ...

Categoría:Crisis Económica
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-02-05

Trends in Longevity in the Americas: Disparities in Life Expectancy in Women and Men, 1965-2010

Trends in Longevity in the Americas: Disparities in Life Expectancy in Women and Men, 1965-2010 Objective: We describe trends in life expectancy at birth (LE) and between-country LE disparities since 1965, in Latin America and the Caribbean. Methods and Findings:LE trends since 1965 are described for three geographical sub-regions: the Caribbean, Central America, and South America. LE disparities are explored using a suite of absolute and relative disparity metrics, with measurement consensus providing confidence to observed differences. LE has increased throughout Latin America and the Caribbean. Compared to the Caribbean, LE has increased by an additional 6.6 years in Central America and 4.1 years in South America. Since 1965, average reductions in between-country LE disparities were 14% (absolute disparity) and 23% (relative disparity) in the Caribbean, 55% and 51% in Central America, 55% and 52% in South America. Conclusions:LE in Latin America and the Caribbean is exceeding "minimum standard", international targets, and is improving relative to the world region with the highest human longevity. The Caribbean, which had the highest LE and the lowest between-country LE disparities in Latin America and the Caribbean in 1965-70, had the lowest LE and the highest LE disparities by 2005-10. Caribbean Governments have championed a collaborative solution to the growing burden of non-communicable disease, with 15 territories signing on to the Declaration of Port of Spain, signalling regional commitment to a coordinated public-health response. The persistent LE inequity be ...

Categoría:Territorio
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-07-15

Tracking universal health coverage: First global monitoring report

Tracking universal health coverage:  First global monitoring report The report, Tracking Universal Health Coverage, is the first of its kind to measure health service coverage and financial protection to assess countries progress towards universal health coverage. The report looked at global access to essential health services including family planning, antenatal care, skilled birth attendance, child immunization, antiretroviral therapy, tuberculosis treatment, and access to clean water and sanitation in 2013, and found that at least 400 million people lacked access to at least one of these services.

Categoría:Servicios de salud
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-07-02

The motherhood pay gap: A review of the issues, theory and international evidence

The motherhood pay gap: A review of the issues, theory and international evidence The motherhood pay gap measures the pay gap between mothers and non-mothers,the latter defined in most econometric studies as women without dependent children. It also measures the pay gap between mothers and fathers. This is different from the gender pay gap, which measures the pay gap between all women and all men in the workforce.While there is a considerable international literature on the motherhood gap, differences both in methodologies and in how mothers, non-mothers and fathers are defined using available data create difficulties in comparing estimates. Moreover, in many countries,the data are often unsuitable for analysis, typically because the questions posed insurveys make it difficult to establish the identity of a child’s mother or father(particularly in developing countries where the nuclear family is less common.

Categoría:Género
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-04-22

The impact of financial crisis on health systems in Europe: a review of practices during recession

A new set of six case studies, analysing the impact of the financial crisis on health systems and population health, has just been published. The countries covered (Estonia, Greece, Ireland, Latvia, Lithuania and Portugal) were affected relatively harder than most other European states. Each case study analyses how the severe fiscal pressures applied on the health budgets from 2008 onwards have pushed policy makers in these countries to respond in different ways.

Categoría:Servicios de salud

The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis

Objectives:To complete a 30-year interrupted time-series analysis of the impact of austerity-related and prosperity-related events on the occurrence of suicide across Greece. Setting: Greece from 1 January 1983 to 31 December 2012. Participants: A total of 11?505 suicides, 9079 by men and 2426 by women, occurring in Greece over the study period. Primary and secondary outcomes: National data from the Hellenic Statistical Authority assembled as 360 monthly counts of: all suicides, male suicides, female suicides and all suicides plus potentially misclassified suicides. Results: In 30?years, the highest months of suicide in Greece occurred in 2012. The passage of new austerity measures in June 2011 marked the beginning of significant, abrupt and sustained increases in total suicides (+35.7%, p<0.001) and male suicides (+18.5%, p<0.01). Sensitivity analyses that figured in undercounting of suicides also found a significant, abrupt and sustained increase in June 2011 (+20.5%, p<0.001). Suicides by men in Greece also underwent a significant, abrupt and sustained increase in October 2008 when the Greek recession began (+13.1%, p<0.01), and an abrupt but temporary increase in April 2012 following a public suicide committed in response to austerity conditions (+29.7%, p<0.05). Suicides by women in Greece also underwent an abrupt and sustained increase in May 2011 following austerity-related events (+35.8%, p<0.05). One prosperity-related event, the January 2002 la ...

Categoría:Clase Social
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-03-11

Towards a Health Inequalities Audit Process. Process and learning

www.health-inequalities.eu/HEALTHEQUITY/EN/projects/equity_a

Towards a Health Inequalities Audit Process. Process and learning A Health Inequalities Audit is a useful process that can be used by professionals with a good grasp of the health inequalities agenda and of public health. It can be used to facilitate a discussion on policies and programmes both within and outside the health sector, by those with an interest in promoting action on health inequalities across populations. It is a non-legislative process which is used in agreement with other policy areas to assist in reviewing the impacts of policies and their implementation on health impacts and their distribution. Equity Action undertook Health Inequalities Audits on two policy areas, air quality and nutrition and obesity, although the initial process identified 5 potential areas: Air quality, child poverty, nutrition, Patient rights – cross border health care, and tobacco control - which were then screened to identify the final two. We pre-screened five policy areas by a desk review of policies, evidence, and the potential impact of the policy on health inequalities, and then undertook a further screening of the remaining three policy areas by face-to-face dialogue with both the EC health inequalities leads, and the air quality, nutrition and tobacco policy leads. While it is helpful to use the skills associated with health impact assessment, it is within the competency of public health professionals to manage the process at least up the scoping phase. Beyond that phase we found it useful to have specialist research commissioned on air-qual ...

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

Tackling Health Inequities: from concepts to practice

Tackling Health Inequities: from concepts to practice Despite remarkable health gains, inequities persist between and within countries in the WHO European Region, and Sweden is no exception. Actions to effectively tackle health inequities need to be carried out at all levels of government. Regions have a key role to play because they are close to their populations and have the power and skills to develop efficient public health policies that may help to reduce health disparities by changing the distribution of the social determinants of health. This report describes the process that the Region Västra Götaland, Sweden followed to mainstream health equity in its regional health plan; this resulted in the adoption of the Action Plan for Health Equity in Region Västra Götaland. This publication give an account of not only the factors that made the Action Plan possible but also the obstacles encountered and the measures taken to overcome them. The report illustrates how the whole-of-government and whole-of-society approaches central to the new European health policy, Health 2020, were implemented in a real setting.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-10-14

The relationship of green space, depressive symptoms and perceived general health in urban population.

Aims:To assess the relationship between green space proximity, use of green space and depressive symptoms and perceived general health among a random sample men and women. Methods: Cross-sectional study of a population-based sample of 6,944 45-72 year old Kaunas city residents. Self-reported questionnaires provided information on sociodemographic variables, health behaviours, depressive symptoms and poor and very poor perceived general health. Residential proximity to green spaces was defined as living less than 300 m, within interval of 300-999 m, and equal or more than 1 km from a park. The use of the park was divided into two categories: no park use or use <4hrs/week and use of the park ?4 h/week. The study received approval from the Kaunas Regional Research Ethics Committee. Multiple logistic regression assessed the associations controlling for confounding variables. Results: The prevalence of depressive symptoms and poor and or very poor perceived general health was higher in women than in men. The association between the use of the park and residential proximity to the park revealed that women living >300 m from a green space and who used the space ?4 h/week showed higher odds 1.92 (1.11-3.3) and 1.68 (0.81-3.48) of depressive symptoms and poor and very poor perceived general health as compared to those who used the park <4 hrs="" week="" and="" residential="" proximity="" was="">300 m. Conclusions: The results of our study confirmed an association between u ...

Categoría:Territorio
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-10-08

The inclusion of migrants in health impact assessments: A scoping review

bit.ly/1pE5iuu

This article reports the findings of a scoping review assessing the extent and ways in which migrants have been included in health impact assessments (HIAs) and HIA evaluations worldwide. A total of 117 HIAs and two HIA evaluations were included. Only 14% of hand-searched HIAs mentioned migrants, 5% analysed migrants and only 2% included them in their recommendations. Nonetheless, migrants would be expected to be part of the analysis based on the reasons for which migrants were most commonly mentioned. Although the majority of HIAs included in the review mentioned migrants in baseline conditions and impact analysis steps, migrants were seldom included in recommendations. Furthermore, the use of frameworks or tools guiding the completion of an HIA was negatively associated with the inclusion of migrants in recommendations. This is a pivotal risk of frameworks not mentioning migrants. Although workshops and stakeholder engagement were a frequent way of including migrants in HIAs, this usually involved organizations representing migrants, and only seldom included members of the migrant community themselves. The main barriers to including migrants in the HIA impact analysis were the lack of available data on migrants and the significant additional resources required to gather and analyse additional data on migrants. Guidance is needed on ways to optimally include migrants in HIAs and ensure that recommendations for mitigation measures are optimal.

Categoría:Etnia
TipoRevisión
Publicado en ODS2014-09-30

The impact of economic crises on social inequalities in health: what do we know so far?

Since 2008, Western countries are going through a deep economic crisis whose health impacts seem to be fundamentally counter-cyclical: when economic conditions worsen, so does health, and mortality tends to rise. While a growing number of studies have presented evidence on the effect of crises on the average population health, a largely neglected aspect of research is the impact of crises and the related political responses on social inequalities in health, even if the negative consequences of the crises are primarily borne by the most disadvantaged populations. This commentary will reflect on the results of the studies that have analyzed the effect of economic crises on social inequalities in health up to 2013. With some exceptions, the studies show an increase in health inequalities during crises, especially during the Southeast Asian and Japanese crises and the Soviet Union crisis, although it is not always evident for both sexes or all health or socioeconomic variables. In the Nordic countries during the nineties, a clear worsening of health equity did not occur. Results about the impacts of the current economic recession on health equity are still inconsistent. Some of the factors that could explain this variability in results are the role of welfare state policies, the diversity of time periods used in the analyses, the heterogeneity of socioeconomic and health variables considered, the changes in the socioeconomic profile of the groups under comparison in times of cris ...

Categoría:Crisis Económica
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-09-16

The influence of gender equality policies on gender inequalities in health in Europe

bit.ly/U6cas7

The influence of gender equality policies on gender inequalities in health in Europe Few studies have addressed the effect of gender policies on women’s health and gender inequalities in health. This study aims to analyse the relationship between the orientation of public gender equality policies and gender inequalities in health in European countries, and whether this relationship is mediated by gender equality at country level or by other individual social determinants of health. A multilevel cross-sectional study was performed using individual-level data extracted from the European Social Survey 2010. The study sample consisted of 23,782 men and 28,655 women from 26 European countries. The dependent variable was self-perceived health. Individual independent variables were gender, age, immigrant status, educational level, partner status and employment status. The main contextual independent variable was a modification of Korpi’s typology of family policy models (Dual-earner, Traditional-Central, Traditional-Southern, Market-oriented and Contradictory). Other contextual variables were the Gender Empowerment Measure (GEM), to measure country-level gender equality, and the Gross Domestic Product (GDP). For each country and country typology the prevalence of fair/poor health by gender was calculated and prevalence ratios (PR, women compared to men) and 95% confidence intervals (CI) were computed. Multilevel robust Poisson regression models were fitted. Women had poorer self-perceived health than men in countries with traditional family policies (PR=1.13, 95%C ...

Categoría:Género
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-07-10

The influence of gender equality policies on gender inequalities in health in Europe

bit.ly/U6cas7

The influence of gender equality policies on gender inequalities in health in Europe Few studies have addressed the effect of gender policies on women’s health and gender inequalities in health. This study aims to analyse the relationship between the orientation of public gender equality policies and gender inequalities in health in European countries, and whether this relationship is mediated by gender equality at country level or by other individual social determinants of health. A multilevel cross-sectional study was performed using individual-level data extracted from the European Social Survey 2010. The study sample consisted of 23,782 men and 28,655 women from 26 European countries. The dependent variable was self-perceived health. Individual independent variables were gender, age, immigrant status, educational level, partner status and employment status. The main contextual independent variable was a modification of Korpi’s typology of family policy models (Dual-earner, Traditional-Central, Traditional-Southern, Market-oriented and Contradictory). Other contextual variables were the Gender Empowerment Measure (GEM), to measure country-level gender equality, and the Gross Domestic Product (GDP). For each country and country typology the prevalence of fair/poor health by gender was calculated and prevalence ratios (PR, women compared to men) and 95% confidence intervals (CI) were computed. Multilevel robust Poisson regression models were fitted. Women had poorer self-perceived health than men in countries with traditional family policies (PR=1.13, 95%C ...

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

The impact of NHS resource allocation policy on health inequalities in England 2001-11: longitudinal ecological study

www.bmj.com

The impact of NHS resource allocation policy on health inequalities in England 2001-11: longitudinal ecological study This longitudinal ecological study investigated whether the policy of increasing National Health Service funding to a greater extent in deprived areas in England compared with more affluent areas led to a reduction in geographical inequalities in mortality amenable to healthcare. Between 2001 and 2011 the increase in NHS resources to deprived areas accounted for a reduction in the gap between deprived and affluent areas in male mortality amenable to healthcare of 35 deaths per 100?000 population and female mortality of 16 deaths per 100?000. This explained 85% of the total reduction of absolute inequality in mortality amenable to healthcare during this time. Each additional £10m of resources allocated to deprived areas was associated with a reduction in 4 deaths in males per 100?000 and 1.8 deaths in females per 100?000. The association between absolute increases in NHS resources and improvements in mortality amenable to healthcare in more affluent areas was not significant.

Categoría:Territorio
TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-07-01

The changing health status of economic migrants in the aftermatth of the economic crisis

jech.bmj.com

Migration flows have changed in the European Union (EU) since the beginning of the worldwide economic crisis in 2008.1Eurostat estimates indicate that net migration (statistically adjusted for total population growth) increased in the region throughout the 1990s and peaked in 2003. Since then, it has declined. During 2011, there were an estimated 1.7 million immigrants to the EU-27 member states from a country outside the region. Additionally, 1.3 million people previously residing in an EU-27 member state migrated to another member state. As a result, 16 out of the EU-27 member states reported more immigration than emigration in 2011, but in 11 out of the 27 member states emigrants outnumbered immigrants. Therefore, in total, compared with 2007, the year just before the economic crash, immigration into EU member states is estimated to have decreased by 6% and emigration to have increased by 13%.In 2012, there were 13.6 million persons living in EU-27 member state with citizenship of another EU-27 member state. The citizenship structure of the population of non-nationals living in the EU varies greatly between member states. It is influenced by factors such as labour migration, historical links between countries of origin and destination and established networks in destination countries. Migrants remain a vulnerable group in many societies because of social exclusion, social isolation and discrimination. Urgent studies are needed to asses these vulnerabilities and to develop ...

Categoría:Etnia
TipoEditores
Publicado en ODS2014-06-26

The fit between health impact assessment and public policy: Practice meets theory

www.sciencedirect.com/science/journal/02779536/108/supp/C

Purpose and setting:The last decade has seen increased use of health impact assessment (HIA) to influence public policies developed outside the Health sector. HIA has developed as a structured, linear and technical process to incorporate health, broadly defined, into policy. This is potentially incongruent with complex, non-linear and tactical policy making which does not necessarily consider health. HIA research has however not incorporated existing public policy theory to explain practitioners' experiences with HIA and policy. This research, therefore, used public policy theory to explain HIA practitioners' experiences and investigate ‘What is the fit between HIA and public policy?’.Methods:Empirical findings from nine in-depth interviews with international HIA practitioners were re-analysed against public policy theory. We reviewed the HIA literature for inclusion of public policy theories then compared these for compatibility with our critical realist methodology and the empirical data. The theory ‘Policy Cycles and Subsystems’ (Howlett et al., 2009) was used to re-analyse the empirical data.Findings:HIAs for policy are necessarily both tactical and technical. Within policy subsystems using HIA to influence public policy requires tactically positioning health as a relevant public policy issue and, to facilitate this, institutional support for collaboration between Public Health and other sectors. HIA fits best within the often non-linear public policy cycle as a policy fo ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2014-06-16

The science of inequality

www.sciencemag.org

This special issue uses these fresh waves of data to explore the origins, impact, and future of inequality around the world. Archaeological and ethnographic data are revealing how inequality got its start in our ancestors . New surveys of emerging economies offer more reliable estimates of people's incomes and how they change as countries develop . And in the past decade in developed capitalist nations, intensive effort and interdisciplinary collaborations have produced large data sets, including the compilation of a century of income data and two centuries of wealth data into the World Top Incomes Database (WTID).

TipoRevistas - texto completo
Publicado en ODS2014-06-02