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Desigualdades en salud mental en población trabajadora de España: un estudio basado en la Encuesta Nacional de Salud

Desigualdades en salud mental en población trabajadora de España: un estudio basado en la Encuesta Nacional de Salud Objetivo:En población trabajadora, los problemas de salud mental son un problema significativo cuya prevalencia y factores asociados pueden diferir según el sexo, en especial durante un periodo de cambios socioeconómicos. Los objetivos de este estudio son: a) conocer la prevalencia de problemas de salud mental en población trabajadora de España en 2011; b) evaluar la asociación de esta prevalencia con variables socioeconómicas y laborales para hombres y mujeres por separado; c) determinar si los patrones difieren por sexos. Métodos:Estudio transversal con datos de la Encuesta Nacional de Salud de España (2011). De los 21.007 participantes en la encuesta, se seleccionaron 7396 cuya situación laboral era "trabajando". Se utilizón el General Health Questionnaire (GHQ-12) como herramienta de cribado para detectar problemas de salud mental. Se calcularon las prevalencias y se realizaron modelos bivariados y multivariados de regresión logísstica para comprobar la asociación entre variables. Resultados:La prevalencia de problemas de salud mental fue mayor entre las mujeres (19,9%) que entre los hombres (13,9%), con una prevalencia global del 16,8%. Las variables asociadas a una mayor prevalencia fueron el tipo de contrato y las relacionadas con el empleo remunerado entre hombres, y la edad y las variables socioeconómicas en las mujeres Conclusiones:En población trabajadora de España, la prevalencia de problemas de salud mental y sus factores relacionados difieren en función del s ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-04-11

Lone parents, health, wellbeing and welfare to work: a systematic review of qualitative studies

Lone parents, health, wellbeing and welfare to work: a systematic review of qualitative studies Background: Lone parents and their children experience higher than average levels of adverse health and social outcomes, much of which are explained by high rates of poverty. Many high income countries have attempted to address high poverty rates by introducing employment requirements for lone parents in receipt of welfare benefits. However, there is evidence that employment may not reduce poverty or improve the health of lone parents and their children. Methods: We conducted a systematic review of qualitative studies reporting lone parents’ accounts of participation in welfare to work (WtW), to identify explanations and possible mechanisms for the impacts of WtW on health and wellbeing. Twenty one bibliographic databases were searched. Two reviewers independently screened references and assessed study quality. Studies from any high income country that met the criteria of focussing on lone parents, mandatory WtW interventions, and health or wellbeing were included. Thematic synthesis was used to investigate analytic themes between studies. Results: Screening of the 4703 identified papers and quality assessment resulted in the inclusion of 16 qualitative studies of WtW in five high income countries, USA, Canada, UK, Australia, and New Zealand, covering a variety of welfare regimes. Our synthesis found that WtW requirements often conflicted with child care responsibilities. Available employment was often poorly paid and precarious. Adverse health impacts, such as increa ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-03-04

Access to health services by lesbian, gay, bisexual and transgender persons: systematic literature review

Access to health services by lesbian, gay, bisexual and transgender persons: systematic literature review Background:The relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services. Method:A systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 2004 to 2014. The studies were evaluated according to predefined inclusion and exclusion criterias. Were included manuscripts written in English or Portuguese, articles examining the Lesbian, Gay, Bisexual, and Transgender population’s access to health services and original articles with full text available online. Results:The electronic databases search resulted in 667 studies, of which 14 met all inclusion criteria. Quantitative articles were predominant, showing the country of United States of America to be the largest producer of research on the topic. The studies reveal that the homosexual population have difficulties of access to health services as a result of heteronormative attitudes imposed by health professionals. The discriminatory attendance implies in human rights violations in access to health services. Conclusions:The non-heterosexual orientation was a determinant factor in the difficulties of accessing health care. A lot must still be achieved to ensure access to hea ...

Publicado en ODS2016-02-24

Factors Associated With Women’s Reporting of Intimate Partner Violence in Spain

In Spain, in 2013, the 20% of women who were murdered by their partner had reported him previously. We analyze the 2011 Spanish-Macrosurvey on Gender Violence to identify and analyze the prevalence of and the principal factors associated with reporting a situation of intimate partner violence (IPV) and the main reasons women cite for not filing such reports, or for subsequently deciding to withdraw their complaint. Overall, 72.8% of women exposed to IPV did not report their aggressor. The most frequent reasons for not reporting were not giving importance to the situation (33.9%), and fear and lack of trust in the reporting process (21.3%). The main reasons for withdrawing the complaint were cessation of the violence (20.0%), and fear and threats (18.2%). The probability of reporting increased among women with young children who were abused, prevalence ratio (95% confidence interval [CI]): 2.14 [1.54, 2.98], and those whose mother was abused, prevalence ratio (95% CI): 2.25 [1.42, 3.57]. Always focusing on the need to protect women who report abuse, it is necessary to promote the availability of and access to legal resources especially among women who use them less: women who do not have children and women who do not have previous family exposure to violence.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2016-02-17

Families in the economic crisis: Changes in policy measures in the EU

Families in the economic crisis: Changes in policy measures in the EU This report describes the situation and experience of families during the economic crisis and examines how family-focused policies have changed since 2010. In some countries, benefits have been reduced, affecting disadvantaged families disproportionately. Other countries have introduced new measures to help those families worst affected by the economic crisis. This report also looks at the social situation of different types of families with dependent children and examines what kind of responses can help mitigate the effect of the crisis on disadvantaged families. It focuses on in-depth analyses of developments in 10 EU Member States.

TipoComunicaciones/Informes/Artículos (colecciones)
Publicado en ODS2016-02-02

Did Equity of Reproductive and Maternal Health Service Coverage Increase during the MDG Era?

Introduction: Despite widespread gains toward the 5th Millennium Development Goal (MDG), pro-rich inequalities in reproductive health (RH) and maternal health (MH) are pervasive throughout the world. As countries enter the post-MDG era and strive toward UHC, it will be important to monitor the extent to which countries are achieving equity of RH and MH service coverage. This study explores how equity of service coverage differs across countries, and explores what policy factors are associated with a country's progress, or lack thereof, toward more equitable RH and MH service coverage. Methods: We used RH and MH service coverage data from Demographic and Health Surveys (DHS) for 74 countries to examine trends in equity between countries and over time from 1990 to 2014. We examined trends in both relative and absolute equity, and measured relative equity using a concentration index of coverage data grouped by wealth quintile. Through multivariate analysis we examined the relative importance of policy factors, such as political commitment to health, governance, and the level of prepayment, in determining countries progress toward greater equity in RH and MH service coverage. Results: Relative equity for the coverage of RH and MH services has continually increased across all countries over the past quarter century; however, inequities in coverage persist, in some countries more than others. Multivariate analysis shows that higher education and greater political commitment (measur ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-09-13

Gender differences in psychotropic use across Europe: results from a large cross-sectional population-based study

Background:In many epidemiological studies, women have been observed to consume psychotropic medication more often than men. However, the consistency of this relationship across Europe, with differences in mental health care (MHC) resources and reimbursement policies, is unknown. Methods:Questions on 12-month psychotropic use (antidepressants, benzodiazepines, antipsychotics, mood stabilizers) were asked to 34,204 respondents from 10 European countries of the EU-World Mental Health surveys. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria were used to determine 12-month prevalence of mood/anxiety disorders using the Composite International Diagnostic Interview (v3.0). Results:For all participating countries, women were significantly more likely than men to use psychotropic medication within the previous 12 months (overall-OR?=?2.04, 95% CI: 1.81–2.31). This relationship remained significant after adjusting for common sociodemographic factors (age, income level, employment status, education, marital status) and country-level indicators (MHC provision, private household out-of-pocket expenditure, and Gender Gap Index). In multivariable gender-stratified risk-factor analysis, both women and men were more likely to have taken psychotropic medication with increasing age, decreasing income level, and mental health care use within the past 12 months, with no significant differences between genders. When only including participants with a mental ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-07-27

Explicaciones de las prácticas sexuales de riesgo en hombres que tienen sexo con hombres

Explicaciones de las prácticas sexuales de riesgo en hombres que tienen sexo con hombres Objetivo:Conocer las explicaciones sobre prácticas sexuales de riesgo, la percepción del virus de la inmunodeficiencia humana (VIH) y propuestas de intervención para prevenir infecciones por VIH en un grupo de hombres que tienen sexo con hombres. Métodos:Estudio cualitativo con una muestra de 13 hombres que tenían sexo con hombres, participantes de una cohorte de VIH seronegativos contactados en saunas gay de Barcelona. Se realizaron entrevistas en profundidad semiestructuradas y un posterior análisis de contenido temático. Resultados:Las prácticas sexuales de riesgo se atribuyeron a una masculinidad asociada a una alta necesidad sexual, a determinados lugares de intercambio sexual (como saunas, fiestas privadas y clubs), al consumo de drogas y al deseo de experimentar con el riesgo y la propia sexualidad. La infección por VIH se percibía como una enfermedad normalizada, aunque contraerla se asociaba a vergüenza y culpa. Entre las propuestas de intervención se encontraban: concienciar sobre lo que significa vivir con el VIH, generar más alarma social, incorporar las nuevas tecnologías en la prevención y aumentar las acciones en lugares de encuentro gay. Conclusiones:El concepto de la masculinidad desempeña un papel fundamental en las prácticas sexuales entre los hombres que tienen sexo con hombres. Se sugiere innovar en los programas preventivos e incorporar la percepción de riesgo y la infección por el VIH desde una perspectiva de género.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-07-23

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

Elderly women living alone: an update of their living conditions

Elderly women living alone: an update of their living conditions Upon request by the FEMM Committee, this study presents recent changes in the living conditions of elderly women living alone with a focus on the effects of recent pension reforms and active ageing policies. The study is largely based on a literature review and a desk analysis of the micro-data and information available at the European level, as well as a qualitative analysis of good practices in active ageing introduced in recent years in six countries selected as representative of European welfare systems.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-30

Developing a programme theory to explain how primary health care teams learn to respond to intimate partner violence: a realist case-study

Background: Despite the progress made on policies and programmes to strengthen primary health care teams’ response to Intimate Partner Violence, the literature shows that encounters between women exposed to IPV and health-care providers are not always satisfactory, and a number of barriers that prevent individual health-careproviders from responding to IPV have been identified. We carried out a realist case study, for which we developed and tested a programme theory that seeks to explain how, why and under which circumstances a primary health care team in Spain learned to respond to IPV.Methods: A realist case study design was chosen to allow for an in-depth exploration of the linkages between context,intervention, mechanisms and outcomes as they happen in their natural setting. The first author collected data at the primary health care center La Virgen (pseudonym) through the review of documents, observation and interviews withhealth systems’ managers, team members, women patients, and members of external services. The quality of the IPV case management was assessed with the PREMIS tool.Results: This study found that the health care team at La Virgen has managed 1) to engage a number of staff members in actively responding to IPV, 2) to establish good coordination, mutual support and continuous learning processes related to IPV, 3) to establish adequate internal referrals within La Virgen, and 4) to establish goodcoordination and referral systems with other servi ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-22

Achieving gender equality to reduce intimate partner violence against women

This year marks 20 years since 189 countries signed the Beijing Declaration and Platform for Action and committed to prioritisation of women's empowerment and gender equality. Yet a recently released UN analysis1 shows that violence against women persists at “alarmingly high levels”. Worldwide, one in three women reports sexual or physical violence from a male partner at some point in their lifetime, and such experiences have been linked with harmful effects on health, including maternal morbidity, poor mental health, and vulnerability to HIV/AIDS.2 The UN report also contends that progress towards gender equality has been slow.1 Effective and scalable interventions to reduce intimate partner violence remain scarce, and questions remain about what drives individual violence and why prevalence differs across settings and countries.

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-12

Violence against young women attending primary care services in Spain: prevalence and health consequences

Background. There are a significant number of studies assessing the negative health consequences of violence against women. However, a limited number of studies analyse the health consequences of violence committed against young women by different types of aggressors. Objectives. The goal of this study is to assess the prevalence of interpersonal violence against young women in Spain and analyse its impact on the physical and mental health of the victims. Methods. A total of 1076 women aged 18–25 years attending Spanish primary care services were selected. We estimated the prevalence of interpersonal violence and compared the health data and demographic characteristics of abused and non-abused young women, multi-logistic regression models were fitted. The Wald test was used to assess whether there were differences in the negative health consequences of intimate partner (IPV) versus non-IPV. Results. As many as 27.6% young women reported a history of abuse, of whom 42.7% had been assaulted by their partner, 41.1% by someone other than their partner and 16.2% both by their partner and another person. The distribution of social and demographic characteristics was similar for IPV and non-IPV victims. Young abused women were three times more likely to suffer psychological distress and have somatic complaints, and they were four times more likely to use medication as compared to non-abused women. Conclusion. Our results suggest that all forms of violence compromise young women’ ...

TipoComunicaciones/Informes/Artículos (individual)
Publicado en ODS2015-06-04

State of inequality: reproductive, maternal, newborn and child health

State of inequality: reproductive, maternal, newborn and child health The State of inequality: reproductive, maternal, newborn and child health report delivers both promising and disappointing messages about the situation in low- and middle-income countries. On the one hand,within-country inequalities have narrowed, with a tendency for national improvements driven by faster improvements in disadvantaged subgroups. In certain indicators and countries, these improvements have been substantial. On the other hand, however, inequalities still persist in most reproductive, maternal,newborn and child health (RMNCH) indicators. The extent of within-country inequality differed by dimension of inequality and by country, country income group and geographical region. There is still much progress to be made in reducing inequalities in RMNCH.The objective of this report is to showcase best practices in reporting the state of inequality in low- and middle-income countries using high-quality data, sound and transparent analysis methods, and user-oriented, comprehensive reporting.

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