Neglected housing insecurity and its relationship with renters health: the case of Barcelona,Spain

ObjectiveTo analyze by gender the relationship of forced displacements due to neglected housing insecurity with the physical and mental health of renters in Barcelona in 2019, distinguishing between economic (EHI) and legal (LHI) housing insecurity.MethodWe conducted a cross-sectional study based on the Survey of the Living Conditions of Renters in the Barcelona Metropolitan Area 2019 (1021 women; 584 men). Self-reported health and mental well-being were the dependents variables; the main explanatory variable was neglected housing insecurity. We used adjusted robust Poisson regression models to compare health outcomes among people affected by neglected housing insecurity and those who were not affected.ResultsWe observed that the probability of worse health outcomes are greater in those affected by EHI, followed by those affected by LHI, both compared to those who have not been affected by housing insecurity. This association are mainly observed in mental health of renters affected by EHI, even after adjusting for socioeconomic and other housing variables (in women PR: 1,17, CI95%: 1,03-1,33; in men PR: 1,21, CI95%: 1,01-1,43).ConclusionsNeglected housing insecurity is associated with worse mental health. Enhancing the visibility of neglected housing insecurity and raising awareness of its effects on health is urgently needed to tackle this massive but hidden problem.     

Access to healthcare among Chinese immigrants living in Seville,Spain

ObjectiveTo investigate the use of healthcare services and factors associated with accessing them among Chinese immigrants living in Southern Spain.MethodA mixed methodology was used. A cross-sectional survey was first administered to Chinese immigrants (n = 133), and they were asked about their visits to the doctor, use of emergency services, and hospitalization. A phenomenological approach was then used with key informants (n = 7). In the interviews, additional information, such as barriers and facilitators to improving accessibility, was explored.ResultsIn the previous year, 51% had visited a doctor and 34% had visited an Emergency Department. The main reasons for hospitalization were pregnancy (37.5%) and surgery (25%). At least 20% of the sample reported having never visited a doctor. Language difficulties and time constraints were identified as important barriers to accessibility. Sex differences were found among the reasons for lack of time, which, in men, were related to work (odds ratio [OR] = 7.7) and, in women, were related to childcare (OR = 12). The majority of Chinese immigrants preferred to use Traditional Chinese Medicine as their first treatment rather than visiting a doctor.ConclusionsA lower use of health services was found among Chinese immigrants in Spain compared to the native population. When using health services, they choose acute care settings. Communication and waiting times are highlighted as major barriers. Adapting these demands to the healthcare system may help immigrants to trust their healthcare providers, thus increasing their use of health services and improving their treatment.     

El envase neutro de los productos de tabaco: una nueva estrategia para el control del tabaquismo

There is evidence that global tobacco smoking control policies contribute to decrease the prevalence of smoking among populations, so there is a need to effectively implement different measures in a coordinated way. The plain packaging and labelling of tobacco products is one of the measures proposed by the World Health Organisation Framework Convention on Tobacco Control. At the moment, leading countries are implementing this tobacco control measure, which involves a plain packaging for all tobacco products, i.e., the absence of any promotional or communication tool in the packaging, except the name of the brand, appearing with a standardised font, size, colour and placing in the pack. Australia was the first country to implement this measure in 2012 and recently other countries are legislating and approving it. In Spain, tobacco legislation (2005 and 2010), was an important advance in tobacco control policies. The introduction of plain packaging in Spain would mean the next step in the development of a global strategy for fighting this significant health problem. The aim of this article is to synthesise in a structured manner the role that the packaging of tobacco products has within marketing and communication strategies, as well as to describe the potential effects that the plain packaging has on some aspects of smoking behaviour, according to current literature.     

Salutogenic interventions and health effects: a scoping review of the literature

ObjectiveTo explore the typology of implemented salutogenic interventions and the health effects described by the authors.MethodA scoping review of the literature published (PubMed, Embase, Web of Science and Scopus) over the last ten years (2007-2016) was conducted. Articles that included interventions with assessments of health outcomes were selected for this review. The kappa index (86.4%) was calculated for the classification and extraction of information.Results61 papers were selected out of the 676 works identified. These were categorized into individual, grouped, mixed and intersectoral interventions. A total of 85% of the interventions described positive effects. Adverse effects were not reported. Methodological limitations were identified in 75% of the papers. The interventions addressed a large variety of topics, especially in the field of mental health and chronic diseases. Collective actions described more positive effects. Intersectoral actions were the only type of interventions to have approached the impact of mortality reduction.ConclusionsFindings support the existence of positive health effects of salutogenic approaches. Important methodological limitations were identified, such as biases in the selection of participants and sample sizes. Studies need to be conducted with improved monitoring and evaluation designs. A more robust theoretical framework and tools to evaluate the salutogenic contents are needed.     

Explaining differences in perceived health-related quality of life: a study within the Spanish population

Objective

To assess the burden of several determinants on health-related quality of life (HRQOL) and to study its heterogeneity among the different Spanish regions.

Neighbourhood income inequalities in mental health in Barcelona 2001-2016: a Bayesian smoothed estimate

ObjectiveObtaining reliable health estimates at the small area level (such as neighbourhoods) using survey data usually poses the problem of small sample sizes. To overcome this limitation, we explored smoothing techniques in order to estimate poor mental health prevalence at the neighbourhood level and analyse its profile by income in Barcelona city (Spain).MethodA Bayesian smoothing model with a logit-normal transformation was applied to four repeated cross-sectional waves of the Barcelona health survey for 2001, 2006, 2011 and 2016. Mental health status was identified from the 12-item General Health Questionnaire. Income inequalities were analysed with neighbourhood income in quantiles for each year and trends in the pooled analysis.ResultsThe prevalence of poor mental health ranged from 14.6% in 2001 to 18.9% in 2016. The yearly difference between neighbourhoods was 12.4% in 2001, 16.7% in 2006, 14.2% in 2011, and 20.0% in 2016. The odds ratio and 95% credible interval (95%CI) of experiencing poor mental health was 1.40 times higher (95%CI: 1.02-1.91) in less advantaged neighbourhoods than in more advantaged neighbourhoods in 2001, 1.61 times higher (95%CI: 1.01-2.59) in 2006 and 2.31 times higher (95%CI: 1.57-3.40) in 2016.ConclusionsThis study shows that the Bayesian smoothed techniques allows detection of inequalities in health in neighbourhoods and monitoring of interventions against them. In Barcelona, mental health problems are more prevalent in low-income neighbourhoods and raised in 2016.     

Time trends in health inequalities due to care in the context of the Spanish Dependency Law

Objective

In Spain, responsibility for care of old people and those in situations of dependency is assumed by families, and has an unequal social distribution according to gender and socioeconomic level. This responsibility has negative health effects on the carer. In 2006, the Dependency Law recognised the obligation of the State to provide support. This study analyses time trends in health inequalities attributable to caregiving under this new law.

Inequalities in mental health in the working population of Spain: a National Health Survey-based study

ObjectiveIn the working population, poor mental health is a significant problem whose prevalence rates and associated factors could differ by gender, especially in a period of socioeconomic changes. The aims of this study were: a) to determine the prevalence of poor mental health in the working population of Spain in 2011; b) to identify the association of this prevalence with socioeconomic and work-related variables for men and women separately; c) to determine if the patterns differ by gender.MethodsA cross-sectional study was conducted with data from the National Health Survey of Spain (2011). Of the 21,007 participants in the survey, we selected 7396 whose employment status was described as “working” The General Health Questionnaire (GHQ-12) was used as a screening tool to detect poor mental health. Prevalences were calculated and bivariate and multivariate logistic regression models were fitted to verify the association between variables.ResultsThe prevalence of poor mental health was higher among women (19.9%) than men (13.9%), the overall prevalence being 16.8%. The variables associated with a higher prevalence were type of contract and work-related variables in men, and age and socioeconomic variables in women.ConclusionsThis study shows that, in the working population of Spain, the prevalence of poor mental health and its related factors differ by gender. Poor mental health is mainly related to socioeconomic variables in women but is mostly associated with work-related variables in men.