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

Objective To explore the typology of implemented salutogenic interventions and the health effects described by the authors. Method A 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. Results 61 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. Conclusions Findings 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

Advancing gender equ(al)ity, lifting mens health: Dealing with the spirit of our time

In this paper, we jointly address two connected issues that should be addressed together more purposefully within both public health policies and programmes: The health and well-being of men and boys, and the focus on equity versus equality from a gender perspective. Awareness of these issues has boosted the debate on the impacts of gender inequality on health and mens role within it. Although this essay is not intended as an in-depth review on the subject, we provide a brief approach to some critical factors interwoven in the process of achieving greater gender equality. We identify some of the challenges that may arise for both policy and new research that seek to assume a relational gender approach that also pays greater attention to mens health

Socioeconomic patterns in the use of public and private health services and equity in health care

<p>Abstract</p> <p>Background</p> <p>Several studies in wealthy countries suggest that utilization of GP and hospital services, after adjusting for health care need, is equitable or pro-poor, whereas specialist care tends to favour the better off. Horizontal equity in these studies has not been evaluated appropriately, since the use of healthcare services is analysed without distinguishing between public and private services. The purpose of this study is to estimate the relation between socioeconomic position and health services use to determine whether the findings are compatible with the attainment of horizontal equity: equal use of public healthcare services for equal need.</p> <p>Methods</p> <p>Data from a sample of 18,837 Spanish subjects were analysed to calculate the percentage of use of public and private general practitioner (GP), specialist and hospital care according to three indicators of socioeconomic position: educational level, social class and income. The percentage ratio was used to estimate the magnitude of the relation between each measure of socioeconomic position and the use of each health service.</p> <p>Results</p> <p>After adjusting for age, sex and number of chronic diseases, a gradient was observed in the magnitude of the percentage ratio for public GP visits and hospitalisation: persons in the lowest socioeconomic position were 61–88% more likely to visit public GPs and 39–57% more likely to use public hospitalisation than those in the highest socioeconomic position. In general, the percentage ratio did not show significant socioeconomic differences in the use of public sector specialists. The magnitude of the percentage ratio in the use of the three private services also showed a socioeconomic gradient, but in exactly the opposite direction of the gradient observed in the public services.</p> <p>Conclusion</p> <p>These findings show inequity in GP visits and hospitalisations, favouring the lower socioeconomic groups, and equity in the use of the specialist physician. These inequities could represent an overuse of public healthcare services or could be due to the fact that persons in high socioeconomic positions choose to use private health services.</p

Smoking among pregnant women in Cantabria (Spain): trend and determinants of smoking cessation

<p>Abstract</p> <p>Background</p> <p>Cantabria (Spain) has one of the highest prevalence of smoking among women of the European Union. The objectives are to assess the trend of smoking during pregnancy in a five-year period and the determinants of smoking cessation during pregnancy in Cantabria.</p> <p>Methods</p> <p>A 1/6 random sample of all women delivering at the reference hospital of the region for the period 1998–2002 was drawn, 1559 women. Information was obtained from personal interview, clinical chart, and prenatal care records. In the analysis relative risks and 95% confidence intervals were estimated. Multivariable analysis was carried out using stepwise logistic regression.</p> <p>Results</p> <p>Smoking prior to pregnancy decreased from 53.6% in 1998 to 39.4% in 2002. A decrease in smoking cessation among women smoking at the beginning of pregnancy was observed, from 37.3% in 1998 to 20.6% in 2002. The mean number of cigarettes/day (cig/d) before pregnancy remained constant, around 16 cig/d, whereas a slight trend to increase over time was seen, from 7.7 to 8.9 cig/d. In univariate analysis two variables favoured significantly smoking cessation, although they were not included in the stepwise logistic regression analysis, a higher education level and to be married. The logistic regression model included five significant predictors (also significant in univariate analysis): intensity of smoking, number of previous pregnancies, partner's smoking status, calendar year of study period (these four variables favoured smoking continuation), and adequate prenatal care (which increased smoking cessation).</p> <p>Conclusion</p> <p>The frequency of smoking among pregnant women is very high in Cantabria. As smoking cessation rate has decreased over time, a change in prenatal care programme on smoking counseling is needed. Several determinants of smoking cessation, such as smoking before pregnancy and partner's smoking, should be also addressed by community programmes.</p

Cancer mortality by educational level in the city of Barcelona

The objective of this study was to examine the relationship between educational level and mortality from cancer in the city of Barcelona. The data were derived from a record linkage between the Barcelona Mortality Registry and the Municipal Census. The relative risks (RR) of death and 95% confidence intervals (CIs) according to level of education were derived from Poisson regression models. For all malignancies, men in the lowest educational level had a RR of death of 1.21 (95% CI 1.13–1.29) compared with men with a university degree, whereas for women a significant decreasing in risk was observed (RR 0.81; 95% CI 0.74–0.90). Among men, significant negative trends of increasing risk according to level of education were present for cancer of the mouth and pharynx (RR 1.70 for lowest vs. highest level of education), oesophagus (RR 2.14), stomach (RR 1.99), larynx (RR 2.56) and lung (RR 1.35). Among women, cervical cancer was negatively related to education (RR 2.62), whereas a positive trend was present for cancers of the colon (RR 0.76), pancreas (RR 0.59), lung (RR 0.55) and breast (RR 0.65). The present study confirms for the first time, at an individual level, the existence of socioeconomic differences in mortality for several cancer sites in Barcelona, Spain. There is a need to implement health programmes and public health policies to reduce these inequities. © 1999 Cancer Research Campaig