Determinantes socioeconómicos de la salud en Andalucía: estudio comparado del impacto de la crisis económica en la salud de los andaluces (Proyecto IMPACT-A)

Los estudios sobre determinantes socioeconómicos de la salud se han centrado fundamentalmente en el análisis de los factores de carácter económico, es decir, en las diferencias de salud generadas por los ingresos. Sin embargo, la relación entre los ingresos y las desigualdades de salud parece ser algo más compleja. Como se ha puesto de manifiesto en recientes estudios, la inclusión de los ingresos como factor explicativo de las desigualdades de salud, aunque resulta necesaria, no es suficiente para entender la diversidad y la complejidad de otras dimensiones sociales como la educación o la clase social, que resultan igualmente relevantes en la explicación de estas desigualdades. En línea con este conjunto de consideraciones, el objetivo del presente trabajo se dirige a comparar el impacto de diferentes medidas del estatus socioeconómico (educación, clase social, ocupación e ingresos) sobre la salud auto-percibida (self-rated health - SRH) en las diferentes Comunidades Autónomas españolas, a partir de datos de los Barómetros Sanitarios del Centro de Investigaciones Sociológicas. Adicionalmente, se estudia el efecto contextual de indicadores macroeconómicos, de servicios sanitarios, y calidad de vida mediante el diseño de diferentes modelos de regresión logística ordinal multinivel. Los datos del presente trabajo revelan que, a pesar de que España es un país que goza de una auto-percepción de la salud positiva, se observan desigualdades en la salud a nivel interregional. Si bien en nuestro país no existen grandes diferencias en la salud, los datos ponen de manifiesto que factores socioeconómicos como los ingresos, clase social, la ocupación o la educación pueden tener un importante impacto sobre la salud de los grupos en riesgo de exclusión social. En el nivel contextual, el riesgo de pobreza y el desempleo se encuentran negativamente relacionados con la auto-percepción de la salud de los españoles. Unos resultados que tienen implicaciones muy claras en el reciente contexto de crisis económica. El presente análisis aporta claros indicios de la importancia de tener unas condiciones vitales dignas para poder mantener la salud. Sin lugar a dudas vivir en la pobreza o en una condición de riesgo de caer en un estado de privación material, aumenta la probabilidad de tener una mala salud, y esta misma relación se aplica a la falta de trabajo. En este sentido, es necesario considerar el impacto socioeconómico de la actual crisis económica y los actuales recortes del gasto público en la salud de los grupos más desfavorecidos de nuestra sociedad

Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of the health services and mortality (DESVELA cohort): qualitative study protocol for a prospective cohort study in a hybrid analysis

IntroductionMaintaining or acquiring healthier health-oriented behaviours and promoting physical and mental health amongst the Spanish population is a significant challenge for Primary Health Care. Although the role of personal aptitudes (characteristics of each individual) in influencing health behaviours is not yet clear, these factors, in conjunction with social determinants such as gender and social class, can create axes of social inequity that affect individuals’ opportunities to engage in health-oriented behaviours. Additionally, lack of access to health-related resources and opportunities can further exacerbate the issue for individuals with healthy personal aptitudes. Therefore, it is crucial to investigate the relationship between personal aptitudes and health behaviours, as well as their impact on health equity.ObjectivesThis paper outlines the development, design and rationale of a descriptive qualitative study that explores in a novel way the views and experiences on the relationship between personal aptitudes (activation, health literacy and personality traits) and their perception of health, health-oriented behaviours, quality of life and current health status.Method and analysisThis qualitative research is carried out from a phenomenological perspective. Participants will be between 35 and 74 years of age, will be recruited in Primary Health Care Centres throughout Spain from a more extensive study called DESVELA Cohort. Theoretical sampling will be carried out. Data will be collected through video and audio recording of 16 focus groups in total, which are planned to be held in 8 different Autonomous Communities, and finally transcribed for a triangulated thematic analysis supported by the Atlas-ti program.DiscussionWe consider it essential to understand the interaction between health-related behaviours as predictors of lifestyles in the population, so this study will delve into a subset of issues related to personality traits, activation and health literacy.Clinical trial registration: ClinicalTrials.gov, identifier NCT04386135

Global prevalence of perinatal depression and anxiety during the COVID-19 pandemic: An umbrella review and meta-analytic synthesis

Introduction: The prevalence of depression and anxiety symptoms in pregnant and post-partum women during the COVID- 19 pandemic was assessed by several systematic reviews (SRs) and meta- analyses which provided contrasting and different results. We aimed to summarize the evidence relating to the global prevalence of anxiety and depres-sion among pregnant and postpartum women during the COVID- 19 pandemic.Material and methods: An umbrella review of SRs and meta-analyses was performed. Searches were conducted in electronic databases up to April 2023. SRs and meta- analyses reporting the prevalence of perinatal anxiety and depression during the COVID-19 pandemic were selected for eligibility. Primary studies extracted from eli-gible meta-analyses were included in the quantitative synthesis. The research proto-col was registered on PROSPERO (CRD42020173125).Results: A total of 25 SRs (198 primary studies) and 12 meta- analyses (129 primary studies) were included in the qualitative and quantitative synthesis, respectively. Studies involved data from five continents and 45 countries. The pooled prevalence of antenatal and postpartum depression was 29% (n= 55; 95% CI: 25%–33%) and 26% (n= 54; 95% CI: 23%–30%), respectively. In the case of anxiety, the pooled antenatal and postnatal prevalence was 31% (n= 44; 95% CI: 26%–37%; n= 16; 95% CI: 24%–39%). Differences emerged between continents, with Africa having the highest prevalence of perinatal depression and Oceania and Europe having the highest prevalence of antenatal and postnatal anxiety. The prevalence also varied depending on the assessment tools, espe-cially for antenatal anxiety. A medium- high quality of the studies was observed. One SR assessed strength- of- evidence, reporting very low strength.Conclusions: During the COVID-19 pandemic, depression and anxiety were common, affecting almost one in three perinatal women globally. A high heterogeneity and a risk of publication bias were found, partially due to the variety of assessment tools and cut-offs. The results may not be generalized to minorities. Studies on the preva-lence of clinical diagnoses are needed. Based on our results it is not possible to firmly affirm that the COVID-19 pandemic was the main factor that directly increased peri-natal depression and anxiety during the past few years. Future studies should study other factors' impact

Understanding and treating body image disturbances in eating disorders through body illusion interventions: a scoping review protocol

Background We plan a scoping review aimed to synthesize what is known about the use of sensory-driven body illusion (BI) interventions for understanding and treating body image disturbance (BID) in people diagnosed with clinical eating disorders (EDs) and people with subclinical ED symptomatology. Our study will provide an outline of the current literature, identify gaps within the literature, and suggest novel directions for future research. Methods/design The scoping review process will be guided by the methodological framework of Arksey and O’Malley, subsequent recommendations by Levac et al., and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched: MEDLINE (via PubMed), Web of Science, PsycINFO, and Scopus. Furthermore, to identify additional studies, we will use a search engine such as Google Scholar, and for grey literature, we will include Proquest for Dissertations and Theses. A search strategy has been identified and agreed upon by the research team in conjunction with a research librarian. Two researchers will screen the titles and abstracts independently and then assess the full text of the selected citations for the inclusion criteria. A third reviewer will be involved in cases of disagreement. Data will be extracted, collated, and charted to summarize all the relevant methods, outcomes, and key findings in the articles. Discussion A better understanding of this topic will aid in the development and refinement of current treatments aimed at treating BID in people with EDs. Implications and recommendations for research, policy, and practice in the context of the ED community will be discussed