[Cognitive, ethical, social and political aspects in risk assessment: regarding vaccines against SARS-CoV-2]. / Aspectos cognitivos, éticos, sociales y políticos en la evaluación de riesgos: a propósito de las vacunas contra el SARS-CoV-2.

Risk is a concept that is usually evaluated by scientists and public health experts by comparing probabilities. However, this ethical utilitarian perspective, which considers that the best decision is the one that has less probability of harm than of benefit, does not consider normative aspects based on other ethical perspectives. Interpreting the origin of public controversies arising from people's reactions to the small risks of attenuated SARS-CoV-2 vaccines and evaluating the responses of public institutions requires an understanding of both the cognitive aspects that introduce systematic biases in the assessment of probabilities and the sociological, ethical, and political framework that contextualizes risk management in modern societies.

[Impact of the Dependency Act on regional spending on social services]. / Impacto de la Ley de Dependencia sobre el gasto autonómico en servicios sociales.

OBJECTIVE: In this paper we address whether the System for Personal Autonomy and Care of Dependent Persons contributes to increasing the volume of resources of the public social services system (displacement effect) or, on the contrary, whether this development has taken place at the expense of other social services (substitution effect). METHOD: Panel data analysis is used to explain how per capita expenditure on social services evolves in the Spanish Regions under the common regime in the period 2002-2016. RESULTS: The implementation of the Dependency Act is associated with a 14% increase in the level of per capita expenditure on social services. This effect raises 25% when the variable explained is expenditure on current transfers of a social nature. On the other hand, law changes introduced in 2012 and 2013 were associated with a reduction in per capita expenditure on current transfers of around 10%. CONCLUSIONS: This evidence would refute the hypothesis that the System for Personal Autonomy and Care of Dependent Persons had merely a "substitution" effect on autonomous spending on social services.

[Behavioral economics to improve lifestyle choices and to reduce risk factors]. / Economía del comportamiento para mejorar estilos de vida y reducir factores de riesgo.

A large part of morbimortality is caused by lifestyle habits and modifiable risk factors. A promising strategy to promote the change of such factors is the implementation of public health interventions based on behavioral economics, a discipline that combines psychological and economic principles. In the present article, we focus on a type of intervention known as "nudge" (that has been translated into Spanish as empujón or acicate), that changes behaviour without limiting the individual's choice. We analyze the properties that characterize nudges, and several areas in which they have been successfully implemented: vaccination, nutrition, physical activity, smoking cessation and drug prescription. We conclude that behavioural economics and nudges have great potential for their implementation in the public health sphere in Spain.

Economic evaluation of colorectal cancer (CRC) screening.

Because of its incidence and mortality colorectal cancer represents a serious public health issue in industrial countries. In order to reduce its social impact a number of screening strategies have been implemented, which allow an early diagnosis and treatment. These basically include faecal tests and studies that directly explore the colon and rectum. No strategy, whether alone or combined, has proven definitively more effective than the rest, but any such strategy is better than no screening at all. Selecting the most efficient strategy for inclusion in a population-wide program is an uncertain choice. Here we review the evidence available on the various economic evaluations, and conclude that no single method has been clearly identified as most cost-effective; further research in this setting is needed once common economic evaluation standards are established in order to alleviate the methodological heterogeneity prevailing in study results.