[Health vulnerability mapping in the Community of Madrid (Spain)]. / Implementación del mapa de la vulnerabilidad en salud en la Comunidad de Madrid.

The Public Health General Directorate of Madrid has developed a health vulnerability mapping methodology to assist regional social health teams in health planning, prioritisation and intervention based on a model of social determinants of health and an equity approach. This process began with the selection of areas with the worst social indicators in health vulnerability. Then, key stakeholders of the region jointly identified priority areas of intervention and developed a consensual plan of action. We present the outcomes of this experience and its connection with theoretical models of asset-based community development, health-integrated georeferencing systems and community health interventions.

[Health and its determinants in the immigrant population of the region of Madrid]. / La salud y sus determinantes en la población inmigrante de la Comunidad de Madrid.

OBJECTIVES: To describe health status and its determinants in immigrants living in the region of Madrid and to compare these factors with those in the native-born population. MATERIAL AND METHODS: We performed a descriptive, cross-sectional study based on data from the Madrid Regional Health Survey 2007 (n=12,190). Subjects were classified as native-born or immigrants born in medium-to-low-income countries and with less or more than 5 years of residence in Spain. The results were adjusted for age. Proportions and means were compared through the ji square test and linear regression. RESULTS: Compared with native-born residents, immigrants were younger, carried out mainly precarious manual jobs that did not match their educational level and had a lower income and less space in their dwellings. Both immigrant men and women smoked and drank less, but women showed a higher prevalence of overweight (10% more) and physical inactivity. Adherence to smear test and blood pressure screening was up to a 16% lower. Attendance at primary care and emergency facilities was less frequent in men and women with less residence time than in those with longer residence in Spain. Self-perceived health and mental health were worse in women with 5 or more years of residence. Chronic diseases were similar in both populations but were less prevalent in immigrants. CONCLUSIONS: Immigrants' health status is not as unfavorable as could be expected from the higher prevalence of harmful determinants of health.