Effect of COVID-19 prevention as part of an urban renewal programme.

OBJECTIVES: To address existing inequalities, the Barcelona City Council launched a Neighbourhood Plan in 2016-2020. During the first wave of the COVID-19 pandemic, the Neighbourhood Plan interventions were intensified. This study aimed to assess the effect of the plan on the incidence of COVID-19 during the first wave of the pandemic in Barcelona. STUDY DESIGN: We used a quasi-experimental design with 16 intervention neighbourhoods and 17 neighbourhoods in the comparison group with similar socioeconomic characteristics. METHODS: We calculated the cumulative incidence rate (CIR) of COVID-19 per 100,000 inhabitants by sex, age groups, and neighbourhood of residence. Poisson regression models were fitted to estimate the crude relative risk and relative risk adjusted by socioeconomic status (cRR and aRR) and their 95% confidence intervals (CIs). RESULTS: The CIR of COVID-19 was lower in the intervention neighbourhoods (CIR: 841 per 100,000 inhabitants) than in the comparison group (CIR: 973 per 100,000 inhabitants). On multivariate analysis, the aRR was 0.77 (CI: 0.70-0.83) for men and 0.89 (CI: 0.83-0.96) for women. Among men older than 75 years (aRR = 0.73; CI: 0.62-0.86), statistically significant differences were found in the intervention neighbourhoods compared to the comparison group. This pattern was not observed in women older than 75 years (aRR = 1.13; CI: 0.99-1.30). CONCLUSION: This research finds positive short-term effect in the intervention neighbourhoods. We conclude that the COVID-19 control and prevention interventions are likely to explain the better performance in the neighbourhoods included in the Neighbourhood Plan.

Personal and psychosocial predictors of psychological abuse by partners during and after pregnancy: a longitudinal cohort study in a community sample.

OBJECTIVE: To describe the incidence and risk factors of psychological intimate partner violence (IPV) during pregnancy and the first year after childbirth. DESIGN: Longitudinal cohort study. SETTING: Nine primary care centers in the Valencia Region (Spain). POPULATION: A consecutive sample of 1400 women in the first trimester of pregnancy, attending the prenatal programme in the Valencia Region of Spain in 2008, with follow-up in the third trimester of pregnancy, and at 5 and 12 months postpartum. A total of 888 women (66.5%) participated in all four phases. METHODS: A logistic regression model was fitted using generalised estimating equations to assess the effects of previous partner violence, consumption of alcohol or illicit drugs and social support on subsequent psychological partner violence. MAIN OUTCOME MEASURE: Psychological IPV during follow-up. RESULTS: We observed an increase in the incidence of psychological IPV after birth, particularly at 5 months postpartum. The strongest predictor of psychological IPV was having experienced abuse 12 months before pregnancy (OR 10.46, 95%CI 2.40-45.61). Other predictors were consumption of alcohol or illicit drugs by the partner or a family member (OR3.50, 95%CI 1.38-8.85) and lack of affective social support (OR2.83, 95%CI 1.31-6.11). CONCLUSIONS: Previous abuse and psychosocial risk factors predict partner psychological abuse after birth. Monitoring psychological IPV and effective interventions are needed not only during pregnancy but also during the postpartum period.

Understanding the relationship of long working hours with health status and health-related behaviours.

BACKGROUND: The objectives of this study are to identify family and job characteristics associated with long work hours, to analyse the relationship between long work hours and several health indicators, and to examine whether gender differences for both objectives exist. METHODS: The sample was composed of all salaried workers aged 16-64 years (3950 men and 3153 women) interviewed in the 2006 Catalonian Health Survey. Weekly work hours were categorised as less than 30 h (part-time), 30-40 (reference category), 41-50 and 51-60 h. Multiple logistic regression models separated by sex were fitted. RESULTS: Factors associated with long working hours differed by gender. Among men, extended work hours were related with being married or cohabiting and with being separated or divorced. In men, working 51-60 h a week was consistently associated with poor mental health status (aOR 2.06, 95% CI 1.31 to 3.24), self-reported hypertension (aOR 1.60, 95% CI 1.12 to 2.29), job dissatisfaction (aOR 2.05, 95% CI 1.49 to 2.82), smoking (aOR 1.33, 95% CI 1.03 to 1.72), shortage of sleep (aOR 1.42, 95% CI 1.09 to 1.85) and no leisure-time physical activity (aOR 2.43, 95% CI 1.64 to 3.60). Moreover, a gradient from standard working hours to 51-60 h a week was found for these six outcomes. Among women it was only related to smoking and to shortage of sleep. CONCLUSION: The association of overtime with different health indicators among men could be explained by their role as the family breadwinner: in situations of family financial stress men work overtime in order to increase the income and/or accept poor working conditions for fear of job loss, one of them being long working hours.

Health inequalities among the elderly in western Europe.

BACKGROUND: This paper analyses gender inequalities in health status and in social determinants of health among the elderly in western Europe. METHODS: Data came from the first wave of the "Survey of Health, Ageing and Retirement in Europe" (2004). For the purposes of this study a subsample of community-residing people aged 65-85 years with no paid work was selected (4218 men and 5007 women). Multiple logistic regression models separated by sex and adjusted for age and country were fitted. RESULTS: Women were more likely to report poor health status, limitations in mobility and poor mental health. Whereas in both sexes educational attainment was associated with the three health indicators, household income was only related to poor self-rated health among women. The relationship between living arrangements and health differed by gender and was primarily associated with poor mental health. In both sexes, not living with their partner but living with other people and being the household head was related to poor mental health status (adjusted odds ratio (aOR) 2.14; 95% CI 1.11 to 4.14 for men and aOR 1.75; 95% CI 1.12 to 2.72 for women). In addition, women living with their partner and other(s) and those living alone were more likely to report poor mental health status (aOR 1.67; 95% CI 1.17 to 2.41 and aOR 1.58; 95% CI 1.26 to 1.97, respectively). CONCLUSIONS: Health inequalities persist among the elderly. Women have poorer health status than men and in both sexes the risk of poor health status increases among those with low educational attainment. Living arrangements are primarily associated with poor mental health status with patterns that differ by gender.

Factors related to depression during pregnancy: are there gender differences?

OBJECTIVE: To determine gender differences between women and their partners in the effect of psychosocial and personal factors on depression during the third trimester of pregnancy. METHOD: A cross-sectional survey was carried out among 687 women and their partners (n = 669) attending the prenatal programme of Valencia province (Spain). Data collection was carried out by means of a self-reported questionnaire. The outcome variable was depression during the third trimester of pregnancy measured by the Edinburgh Postnatal Depression Scale. Predictor variables were psychosocial (marital dissatisfaction, confidant and affective social support) and personal (previous history of depression, partner depression and unplanned pregnancy) variables. The adjusted odds ratios (aOR) and their 95% confidence intervals were calculated by fitting a logistic regression model. RESULTS: The prevalence of pregnancy depression was higher among women (10.3%) than men (6.5%). In both sexes, the probability of depression during pregnancy was higher in those with marital dissatisfaction (aOR 3.05, 95% CI 1.59 to 5.82 for women and 3.14, 95% CI 1.24 to 7.99 for men) and among those whose with a previous history of depression (aOR 2.18, 95% CI 1.22 to 3.89 for women and 5.22, 95% CI 2.05 to 13.34 for men). Unplanned pregnancy did not increase the risk of pregnancy depression either in women or men. Gender differences were found on the impact of social support and partner's depression. Whereas among men low affective social support and partner depression were associated with a higher probability of reporting depression, none of these variables were related to women's depression. CONCLUSION: Most predictor factors of depression during pregnancy are similar for both sexes but a gender-different impact of social support and partner depression on pregnancy depression was appreciated. Health professionals should be aware of potentially vulnerable groups for early diagnosis of pregnancy depression and to provide effective interventions.

Immigration and self-reported health status by social class and gender: the importance of material deprivation, work organisation and household labour.

OBJECTIVE: Spain and Catalonia have experienced several immigration waves over the last century. The goal of this study was to examine the role of social class and its mediating pathways (ie, work organisation, material deprivation at home and household labour) in the association between migration status and health, as well as whether these associations were modified by social class or gender. SETTING: Barcelona city, Spain. DESIGN AND PARTICIPANTS: The study used the Barcelona Health Interview Survey, a cross-sectional survey of 10,000 residents of the city's non-institutionalised population in 2000. The present study was conducted on the working population, aged 16-64 years (2342 men and 1872 women). The dependent variable was self-reported health status. The main independent variable was migration status. Other variables were: social class (measured using Erik Olin Wright's indicators); age; psychosocial and physical working conditions; job insecurity; type of labour contract; number of hours worked per week; material deprivation at home and household labour. Two hierarchical logistic regression models were built by adding different independent variables. RESULTS: Among men, foreigners presented the poorest health status (fully adjusted odds ratios (OR) 2.16; 95% CI 1.14 to 4.10), whereas among women the poorest health status corresponded to those born in other regions of Spain. There was an interaction between migration and social class among women, with women owners, managers, supervisors or professionals born in other regions of Spain reporting a worse health status than the remaining groups (fully adjusted OR 3.60; 95% CI 1.83 to 7.07). CONCLUSION: This study has shown that the pattern of perceived health status among immigrant populations varies according to gender and social class. These results have to be taken into account when developing policies addressed at the immigrant population.

Clinical characteristics associated with psychosocial functioning among patients with uncomplicated epilepsy in Spain.

OBJECTIVE: To identify the clinical characteristics associated with poor psychosocial functioning among Spanish patients with epilepsy but no other neurological or psychiatric disorder. METHODS: Between May and September 2001 a survey among patients with epilepsy was carried out in 32 Spanish health care centres. The selection criteria of patients were attendance to a routine neurologist visit, to be aged between 25 and 64 and not having another additional neurological handicap (n=812). Psychosocial function was elicited through six indicators: educational level, marital status, unemployment status, restricted car driving, self-perception of epilepsy as an important limiting factor in the educational level achieved and, among unemployed, as the cause of their unemployment. Multiple logistic regression models were fitted in order to calculate adjusted odds ratios (aOR) and their 95% confidence intervals. RESULTS: After simultaneously adjusting for socio-demographic variables and clinical characteristics, the six outcomes analysed increased with seizure frequency. Moreover, all the outcomes except low educational level were also related to early age at onset of epilepsy. Although no relation with objective educational level was found, there was a strong association between early age at onset of symptoms and self-perception of epilepsy as an important limiting factor of educational achievement. CONCLUSION: These findings emphasize the need for more effective treatment of epilepsy and also highlight the importance of a psychosocial approach to management of epilepsy for patients with an early onset of symptoms in order to prevent social limitations in adult life.

Fármacos antiepilépticos clásicos y de nueva generación: diferencias de sexo en la efectividad y en las reacciones adversas / Classic antiepileptic and new generation antiepileptic drugs: gender differences in effectiveness and adverse drug reactions

Introducción. Las mujeres sufren más reacciones adversas a los fármacos que los hombres y además las reacciones son diferentes según el sexo. Los fármacos antiepilépticos (FAEs) de nueva generación tienen como principal objetivo reducir los efectos secundarios de los clásicos sin perder la efectividad de éstos. Objetivos. a) Identificar las variables sociodemográficas y clínicas asociadas a recibir tratamiento de monoterapia con FAEs de nueva generación, y b) comparar la efectividad, las reacciones adversas y la calidad de vida entre pacientes tratados en régimen de monoterapia con FAEs clásicos o con nuevos, examinando las posibles diferencias de sexo. Pacientes y métodos. A partir de una encuesta realizada en 32 centros sanitarios en la que participaron 990 pacientes de 16 a 64 años con epilepsia (tasa de respuesta: 96 %). Para los objetivos de este estudio se han seleccionado los pacientes que seguían tratamiento en régimen de monoterapia (496). Las variables dependientes fueron la efectividad para el control de las crisis, los efectos adversos y tres dimensiones de calidad de vida del cuestionario SF-36 (vitalidad, salud percibida y salud mental). Resultados. El 21 % de las mujeres y el 8% de los hombres eran tratados con FAEs de nueva generación. Las mujeres recibían con mayor frecuencia FAEs de nueva generación. Además, también la edad de inicio de la epilepsia se asoció positivamente con recibir tratamiento con FAEs nuevos y se observó un gradiente. Si en los hombres no se observaron diferencias en la efectividad, las reacciones adversas y en la calidad de vida entre los dos tipos de FAEs, las mujeres las tratadas con los de nueva generación tuvieron menos efectos adversos, pero el control de las crisis fue peor. Conclusiones. Los FAEs de nueva generación se prescriben con mayor frecuencia a las mujeres. En éstas, pero no en los hombres, los FAEs de nueva generación podrían tener menos efectos adversos, pero ser menos efectivos para el control de las crisis epilépticas

Introduction. Women are more likely to suffer adverse drug reactions. Moreover adverse drug reactions differ depending on gender. The main objective of new generation antiepileptic drugs (AED) is to reduce adverse drug reactions while maintaining the same effectiveness as the classic ones. Objectives. a) To identify sociodemographic and clinical variables associated with being treated with new generation AEDs, and b) to compare effectiveness, averse drug reactions and quality of life among patients treated with monotherapy, either with classic or with new generation AEDs, examining the potential gender differences. Patients and methods. A survey among 990 patients aged 16-64 with epilepsy was carried out in 32 Spanish hospitals (response rate: 96 %). For the purposes of this study patients treated with monotherapy (n = 496) were selected. The outcome variables were: effectiveness in seizure control, adverse drug reactions and three dimensions of the SF-36 questionnaire (vitality, mental health and self-perceived health status). Results. 21 % of women and 8% of men were treated with new AEDs. Women were more likely to be treated with new generation AEDs. Moreover, age of epilepsy onset was also positively related to new AEDs and a gradient was found. Whereas no differences in effectiveness, adverse drug reactions or quality of life were observed among men, among women, those treated with new generation AEDs had less adverse drug reactions but, on the other hand, effectiveness for controlling seizures was lower. Conclusions. Women are more likely to be treated with new AEDs. Althought these new treatments seem to have less adverse drug reactions among females, their effectiveness in controlling seizures are lower than that of classic AEDs

[Classic antiepileptic and new generation antiepileptic drugs: gender differences in effectiveness and adverse drug reactions]. / Fármacos antiepilépticos clásicos y de nueva generación: diferencias de sexo en la efectividad y en las reacciones adversas.

INTRODUCTION: Women are more likely to suffer adverse drug reactions. Moreover adverse drug reactions differ depending on gender. The main objective of new generation antiepileptic drugs (AED) is to reduce adverse drug reactions while maintaining the same effectiveness as the classic ones. OBJECTIVES: a) To identify sociodemographic and clinical variables associated with being treated with new generation AEDs, and b) to compare effectiveness, averse drug reactions and quality of life among patients treated with monotherapy, either with classic or with new generation AEDs, examining the potential gender differences. PATIENTS AND METHODS: A survey among 990 patients aged 16-64 with epilepsy was carried out in 32 Spanish hospitals (response rate: 96 %). For the purposes of this study patients treated with monotherapy (n = 496) were selected. The outcome variables were: effectiveness in seizure control, adverse drug reactions and three dimensions of the SF-36 questionnaire (vitality, mental health and self-perceived health status). RESULTS: 21 % of women and 8% of men were treated with new AEDs. Women were more likely to be treated with new generation AEDs. Moreover, age of epilepsy onset was also positively related to new AEDs and a gradient was found. Whereas no differences in effectiveness, adverse drug reactions or quality of life were observed among men, among women, those treated with new generation AEDs had less adverse drug reactions but, on the other hand, effectiveness for controlling seizures was lower. CONCLUSIONS: Women are more likely to be treated with new AEDs. Although these new treatments seem to have less adverse drug reactions among females, their effectiveness in controlling seizures are lower than that of classic AEDs.

Evaluación de los factores de riesgo psicosocial combinando metodología cuantitativa y cualitativa / Assessment of the psychosocial risk hazards by combining quantitative and qualitative methods

Objetivo: Ilustrar la utilidad del uso combinado de métodos cuantitativos y qualitativos en la evaluación de los factores de riesgo psycosocial, así como la importancia de la inclusión de indicadores de salud mental, mediante un estudio que tiene como objetivo determinar la magnitud y la distribución según puesto de trabajo de los factores de riesgo psicosocial y del mal estado de salud mental. Métodos: La recogida de datos se realizó a través de dos grupos de discusión y una encuesta. Los primeros sirvieron para elaborar un cuestionario que, basado en los modelos exigencias-control-apoyo y esfuerzo-recompensa, fue adaptado a las características del centro de trabajo, una fábrica de componentes eléctricos, añadiendo ítems específicos. La salud mental se midió con el cuestionario GHQ-12. El puesto de trabajo se caracterizó según la variable sección (montaje, termoplástico y oficinas). Los resultados cuantitativos fueron complementados por los elementos del discurso de dos grupos de discusión y con los comentarios hechos por los trabajadores de los cuestionarios. Resultados: La encuesta fue contestada por 199 trabajadores (tasa de respuesta 92 por ciento). El control sobre el trabajo y el apoyo de los superiores fueron más negativos entre los trabajadores de la sección de montaje, mientras que los peores resultados en cuanto a las exigencias psicológicas y el apoyo de los compañeros se obtuvieron entre los más cualificados, los de oficinas. En contra de lo esperado, el peor estado de salud mental correspondió a estos últimos, entre los que la prevalencia de trastornos de salud mental alcanzada el 53 por ciento frente al 23 por ciento en la sección de montaje o el 16 por ciento en la de termoplástico. Las altas exigencias psicológicas fueron el único factor de riesgo psicosocial asociado con el mal estado de salud mental. La contextualización de la situación mediante el discurso de los propios trabajadores contribuyó qa entender la situación y a plantear líneas de prevención concretas. Conclusión: Frente al uso de cuestionarios estándar, la combinación de métodos cuantitativos y cualitativos permite realizar evaluaciones de riesgo psicosocial adaptadasa la realidad específica de cada centro, lo que contribuye a identificar acciones concretas de prevención (AU)

[Impact of a smoke-free workplace policy in a company]. / Impacto de la implantación de una política de trabajo libre de humo en una empresa.

OBJECTIVE: To assess the impact of a smoke-free workplace policy in a company. METHOD: The impact of the implementation of a smoke-free workplace policy was assessed between October 2001 and February 2003 in a company with 184 employees. Two surveys of the entire staff were performed, one before the implementation of the new policy and the other 14 months after. RESULTS: Both passive exposure to tobacco smoke and tobacco consumption among smokers decreased. The proportion of workers free of tobacco smoke exposure at their workplace increased from 32% to 84% (p < 0.001) and, among smokers, the mean daily consumption of cigarettes was reduced by 7.3 cigarettes (p = 0.049). CONCLUSIONS: Demarkation of areas where smoking is allowed not only reduces passive exposure to tobacco smoke at the workplace but also seems to encourage smokers to quit smoking or to reduce tobacco consumption.

Encuesta sobre condiciones del trabajo: reflexiones y sugerencias / A survey of working conditions survey: reflections and suggestions

No disponible

[Halogenated by-products of chlorination in tap water]. / Subproductos halogenados de la cloración en el agua de consumo público.

OBJECTIVE: The presence of trihalomethanes in the water systems of several Spanish cities has been demonstrated. The aim of this study was to analyze trihalomethane concentrations in the water provided for human consumption in the city of Barcelona. METHODS: We analyzed 151 water samples collected in 1998. The analyses were performed in the Public Health Laboratory of Barcelona using the purge-and-trap method and subsequent determination by gas chromatography and mass spectrometry. The results are presented according to the source of the water: the rivers of Llobregat or Ter, or a mixture of these. RESULTS: Trihalomethane concentrations in the water from Ter were relatively low, with a predominance of chloroform and bromodichloromethane, while concentrations in the water from Llobregat were much higher, with a predominance of bromoform and dibromochloromethane. Mixed water showed intermediate concentrations. The total concentrations reached in the water from Llobregat were above 100 microg/l. CONCLUSIONS: The results show the need to continue reducing organic pollution and halogenated compounds in the water used for human consumption in Barcelona.

Subproductos halogenados de la cloración en el agua de consumo público / Halogenated by-products of chlorination in tap water

Objetivo: La presencia de trihalometanos en el agua de diversas ciudades españolas está demostrada. Este estudio pretende analizar sus concentraciones en el agua de la ciudad de Barcelona. Métodos: Se analizan 151 muestras de agua recogidas durante el año 1998. Los análisis se realizaron en el laboratorio municipal mediante purge and trap y posterior determinación por cromatografía de gases acoplada a espectrofotometría de masas. Los resultados se presentan según el origen del agua: ríos Llobregat, Ter o mezcla. Resultados: En aguas del Ter los valores son relativamente bajos y predominan cloroformo y bromodiclorometano, mientras que en las del Llobregat son más elevados y predominan bromoformo y dibromoclorometano. Las aguas de mezcla presentan valores intermedios. Los valores totales alcanzados en las muestras procedentes del Llobregat superan los 100 µg/l. Conclusiones: Estos resultados muestran la necesidad de seguir corrigiendo la contaminación orgánica y los compuestos halogenados en el agua captada para el consumo humano en Barcelona (AU)

Objective: The presence of trihalomethanes in the water systems of several Spanish cities has been demonstrated. The aim of this study was to analyze trihalomethane concentrations in the water provided for human consumption in the city of Barcelona. Methods: We analyzed 151 water samples collected in 1998. The analyses were performed in the Public Health Laboratory of Barcelona using the purge-and-trap method and subsequent determination by gas chromatography and mass spectrometry. The results are presented according to the source of the water: the rivers of Llobregat or Ter, or a mixture of these. Results: Thrihalomethane concentrations in the water from Ter were relatively low, with a predominance of chloroform and bromodichloromethane, while concentrations in the water from Llobregat were much higher, with a predominance of bromoform and dibromochloromethane. Mixed water showed intermediate concentrations. The total concentrations reached in the water from Llobregat were above 100 µg/l. Conclusions: The results show the need to continue reducing organic pollution and halogenated compounds in the water used for human consumption in Barcelona (AU)

Identificación de los factores de riesgo laboral en docentes: un estudio Delphi / Identification of occupational risk factors in teachers: a delphi study

Objetivo: Identificar y priorizar los factores de riesgo laboral que afectan a la salud y el bienestar del profesorado de educación infantil, primaria y secundaria de centros públicos de la Generalitat de Catalunya de la ciudad de Barcelona. Métodos: Se ha utilizado la técnica Delphi con tres rondas consecutivas. Han participado 43 profesores de 180 seleccionados (24 por ciento), aleatoriamente, entre los afiliados y afiliadas a la Federación de Enseñanza del Sindicato Comisiones Obreras (CC.OO.) en Cataluña que trabajaban en centros públicos de Barcelona. Resultados: Los factores identificados, con diferente grado de importancia, por el profesorado de enseñanza primaria y secundaria, ponen de manifiesto que las principales causas por las que se puede enfermar a consecuencia del trabajo profesional son de carácter psicosocial. La complejidad de atención al alumnado con problemas de aprendizaje y la desmotivación de éste son, respectivamente, los factores más puntuados en enseñanza primaria y secundaria. La demanda y delegación de problemas y conflictos, los problemas de disciplina, la falta de colaboración entre compañeros y de reconocimiento social, el exceso de horario lectivo y la incertidumbre sobre los resultados de los alumnos completan los factores más votados. Los problemas musculosqueléticos y de esfuerzo vocal aparecen con una menor significación y solamente en enseñanza primaria. Conclusiones: Los resultados obtenidos en el presente estudio ponen de manifiesto que los factores psicosociales constituyen los principales riesgos laborales que afectan a la salud y el bienestar del profesorado. Considerando las características de los factores manifestados, es necesario promover entre el profesorado acciones destinadas a mejorar la satisfacción laboral entre el colectivo docente, así como otras de apoyo para resolver los problemas de complejidad de atención al alumnado con problemas de aprendizaje en la enseñanza primaria y de motivación y disciplina en enseñanza secundaria, como por ejemplo la solución de conflictos en el aula y metodologías didácticas que faciliten la adopción de nuevas estrategias (AU)

Gender inequalities in health among workers: the relation with family demands.

OBJECTIVES: To analyse whether there are gender inequalities in health among male and female workers who are married or cohabiting and to assess whether there are gender differences in the relation between family demands and health. Additionally, for both objectives it will be examined whether these gender patterns are similar for manual and non-manual workers. DESIGN AND SETTING: The data have been taken from the 1994 Catalonian Health Survey (CHS), a cross sectional survey based on a representative sample of the non-institutionalised population of Catalonia, a region in the north east of Spain that has about 6 million inhabitants. The dependent variables were four ill health indicators (self perceived health status, limiting longstanding illness, having at least one chronic condition and mental health) and two health related behaviours closely related to having time for oneself (no leisure time physical activity and sleeping six hours or less a day). Family demands were measured with three variables: household size, living with children under 15 years and living with adults older than 65 years. The analysis was separated for gender and social class (manual and non-manual workers) and additionally adjusted for age. Gender differences for all dependent and independent variables were first tested at the bivariate level using the chi(2) test for categorical variables and the t test for age. Secondly, multivariate logistic regression models were fitted. PARTICIPANTS: Persons who were employed, married or cohabiting, aged 25 to 64 years (2148 men and 1185 women). RESULTS: A female excess for all the ill health indicators was found, while there were no gender differences in the health related behaviours analysed. Family demands had a greater impact on health and health related behaviours of female manual workers. In this group household size was positively related to four dependent variables. The adjusted odds ratios (ORs) to living in family units of more than four persons versus living only with the spouse were 2.74 (95%CI=1.22, 6.17) for poor self perceived health status, 3.16 (95%CI=0.98, 10.15) for limiting long standing illness, 3.28 (95%CI=1.45, 7.44) for having at least one chronic condition, and 2.60 (95%CI=1.12, 6.00) for sleeping six hours or less a day. Among female manual workers living with children under 15 years was positively associated with no leisure time physical activity (adjusted OR=2.37; 95% CI=1.43, 3.92) and with sleeping six hours or less a day (adjusted OR=1.91; 95% CI=1.13, 3.32). Living with adults older than 65 years had an unexpected negative relation with poor self perceived health status (adjusted OR=0.33; 95%CI=0.16, 0.66), and with chronic conditions (adjusted OR=0.45; 95%CI=0.24, 0.87) in female manual workers. Among male manual workers living with children under 15 years was positively associated with longstanding limiting illness (adjusted OR=2.44; 95%CI=1.36, 4.38). CONCLUSION: When gender differences in health are analysed, both the paid and the non-paid work should be considered as well as the interaction between these two dimensions, gender and social class. In Catalonia, as probably in Spain and in other countries, private changes such as sharing domestic responsibilities, as well as active public policies for facilitating family care are needed in order to reduce gender health inequalities attributable to the unequal distribution of family demands.

[Housework, gender and health in the working population]. / Trabajo doméstico, género y salud en población ocupada.

OBJECTIVE: To analyse the relation between domestic workload and self-perceived health status among workers and to examine whether there are gender inequalities. METHODS: The selected population were the 215 men and 106 women younger than 65 years interviewed in the Terrassa Health Survey, 1998 who had a paid work and were married or cohabiting. Adjusted odds ratios (aOR) by domestic workload, age and occupational social class with their 95% confidence intervals (CI) were calculated. RESULTS: Whereas among men domestic workload was not associated with health status, among women poor self-perceived health status was positively related to household size (aOR = 3.65; 95% IC = 1.06-12.54) and to lack of a person for doing domestic tasks (aOR = 4.43; 95% CI = 1.05-18.62). CONCLUSION: Both household characteristics and having a support for facing domestic tasks play an important role in gender health inequalities.

Ocupar cargos de responsabilidad, ¿un factor protector de la salud? / Positions of responsability: a protective health factor?

Objetivo: analizar la relación del trabajo en puestos de responsabilidad con los factores de riesgo psicosocial, entendidos según el modelo demanda-control-apoyo, y con el estado de salud percibido y la satisfacción laboral. Métodos: la población de estudio fueron los trabajadores de una administración pública que acudieron voluntariamente a la revisión médica de empresa, de febrero a junio de 1999. La recogida de datos se realizó a través de un cuestionario autoadministrado. La ocupación de puestos de responsabilidad se midió a través de la pregunta "¿tiene trabajadores a su cargo?". Los factores de riesgo psicosocial se recogieron con el cuestionario de "Contenido del trabajo". Además se incluyó una pregunta sobre el estado de salud percibido y otra sobre satisfacción laboral. Se ajustaron modelos de regresión logística para analizar la asociación multivariada entre los puestos de jefatura y el resto de las variables. La edad y la ocupación se trataron como variables de ajuste. Resultados: el cuestionario fue contestado por 1.550 personas (tasa de respuesta = 89 por ciento). El 24 por ciento de los hombres y el 17 por ciento de las mujeres ocupaban puestos de responsabilidad. Ejercer cargos de responsabilidad se asoció, en ambos sexos, a altas demandas psicológicas y alto control sobre las tareas y, además en mujeres, a un mayor apoyo social de los compañeros. Aun ajustando por la ocupación y por la edad, trabajar en este tipo de puestos tuvo un efecto protector sobre la salud y la insatisfacción laboral. Mientras el efecto protector sobre la salud se mantuvo tras ajustar por los factores de riesgo psicosocial, el de la insatisfacción laboral desapareció. Conclusión: en ambos sexos, ejercer cargos de responsabilidad, como mínimo, parece no ser un factor de riesgo sino que incluso podría tener un efecto protector de la salud y promotor de satisfacción laboral. Sería necesario profundizar en el análisis de los factores asociados a los cargos de responsabilidad en otros colectivos de trabajadores, mediante estudios longitudinales y, preferentemente, fuera del contexto de la revisión médica (AU)