Geometric and colour data fusion for outdoor 3D models.

This paper deals with the generation of accurate, dense and coloured 3D models of outdoor scenarios from scanners. This is a challenging research field in which several problems still remain unsolved. In particular, the process of 3D model creation in outdoor scenes may be inefficient if the scene is digitalized under unsuitable technical (specific scanner on-board camera) and environmental (rain, dampness, changing illumination) conditions. We address our research towards the integration of images and range data to produce photorealistic models. Our proposal is based on decoupling the colour integration and geometry reconstruction stages, making them independent and controlled processes. This issue is approached from two different viewpoints. On the one hand, given a complete model (geometry plus texture), we propose a method to modify the original texture provided by the scanner on-board camera with the colour information extracted from external images taken at given moments and under specific environmental conditions. On the other hand, we propose an algorithm to directly assign external images onto the complete geometric model, thus avoiding tedious on-line calibration processes. We present the work conducted on two large Roman archaeological sites dating from the first century A.D., namely, the Theatre of Segobriga and the Fori Porticus of Emerita Augusta, both in Spain. The results obtained demonstrate that our approach could be useful in the digitalization and 3D modelling fields.

The association between birthplace in different regions of the world and cardiovascular mortality among residents of Spain.

The objective of this study is to estimate the association of birthplace with mortality from cardiovascular diseases in residents of Spain by analysing immigrant populations that are unlikely to have adopted health-related attitudes and behaviours of the host country. Data from the population register and cause of death register were used for the period 2001-2005. The study included people aged 20-64 years. Age-adjusted mortality from cardiovascular diseases--and from ischaemic heart disease, cerebrovascular disease and hypertension-related disease--according to birthplace were estimated and compared with those for the native Spanish population by mortality rate ratios. Compared with the native Spanish population, residents who came from Eastern Europe, Sub-Saharan Africa and South Asia had a higher risk of mortality from most of the cardiovascular diseases analysed. Women from North Africa and the Caribbean also had a higher risk of cardiovascular mortality. A higher risk of mortality from ischemic heart disease was observed in persons from the Middle East, and from cerebrovascular disease in those from Eastern Asia. Compared with the native Spanish population, residents from South America and Eastern Asia had a lower risk of mortality from ischemic heart disease. This pattern of mortality from cardiovascular diseases in residents of Spain who have come from different regions of the world is very similar to the findings of studies in other countries, and probably reflects the burden of disease in the countries of origin.

Mortalidad por enfermedades cardiovasculares en inmigrantes residentes en la Comunidad de Madrid / Mortality from cardiovascular diseases in immigrants residing in Madrid

Fundamento y objetivo: Estimar la mortalidad por enfermedades cardiovasculares entre inmigrantes residentes en una de las comunidades españolas con la tasa de inmigración más alta en los primeros años del siglo xxi. Población y método: Se estudió a la población de 20 a 64 años de edad residente en la Comunidad de Madrid en el período 2000-2004. La mortalidad por enfermedades cardiovasculares en los inmigrantes de diferentes partes del mundo se comparó con la mortalidad en la población autóctona española. Para ello se estimó la razón de tasas ajustada por edad, sexo y renta per cápita del lugar de residencia. Resultados: Los inmigrantes del África subsahariana mostraron la mayor razón de tasas de mortalidad por el conjunto de enfermedades cardiovasculares y por enfermedad isquémica del corazón, y los procedentes de América del Sur, la menor. La mayor razón de tasas de mortalidad por enfermedad cerebrovascular se observó en los inmigrantes de América Central y el Caribe. Conclusiones: El patrón de mortalidad por enfermedades cardiovasculares en la población inmigrante es muy similar al encontrado en investigaciones realizadas en otros países y probablemente refleje la carga de enfermedad en sus lugares de origen (AU)

Background and objective: To estimate the mortality from cardiovascular diseases in immigrants residing in one of the regions of Spain with the highest immigration rate during the early years of the 21st century. Population and method: The study included people aged 20 to 64 years of age residing in Madrid for the period 2000-2004. Mortality form cardiovascular disease in immigrants from different parts of the world was compared with the mortality in the native Spanish population. Mortality rates ratios adjusted for age, sex and per capita income in the area of residence were estimated. Results: Immigrants from Sub-Saharan Africa and from South America showed, respectively, the highest and the lowest mortality rate ratio of cardiovascular diseases and ischemic heart disease. Immigrants from the region of Central America and the Caribbean showed the highest mortality rate ratio of cerebrovascular disease. Conclusions: The pattern of cardiovascular disease mortality in immigrants residing in Madrid is quite similar to those found in studies made in other countries, and probably reflect the burden of disease in their places of origin (AU)

[Mortality from cardiovascular diseases in immigrants residing in Madrid]. / Mortalidad por enfermedades cardiovasculares en inmigrantes residentes en la Comunidad de Madrid.

BACKGROUND AND OBJECTIVE: To estimate the mortality from cardiovascular diseases in immigrants residing in one of the regions of Spain with the highest immigration rate during the early years of the 21st century. POPULATION AND METHOD: The study included people aged 20 to 64 years of age residing in Madrid for the period 2000-2004. Mortality form cardiovascular disease in immigrants from different parts of the world was compared with the mortality in the native Spanish population. Mortality rates ratios adjusted for age, sex and per capita income in the area of residence were estimated. RESULTS: Immigrants from Sub-Saharan Africa and from South America showed, respectively, the highest and the lowest mortality rate ratio of cardiovascular diseases and ischemic heart disease. Immigrants from the region of Central America and the Caribbean showed the highest mortality rate ratio of cerebrovascular disease. CONCLUSIONS: The pattern of cardiovascular disease mortality in immigrants residing in Madrid is quite similar to those found in studies made in other countries, and probably reflect the burden of disease in their places of origin.

Major reduction in AIDS-mortality inequalities after HAART: the importance of absolute differences in evaluating interventions.

This study estimates the magnitude of inequalities in AIDS mortality in the period when highly active antiretroviral therapy (HAART) was introduced and after its widespread dissemination in the Region of Madrid, Spain. Two population cohorts were constructed by linking records from 1996 and 2001 population censuses with mortality registry records after initial and full implementation of HAART, respectively. Absolute and relative differences in AIDS mortality in people aged 20-49 years were estimated in each population cohort according to neighbourhood and individual socioeconomic position. The absolute difference in mortality between neighbourhoods with highest and lowest socioeconomic position (unemployment rate, per capita income) declined from about 30/100,000 person-years in the 1996 population cohort to 8/100,000 person-years in the 2001 population cohort. The absolute difference in mortality between individuals with the highest and lowest socioeconomic position fell from about 60/100,000 person-years in the first cohort to about 20/100,000 in the second. Relative differences in mortality by neighbourhood socioeconomic position and by individual education level also decreased in the 2001 cohort with respect to the 1996 cohort. Although relative differences by individual occupation increased, there was no evidence of a significant change. These findings show major reduction in absolute socioeconomic differences in AIDS mortality after HAART and indicate that the use of relative differences alone may be inadequate to fully evaluate the results of health interventions.

Socioeconomic environment, availability of sports facilities, and jogging, swimming and gym use.

The aim of the study was to evaluate the association of the availability of sports facilities and socioeconomic environment with jogging, swimming and gym use in Spain. The indicators of availability of sports facilities were the number of swimming pools and the number of gyms per 10,000 population. The indicators of socioeconomic environment were average provincial income and provincial unemployment rate. The number of sports facilities was not related with either swimming or gym use and the indicators of socioeconomic environment were not associated with swimming in either sex, or with gym use in men. The findings of this study do not support the hypotheses proposed in previous investigations to explain the consistent relation between socioeconomic environment and lack of physical activity.

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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Heterogeneity in cause-specific mortality according to birthplace in immigrant men residing in Madrid, Spain.

PURPOSE: To evaluate whether mortality in immigrants in the region of Madrid (Spain) differs from mortality in Spanish in-country migrants. METHODS: Analyses of mortality in men aged 20 to 64 years residing in Madrid were conducted, using data from the municipal population register and the cause of death register for the period 2000 through 2004. Mortality rate ratios were used to compare mortality in immigrants from different parts of the world with mortality in men residing in Madrid who were born in other regions in Spain. RESULTS: After adjustment was made for age and per capita income of the area of residence, the highest mortality rate ratio for the leading causes of death by disease category was observed in immigrants from sub-Saharan Africa and the lowest in those from South America and Asia. In immigrants from Western countries and from North Africa, the mortality rate ratios for most of the diseases studied did not differ significantly from those of Spanish in-country migrants. In general, the mortality rate ratios for external causes of death were higher than 1, and they were very high for mortality from homicide. CONCLUSIONS: Mortality from the leading causes of death in immigrants shows important heterogeneity depending on the place of origin and, with some exceptions, shows a pattern similar to that observed in studies carried out in other wealthy countries.

Relación del perfil lipoproteico en sangre de cordón con las variables obstétricas y antropométricas en los recién nacidos. Diferencias en función del sexo / Relationship between lipoprotein profile in cord blood with obstetric variables and anthropometry in newborns. Differences related with sex

Introducción. El bajo peso al nacer se ha reconocido como un nuevo factor de riesgo cardiovascular. La razón parece ser una resistencia a la insulina de origen genético o por nutrición insuficiente durante el desarrollo intrauterino. No se conoce la importancia que pueden tener en esta situación las alteraciones del metabolismo lipídico. Pacientes y método. Estudio prospectivo de una cohorte consecutiva de 265 niños recién nacidos a término de embarazos no gemelares. Se recogieron los datos sobre la edad materna, las semanas de gestación, el tipo de parto, la puntuación en el test de Apgar y las variables antropométricas (circunferencia cefálica, talla, peso e índice ponderal [kg/m3]). Además, en todos ellos se analizó sangre del cordón para determinar las concentraciones de colesterol total, colesterol unido a lipoproteínas de baja densidad (cLDL) y lipoproteínas de alta densidad (cHDL), triglicéridos y apolipoproteínas (apo) A-1 y B. Se investigaron las posibles asociaciones y correlaciones entre los parámetros lipídicos y las variables obstétricas y antropométricas del recién nacido, así como la influencia del sexo. Resultados. Los parámetros antropométricos estuvieron muy correlacionados entre sí y con las semanas de gestación. No hubo diferencias relevantes de éstos entre ambos sexos, salvo en la circunferencia cefálica. Las niñas presentaron concentraciones medias significativamente más altas que los niños de colesterol total (68,7 frente a 62,2 mg/dl), HDL (23,4 frente a 21,2), LDL (37,3 frente a 32,9), apo A-1 (70,7 frente a 66,5) y apo B (30,8 frente a 28,4). Los valores de los triglicéridos fueron similares (40,1 frente a 40,7). Se observaron correlaciones elevadas y significativas entre las distintas fracciones lipídicas y con las apoproteínas. Sin embargo, sólo se observó una correlación ligera entre la edad gestacional y los triglicéridos (rho = 0,27) y del peso de las niñas con su HDL (rho = 0,26). No hubo diferencias lipídicas relevantes entre los recién nacidos con índice ponderal bajo o normal. Conclusiones. Las diferencias en el perfil lipídico de los recién nacidos dependen más de su sexo que de factores relacionados con el desarrollo fetal. La posible dislipemia asociada al peso bajo al nacer sería un factor aterogénico de aparición posterior (AU)

Introduction. Low birth weight has been recognized as a new risk factor for the development of cardiovascular disease in adulthood. Possible causes are insulin resistance of genetic origin or adaptation to poor fetal nutrition during intrauterine growth. The importance of lipid metabolism at birth is unknown and data on the relationship between birth weight and later lipid profile are contradictory. Patients and method. We performed a prospective study of a consecutive cohort of 265 full term newborns from single pregnancies. Data on maternal age, weeks of gestation, route of delivery, Apgar test, and anthropometric measures [head circumference, height, weight and ponderal index (kg/m3)] were gathered. In addition, a cord blood sample was analyzed to determine concentrations of total cholesterol, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, triglycerides, and apolipoproteins A-1 and B. The possible relationship between lipid parameters and obstetric and anthropometric variables in newborns, as well as the influence of sex, were investigated. Results. Anthropometric measures were highly interrelated and were also correlated with gestational weeks, but no differences were found between the sexes, with the exception of head circumference. Girls showed a higher average concentration than boys of total cholesterol (68.7 vs. 62.2 mg/dl), HDL-cholesterol (23.4 vs. 21.2), LDL-cholesterol (37.3 vs. 32.9), apolipoprotein A1 (70.7 vs. 66.5), and apolipoprotein B (30.8 vs. 28.4). Triglyceride levels were similar (40.1 vs. 40.7) between girls and boys. Significant and elevated correlations among lipid values were observed. However, there was only a weak correlation between gestational age and triglyceride values (rho=0.27) and between birth weight in girls and HDL (rho=0.26). No lipid differences were found between newborns with low or normal ponderal index. Conclusions. Lipid profile in newborns is more closely related to sex than to fetal growth. Any possible association of dyslipidemia with low birth weight would appear later in life (AU)

The association of current and sustained area-based adverse socioeconomic environment with physical inactivity.

This paper evaluates the association between socioeconomic environment in the province of residence and physical inactivity, using measures of current and sustained area-based adverse socioeconomic environment. The analysis included 19,324 individuals representative of the Spanish non-institutionalised population aged 16-74 years. The measure of association estimated was the prevalence odds ratio for physical inactivity by current gross domestic product per capita (GDPpc) and current Gini coefficient, and by number of times each province has had a low GDPpc and number of times each province has had a high Gini coefficient in the last two decades. After adjusting for age, individual socioeconomic characteristics, and number of sports facilities per 1,000 population, the odds ratio for physical inactivity in residents of provinces with the lowest current GDPpc versus those with the highest was 1.64 in men and 2.01 in women. The odds ratio in residents of provinces that had always been among those with the lowest GDPpc versus residents in provinces that had never been among those with lowest GDPpc was 1.54 in men and 1.91 in women. Neither the current Gini coefficient nor the indicator that reflects sustained high Gini coefficient were associated with physical inactivity. These findings show that physical inactivity is associated with current socioeconomic context and with the duration of exposure of the area of residence to adverse socioeconomic circumstances when the indicators of socioeconomic environment are based on GDPpc, but not on income inequality. Also, this association is not explained by individual socioeconomic characteristics or the number of sports facilities.

Influencia a lo largo de la vida de las circunstancias socioeconómicas, de la inactividad física y de la obesidad sobre la presencia de síndrome metabólico / Life socioeconomic circumstances, physical inactivity and obesity influences on metabolic syndrome

Fundamento: La mayoría de los estudios han evaluado el efecto independiente de cada factor de riesgo sobre los distintos componentes del síndrome metabólico. Este estudio examina la influencia de la acumulación de factores de riesgo a lo largo de la vida (circunstancias socioeconómicas, actividad física y obesidad general) sobre el riesgo de síndrome metabólico y sus componentes en la población adulta mayor de España. Método. Se han estudiado 4.009 personas representativas de la población española de 60 y más años no institucionalizada. Se ha obtenido una medida de la exposición a lo largo de la vida mediante la combinación de cinco indicadores de riesgo: clase social baja en la infancia baja, nivel de estudios bajo, clase social baja de adulto, inactividad física y obesidad general en la vida adulta. El indicador tiene seis categorías desde la más favorable (0 factores de riesgo) a la más desfavorable (5 factores de riesgo presentes). En este trabajo se consideró que síndrome metabólico fue la presentación simultánea de obesidad abdominal, presión arterial elevada y diabetes mellitus tipo 2. Resultados. La prevalencia de obesidad abdominal osciló entre 74,2% y 95,8% en hombres y entre 87,8% y 99,1% en mujeres, la de presión arterial elevada osciló entre 77,5% y 85,0% en hombres y 75,7% y 88,0% en mujeres, y la de diabetes mellitus tipo 2 varió entre 13,0% y 34,8% en hombres y 7,6% y 25,4% en mujeres. Excepto en la presión arterial elevada y en la diabetes mellitus tipo 2 en hombres, el incremento fue gradual con el aumento de factores de riesgo. La diferencia absoluta en la prevalencia de síndrome metabólico en los sujetos con el perfil de riesgo más desfavorable a lo largo de su vida, con respecto a la prevalencia en los sujetos con el perfil de riesgo más favorable, fue 22% en hombres y 17% en mujeres. Conclusiones: El riesgo de síndrome metabólico está influenciado por la acumulación de exposiciones socioeconómicas y de conductas de riesgo para la salud a lo largo de la vida. Las prevalencias de obesidad abdominal, de presión arterial elevada y de diabetes mellitus tipo 2 aumentaron progresivamente desde la categoría de riesgo más favorable a la menos favorable, excepto en la presión arterial elevada y en la diabetes mellitus tipo 2 en hombres

Background: Majority of the studies have evaluated the independent effect of each risk factor on several component of metabolic syndrome. This study investigates the influence of accumulation of risk factor through life course (socioeconomic circumstances, physical activity and obesity) on the risk of metabolic syndrome and their components in older population in Spain. Method: We have studied 4009 subjects representative of the Spanish non-institutionalised population aged 60 years and older. We have elaborated a measure of exposure through life course exposure after combining five risk indicators: low childhood social class, low education, low adult social class, physical inactivity and general obesity. The indicator has six categories of risk from the most favourable (0 risk factors) to the least favourable exposure (5 risk factors). Study participants were considered to have metabolic syndrome if they simultaneously had abdominal obesity, raised blood pressure and diabetes mellitus. Results: The prevalence of abdominal obesity fluctuated between 74.2% and 95.8% in men and between 87.8% and 99.1% en women, prevalence of raised blood pressure did between 77.5% and 85.0% in men and 75.7% and 88.0% in women, and prevalence of diabetes mellitus did between 13.0% and 34.8% in men and 7.6% y 25.4% in women. Except for raised blood pressure and diabetes mellitus in men, increase was gradual with the number of risk factors. The absolute difference in the prevalence of metabolic syndrome between people that had the risk indicator profile least favourable and people that had the risk indicator profile most favourable through life course was 22% in men and 17% in women. Conclusions: The risk of metabolic syndrome is influenced in a cumulative fashion by socioeconomic exposures and risk behavioural to health acting throughout the life course. The prevalences of abdominal obesity, of raised blood pressure, and of diabetes mellitus show an ascending gradient from the most favourable categories of risk to the least favourable categories of risk, except for raised blood pressure and diabetes mellitus in men

[Association of income with use of and access to health services in Spain at the beginning of the XXI century]. / Asociación de los ingresos económicos con la utilización y la accesibilidad de los servicios sanitarios en España al inicio del siglo XXI.

OBJECTIVE: To estimate the association of household income and provincial income with visits to general practitioners and specialists and with hospitalization and to determine whether waiting times to access these services vary with both economic variables. METHOD: Data from the 2001 National Health Survey were used. The association was estimated by sex- and age-adjusted odds ratios; in the case of per capita income, odds ratios were also adjusted for household income. Percentiles and the geometric mean of waiting times in each health service were estimated and the statistical significance of their association with both economic variables was evaluated. RESULTS: Subjects with the lowest household income showed the highest frequency of visits to general practitioners and hospitalization, although they waited longer for hospital admission. Subjects with the lowest household income also showed the lowest frequency of specialist visits: the odds ratio in the lowest income quartile with respect to the highest income quartile was 0.73 (95% CI: 0.62-0.87). However, when only visits to specialists working in the public system were analyzed, the lowest frequency of visits was observed in subjects with the highest household income. No differences were found in health services utilization or in waiting times according to provincial income. CONCLUSIONS: The frequency of specialist visits according to household income shows a different pattern from that observed for visits to general practitioners and hospitalizations. The longest waiting times for admission to hospital were observed in subjects with the lowest household income.

Asociación de los ingresos económicos con la utilización y la accesibilidad de los servicios sanitarios en España al inicio del siglo XXI / Association of income with use of and access to health services in Spain at the beginning of the XXI century

Objetivo: Estimar la asociación de los ingresos económicos del hogar y de la renta provincial con las consultas al médico general y al especialista y con la hospitalización. Estimar si el tiempo de espera para acceder a esos servicios varía con esas características. Método: Datos de la Encuesta Nacional de Salud de 2001. La asociación se estimó mediante la odds ratio, ajustada por edad y sexo, y en el caso de la renta per cápita se ajustó también por los ingresos económicos del hogar. Se estimaron los percentiles y la media geométrica de los tiempos de espera en cada servicio sanitario y se evaluó la significación estadística de su asociación con ambas variables económicas. Resultados: Los sujetos con menores ingresos económicos presentan la mayor frecuencia de consultas al médico general y hospitalización, aunque esperan más tiempo para ser hospitalizados. Estos sujetos presentan la menor frecuencia de consultas al especialista: la odds ratio en el cuartil más bajo de ingresos frente al más alto fue 0,73 (intervalo de confianza del 95%, 0,62-0,87), aunque en las consultas financiadas públicamente la menor frecuencia se observa en los sujetos con mayores ingresos. No se han encontrado diferencias en la utilización y en los tiempos de espera según la renta provincial. Conclusiones: La frecuencia de consultas al especialista según los ingresos económicos del hogar muestra un patrón distinto al observado en las consultas al médico general y en la hospitalización. El mayor tiempo de espera para hospitalización se observa en los sujetos con menores ingresos económicos

Objective: To estimate the association of household income and provincial income with visits to general practitioners and specialists and with hospitalization and to determine whether waiting times to access these services vary with both economic variables. Method: Data from the 2001 National Health Survey were used. The association was estimated by sex- and age-adjusted odds ratios; in the case of per capita income, odds ratios were also adjusted for household income. Percentiles and the geometric mean of waiting times in each health service were estimated and the statistical significance of their association with both economic variables was evaluated. Results: Subjects with the lowest household income showed the highest frequency of visits to general practitioners and hospitalization, although they waited longer for hospital admission. Subjects with the lowest household income also showed the lowest frequency of specialist visits: the odds ratio in the lowest income quartile with respect to the highest income quartile was 0.73 (95% CI: 0.62-0.87). However, when only visits to specialists working in the public system were analyzed, the lowest frequency of visits was observed in subjects with the highest household income. No differences were found in health services utilization or in waiting times according to provincial income. Conclusions: The frequency of specialist visits according to household income shows a different pattern from that observed for visits to general practitioners and hospitalizations. The longest waiting times for admission to hospital were observed in subjects with the lowest household income

Trends of socioeconomic inequalities and socioeconomic inequalities in self-perceived health in Spain.

OBJECTIVE: To study the trends of socioeconomic inequalities and socioeconomic inequalities in self-perceived health in Spain between 1987 and 2001. METHODS: We estimated the distribution of educational level and per capita provincial income, and the differences in less-than-good self-perceived health by educational level and per capita provincial income in each period. RESULTS: The percentage of the population that had completed secondary or higher education was larger and inequality in per capita provincial income was smaller in 2001 than in 1987. In general, the differences in less-than-good self-perceived health by educational level and provincial income were greater in 2001 than in 1987, in both absolute and relative terms. However, when the effect of residual correlation within provinces was taken into account, the differences by per capita provincial income were smaller in 1987 than in 2001. CONCLUSIONS: The redistribution of socioeconomic resources achieves greater social justice, but probably does not lead to reduced health inequalities in all cases.

Trends of socioeconomic inequalities and socioeconomic inequalities in self-perceived health in Spain

Objetivo: Estudiar la evolución de las desigualdades socioeconómicas y las desigualdades socioeconómicas en la percepción subjetiva de la salud en España entre 1987 y 2001. Métodos: Se han estimado la distribución del nivel de estudios y de la renta per cápita provincial, así como las diferencias en la percepción de la salud según el nivel de estudios y según la renta per cápita provincial en cada período. Resultados: El porcentaje de población que había completado estudios de segundo grado o superiores fue mayor, y la desigualdad en la renta per cápita provincial fue menor en el año 2001 que en 1987. En líneas generales, las diferencias en la percepción negativa de la salud como según el nivel de estudios y la renta per cápita provincial fueron mayores en 2001 que en 1987, en términos relativos y absolutos. En cambio, cuando se tuvo en cuenta el efecto de la correlación residual dentro de las provincias en el resultado, las diferencias según la renta per cápita provincial fueron menores en 2001 que en 1987. Conclusión: La redistribución de los recursos socioeconómicos básicos consigue una mayor justicia social, pero probablemente no siempre consigan reducir las desigualdades en salud

Objective: To study the trends of socioeconomic inequalities and socioeconomic inequalities in self-perceived health in Spain between 1987 and 2001. Methods: We estimated the distribution of educational level and per capita provincial income, and the differences in less-than-good self-perceived health by educational level and per capita provincial income in each period. Results: The percentage of the population that had completed secondary or higher education was larger and inequality in per capita provincial income was smaller in 2001 than in 1987. In general, the differences in less-than-good self-perceived health by educational level and provincial income were larger in 2001 than in 1987, in both absolute and relative terms. However, when the effect of residual correlation within provinces was taken into account, the differences by per capita provincial income were smaller in 2001 than in 1987. Conclusions: The redistribution of socioeconomic resources achieves greater social justice, but probably does not lead to reduced health inequalities in all cases

Evolución de las desigualdades socioeconómicas y las desigualdades en la percepción de la salud en España / Trends in socioeconomic inequalities and self-perceived health in Spain

Objetivo: Estudiar la evolución de las desigualdades socioeconómicas y las desigualdades socioeconómicas en la percepción subjetiva de la salud en España entre 1987 y 2001. Métodos: Se han estimado la distribución del nivel de estudios y de la renta per cápita provincial, así como las diferencias en la percepción de la salud según el nivel de estudios y según la renta per cápita provincial en cada período. Resultados: El porcentaje de población que había completado estudios de segundo grado o superiores fue mayor, y la desigualdad en la renta per cápita provincial fue menor en el año 2001 que en 1987. En líneas generales, las diferencias en la percepción de la salud como según el nivel de estudios y la renta per cápita provincial fueron mayores en 2001que en 1987, en términos relativos y absolutos. En cambio, cuando se tuvo en cuenta el efecto de la correlación residual dentro de las provincias en el resultado, las diferencias según la renta per cápita provincial fueron menores en 2001 que en 1987. Conclusión: La redistribución de los recursos socioeconómicos básicos consigue una mayor justicia social, pero probablemente no siempre consigan reducir las desigualdades en salud

Objective: To study the evolution of sociaoeconomic inequalities and socioeconomic inequalities in self-perceived health in Spain between from 1987 to 2001. Methods: We estimated the distributions of educational level and per capita provincial income and the differences of less-than-good self-assessed health according education level and per capita provincial in both periods. Results: The percentage of the population that had completed secondary education was greater, and inequality in per capita provincial income was lower, in 2001 than in 1987. In general terms, the differences in suboptimal (less-than-good) self-perceived health by education and by provincial income were greater in 2001 than in 1987, in both absolute and relative terms. However, when the potential within-province correlation in outcomes was taken into account, the differences according provincial income were lower in 1987 than in 2001. Conclusions: The redistribution of socioeconomic resources achieves greater social justice, but probably does not lead to reduced health inequalities in all cases

Decreasing socioeconomic inequalities and increasing health inequalities in Spain: a case study.

OBJECTIVES: We examined the evolution of income inequalities and health inequalities in Spain from the time of the country's entry into the European Union. METHODS: We estimated distributions of provincial income and household income, relations of provincial income with mortality and disability, and relations of household income with disability in 1984-1986 and 1999-2001. RESULTS: Inequalities in average provincial income and household income were lower in 2000 than in 1985. Differences in mortality and disability according to income were greater in 2000 than in 1985, in both absolute and relative terms, except for differences in mortality among individuals aged 25 to 44 years. In most cases, differences in mortality from leading causes of death and differences in major types of disabilities were also greater in 2000. CONCLUSIONS: Our results show that redistribution of income might achieve greater social justice but probably does not lead to reduced health inequalities, despite observed improvements in material circumstances as well as in most health indicators among disadvantaged population groups.

Association of adult socioeconomic position with hypertension in older people.

OBJECTIVE: To determine the role of obesity, adult behavioural risk factors, and markers of specific childhood exposures in the association between adult socioeconomic position and hypertension in a cohort of people aged 60 years and older. DESIGN: Cross sectional study. SETTING: Spain. PARTICIPANTS: 4009 subjects representative of the Spanish non-institutionalised population aged 60 years and older. MAIN OUTCOME MEASURE: Prevalence of hyperteMarinhonsion according to education and social class, and proportion of excess difference in hypertension prevalence in lower socioeconomic groups explained by different risk factors for hypertension. RESULTS: The highest prevalence of hypertension was seen in subjects with less education and in those belonging to a low social class. In men, the hypertension risk factors analysed did not explain the difference in prevalence by education, but they explained almost half of the difference by social class. In women, these risk factors explained the differences in hypertension prevalence by education and a substantial part of the differences by social class. Central and general obesity, and physical inactivity were the risk factors that were the most important in this association in women. CONCLUSIONS: In women, socioeconomic position has no direct effect on hypertension in the case of education and only a small effect in the case of social class. In contrast, most of the effect of education and half of the effect of social class on hypertension in men is direct or, at least, is not explained by the risk factors analysed. The mechanisms that can explain the association between socioeconomic position and hypertension in older men remain to be established.

Income in large residential areas and premature mortality in six countries of the European Union.

We study the relation between per capita income and mortality within six countries of the European Union - Finland, the Netherlands, Belgium, France, Italy and Spain - in 1981-1985 and 1996-2000. We obtained information on gross domestic product per capita (GDPpc) and mortality in large residential areas. The areas in each country were grouped in quintiles as a function of GDPpc. In 1996-2000, a negative gradient was seen in premature mortality from all causes in men and women in accordance with the GDPpc quintile, except in the Netherlands and in women in Finland. In Belgium, France, Italy and Spain, the impact of GDPpc on premature mortality was stronger in 1996-2000 than in 1981-1985. All six countries showed a negative gradient in premature mortality from cardiovascular disease by GDPpc. The pathways by which residential area with lower wealth is associated with higher mortality are probably related with investment in economic and social resources over time, although for some causes of death, this association is not seen in some countries due to specific historic and cultural circumstances.

Bienestar material de la provincia de residencia e inactividad física / Material well-being of the province of residence and leisure-time physical inactivity

Objetivo: Estimar la asociación entre el bienestar material de la provincia de residencia y la inactividad física durante el tiempo libre en la población española mayor de 15 años. Métodos: Los datos proceden de la encuesta de Discapacidades, Deficiencias y Estado de Salud, realizada por el Instituto Nacional de Estadística en 1999. Se analizaron los datos de 24.561 mujeres y 21.133 varones. Se consideró un sujeto inactivo cuando declaraba no realizar ningún tipo de actividad física durante el tiempo libre. La medida de bienestar material fue la renta per cápita de la provincia agrupada en cuartiles. La medida de asociación entre la renta per cápita y la inactividad física fue la odds ratio (OR) estimada mediante modelos logit multinivel. Resultados: En los individuos ≥ 45 años de edad se encontró una asociación entre la renta per cápita y la inactividad física. Las provincias con mayor renta per cápita presentaron la menor prevalencia de inactividad física. No obstante, la OR de mayor magnitud se encontró en el cuartil 2 de renta per cápita, no observándose diferencias estadísticamente significativas entre el cuartil más rico y el cuartil más pobre. Al ajustar por características socioeconómicas y otras variables individuales, esa asociación persistió en las mujeres y desapareció en los varones. En las mujeres la asociación fue mayor en el grupo de ingresos personales más bajos. Conclusiones: Los resultados sugieren que en las mujeres mayores de 45 años la inactividad física podría estar relacionada no sólo con las características individuales, sino también con el contexto socioeconómico del área de residencia

Objective: To estimate the association between material wellbeing of the province of residence and leisure-time physical inactivity in the Spanish population aged 16 years and older.Methods: We used data from the Survey on Disabilities, Impairments and Health Status carried out by the Statistical National Institute in 1999. We analyse 24,561 women and 21,133 men. Respondents were classified as inactive if they reported no leisure-time physical activity. The measure of material wellbeing was the per capita income of the province of residence grouped in quartiles. The measure of the association between per capita income and physical inactivity was the odds ratio (OR) estimated from logit multilevel models. Results: Association between per capita income and physical inactivity was observed in people aged 45 years and older. The lower prevalence of physical inactivity was observed in provinces with the higher per capita income. However the higher OR was found in quartile 2 of per capita income, because no significant difference was observed between quartile 4 (richest) and quartile 1 (poorest). After adjusting for socioeconomic characteristics and other individual variables, association remained significant in women and disappeared in men. In women, association between per capita income and physical inactivity was higher in the population group with lower personal income. Conclusions: Results suggest that physical inactivity in women aged 45 years and older could be related not only with individual characteristics but with the socioeconomic context of the area of residence