Impact of sleep health on self-perceived health status.

Although sleep habits have long been recognized as a promoter of health, the World Health Organization 2014 report on non-communicable diseases (NCDs) only listed smoking, alcohol intake, diet and physical activity (PA) as key modifiable risk factors that could enhance health and prevent NCDs. Cross-sectional data on 4385 surveys from the 2015 Catalan Health Survey, representative of the 2015 non-institutionalized Catalan population over age 14, were used to assess and compare the independent associations of low PA (International Physical Activity Questionnaire (IPAQ): low activity); poor diet (PREvención con DIeta MEDiterránea questionnaire (PREDIMED): low-adherent); poor sleep health (Satisfaction, Alertness, Timing, Efficiency and Duration scale (SATED): <8); smoking status; and, alcohol intake (high-risk drinker based on standard drink units) with having a poor self-perceived health status. Logistic regression models adjusted by age, gender, education level and number of comorbidities showed that poor sleep health had the strongest independent association with poor self-perceived health status (OR = 1.70; 95%CI: 1.37-2.12), followed by poor diet (OR = 1.37; 95%CI: 1.10-1.72) and low PA (OR = 1.31; 95%CI: 1.01-1.69). This suggests that sleep habits should be included among the important modifiable health risk factors and be considered a key component of a healthy lifestyle.

Head-to-head comparison between the EQ-5D-5L and the EQ-5D-3L in general population health surveys.

BACKGROUND: The EQ-5D has been frequently used in national health surveys. This study is a head-to-head comparison to assess how expanding the number of levels from three (EQ-5D-3L) to five in the new EQ-5D-5L version has improved its distribution, discriminatory power, and validity in the general population. METHODS: A representative sample (N = 7554) from the Catalan Health Interview Survey 2011-2012, aged ≥18, answered both EQ-5D versions, and we evaluated the response redistribution and inconsistencies between them. To assess validity of this redistribution, we calculated the mean of the Visual Analogue Scale (VAS), which measures perceived health. The discriminatory power was examined with Shannon Indices, calculated for each dimension separately. Spanish preference value sets were applied to obtain utility indices, examining their distribution with statistics of central tendency and dispersion. We estimated the proportion of individuals reporting the best health state in EQ-5D-5L and EQ-5D-3L within groups of specific chronic conditions and their VAS mean. RESULTS: A very small reduction in the percentage of individuals with the best health state was observed, from 61.8% in EQ-5D-3L to 60.8% in EQ-5D-5L. In contrast, a large proportion of individuals reporting extreme problems in the 3 L version moved to severe problems (level 4) in the 5 L version, particularly for pain/discomfort (75.5%) and anxiety/depression (66.4%). The average proportion of inconsistencies was 0.9%. The pattern of the perceived health VAS mean confirmed the hypothesis established a priori, supporting the validity of the observed redistribution. Shannon index showed that absolute informativity was higher in the 5 L version for all dimensions. The means (SD) of the Spanish EQ-5D-3L and EQ-5D-5L indices were 0.87 (0.25) and 0.89 (0.22). The proportion of individuals with the best health state within each specific chronic condition was very similar, regardless of the EQ-5D version (≤ 30% in half of the 28 chronic conditions). CONCLUSION: Although the proportion of individuals with the best possible health state is still very high, our findings support that the increase of levels provided by the EQ-5D-5L contributed to the validity and discriminatory power of this new version to measure health in general population, as in the national health surveys.

Assessing sleep health in a European population: Results of the Catalan Health Survey 2015.

OBJECTIVE: To describe the overall sleep health of the Catalan population using data from the 2015 Catalan Health Survey and to compare the performance of two sleep health indicators: sleep duration and a 5-dimension sleep scale (SATED). METHODS: Multistage probability sampling representative of the non-institutionalized population aged 15 or more years, stratified by age, gender and municipality size, was used, excluding nightshift-workers. A total of 4385 surveys were included in the analyses. Associations between sleep health and the number of reported chronic diseases were assessed using non-parametric smoothed splines. Differences in the predictive ability of age-adjusted logistic regression models of self-rated health status were assessed. Multinomial logistic regression models were used to assess SATED determinants. RESULTS: Overall mean (SD) sleep duration was 7.18 (1.16) hours; and SATED score 7.91 (2.17) (range 0-10), lower (worse) scores were associated with increasing age and female sex. Alertness and efficiency were the most frequently impaired dimensions across age groups. SATED performed better than sleep duration when assessing self-rated health status (area under the curve = 0.856 vs. 0.798; p-value <0.001), and had a linear relationship with the number of reported chronic diseases, while the sleep duration relationship was u-shaped. CONCLUSIONS: Sleep health in Catalonia is associated with age and gender. SATED has some advantaged compared to sleep duration assessment, as it relates linearly to health indicators, has a stronger association with self-rated health status, and provides a more comprehensive assessment of sleep health. Therefore, the inclusion of multi-dimensional sleep health assessment tools in national surveys should be considered.

Risk of dependence associated with health, social support, and lifestyle.

OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.

Risk of dependence associated with health, social support, and lifestyle / Riesgo de dependencia asociado a la salud, el apoyo social y el estilo de vida

OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors.METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered.RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women.CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.

OBJETIVO Analizar la prevalencia de personas en riesgo de dependencia y los factores asociados.MÉTODOS El estudio se basó en datos de la Encuesta de Salud de Cataluña, España, realizada de 2010 a 2011. A partir de una muestra aleatoria de 3.842 individuos, de 15 años o más, se llevaron a cabo modelos de regresión logística para clasificar a los individuos según el estado de su autonomía personal. Se plantearon modelos predictivos para identificar las variables susceptibles de intervención que permitieran distinguir a los individuos dependientes de aquellos en riesgo. Se consideraron variables acerca del estado de salud, apoyo social y estilos de vida.RESULTADOS El 18,6% de la población presentó riesgo de dependencia, con efecto más acusado a partir de los 65 años. En comparación con este colectivo, los individuos que se declararon dependientes (11,0%) manifestaron problemas para realizar las actividades cotidianas y obtuvieron apoyo para ello. Estilos de vida, como fumar, consumir alcohol en exceso y ser sedentario se asociaron con mayor probabilidad de dependencia, en particular para las mujeres.CONCLUSIONES Las dificultades para llevar a cabo las actividades cotidianas preceden a la aparición de dependencia. Preservar la propia autonomía y desenvolverse sin recibir apoyo aparecen como factores protectores. La adopción de un estilo de vida activo y saludable contribuye a reducir el riesgo de dependencia.

Prevalencia y condicionantes de la obesidad en la población infantojuvenil de Cataluña, 2006-2012 / Prevalence and determinants of obesity in children and young people in Catalonia, Spain, 2006-2012

Fundamento y objetivo: Estimar la prevalencia de obesidad y sobrepeso en la población catalana de 2 a 14 años, conocer su evolución durante los períodos 2006 y 2010-2012 y evaluar los determinantes sociales y estilos de vida relacionados con la obesidad. Material y métodos: Estudio transversal a partir de 4.389 encuestas correspondientes a las ediciones 2006 y 2010-2012 de la Encuesta de Salud de Cataluña. El sobrepeso y la obesidad se determinaron aplicando los criterios de la Organización Mundial de la Salud. Los condicionantes evaluados fueron la clase social, el nivel de estudios de los padres/madres, los hábitos alimentarios, las actividades de ocio y el sueño. Resultados: Durante el período 2010-2012, las prevalencias de obesidad y sobrepeso fueron, respectivamente, 15,4 y 20,2%. La obesidad fue superior en niños (15,5%) que en niñas (12,8%) (p < 0,05), y superior en el grupo de 2 a 9 años (17,5%) que en el de 10 a 14 años (7,7%) (p < 0,05). Durante el período 2006, las prevalencias de obesidad y sobrepeso fueron similares a las observadas durante 2010-2012. La clase social baja y el bajo nivel de estudios de los progenitores se relacionaron significativamente con una mayor prevalencia de obesidad. Conclusiones: La obesidad y el sobrepeso en la población infantojuvenil catalana se han mantenido estables durante 2006-2012, siendo de las más altas de Europa. Para afrontar este importante problema de salud pública, es necesario un enfoque integral e interdisciplinario que considere tanto los determinantes sociales como los estilos de vida del entorno infantil (AU)

Background and objective: To estimate the prevalence of obesity and overweight in children aged 2 to 14 years in Catalonia, its trends between 2006 and 2010-2012, and to evaluate social determinants and lifestyle associated with obesity. Material and methods: A cross-sectional study, using the data from 4,389 surveys from Catalonia Health Surveys of the years 2006 and 2010-2012, was conducted. Obesity and overweight were determined by World Health Organization criteria. Socioeconomic position, parent's education, usual diet and activity, and hours of sleep were assessed. Results: The prevalence of obesity and overweight were: 15.4 and 20.2% in 2010-2012. The prevalence of obesity was higher in boys (15.5%) compared to girls (12.8%) (P < .05), and higher in children ranging from 2 to 9 years old (17.5%) than children aged 10 to 14 years (7.7%) (P < .05). In 2006, the prevalence of obesity and overweight were similar to the prevalence in 2010-2012. Obesity was more frequent in children with parents with a low socioeconomic position and/or a primary or elementary parent's education. Conclusions: During the last 5 years (2006-2012), child obesity and overweight have remained stable in Catalonia, yet they are relatively high in Europe. Public health programmes against obesity must consider conducting an intersectional action taking social determinants and family life styles into account (AU)

Nuevo diseño de la Encuesta de Salud de Cataluña (2010-2014): un paso adelante en planificación y evaluación sanitaria / New design of the Health Survey of Catalonia (Spain, 2010-2014): A step forward in health planning and evaluation

Se presenta la génesis de la Encuesta de Salud de Cataluña (2010-2014) con sus submuestras semestrales. Se detallan las características básicas de su diseño muestral polietápico. Entre las ventajas organizativas de esta nueva operación, en comparación con las anteriores, destacan la agilidad en la disponibilidad de datos y la capacidad de monitorización continuada de la población. Se señalan como beneficios la puntualidad en la obtención de indicadores y la posibilidad de introducir nuevos tópicos a través del cuestionario complementario, según las necesidades de información. Como limitación se apunta la mayor complejidad del diseño muestral y la falta de seguimiento longitudinal de la muestra. Se hace hincapié en la necesidad de utilizar ponderaciones adaptadas a las submuestras para el análisis estadístico que emplee microdatos, así como de acumular oleadas si se desea elevar el grado de desagregación del análisis, ya sea en el territorio o por subgrupos de población (AU)

This article presents the genesis of the Health Survey of Catalonia (Spain, 2010-2014) with its semiannual subsamples and explains the basic characteristics of its multistage sampling design. In comparison with previous surveys, the organizational advantages of this new statistical operation include rapid data availability and the ability to continuously monitor the population. The main benefits are timeliness in the production of indicators and the possibility of introducing new topics through the supplemental questionnaire as a function of needs. Limitations consist of the complexity of the sample design and the lack of longitudinal follow-up of the sample. Suitable sampling weights for each specific subsample are necessary for any statistical analysis of micro-data. Accuracy in the analysis of territorial disaggregation or population subgroups increases if annual samples are accumulated (AU)

[Prevalence and determinants of obesity in children and young people in Catalonia, Spain, 2006-2012]. / Prevalencia y condicionantes de la obesidad en la población infantojuvenil de Cataluña, 2006-2012.

BACKGROUND AND OBJECTIVE: To estimate the prevalence of obesity and overweight in children aged 2 to 14 years in Catalonia, its trends between 2006 and 2010-2012, and to evaluate social determinants and lifestyle associated with obesity. MATERIAL AND METHODS: A cross-sectional study, using the data from 4,389 surveys from Catalonia Health Surveys of the years 2006 and 2010-2012, was conducted. Obesity and overweight were determined by World Health Organization criteria. Socioeconomic position, parent's education, usual diet and activity, and hours of sleep were assessed. RESULTS: The prevalence of obesity and overweight were: 15.4 and 20.2% in 2010-2012. The prevalence of obesity was higher in boys (15.5%) compared to girls (12.8%) (P<.05), and higher in children ranging from 2 to 9 years old (17.5%) than children aged 10 to 14 years (7.7%) (P<.05). In 2006, the prevalence of obesity and overweight were similar to the prevalence in 2010-2012. Obesity was more frequent in children with parents with a low socioeconomic position and/or a primary or elementary parent's education. CONCLUSIONS: During the last 5 years (2006-2012), child obesity and overweight have remained stable in Catalonia, yet they are relatively high in Europe. Public health programmes against obesity must consider conducting an intersectional action taking social determinants and family life styles into account.

[New design of the Health Survey of Catalonia (Spain, 2010-2014): a step forward in health planning and evaluation]. / Nuevo diseño de la Encuesta de Salud de Cataluña (2010-2014): un paso adelante en planificación y evaluación sanitaria.

This article presents the genesis of the Health Survey of Catalonia (Spain, 2010-2014) with its semiannual subsamples and explains the basic characteristics of its multistage sampling design. In comparison with previous surveys, the organizational advantages of this new statistical operation include rapid data availability and the ability to continuously monitor the population. The main benefits are timeliness in the production of indicators and the possibility of introducing new topics through the supplemental questionnaire as a function of needs. Limitations consist of the complexity of the sample design and the lack of longitudinal follow-up of the sample. Suitable sampling weights for each specific subsample are necessary for any statistical analysis of micro-data. Accuracy in the analysis of territorial disaggregation or population subgroups increases if annual samples are accumulated.

Impact of the economic crisis on children's health in Catalonia: a before-after approach.

OBJECTIVES: To analyse changes in the family living conditions of children in Catalonia between 2006 and the 2010-2012 period, and to study associations between these changes and health outcomes. DESIGN: A before-after analysis of two cross-sectional surveys. SETTING: Population younger than 15 years of age from Catalonia, Spain. PARTICIPANTS: Representative samples of children in the 2006 Catalan Health Survey (ESCA), baseline, before the crisis; n=2200) and the first four waves of ESCA 2010-2012 (after start of the crisis, n=1967). MAIN OUTCOME MEASURES: Overweight/obesity, health behaviour, mental health and health-related quality of life (HRQOL). Logistic regression and multiple linear regression models were used to analyse the influence of changes in family conditions on outcome measures, including interaction terms to describe the potential influence of the study period on the results. RESULTS: The percentage of unemployed families rose from 9.1% (2006) to 20.6% (2010-2012), with inequalities by level of education. Overweight/obesity increased from 18.4% (95% CI 16.5% to 20.4%) to 26.9% (24.6% to 29.2%) in 2010-2012, and inequalities related to maternal education and employment status persisted. Eating habits have improved in 2010-2012 in disadvantaged families (ie, junk food consumption improved in families with a maternal primary education level; beta (B)=2.85; 0.83 to 4.88, for the survey interaction by primary education level). An improvement in HRQOL was found in the second survey (B=6.07; 4.15 to 7.99), although children whose mothers had a primary education showed poorer HRQOL scores in this survey than in 2006 (B=-4.14; -7.17 to -1.12). CONCLUSIONS: Although some health-related behaviour improved during the study period, childhood obesity increased and inequalities in HRQOL appeared. Policy measures that fight against these inequalities should be urgently implemented to avoid their negative impact on the health of future generations of Catalans.

Características metodológicas de la Encuesta de Salud de Cataluña 2006 / Methodological characteristics of the Catalan Health Survey 2006

La Encuesta de Salud de Cataluña (ESCA) aporta información poblacional imprescindible para la planificación y evalución sanitaria. En la edición de 2006 se entrevistó a 18.126 personas no institucionalizadas. La muestra tiene un diseño complejo con el objetivo de garantizar la representatividad en las áreas geográficas pequeñas que son de interés en la planificación de salud y servicios. Algunas novedades de esta tercera edición son: relevancia otorgada al territorio; adaptación de los cuestionarios a la población entrevistada, e inclusión de nuevos ámbitos temáticos. El artículo presenta aquellos aspectos metodológicos que pueden ser utiles para los usuarios de la ESCA 2006. Concretamente, en el primer apartado de metodología se describe el diseño muestral, los cuestionarios, el trabajo de campo, la formación de los encuestadores, la codificación y control de calidad, y la cesión de los microdatos. En el segundo apartado se presentan las variables compuestas y los instrumentos utilizados y sus referencias. En el tercer apartado se describe la construcción de indicadores, puesto que el diseño muestral condiciona el uso de factores de ponderación y elevación para obtener estimadores representativos (AU)

The Health Survey of Catalonia (ESCA) gives essential population information for health planning and evaluation. On the edition of 2006, 18,126 non-institutionalized persons were interviewed. The sample design is complex with the aim to guarantee the representatively also in small geographic areas with interest in health and service planning. There are certain novelties in the third edition such as the relevance given to the territory, questionnaires adaptations to the interviewed population and new subject areas studied. This paper describes the useful methodological aspects for the ESCA 2006 users. In the first part we describe the sample design, questioners, field work, interviewer’s formation, codification and quality micro data control. In the second part compound variables, used tools and their references are shown. And the third part describes the indicators construction since the sample design determines the use of weighing and elevation factors to obtain representative estimation values (AU)

Riesgo individual y poblacional en salud mental en Cataluña / Individual and population-based risk in mental health in Catalonia, Spain

Los trastornos mentales son problemas de salud con un fuerte impacto social, sanitario, económico y una importante repercusión en la calidad de vida de las personas que los padecen y de sus familias. El objetivo de este artículo es medir la prevalencia de los trastornos mentales en Cataluña y comparar los cambios observados en los resultados obtenidos entre 1994 y 2006 de la Encuesta de Salud de Cataluña a partir del Goldberg General Health Questionnaire. La población con probabilidad de padecer un trastorno mental en el momento de la entrevista es similar en 1994 (12,6%) y 2006 (11,6%), con una prevalencia superior en las mujeres. Paradójicamente, entre la población sin riesgo es donde se concentran los casos declarados de depresión y/o ansiedad, sentirse ansioso o deprimido, consumir antidepresivos, visitar al psiquiatra o tener un estado de salud regular o malo. Los resultados concuerdan tanto con la paradoja del riesgo como con la paradoja de la prevención, hechos a tener en cuenta en las estrategias preventivas (AU)

Mental health disorders are health problems with a high health, social and economic impact and with relevant effects on the quality of life of both the patients and their families. The objective of this article is to measure the prevalence of mental disorders in Catalonia and to analyze changes the changes in the results obtained in the Goldberg General Health Questionnaire in the Catalan Health Survey editions developed in 1994 and 2006. The prevalence of population at risk of suffering of a mental health disorder does not differ in both years (12.6% in 1994 and 11.6% in 2006). Women showed a higher risk than men in both surveys. Paradoxically, it is amongst the people without risk where the highest number of cases of depression, anxiety, antidepressant use, psychiatry visits or bad perception of health was declared. The results agreed with the risk and prevention paradox and are relevant at the time of designing strategies for mental health disorders prevention (AU)

La salud de los hombres y las mujeres en Cataluña. ¿Se están produciendo cambios? / The health of men and women in Catalonia, Spain. Are changes occurring?

El objetivo de este artículo es mostrar los cambios observados en la población de Cataluña en el perfil de salud en función del género en 2006 respecto de 1994, a través de la comparación de los datos obtenidos en 1994 y 2006 en la Encuesta de Salud de Cataluña. El aumento del nivel de estudios de la población ha tendido a equiparar ambos sexos. El patrón según gradiente de clase social se ha invertido de manera que, en 2006, la proporción de mujeres que se sitúa en las clases altas e intermedias es superior a la de los hombres y la proporción de mujeres pertenecientes a la clase baja es inferior a la de los hombres. Ha aumentado el número de mujeres que se incorporan al mundo laboral y disminuido el de las que se declaran amas de casa. Las conductas poco saludables continúan siendo más frecuentes entre los hombres pero la proporción de mujeres fumadoras y sedentarias aumentó entre 1994 y 2006. Las mujeres tienen una actitud más preventiva que los hombres con relación a la toma de la presión arterial y la medida de las concentraciones de colesterol. La población que valora su salud como positiva ha aumentado, pero se mantiene que el porcentaje de mujeres es inferior al de hombres. Las mujeres continúan presentando más enfermedades crónicas, trastornos mentales y discapacidades. En comparación con 1994, en 2006 se observa que en Cataluña se mantiene el perfil de salud en función del género, caracterizado porque las mujeres tienen peor percepción del estado de salud, mayor número de enfermedades crónicas y discapacidades, y mayor riesgo de mala salud mental que los hombres. Los hábitos poco saludables continúan siendo más prevalentes entre los hombres, a excepción del sedentarismo, que es más frecuentre entre las mujeres. Las mujeres continúan practicando actividades preventivas en mayor proporción que los hombres (AU)

The aim of this work is to show the changes observed in the health profile according to gender in 2006 with respect to 1994 of the population of Catalonia, through the comparison of data obtained in 1994 and 2006 from the Encuesta de Salud de Cataluña. The increase of the level of studies of the population has tended to comparing both sexes. The pattern of the social classes has been invested, so that in 2006 the proportion of women who place themselves in the upper classes and intermediate is superior to that of the men, and the proportion of women belonging to the lower class is inferior to that of the men. The number of women who incorporate into the work and handicapped world has increased those who are declared housewives. The little healthy behaviors continue being more frequent among men but the proportion of smoker and sedentary women increased between 1994 and 2006. Women have a more preventive than men in relation to the taking of blood pressure and measurement of cholesterol levels. People who value their health as positive has increased, but maintains that the percentage of women is lower than in males. The women continue to have more chronic diseases, mental disorders and disabilities. In 2006, and in comparison with 1994, it is observed that in Catalonia the health profile by gender, wherein women have poorer perception of health status, greater number of chronic diseases and disabilities and greater risk of poor mental health than men. Unhealthy habits are still more prevalent among men with the exception of the sedentarism, which is more frequent among women. Women continue practicing preventive activities in greater proportion than men (AU)

[Methodological characteristics of the Catalan Health Survey 2006]. / Características metodológicas de la Encuesta de Salud de Cataluña 2006.

The Health Survey of Catalonia (ESCA) gives essential population information for health planning and evaluation. On the edition of 2006, 18,126 non-institutionalized persons were interviewed. The sample design is complex with the aim to guarantee the representatively also in small geographic areas with interest in health and service planning. There are certain novelties in the third edition such as the relevance given to the territory, questionnaires adaptations to the interviewed population and new subject areas studied. This paper describes the useful methodological aspects for the ESCA 2006 users. In the first part we describe the sample design, questioners, field work, interviewer's formation, codification and quality micro data control. In the second part compound variables, used tools and their references are shown. And the third part describes the indicators construction since the sample design determines the use of weighing and elevation factors to obtain representative estimation values.

[Individual and population-based risk in mental health in Catalonia, Spain]. / Riesgo individual y poblacional en salud mental en Cataluña.

Mental health disorders are health problems with a high health, social and economic impact and with relevant effects on the quality of life of both the patients and their families. The objective of this article is to measure the prevalence of mental disorders in Catalonia and to analyze changes the changes in the results obtained in the Goldberg General Health Questionnaire in the Catalan Health Survey editions developed in 1994 and 2006. The prevalence of population at risk of suffering of a mental health disorder does not differ in both years (12.6% in 1994 and 11.6% in 2006). Women showed a higher risk than men in both surveys. Paradoxically, it is amongst the people without risk where the highest number of cases of depression, anxiety, antidepressant use, psychiatry visits or bad perception of health was declared. The results agreed with the risk and prevention paradox and are relevant at the time of designing strategies for mental health disorders prevention.

[The health of men and women in Catalonia, Spain. Are changes occurring?]. / La salud de los hombres y las mujeres en Cataluña. ¿Se están produciendo cambios?

The aim of this work is to show the changes observed in the health profile according to gender in 2006 with respect to 1994 of the population of Catalonia, through the comparison of data obtained in 1994 and 2006 from the Encuesta de Salud de Cataluña. The increase of the level of studies of the population has tended to comparing both sexes. The pattern of the social classes has been invested, so that in 2006 the proportion of women who place themselves in the upper classes and intermediate is superior to that of the men, and the proportion of women belonging to the lower class is inferior to that of the men. The number of women who incorporate into the work and handicapped world has increased those who are declared housewives. The little healthy behaviors continue being more frequent among men but the proportion of smoker and sedentary women increased between 1994 and 2006. Women have a more preventive than men in relation to the taking of blood pressure and measurement of cholesterol levels. People who value their health as positive has increased, but maintains that the percentage of women is lower than in males. The women continue to have more chronic diseases, mental disorders and disabilities. In 2006, and in comparison with 1994, it is observed that in Catalonia the health profile by gender, wherein women have poorer perception of health status, greater number of chronic diseases and disabilities and greater risk of poor mental health than men. Unhealthy habits are still more prevalent among men with the exception of the sedentarism, which is more frequent among women. Women continue practicing preventive activities in greater proportion than men.

Prevalencia de incontinencia urinaria en Cataluña / Prevalence of urinary incontinence in Catalonia, Spain

Fundamento y objetivo: Estudiar la prevalencia y la gravedad de los síntomas de incontinencia urinaria (IU) en la población de: descriptivo y transversal. Muestra de 18.126 individuos, de los cuales 15.926 eran mayores de 15 años, representativa del conjunto de la población residente en Cataluña, no institucionalizada y que participó en la Encuesta de Salud de Cataluña (ESCA). Dentro de la ESCA se incorporaron 2 preguntas en relación con la IU, en las que se preguntaba sobre la frecuencia y la cantidad de los escapes de orina. Estas preguntas constituyen la versión española del Incontinence Severity Index (ISI), que proporciona un índice numérico de la gravedad de la IU. Resultados: En Cataluña, el 7,9% de la población declara tener IU, el 12,2% de las mujeres y el 3,6% de los varones, lo que supone que más de 500.000 personas tienen pérdidas involuntarias de orina, de las cuales el 77,8% son mujeres. Se observa que la prevalencia aumenta con la edad: entre las mujeres de 45 a 64 años, un 12,0% refiere síntomas de IU, esta cifra alcanza un 26,6% entre las mujeres de 65 a 74 años y un 41,8% entre las mujeres de 75 o más años. Sólo un 2,8% de los varones entre 45 y 64 años refiere IU, un 10,2% de entre 65 y 74 años y un 22,7% de 75 o más años. Conclusiones: Se detecta una alta prevalencia de IU en la población de Cataluña. En dos tercios de las personas que reconocen tener IU, sus síntomas son moderados, graves o muy graves. La gravedad de los síntomas aumenta con la edad, tanto en varones como en mujeres. La prevalencia global de IU es 3 veces superior en las mujeres que en los varones (AU)

Background and objective: To study the prevalence and severity of urinary incontinence (IU) in the population of Catalonia. Design Descriptive and cross-sectional study. Patients and method: Sample of 18.126 individuals, representative of the population of Catalonia, not institutionalized. 15.926 of them were older than 15 years and answered the Survey of Health of Catalonia (ESCA). Two questions about frequency and quantity of leakages of urine were added to the ESCA, a health questionnaire with 197 questions. Questions about UI were the Spanish version of Incontinence Severity Index (ISI). Results: In Catalonia (Spain) 7,9% of the population (more than 500.000 persons) had symptoms of IU, corresponding to 12,2% of the women and 3,6% of the men. 77,8% of the total population with UI symptoms were women. The prevalence increased with age in both sexes . 12% of women with an age between the 45–64-years, 26,6% between 65–74 years and 41,8% with 75 years or more, had UI symptoms. Symptoms of UI were present in only 2,8% of the men between 45–64 years , 10,2% between 65–74 years and 22,7% of those of 75 years or more. Conclusions: A high prevalence of IU was found in the population of Catalonia. In two thirds of individuals with IU, their symptoms were moderate to severe. Severity of UI increases with age in men and women. Overall, symptoms of UI are 3 times more prevalent in women than in men (AU)

[Prevalence of urinary incontinence in Catalonia, Spain]. / Prevalencia de incontinencia urinaria en Cataluña.

BACKGROUND AND OBJECTIVE: To study the prevalence and severity of urinary incontinence (IU) in the population of Catalonia. DESIGN: Descriptive and cross-sectional study. PATIENTS AND METHOD: Sample of 18.126 individuals, representative of the population of Catalonia, not institutionalized. 15.926 of them were older than 15 years and answered the Survey of Health of Catalonia (ESCA). Two questions about frequency and quantity of leakages of urine were added to the ESCA, a health questionnaire with 197 questions. Questions about UI were the Spanish version of Incontinence Severity Index (ISI). RESULTS: In Catalonia (Spain) 7.9% of the population (more than 500.000 persons) had symptoms of IU, corresponding to 12.2% of the women and 3.6% of the men. 77.8% of the total population with UI symptoms were women. The prevalence increased with age in both sexes. 12% of women with an age between the 45-64-years, 26.6% between 65-74 years and 41.8% with 75 years or more, had UI symptoms. Symptoms of UI were present in only 2.8% of the men between 45-64 years , 10.2% between 65-74 years and 22.7% of those of 75 years or more. CONCLUSIONS: A high prevalence of IU was found in the population of Catalonia. In two thirds of individuals with IU, their symptoms were moderate to severe. Severity of UI increases with age in men and women. Overall, symptoms of UI are 3 times more prevalent in women than in men.