Relationship between parents' mental disorders and socioeconomic status and offspring's psychopathology: A cross-sectional study.

Mental disorders (MD) are one of the main causes of the disease burden worldwide. Associations between socioeconomic status (SES) and presence of MD in parents have been related with increased odds of MD in offspring. However, there is a lack of population-based research in this field. The aim of the present study was to examine together the relationship between the presence of MD in children, and the SES and presence of MD in their parents, in a whole of population data. A gender approach was undertaken aiming to discern how these variables influence children's mental health when related with the father and the mother. Using administrative individual data from the National Health System, a retrospective cross-sectional study was conducted. The entire children population aged 6 to 15 resident in Catalonia in 2017 was examined. A logistic regression model was performed. Low SES was associated with increased odds of children's MD. Offspring of a parent with MD were at more risk of presenting MD than offspring of parents without these problems. Although these associations were consistent for both boys and girls when looking at the father's or mother's SES and MDs, the mother's SES and MDs showed a higher association with the offspring's MDs than the father's. Lowest associations, found for boys when looking at the father's SES and MDs, were: OR of 1.21, 95%CI 1.16 to 1.27 for lowest SES, and OR of 1.66, 95%CI 1.61 to 1.70 for parental MDs. Children's familiar environment, which includes SES and mental health of parents, plays an important role in their mental health. Socially constructed gender roles interfere with SES and parent's MD. These findings support the relevance of examining MD and its risk factors within a gender approach.

Socioeconomic inequalities in health and the use of healthcare services in Catalonia: analysis of the individual data of 7.5 million residents.

BACKGROUND: The aim of this study is to analyse the health status, the use of public healthcare services and the consumption of prescription drugs in the population of Catalonia, taking into consideration the socioeconomic level of individuals and paying special attention to vulnerable groups. METHODS: Cross-sectional study of the entire population resident in Catalonia in 2015 (7.5 million people) using administrative records. Twenty indicators are analysed related to health, the use of healthcare services and consumption of prescription drugs. Rates, frequencies and averages are obtained for the different variables stratified by age groups (under 15 years, 15-64 years and 65 years or older), gender and socioeconomic status (calculated on the basis of pharmacy copayment levels and Social Security benefits received). RESULTS: A socioeconomic gradient was observed in all the indicators analysed, in both sexes and in all age groups. Morbidity, use of mental healthcare centres, hospitalisation rates and probability of drug consumption among children is 3-7 times higher for those with low socioeconomic level respect to those with a higher one. In children and adults, the steepest gradient was found in the use of mental health services. Moreover, there are gender inequalities. CONCLUSION: There are significant socioeconomic inequalities in health status and in the use of healthcare services in the population of Catalonia. To respond to this situation, new policies on health and other areas, such as education and employment, are required, especially those that have an impact on early years.

Social and economic inequalities in induced abortion in Spain as a function of individual and contextual factors.

BACKGROUND AND OBJECTIVES: The socioeconomic position of women who have an induced abortion has been explored extensively, but without taking contextual factors into account. The objective was to describe socioeconomic inequalities in the rate of induced abortion in Spain in 2001, jointly evaluating the effects of both regional and individual socioeconomic characteristics. METHODS: A cross-sectional study using a multilevel approach was carried out among women who were resident in Spain in 2001, considering the hierarchical structure of relevant factors. Analyses were carried out at the individual and regional level. We fit Poisson regression models to calculate adjusted relative risks (aRR) of induced abortion and 95% confidence intervals (CIs). RESULTS: The estimated abortion rate was 6.26 per 1000 women aged 20-49 years. Induced abortion was more frequent among younger women (aRR = 1.55 for women aged 20-24 years, compared with those aged 25-34 years) and those with less than primary education (aRR = 2.25 compared with women with university studies). Women residing in regions with lower public spending on non-university education (aRR = 0.83, 95% CI: 0.70-0.98) and a higher percentage of non-European Union immigrants (aRR = 1.06, 95% CI: 1.02-1.10) were also more likely to have had an induced abortion. CONCLUSIONS: Socioeconomic inequalities in the practice of induced abortion in Spain exist not only at the individual level but also at the regional level. The prevention of unintended pregnancy should be approached using a global political strategy aimed at changing contextual and individual factors that contribute to unintended pregnancy.

Sexual health and socioeconomic-related factors in Spain.

PURPOSE: The aim of the present study was to describe sexual health in Spain according to three important indicators of the World Health Organization definition and explore the influence of socioeconomic factors. METHODS: We performed a population-based cross-sectional study of sexually active people aged 16-44 years residing in Spain in 2009 (2365 women and 2532 men). Three main aspects of sexual health were explored: sexual satisfaction, safe sex, and sexual abuse. The independent variables explored were age, age at first intercourse, reason for first intercourse, type of partner, level of education, country of origin, religiousness, parity, and social class. Bivariate and multivariate logistic regression models were fitted. RESULTS: Both men and women were quite satisfied with their sexual life, their first sexual intercourse, and their sexual relationships during the previous year. Most participants had practiced safe sex both at first intercourse and during the previous year. Levels of sexual abuse were similar to those in other developed countries. People of disadvantaged socioeconomic position have less satisfying, more unsafe, and more abusive sexual relationships. Women experienced more sexual abuse and had less satisfaction at their first intercourse. CONCLUSIONS: The state of sexual health in Spain is relatively good. However, we observed inequalities according to gender and socioeconomic position.

Women’s socioeconomic factors associated to the choiceof contraceptive method in Spain

Objective: To describe the influence of socioeconomic characteristics on the choice of the contraceptivemethod used among women in Spain in 2006.Methods: This is a cross-sectional study of women aged 15-49 who reported the contraceptive methodused during the first sexual intercourse (n = 3352) and during the 4 weeks prior to the interview (n =2672). Data were analyzed taking into account women’s socioeconomic characteristics.Results: The mostly used method during the first sexual intercourse was the condom. Women fromdeveloping countries more frequently used the pill than native-born Spanish women. The condom wasalso the most commonly used method in the 4 weeks prior to the interview. The use of other contraceptivemethods increased with age. Being older and having children were both associated with an increased useof permanent methods.Conclusions: The choice of a specific contraceptive method seems to be more strongly influenced bywomen’s stage of life than by socioeconomic characteristics (AU)

Objetivos: Describir la influencia de las características socioeconómicas en la elección del método anticonceptivo utilizado por las mujeres en Espana en 2006. ˜Métodos: Estudio transversal de las mujeres de 15-49 anos de edad que declararon el método anticoncep- ˜tivo utilizado en la primera relación sexual (n = 3352) y durante las cuatro últimas semanas (n = 2672),teniendo en cuenta sus características socioeconómicas.Resultados: El preservativo fue el método más utilizado durante la primera relación sexual. Las mujeresde países en vías de desarrollo usaron más frecuentemente la píldora que las autóctonas. El preservativo fue también el método más utilizado durante las cuatro últimas semanas. El uso del resto de losmétodos aumenta con la edad. Tener una edad más alta e hijos se asoció con un mayor uso de métodospermanentes.Conclusiones: La elección de un método anticonceptivo concreto parece estar más influenciada por elciclo vital de la mujer que por sus características socioeconómicas (AU)

Social determinants of sexual satisfaction in Spain considered from the gender perspective.

AIMS: To describe gender- and social class-related inequalities in sexual satisfaction and analyze their relationship with self-perceived health status. METHODS: This population-based, cross-sectional study included 7384 sexually active people aged 16 years and over residing in Spain in 2009 (3951 men and 3433 women). The explanatory variables were gender, age, social class, share in performing domestic tasks, spend time looking after oneself, collaborate economically in supporting the family, caring for children, self-perceived health status, and the desire to increase or decrease frequency of having sexual relations. Bivariate and multivariate logistic regression models were fitted. RESULTS: Among women, sexual satisfaction declines progressively after age 45. Sexual satisfaction is 1.7 times higher among women who look after themselves and who feel good compared with those who do not. The odds of wanting to increase sex is 3.3 times higher for women who are satisfied compared with women who desire a lower frequency of sexual intercourses; and good perceived health was associated with sexual satisfaction. In satisfied men, the corresponding odds is 1.9 times that of men desiring to reduce their frequency of sex. CONCLUSIONS: Gender and social class inequalities are found in sexual satisfaction. This is associated with perceived health status, adding evidence in support of the World Health Organization definition of sexual health.

Women's socioeconomic factors associated to the choice of contraceptive method in Spain.

OBJECTIVE: To describe the influence of socioeconomic characteristics on the choice of the contraceptive method used among women in Spain in 2006. METHODS: This is a cross-sectional study of women aged 15-49 who reported the contraceptive method used during the first sexual intercourse (n = 3352) and during the 4 weeks prior to the interview (n = 2672). Data were analyzed taking into account women's socioeconomic characteristics. RESULTS: The mostly used method during the first sexual intercourse was the condom. Women from developing countries more frequently used the pill than native-born Spanish women. The condom was also the most commonly used method in the 4 weeks prior to the interview. The use of other contraceptive methods increased with age. Being older and having children were both associated with an increased use of permanent methods. CONCLUSIONS: The choice of a specific contraceptive method seems to be more strongly influenced by women's stage of life than by socioeconomic characteristics.

Regional inequalities in the use of contraception in Spain: a multilevel approach.

The aim of the present study was to describe the influence of individual and regional socioeconomic factors on the use of contraception among women in Spain in 2006. A cross-sectional study was carried out among women aged 15-49 years (n=5141). The prevalence of contraception use was analyzed as a function of individual and regional characteristics using weighted multilevel logistic regression models. The use of contraception in more deprived regions was lower during first sexual intercourse but higher during the four weeks prior to the interview. Inequalities in the use of contraception were observed among women in Spain after accounting for both individual and regional characteristics.

Neighborhood inequalities in adverse pregnancy outcomes in an urban setting in Spain: a multilevel approach.

The aim of the present study was to describe socioeconomic inequalities in low birth weight (LBW), premature birth (PM) and small size for gestational age at birth (SGA) between 2000 and 2005 in Barcelona, Spain, jointly evaluating the effect of mother's country of origin, and neighborhood of residence socioeconomic level measured using unemployment and educational level. We performed a cross-sectional study of births to mothers aged 12-49 years who were residents in the city of Barcelona in 2000-2005, analyzing adverse pregnancy outcomes (n = 61,676). Weighted multilevel logistic regression models were fitted with individual data on level 1 and neighborhood data on level 2, to obtain adjusted odds ratios (aOR) with 95% confidence intervals and residual variance. Individually, pregnancy outcomes are more favorable in births to older mothers and to mothers from Maghrib and Central and South America than from developed countries (including Spain) or from other developing countries. After adjusting for individual variables, poor pregnancy outcomes were associated with poor neighborhoods (more unemployment was associated to LBW: aOR = 1.56; PM aOR = 1.51; SGA aOR = 1.66). The same trend was observed for associations with illiteracy rate. The present study shows that there are socioeconomic inequalities in adverse pregnancy outcomes in the city of Barcelona. One of the main challenges in perinatal health continues to be the reduction of adverse pregnancy outcomes in the city.

Social and economic inequalities in the use of contraception among women in Spain.

BACKGROUND: Socioeconomic inequalities affect different areas of health, including sexual and reproductive health. The aim of the present study was to analyze inequalities in the use of contraception among women resident in Spain in 2006. METHODS: This is a cross-sectional study of women aged 15-49 years and resident in Spain in 2006 that analyzes the use of contraception during their first experience of sexual intercourse and during the 4 weeks before the interview (n = 5,141). Socioeconomic inequalities are measured with indicators of socioeconomic position, such as level of education, social class, and country of origin, and such characteristics as age, religion, age at first intercourse, living with partner, and number of children. RESULTS: Contraception was used by 70.4% of the women during their first experience of sexual intercourse and by 78.1% during the previous 4 weeks. The women who used contraception most during their first experience of sexual intercourse were nonreligious younger women from developed countries who had a higher level of education and who had their first experience after the age of 18. The women who used contraception most often during sex in the previous 4 weeks were younger women with a higher level of education who did not live with a partner, who had children, and who had used contraception during their first experience. CONCLUSIONS: There are socioeconomic inequalities in the use of contraception among women in Spain. The use of contraception during the first experience of sexual intercourse was associated with more frequent use of contraception during sex in the 4 weeks before the interview.