Pasos hacia la institucionalización de la evaluación del impacto en salud en España: la percepción de los profesionales de salud pública / Steps towards the institutionalization of health impact assessment in Spain: perception of public health professionals

Fundamento. La actual reforma normativa de la salud pública en España ha previsto la inclusión de la Evaluación del Impacto en Salud (EIS). El objetivo de este estudio es describir la visión de los profesionales de salud pública y planificación sobre la utilidad y aplicabilidad de la EIS en su trabajo diario y con ello reflexionar sobre la mejor manera de institucionalizarla. Metodología. Se han desarrollado 3 talleres de formación en EIS dirigidos a profesionales de las diferentes ramas de la salud pública. Se ofreció un cuestionario para cumplimentar por las personas asistentes. Resultados. El 41% de las personas asistentes contestaron al cuestionario. Entre quienes respondieron, el 92%consideró que el modelo de los determinantes sociales de la salud resulta de gran utilidad en el ámbito de la salud pública. Las principales vías identificadas para introducirla EIS fueron: la obligatoriedad normativa (85%),la integración en otras herramientas de evaluación ya existentes (65%) y la sistematización de esta metodología(40%). En relación a la aplicabilidad de la EIS, se propusieron estrategias específicas para su introducción en las diferentes ramas de la salud pública. Conclusiones. La institucionalización exitosa de la EIS requerirá de la opinión y colaboración del personal técnico. Se constata la aprobación generalizada de esta herramienta para su utilización en la administración. Para garantizar la viabilidad de su implementación, será necesario sensibilizar a los profesionales sobre el modelo de los determinantes sociales de la salud, y recoger sus demandas y sugerencias(AU)

Background. The current normative reform of public health policy in Spain envisages the inclusion of Health Impact Assessment (HIA). This study contributes the vision of public health and planning professionals on the usefulness and applicability of HIA in their daily work and thus reflects on how best to institutionalize it. Methodology. Three training workshop were carried out with public health professionals. Participants were specialists in different branches: epidemiological surveillance, environmental health, food safety and health promotion. In this HIA workshop, a questionnaire was given to the attendees to be completed. Results. Forty-one percent of the people attending answered the questionnaire; 92% of the staff considered that the model of social determinants of health is useful in the field of public health. The principal routes for introducing HIA were: mandatory rules (85%), integration into other existing assessment tools (65%) and the systematization of this methodology (40%). Concerning the applicability of HIA, specific strategies are proposed for its introduction into the different branches of public health. Conclusions. The successful institutionalization of HIA will require the opinion and collaboration of the technical personnel. A widespread approval of this tool for its utilization in the administration was verified. To guarantee the viability of its implementation, it will be necessary to raise the awareness of professionals about the model of the social determinants of health, as well as to attend to their demands and suggestions(AU)

[Steps towards the institutionalization of health impact assessment in Spain: perception of public health professionals]. / Pasos hacia la institucionalización de la evaluación del impacto en salud en España: la percepción de los y las profesionales de salud pública.

BACKGROUND: The current normative reform of public health policy in Spain envisages the inclusion of Health Impact Assessment (HIA). This study contributes the vision of public health and planning professionals on the usefulness and applicability of HIA in their daily work and thus reflects on how best to institutionalize it. METHODOLOGY: Three training workshop were carried out with public health professionals. Participants were specialists in different branches: epidemiological surveillance, environmental health, food safety and health promotion. In this HIA workshop, a questionnaire was given to the attendees to be completed. RESULTS: Forty-one percent of the people attending answered the questionnaire; 92% of the staff considered that the model of social determinants of health is useful in the field of public health. The principal routes for introducing HIA were: mandatory rules (85%), integration into other existing assessment tools (65%) and the systematization of this methodology (40%). Concerning the applicability of HIA, specific strategies ere proposed for its introduction into the different branches of public health. CONCLUSIONS: The successful institutionalization of HIA will require the opinion and collaboration of the technical personnel. A widespread approval of this tool for its utilization in the administration was verified. To guarantee the viability of its implementation, it will be necessary to raise the awareness of professionals about the model of the social determinants of health, as well as to attend to their demands and suggestions.

Health impact assessment of an urban regeneration project: opportunities and challenges in the context of a southern European city.

BACKGROUND: Social values and the political context have an influence on the use and spread of health impact assessment (HIA). In Spain, there is little experience in HIA but some regional governments are already introducing it. The aim of this article is to describe the health impacts of a local regeneration project to improve accessibility in a neighbourhood of Bilbao (Spain), and discuss the main difficulties, opportunities and challenges of the process, considering the specificities of the social and political context. METHODS: A concurrent and prospective assessment, based on a broad model of health, was carried out following the Merseyside guidelines. A literature review, community profiling and qualitative data collection were undertaken. Profound involvement of members of the community and key informants was judged as essential in the HIA process. RESULTS: The overall expected effect of the new lifts, roads, park and the rainwater collection system was positive. Uncertain or negative impacts were identified in some of those areas, and also concerning the burying of four high-voltage power lines. Historical and current characteristics of the community were highly influential on the way local people perceived the project and its impacts. Likewise, the way in which processes of planning and implementation were developing also played an important role. CONCLUSION: The spread of HIA in southern European countries will depend on the progressive introduction of values underlying HIA, as well as on the promotion of intersectoral work, a better knowledge of the social model of health and community's participation in policy making.

Valoracion del estudio radiografico de la membrana periodontal en esclerodermia y colagenopatia mixta. / Value of the radiographic study of periodontal membrane in systemic sclerosis and mixed connective tissue disease

Se efectua estudio radiografico de membrana periodontal en un grupo de 12 pacientes afectados de esclerodermia y colagenopatia mixta que fuera dignosticada previamente como tal. Se relaciona con estado clinico dentario, evolucion de la afeccion, estado de manos y disfagia. Se compara con grupo control de afecciones comunes bucales (enfermedad periodontal y trauma oclusal) seleccionado por sexo y edad correspondiente, agregando 5 pacientes en un grupo miscelanea con diagnosticos de LES, dermatomiositis, artritis reumatoide, esclerodermia, esclerodermia zoniforme y escleredema de Buschke. Se halla engrosamiento notable en 40% de los estudiados, leve en el resto. Sin alteraciones en el grupo miscelanea y frecuente engrosamiento leve y desigual em el grupo control, asociado a reabsorcion osea. En algunos casos es indistinguible sin examen clinico dentario previo. No se encuentra relacion con evolucion, estado de afeccion de manos y disfagia

Valoracion del estudio radiografico de la membrana periodontal en esclerodermia y colagenopatia mixta. / Value of the radiographic study of periodontal membrane in systemic sclerosis and mixed connective tissue disease

Se efectua estudio radiografico de membrana periodontal en un grupo de 12 pacientes afectados de esclerodermia y colagenopatia mixta que fuera dignosticada previamente como tal. Se relaciona con estado clinico dentario, evolucion de la afeccion, estado de manos y disfagia. Se compara con grupo control de afecciones comunes bucales (enfermedad periodontal y trauma oclusal) seleccionado por sexo y edad correspondiente, agregando 5 pacientes en un grupo miscelanea con diagnosticos de LES, dermatomiositis, artritis reumatoide, esclerodermia, esclerodermia zoniforme y escleredema de Buschke. Se halla engrosamiento notable en 40% de los estudiados, leve en el resto. Sin alteraciones en el grupo miscelanea y frecuente engrosamiento leve y desigual em el grupo control, asociado a reabsorcion osea. En algunos casos es indistinguible sin examen clinico dentario previo. No se encuentra relacion con evolucion, estado de afeccion de manos y disfagia