Assessing the social impacts of the COVID-19 crisis using phone helplines. The case of the Balearic Islands, Spain.

Background: Crises and health policies to tackle them can increase health inequalities. We explored the scope and usefulness of helplines set up during the COVID-19 crisis and characterised the vulnerability of their users. This study explored the geographic and socioeconomic effects of the telephone helplines set up by the Balearic Islands Government and aimed to characterise the vulnerability of their users. Methods: Telephonic survey combined with a geographical analysis of a sample of calls made between 15th of March and 30th of June of 2020 to five helplines: COVID-19 general information; psychological, social (minimum vital income), labour (temporary employment regulation), and housing (rental assistance) helps. The questionnaire included sociodemographic and housing characteristics, type of problem, and if it was solved or not. We used multinomial regression to explore factors associated with having solved the problem. We calculated the standardised rate of calls by municipality using Chi-squared and z-test to test differences. Results: 1,321 interviews from 2,678 selected (231 excluded, 608 untraceable, and 518 refusals). 63.8% of women, 48.7% were born in another country. They had no internet at home in 3.1%, only on the phone in 17.3%. The 23.5% had no income at home. The Problem was solved in 25.4%, and partly in 30.9%. Factors associated with not solving the problem were not having income at home (p = 0.021), labour (p = 0.008), economic (p = 0.000) or housing (p = 0.000) problems. People from 55 of 67 municipalities did at least one call. The highest rates of calls were from coastal tourist municipalities. Conclusion: Helplines reached most of the territory of the Balearic Islands and were used mainly in tourist municipalities. It probably has not been helpful for families with more significant deprivation. Digital inequalities have emerged.

Analysis of the impact of social determinants and primary care morbidity on population health outcomes by combining big data: A research protocol.

Background: In recent years, different tools have been developed to facilitate analysis of social determinants of health (SDH) and apply this to health policy. The possibility of generating predictive models of health outcomes which combine a wide range of socioeconomic indicators with health problems is an approach that is receiving increasing attention. Our objectives are twofold: (1) to predict population health outcomes measured as hospital morbidity, taking primary care (PC) morbidity adjusted for SDH as predictors; and (2) to analyze the geographic variability of the impact of SDH-adjusted PC morbidity on hospital morbidity, by combining data sourced from electronic health records and selected operations of the National Statistics Institute (Instituto Nacional de Estadística/INE). Methods: The following will be conducted: a qualitative study to select socio-health indicators using RAND methodology in accordance with SDH frameworks, based on indicators published by the INE in selected operations; and a quantitative study combining two large databases drawn from different Spain's Autonomous Regions (ARs) to enable hospital morbidity to be ascertained, i.e., PC electronic health records and the minimum basic data set (MBDS) for hospital discharges. These will be linked to socioeconomic indicators, previously selected by geographic unit. The outcome variable will be hospital morbidity, and the independent variables will be age, sex, PC morbidity, geographic unit, and socioeconomic indicators. Analysis: To achieve the first objective, predictive models will be used, with a test-and-training technique, fitting multiple logistic regression models. In the analysis of geographic variability, penalized mixed models will be used, with geographic units considered as random effects and independent predictors as fixed effects. Discussion: This study seeks to show the relationship between SDH and population health, and the geographic differences determined by such determinants. The main limitations are posed by the collection of data for healthcare as opposed to research purposes, and the time lag between collection and publication of data, sampling errors and missing data in registries and surveys. The main strength lies in the project's multidisciplinary nature (family medicine, pediatrics, public health, nursing, psychology, engineering, geography).

Diálogo sobre la implementación local de la Estrategia de Promoción de la Salud y Prevención en el Sistema Nacional de Salud. Informe SESPAS 2018 / Dialogue on the local implementation of the Prevention and Health Promotion Strategy of the Spanish National Health System. SESPAS Report 2018

La implementación local de la Estrategia de Promoción de la Salud y Prevención en el Sistema Nacional de Salud se presenta como una oportunidad para avanzar en promoción de la salud. Aunque existen diferentes visiones desde los ámbitos municipal, autonómico y nacional, así como desde la salud pública y desde la atención primaria, hay consenso en cuanto a que es necesario impulsar las estrategias de salud local. Se deben establecer mecanismos de coordinación que faciliten el trabajo multinivel e intersectorial. La implementación local debe avanzar en la promoción de la participación ciudadana y la salud comunitaria, más allá de la elaboración del mapa de recursos

The local implementation of the Prevention and Health Promotion Strategy of the National Health System is presented as an opportunity to advance in health promotion. Although there are different visions from the municipal, regional and national levels, as well as from public health and from primary care, there is a consensus that it is necessary to promote local health strategies. Coordination mechanisms should be established to facilitate multilevel and intersectoral work. Local implementation must advance in the promotion of citizen participation and community health, beyond the preparation of the resource map

[Dialogue on the local implementation of the Prevention and Health Promotion Strategy of the Spanish National Health System. SESPAS Report 2018]. / Diálogo sobre la implementación local de la Estrategia de Promoción de la Salud y Prevención en el Sistema Nacional de Salud. Informe SESPAS 2018.

The local implementation of the Prevention and Health Promotion Strategy of the National Health System is presented as an opportunity to advance in health promotion. Although there are different visions from the municipal, regional and national levels, as well as from public health and from primary care, there is a consensus that it is necessary to promote local health strategies. Coordination mechanisms should be established to facilitate multilevel and intersectoral work. Local implementation must advance in the promotion of citizen participation and community health, beyond the preparation of the resource map.

The impact of tourism on municipal solid waste generation: the case of Menorca Island (Spain).

Tourism can sustain high levels of employment and income, but the sector is a source of environmental and health impacts. One of the most important is the generation of municipal solid waste (MSW). However, there is a lack of studies which quantify how much the tourist population engages in total MSW and separately collected recyclables. The aim of this paper is to estimate the impact of the tourist population on MSW, both total and separately collected, for the period 1998-2010, for the Mediterranean island of Menorca (Spain). We use dynamic regressions models, including data for monthly stocks of tourists. The results show that, on average, a 1% increase in the tourist population in Menorca causes an overall MSW increase of 0.282% and one more tourist in Menorca generates 1.31 kg day(-1) (while one more resident generates 1.48 kg day(-1)). This result could be useful to better estimate the seasonal population of different regions, since intrannual fluctuation of MSW is used as a proxy measure of actual population (the sum of residents and tourists). Moreover, an increase of 1% in the tourist population causes an increase of 0.232% in separately collected recyclables and an additional tourist generates 0.160 kg day(-1). One resident selectively collects on average 47.3% more than one tourist. These results can help in the planning of waste infrastructure and waste collection services in tourist areas.

Diagnosis delay and follow-up strategies in colorectal cancer. Prognosis implications: a study protocol.

BACKGROUND: Controversy exists with regard to the impact that the different components of diagnosis delay may have on the degree of invasion and prognosis in patients with colorectal cancer. The follow-up strategies after treatment also vary considerably. The aims of this study are: a) to determine if the symptoms-to-diagnosis interval and the treatment delay modify the survival of patients with colorectal cancer, and b) to determine if different follow-up strategies are associated with a higher survival rate. METHODS/DESIGN: Multi-centre study with prospective follow-up in five regions in Spain (Galicia, Balearic Islands, Catalonia, Aragón and Valencia) during the period 2010-2012. Incident cases are included with anatomopathological confirmation of colorectal cancer (International Classification of Diseases 9th revision codes 153-154) that formed a part of a previous study (n = 953).At the time of diagnosis, each patient was given a structured interview. Their clinical records will be reviewed during the follow-up period in order to obtain information on the explorations and tests carried out after treatment, and the progress of these patients.Symptoms-to-diagnosis interval is defined as the time calculated from the diagnosis of cancer and the first symptoms attributed to cancer. Treatment delay is defined as the time elapsed between diagnosis and treatment. In non-metastatic patients treated with curative intention, information will be obtained during the follow-up period on consultations performed in the digestive, surgery and oncology departments, as well as the endoscopies, tumour markers and imaging procedures carried out.Local recurrence, development of metastases in the follow-up, appearance of a new tumour and mortality will be included as outcome variables.Actuarial survival analysis with Kaplan-Meier curves, Cox regression and competitive risk survival analysis will be performed. DISCUSSION: This study will make it possible to verify if the different components of delay have an impact on survival rate in colon cancer and rectal cancer. In consequence, this multi-centre study will be able to detect the variability present in the follow-up of patients with colorectal cancer, and if this variability modifies the prognosis. Ideally, this study could determine which follow-up strategies are associated with a better prognosis in colorectal cancer.

Prevalencia de la obesidad infantil y juvenil en las Illes Balears (EPOIB)

Estudio descriptivo de diseño transversal, realizado en la población infantil y juvenil residente en las Illes Balears escolarizada en 1º y 6º de Educación Primaria (EP) y en 4º de Educación Secundaria Obligatoria (ESO) durante el curso académico 2004-2005. Cuantifica una serie de parámetros mensurables y los relaciona con hábitos alimentarios, ejercicio físico e imagen corporal.

Guía para el fomento de la alimentación saludable y la actividad física

Guía cuyo objetivo es proporcionar a la población la información necesaria para conseguir incorporar a nuestra vida hábitos alimentarios y un estilo de vida saludable.