[The accuracy of the causes of death with judicial intervention in Catalonia in the period 2015-2020. Effect of declaration through IML-Web application]. / La precisión de las causas de defunción con intervención judicial en Cataluña en el periodo 2015-2020. Efecto de la declaración a través de la aplicación IML-Web.

OBJECTIVE: On January first, 2020, the Institutes of Legal Medicine and Forensic Sciences (IMLCF) began to inform the causes of death directly to the National Statistics Institute (INE) through a web application (IML-Web). The objective of this study was to evaluate the impact of the implementation of this application on the quality of the data collected. METHODS: A descriptive study using deaths data with judicial intervention that occurred in Catalonia was carried out. The data of the period 2015-2018 and 2019 was compared with 2020. The percentages, with confidence intervals, of the causes of death that were not specific, according to different classifications, were calculated on the total of cases by period and territory. RESULTS: The total percentage of non-specific deaths had decreased, not significantly, by 1.6 points between the period 2015-2018 and 2020. The same indicator between 2019 and 2020 had decreased by 13.4 points. The percentage of non-specific deaths from external causes showed significant drops between both periods and 2020. In general, the indicators displayed territorial differences. CONCLUSIONS: The roll-out of the IML-Web implies, compared to 2019, an improvement in the quality of the data. On the other hand, compared to the period 2015-2018, the data show a similar level of quality. Generally, it is assessed that the information provided by IMLCF of Catalonia through the IML-Web is accurate, but still has room for improvement.

OBJECTIVE: A partir del 1 enero de 2020, los Institutos de Medicina Legal y Ciencias Forenses (IMLCF) empezaron a declarar las causas de muerte directamente al Instituto Nacional de Estadística (INE) mediante una aplicación web (IML-Web). El objetivo de este trabajo fue evaluar el impacto de la implementación de esta aplicación en la calidad de los datos recogidos. METHODS: Se realizó un estudio descriptivo utilizando datos de las defunciones con intervención judicial ocurridas en Cataluña. Se comparó la información del período 2015-2018 y de 2019 con la de 2020. Se calcularon los porcentajes, con intervalo de confianza, de las causas de defunción poco específicas, según diferentes clasificaciones, sobre el total de causas por período y división judicial. RESULTS: El porcentaje total de causas de defunción poco específicas se redujo, de forma no significativa, 1,6 puntos entre el período 2015-2018 y el año 2020. El mismo indicador entre el año 2019 y 2020 se redujo 13,4 puntos. El porcentaje de defunciones poco específicas de causas externas mostró reducciones estadísticamente significativas entre ambos períodos. En general los indicadores mostraron diferencias territoriales. CONCLUSIONS: La implementación del IML-Web en el año 2020 supone, en comparación con 2019, una mejora en la calidad de la información notificada. En cambio, si se compara con el período 2015-2018, los datos muestran una calidad similar. A nivel general se valora que la información proporcionada por el IMLCF de Cataluña a través del IML-Web es precisa, pero todavía tiene margen de mejora.

La precisión de las causas de defunción con intervención judicial en Cataluña en el periodo 2015-2020. Efecto de la declaración a través de la aplicación IML-Web / The accuracy of the causes of death with judicial intervention in Catalonia in the period 2015-2020. Effect of declaration through IML-Web application

Fundamentos: a partir del 1 enero de 2020, los institutos de medicina legal y ciencias forenses (imlcf) empezaron a declarar las causas de muerte directamente al instituto nacional de estadística (ine) mediante una aplicación web (iml-web). El objetivo de este trabajo fue evaluar el impacto de la implementación de esta aplicación en la calidad de los datos recogidos. Métodos: se realizó un estudio descriptivo utilizando datos de las defunciones con intervención judicial ocurridas en cataluña. Se comparó la información del período 2015-2018 y de 2019 con la de 2020. Se calcularon los porcentajes, con intervalo de confianza, de las causas de defunción poco específicas, según diferentes clasificaciones, sobre el total de causas por período y división judicial. Resultados: el porcentaje total de causas de defunción poco específicas se redujo, de forma no significativa, 1,6 puntos entre el período 2015-2018 y el año 2020. El mismo indicador entre el año 2019 y 2020 se redujo 13,4 puntos. El porcentaje de defunciones poco específicas de causas externas mostró reducciones estadísticamente significativas entre ambos períodos. En general los indicadores mostraron diferencias territoriales. Conclusiones: la implementación del iml-web en el año 2020 supone, en comparación con 2019, una mejora en la calidad de la información notificada. En cambio, si se compara con el período 2015-2018, los datos muestran una calidad similar. A nivel general se valora que la información proporcionada por el imlcf de cataluña a través del iml-web es precisa, pero todavía tiene margen de mejora.(AU)

Background: on january first, 2020, the institutes of legal medicine and forensic sciences (imlcf) began to inform the causes of death directly to the national statistics institute (ine) through a web application (iml-web). The objective of this study was to evaluate the impact of the implementation of this application on the quality of the data collected.methods: a descriptive study using deaths data with judicial intervention that occurred in catalonia was carried out. The data of the period 2015-2018 and 2019 was compared with 2020. The percentages, with confidence intervals, of the causes of death that were not specific, according to different classifications, were calculated on the total of cases by period and territory.results: the total percentage of non-specific deaths had decreased, not significantly, by 1.6 points between the period 2015-2018 and 2020. The same indicator between 2019 and 2020 had decreased by 13.4 points. The percentage of non-specific deaths from external causes showed significant drops between both periods and 2020. In general, the indicators displayed territorial differences.conclusions: the roll-out of the iml-web implies, compared to 2019, an improvement in the quality of the data. On the other hand, compared to the period 2015-2018, the data show a similar level of quality. Generally, it is assessed that the information provided by imlcf of catalonia through the iml-web is accurate, but still has room for improvement.(AU)

Decreasing prevalence of chronic back pain in Catalonia. Analysis of the Catalan Health Survey.

OBJECTIVES: Chronic back pain is one of the main health problems reported by the adult population and its prevalence is influenced by different sociodemographic, work and lifestyle-related factors. The aim of this study was to describe the trend in the lifetime prevalence of chronic back pain in the adult Catalan population between 2011 and 2018 and its associated factors. STUDY DESIGN: Cross-sectional study. Secondary analysis of a health survey. METHODS: Trend in lifetime prevalence of chronic back pain by age and sex groups was estimated from the Catalan Health Survey. Association of chronic back pain with sex, age, health status, lifestyle factors, comorbidities, socio-economic and work-related variables was analysed. RESULTS: A total of 31,823 people were interviewed between 2011 and 2018. The prevalence of chronic back pain decreased from 29.7% to 24.2% between 2011-2014 and 2015-2018 in the total population with higher prevalence and a greater difference in women (35%-28.50%) than in men (24.2%-19.7%). Factors associated with higher prevalence of chronic back pain were female sex, older age, poor health status, smoking, alcohol consumption, insufficient physical activity, overweight or obesity, mental health problems, lower educational level or social class, dissatisfaction at workplace, poor social support and family financial problems. CONCLUSIONS: The analysis shows a decreasing prevalence of chronic back pain from 2011 to 2018 in the adult population of Catalonia in all age groups and more significantly in women. An improvement of healthy lifestyle habits, social and occupational determinants, could have reduced the burden of chronic back pain in our community.

Improving prevalence estimation through data fusion: methods and validation.

BACKGROUND: Estimation of health prevalences is usually performed with a single survey. Some attempts have been made to integrate more than one source of data. We propose here to validate this approach through data fusion. Data Fusion is the process of integrating two sources of data into one combined file. It allows us to take even greater advantage of existing information collected in databases. Here, we use data fusion to improve the estimation of health prevalences for two primary health factors: cardiovascular diseases and diabetes. METHODS: We use a real data fusion operation on population health, where the imputation of basic health risk factors is used to enrich a large-scale survey on self-reported health status. We propose choosing the imputation methodology for this problem through a suite of validation statistics that assess the quality of the fused data. The compared imputation techniques have been chosen from among the main imputation methodologies: k-nearest neighbor, probabilistic modeling and regression. We use the 2006 Health Survey of Catalonia, which provides a complete report of the perceived health status. In order to deal with the uncertainty problem, we compare these methodologies under the single and multiple imputation frames. RESULTS: A suite of validation statistics allows us to discern the strengths and weaknesses of studied imputation methods. Multiple outperforms single imputation by providing better and much more stable estimates, according to the computed validation statistics. The summarized results indicate that the probabilistic methods preserve the multivariate structure better; sequential regression methods deliver greater accuracy of imputed data; and nearest neighbor methods end up with a more realistic distribution of imputed data. CONCLUSIONS: Data fusion allows us to integrate two sources of information in order to take grater advantage of the available data. Multiple imputed sequential regression models have the advantage of grater interpretability and can be used for health policy. Under certain conditions, more accurate estimates of the prevalences can be obtained using fused data (the original data plus the imputed data) than just by using only the observed data.

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.

The local burden of emotional disorders. An analysis based on a large health survey in Catalonia (Spain)

Objective Mental health conditions are associated with a significant burden on individuals. Using data from a large population health survey, the present study aimed to quantify the burden of emotional disorders (depression and anxiety) on health-related quality of life (HRQoL) in the region of Catalonia (Spain) for evidence-informed policy making. Methods Regression models were used to estimate the impact of emotional disorders on HRQoL, controlling by socioeconomic factors and somatic health problems. The rate of emotional disorders was based on the General Health Questionnaire (GHQ-12) and quality of life scores were based on the EQ-5D.ResultsThe impact of emotional disorders on HRQoL was equal to a reduction of 0.17 in the EQ-5D score. Translation of this individual impact to population figures yielded a total loss of 78,742 quality-adjusted life years (QALYs) for 2006. This strong impact highlights the need for global policies aiming to reduce this burden. Conclusion The negative relation between emotional disorders and the HRQoL of individuals was confirmed and quantified for the population of Catalonia. The use of quality of life scales such as the SF or EQ-5D, combined with data on quasi-specific health conditions provides substantial information for prioritizing and planning health programs (AU)

Objetivo Los trastornos mentales suponen una importante carga sobre los individuos. A partir de los datos de una encuesta de salud poblacional, el presente estudio cuantifica la carga que suponen los trastornos emocionales (depresión y ansiedad) sobre la calidad de vida relacionada con la salud (CVRS) en Cataluña (España) para una política basada en evidencia informada. Método Se utilizó un modelo de regresión para evaluar el impacto de los trastornos depresivos y de ansiedad sobre la CVRS, controlando por factores socioeconómicos y por otras condiciones de salud. La prevalencia de los trastornos mentales se basó en el Cuestionario de Salud General (GHQ-12), y para obtener la valoración de la calidad de vida se empleó el cuestionario EQ-5D.ResultadosEl impacto de los trastornos emocionales en la CVRS equivale a una reducción de 0,17 en la puntuación del EQ-5D. Este impacto individual, cuando se traslada a cifras poblacionales, equivale a una pérdida de 78.742 años de vida ajustados por calidad para el año 2006. Esta importante cifra señala la necesidad de políticas globales que tengan como objetivo la reducción de esta carga. Conclusión Este estudio confirma y cuantifica para la población de Cataluña la relación negativa entre los trastornos emocionales y la CVRS. El empleo de escalas de calidad de vida, como el SF y el EQ-5D, combinadas con información sobre condiciones de salud, proporciona datos relevantes para la priorización y la planificación de programas sanitarios (AU)

The local burden of emotional disorders. An analysis based on a large health survey in Catalonia (Spain).

OBJECTIVE: Mental health conditions are associated with a significant burden on individuals. Using data from a large population health survey, the present study aimed to quantify the burden of emotional disorders (depression and anxiety) on health-related quality of life (HRQoL) in the region of Catalonia (Spain) for evidence-informed policy making. METHODS: Regression models were used to estimate the impact of emotional disorders on HRQoL, controlling by socioeconomic factors and somatic health problems. The rate of emotional disorders was based on the General Health Questionnaire (GHQ-12) and quality of life scores were based on the EQ-5D. RESULTS: The impact of emotional disorders on HRQoL was equal to a reduction of 0.17 in the EQ-5D score. Translation of this individual impact to population figures yielded a total loss of 78,742 quality-adjusted life years (QALYs) for 2006. This strong impact highlights the need for global policies aiming to reduce this burden. CONCLUSION: The negative relation between emotional disorders and the HRQoL of individuals was confirmed and quantified for the population of Catalonia. The use of quality of life scales such as the SF or EQ-5D, combined with data on quasi-specific health conditions provides substantial information for prioritizing and planning health programs.

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)

Impacto de los trastornos crónicos en la esperanza de vida de la población de Cataluña en 1994 y 2006 / Impact of chronic diseases on life expectancy in the population of Catalonia, Spain, in 1994 and 200

Este trabajo analiza los cambios en la prevalencia de determinados trastornos crónicos y estima su impacto en la esperanza de vida de la población de Cataluña. Los trastornos crónicos seleccionados son: hipertensión arterial, diabetes, ictus, enfermedades del corazón, bronquitis crónica, asma, alergias crónicas, enfermedades del aparato locomotor y ansiedad/depresión. La prevalencia de estos trastornos se estima a partir de los datos recogidos por la Encuesta de Salud de Cataluña en 1994 y 2006. Los trastornos crónicos más frecuentemente presentes en la población catalana son los del aparato locomotor, la hipertensión arterial y la depresión y/o ansiedad. Mediante el análisis de los cambios en la esperanza de vida libre de trastornos crónicos se profundiza en el impacto que estas patologías tienen en la esperanza de vida. La importancia de la morbilidad crónica en nuestra sociedad, así como su impacto en los sistemas de salud, requiere de nuevos estudios que profundicen en el conocimiento de este fenómeno (AU)

This paper analyzes the changes in the prevalence of selected chronic conditions and their impact on the life expectancy in the population of Catalonia. The chronic conditions selected are: hypertension, diabetes, stroke, heart diseases, chronic bronchitis, asthma, chronic allergies, musculoskeletal system diseases, and anxiety/depression. The prevalence of these diseases is estimated from data collected by the Health Survey of Catalonia in 1994 and 2006. The most frequently chronic conditions among the Catalan population are the musculoskeletal disorders, the high blood pressure and the depression and/or anxiety. By the analysis of the changes in the life expectancy free of chronic disorders, this study shows the impact of these disorders in the life expectancy. The burden of the chronic morbidity in our community, and its impact on the health systems, requires further studies to increase the knowledge of this phenomenon (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)

Dependencia para la realización de actividades de la vida diaria en las personas mayores de Cataluña / Dependency for activities of daily living in the elderly in Catalonia, Spain

El objetivo de este artículo es estimar la prevalencia de la dependencia para las actividades de la vida diaria (AVD), características sociodemográficas, de salud y de utilización de servicios en la población ≥ 65 años, diferenciando la población que recibe ayuda y la que no. Estudio transversal (Encuesta de Salud de Cataluña [ESCA] 2006) en el que se analizan 17 AVD. Se estiman las diferencias de proporciones con un intervalo de confianza del 95% para caracterizar los grupos de análisis. Una regresión logística describe las variables explicativas con relación a tener o no ayuda. La prevalencia de dependencia para las AVD es del 26,6% en hombres y el 48,2% en mujeres, de los cuales el 79,6% recibe ayuda. En la prevalencia se observa un gradiente por nivel socioeconómico que no se observa con relación a recibir ayuda o no. Es necesario profundizar en el conocimiento del fenómeno y su evolución, para lo cual la ESCA es un instrumento esencial (AU)

The aim of this article is to estimate the disabilty prevalence for the activities of daily living (ADL), the socioeconomic and demographic characteristics and the use of health services, distinguishing between the population receiving assistance for ADL and not. Cross-sectional study (Encuesta de Salud de Cataluña [ESCA] 2006). We have analyzed 17 ADL. Differences among proportions are estimated with a 95% confidence interval to characterize the analysis groups. Logistic regression describes the explanatory variables about getting help or not. Disabilty prevalence for the ADL: 26.6% men and 48.2% in women. Of these, 79.6% is getting help. There is a socioeconomic gradient in prevalence, not being observed in relation to assistance or not. We must deepen our understanding of the phenomenon and its evolution to which the ESCA is an essential tool (AU)

Calidad de vida relacionada con la salud y factores asociados al sobrepeso y la obesidad en la población infantil de Cataluña / Health-related quality of life and factors associated with overweight and obesity in the pediatric population of Catalonia, Spain

El objetivo de este artículo es describir la calidad de vida relacionada con la salud (CVRS) y analizar los factores asociados al sobrepeso/obesidad en una muestra representativa de población infantil de 0-14 años de Cataluña. Los informadores indirectos respondieron el cuestionario infantil de la Encuesta de Salud de Cataluña (ESCA) 2006 (n = 2.200). Se analizó el peso y la talla, el cuestionario para CVRS KIDSCREEN-10 y escalas de conductas de riesgo, actividad física, frecuencia de consumo de comida rápida, y número de horas de televisión. Se ajustaron modelos de regresión logística. En el 31% de menores la CVRS fue excelente/ muy buena. Las conductas de riesgo y la restricción de actividad fueron factores asociados a la mejor y la peor CVRS. El nivel de estudios materno y algunas conductas y hábitos se asociaron a obesidad y sobrepeso. La ESCA aporta información útil para monitorizar y evaluar las intervenciones dirigidas a la población infantil (AU)

The aim of this work is to describe the health-related quality of life (HRQOL), and to analyze the associated factors to overweight/obesity in a representative sample of the Catalan population 0-14 years old. Proxyrespondents answered the child’s questionnaire of the Encuesta de Salud de Cataluña (ESCA) 2006 (n = 2.200). Variables analyzed were weight and height, the KIDSCREEN-10 HRQOL questionnaire, and also scales on risky behaviors, physical activity, frequency of fast food consumption, and number of hours of television viewing. Logistic regression models were adjusted. In 31% of children HRQOL was excellent/very good. Risky behaviors and restriction of activity were the associated factors to the best and the worst HRQOL. Maternal level of education and some habits and behaviors were associated to overweight/obesity. The ESCA contributes with useful information to monitor and to assess interventions addressed to the children population (AU)