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1.
Adicciones ; 0(0): 1367, 2020 Jul 14.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32677698

RESUMO

We aimed to characterize the availability and promotion of alcohol at alcohol outlets in Madrid and to compare them according to type of outlet and area-level socioeconomic status. We used the OHCITIES instrument to characterise the alcohol outlets in 42 census tracts of Madrid in 2016. We specified alcohol availability as the density of alcohol outlets and the number of alcohol outlets with extended opening hours (12 or more). We registered any type of promotion associated to alcohol outlets that could be perceived from outside the outlet. We calculated and compared proportions of availability and promotion by alcohol outlet (on- and off-premise) using chi-squared and Fisher Exact tests. We estimated the availability and promotion of alcohol densities per census tract according to area-level socioeconomic status. To assess statistical significance, we used Kruskal-Wallis tests. We recorded 324 alcohol outlets, 241 on-premise and 83 off-premise. Most of the outlets had extended opening hours (73.77%) and at least one sign promoting alcohol (89.51%). More on-premise outlets had extended opening hours and higher presence of alcohol promotion than off-premise (p < 0.001). Higher density of alcohol outlets, extended opening hours and presence of alcohol promotion were found in higher socioeconomic areas (all p < 0.001). These results were also observed for on-premise alcohol outlets. Alcohol availability and promotion were associated with alcohol outlets in Madrid. Future alcohol policies regulating the availability and promotion of alcohol should consider outlet types and area-level socioeconomic status.

2.
Rev Esp Salud Publica ; 942020 Jun 15.
Artigo em Espanhol | MEDLINE | ID: mdl-32536686

RESUMO

OBJECTIVE: Gambling may cause a variety of problems, both health and social, to the player, his family and his environment; Problems can be more serious for those who gamble more frequently or bet more money. Beyond the mental health gambling disorder and considering other harms derived from gambling, it is possible to develop a public health approach to the issue, including both prevention and harm reduction aspects. In recent decades gambling availability has expanded, with attempts at regulation. The objective of this paper is to provide basic information about gambling in Spain, stratifying data by Autonomous Communities (AC), from a public health perspective. METHODS: A descriptive study of some aspects of gambling in Spain was carried out. The data for amounts gambled by participants, gross gaming revenue of the industry, and establishments or machines licensed for the year 2017 were extracted from the available systematic sources. Aggregated data were tabulated and stratified by AC for those presential gambling categories with the greatest compulsive gambling potential and relevant business volume. Crude results and ratios per 100,000 inhabitants were calculated. RESULTS: Up to 41,826.8 million euros were spent gambling throughout Spain in 2017, a figure that exceeds 3.5% of the Gross Domestic Product, and the largest segment was online gambling in its various modalities (32%), followed by the national lottery and similar traditional games (27%). The supply of gambling venues (74.9 establishments per million inhabitants) was assessed by AC, showing large differences among them: their density in the region of Murcia is tenfold that of Catalonia. Gambling machines that can be installed in hospitality establishments (B machines) showed a density of 43.4 per 1,000 inhabitants, with greater homogeneity across AC than gambling premises. Regional data on the amounts spent in casinos, bingo cards, and sports betting show no homogeneous patterns. CONCLUSIONS: The volume of money spent on gambling in Spain is very important, and online gambling has become the largest business segment. The most traditional game modes and probably with less addictive potential such as lotteries and draws continue to have a relevant presence. The availability of presential gambling shows wide heterogeneity among AC, especially for licensed gambling establishments, whose density is ten times greater in the community with more supply compared to the one with less. The data by AC of some game modalities suggest that availability may be a relevant factor for gambling, but not the only one.

3.
BMC Public Health ; 20(1): 26, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31914967

RESUMO

BACKGROUND: From 2000 to 2008, in urban areas in Spain, adolescent fertility and abortion rates underwent unprecedented increases, consecutive to intensive immigration from developing countries. To address unmet needs for contraception information and services, a community-based, gender-sensitive and culturally adapted brief counselling intervention (SIRIAN program) was launched in some deprived neighbourhoods with a high proportion of immigrants in Barcelona. Once a randomized controlled trial demonstrated its effectiveness in increasing the use of contraceptives, we aim to examine its population impact on adolescent fertility rates. METHODS: Quasi-experimental study with comparison group, using population data from 2005 to 2016. Five neighbourhoods in the lowest tercile of Disposable Household Income were intervened in 2011-13. The comparison group included the three neighbourhoods which were in the same municipal district and in the lowest Disposable Household Income tercile, and displayed the highest adolescent fertility rates. Generalized linear models were fitted to assess absolute adolescent fertility rates and adjusted by immigrant population between pre-intervention (2005-10) and post-intervention periods (2011-16); Difference in Differences and relative pre-post changes analysis were performed. RESULTS: In 2005-10 the intervention group adolescent fertility rate was 27.90 (per 1000 women 15-19) and 21.84 in the comparison group. In 2011-16 intervention areas experienced great declines (adolescent fertility rate change: - 12.30 (- 12.45 to - 12.21); p < 0.001), while comparison neighbourhoods remained unchanged (adolescent fertility rate change: 1.91 (- 2.25 to 6.07); p = 0.368). A reduction of - 10.97 points (- 13.91 to - 8.03); p < 0.001) is associated to the intervention. CONCLUSION: Adolescent fertility rate significantly declined in the intervention group but remained stable in the comparison group. This quasi-experimental study provide evidence that, in a country with universal health coverage, a community counselling intervention that increases access to contraception, knowledge and sexual health care in hard-to-reach segments of the population can contribute to substantially reduce adolescent fertility rates. Reducing adolescent fertility rates could become a feasible goal in cities with similar conditions.


Assuntos
Coeficiente de Natalidade/tendências , Serviços de Saúde Comunitária , Anticoncepção/psicologia , Aconselhamento , Adolescente , Cidades , Anticoncepção/estatística & dados numéricos , Anticoncepcionais/administração & dosagem , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Áreas de Pobreza , Gravidez , Avaliação de Programas e Projetos de Saúde , Características de Residência/estatística & dados numéricos , Espanha , Adulto Jovem
4.
Rev. esp. salud pública ; 94: 0-0, 2020. tab, graf
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET1-5962

RESUMO

OBJETIVO: Participar en juegos de azar puede causar problemas diversos, tanto sanitarios como sociales, que afectan a la persona jugadora, a su familia y a su entorno. Éstos pueden ser más graves para las personas que juegan con mayor frecuencia o que se juegan más dinero. Más allá del trastorno por juego reconocido en la salud mental, y teniendo en cuenta que de las apuestas se derivan otros daños sociales, es posible desarrollar un enfoque de salud pública sobre el juego, contemplando tanto aspectos de prevención como de reducción de daños. En las últimas décadas ha proliferado la oferta de juegos de azar, con algunos intentos de regulación. El objetivo de este trabajo fue aportar información básica sobre la oferta actual de juego en España, desagregando los datos según comunidades autónomas (CCAA), desde una perspectiva de salud pública. MÉTODOS: Se realizó un estudio descriptivo de algunos aspectos de la oferta de juego en España. Los datos de importes jugados, los márgenes estimados de los operadores y establecimientos, o las máquinas licenciadas para el año 2017 se extrajeron de las fuentes sistemáticas consolidadas sobre el juego en España. Se tabularon datos agregados, y se desglosaron por CCAA para las categorías de juego presencial con mayor potencial de juego compulsivo y por volumen relevante de negocio. Se calcularon resultados brutos y razones por 100.000 habitantes. RESULTADOS: En 2017 se jugaron un total de 41.826,8 millones de euros en toda España, cifra que supera el 3,5% del Producto Interior Bruto, y el mayor segmento de negocio fue el juego online en sus diversas modalidades (32%), seguido de los juegos tradicionales como la Lotería Nacional y otros similares (27%). Se valoró la oferta de locales de juego (74,9 locales por millón de habitantes), con grandes diferencias entre CCAA: la región de Murcia tuvo una densidad diez veces mayor que Cataluña. Las máquinas B que pueden instalarse en establecimientos de hostelería presentaron una densidad de 43,4 por 1.000 habitantes, con mayor homogeneidad entre CCAA que los locales de juego. Los datos territorializados de gasto en casinos, cartones de bingo y apuestas deportivas mostraron patrones no concordantes. CONCLUSIONES: El volumen de dinero gastado en juegos de azar en España es muy importante, y el juego online se ha convertido en el mayor segmento de negocio. Las modalidades de juego más tradicionales, y probablemente con menos potencial adictivo, como son las loterías y sorteos, siguen teniendo una presencia muy relevante. La oferta de juego presencial muestra cierta heterogeneidad entre CCAA, especialmente por lo que respecta a los salones de juego. Los datos territorializados de algunas modalidades de juego sugieren que la oferta puede ser un factor condicionante del juego, aunque no el único


OBJECTIVE: Gambling may cause a variety of problems, both health and social, to the player, his family and his environment; Problems can be more serious for those who gamble more frequently or bet more money. Beyond the mental health gambling disorder and considering other harms derived from gambling, it is possible to develop a public health approach to the issue, including both prevention and harm reduction aspects. In recent decades gambling availability has expanded, with attempts at regulation. The objective of this paper is to provide basic information about gambling in Spain, stratifying data by Autonomous Communities (AC), from a public health perspective. METHODS: A descriptive study of some aspects of gambling in Spain was carried out. The data for amounts gambled by participants, gross gaming revenue of the industry, and establishments or machines licensed for the year 2017 were extracted from the available systematic sources. Aggregated data were tabulated and stratified by AC for those presential gambling categories with the greatest compulsive gambling potential and relevant business volume. Crude results and ratios per 100,000 inhabitants were calculated. RESULTS: Up to 41,826.8 million euros were spent gambling throughout Spain in 2017, a figure that exceeds 3.5% of the Gross Domestic Product, and the largest segment was online gambling in its various modalities (32%), followed by the national lottery and similar traditional games (27%). The supply of gambling venues (74.9 establishments per million inhabitants) was assessed by AC, showing large differences among them: their density in the region of Murcia is tenfold that of Catalonia. Gambling machines that can be installed in hospitality establishments (B machines) showed a density of 43.4 per 1,000 inhabitants, with greater homogeneity across AC than gambling premises. Regional data on the amounts spent in casinos, bingo cards, and sports betting show no homogeneous patterns. CONCLUSIONS: The volume of money spent on gambling in Spain is very important, and online gambling has become the largest business segment. The most traditional game modes and probably with less addictive potential such as lotteries and draws continue to have a relevant presence. The availability of presential gambling shows wide heterogeneity among AC, especially for licensed gambling establishments, whose density is ten times greater in the community with more supply compared to the one with less. The data by AC of some game modalities suggest that availability may be a relevant factor for gambling, but not the only one

5.
Rev Esp Salud Publica ; 932019 Jul 15.
Artigo em Espanhol | MEDLINE | ID: mdl-31298227

RESUMO

This paper presents a strategic analysis of the prevention of smoking in Spain. After a review of the situation of the epidemic and of the current prevention policies with the data available in 2019, it identifies the main problems to improve the prevention of smoking, while proposing strategies and key actions for the future. Considering as major objectives reducing the initiation of smoking and helping smokers quit, the different strategies of action and the key actions to be developed. In addition to helping smokers to stop smoking from the health services, key preventive actions include several public policies including taxation, banning advertising and other forms of promotion, the regulation of tobacco packaging, the expansion of smoke-free spaces, and information to the public on its effects. Some of them have followed a positive path for prevention in Spain but for others there is wide room for improvement. The MPOWER strategy of the WHO offers a guide for the development of the most effective tobacco control policies. In its light it is recommended to put emphasis on actions related to expanding smoke-free areas, to develop distance support services to stop smoking, to periodically carry out advertising campaigns of wide coverage to encourage quitting, to reinforce support for quitting in health care services, to finance pharmacological treatments, to expand the advertising ban to electronic devices that release nicotine, and to increase the tax burden on tobacco and other products delivering nicotine.


Assuntos
Abandono do Hábito de Fumar/métodos , Tabagismo/epidemiologia , Tabagismo/prevenção & controle , Política de Saúde , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Humanos , Política Pública , Fumar/economia , Fumar/legislação & jurisprudência , Espanha/epidemiologia , Organização Mundial da Saúde
6.
Gac. sanit. (Barc., Ed. impr.) ; 33(3): 293-295, mayo-jun. 2019. mapas, graf
Artigo em Espanhol | IBECS | ID: ibc-183752

RESUMO

El objetivo de este trabajo es analizar el desempeño de la salud pública por las comunidades autónomas en España a partir de la información accesible en sus documentos anuales de revisión de gestión. Se realizó una búsqueda de sus memorias anuales, que se localizaron en 9 de las 17 comunidades autónomas. De su análisis se desprenden algunas diferencias en las estructuras de salud pública, así como en los contenidos publicados y en la utilización de indicadores de gestión. No siempre se aprecia una explicitación de la cartera de servicios, de los objetivos ni de los recursos adscritos. Si la evaluación de los servicios públicos y su difusión son ejercicios básicos de transparencia y de calidad de gestión, su práctica tiene amplio margen de mejora. La realización de memorias anuales por los servicios de salud pública no es sistemática, y las publicadas aportan poca información para una comparación de su actividad, efectividad y eficiencia


The objective of this study is to analyze the performance of regional public health services in Spain using the information accessible in their annual reports. A search of these was conducted, and 9 were obtained from the 17 Autonomous Communities. Their analysis shows some variation in the structure of the organizations providing public health services, as well as in the published contents and in the indicators used for management. The service portfolio, annual objectives and resources allocated are not always detailed. If the evaluation of public services and its dissemination are basic for transparency and quality management, there is much room for improvement. The compilation of annual reports by public health services is not systematic, and those that exist provide insufficient information for a comparative analysis of their activity, effectiveness and efficiency


Assuntos
Humanos , Administração de Serviços de Saúde/tendências , Relatórios Anuais como Assunto , Administração em Saúde Pública/tendências , Tomada de Decisões Gerenciais , Sistemas de Informação Hospitalar/organização & administração
7.
Rev Esp Salud Publica ; 932019 May 01.
Artigo em Espanhol | MEDLINE | ID: mdl-31038127

RESUMO

OBJECTIVE: The health system in Spain rests mostly in the Autonomous Communities (similar to the states in the US). The public health activities of many local governments are little studied. The objective of this work was to bring knowledge about the public health activities of the municipalities, providing information obtained from a recent survey in Catalonia. METHODS: Descriptive study based on a survey to public health officers in the 119 municipalities above 10,000 population in Catalonia, excluding the city of Barcelona. The survey was conducted between May and October 2016, with 103 municipalities (86.6%) reporting on their services in 2015, prior to the survey. Data were collected and descriptive analyses performed. RESULTS: A consolidation of both political and professional public health structures of the municipalities was observed. Most frequent activities in health protection were related to legionella control, the control of urban pests and the management of complaints and requests by citizens. Most frequent activities in the field of health promotion were related to physical activity and health, prevention in tobacco and alcohol, food and nutrition. There were relatively few changes reported in public health structures and their officers, as well as in human resources. CONCLUSIONS: In Catalonia, municipalities above 10,000 population have a remarkable level of activity in public health. Both the areas of health protection (with mandatory minimum services for local governments) and of health promotion show high levels of activity. The system seems stable regarding political changes and budget constraints. There are opportunities for improvement in the training of professionals and service accreditation. It would be desirable to find ways to improve coordination among these services.


Assuntos
Serviços de Saúde/estatística & dados numéricos , Governo Local , Administração em Saúde Pública/estatística & dados numéricos , Prática de Saúde Pública/estatística & dados numéricos , Serviços Urbanos de Saúde/provisão & distribução , Pesquisas sobre Serviços de Saúde , Promoção da Saúde/organização & administração , Promoção da Saúde/estatística & dados numéricos , Humanos , Espanha , Serviços Urbanos de Saúde/organização & administração
8.
Gac. sanit. (Barc., Ed. impr.) ; 33(1): 89-91, ene.-feb. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183633

RESUMO

Este trabajo describe la aplicación de la técnica de grupos focales a la evaluación de los programas de control de riesgos por alergias e intolerancias alimentarias (AIA) en los comedores escolares de Barcelona. Tras impulsar su implantación, y como un componente cualitativo de su evaluación, los servicios de salud pública realizaron dos grupos focales, uno con personas procedentes de escuelas que gestionan su propia cocina y otro con personas de empresas externas que gestionan este servicio. Participaron 28 personas de un 46% de los centros invitados. Todas las escuelas parecen haber implantado un programa de autocontrol de AIA. Aunque las empresas gestoras externas solían contar ya con él, la mayoría de las escuelas que gestionan su propia cocina no lo tenía y adoptó el programa propuesto por los servicios de salud pública. El número de escolares con alguna AIA notificada disminuyó tras el programa, al exigir este un mayor rigor en su documentación


This paper describes the use of focus groups as part of the evaluation of programmes to control food allergy and intolerance (FAI) in school settings in the city of Barcelona (Spain). After fostering their adoption and as a qualitative component of their evaluation, the public health services ran two focus groups, one with people from schools that manage their own kitchen, and another from companies that outsource this service. There were 28 participants from 46% of the centres invited. All the schools seem to have implemented a self-control programme on FAI. Although outsourcing companies already had a programme, the schools that managed their own service mostly adopted the programme promoted by the public health services. The number of schoolchildren with reported FAI reduced after the programme, as it required more rigorous documentation from families


Assuntos
Humanos , Criança , Intolerância Alimentar/prevenção & controle , Hipersensibilidade Alimentar/prevenção & controle , Alimentação Escolar/normas , Melhoria de Qualidade/tendências , Serviços de Saúde Escolar/organização & administração , Grupos Focais/estatística & dados numéricos , Pesquisa Qualitativa , Gestão de Riscos/organização & administração , Manipulação de Alimentos/classificação
9.
Gac Sanit ; 33(3): 293-295, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-30471836

RESUMO

The objective of this study is to analyze the performance of regional public health services in Spain using the information accessible in their annual reports. A search of these was conducted, and 9 were obtained from the 17 Autonomous Communities. Their analysis shows some variation in the structure of the organizations providing public health services, as well as in the published contents and in the indicators used for management. The service portfolio, annual objectives and resources allocated are not always detailed. If the evaluation of public services and its dissemination are basic for transparency and quality management, there is much room for improvement. The compilation of annual reports by public health services is not systematic, and those that exist provide insufficient information for a comparative analysis of their activity, effectiveness and efficiency.


Assuntos
Relatórios Anuais como Assunto , Serviços de Saúde , Saúde Pública , Serviços de Saúde/normas , Administração de Serviços de Saúde/normas , Humanos , Espanha
10.
Adicciones ; 31(1): 33-40, 2019 Jan 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29353296

RESUMO

INTRODUCTION: This paper describes the presence of alcohol in the public space, assessing establishments that offer it, its advertising, and signs of consumption, as factors that may influence its consumption. METHOD: Descriptive observational study based on cluster sampling with two-step selection. Results are described, and the spatial association between variables is assessed. RESULTS: In the 20 census tracts studied, 306 premises were identified that offered alcoholic beverages: 204 were on-premises and 102 were off-premises, mainly supermarkets and food retail stores. Their spatial distribution was uneven, concentrated in two central districts. We identified 72 publicity items, mostly sponsorship of musical events. There were many promotional items linked to on- premises, especially in their terraces. Five people were detected promoting consumption or selling alcohol in the Old Town. In each time slot, between 39 and 51 signs of consumption on the public space were observed (mostly abandoned beer cans), more frequent at night and in the Old Town. There is an association between the presence of establishments that offer alcohol and advertising. There is no relationship between these variables and signs of consumption in the public space; these are concentrated in the Old Town, which has greater presence of tourism. CONCLUSIONS: The urban environment is characterized by elements that stimulate alcohol use and its distribution is uneven, with a strong influence of tourism-related activities. Further regulation of alcohol promotion, availability and consumption in the public space may change its social image and decrease its use.


Assuntos
Publicidade , Consumo de Bebidas Alcoólicas , Bebidas Alcoólicas/provisão & distribução , Características de Residência , Humanos , Espanha
11.
Gac Sanit ; 33(1): 89-91, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-29691074

RESUMO

This paper describes the use of focus groups as part of the evaluation of programmes to control food allergy and intolerance (FAI) in school settings in the city of Barcelona (Spain). After fostering their adoption and as a qualitative component of their evaluation, the public health services ran two focus groups, one with people from schools that manage their own kitchen, and another from companies that outsource this service. There were 28 participants from 46% of the centres invited. All the schools seem to have implemented a self-control programme on FAI. Although outsourcing companies already had a programme, the schools that managed their own service mostly adopted the programme promoted by the public health services. The number of schoolchildren with reported FAI reduced after the programme, as it required more rigorous documentation from families.


Assuntos
Grupos Focais , Hipersensibilidade Alimentar/prevenção & controle , Intolerância Alimentar/prevenção & controle , Serviços de Alimentação , Humanos , Fatores de Risco , Instituições Acadêmicas , Espanha
12.
Rev. esp. salud pública ; 93: 0-0, 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-189453

RESUMO

Este trabajo presenta un análisis estratégico de la prevención del tabaquismo en España. A partir de una revisión de la situación de la epidemia y de las políticas de prevención vigentes con los datos disponibles en el año 2019, se plantean los problemas prioritarios para mejorar la prevención del tabaquismo, proponiendo unas estrategias y acciones clave para el futuro. Considerando como grandes objetivos evitar el inicio en el tabaquismo y ayudar a los fumadores a dejar el consumo de tabaco, se valoran las di-versas estrategias de actuación y las acciones clave a desarrollar. Además de ayudar a los fumadores a dejar de fumar desde los servicios sanitarios, destacan como acciones clave de prevención diversas políticas públicas como la política fiscal, la prohibición de la publicidad y otras formas de promoción, la regulación de los envases del tabaco, la generalización de los espacios sin humo, y la información a la ciudadanía sobre sus efectos perjudiciales. Algunas han seguido una evolución favorable en España, pero en otras hay amplio margen de mejora. La estrategia MPOWER de la Organización Mundial de la Salud ofrece una guía para el desarrollo de las políticas más efectivas de control del tabaquismo. A su luz, se recomienda poner énfasis en acciones relativas a ampliar las normas sobre aire limpio, en desarrollar servicios de apoyo a distancia para dejar de fumar, en realizar periódicamente campañas publicitarias de amplia cobertura para fomentar el abandono del tabaco, en reforzar el apoyo para dejar de fumar desde los servicios sanitarios, en financiar los tratamientos farmacológicos, en ampliar la prohibición de la publicidad de tabaco a los dispositivos electrónicos que liberan nicotina, y en incrementar la carga fiscal sobre el conjunto de labores de tabaco y otros pro-ductos con nicotina


This paper presents a strategic analysis of the prevention of smoking in Spain. After a review of the situation of the epidemic and of the current prevention policies with the data available in 2019, it identifies the main problems to improve the prevention of smoking, while proposing strategies and key actions for the future. Considering as major objectives reducing the initiation of smoking and helping smokers quit, the different strategies of action and the key actions to be developed. In addition to helping smokers to stop smoking from the health services, key preventive actions include several public policies including taxation, banning advertising and other forms of promotion, the regulation of tobacco packaging, the expansion of smoke-free spaces, and information to the public on its effects. Some of them have followed a positive path for prevention in Spain but for others there is wide room for improvement. The MPOWER strategy of the WHO offers a guide for the development of the most effective tobacco control policies. In its light it is recommended to put emphasis on actions related to expanding smoke-free areas, to develop distance support services to stop smoking, to periodically carry out advertising campaigns of wide coverage to encourage quitting, to reinforce support for quitting in health care services, to finance pharmacological treatments, to expand the advertising ban to electronic devices that release nicotine, and to increase the tax burden on tobacco and other products delivering nicotine


Assuntos
Humanos , Abandono do Hábito de Fumar/métodos , Tabagismo/epidemiologia , Tabagismo/prevenção & controle , Política de Saúde , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Política Pública , Fumar/economia , Fumar/legislação & jurisprudência , Espanha/epidemiologia , Organização Mundial da Saúde
13.
Rev. esp. salud pública ; 93: 0-0, 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-189515

RESUMO

OBJETIVO: El sistema sanitario en España pivota sobre las Comunidades Autónomas. La salud pública gestionada por muchos gobiernos locales está poco estudiada. El objetivo de este trabajo fue contribuir al conocimiento de las actividades de salud pública de los municipios con una encuesta reciente. MÉTODOS: Estudio descriptivo basado en cuestionario a los responsables de salud pública de los 119 municipios mayores de 10,000 habitantes de Catalunya, excluyendo la ciudad de Barcelona. Se realizó entre mayo y octubre de 2016, respondiendo 103 municipios (86,6 %) sobre la situación en 2015, anterior a la encuesta. Los datos se tabularon y sometieron a análisis descriptivos. RESULTADOS: Se apreció una consolidación de las estructuras políticas y técnicas de los municipios en salud pública. Las actuaciones más frecuentes en protección de la salud eran las referidas a la legionelosis, el control de plagas urbanas y la gestión de quejas y denuncias de la ciudadanía; en el ámbito de la promoción de la salud fueron actividad física y salud, prevención en tabaco y alcohol, alimentación y nutrición. Se refirieron relativamente pocos cambios recientes en las estructuras de salud pública, de sus responsables, y de los recursos humanos. CONCLUSIONES: Los municipios catalanes de más de 10.000 habitantes tienen un notable nivel de actividad en salud pública. Tanto los ámbitos de protección de la salud (con servicios mínimos obligatorios para los gobiernos locales) como los de promoción de la salud muestran niveles altos de actividad. El sistema parece estable respecto a cambios políticos y restricciones presupuestarias. Hay oportunidades de mejora en formación de profesionales y acreditación de servicios. Sería deseable mejorar la coordinación entre estos servicios


OBJECTIVE: The health system in Spain rests mostly in the Autonomous Communities (similar to the states in the US). The public health activities of many local governments are little studied. The objective of this work was to bring knowledge about the public health activities of the municipalities, providing information obtained from a recent survey in Catalonia. METHODS: Descriptive study based on a survey to public health officers in the 119 municipalities above 10,000 population in Catalonia, excluding the city of Barcelona. The survey was conducted between May and October 2016, with 103 municipalities (86.6%) reporting on their services in 2015, prior to the survey. Data were collected and descriptive analyses performed. RESULTS: A consolidation of both political and professional public health structures of the municipalities was observed. Most frequent activities in health protection were related to legionella control, the control of urban pests and the management of complaints and requests by citizens. Most frequent activities in the field of health promotion were related to physical activity and health, prevention in tobacco and alcohol, food and nutrition. There were relatively few changes reported in public health structures and their officers, as well as in human resources. CONCLUSIONS: In Catalonia, municipalities above 10,000 population have a remarkable level of activity in public health. Both the areas of health protection (with mandatory minimum services for local governments) and of health promotion show high levels of activity. The system seems stable regarding political changes and budget constraints. There are opportunities for improvement in the training of professionals and service accreditation. It would be desirable to find ways to improve coordination among these services


Assuntos
Humanos , Serviços de Saúde/estatística & dados numéricos , Governo Local , Administração em Saúde Pública/estatística & dados numéricos , Prática de Saúde Pública/estatística & dados numéricos , Serviços Urbanos de Saúde/provisão & distribução , Pesquisas sobre Serviços de Saúde , Promoção da Saúde/organização & administração , Promoção da Saúde/estatística & dados numéricos , Espanha , Serviços Urbanos de Saúde/organização & administração
14.
J Subst Abuse Treat ; 92: 11-16, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30032939

RESUMO

OBJECTIVE: To provide information on persons treated for alcohol use disorders (AUD) over 20 years in a large city in a Southern European country and its trends, adding knowledge on the frequency of treatment from a population perspective. METHODS: This is a study of the number of annual admissions to ambulatory addiction treatment centers funded by the public sector in Barcelona (Catalonia, Spain) for the years 1996-2015. Descriptive analyses of AUD admissions were conducted, comparing changes in the number of patients entering treatment by different independent variables across periods. For city residents, sex and age-specific population annual treatment initiation rates were estimated. RESULTS: The number of ambulatory admissions to AUD treatment increased over the study period. There were about 2100 treatment admissions per year in 2011-2015, of which one fourth were women. About half of these patients had never been treated before for any substance use disorder. Annual rates of treatment initiation among city residents were 208 and 68 per 100,000 people aged 15 and older for men and women respectively, almost the double among 45-54 years old citizens. Rates of total AUD treatment admission increased moderately, but declined among younger adult men. CONCLUSIONS: These figures provide a basic population-based estimation for formal AUD treatment use in a Southern European urban setting with services available free of charge. The development of ambulatory publicly funded addiction centers may have improved access to treatment for people with AUD. age-related changes in treatment admissions may either be related to trends in the population pattern of drinking or to changes in the city demographics.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/reabilitação , Assistência Ambulatorial/estatística & dados numéricos , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Consumo de Bebidas Alcoólicas/prevenção & controle , Assistência Ambulatorial/economia , Assistência Ambulatorial/tendências , Feminino , Financiamento Governamental , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Centros de Tratamento de Abuso de Substâncias/economia , Centros de Tratamento de Abuso de Substâncias/tendências , Adulto Jovem
15.
Gac. sanit. (Barc., Ed. impr.) ; 32(2): 172-175, mar.-abr. 2018. ilus
Artigo em Inglês | IBECS | ID: ibc-171474

RESUMO

Alcohol urban environment has been associated with individual alcohol behaviors. We are constantly exposed to a wide variety of alcohol products, its marketing and promotion and signs of alcohol consumption that may influence alcohol-drinking behaviors. In this photo-essay, we include photographs that visually explain the exposure to alcohol in the urban streetscape of Madrid. These photographs show the pervasiveness of alcohol products in this city, which can be found everywhere at any time (AU)


El entorno urbano del alcohol se ha asociado a su consumo individual. Estamos constantemente expuestos a una amplia variedad de productos con contenido de alcohol, su promoción y signos de consumo, que pueden influir en la normalización del mismo. En este ensayo fotográfico se incluyen imágenes que explican visualmente la exposición al alcohol en el paisaje urbano de Madrid. Estas fotografías muestran la omnipresencia de los productos con contenido de alcohol en esta ciudad, que se puede encontrar en todas partes y en cualquier momento (AU)


Assuntos
Humanos , Masculino , Feminino , Consumo de Bebidas Alcoólicas/epidemiologia , Publicidade/ética , Publicidade/normas , Saúde da População Urbana/economia , Saúde da População Urbana/ética , Fotografia , Controle da Publicidade de Produtos , Saúde da População Urbana/normas
16.
Gac Sanit ; 32(2): 172-175, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28802515

RESUMO

Alcohol urban environment has been associated with individual alcohol behaviors. We are constantly exposed to a wide variety of alcohol products, its marketing and promotion and signs of alcohol consumption that may influence alcohol-drinking behaviors. In this photo-essay, we include photographs that visually explain the exposure to alcohol in the urban streetscape of Madrid. These photographs show the pervasiveness of alcohol products in this city, which can be found everywhere at any time.


Assuntos
Publicidade , Consumo de Bebidas Alcoólicas , Cidades , Saúde da População Urbana , Consumo de Bebidas Alcoólicas/economia , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Consumo de Bebidas Alcoólicas/psicologia , Política de Saúde , Humanos , Marketing , Características de Residência , Espanha/epidemiologia , Fatores de Tempo
17.
Eur J Public Health ; 28(1): 10-15, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-28430945

RESUMO

Background: This study aims to evaluate the effects of a community-based counselling intervention to improve contraception use among immigrant and native residents in deprived neighbourhoods. Methods: Randomized controlled trial. Women aged 14-49 years and men aged 14-39 years from two low-income neighbourhoods with high proportion of immigration in Barcelona (Catalonia, Spain) who had not undergone irreversible contraception and were not planning a pregnancy were recruited (2011-13). A culturally developed and theoretically based brief counselling intervention was delivered in community settings. The primary outcome was the consistent use of effective contraceptive methods (optimal use). Secondary outcomes were the incorrect use of effective methods and the use of less effective methods stratified by sex and migrant status. Differences within subgroups from baseline to the 3-month follow-up were analysed by intention to treat and per protocol. The effects were assessed with adjusted robust Poisson regressions. Results: The study enrolled and randomized 746 eligible participants. There were no differences between the intervention and control groups in demographic characteristics. Optimal use significantly increased in men, women, immigrants and natives in the intervention group, with no changes in the control group. In the intervention group, inconsistent use of effective methods decreased by 54.9% and that of less effective methods by 47.2%. The overall adjusted prevalence ratio of optimal use in the intervention group versus the control group was 1.138 (95% CI: 1.010-1.284). Conclusion: This brief counselling intervention increased the consistent use of effective contraception in low-income neighbourhoods with a high proportion of immigration.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Aconselhamento/métodos , Pobreza , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fatores Socioeconômicos , Espanha , Adulto Jovem
18.
BMJ Open ; 7(10): e017362, 2017 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-28982829

RESUMO

OBJECTIVES: To describe the development and test-retest reliability of OHCITIES, an instrument characterising alcohol urban environment in terms of availability, promotion and signs of consumption. DESIGN: This study involved: (1) developing the conceptual framework for alcohol urban environment by means of literature reviewing and previous alcohol environment research experience; (2) pilot testing and redesigning the instrument; (3) instrument digitalisation; (4) instrument evaluation using test-retest reliability. SETTING: Data for testing the reliability of the instrument were collected in seven census sections in Madrid in 2016 by two observers. PRIMARY AND SECONDARY OUTCOME MEASURES: We computed per cent agreement and Cohen's kappa coefficients to estimate inter-rater and test-retest reliability for alcohol outlet environment measures. We calculated interclass coefficients and their 95% CIs to provide a measure of inter-rater reliability for signs of alcohol consumption measures. RESULTS: We collected information on 92 on-premise and 24 off-premise alcohol outlets identified in the studied areas about availability, accessibility and promotion of alcohol. Most per cent-agreement values for alcohol measures in on-premise and off-premise alcohol outlets were greater than 80%, and inter-rater and test-retest reliability values were generally above 0.80. Observers identified 26 streets and 3 public squares with signs of alcohol consumption. Intraclass correlation coefficient between observers for any type of signs of alcohol consumption was 0.50 (95% CI -0.09 to 0.77). Few items promoting alcohol unrelated to alcohol outlets were found on public spaces. CONCLUSIONS: The OHCITIES instrument is a reliable instrument to characterise alcohol urban environment. This instrument might be used to understand how alcohol environment associates with alcohol behaviours and its related health outcomes, and can help in the design and evaluation of policies to reduce the harm caused by alcohol.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Bebidas Alcoólicas/provisão & distribução , Comércio/estatística & dados numéricos , Características de Residência , População Urbana/estatística & dados numéricos , Feminino , Humanos , Masculino , Modelos Estatísticos , Espanha/epidemiologia
19.
Gac. sanit. (Barc., Ed. impr.) ; 31(3): 242-245, mayo-jun. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-162090

RESUMO

Este trabajo describe el proceso de revisión del catálogo de servicios de salud pública de la ciudad de Barcelona para responder a la reducción presupuestaria producida a partir de 2010 en las administraciones públicas en España. Se basó en un grupo de trabajo que revisó las diferentes líneas de actividad, teniendo en cuenta los gastos y los ingresos asociados y su razón de ser, valorando factores como la obligación legal de desempeño, la financiación finalista, la petición explícita por las administraciones fundadoras y la existencia o no de otros actores capaces de asumirla. Se describen los cambios y sus consecuencias. Se valora que el nuevo catálogo está consolidado y se considera ratificado por los órganos de gobierno, que se han renovado tras los relevos políticos. Creemos que esto es fruto de haberlo basado en el consenso profesional y los criterios de gestión, claves para el buen funcionamiento de un organismo autónomo ejecutivo de carácter público (AU)


This paper describes the review process of the Agency of Public Health of Barcelona's service portfolio in response to the budget cuts introduced since 2010 in the public administrations in Spain. A working group reviewed the different business activities, taking into account their costs and generated revenue and their justification, assessing factors such as the existence of legal constraints, tied funding, explicit demands from the founding administrations and other actors that may be capable of undertaking particular activities. The changes and their consequences are described. The new service portfolio has been consolidated and is considered ratified by the Agency board, which was renewed after political changes. We conclude that this is because it was based on professional consensus and management criteria, which are key for the smooth operation of a public autonomous executive organization (AU)


Assuntos
Humanos , Recessão Econômica/tendências , Atenção à Saúde , Alocação de Recursos/tendências , Administração de Serviços de Saúde/tendências , Resolução de Problemas
20.
Eur J Public Health ; 27(4): 692-699, 2017 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-28431128

RESUMO

Background: We aimed to describe gender and region differences in the prevalence of binge drinking and in the association between binge drinking and well-being, among older adult Europeans. Methods: This is a cross-sectional study using the Survey of Health, Ageing and Retirement in Europe (SHARE) wave 4, conducted between 2011 and 2012, including 58 489 individuals aged 50 years or older. Sixteen European countries were grouped in four drinking culture regions: South, Central, North and East. We categorized drinking patterns as: never, former, no-binge and binge drinkers. We used the CASP-12 questionnaire to measure well-being. To assess the association between binge drinking and well-being, we fitted two-level mixed effects linear models. Results: The highest percentage of binge drinkers was found in Central Europe (17.25% in men and 5.05% in women) and the lowest in Southern Europe (9.74% in men and 2.34% in women). Former, never and binge drinkers had a significant negative association with well-being as compared with no-binge drinkers. There was a significant interaction in this association by gender and region. Overall, associations were generally stronger in women and in Southern and Eastern Europe. The negative association of binge drinking with well-being was especially strong in Southern European women (ß = -3.80, 95% CI: -5.16 to - 2.44, P value <0.001). Conclusion: In Southern and Eastern European countries the association between binge drinking and well-being is stronger, especially in women, compared with Northern and Central Europe. Cultural factors (such as tolerance to drunkenness) should be further explored.


Assuntos
Bebedeira/epidemiologia , Satisfação Pessoal , Idoso , Bebedeira/psicologia , Estudos Transversais , Cultura , Europa (Continente) , Europa Oriental/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários
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