Indicadores socioeconómicos de área pequeña en el estudio de las desigualdades en salud
Small area-based socio-economic indicators in the study of inequalities in health
María Felícitas Domínguez-Berjóna,
, Carme Borrellb, Vicente Pastorc
Autor para correspondencia
felicitas.dominguez@madrid.org
Correspondencia: Servicio de Salud Pública Área 2. Comunidad de Madrid. Avda. Constitución, s/n. 28820 Coslada (Madrid). España.
Correspondencia: Servicio de Salud Pública Área 2. Comunidad de Madrid. Avda. Constitución, s/n. 28820 Coslada (Madrid). España.
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=> "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Carme" "apellidos" => "Borrell" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Vicente" "apellidos" => "Pastor" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "<span class="elsevierStyleItalic">Servicio de Salud Pública del Área 2. Instituto de Salud Pública. Comunidad de Madrid</span>" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "<span class="elsevierStyleItalic">Agencia de Salud Pública de Barcelona. Barcelona</span>" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "<span class="elsevierStyleItalic">Departamento de Medicina Preventiva y Salud Pública. Universidad Autónoma de Madrid. Madrid. España</span>" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Servicio de Salud Pública Área 2. Comunidad de Madrid. Avda. Constitución, s/n. 28820 Coslada (Madrid). España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Small area-based socio-economic indicators in the study of inequalities in health" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-07-31" "fechaAceptado" => "2003-10-06" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec268643" "palabras" => array:5 [ 0 => "Desigualdades sociales en salud" 1 => "Factores socioeconómicos" 2 => "Áreas pequeñas" 3 => "Geocodificación" 4 => "Censo" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec268644" "palabras" => array:5 [ 0 => "Social inequalities in health" 1 => "Socioeconomic factors" 2 => "Small areas" 3 => "Geocoding" 4 => "Census" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Valorar si dos indicadores socioeconómicos (uno simple y otro compuesto) elaborados en el ámbito de sección censal permiten detectar desigualdades sociales en salud.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">De la Encuesta de Salud de Barcelona de 1992 (ESB92) se han considerado el estado de salud percibido, la presencia de trastornos crónicos, el consumo de tabaco y la realización de una citología cervical preventiva, así como el nivel de estudios y la clase social. A partir del censo de 1991, como indicadores socioeconómicos de área se han calculado el porcentaje de desempleo y un índice de privación en las secciones censales. Se analiza la asociación entre las medidas socioeconómicas de área e individuales y la asociación de ambas con las variables de salud.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Existe una clara asociación positiva entre las medidas socioeconómicas de área pequeña y las individuales y, en general, con ambas se han observado similares efectos en diversos aspectos relacionados con la salud, tanto en varones como en mujeres. Con la mayoría de las variables analizadas, las diferencias son superiores con el índice de privación que con el desempleo. Así, en los varones la odds ratio ajustada por edad (ORa) de tener un estado de salud regular, malo o muy malo es de 2,0 (intervalo de confianza [IC] del 95%, 1,4-2,9) en el cuartil más desfavorable de desempleo; en relación con el menos desfavorable y con el índice de privación, la ORa es de 2,7 (IC del 95%, 1,9-3,9), y en las mujeres las ORa son, respectivamente, de 1,8 (IC del 95%, 1,4-2,4) y 2,4 (IC del 95%, 1,8-3,2).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La clasificación por la situación socioeconómica del área de residencia, como la que permite el censo español, se puede aplicar a todos los miembros de una población y es útil para detectar las desigualdades sociales en salud.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess whether 2 area-level socioeconomic indicators (one single and the other composite) are able to detect social inequalities in health.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We used the Health Interview Survey of Barcelona, 1992. Perceived health status, the presence of chronic conditions, smoking, pap test, educational level and social class were analyzed. As area-level indicators, the percentage of unemployment and a deprivation index at census tract level were obtained from the 1991 census. The associations between area-based socioeconomic indicators and individual-level socioeconomic position, as well as the associations among both types of socioeconomic indicator and health, were analyzed.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A clear positive association was found between small area-based socioeconomic indicators and individuallevel indicators. Similar effects were observed for different health outcomes among men as well as among women. For most of the outcomes analyzed, the differences were greater with the deprivation index than with unemployment. Thus, in men the age-adjusted odds ratio (ORa) of average, poor or very poor perceived health status was 2.0 (95% CI, 1.4- 2.9) in the most disadvantaged unemployment quartile in relation to the least disadvantaged quartile while with the deprivation index the ORa was 2.7 (95% CI, 1.9-3.9). For women these ORa were 1.8 (95% CI, 1.4-2.4) and 2.4 (95% CI, 1.8- 3.2), respectively.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Area-based socioeconomic indicators, such as those available through the Spanish census, can be applied in all members of a population and are useful for detecting social inequalities in health.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 7 | 5 | 12 |
| 2024 Octubre | 59 | 36 | 95 |
| 2024 Septiembre | 42 | 26 | 68 |
| 2024 Agosto | 56 | 32 | 88 |
| 2024 Julio | 37 | 31 | 68 |
| 2024 Junio | 41 | 18 | 59 |
| 2024 Mayo | 36 | 27 | 63 |
| 2024 Abril | 28 | 13 | 41 |
| 2024 Marzo | 41 | 21 | 62 |
| 2024 Febrero | 35 | 49 | 84 |
| 2024 Enero | 22 | 19 | 41 |
| 2023 Diciembre | 26 | 15 | 41 |
| 2023 Noviembre | 30 | 18 | 48 |
| 2023 Octubre | 23 | 16 | 39 |
| 2023 Septiembre | 35 | 16 | 51 |
| 2023 Agosto | 32 | 17 | 49 |
| 2023 Julio | 29 | 21 | 50 |
| 2023 Junio | 38 | 21 | 59 |
| 2023 Mayo | 33 | 18 | 51 |
| 2023 Abril | 33 | 25 | 58 |
| 2023 Marzo | 47 | 41 | 88 |
| 2023 Febrero | 18 | 17 | 35 |
| 2023 Enero | 20 | 27 | 47 |
| 2022 Diciembre | 50 | 50 | 100 |
| 2022 Noviembre | 40 | 40 | 80 |
| 2022 Octubre | 34 | 38 | 72 |
| 2022 Septiembre | 35 | 33 | 68 |
| 2022 Agosto | 40 | 43 | 83 |
| 2022 Julio | 29 | 35 | 64 |
| 2022 Junio | 30 | 32 | 62 |
| 2022 Mayo | 26 | 40 | 66 |
| 2022 Abril | 28 | 37 | 65 |
| 2022 Marzo | 28 | 35 | 63 |
| 2022 Febrero | 38 | 36 | 74 |
| 2022 Enero | 29 | 37 | 66 |
| 2021 Diciembre | 31 | 44 | 75 |
| 2021 Noviembre | 38 | 48 | 86 |
| 2021 Octubre | 31 | 44 | 75 |
| 2021 Septiembre | 33 | 40 | 73 |
| 2021 Agosto | 19 | 36 | 55 |
| 2021 Julio | 23 | 39 | 62 |
| 2021 Junio | 18 | 32 | 50 |
| 2021 Mayo | 39 | 36 | 75 |
| 2021 Abril | 55 | 55 | 110 |
| 2021 Marzo | 49 | 21 | 70 |
| 2021 Febrero | 27 | 10 | 37 |
| 2021 Enero | 25 | 21 | 46 |
| 2020 Diciembre | 19 | 15 | 34 |
| 2020 Noviembre | 19 | 11 | 30 |
| 2020 Octubre | 25 | 20 | 45 |
| 2020 Septiembre | 19 | 12 | 31 |
| 2020 Agosto | 7 | 9 | 16 |
| 2020 Julio | 27 | 13 | 40 |
| 2020 Junio | 32 | 7 | 39 |
| 2020 Mayo | 22 | 8 | 30 |
| 2020 Abril | 21 | 19 | 40 |
| 2020 Marzo | 17 | 6 | 23 |
| 2020 Febrero | 25 | 37 | 62 |
| 2020 Enero | 21 | 17 | 38 |
| 2019 Diciembre | 20 | 17 | 37 |
| 2019 Noviembre | 12 | 7 | 19 |
| 2019 Octubre | 22 | 2 | 24 |
| 2019 Septiembre | 21 | 10 | 31 |
| 2019 Agosto | 16 | 14 | 30 |
| 2019 Julio | 26 | 3 | 29 |
| 2019 Junio | 17 | 8 | 25 |
| 2019 Mayo | 22 | 8 | 30 |
| 2019 Abril | 19 | 9 | 28 |
| 2019 Marzo | 13 | 7 | 20 |
| 2019 Febrero | 11 | 5 | 16 |
| 2019 Enero | 9 | 5 | 14 |
| 2018 Diciembre | 5 | 10 | 15 |
| 2018 Noviembre | 8 | 9 | 17 |
| 2018 Octubre | 23 | 17 | 40 |
| 2018 Septiembre | 17 | 9 | 26 |
| 2018 Agosto | 11 | 8 | 19 |
| 2018 Julio | 24 | 9 | 33 |
| 2018 Junio | 11 | 10 | 21 |
| 2018 Mayo | 20 | 7 | 27 |
| 2018 Abril | 18 | 8 | 26 |
| 2018 Marzo | 4 | 4 | 8 |
| 2018 Febrero | 14 | 6 | 20 |
| 2018 Enero | 4 | 2 | 6 |
| 2017 Diciembre | 15 | 11 | 26 |
| 2017 Noviembre | 14 | 9 | 23 |
| 2017 Octubre | 6 | 10 | 16 |
| 2017 Septiembre | 13 | 8 | 21 |
| 2017 Agosto | 8 | 6 | 14 |
| 2017 Julio | 10 | 9 | 19 |
| 2017 Junio | 22 | 10 | 32 |
| 2017 Mayo | 23 | 7 | 30 |
| 2017 Abril | 21 | 7 | 28 |
| 2017 Marzo | 20 | 4 | 24 |
| 2017 Febrero | 9 | 2 | 11 |
| 2017 Enero | 11 | 3 | 14 |
| 2016 Diciembre | 26 | 4 | 30 |
| 2016 Noviembre | 28 | 6 | 34 |
| 2016 Octubre | 23 | 8 | 31 |
| 2016 Septiembre | 26 | 9 | 35 |
| 2016 Agosto | 38 | 8 | 46 |
| 2016 Julio | 20 | 4 | 24 |
| 2016 Junio | 1 | 0 | 1 |
| 2016 Marzo | 1 | 0 | 1 |
| 2016 Febrero | 3 | 0 | 3 |
| 2015 Diciembre | 1 | 0 | 1 |
| 2015 Octubre | 0 | 7 | 7 |
| 2015 Septiembre | 1 | 7 | 8 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 1 | 7 | 8 |
| 2015 Junio | 2 | 0 | 2 |
| 2015 Marzo | 1 | 0 | 1 |
| 2015 Febrero | 1 | 0 | 1 |
| 2015 Enero | 1 | 0 | 1 |
| 2014 Diciembre | 5 | 0 | 5 |
| 2014 Noviembre | 3 | 0 | 3 |
| 2014 Octubre | 3 | 0 | 3 |
| 2014 Septiembre | 9 | 0 | 9 |
| 2014 Agosto | 22 | 0 | 22 |
| 2014 Julio | 19 | 0 | 19 |
| 2014 Junio | 16 | 0 | 16 |
| 2014 Mayo | 9 | 0 | 9 |
| 2014 Abril | 7 | 2 | 9 |
| 2014 Marzo | 19 | 0 | 19 |
| 2014 Febrero | 9 | 4 | 13 |
| 2014 Enero | 17 | 1 | 18 |
| 2013 Diciembre | 12 | 1 | 13 |
| 2013 Noviembre | 25 | 2 | 27 |
| 2013 Octubre | 29 | 2 | 31 |
| 2013 Septiembre | 14 | 6 | 20 |
| 2013 Agosto | 32 | 5 | 37 |
| 2013 Julio | 27 | 3 | 30 |
| 2004 Marzo | 986 | 0 | 986 |
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