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array:24 [ "pii" => "S0213911108760692" "issn" => "02139111" "doi" => "10.1016/S0213-9111(08)76069-2" "estado" => "S300" "fechaPublicacion" => "2008-04-01" "aid" => "76069" "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria" "copyrightAnyo" => "2008" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Gac Sanit. 2008;22 Supl 1:8-13" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2256 "formatos" => array:3 [ "EPUB" => 139 "HTML" => 1660 "PDF" => 457 ] ] "itemSiguiente" => array:19 [ "pii" => "S0213911108760709" "issn" => "02139111" "doi" => "10.1016/S0213-9111(08)76070-9" "estado" => "S300" "fechaPublicacion" => "2008-04-01" "aid" => "76070" "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Gac Sanit. 2008;22 Supl 1:14-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2012 "formatos" => array:3 [ "EPUB" => 144 "HTML" => 1360 "PDF" => 508 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Capítulo 1. Mejorando la información y el conocimiento para las intervenciones sobre la salud</span>" "titulo" => "Integración de la información para las intervenciones sanitarias: de los datos a la información; de la información a la acción. Informe SESPAS 2008" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "14" "paginaFinal" => "18" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Integration of information for health interventions: from data to information and from information to action" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Campillo Artero" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Carlos" "apellidos" => "Campillo Artero" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760709?idApp=WGSE" "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760709/v1_201301221349/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0213911108760680" "issn" => "02139111" "doi" => "10.1016/S0213-9111(08)76068-0" "estado" => "S300" "fechaPublicacion" => "2008-04-01" "aid" => "76068" "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "edi" "cita" => "Gac Sanit. 2008;22 Supl 1:1-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4276 "formatos" => array:3 [ "EPUB" => 148 "HTML" => 2436 "PDF" => 1692 ] ] "es" => array:9 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Introducción</span>" "titulo" => "Los siete pecados capitales de la evaluación del impacto. Informe SESPAS 2008" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1" "paginaFinal" => "7" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The seven deadly sins of impact evaluations" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cesar G. Victora, Iná S. Santos" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Cesar G." "apellidos" => "Victora" ] 1 => array:2 [ "nombre" => "Iná S." "apellidos" => "Santos" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760680?idApp=WGSE" "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760680/v1_201301221349/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Capítulo 1. Mejorando la información y el conocimiento para las intervenciones sobre la salud</span>" "titulo" => "El papel de la epidemiología en la definición de políticas. Hacia la salud pública que se necesita. Informe SESPAS 2008" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "8" "paginaFinal" => "13" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carlos Álvarez-Dardet" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Carlos" "apellidos" => "Álvarez-Dardet" "email" => array:1 [ 0 => "carlos.alvarez@ua.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Universidad de Alicante, Alicante, España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Carlos Álvarez-Dardet. Universidad de Alicante." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The role of epidemiology in policy definition. Toward the public health required" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec13626" "palabras" => array:2 [ 0 => "Epidemiología" 1 => "Políticas de salud" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec13625" "palabras" => array:2 [ 0 => "Epidemiology" 1 => "Health policy" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La epidemiología ocupa ya un papel relevante en la definición de políticas públicas y corporativas, tanto en España como en otros países desarrollados, especialmente en los últimos años, en que como consecuencia de la entronización por la Organización Mundial de la Salud de la noción de determinantes sociales de la salud, la conexión entre la salud y lo construido socialmente se ha hecho más evidente.</p><p class="elsevierStyleSimplePara elsevierViewall">El uso de la epidemiología, sin embargo, suele verse restringido al desarrollo y la evaluación de políticas originadas en burocracias sanitarias y con la mejora de la salud como único objetivo social; son las llamadas políticas directas de salud. Esto supone una visión reduccionista del tema, ya que la salud se gana y se pierde por políticas extrasanitarias primordialmente.</p><p class="elsevierStyleSimplePara elsevierViewall">Para ampliar el papel de la epidemiología como herramienta para las políticas, necesitaríamos tener una visión de las exposiciones y los efectos más allá de la esfera sanitaria y de los factores de riesgo –biológicos y conductuales–propuestos por el paternalismo médico. Hay que tener una actitud más participative que prescriptiva, desarrollar más estudios de evaluación del impacto en salud y empezar a valorar también el efecto sobre la salud de las decisiones de las instituciones que derivan del poder político. Es decir, construir una epidemiología política.</p><p class="elsevierStyleSimplePara elsevierViewall">Para esta tarea, quizás clave para desarrollar la salud pública que necesitamos, los salubristas deberían ser más visibles y más creíbles, tender más a la independencia del poder político, y suministrar información directamente a la población y otros interesados (transparencia), desarrollando su profesionalización plena (competencia) más como redes de profesionales que como pirámides burocráticas.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Epidemiology already plays a substantial role in the definition of public and corporate policies in Spain as well as in other developed countries. The World Health Organization reinforced the position of epidemiology by enshrining the notion of social health determinants and, as a result, the connection between health and social constructs has become more visible.</p><p class="elsevierStyleSimplePara elsevierViewall">However, the use of epidemiology is usually restricted to the development and evaluation of policies originating in health bureaucracies with health improvement as the only public objective; these are called direct health policies. This view is somewhat reductionistic insofar as health gains and losses occur mainly due to policies outside the health sector.</p><p class="elsevierStyleSimplePara elsevierViewall">To expand the role of epidemiology as a tool to shape policies, we need a view of exposures and effects beyond healthcare and the biological and behavioral risk factors proposed by medical paternalism. Also required are an attitude that is more participative than prescriptive and the development of more health impact assessments. In addition, the health effects of the decisions taken by politically-empowered institutions should be included in the epidemiologist's tool kit. In other words, a political epidemiology should be constructed.</p><p class="elsevierStyleSimplePara elsevierViewall">For this endeavor, which may be crucial to attain the public health required, public health practitioners should be more visible and credible, have greater independence from political power, provide information directly to the public and other stake holders (greater transparency), and further develop the professionalization of public health (greater competence) by working increasingly in networks of professionals rather than in bureaucratic pyramids.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Promoting health trough public policies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "N. 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