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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Valorar si dos indicadores socioecon&#243;micos &#40;uno simple y otro compuesto&#41; elaborados en el &#225;mbito de secci&#243;n censal permiten detectar desigualdades sociales en salud&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">De la Encuesta de Salud de Barcelona de 1992 &#40;ESB92&#41; se han considerado el estado de salud percibido&#44; la presencia de trastornos cr&#243;nicos&#44; el consumo de tabaco y la realizaci&#243;n de una citolog&#237;a cervical preventiva&#44; as&#237; como el nivel de estudios y la clase social&#46; A partir del censo de 1991&#44; como indicadores socioecon&#243;micos de &#225;rea se han calculado el porcentaje de desempleo y un &#237;ndice de privaci&#243;n en las secciones censales&#46; Se analiza la asociaci&#243;n entre las medidas socioecon&#243;micas de &#225;rea e individuales y la asociaci&#243;n de ambas con las variables de salud&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Existe una clara asociaci&#243;n positiva entre las medidas socioecon&#243;micas de &#225;rea peque&#241;a y las individuales y&#44; en general&#44; con ambas se han observado similares efectos en diversos aspectos relacionados con la salud&#44; tanto en varones como en mujeres&#46; Con la mayor&#237;a de las variables analizadas&#44; las diferencias son superiores con el &#237;ndice de privaci&#243;n que con el desempleo&#46; As&#237;&#44; en los varones la odds ratio ajustada por edad &#40;ORa&#41; de tener un estado de salud regular&#44; malo o muy malo es de 2&#44;0 &#40;intervalo de confianza &#91;IC&#93; del 95&#37;&#44; 1&#44;4-2&#44;9&#41; en el cuartil m&#225;s desfavorable de desempleo&#59; en relaci&#243;n con el menos desfavorable y con el &#237;ndice de privaci&#243;n&#44; la ORa es de 2&#44;7 &#40;IC del 95&#37;&#44; 1&#44;9-3&#44;9&#41;&#44; y en las mujeres las ORa son&#44; respectivamente&#44; de 1&#44;8 &#40;IC del 95&#37;&#44; 1&#44;4-2&#44;4&#41; y 2&#44;4 &#40;IC del 95&#37;&#44; 1&#44;8-3&#44;2&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La clasificaci&#243;n por la situaci&#243;n socioecon&#243;mica del &#225;rea de residencia&#44; como la que permite el censo espa&#241;ol&#44; se puede aplicar a todos los miembros de una poblaci&#243;n y es &#250;til para detectar las desigualdades sociales en salud&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess whether 2 area-level socioeconomic indicators &#40;one single and the other composite&#41; are able to detect social inequalities in health&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We used the Health Interview Survey of Barcelona&#44; 1992&#46; Perceived health status&#44; the presence of chronic conditions&#44; smoking&#44; pap test&#44; educational level and social class were analyzed&#46; As area-level indicators&#44; the percentage of unemployment and a deprivation index at census tract level were obtained from the 1991 census&#46; The associations between area-based socioeconomic indicators and individual-level socioeconomic position&#44; as well as the associations among both types of socioeconomic indicator and health&#44; were analyzed&#46;</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&#46; Similar effects were observed for different health outcomes among men as well as among women&#46; For most of the outcomes analyzed&#44; the differences were greater with the deprivation index than with unemployment&#46; Thus&#44; in men the age-adjusted odds ratio &#40;ORa&#41; of average&#44; poor or very poor perceived health status was 2&#46;0 &#40;95&#37; CI&#44; 1&#46;4- 2&#46;9&#41; in the most disadvantaged unemployment quartile in relation to the least disadvantaged quartile while with the deprivation index the ORa was 2&#46;7 &#40;95&#37; CI&#44; 1&#46;9-3&#46;9&#41;&#46; For women these ORa were 1&#46;8 &#40;95&#37; CI&#44; 1&#46;4-2&#46;4&#41; and 2&#46;4 &#40;95&#37; CI&#44; 1&#46;8- 3&#46;2&#41;&#44; respectively&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Area-based socioeconomic indicators&#44; such as those available through the Spanish census&#44; can be applied in all members of a population and are useful for detecting social inequalities in health&#46;</p>"
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Vol. 18. Núm. 2.
Páginas 92-100 (marzo - abril 2004)
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Vol. 18. Núm. 2.
Páginas 92-100 (marzo - abril 2004)
Open Access
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
Visitas
5745
María Felícitas Domínguez-Berjóna,
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.
, Carme Borrellb, Vicente Pastorc
a Servicio de Salud Pública del Área 2. Instituto de Salud Pública. Comunidad de Madrid
b Agencia de Salud Pública de Barcelona. Barcelona
c Departamento de Medicina Preventiva y Salud Pública. Universidad Autónoma de Madrid. Madrid. España
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Bibliografía
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Resumen
Objetivo

Valorar si dos indicadores socioeconómicos (uno simple y otro compuesto) elaborados en el ámbito de sección censal permiten detectar desigualdades sociales en salud.

Métodos

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.

Resultados

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).

Conclusiones

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.

Palabras clave:
Desigualdades sociales en salud
Factores socioeconómicos
Áreas pequeñas
Geocodificación
Censo
Abstract
Objective

To assess whether 2 area-level socioeconomic indicators (one single and the other composite) are able to detect social inequalities in health.

Methods

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.

Results

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.

Conclusions

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.

Key words:
Social inequalities in health
Socioeconomic factors
Small areas
Geocoding
Census
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