Trends in social class inequalities in health status, health-related behaviors, and health services utilization in a southern European urban area (1983-1994)
Trends in social class inequalities in health status, health-related behaviors, and health services utilization in a southern European urban area (1983-1994)
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DOI：
10.1006/pmed.2000.0751
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发表时间：
2000-12-01
影响因子：
5.1
通讯作者：
Fernandez, E
中科院分区：
文献类型：
--
作者：
Borrell, C;Rue, M;Fernandez, E
背景资料。本研究的目的是描述西班牙巴塞罗那居民在1983-1994年间在感知健康状况、健康相关行为和卫生服务利用方面的社会阶层不平等的演变。这些信息是从1983年、1986年、1992年和1994年在巴塞罗那进行的健康访谈调查中获得的，在这项研究中，我们包括了14岁的非住院人群。社会阶层是从西班牙改编的英国注册总署署长分类中获得的。我们研究了健康状况、健康相关行为和健康服务利用变量。得到年龄调整后的百分比和不平等的相对指数。在健康状况变量中，被限制在床上和在访谈前两周内严重限制活动的情况表明，1994年按社会阶层划分的不平等现象有所增加。1983至1994年间，按社会阶层划分的男性慢性病模式没有改变。妇女的慢性病患病率更高，社会阶层之间的不平等加剧。1983年，男性在吸烟方面不存在社会阶层不平等。1992年和1994年，吸烟在社会阶层IV和V的男子中更为普遍。1983年，在妇女中，吸烟在社会阶层I和II中比在社会阶层IV和V中更为普遍，这种情况到1994年发生了变化。男性缺乏正常的体力活动总是在社会阶层I和II中更为普遍，而且这种差异随着更多处于有利地位的阶层的人进入不活动而加剧。卫生服务利用不存在不平等现象。政策制定者和公共卫生工作者需要考虑到吸烟和体育活动实践根据社会阶层的变化而变化的模式。(C)2000年美国健康基金会和学术出版社。
Background. The objective of this study was to describe the evolution of social class inequalities in Barcelona (Spain) residents in perceived health status, health-related behaviors, and utilization of health services between 1983 and 1994.Methods. The information was obtained from the Health Interview Surveys conducted in 1983, 1986, 1992, and 1994 in Barcelona, In this study we included noninstitutionalized people ages >14 years. Social class was obtained from the Spanish adaptation of the British Registrar General classification. We studied health status, health-related behaviors, and health services utilization variables. Age-adjusted percentages and the relative index of inequality were obtained.Results. Of the health status variables, having been confined to bed and acute restriction of activity in the 2 weeks prior to the interview showed an increase in inequalities by social class in 1994. The pattern of chronic conditions by social class in men did not change between 1983 and 1994. Women had a higher prevalence of chronic conditions and the inequalities among social classes had increased. In men there were no social class inequalities in smoking in 1983. In 1992 and 1994 smoking was more prevalent in men of social classes IV and V. In women, smoking was more prevalent in social classes I and II in 1983 than in social classes IV and V, something that had changed by 1994. Lack of usual physical activity in men was always more prevalent in social, classes I and II, and this difference increased since more people of advantaged classes moved into inactivity. Health services utilization showed no inequalities in the years studied.Conclusion. The changing pattern according to social class of smoking and physical activity practice needs to be taken into account by policy-makers and public health workers. (C) 2000 American Health Foundation and Academic Press.