Innovando en salud pública: monitorización de los determinantes sociales de la salud y reducción de las desigualdades en salud: una prioridad para la presidencia española de la Unión Europea en 2010

Mapping the awareness of inequalities in health programs in Spanish communities: moving forward together

The aim of this study is to map the awareness of gender, socioeconomic, immigrant and ethnic health inequalities in health at schools, maternal health and traffic injury health prevention programs. The study was conducted in the 19 health descentralized areas in Spain, 17 autonomous community (ACs) and the 2 autonomous cities (ACities). The data were collected from May 2008 to January 2009. The unit of analysis was the collection of policy documents setting out the programs mentioned above and the related support material in each AC. A reading guide was used to analyze the awareness of inequalities. With regard to health at schools, 2 of 10 programs show a high awareness of inequalities and include many specific proposals to be implemented at the local level. Regarding maternal health, 13 ACs have prepared support material with high awareness of inequalities to be implemented. A traffic injury program has been created in two ACs. We map the whole situation in Spain regarding the health programs that we have used as examples and their awareness of inequalities. We can conclude that there are differences between the regions studied in Spain and in general, the awareness of inequalities is low.

Monitoring Social Determinants of Health Inequalities: The Impact of Unemployment among Vulnerable Groups

Surveillance of social determinants of health inequalities is an essential but still underdeveloped issue in public health. Existing research has identified unemployment as an important social determinant of health inequalities. This cross-sectional study investigates the impact of unemployment on mental health outcomes among vulnerable groups, using the 2006 Catalonian Health Survey (N = 8,591). The authors estimate the prevalence ratios and differences (excess of prevalence) for poor mental health in the unemployed and employed, with 95 percent confidence intervals. After taking into account the interactions among social mechanisms of inequality and related factors, the authors identified seven vulnerable groups to monitor. Primary findings indicate that unemployment has a greater adverse effect on the mental health of male manual workers, single mothers, main-earner women, and manual workers without unemployment benefits for both sexes. Findings support the need to devote more research to the surveillance of unemployment as a social determinant of health inequalities, to identify additional unemployment indicators, and to consider how various social mechanisms of inequality interact with each other to produce health inequalities among vulnerable groups.