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Biomedical subjects

E Regidor

Publications and source records attributed to E Regidor.

At least 37 records · Page 2Linked to original sources
PubMed2000

Increasing prevalence of overweight and obesity among Spanish adults, 1987-1997.

OBJECTIVE: To study the trend in the prevalence of obesity and overweight in Spanish men and women 25-64 y of age between 1987 and 1997. DESIGN: Cross-sectional surveys of representative samples of the non-institutionalized population in Spain in 1987, 1995 and 1997. SUBJECTS: 14,676 and 7004 adults aged 25-64 who were representative of the Spanish population in 1987 and 1995/1997. MEASURES: Body mass index (BMI) calculated from self-reported weight and height. Overweight is defined as BMI = 27-29.9 kg/m2 and obesity as BMI > or = 30 kg/m2. RESULTS: Between 1987 and 1995/97, the prevalence of overweight in the Spanish population aged 25-64 increased by 2.2% (P < 0.01); the increase was greater in men (3.8%; P < 0.01) than in women (0.6%; P > 0.05). The largest increases in the prevalence of overweight were seen in men (5.2%; P < 0.01) and women (2.3%; P < 0.05) aged 25-34. During the same period, the prevalence of obesity increased by 3.9% (P < 0.01), 4.6% in men (P < 0.01) and 3.2% in women (P < 0.01). The largest increases were seen in men aged 45-54 (6.5%, P < 0.01) and in women aged 25-34 (2.2%, P < 0.05). By educational level, the prevalence of overweight increased significantly in men with fewer than 12 y of education (4.7%, P < 0.01). Obesity increased by 4.6% (P < 0.01) and by 4.9% (P < 0.01) in men and women with fewer than 12 y of education, respectively. CONCLUSIONS: The prevalence of overweight and obesity is increasing in Spain, the same as it is in other developed countries. The increase, which is found in most age and sex groups in the population, especially affects middle-aged men, young women and persons with lower educational level. The causes of the increase in the prevalence of overweight and obesity are likely to be multifactorial.

Adult↗
PubMed1999

[Acute respiratory problems and cocaine or heroine smoking].

BACKGROUND: To explore if cocaine or heroin smoking was positively associated to acute respiratory complications (ARC). SUBJECTS AND METHODS: We collected data from medical records for 717 cocaine users who were attended in 14 hospital emergency rooms. The association was studied by logistic regression. RESULTS: The most frequent ARC were respiratory infections and complications with chest pain or dyspnea. Cocaine smokers (OR = 3.3; CI 95% = 1.5-6.9) and cocaine sniffers (OR = 2.5; CI 95% = 1.1-5.6) had greater risk of ARC than cocaine injectors. Heroin smokers (OR = 3.5; COI 95% = 1.8-7.0) and heroin sniffers (OR = 2.8; CI 95% = 1.4-5.6) had greater risk of ARC than non heroin users. CONCLUSIONS: These results suggest that cocaine or heroin smoking increases the risk of ARC.

Acute Disease↗
PubMed1999

Inequalities in mortality according to educational level in two large Southern European cities.

BACKGROUND: In Spain, studies on social inequalities in mortality based on individuals are few due to the poor quality of information on occupation in death certificates. This study looks at the differences in mortality according to educational level, using individual information obtained through the linkage between the Death Register and the Municipal Census, in the cities of Madrid and Barcelona, Spain. METHODS: The study populations were residents of Madrid and Barcelona aged >24 years, who died in 1993 and 1994. Indicators obtained for each city and educational level were: age- and sex-specific mortality rates, and life expectancy at 25 years. Poisson regression models were fitted to obtain the relative risk (RR) of death for each educational level with respect to the reference level (higher education completed), adjusted for age. RESULTS: The mortality rate was lower among individuals with higher educational levels, while life expectancy at 25 years was higher. In both cities men and women with no education showed the highest mortality in all age groups, with very high RR in the youngest age group (RR for men aged 25-34 years = 7.08 in Madrid and 6.02 in Barcelona, whereas in women these RR were 6.33 and 5.63 respectively). In Barcelona the greater part of the overall mortality difference for the group aged 25-34 years was due to AIDS (acquired deficiency syndrome, 33.4% in men and 59.3% in women). CONCLUSION: The present study has found higher mortality (mainly from AIDS) among individuals with no academic qualifications thus drawing attention to the need to implement policies aimed at reducing these inequalities.

Adult↗
PubMed1999

Association between educational level and health related quality of life in Spanish adults.

OBJECTIVE: To analyse differences in health by educational level in Spanish adults by comparing the health dimensions of the SF-36 Heath Survey. DESIGN: Data were taken from the National Survey on Drug Use carried out in February 1996. The information was collected by home personal interview. In addition to measuring the use of legal and illegal drugs and their associated health risks, the health status of the Spanish population was analysed using the Spanish version of the SF-36 Health Survey. MAIN OUTCOME MEASURE: Absolute and standardised differences between mean score on each dimension of the SF-36 Health Survey in each educational group with respect to the group with the highest educational level. RESULTS: Perceived health status declines with decreasing educational level, except in women with second level education who have a higher mean rating than women with third level education on various health dimensions. The absolute differences in perceived health between the different categories of educational level and the reference category become larger with increasing age. The greatest differences by educational level in both men and women were found in mental health and general health among persons 25 to 44 years of age, and in physical function and general health among those 45 to 64 years. In persons aged 65 or older, the greatest differences are seen in physical function and vitality in men, and in bodily pain and emotional role in women. CONCLUSIONS: The influence of educational level on the different dimensions of perceived health may vary by sex.

Adolescent↗
PubMed1999

The magnitude of differences in perceived general health associated with educational level in the regions of Spain.

STUDY OBJECTIVE: To examine and compare the relation between inequalities in perceived general health and education in the 17 regions of Spain. DESIGN AND METHODS: Data were taken from the 1993 Spanish Health Interview Survey. For each region we calculated the magnitude of inequality in perceived general health in association with educational level by a measure of association or effect and by a relative index of inequality. Both measures are odds ratios and were estimated by logistic regression. The first is an odds ratio associated with one year less education, while the second represents the inequality in perceived general health between those at the bottom and those at the top of the educational hierarchy. MAIN RESULTS: The six regions with the highest relative indices of inequality also have the highest odds ratios associated with one year less education, and five of the six regions with the lowest relative indices of inequality have the lowest odds ratios associated with one year less education. Pearson's correlation coefficient between the odds ratio and the relative index of inequality is 0.94. CONCLUSIONS: Regional differences in levels of inequality in perceived general health are attributable exclusively to the effect of education on health and not to the distribution of the population among the different educational levels. It is not known why the magnitude of this effect of education on health varies from one area to another.

Adolescent↗
PubMed1999

Occupational class and ischemic heart disease mortality in the United States and 11 European countries.

OBJECTIVES: Twelve countries were compared with respect to occupational class differences in ischemic heart disease mortality in order to identify factors that are associated with smaller or larger mortality differences. METHODS: Data on mortality by occupational class among men aged 30 to 64 years were obtained from national longitudinal or cross-sectional studies for the 1980s. A common occupational class scheme was applied to most countries. Potential effects of the main data problems were evaluated quantitatively. RESULTS: A north-south contrast existed within Europe. In England and Wales, Ireland, and Nordic countries, manual classes had higher mortality rates than nonmanual classes. In France, Switzerland, and Mediterranean countries, manual classes had mortality rates as low as, or lower than, those among nonmanual classes. Compared with Northern Europe, mortality differences in the United States were smaller (among men aged 30-44 years) or about as large (among men aged 45-64 years). CONCLUSIONS: The results underline the highly variable nature of socioeconomic inequalities in ischemic heart disease mortality. These inequalities appear to be highly sensitive to social gradients in behavioral risk factors. These risk factor gradients are determined by cultural as well as socioeconomic developments.

Adult↗
PubMed1998

[Population reference values of the Spanish version of the Health Questionnaire SF-36].

BACKGROUND: Perceived health status measurements reference values an important information source for health services research. Population-based norms have been proposed to increase their interpretability. In this paper, we have obtained the norms of the Spanish version of the SF-36 Health Survey and have compared them with US norms the questionnaire. MATERIAL AND METHODS: Data were obtained in the home interview survey on drug consumption (February 1996). This is a cross-sectional study of a multi-stage, stratified random sample of non-institutionalized individuals 15 and older residents in Spain. The final sample included 9,984 individuals, but the analysis is based on those individuals 18 or older (n = 9,151). Personal home interviews were carried out. Information included: the SF-36, legal and illegal drugs consumption, and socio-demographic data, among others. Central trend and dispersion statistics were estimated for each of the SF-36 dimension scores according to gender and age group. Cronbach's alpha coefficients were calculated to estimate the reliability of scores. RESULTS: For most SF-36 dimensions, scores were higher (better) among men and among younger age groups (p < 0.01). There was a monotonic score gradient by age which was more intense for physical function and bodily pain. All Cronbach's alpha coefficients were higher than 0.7 (ranging from 0.78 to 0.96). Spanish norms were very similar to those obtained in the US. CONCLUSIONS: Results presented should be considered the population-based norms of the Spanish version of the SF-36 Health Survey and may be useful for interpreting the questionnaire scores. These norms, which are very similar to the original US questionnaire both in absolute values and in the gender and age group distribution patterns, should be carefully used. Considerations for use discussed in the paper should be taken into account.

Adolescent↗
PubMed1998

Differences in self reported morbidity by educational level: a comparison of 11 western European countries.

STUDY OBJECTIVE: To assess whether there are variations between 11 Western European countries with respect to the size of differences in self reported morbidity between people with high and low educational levels. DESIGN AND METHODS: National representative data on morbidity by educational level were obtained from health interview surveys, level of living surveys or other similar surveys carried out between 1985 and 1993. Four morbidity indicators were included and a considerable effort was made to maximise the comparability of these indicators. A standardised scheme of educational levels was applied to each survey. The study included men and women aged 25 to 69 years. The size of morbidity differences was measured by means of the regression based Relative Index of Inequality. MAIN RESULTS: The size of inequalities in health was found to vary between countries. In general, there was a tendency for inequalities to be relatively large in Sweden, Norway, and Denmark and to be relatively small in Spain, Switzerland, and West Germany. Intermediate positions were observed for Finland, Great Britain, France, and Italy. The position of the Netherlands strongly varied according to sex: relatively large inequalities were found for men whereas relatively small inequalities were found for women. The relative position of some countries, for example, West Germany, varied according to the morbidity indicator. CONCLUSIONS: Because of a number of unresolved problems with the precision and the international comparability of the data, the margins of uncertainty for the inequality estimates are somewhat wide. However, these problems are unlikely to explain the overall pattern. It is remarkable that health inequalities are not necessarily smaller in countries with more egalitarian policies such as the Netherlands and the Scandinavian countries. Possible explanations are discussed.

Adult↗
PubMed1997

Inequalities in income and long-term disability in Spain: analysis of recent hypotheses using cross sectional study based on individual data.

OBJECTIVE: To compare the relation between inequalities in long-term disability and income in the 17 regions of Spain. DESIGN: Data were taken from the survey on impairments, disabilities, and handicaps that was carried out in Spain in 1986. For each region the inequality in long-term disability associated with income was calculated as the odds ratio associated with reducing monthly household income by 10,000 pesetas (about Ponds 50) (estimate of effect of inequality of income) and the odds ratio for the inequality in long-term disability between those at the bottom and those at the top of the income hierarchy (relative index of inequality). MAIN OUTCOME MEASURE: Prevalence of long-term disability. RESULTS: Five of the eight regions where lowering income had a greater effect on long-term disability were among those with the lowest income per head, while six of the remaining nine regions where the effect was smaller were among those with the highest income per head. Three regions with the highest estimate of relative index of inequality had the highest estimate of effect, and another three regions with the lowest estimate of relative index of inequality had the lowest estimate of effect. In contrast, the relative position of the remaining 11 regions varied from one measure to another. CONCLUSIONS: These results support the theory that additional increments in material wellbeing have a negligible effect on health in countries with high socioeconomic development. However, inequality in income distribution did not determine inequality in health between those at the bottom and those at the top of the income hierarchy in many Spanish regions.

Cost of Illness↗
PubMed1996

[The main causes of death in Spain, 1992; comment].

BACKGROUND: To study the mortality from the leading causes of death in Spain in 1992 and trends since 1980. POPULATION AND METHOD: The number of deaths was obtained from mortality statistics. We included the 12 causes with the highest mortality rates in 1992 and calculated for each cause of death the age adjusted mortality rates for each year in the study period, the percent change from 1990 to 1992 and from 1980 to 1992, and the adjusted ratio of rates between men and women in 1992. RESULTS: The leading causes of death in 1992 were malignant neoplasms, with 24.3% of deaths and a mortality rate of 205.6 per 100,000 population; diseases of the heart, with 22.6% and a rate of 191.8 per 100,000; and cerebrovascular disease, with 12.7% and a rate of 107.6 per 100,000 population. Between 1980 and 1992 the adjusted mortality rate increased for four causes of death: malignant neoplasms; chronic obstructive pulmonary disease and similar diseases; nephritis, nephrotic syndrome and nephrosis; and suicide. From 1990 to 1992, the adjusted mortality rate declined for all other causes of death. From 1990 to 1992, the adjusted mortality rate declined for all causes of death except for malignant neoplasms and human immunodeficiency virus (HIV) infection, which rose 0.4% and 69%, respectively. The adjusted mortality rate was higher in men than in women for all causes of death except for diabetes mellitus and atherosclerosis. CONCLUSIONS: Except for malignant neoplasms and HIV infection, mortality from all other leading causes of death declined in 1992 with respect to 1990, independently of the trend experienced by each cause of death in the eighties.

Cause of Death↗
PubMed1996

[Socioeconomic differences in the use and accessibility of health care services in Spain].

BACKGROUND: One of the main goals of the public health care systems is to assure an equitable accessibility and utilization of health care services according to the need for care. The present study evaluates the extent to which this objective has been reached in the Spanish National Health System from the socioeconomic perspective. POBLATION AND METHOD: The 1993 National Health Survey was used. Doctor consultation, use of inpatient hospital services, dentist consultation and gynaecologist consultation were the indicators of utilization analysed. Accessibility was measured by time spent travelling to the health centre, time spent waiting at health centre and time spent waiting for an ordinary admission to hospital. Educational level was the socioeconomic variable used. RESULTS: Doctor consultation and use of inpatient hospital services were more frequent in individuals with the lowest level of education, while dentist and gynaecologist consultation were in those with the highest level. No statistically significant differences were observed in doctor consultation and use of inpatient hospital services after adjusting for age, sex, health care coverage and several need indicators by using a multiple logistic regression model. On the contrary, the odds ratios for individuals with first, second and third educational level were 1.31 (CI 95% = 1.14-1.51), 1.74 (1.49-2.03) and 2.06 (1.71-2.47) in dentist consultation and 2.01 (1.71-2.35), 2.40 (2.01-2.87) and 2.54 (2.02-3.21) in gynaecologist consultation. On the other hand, individuals with no education showed the longest average waiting times, especially for an ordinary admission to hospital, which was 83.5 days for subjects with no education and 18.8 for those with third educational level. However, the multiple linear regression analysis only found statistically significant results in time spent travelling to the health center and time spent waiting at the health center. CONCLUSIONS: Although no differences in doctor consultation and use of inpatient hospital services by socioeconomic status were found, the results obtained regarding the use of other health care services and waiting times indicate the persistence of barriers limiting the equitable access and utilization of health care services in Spain.

Dental Health Services↗
PubMed1996

[Socioeconomic differences in mortality in 8 Spanish provinces].

BACKGROUND: The scarce fulfillment of the job in the Bulletin on Death (BD) has limited the study of the socioeconomic differences in mortality in Spain. Nonetheless, the authors have studied the socioeconomic differences in mortality by different causes of death, using the Spanish geographical areas in which the information regarding the occupation of the deceased persons in the BD is of good quality. METHODS: Males between 30-64 years of age who died in eight Spanish provinces from 1988-1990 were included in the study. Overall mortality was compared by the relative risk of mortality adjusted for age and by the main causes of death among the professionals and managers, manual workers and farmers. The relative risk was calculated with the use of log-lineal models (Poisson regression) taking the group of professionals and managers as the reference group. RESULTS: The global relative risk of mortality in the group of manual workers was 1.72 and was 1.56 in the farmers. The highest mortality by different causes of death was observed in the manual workers while intermediate mortality was found in the farmers. The exceptions to this general pattern were colon and rectum cancer and leukemias with a higher mortality being found in the group of professionals and managers, although the differences were not statistically significant. Cerebrovascular diseases, suicide and cancer of the nervous system showed the highest relative risk of mortality in the farmers. Both the manual workers and the farmers demonstrated the highest relative risks of mortality in the youngest age groups although this difference attenuated with age. CONCLUSIONS: Except for colon and rectal cancer and leukemias, manual workers and farmers present higher mortality than professionals and managers. Furthermore, these differences may be underestimated since only the active economic population was studied, thereby excluding the individuals pertaining to the population groups with higher mortality rates.

Adult↗
PubMed1996

Non-fatal injuries and the use of psychoactive drugs among young adults in Spain.

We compared the prevalence of injuries requiring medical treatment in the general population, in cocaine users and in heroin users, and we studied the factors associated with the occurrence of injuries in these groups, using data from two interview surveys carried out in 1993 in Spain: the National Health Interview Survey, a national representative sample of the non-institutionalized general population, and a survey of a non-probability sample of heroin or cocaine users selected from the community. The subjects included in the study were persons 16-40 years of age in urban areas: 4261 persons from the general population, 369 cocaine users and 215 heroin users. The annual prevalence of injuries requiring medical treatment was 7.9 percent in the general population, 10.8 percent in cocaine users and 35.2 percent in heroin users. There was a statistically significant positive association of injury occurrence (1) among the general population: with male sex, alcohol use, use of tranquillizers/sleeping pills, and the use of antidepressants or stimulants; (2) in cocaine users: with the use of opiates other than heroin; and (3) in heroin users: with alcohol use, the use of tranquillizers/sleeping pills, and the injected route. The only statistically significant negative association was with the amount of cocaine consumed among heroin users. The results suggest that other psychoactive substances besides alcohol are positively associated with injury occurrence, and that cocaine use may contribute to a reduced risk of injuries associated with the use of depressants (alcohol, tranquillizers, heroin).

Accidents↗
PubMed1996

Trends in obesity differences by educational level in Spain.

Our objective was to study the trend in differences in the frequency of obesity by educational level in the general population 20 to 64 years of age. We used data from two cross-sectional health surveys carried out in 1987 and 1993 in representative samples of the Spanish population. We investigated the relation between obesity and educational level during the periods 1987 and 1993, taking into account the main factors confounding the relation. We used, as setting, the National Health Interview Surveys representative of the whole Spanish population. In both men and women, the highest odds ratios (ORs) for obesity were observed at lower educational levels. These differences increased in women between 1987 and 1993, while they decreased in men during the same period. Evidence of increased educational differences in the frequency of obesity indicates that future studies should focus on the evaluation and monitoring of this trend in the population.

Adult↗
PubMed1996

Standardisation or modelling of mortality rates.

STUDY OBJECTIVE: To compare the results obtained when estimating a standardised rate using the conventional technique of stratified analysis and using Poisson regression, and to evaluate the speed of the two techniques in making the calculation. DESIGN: Cross sectional study. SETTING AND PARTICIPANTS: The trend in motor vehicle accident mortality in males from 1985 to 1992 in Spain was compared using stratified analysis and Poisson regression. In the stratified analysis the calculations were made using a specially designed spreadsheet while in the Poisson regression the statistical program used was EGRET. RESULTS: The stratified analysis took two hours and the Poisson regression 15 minutes to complete. In the stratified analysis a single estimate for each year was obtained, whereas the model of Poisson regression that best fitted the data included an interaction term between age and year. CONCLUSION: Poisson regression can be considered a serious alternative to stratified analysis when the objective is to compare mortality rates standardised by one or two variables.

Accidents, Traffic↗