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      Diferencias por sexo de la salud percibida antes y durante la crisis económica (2007 y 2011) (*) Translated title: Sex Differences of Perceived Health before and During the Economic Crisis (2007 and 2011). Spain

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          RESUMEN

          Fundamentos:

          Diversos estudios muestran la asociación entre las crisis económicas, el desempleo y la renta con la salud. Sin embargo, se precisa diferenciar su impacto en función del sexo. El objetivo de este estudio fue analizar el efecto que la crisis económica, el desempleo y la renta pueden haber tenido en la salud percibida de hombres y mujeres en España.

          Métodos:

          Se realizó un estudio transversal que combinó las Encuestas de Condiciones de Vida de 2007 y 2011, incluyendo a 43.900 personas adultas de hasta 65 años. Se realizó análisis estratificado y regresión logística multivariante. La variable dependiente fue la salud percibida y las variables independientes la renta, la situación laboral, la educación, la enfermedad crónica y el año de la encuesta.

          Resultados:

          La buena salud percibida se incrementó del 75,1 % en 2007 al 83% en 2011. El desempleo se relacionó con mayor probabilidad de mala salud percibida en hombres: OR de 1,45; IC95%:1,26-1,67, mientras que en mujeres las diferencias fueron OR=1,20; IC95%:0,99-1,47. La probabilidad de mala salud percibida fueron mayores para mujeres (OR=1,81; IC95%:1,56-2,11) que para hombres (OR=1,7; IC95%:1,46-1,97) en el caso de menor renta. El año 2011 se relacionó con tener menor probabilidad de mala salud percibida tanto en hombres (OR=0,41; IC95%: 0,37-0,46) como en mujeres (OR=0,39; CI95%:0,35-0,44).

          Conclusiones:

          La asociación de la crisis económica con la salud percibida fue similar en hombres y mujeres. El desempleo fue un factor de riesgo para la mala salud percibida en hombres mientras que la influencia del nivel de renta, del educativo y la enfermedad crónica fue mayor en mujeres que hombres.

          ABSTRACT

          Background:

          Several studies show the association between economic crisis, unemployment and health income. However, it is necessary to differentiate their impact according to gender. The objective of this study was to analyze the differential effect that the economic crisis, unemployment and income may had on the perceived health of men and women in Spain.

          Methods:

          A cross-sectional study was conducted combining data from the 2007 and 2011 Living Conditions Surveys, which collect data from 43,900 adult individuals up to 65 years of age. A multivariate logistic regression analysis was performed, for the whole population as for each sex. The dependent variable was perceived health and the independent variables were income level, employment status, education level, chronic illness, and the year in which the survey was performed.

          Results:

          Perceived health improved over the period under consideration, from 75.1% in 2007 to 83%,0 in 2011. Unemployment significantly increased the chances of reporting perceived bad health in men [OR=1.45; CI95%:1.26-1.67] but not in women [OR=1.20; CI95%:0.99-1.47]. ORs of perceived bad health were higher for women than for men in the lower income bracket [OR: 1.81; IC95%1,56-2,11 against 1.70; IC95%:1,46-1,97]. 2011 was related to a lower probability of poor perceived health in both men [OR=0.41, CI95%: 0.37-0.46] and women [OR=0.39 ; CI95%:0.35-0.44].

          Conclusions:

          The association of the economic crisis with perceived health was similar in men and women. Unemployment was a risk factor for perceived bad health in the case of men. Available income, education level, and the presence of chronic illness had a larger influence as determinants of perceived bad health for women than they did for men.

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          Most cited references65

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          Closing the gap in a generation: health equity through action on the social determinants of health.

          The Commission on Social Determinants of Health, created to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it, is a global collaboration of policy makers, researchers, and civil society, led by commissioners with a unique blend of political, academic, and advocacy experience. The focus of attention is on countries at all levels of income and development. The commission launched its final report on August 28, 2008. This paper summarises the key findings and recommendations; the full list is in the final report.
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            Welfare state regimes, unemployment and health: a comparative study of the relationship between unemployment and self-reported health in 23 European countries.

            The relationship between unemployment and increased risk of morbidity and mortality is well established. However, what is less clear is whether this relationship varies between welfare states with differing levels of social protection for the unemployed. The first (2002) and second (2004) waves of the representative cross-sectional European Social Survey (37 499 respondents, aged 25-60 years). Employment status was main activity in the last 7 days. Health variables were self-reported limiting long-standing illness (LI) and fair/poor general health (PH). Data are for 23 European countries classified into five welfare state regimes (Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern). In all countries, unemployed people reported higher rates of poor health (LI, PH or both) than those in employment. There were also clear differences by welfare state regime: relative inequalities were largest in the Anglo-Saxon, Bismarckian and Scandinavian regimes. The negative health effect of unemployment was particularly strong for women, especially within the Anglo-Saxon (OR(LI) 2.73 and OR(PH) 2.78) and Scandinavian (OR(LI) 2.28 and OR(PH) 2.99) welfare state regimes. The negative relationship between unemployment and health is consistent across Europe but varies by welfare state regime, suggesting that levels of social protection may indeed have a moderating influence. The especially strong negative relationship among women may well be because unemployed women are likely to receive lower than average wage replacement rates. Policy-makers' attention therefore needs to be paid to income maintenance, and especially the extent to which the welfare state is able to support the needs of an increasingly feminised European workforce.
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              What does self rated health measure? Results from the British Whitehall II and French Gazel cohort studies.

              To investigate the determinants of self rated health (SRH) in men and women in the British Whitehall II study and the French Gazel cohort study. The cross sectional analyses reported in this paper use data from wave 1 of the Whitehall II study (1985-88) and wave 2 of the Gazel study (1990). Determinants were either self reported or obtained through medical screening and employer's records. The Whitehall II study is based on 20 civil service departments located in London. The Gazel study is based on employees of France's national gas and electricity company (EDF-GDF). SRH data were available on 6889 men and 3403 women in Whitehall II and 13 008 men and 4688 women in Gazel. Correlation analysis was used to identify determinants of SRH from 35 measures in Whitehall II and 33 in Gazel. Stepwise multiple regressions identified five determinants (symptom score, sickness absence, longstanding illness, minor psychiatric morbidity, number of recurring health problems) in Whitehall II, explaining 34.7% of the variance in SRH. In Gazel, four measures (physical tiredness, number of health problems in the past year, physical mobility, number of prescription drugs used) explained 41.4% of the variance in SRH. Measures of mental and physical health status contribute most to the SRH construct. The part played by age, early life factors, family history, sociodemographic variables, psychosocial factors, and health behaviours in these two occupational cohorts is modest.

                Author and article information

                Journal
                Rev Esp Salud Publica
                Rev Esp Salud Publica
                resp
                Revista Española de Salud Pública
                Ministerio de Sanidad Servicios Sociales e Igualdad
                1135-5727
                2173-9110
                16 February 2017
                Jan-Dec 2017
                : 91
                : 201702019
                Affiliations
                [1 ] original Área de Gestión Sanitaria Sur de Córdoba. Servicio Andaluz de Salud. Córdoba. España. orgdiv1Área de Gestión Sanitaria Sur de Córdoba orgnameServicio Andaluz de Salud Córdoba España
                [2 ] original Escuela Andaluza de Salud Pública. Granada. España. orgnameEscuela Andaluza de Salud Pública Granada España
                [3 ] original Facultad de Ciencias Económicas y Empresariales. Universidad de Granada. Granada. España. normalizedUniversidad de Granada orgdiv1Facultad de Ciencias Económicas y Empresariales orgnameUniversidad de Granada Granada Spain
                Author notes
                Correspondencia María del Puerto López del Amo González Avda. de la Constitución 41, 1º D 18014 Granada puerto.lopezdelamo@ 123456hotmail.es

                Los autores declaran que no existe conflicto de intereses

                Article
                e201702019
                11587275
                8e02eb71-9aa6-49c6-be0f-b82884eb76e1

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                History
                : 23 December 2016
                : 05 February 2017
                : 16 February 2017
                Page count
                Figures: 0, Tables: 6, Equations: 0, References: 62, Pages: 1
                Categories
                Original

                desempleo,determinantes sociales de la salud,recesión económica,política económica,factores económicos,salud de la mujer,sexismo,distribución por sexo,sesgo por sexo,encuestas de salud,unemployment,sex,spain,social health determinants,economic recession,policy economic,factors economic,women’s health,men,sex distribution,bias gender,sexism,health surveys

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