Excess Mortality During 2020 in Spain: The Most Affected Population, Age, and Educational Group by the COVID-19 Pandemic.

Objective: The objective of this work was to study mortality increase in Spain during the first and second academic semesters of 2020, coinciding with the first 2 waves of the Covid-19 pandemic; by sex, age, and education.

Methods: An observational study was carried out, using linked populations and deaths' data from 2017 to 2020. The mortality rates from all causes and leading causes other than Covid-19 during each semester of 2020, compared to the 2017-2019 averages for the same semester, was also estimated.

Socioeconomic Patterns in the Frequency of Doctor Visits in Germany and Spain in Subjects With and Without Chronic Diseases.

The objective of universal health care systems is to achieve equality in the use of health services at the same level of care need. This study evaluates the relationship of socioeconomic position with the frequency of doctor visits in subjects with and without chronic diseases in Germany and Spain. The dependent variables included number of consultations and if a medical consultation occurred.

Trends in Activity Limitations From an International Perspective: Differential Changes Between Age Groups Across 30 Countries.

Examine trends in limitations among young (15-39), middle-aged (40-64) and older age-groups (>=65) and their socioeconomic differences. Population-based European Social Survey data ( = 396,853) were used, covering 30 mostly European countries and spanning the time-period 2002-2018. Limitations were measured using a global activity limitations indicator.

Trends and equity in the use of health services in Spain and Germany around austerity in Europe.

Background: Following the 2008 economic crisis many countries implemented austerity policies, including reducing public spending on health services. This paper evaluates the trends and equity in the use of health services during and after that period in Spain - a country with austerity policies - and in Germany - a country without restriction on healthcare spending.

Methods: Data from several National Surveys in Spain and several waves of the Socio-Economic Panel in Germany, carried out between 2009 and 2017, were used.

Decline of depressive symptoms in Europe: differential trends across the lifespan.

Purpose: We examined changes in the burden of depressive symptoms between 2006 and 2014 in 18 European countries across different age groups.

Methods: We used population-based data drawn from the European Social Survey (N = 64.683, 54% female, age 14-90 years) covering 18 countries (Austria, Belgium, Denmark, Estonia, Finland, France, Germany, Great Britain, Hungary, Ireland, The Netherlands, Norway, Poland, Portugal, Slovenia, Spain, Sweden, Switzerland) from 2006 to 2014.

Erosion of universal health coverage and trend in the frequency of physician consultations in Spain.

Background: We studied the frequency of physician visits in the native and immigrant populations in Spain before and after implementation of a governmental measure to restrict the use of public healthcare services by undocumented immigrants beginning in 2012.

Methods: Data were taken from the 2009 and 2014 European Health Surveys carried out in Spain. We investigated any physician consultation in the last 4 weeks before the interview, as well as visits to a family physician, public specialist physician and private specialist physician.

Trends in grip strength: Age, period, and cohort effects on grip strength in older adults from Germany, Sweden, and Spain.

Grip strength is seen as an objective indicator of morbidity and disability. However, empirical knowledge about trends in grip strength remains incomplete. As trends can occur due to effects of aging, time periods and birth cohorts, we used hierarchical age-period-cohort models to estimate and disentangle putative changes in grip strength.

Cardiovascular mortality and risk behaviours by degree of urbanization before, during and after the economic crisis in Spain.

Background: To estimate the relationship of the degree of urbanization to cardiovascular mortality and to risk behaviours before, during and after the 2008 economic crisis in Spain.

Methods: In three areas of residence - large urban areas, small urban areas and rural areas - we calculated the rate of premature mortality (0-74 years) from cardiovascular diseases before the crisis (2005-2007), during the crisis (2008-2010 and 2011-2013) and after the crisis (2014-2016), and the prevalence of risk behaviours in 2006, 2011 and 2016. In each period we estimated the mortality rate ratio (MRR) and the prevalence ratio, taking large urban areas as the reference.

Use of health services according to income before and after elimination of copayment in Germany and restriction of universal health coverage in Spain.

Background: In Germany copayment for medical consultation was eliminated in 2013, and in Spain universal health coverage was partly restricted in 2012. This study shows the relationship between income and the use of health services before and after these measures in each country.

Methods: Data were taken from the 2009 and 2014 Socio-Economic Panel conducted in Germany, and from the 2009 and 2014 European Health Surveys in Spain.

Socioeconomic position and health services use in Germany and Spain during the Great Recession.

Objective: The relationship of socioeconomic position with the use of health services may have changed with the emergence of the economic crisis. This study shows that relationship before and during the economic crisis, in Germany and in Spain.

Methods: Data from the 2006 and 2011 Socio-Economic Panel carried out in Germany, and from the 2006 and 2011 National Health Surveys carried out in Spain were used.

Stabilisation of the trend in prevalence of childhood overweight and obesity in Spain: 2001-11.

Backgrounds: To ascertain whether the prevalence of childhood overweight and obesity had stabilised in Spain, in the same way as in other developed countries.

Methods: Data were drawn from the 2001, 2006 and 2011 Spanish National Health Surveys. We estimated overweight and obesity on the basis of body mass index, and then calculated the prevalence of overweight and obesity for each year studied among boys and girls, respectively, in two different age groups; 5 -9 and 10 -15 years.

[Inequalities in Total Mortality and by Cause of Death According to the Level of Education in Navarra: findings from a Longitudinal Study from 2001 to 2008].

Background: Due to the lack of evidence, the objective was to show the inequalities in mortality by educational level in Navarra and the contribution of the main causes of death to the magnitude of inequalities in mortality from all causes of death.

Methods: All citizens aged 25 years and older residing in Spain in 2001 were followed during 7 years to determine their vital status. Level of education was used as socioeconomic status indicator.

[Socioeconomic pattern in unhealthy diet in children and adolescents in Spain].

Objective: To investigate the possible association of dietary patterns associated with obesity and socioeconomic status in Spanish children and adolescents.

Design: Cross-sectional study.

Participants: Data were drawn from the 2007 National Health Survey, conducted on a representative sample of Spanish 0-15 years.

Socioeconomic patterns in use of private and public health services in Spain and Britain: implications for equity in health care.

This paper estimates the pattern of private and public physician visits and hospitalisation by socioeconomic position in two countries in which private healthcare expenditure constitutes a different proportion of the total amount spent on health care: Britain and Spain. Private physician visits and private hospitalisations were quantitatively more important in Spain than in Britain. In both countries, the use of private services showed a direct socioeconomic gradient.

Socioeconomic patterns in health services use in Great Britain and Spain before and after the health system reforms of the 1990s.

This paper aims to estimate the pattern of physician visits and hospitalisation by socioeconomic position in Great Britain and Spain before and after important changes in their health systems during the 1990s. These changes have been accompanied by a trend toward pro-rich inequality in physician use, especially in outpatient consultation in Great Britain, whereas the pro-poor inequality in GP consultation and the pro-rich inequality in specialist consultation in Spain before the changes have been maintained. Although the pro-rich inequality in hospitalisation observed in both countries before their health system changes continues to be seen, the differences have been reduced, suggesting a trend toward socioeconomic equality in hospitalisation.

Pattern of health services use by immigrants from different regions of the world residing in Spain.

Objective: To determine immigrants' frequency of use of four health services by place of origin and compare it with that of the Spanish population.

Methods: Based on the 2006 National Health Survey in Spain, we estimated the frequency of use of four health services in men and women from: Spain, Western countries, Eastern Europe, Latin America, North Africa, Sub Saharan Africa and Asia/Oceania. These results were compared with the Spanish population by calculating odds ratios adjusted for age, socioeconomic position, health status, and type of health coverage.

[Health services utilization by the immigrant population in Spain].

Objective: To compare health services utilization between the immigrant and indigenous populations in Spain.

Methods: We used information provided by the following four health surveys carried out around 2005: Catalonia 2005; city of Madrid 2005, Canary Islands 2004 and the Autonomous Community of Valencia 2005. The health services studied were general practice, specialist services, emergency services, hospitalization, and two preventive services: pap smear test and mammography.

[SA-45: a brief form of the SCL-90].

The Symptom Assessment-45 Questionnaire (SA-45) is a 45-item self-report instrument of psychiatric symptomatology derived from the original SCL-90. The SA-45 consists of nine 5-item scales assessing each of the same symptom domains as its parent instrument with no item overlap across domains. This paper provides preliminary validation of the Spanish version of the questionnaire in an undergraduate sample.

Patient cost sharing and social inequalities in access to health care in three western European countries.

This study evaluates the association between social class and health services use in France, Germany and Spain, three countries with universal health coverage but with different cost-sharing systems. In France, patients share the cost of both physician visits and hospitalization, in Germany they share the cost of hospitalization, and in Spain there is no system of patient cost sharing. The data were obtained from national health surveys carried out in each of these countries during the last decade of the 20th century.

Patient cost sharing and physician visits by socioeconomic position: findings in three Western European countries.

The association between educational level and the probability of physician visits in three Western European countries, one of which has a system of patient cost sharing was evaluated. Cross-sectional surveys were performed in France, Germany and Spain around 1990 and around 2000. People representative of the French, German and Spanish populations, aged 25-74 years were studied.

Income in large residential areas and premature mortality in six countries of the European Union.

We study the relation between per capita income and mortality within six countries of the European Union - Finland, the Netherlands, Belgium, France, Italy and Spain - in 1981-1985 and 1996-2000. We obtained information on gross domestic product per capita (GDPpc) and mortality in large residential areas. The areas in each country were grouped in quintiles as a function of GDPpc.

Adverse psychological effects in women attending a second-stage breast cancer screening.

Objective: The purpose of this study was to examine the emotional and psychopathological impact associated with a second-stage screening for breast cancer.

Method: We used a short-term longitudinal design. Interviews were conducted with 1195 women of 45-65 years old in three temporal conditions (premammogram, postmammogram, and follow-up).