Borrell Carme, Peiró Rosana, Ramón Nieves, Pasarín M Isabel, Colomer Concha, Zafra Eduardo, Alvarez-Dardet Carlos
Agencia de Salud Pública de Barcelona, Barcelona, Spain.
Gac Sanit. 2005 Jul-Aug;19(4):277-85. doi: 10.1157/13078025.
To systematically examine sensitivity to socioeconomic (SE) inequalities in the policies formulated in the health plans of the Autonomous Communities of Spain.
We performed a systematic review of 14 health plans. The introductory content of the health plans was called the "symbolic content" and was separated from specific interventions, or "operative content". The symbolic content was analyzed through the presence or absence of SE description of the health areas, the principles and values to reduce SE inequalities in health, and the general objectives for this topic (sensitivity index, range 0-3). To review the operative content, consideration of SE inequalities in the description of health areas and proposed interventions were evaluated.
The Basque Country and Extremadura had a sensitivity index of 3 for symbolic content. Six Autonomous Communities had an index of 0 (Canary Islands, Catalonia, Castilla-León, Galicia, Murcia and Navarre). Regarding operative content, the Autonomous Communities that most clearly took SE inequalities into account were the Basque Country, Galicia and the Canary Islands. The specific health-related areas most frequently analyzed according to SE inequalities were alcohol and drug consumption and reproductive health.
This study shows that little attention is paid to SE inequalities in the health plans of the various Autonomous Communities, with the exception of the Basque Country. The national and regional governments of Spain should prioritize inequalities in health in the political agenda, which would translate into their presence in the health plans.
系统研究西班牙自治区卫生计划所制定政策对社会经济(SE)不平等的敏感性。
我们对14项卫生计划进行了系统评价。卫生计划的介绍性内容被称为“象征性内容”,并与具体干预措施或“操作性内容”分开。通过卫生领域是否存在SE描述、减少卫生领域SE不平等的原则和价值观以及该主题的总体目标(敏感性指数,范围为0 - 3)来分析象征性内容。为了审查操作性内容,对卫生领域描述和提议干预措施中对SE不平等的考虑进行了评估。
巴斯克地区和埃斯特雷马杜拉的象征性内容敏感性指数为3。六个自治区的指数为0(加那利群岛、加泰罗尼亚、卡斯蒂利亚 - 莱昂、加利西亚、穆尔西亚和纳瓦拉)。关于操作性内容,最明确考虑SE不平等的自治区是巴斯克地区、加利西亚和加那利群岛。根据SE不平等最常分析的具体卫生相关领域是酒精和药物消费以及生殖健康。
本研究表明,除巴斯克地区外,各自治区的卫生计划对SE不平等关注甚少。西班牙国家和地区政府应将卫生不平等问题作为政治议程的优先事项,这将转化为其在卫生计划中的体现。