[Evolution of health inequalities in Catalonia [Spain]].

OBJECTIVE

To analyze the evolution of social inequalities in health in Catalonia (Spain) in the last 20 years.

METHODS

Mortality in 354 small areas of Catalonia (288 cities in Catalonia and 66 health areas in the city of Barcelona) was analyzed for the 1984-98 period. Indicators of self-perceived health status, lifestyles, and health services utilization by social class and gender were compared for 1994 and 2002. Factors related to occupational health, immigration and health, environmental health, and policies to reduce social inequalities in health were also analyzed.

RESULTS

Although most health indicators improved, multiple inequalities in health were found in both 1994 and 2002. These inequalities were the same in 2002 as in 1994 or, in some cases, worse. The collectives with the worst indicators were persons living in the most deprived areas, those from disadvantaged social classes, women, and immigrants from low-income countries.

CONCLUSION

Social inequalities in health have persisted over the past 20 years in Catalonia. We present some recommendations on health information systems, research, and policies to reduce these inequalities.