Borrell Carme, Benach Joan
Centre d'Anàlisi i Programes Sanitaris, Barcelona, Spain.
Gac Sanit. 2006 Sep-Oct;20(5):396-406. doi: 10.1157/13093210.
To analyze the evolution of social inequalities in health in Catalonia (Spain) in the last 20 years.
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.
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.
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.
分析西班牙加泰罗尼亚地区过去20年健康领域社会不平等状况的演变。
对加泰罗尼亚354个小区域（加泰罗尼亚的288个城市以及巴塞罗那市的66个健康区域）1984 - 1998年期间的死亡率进行分析。比较了1994年和2002年按社会阶层和性别划分的自我感知健康状况、生活方式及健康服务利用指标。还分析了与职业健康、移民与健康、环境卫生以及减少健康领域社会不平等的政策相关的因素。
尽管多数健康指标有所改善，但1994年和2002年都存在多种健康不平等现象。2002年的这些不平等状况与1994年相同，或在某些情况下更严重。指标最差的群体是居住在最贫困地区的人群、处于弱势社会阶层的人群、女性以及来自低收入国家的移民。
在过去20年里，加泰罗尼亚地区健康领域的社会不平等现象持续存在。我们针对健康信息系统、研究及减少这些不平等的政策提出了一些建议。
