Agència de Qualitat i Avaluació Sanitàries (AQuAS), Barcelona, Spain.
BMJ Open. 2013 Aug 23;3(8):e003286. doi: 10.1136/bmjopen-2013-003286.
To analyse changes in the family living conditions of children in Catalonia between 2006 and the 2010-2012 period, and to study associations between these changes and health outcomes.
A before-after analysis of two cross-sectional surveys.
Population younger than 15 years of age from Catalonia, Spain.
Representative samples of children in the 2006 Catalan Health Survey (ESCA), baseline, before the crisis; n=2200) and the first four waves of ESCA 2010-2012 (after start of the crisis, n=1967).
Overweight/obesity, health behaviour, mental health and health-related quality of life (HRQOL). Logistic regression and multiple linear regression models were used to analyse the influence of changes in family conditions on outcome measures, including interaction terms to describe the potential influence of the study period on the results.
The percentage of unemployed families rose from 9.1% (2006) to 20.6% (2010-2012), with inequalities by level of education. Overweight/obesity increased from 18.4% (95% CI 16.5% to 20.4%) to 26.9% (24.6% to 29.2%) in 2010-2012, and inequalities related to maternal education and employment status persisted. Eating habits have improved in 2010-2012 in disadvantaged families (ie, junk food consumption improved in families with a maternal primary education level; beta (B)=2.85; 0.83 to 4.88, for the survey interaction by primary education level). An improvement in HRQOL was found in the second survey (B=6.07; 4.15 to 7.99), although children whose mothers had a primary education showed poorer HRQOL scores in this survey than in 2006 (B=-4.14; -7.17 to -1.12).
Although some health-related behaviour improved during the study period, childhood obesity increased and inequalities in HRQOL appeared. Policy measures that fight against these inequalities should be urgently implemented to avoid their negative impact on the health of future generations of Catalans.
分析 2006 年至 2010-2012 年期间加泰罗尼亚儿童家庭生活条件的变化，并研究这些变化与健康结果之间的关联。
两项横断面调查的前后分析。
西班牙加泰罗尼亚的 15 岁以下人群。
2006 年加泰罗尼亚健康调查（ESCA）基线时（危机前）的代表性儿童样本（n=2200）和 ESCA 2010-2012 的前四个波次（危机开始后，n=1967）。
超重/肥胖、健康行为、心理健康和健康相关生活质量（HRQOL）。使用逻辑回归和多元线性回归模型分析家庭条件变化对结果的影响，包括交互项来描述研究期间对结果的潜在影响。
失业家庭的比例从 9.1%（2006 年）上升到 20.6%（2010-2012 年），且与教育程度有关。2010-2012 年期间，超重/肥胖率从 18.4%（95%CI 16.5%至 20.4%）上升至 26.9%（24.6%至 29.2%），且与母亲教育和就业状况相关的不平等现象仍在持续。2010-2012 年期间，弱势群体家庭的饮食习惯有所改善（即，母亲接受小学教育的家庭 Junk 食品消费有所改善；B=2.85；0.83 至 4.88，小学教育水平的调查交互作用）。在第二次调查中发现 HRQOL 有所改善（B=6.07；4.15 至 7.99），尽管在此项调查中，母亲接受小学教育的儿童 HRQOL 评分低于 2006 年（B=-4.14；-7.17 至-1.12）。
尽管研究期间某些与健康相关的行为有所改善，但儿童肥胖率上升，HRQOL 不平等现象出现。应紧急实施政策措施来应对这些不平等现象，以避免其对加泰罗尼亚未来几代人的健康造成负面影响。
