Font-Ribera Laia, García-Continente Xavier, Davó-Blanes M Carmen, Ariza Carles, Díez Elia, García Calvente M del Mar, Maroto Gracia, Suárez Mónica, Rajmil Luis
Centre for Research in Environmental Epidemiology (CREAL), Barcelona, España; IMIM (Hospital del Mar Medical Research Institute), Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
CIBER de Epidemiología y Salud Pública (CIBERESP), España; Agència de Salut Pública de Barcelona, Barcelona, España.
Gac Sanit. 2014 Jul-Aug;28(4):316-25. doi: 10.1016/j.gaceta.2013.12.009. Epub 2014 Jan 30.
To identify and describe studies on social inequalities in child and adolescent health conducted in Spain with special emphasis on social determinants.
In July 2012, we conducted a systematic review in the PubMed, MEDES, SCOPUS and COCHRANE databases. We included studies on social inequalities in child and adolescent health in Spain published between 2000 and 2012. A total of 2147 abstracts were reviewed by two researchers and 80 manuscripts were fully reviewed by three researchers. Risk of bias was assessed. Seventy-two articles were finally included.
A total of 83% of the studies were cross-sectional and the most frequently studied age group consisted of 13-15-year-olds. More than 20 individual or group determinants were identified. The most frequently analyzed determinants were the most advantaged educational level and occupation of the mother or the father. In 38% of the studies analyzing education and occupation, there was no definition of the determinant. Social inequalities were detected in dental health with all determinants and in all age groups (9% of studies with a high risk of bias). Social inequalities were also detected in obesity, physical activity and mental health with some determinants. Specific data were missing for younger children. No social inequalities were found in the use of health services, excluding dental care. Few studies analyzed immigration and 42% of them had a high risk of bias.
Wide diversity was found in the measurement of social determinants, with a lack of studies in preschoolers and of studies with longitudinal designs. The results of this study confirm social inequalities in some aspects of health.
识别并描述在西班牙开展的关于儿童和青少年健康方面社会不平等现象的研究，特别关注社会决定因素。
2012年7月，我们在PubMed、MEDES、SCOPUS和Cochrane数据库中进行了系统综述。我们纳入了2000年至2012年间发表的关于西班牙儿童和青少年健康社会不平等现象的研究。两名研究人员对总共2147篇摘要进行了评审，三名研究人员对80篇手稿进行了全文评审。评估了偏倚风险。最终纳入72篇文章。
总共83%的研究为横断面研究，最常研究的年龄组为13至15岁。识别出了20多个个体或群体决定因素。最常分析的决定因素是父母中最具优势的教育水平和职业。在38%分析教育和职业的研究中，未对决定因素进行定义。所有决定因素和所有年龄组在牙齿健康方面均检测到社会不平等现象（9%的研究存在高偏倚风险）。在肥胖、身体活动和心理健康方面，部分决定因素也检测到了社会不平等现象。年幼儿童缺少具体数据。在使用医疗服务（不包括牙科护理）方面未发现社会不平等现象。很少有研究分析移民问题，其中42%存在高偏倚风险。
在社会决定因素的衡量方面发现了广泛的多样性，学龄前儿童研究和纵向设计研究较少。本研究结果证实了健康某些方面存在社会不平等现象。
