Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain.
Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
Gac Sanit. 2022 Sep-Oct;36(5):452-458. doi: 10.1016/j.gaceta.2021.02.009. Epub 2021 Mar 24.
Previous research has found persistent socioeconomic inequalities in health outcomes at the national level, with different patterns after the economic crisis. However, inequalities in urban areas are also important. This study analyses socioeconomic inequalities in self-assessed health and mental health in the city of Barcelona.
Repeated cross-sectional design using quinquennial data from the Barcelona Health Surveys carried out in 2001, 2006, 2011 and 2016 for the population older than 22 years. Robust Poisson regressions models were used to compute socioeconomic gradients and relative (RII) and slope indexes of inequality (SII) by occupational social class, with stratification by sex. RII and SII were also obtained with further adjustment by employment situation.
A consistent socioeconomic gradient was found for all years except for 2011. Relative and absolute inequalities followed a V-shape, showing a drop during the economic crisis but widening thereafter to recover pre-crisis figures for self-assessed health and widening for mental health, in both relative and absolute terms in 2016. Adjustment for employment situation reduces inequalities but a large part of these inequalities remains, with variability across years.
The lasting effects of the 2008 economic crisis and the austerity programmes imposed since then may have contributed to the persistence of socioeconomic inequalities in self-assessed health and the widening of those for mental health.
先前的研究发现，在国家层面上，健康结果存在持续的社会经济不平等，经济危机后呈现出不同的模式。然而，城市地区的不平等也很重要。本研究分析了巴塞罗那市自我评估健康和心理健康方面的社会经济不平等。
使用 2001 年、2006 年、2011 年和 2016 年进行的巴塞罗那健康调查的五年期数据，采用重复横断面设计，对 22 岁以上的人群进行分析。使用稳健泊松回归模型，根据职业社会阶层计算社会经济梯度和相对（RII）和不平等斜率指数（SII），并按性别分层。还通过进一步调整就业情况获得了 RII 和 SII。
除 2011 年外，所有年份均存在一致的社会经济梯度。相对和绝对不平等呈 V 形，在经济危机期间下降，但此后扩大，自我评估健康的危机前数字恢复，2016 年心理健康的相对和绝对不平等均扩大。调整就业情况会减少不平等，但仍有很大一部分不平等存在，且各年之间存在差异。
2008 年经济危机的持久影响以及此后实施的紧缩方案可能导致自我评估健康方面的社会经济不平等持续存在，并扩大了心理健康方面的不平等。
