ABSTRACT
OBJETIVO: Analizar la tendencia de las tasas de mortalidad por edad y sexo en España e identificar si se han producido cambios tras el comienzo de la crisis económica. MÉTODO: Estudio de tendencias de las tasas de mortalidad por grupos quinquenales de edad y sexo en el periodo 1981-2016, mediante regresión joint-point. Se detallan los resultados de los dos últimos periodos identificados en las regresiones, que permiten identificar cambios ocurridos después del inicio de la crisis. En caso de ralentización o estancamiento de la tendencia de mortalidad en varios grupos de edad sucesivos, se realizó un análisis de tendencias por causas. RESULTADOS: La mortalidad se redujo de forma significativa entre 1981 y 2016. Tras el inicio de la crisis económica, la tendencia de la mortalidad total estandarizada no cambió en los hombres, y sufrió un estancamiento en las mujeres entre 2013 y 2016. En el análisis por grupos quinquenales de edad, la tendencia descendente de la mortalidad sufrió un estancamiento en los hombres en todos los grupos entre los 15 y 39 años, que se inició entre 2011 y 2014 y duró hasta 2016. En ambos sexos, en los cuatro grupos de edad entre 60 y 79 años, la reducción previa de la mortalidad sufrió una ralentización o estancamiento, que se inició entre 2009 y 2014, y continuó hasta 2016. Las causas que más contribuyeron al cambio de tendencia fueron las causas externas en hombres de 15-39 años, y las enfermedades del sistema circulatorio y respiratorio en las personas de 60-79 años. CONCLUSIÓN: La tendencia descendente de la mortalidad ha sufrido una ralentización o un estancamiento después del inicio de la crisis económica, principalmente en hombres jóvenes, y en hombres y mujeres de 60-79 años
OBJECTIVE: To analyze trends in age-sex-specific mortality in Spain, and to identify if there have been changes following the onset of economic crisis. METHOD: A study of trends in mortality rates by sex and quinquennial groups of age was carried out, from 1981 to 2016. Time trends were established by joint-point regression models. The results of the last two periods identified in the regressions are presented in detail, identifying changes after the onset of the economic crisis. When slowdown or stagnation of the mortality trends were identified in several successive age groups, an analysis of trends by causes was carried out. RESULTS: Mortality was significantly reduced between 1981 and 2016. After the beginning of the economic crisis, the trend in total age-standardized mortality did not change for men, but it stagnated for women from 2013 to 2016. In the analysis by quinquennial age groups, the downward trend in mortality suffered a stagnation in men in all the groups between 15 and 39 years, which started between 2011 and 2014, and lasted until 2016. In both women and men, in the four groups between 60 and 79 years, the previous decline in mortality suffered a slowdown or stagnation, which began between 2009 and 2014, and continued until 2016. Negative changes in mortality trends were mainly influenced by external causes (in 15-39 years men) and diseases of the circulatory and respiratory systems (in 60-79 years men and women). CONCLUSIONS: The downward trend of mortality suffered stagnation or deceleration after the onset of the economic crisis in young men and 60-79 years old men and women
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Mortality/trends , Age and Sex Distribution , Life Expectancy/trends , Cause of Death/trends , Economic Recession/statistics & numerical data , Delivery of Health Care/economics , Health Status Disparities , Indicators of Morbidity and Mortality , Spain/epidemiologyABSTRACT
OBJECTIVE: To analyze trends in age-sex-specific mortality in Spain, and to identify if there have been changes following the onset of economic crisis. METHOD: A study of trends in mortality rates by sex and quinquennial groups of age was carried out, from 1981 to 2016. Time trends were established by joint-point regression models. The results of the last two periods identified in the regressions are presented in detail, identifying changes after the onset of the economic crisis. When slowdown or stagnation of the mortality trends were identified in several successive age groups, an analysis of trends by causes was carried out. RESULTS: Mortality was significantly reduced between 1981 and 2016. After the beginning of the economic crisis, the trend in total age-standardized mortality did not change for men, but it stagnated for women from 2013 to 2016. In the analysis by quinquennial age groups, the downward trend in mortality suffered a stagnation in men in all the groups between 15 and 39 years, which started between 2011 and 2014, and lasted until 2016. In both women and men, in the four groups between 60 and 79 years, the previous decline in mortality suffered a slowdown or stagnation, which began between 2009 and 2014, and continued until 2016. Negative changes in mortality trends were mainly influenced by external causes (in 15-39 years men) and diseases of the circulatory and respiratory systems (in 60-79 years men and women). CONCLUSIONS: The downward trend of mortality suffered stagnation or deceleration after the onset of the economic crisis in young men and 60-79 years old men and women.
Subject(s)
Age Distribution , Mortality/trends , Sex Distribution , Adolescent , Adult , Aged , Aged, 80 and over , Cause of Death , Child , Child, Preschool , Economic Recession , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Regression Analysis , Spain/epidemiology , Young AdultABSTRACT
Las leyes de salud pública aprobadas o en tramitación suponen una adecuación conceptual y metodológica de la salud pública a las necesidades sociales actuales, y tienen en común la incorporación de la salud en todas las políticas. Ello significa un nuevo enfoque estratégico que requerirá unos sistemas de información distintos, que además deberán incorporar los rápidos avances en el campo de las tecnologías de la información y la comunicación. El objetivo de este trabajo es identificar los aspectos más relevantes a tener en cuenta en los sistemas de información en salud pública desde la perspectiva tecnológica, tanto en su desarrollo como en los elementos que los componen. Para superar la fragmentación de los sistemas de información en salud pública es fundamental conseguir la integración de ellos entre sí y con los sistemas asistenciales y extrasanitarios, para lo que es preciso avanzar en la interoperabilidad técnica, semántica y organizativa. Habrá que tener en cuenta las tecnologías emergentes como apoyo a las nuevas estrategias, entre las que destacan las herramientas soporte a la Web 2.0. El desarrollo de los sistemas de información de apoyo a la nueva estrategia presentará dificultades añadidas por su tamaño y por la diversidad de organismos que intervendrán. Se propone que los sistemas de información, además de los ya tradicionales sistemas transaccionales, incluyan los elementos de la Web 2.0 y los sistemas de soporte a la toma de decisiones (AU)
New public health laws are a conceptual and methodological adaptation of public health to current social needs, their common link being the incorporation of health in all policies. This represents a new strategic approach that will require different information systems, which should incorporate the rapid advances made in the field of information technology and communication. The aim of this article was to identify the most important aspects to be taken into account in information systems in public health from a technological perspective, both in their development and in the elements that compose them. To overcome the fragmentation of information systems in public health, these systems must be successfully integrated among themselves and with other health and non-health systems. To achieve this task, technical, semantic and organizational interoperability must be ensured. Emerging technologies should be considered to support these new strategies, especially Web 2.0 tools. This new strategic development will pose additional challenges because of its size and the diversity of the departments involved. It is proposed that information systems will include the elements of Web 2.0 and support systems for decision-making technologies in addition to the traditional operational systems (AU)
Subject(s)
Public Health , Information Systems/organization & administration , SpainABSTRACT
New public health laws are a conceptual and methodological adaptation of public health to current social needs, their common link being the incorporation of health in all policies. This represents a new strategic approach that will require different information systems, which should incorporate the rapid advances made in the field of information technology and communication. The aim of this article was to identify the most important aspects to be taken into account in information systems in public health from a technological perspective, both in their development and in the elements that compose them. To overcome the fragmentation of information systems in public health, these systems must be successfully integrated among themselves and with other health and non-health systems. To achieve this task, technical, semantic and organizational interoperability must be ensured. Emerging technologies should be considered to support these new strategies, especially Web 2.0 tools. This new strategic development will pose additional challenges because of its size and the diversity of the departments involved. It is proposed that information systems will include the elements of Web 2.0 and support systems for decision-making technologies in addition to the traditional operational systems.
Subject(s)
Information Systems/organization & administration , Public Health , SpainABSTRACT
In April 2009, in response to the WHO's alert due to the existence of human infection cases with a new AH1N1 influenza virus, known as swine flu, Andalusian Health Authorities trigger an specific action plan. The surveillance actions developped provided us with appropriate clinical, epidemiological and virological characteristics of the disease. During the first few days, contingency plans were set up based on epidemiological surveillance and outbreak control measures were adopted through early alert and rapid response systems. After phase 6 was declared, influenza sentinel and severe cases surveillance were used in order to plan healthcare services, to reduce transmission and to identify and protect the most vulnerable population groups. Behaviour of pandemic influenza in Andalusia was similar to that observed in the rest of the world. Atack rate was similar to a seasonal flu and the peak was reached at the 46th/2009 week. Most of them were mild cases and affected particularly to young people. The average age of hospitalised patients was 32. Prior pulmonary disease, smoking and morbid obesity (BMI > 40) were the most common pathologies and risk factors in severe cases. An impact scenario of pandemic wave in Andalusia, with an expected attack rate from 2 to 5%, was prepared considering watt observed in the southern hemisphere. Characteristics of the epidemic concerning its extent, severity and mortality rate were adjusted to this scenario.
Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics , Adolescent , Adult , Aged , Child , Child, Preschool , Humans , Infant , Middle Aged , Population Surveillance , Spain/epidemiology , Time Factors , Young AdultABSTRACT
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