[30 years since Ardystil Syndrome]. / Treinta años del síndrome ARDYSTIL.

Con el nombre de Síndrome Ardystil se designó un brote de origen laboral que se produjo entre febrero y noviembre de 1992 en la comarca de L'Alcoià (Alicante), en la industria de la aerografia textil, que provocó un cuadro respiratorio grave a 72 trabajadores, fundamentalmente mujeres jóvenes, con 6 fallecimientos, ocasionando gran impacto social y emocional. Este brote es conocido con el nombre de la empresa donde se produjeron la mayoría de los casos. La epidemia se controló a partir de la identificación del Acramin FWN utilizado en forma de aerosol, como causa responsable del brote….

Las competencias profesionales en Salud Pública / Professional competencies in public health

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[Gender sensitivity in the formulation of Spanish health plans: what it could have been but wasn't]. / Sensibilidad de género en la formulación de planes de salud en España: lo que pudo ser y no fue.

AIM: To systematically examine gender sensitivity in the policies formulated in the health plans of the various Autonomous Communities in Spain in which these plans are available. We defined gender sensitivity as the extent to which the health plans took gender into account as a relation category and developed interventions to ameliorate gender-related inequalities. MATERIAL AND METHODS: A questionnaire with a structure similar to that of the health plans, which were based on the World Health Organization's proposal, was designed. The questionnaire consisted of an introductory section, which we called the symbolic content, and described the general objectives and values of the health plan. In the other section, which we called the operative content of the health plan, the specific objectives and the interventions to achieve them were expressed in concrete terms. A gender sensitivity symbolic index and gender sensitivity operative index were constructed. RESULTS: Thirteen health plans were analyzed. Those of the Basque Country, the Valencian Community and the Canary Islands showed high symbolic content, which did not always match their subsequent operative implementation. The health plans of the Basque Country, Catalonia and Galicia showed the greatest operative gender sensitivity. CONCLUSIONS: Gender sensitivity in health plans varies widely among Autonomous Communities. Some channels for action would be to set up partnerships and networks for health professionals and collectives in order to raise awareness of the problem and build on the experience of the Autonomous Communities whose initiatives are carried out with the greatest gender sensitivity.

[Adult health]. / La salud de las personas adultas.

The objective of this study is to analyse the social inequalities in health status, health related behaviours and mortality among the 25-64 years Spanish population. Data come from the 1997 Spanish National Health Survey, the 1999 Spanish National Survey on Working Conditions, the 2001 Yearbook of Labour and Social Affairs Statistics and the 1998 Mortality Statistics. Most health-related behaviours are more unfavourable for men (smoking, alcohol consumption and overweight) and for less privileged social classes. Among women, entrance into the labour market is associated with more unhealthy behaviours except for overweight. Low weight, however, is more frequent among employed females. Self-perceived health status is better among men, more privileged social class persons and among workers. Whereas classical physical job hazards and work injuries mostly affect men, the impact of psychosocial job hazards and of exposures derived from the domestic work is higher for women. As in other developed countries, the paradox exists that whereas women have a poorer self-perceived health status, mortality is higher among men. The male excess in mortality is related to health-related behaviours that to a great extent are determined by traditional values assigned to masculinity, with higher consumption of tobacco (lung cancer), alcohol (cirrhosis), drugs (HIV and AIDS) and risky behaviours related to injuries. Health policies should take into account social inequalities in health determined by gender, social class and employment status. For doing so, it is important to increase the development of research on social inequalities and of health information systems sensitive to social inequalities.

Sensibilidad de género en la formulación de planes de salud en España: lo que pudo ser y no fue / Gender sensitivity in the formulation of Spanish health plans: what it could have been but wasn't

Objetivo: Examinar de forma sistemática la sensibilidad de género en las políticas formuladas en los planes de salud, de las comunidades autónomas (CCAA) de España que lo tienen disponible. Definimos «sensibilidad de género» como el grado en que los planes de salud tienen en cuenta la existencia del género como categoría de relación y desarrollan acciones para aminorar las desigualdades debidas a éste. Material y métodos: Se diseñó un cuestionario con una estructura similar a la de los planes de salud, que a su vez están basados en la propuesta de la Organización Mundial de la Salud (OMS). Éstos tienen una parte introductoria, que hemos denominado de «contenido simbólico» y describe objetivos y valores generales del plan de salud, y otra, que hemos denominado el «contenido operativo» del plan de salud, donde se concretan los objetivos específicos y las intervenciones para conseguirlos. Se construyen índices de sensibilidad simbólica de género y de sensibilidad operativa de género. Resultados: Se analizaron 13 planes de salud. El País Vasco, la Comunidad Valenciana y Canarias tienen un alto índice de sensibilidad simbólica que no se corresponde en todas las comunidades con su índice de sensibilidad operativa. El País Vasco, Cataluña y Galicia tienen los índices de sensibilidad operativa de género más altos. Conclusiones: La sensibilidad de género en los planes de salud es muy desigual por CCAA. Algunas vías para la acción serían la formación de coaliciones y redes de profesionales y colectivos para poner de manifiesto el problema, así como construir sobre la experiencia de las CCAA con mayor sensibilidad de género en sus propuestas (AU)

Aim: To systematically examine gender sensitivity in the policies formulated in the health plans of the various Autonomous Communities in Spain in which these plans are available. We defined gender sensitivity as the extent to which the health plans took gender into account as a relation category and developed interventions to ameliorate gender-related inequalities. Material and methods: A questionnaire with a structure similar to that of the health plans, which were based on the World Health Organization's proposal, was designed. The questionnaire consisted of an introductory section, which we called the «symbolic content», and described the general objectives and values of the health plan. In the other section, which we called the «operative content» of the health plan, the specific objectives and the interventions to achieve them were expressed in concrete terms. A gender sensitivity symbolic index and gender sensitivity operative index were constructed.Results: Thirteen health plans were analyzed. Those of the Basque Country, the Valencian Community and the Canary Islands showed high symbolic content, which did not always match their subsequent operative implementation. The health plans of the Basque Country, Catalonia and Galicia showed the greatest operative gender sensitivity. Conclusions: Gender sensitivity in health plans varies widely among Autonomous Communities. Some channels for action would be to set up partnerships and networks for health professionals and collectives in order to raise awareness of the problem and build on the experience of the Autonomous Communities whose initiatives are carried out with the greatest gender sensibility (AU)

Rapid appraisal methodology for 'health for all' policy formulation analysis.

BACKGROUND: Although in the last 20 years, the WHO 'Health for All' principles have been widely used in national, regional and local health policy documents, there is still a gap in the literature regarding how to appraise or compare them, which weakens the social accountability process. METHODOLOGY: A new, rapid approach to analyse the formulation of health policies is proposed. It is based on the selection of a small number of tracers and the development of a gold standard to be completed with input from a review of the literature, and opinions of expert panel members. This methodology has been empirically applied to the health strategies of two Spanish regions (Catalonia and Valencia). RESULTS: A framework for analysis was produced containing three dimensions: timing (early or late policy options), action level (individuals or social focus) and equity (social class, gender and ethnic groups). The health problems selected as tracers were HIV/AIDS, traffic injuries and ageing-related disabilities. In the two regions studied, the policies formulated for HIV/AIDS and age-related disabilities provide interventions late in the evolution of the health problem. The strategy established in the region of Valencia is more community-oriented than in Catalonia. Neither region had implemented specific policies regarding social class, gender or ethnic groups. INTERPRETATION: The methodology proposed here makes it possible to map the formulation of Health Strategies, compare different geographical areas and even forecast the policies' usefulness. The simplicity of the method, together with the fact that citizens and politicians alike can easily understand its results are major advantages. For the framework to be fully useful, it will be necessary to build evidence-based policy databases.