Health and health inequalities impact assessment for non-clinical measures to control COVID-19 in the Basque Country and Navarre (Spain).

This article describes the results of a health and health inequalities impact assessment of the COVID-19 pandemic control measures in the regions of the Basque Country and Navarre in Spain. A literature review was conducted on Pubmed and Web of Science (WoS) databases, in addition to individual semi-structured interviews and focus groups with experts, key informants and different profiles of citizens. A wide variety of social determinants of health have been affected by the measures, which included individual health-related behaviors, service disruption in formal care, educational settings, and health care provision. These changes have particularly affected certain population groups including children and adolescents, older people, those with health conditions and disabilities together with caregivers, women, as well as people with low levels of education, income, and resources. In future scenarios it will be necessary to pay attention to the potential impacts of policy responses on health inequalities to avoid an increase in existing health gaps.

Abordaje de la hipercolesterolemia en planes y estrategias de saluden España: estado actual y propuestas de futuro / The approach to hypercholesterolemia in health strategies and plans in Spain: present situation and future proposals

Fundamento: Las enfermedades cardiovasculares (ECV)son la principal causa de muerte a nivel mundial y la hipercolesterolemia (HC) es un importante factor de riesgo cardiovascular (FRCV). En España, aproximadamente un25% de los adultos de mediana edad presentan hipercolesterolemia. Nuestro objetivo fue analizar las estrategias y planes de salud existentes en España respecto a las ECVy a la HC, y definir líneas de actuación para su controldesde la gestión y política sanitaria. Material y métodos: Estudio observacional, descriptivo.En la primera fase se revisó la literatura y se realizaronseis entrevistas semiestructuradas; en una segunda fase,12 expertos identificaron las barreras existentes y propusieron estrategias para reducir la mortalidad prematura por las ECV.Resultados: Se identificaron 51 documentos de planificación, el 43% hacían referencia a la HC. Se detectó una altavariabilidad en la implementación de iniciativas a nivel autonómico para el control de la HC. Las barreras identificadas para explicar estos resultados fueron: banalización de la HC, falta de participación activa de agentes clave, desconocimiento del impacto de la HC, el modelo de atención y los circuitos asistenciales existentes, y las políticas sanitarias a corto plazo y con escasa dedicación de recursos a la HC.Conclusiones: A pesar del impacto en salud y socioeconómico de las ECV y de la HC en España, el peso de la HC en las políticas de salud no parece corresponderse con esa relevancia. Faltan medidas para su abordaje, pese a la evidencia de su efectividad. Este estudio propone medidas concretas para avanzar en su control.(AU)

Background: Cardiovascular diseases (CVD) are a major cause of death worldwide and Hypercholesterolemia (HC) is an important cardiovascular risk factor. In Spain,approximately 25% of middle-aged adults suffer from HC.Our objective was to analyse current health strategiesand plans in Spain related to CVD and HC in order todefine possible future courses of action to bring aboutbetter control from a health management and policy perspective.Methods: The study was observational and descriptive.In the first step, a literature review was carried out, followed by six semi structured interviews. In the second step, a group of 12 experts in the field identified existing barriers to HC control and suggested ways to reduce premature mortality due to CVD. Results: A total of 51 documents were identified, of which 43% referred to HC. There was a high variability at the regional level in the implementation of measures and initiatives for the control of HC. Barriers that were identified were : trivialization of HC, lack of active participation bykey stakeholders, lack of understanding of the impact ofHC, existing care models and pathways, and short-termhealth policies that limit the provision of resources forHC care and control. Conclusion: Despite the considerable medical and socioeconomic burden of CVD and HC in Spain, the importance of HC is not reflected in health policies. There is a lack of HC control measures, even when they are shown to be highly feasible and beneficial. This article proposes specific measures to improve control of this issue.(AU)

[The approach to hypercholesterolemia in health strategies and plans in Spain: present situation and future proposals].

BACKGROUND: Cardiovascular diseases (CVD) are a major cause of death worldwide and Hypercholesterolemia (HC) is an important cardiovascular risk factor. In Spain, approximately 25% of middle-aged adults suffer from HC. Our objective was to analyse current health strategies and plans in Spain related to CVD and HC in order to define possible future courses of action to bring about better control from a health management and policy perspective. METHODS: The study was observational and descriptive. In the first step, a literature review was carried out, followed by six semi structured interviews. In the second step, a group of 12 experts in the field identified existing barriers to HC control and suggested ways to reduce premature mortality due to CVD. RESULTS: A total of 51 documents were identified, of which 43% referred to HC. There was a high variability at the regional level in the implementation of measures and initiatives for the control of HC. Barriers that were identified were : trivialization of HC, lack of active participation by key stakeholders, lack of understanding of the impact of HC, existing care models and pathways, and short-term health policies that limit the provision of resources for HC care and control. CONCLUSION: Despite the considerable medical and socioeconomic burden of CVD and HC in Spain, the importance of HC is not reflected in health policies. There is a lack of HC control measures, even when they are shown to be highly feasible and beneficial. This article proposes specific measures to improve control of this issue.