Trends and determinants of social inequities in cardiovascular risk factors in Spain: a mixed-methods study

Julia Díez; Guillermo Taulet; Mario Fontán-Vela; Yolanda González-Rábago; Luis Cereijo; María Sandín-Vázquez; Elena Rodríguez; Manuel Franco; Carme Borrell; Usama Bilal; Pedro Gullón

doi:10.1016/j.gaceta.2023.102298

Trends and determinants of social inequities in cardiovascular risk factors in Spain: a mixed-methods study

Gac Sanit. 2023 Mar 31:37:102298. doi: 10.1016/j.gaceta.2023.102298. eCollection 2023.

Authors

Affiliations

¹ Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.
² Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Servicio de Medicina Preventiva, Hospital Universitario Clínico de Valencia, Valencia, Spain.
³ Institute of Language, Literature and Anthropology, Spanish National Research Council, Madrid, Spain.
⁴ Department of Sociology and Social Work, University of the Basque Country, Leioa, Bizkaia, Spain; Research Group on Social Determinants of Health and Demographic Change- OPIK, Leioa, Bizkaia, Spain.
⁵ Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia.
⁶ Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York, NY, USA.
⁷ Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Bizkaia, Spain; Research Group on Social Determinants of Health and Demographic Change- OPIK, Leioa, Bizkaia, Spain.
⁸ Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁹ Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.
¹⁰ Urban Health Collaborative, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
¹¹ Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia. Electronic address: pedro.gullon@uah.es.

PMID: 37004266
DOI: 10.1016/j.gaceta.2023.102298

Abstract

This sequential mixed-methods study aims to: 1) assess spatial and temporal trends in cardiovascular risk factors by socioeconomic position from 2001 to 2020 in Spain; 2) explore public health professionals' perspectives regarding interventions that might have impacted these inequities; and 3) analyze determinants on social inequities in cardiovascular risk factors. First, we will measure the change in absolute and relative social inequities in eight cardiovascular risk factors through time trend analysis using repeated cross-sectional data from both National and European Health Surveys for Spain from 2001 to 2020. Second, we will interview key informants -both at the regional and national level-, to contextualize data obtained in phase 1 and capture the content and variation of policies across regions. Third, we will use econometric methods to analyze how these identified interventions have impacted these social inequities within and across regions.

Keywords: Cardiovascular diseases; Desigualdades sociales; Enfermedades cardiovasculares; España; Factores de riesgo; Factores socioeconómicos; Health inequities; Risk factors; Socioeconomic factors; Spain.

MeSH terms

Adult
Cardiovascular Diseases* / epidemiology
Cross-Sectional Studies
Female
Health Status Disparities*
Health Surveys
Heart Disease Risk Factors
Humans
Male
Qualitative Research
Social Determinants of Health*
Socioeconomic Factors
Spain / epidemiology