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Enrique Regidor

Publications and source records attributed to Enrique Regidor.

35 records · Page 2Linked to original sources
PubMed2003

[The obesity epidemic and related factors: the case of Spain].

The obesity epidemic is a global phenomenon that does not respect geographic or socio-demographic boundaries. Thus, research on factors related to the obesity epidemic has focused on social and economic characteristics of modern societies. This article discusses obesity in Spain and trends in several associated factors. Together with the increase in the prevalence of obesity, important changes in the population's dietary pattern have been observed, although total energy and fat intake appear to be stable. According to several indirect indicators, sedentary behavior predominates, although the percentage of the population reporting some leisure exercise is increasing. An increase in the amount of leisure time in modern societies is suggested as an explanation for this paradox. Factors related to energy expenditure could be as important as dietary factors in the genesis of the obesity epidemic.

Adult↗
PubMed2003

[Socioeconomic circumstances and premature mortality from chronic diseases].

BACKGROUND AND OBJECTIVE: Our aim was to investigate the association between socioeconomic factors in childhood or adolescence and adulthood and premature mortality from various causes of death. SUBJECTS AND METHOD: Men and women aged 25-74 years residing on May 1, 1996, in the Autonomous Community of Madrid. For the next 19 months, information on individuals who died and the cause of death were obtained from the Mortality Register. We estimated the mortality from 5 types of cancer and from 4 chronic diseases by the educational level--as an indicator of the socioeconomic circumstances in childhood or adolescence--and by income--as an indicator of the socioeconomic circumstances in adulthood. RESULTS: When both variables were included in the analysis simultaneously, the relative mortality ratio for men with second grade first phase and lower educational level versus those with second grade, second phase and higher educational level and the relative mortality ratio for men belonging to income quartiles 3 and 4 (lowest) versus those belonging to quartiles 1 and 2 were, respectively: 1.15 (95% confidence interval 1.01-1.31) and 1.22 (1.09-1.36) for lung cancer; 1.46 (1.19-1,93) and 1.13 (0.90-1.41) for gastric cancer; 1.80 (1.32-2.44) and 1.46 (1.18-1.80) for chronic obstructive pulmonary disease; and 1.18 (0.77-1.81) and 0.68 (0.47-0.98) for diabetes mellitus. For women the relative mortality ratios were, respectively: 0.63 (0.43-0.92) and 0.72 (0.52-0.99) for lung cancer; 1.68 (0.99-2.83) and 1.17 (0.86-1.60) for gastric cancer; 0.76 (0.61-0.94) and 0.98 (0.82-1.16) for breast cancer; 1.36 (0.95-1.95) and 1.20 (0.97-1.48) for ischemic heart disease; 1.72 (1.19-2.50) and 0.93 (0.75-1.16) for stroke; and 2.23 (0.94-5.27) and 1.51 (1.02-2.25) for diabetes mellitus. CONCLUSIONS: Premature mortality in adulthood is associated with several socioeconomic factors acting across the whole course of life. The contribution of these socioeconomic circumstances to mortality varies regarding the cause of death and gender.

Adult↗
PubMed2003

Trends in the association between average income, poverty and income inequality and life expectancy in Spain.

In this paper, we study the relation between life expectancy and both average income and measures of income inequality in 1980 and 1990, using the 17 Spanish regions as units of analysis. Average income was measured as average total income per household. The indicators of income inequality used were three measures of relative poverty-the percentage of households with total income less than 25%, 40% and 50% of the average total household income-the Gini index and the Atkinson indices with parameters alpha=1, 1.5 and 2. Pearson and partial correlation coefficients were used to evaluate the association between average income and measures of income inequality and life expectancy. None of the correlation coefficients for the association between life expectancy and average household income was significant for men. The association between life expectancy and average household income in women, adjusted for any of the measures of income inequality, was significant in 1980, although this association decreased or disappeared in 1990 after adjusting for measures of poverty. In both men and women, the partial correlation coefficients between life expectancy and the measures of relative income adjusted for average income were positive in 1980 and negative in 1990, although none of them was significant. The results with regard to women confirm the hypothesis that life expectancy in the developed countries has become more dissociated from average income level and more associated with income inequality. The absence of a relation in men in 1990 may be due to the large impact of premature mortality from AIDS in regions with the highest average total income per household and/or smallest income inequality.

Female↗
PubMed2003

The size of educational differences in mortality from specific causes of death in men and women.

This study examines the association between education and mortality from specific causes of death based on mortality records for 1996 and 1997, and 1996 population census data from the Region of Madrid (Spain). Poisson regression models were used to estimate the percentage increase in mortality associated with 1 year less education. The percentage increases in mortality from stomach cancer, lung, bladder and liver cancers, for aids, chronic obstructive pulmonary disease, pneumonia and influenza, and chronic liver disease and cirrhosis were higher in men than in women, whereas the percentage increases in mortality from colon cancer, diabetes mellitus, ischemic heart disease and nephritis, nephrosis and nephrotic syndrome were higher in women. The results found for some causes of death--lung cancer, ischemic heart disease, diabetes mellitus and chronic obstructive pulmonary disease--reflect the variations by educational level in the prevalence of lifestyle-related risk factors in men and women. Various hypotheses have been suggested for other causes of death, but it is not known why the magnitude of the association between education and mortality from some causes of death differs between men and women. Future studies of this subject may provide some clues as to the underlying mechanisms of this association.

Adult↗
PubMed2003

Unusually strong association between education and mortality in young adults in a community with a high rate of injection-drug users.

BACKGROUND: To examine the association between education and mortality for various causes of death in young adults in a community with a high rate of injection-drug users. METHODS: Linked mortality study based on mortality records for 1996 and 1997 and on 1996 population census data from the Region of Madrid (Spain). The association between educational level and mortality was estimated by the mortality rate ratio. RESULTS: After adjustment for age and other socioeconomic variables the mortality rate in men and women aged 25-44 years with no education was, respectively, 4.7 and 3.7 times higher than in men and women with the highest educational level. The causes of death with the strongest association were chronic liver disease and cirrhosis, AIDS and diseases of the heart in both sexes and suicide in men. For these causes of death the mortality rate ratio between persons with the lowest and highest educational level ranged from 6.8 to 21.8 in men and from 4.1 to 16.9 in women. CONCLUSIONS: These causes of death are the leading specific causes of death in persons aged 25-44 years. Given that probably a substantial part of deaths from diseases of the heart in this age category are drug-related, the common denominator of the excess mortality related poor education seems to be drug injection.

Adult↗
PubMed2003

Higher birth weight and lower prevalence of low birth weight in children of agricultural workers than in those of workers in other occupations.

Agricultural occupation has been associated with different reproductive outcomes. This study examined the relation between mean birth weight (MBW) and the prevalence of low birth weight (LBW) and paternal occupation in 1995-1998. Births and late fetal deaths were analyzed (n = 1,097,817). Paternal occupation was grouped into four categories: professionals and managerial; clerical, sales and service; manual; and agricultural workers. We estimated the difference between the MBW and the prevalence ratio of LBW in each occupational group as compared to the group of professionals and managerial workers. The adjusted difference in the MBW of the children of each occupational category was -8.9 g, -17.2 g, and 16.9 g, respectively. The adjusted prevalence ratio for LBW was 1.04, 1.08, and 0.91. Our results suggest a higher birth weight and lower prevalence of LBW in children of fathers who are agricultural workers.

Adult↗
PubMed2002

[Mortality pattern in Spain, 1998].

BACKGROUND: Our objective was to study the mortality from the 12 leading causes of death in Spain in 1998. PATIENTS AND METHOD: Proportional mortality and death rates according to causes of death in 1998 were estimated. We also calculated death rate trends since 1998. RESULTS: Leading causes of death were cancer heart diseases and cerebrovascular disease. Alzheimer's disease was the 11th leading cause of death. CONCLUSIONS: While mortality from Alzheimer's disease in 1998 was 21 times higher than in 1980, cancer-related mortality decreased over the last years.

Cause of Death↗
PubMed2002

Comparing social inequalities in health in Spain: 1987 and 1995/97.

To evaluate the trend in social inequalities in health in Spain between 1987 and 1995/97, we carried out a secondary analysis of the Spanish National Interview Surveys from 1987, 1995 and 1997. We studied less-than-good perceived general health and four chronic conditions--heart disease, diabetes mellitus, chronic bronchitis/asthma and allergies--by social class and educational level in men and women aged 25-74 years. Among men, the age-adjusted prevalence rate ratio of less-than-good perceived general health by social class decreased from 1.32 to 1.23 between 1987 and 1995,97: however, the prevalence rate ratio by educational level increased from 1.47 to 1.57. Among women, the prevalence rate ratio of less-than-good perceived general health increased between the first and second period as much by social class from 1.18 to 1.26, as by educational level--from 1.59 to 1.66. For heart disease the age-adjusted prevalence rate ratio by social class among men was 1.12 in 1987 and 0.72 in 1995/97, while the prevalence rate ratio by educational level was around I in both periods, among women, the prevalence rate ratio for heart disease by social class was the same in 1987 and in 1995/97, but the prevalence rate ratio by educational level increased between the first and second period. For diabetes mellitus and chronic bronchitis/asthma, the prevalence rate ratio increased by social class and educational level between the first and second period in both men and women. Finally, the prevalence rate ratio for allergies was always < 1, although its magnitude increased between 1987 and 1995/97. In general, health inequalities were larger by educational level than by social class and were larger in women than in men. Inequalities in perceived general health, diabetes mellitus and chronic bronchitis/asthma increased in Spain between 1987 and 1995/97.

Adult↗
PubMed2002

Factors associated with non-fatal heroin overdose: assessing the effect of frequency and route of heroin administration.

AIMS: To examine risk factors associated with non-fatal heroin overdose, particularly frequency and route of heroin administration. DESIGN: Data from cross-sectional surveys were analysed as a case-control and as a case cross-over design. SETTING AND PARTICIPANTS: 2556 subjects treated for heroin dependence in 164 outpatient facilities in Spain. MEASUREMENTS: Prevalence of overdose involving emergency care in the 12 months before treatment admission. CASE CONTROL DESIGN: Odds ratio (OR) adjusted by logistic regression. CASE-CROSSOVER DESIGN: Estimated relative risk (RR) of transient risk of injecting heroin. FINDINGS: The prevalence of overdose was 10%. In the case control analysis the cumulative risk of overdose increased as the frequency of heroin use decreased. However, among daily heroin users this risk increased as the frequency of heroin injection rose, with an OR of 6.0 (95% CI: 3.9-9.6) for daily injectors versus non-injectors. Sniffers had a higher risk than smokers among non-daily users, but not among daily users. Other factors associated with increased risk of overdose were: tranquilizers, alcohol or cocaine use, living in certain regions and being long-term HIV+ 0. In the case-crossover analysis, the RR for injecting heroin versus using other routes immediately before overdose was 15.9 (95% CI: 9.5-26.6), and was much higher for non-daily heroin users than for daily users. CONCLUSIONS: These findings suggest that the rapid entry of a large quantity of heroin into the blood (as occurs when injecting) involves a high risk of overdose, especially when the heroin tolerance level is low (as occurs in sporadic users).

Adult↗
PubMed2002

Infant mortality at time of birth and cause-specific adult mortality among residents of the Region of Madrid born elsewhere in Spain.

BACKGROUND: To investigate the association between infant mortality at time of birth and mortality from various causes of death in adulthood in men and women. METHODS: Linked mortality study based on mortality records for 1996 and 1997 and on 1996 population census data of the Region of Madrid (Spain). Deaths from five cancer sites and from five chronic diseases were estimated for 1 224 894 people aged 35-74 years residing in the Region of Madrid who were born elsewhere in Spain. RESULTS: A gradient in mortality by infant mortality quartile was seen for mortality from stomach cancer, colon cancer, diabetes mellitus and chronic liver disease in men, and for stomach cancer, ischaemic heart disease and chronic liver disease in women. The association was positive for stomach cancer and negative for all other causes. The relative mortality rates adjusted for age and adult socioeconomic factors for men belonging to infant mortality quartiles 3 and 4 (highest) versus those belonging to quartiles 1 and 2 as baseline were 1.06 (95% CI : 0.75-1.56) for stomach cancer, 0.67 (95% CI : 0.47-0.95) for colon cancer, 0.59 (95% CI : 0.35- 1.00) for diabetes mellitus, and 0.70 (95% CI : 0.49-0.99) for chronic heart disease. The relative mortality rates for women were 2.06 (95% CI : 1.09-3.88) for stomach cancer, 0.58 (95% CI : 0.41-0.80) for ischaemic heart disease, and 0.44 (95% CI : 0.27-0.70) for chronic liver disease. CONCLUSION: Higher infant mortality at time of birth is associated with adult mortality from diabetes mellitus and colon cancer in men, from ischaemic heart disease in women, and from stomach cancer and chronic liver disease in both sexes. These results most likely reflect adverse living conditions and/or nutritional deprivation in childhood.

Adult↗
PubMedDate not supplied

Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations.

BACKGROUND: Studies of socioeconomic disparities in patterns of cause of death have been limited to single countries, middle-aged people, men, or broad cause of death groups. We assessed contribution of specific causes of death to disparities in mortality between groups with different levels of education, in men and women, middle-aged and old, in eight western European populations. METHODS: We analysed data from longitudinal mortality studies by cause of death, between Jan 1, 1990, and Dec 31, 1997. Data were included for more than 1 million deaths in 51 million person years of observation. FINDINGS: Absolute educational inequalities in total mortality peaked at 2127 deaths per 100000 person years in men, and at 1588 deaths per 100000 person years in women aged 75 years and older. In this age-group, rate ratios were greater than 1.00 for total mortality and all specific causes of death, apart form prostate cancer in men and lung cancer in women, showing increased mortality in low versus high educational groups. In men, cardiovascular diseases accounted for 39% of the difference between low and high educational groups in total mortality, cancer for 24%, other diseases for 32%, and external causes for 5%. Among women, contributions were 60%, 11%, 30%, and 0%, respectively. The contributions of cerebrovascular disease, other cardiovascular diseases, pneumonia, and COPD strongly increased by age, whereas those of cancer and external causes declined. Although relative inequalities in total mortality were closely similar in all populations, we noted striking differences in the contribution of specific causes to these inequalities. INTERPRETATION: Research needs to be broadened to include older populations, other diseases, and populations from different parts of Europe. Effective interventions should be developed and implemented to reduce exposure to cardiovascular risk factors in low-educational groups.

Aged↗
PubMedDate not supplied

[Material well-being of the province of residence and leisure-time physical inactivity].

OBJECTIVE: To estimate the association between material wellbeing of the province of residence and leisure-time physical inactivity in the Spanish population aged 16 years and older. METHODS: We used data from the Survey on Disabilities, Impairments and Health Status carried out by the Statistical National Institute in 1999. We analyse 24,561 women and 21,133 men. Respondents were classified as inactive if they reported no leisure-time physical activity. The measure of material wellbeing was the per capita income of the province of residence grouped in quartiles. The measure of the association between per capita income and physical inactivity was the odds ratio (OR) estimated from logit multilevel models. RESULTS: Association between per capita income and physical inactivity was observed in people aged 45 years and older. The lower prevalence of physical inactivity was observed in provinces with the higher per capita income. However the higher OR was found in quartile 2 of per capita income, because no significant difference was observed between quartile 4 (richest) and quartile 1 (poorest). After adjusting for socioeconomic characteristics and other individual variables, association remained significant in women and disappeared in men. In women, association between per capita income and physical inactivity was higher in the population group with lower personal income. CONCLUSIONS: Results suggest that physical inactivity in women aged 45 years and older could be related not only with individual characteristics but with the socioeconomic context of the area of residence.

Exercise↗
PubMedDate not supplied

Trends of socioeconomic inequalities and socioeconomic inequalities in self-perceived health in Spain.

OBJECTIVE: To study the trends of socioeconomic inequalities and socioeconomic inequalities in self-perceived health in Spain between 1987 and 2001. METHODS: We estimated the distribution of educational level and per capita provincial income, and the differences in less-than-good self-perceived health by educational level and per capita provincial income in each period. RESULTS: The percentage of the population that had completed secondary or higher education was larger and inequality in per capita provincial income was smaller in 2001 than in 1987. In general, the differences in less-than-good self-perceived health by educational level and provincial income were greater in 2001 than in 1987, in both absolute and relative terms. However, when the effect of residual correlation within provinces was taken into account, the differences by per capita provincial income were smaller in 1987 than in 2001. CONCLUSIONS: The redistribution of socioeconomic resources achieves greater social justice, but probably does not lead to reduced health inequalities in all cases.

Adult↗
PubMedDate not supplied

[Association of income with use of and access to health services in Spain at the beginning of the XXI century].

OBJECTIVE: To estimate the association of household income and provincial income with visits to general practitioners and specialists and with hospitalization and to determine whether waiting times to access these services vary with both economic variables. METHOD: Data from the 2001 National Health Survey were used. The association was estimated by sex- and age-adjusted odds ratios; in the case of per capita income, odds ratios were also adjusted for household income. Percentiles and the geometric mean of waiting times in each health service were estimated and the statistical significance of their association with both economic variables was evaluated. RESULTS: Subjects with the lowest household income showed the highest frequency of visits to general practitioners and hospitalization, although they waited longer for hospital admission. Subjects with the lowest household income also showed the lowest frequency of specialist visits: the odds ratio in the lowest income quartile with respect to the highest income quartile was 0.73 (95% CI: 0.62-0.87). However, when only visits to specialists working in the public system were analyzed, the lowest frequency of visits was observed in subjects with the highest household income. No differences were found in health services utilization or in waiting times according to provincial income. CONCLUSIONS: The frequency of specialist visits according to household income shows a different pattern from that observed for visits to general practitioners and hospitalizations. The longest waiting times for admission to hospital were observed in subjects with the lowest household income.

Adolescent↗
PubMedDate not supplied

[Failure in the control of the number of traffic accident victims in Spain. Is this a result of the correct answer to the wrong question?].

Although various measures have been implemented in Spain with the aim to modifying the behavior of motor vehicle users, it has not been observed a descending trend in traffic accident and injuries from traffic accident. This article considers the question of whether the measures taken to reduce motor vehicle crash-related injuries in Spain have targeted the causes that are truly responsible for this trend. Using several sources of data, beginning in 1990 it has been observed a significant reduction in traffic accidents and their consequences, but in the second half of the 90s the growth in motor vehicle crash-related injuries was similar to the increase observed in the 80s. Likewise per capita alcohol consumption shows a downward trend from 1980 while the number of injuries has been strong associated with the economic cycle during the last twenty years. We conclude pointing out that intervention measures to control this problem in Spain have focused mainly on modifying behaviour that increases the risk and severity of traffic accident injuries and have ignored the macro-economic determinants that explain the trend in the frequency of this health problem.

Accidents, Traffic↗