Biomedical subjects

Joan Benach

Publications and source records attributed to Joan Benach.

29 records · Page 2Linked to original sources

PubMed2003

Comparison of fatal occupational injury surveillance systems between the European Union and the United States.

BACKGROUND: Comparison of workplace injury statistics among countries is often problematic, mainly because work injury statistics are based on different national recording and notification systems. METHODS: Definitions of fatal work-related injuries, identification of the reference population, and rates of fatal work-related injuries, from 1995 to 1998, were compared between the European Statistics on Accidents at Work (ESAW) and the United States (U.S.) Census of Fatal Occupational Injuries (CFOI). RESULTS: Similar definitions for workplace fatalities were found, but CFOI is based on an active search, and ESAW on passive notification. Daily fatal occupational injury numbers were similar in both: about 17 workers die per day, but average annual work-related death rates were higher in the U.S. CONCLUSIONS: There are enough differences to allow direct comparisons between both systems. CFOI is likely to be more comprehensive than ESAW. It is conceivable that the true number of fatal occupational injuries in the European Union (E.U.) could be higher, and thus the apparent difference in U.S. and E.U. fatal injury rates may be an artifact of the different surveillance systems.

Accidents, Occupational↗

PubMed2003

The public health burden of material deprivation: excess mortality in leading causes of death in Spain.

OBJECTIVE: The aim of the study is to investigate the burden of deprivation-associated excess of deaths by 10 leading causes of death in each gender and two age groups. DESIGN: A small-area ecological study using two indices of material deprivation drawn from 1991 census and mortality data aggregated for 1987-1995 was undertaken. SETTING: 2218 small areas in Spain. Data are presented by region. MAIN OUTCOME MEASURES: The 10 leading causes of death in each gender and two age groups were determined. RESULTS: The deprivation-associated excess mortality in the top 10 leading causes of death was 14.4 and 11% for males and females, respectively. Excess mortality in the 9-year period studied accounted for more than 222,000 deaths. A large proportion of excess deaths was found in causes related to smoking and alcohol consumption among males and diet-related causes of death among females. The most deprived regions within the country showed the highest mortality risk. CONCLUSIONS: Material deprivation appears to be manifested in high mortality rates differently by gender and region. It imposes a significant public health burden that demands urgently attention and action by health policy-makers.

Adolescent↗

PubMed2003

Occupational categories and sickness absence certified as attributable to common diseases.

BACKGROUND: [corrected] This paper focuses on the relationship between sickness absence rates certified as attributable to common (non-work-related) diseases and occupational categories. METHODS: A cohort of 2,909 workers from an urban bus company was analysed from 1994 to 1996 (8,388.7 person-years), who reported 2,893 non-work-related sickness absence spells of three days or more (78% of all sickness absence spells in the period). Rates of sickness absence were calculated and an extension of the Andersen-Gill approach to proportional hazards modelling was used to adjust covariables. RESULTS: Assistant staff (35.63 per 100 person-years), and bus drivers (37.23) had the highest incidence rates. After adjusting for demographic variables, employment duration and health status, it was found that all occupational categories had a significant rate ratio (RR) in comparison to the manager category. The strongest positive associations were found among bus drivers (RR = 2.45; 95% CI: 1.52-3.97), assistant staff (RR = 2.57; 1.67-3.94), and technical staff (RR = 2.42; 1.57-3.74). CONCLUSION: Occupational category was an important predictor of sickness absence incidence certified as attributable to common disease. Further research on the associations between working conditions and sickness absence needs to take into account the distinction between sickness absences due to work-related diseases and those due to common diseases.

Administrative Personnel↗

PubMed2003

Examining geographic patterns of mortality: the atlas of mortality in small areas in Spain (1987-1995).

BACKGROUND: Small-area mortality atlases have been demonstrated to be a useful tool for both showing general geographical patterns in mortality data and identifying specific high-risk locations. In Spain no study has so far systematically examined geographic patterns of small-area mortality for the main causes of death. This paper presents the main features, contents and potential uses of the Spanish Atlas of Mortality in small areas (1987-1995). METHODS: Population data for 2,218 small areas were drawn from the 1991 Census. Aggregated mortality data for 14 specific causes of death for the period 1987-1995 were obtained for each small area. Empirical Bayes-model-based estimates of age-adjusted relative risk were displayed in small-area maps for each cause/gender/age group (0-64 or 65 and over) combination using the same range of values (i.e. septiles) and colour schemes. RESULTS: The 'Spanish Atlas of Mortality' includes multiple choropleth (area-shaded) small-area maps and graphs to answer different questions about the data. The atlas is divided into three main sections. Section 1 includes the methods and comments on the main maps. Section 2 presents a two-page layout for each leading cause of death by gender including 1) a large map with relative risk estimates, 2) a map that indicates high- and low-risk small areas, 3) a graph with median and interquartile range of relative risk estimates for 17 large regions of Spain, and 4) relative-risk maps for two age groups. Section 3 provides specific information on the geographical units of analysis, statistical methods and other supplemental maps. CONCLUSION: The 'Spanish Atlas of Mortality' is a useful tool for examining geographical patterns of mortality risk and identifying specific high-risk areas. Mortality patterns displayed in the atlas may have important implications for research and social/health policy planning purposes.

Adolescent↗

PubMed2003

The associations of social class and social stratification with patterns of general and mental health in a Spanish population.

BACKGROUND: Social class, as a theoretical framework, represents a complementary approach to social stratification by introducing social relations of ownership and control over productive assets to the analysis of inequalities in economic, political, and cultural resources. In this study we examined whether measures of social class were able to explain and predict self-reported general and mental health over and above measures of social stratification. METHODS: We tested this using the Barcelona Health Interview Survey, a cross-sectional survey of 10 000 residents of the city's non-institutionalized population in 2000. We used Erik Olin Wright's indicators of social class position, based on ownership and control over productive assets. As measures of social stratification we used the Spanish version of the British Registrar General (BRG) classification, and education. Health-related variables included self-perceived health and mental health as measured by Goldberg's questionnaire. RESULTS: Among men, high level managers and supervisors reported better health than all other classes, including small business owners. Low-level supervisors reported worse mental health than high-level managers and non-managerial workers, giving support to Wright's contradictory class location hypothesis with regard to mental health. Social class indicators were less useful correlates of health and mental health among women. CONCLUSIONS: Our findings highlight the potential health consequences of social class positions defined by power relations within the labour process. They also confirm that social class taps into parts of the social variation in health that are not captured by conventional measures of social stratification and education.

Adolescent↗

PubMed2003

The importance of the political and the social in explaining mortality differentials among the countries of the OECD, 1950-1998.

This article analyzes (within the conceptual frame defined in the previous article) the impact of political variables such as time of government by political parties (social democratic, Christian democratic or conservative, liberal, and ex-dictatorial that have governed the OECD countries during the 1950-1998 period) and their electoral support on (1) redistributional policies in the labor market and in the welfare state; (2) the income inequalities measured by Theil and Gini indexes; and (3) health indicators, such as infant mortality and life expectancy. This analysis is carried out statistically by a bivariate and a multivariate analysis (a pooled cross-sectional study). Both analyses show that political variables play an important role in defining how public and social policies determine the levels of inequalities and affect the level of infant mortality. In general, political parties more committed to redistributional policies, such as social democratic parties, are the most successful in reducing inequalities and improving infant mortality. Less evidence exists, however, on effects on life expectancy. The article also quantifies statistically the relationship between the political and the policy variables and between these variables and the dependent variables--that is, the health indicators.

Developed Countries↗

PubMed2002

Economic inequality, working-class power, social capital, and cause-specific mortality in wealthy countries.

This study tests two propositions from Navarro's critique of the social capital literature: that social capital's importance has been exaggerated and that class-related political factors, absent from social epidemiology and public health, might be key determinants of population health. The authors estimate cross-sectional associations between economic inequality, working-class power, and social capital and life expectancy, self-rated health, low birth weight, and age- and cause-specific mortality in 16 wealthy countries. Of all the health outcomes, the five variables related to birth and infant survival and nonintentional injuries had the most consistent association with economic inequality and working-class power (in particular with strength of the welfare state) and, less so, with social capital indicators. Rates of low birth weight and infant deaths from all causes were lower in countries with more "left" (e.g., socialist, social democratic, labor) votes, more left members of parliament, more years of social democratic government, more women in government, and various indicators of strength of the welfare state, as well as low economic inequality, as measured in a variety of ways. Similar associations were observed for injury mortality, underscoring the crucial role of unions and labor parties in promoting workplace safety. Overall, social capital shows weaker associations with population health indicators than do economic inequality and working-class power. The popularity of social capital and exclusion of class-related political and welfare state indicators does not seem to be justified on empirical grounds.

Adolescent↗

PubMed2002

A new occupational health agenda for a new work environment.

At the beginning of the 21st century, the emergence of new forms of work organization are transforming what had become standard types of work arrangements in industrialized countries. In this new labor market environment, new firms, types of workers, and risk factors are powerfully emerging. Contrary to common belief, emergent occupational health hazards should not be approached only as "technical" or "economic" value-free problems. Instead, many of the challenges faced by occupational health policy makers are predominantly related to professional values and to the political ideologies and economic interests of key stakeholders in the decision-making process. In this paper some of the key principles leading to efficient and equitable occupational health policies in the new work environment are discussed. An alternative is also proposed for dealing with the conditions and settings needed to meet the new challenges related to establishing an effective occupational health policy.

Environmental Health↗

PubMedDate not supplied

[Evolution of health inequalities in Catalonia [Spain]].

OBJECTIVE: To analyze the evolution of social inequalities in health in Catalonia (Spain) in the last 20 years. METHODS: Mortality in 354 small areas of Catalonia (288 cities in Catalonia and 66 health areas in the city of Barcelona) was analyzed for the 1984-98 period. Indicators of self-perceived health status, lifestyles, and health services utilization by social class and gender were compared for 1994 and 2002. Factors related to occupational health, immigration and health, environmental health, and policies to reduce social inequalities in health were also analyzed. RESULTS: Although most health indicators improved, multiple inequalities in health were found in both 1994 and 2002. These inequalities were the same in 2002 as in 1994 or, in some cases, worse. The collectives with the worst indicators were persons living in the most deprived areas, those from disadvantaged social classes, women, and immigrants from low-income countries. CONCLUSION: Social inequalities in health have persisted over the past 20 years in Catalonia. We present some recommendations on health information systems, research, and policies to reduce these inequalities.

Adolescent↗

PubMedDate not supplied

[Occupational injury, a public health priority].

The aim of this review is to stimulate new ideas and actions for the prevention of this important public health problem. In 2002 and 2003, respectively, the number of non-fatal occupational injuries was 971,406 and 906,638. Thus, every day in Spain there are more than 2500 non-fatal and between 2 and 3 fatal occupational injuries. Although the profile of the at-risk worker population has changed greatly over the past decade, both quantitatively and qualitatively, the risk of occupational injury still centers on blue collar workers, whether qualified or nonqualified, in the primary and secondary sectors of economic activity. The most common mechanisms of occupational injuries are overexertion for non-fatal injuries and traffic-related for fatal events. The adverse health consequences of new types of employment, which emphasize flexibility and deregulation of the labour market, are exemplified by the association between temporary employment and increased risk of occupational injury. New injury prevention programs have emerged in the last decade, but they appear to have had limited impact. Preventive activities should focus both on working conditions at the company level (micro) as well as on employment and industrial public policies (macro). Greater evaluation is needed of these latter policies.

Accidents, Occupational↗

PubMedDate not supplied

[Mortality from neural tube defects in Mexico, 1980-1997].

OBJECTIVE: To describe the mortality due to neural tube defects (NTD) in Mexico for the 1980-1997 period. MATERIAL AND METHODS: The annual NTD mortality rates per 10000 liveborn infants were calculated by state and for the country. The time trend was evaluated with the annual percent change (APC) obtained using a Poisson regression model. The NTD mortality ratio was calculated using the average national rate as reference. NTD mortality rates and ratios were graphically displayed on maps. RESULTS: During the 1980-1997 period the gross NTD mortality rate was 5.8 per 10000 live-born infants. Anencephaly (International Classification of Diseases ICD-9 740.0) was the most frequent type of NTD (37.7%), followed by spina bifida without hydrocephaly (CIE9 741.9) (31.6%). The national trend of NTD mortality increased between 1980 and 1990 (APC 7.5 95% CI 6.5, 8.6) and decreased between 1990 and 1997 (APC-2.3 95% CI-3.6, -0.9). CONCLUSIONS: The high NTD mortality rates were related to the high frequency of anencephaly. Also, the increase observed is not only attributable to diagnostic factors or to improved reporting. In Mexico, the influence of some NTD-associated factors such as specific genetic polymorphisms, folic acid deficit, maternal obesity, occupational exposure to pesticides, and poverty, should be assessed in specific studies.

Humans↗