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The creation of a national centre for public health, with adequate resources, will make it possible to face the public health challenges of the present and the future in our country. To this end, the proposed state agency, should hold functions based on advanced public health organizational schemes, while linking with the sustainable development goals. The coordination of a national public health strategy built on a collaborative network of networks would also be essential, as developing an innovative, benchmarked and prioritised public health communication strategy, among other tasks. The lack of resources, the current relative disconnection of essential public health functions at the state level, and the inequity in their development of these functions at the regional and municipal levels, favour the development of the agency project as a network of networks. In this paper we give ideas for a process that seems decisive for Spanish public health in the 21st century., (Copyright © 2021 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

This paper describes the beginning of the implementation process of the health impact assessment in the Valencian Community (Spain), as an instrument to incorporate the framework of social determinants and health inequalities in the policies issued by the different departments of the Valencian government. The proposal involves: 1) political commitment, with legislative and strategic planning actions; 2) the creation of structures to allow intersectoral collaboration, with the establishment of the health impact assessment commission and the intersectoral technical committee; and 3) the design and validation of a tool for the simplified health impact assessment of non-health policies adapted to the Valencian Community. We highlight the importance of the participatory methodology used in the whole process and the potential of the health impact assessment for the development of public policies oriented to improve health and equity., (Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

It is essential to develop a comprehensive approach to institutionally promoted interventions to assess their impact on health from the perspective of the social determinants of health and equity. Simple, adapted tools must be developed to carry out these assessments. The aim of this paper is to present two tools to assess the impact of programmes and community-based interventions on the social determinants of health. The first tool is intended to assess health programmes through interviews and analysis of information provided by the assessment team. The second tool, by means of online assessments of community-based interventions, also enables a report on inequality issues that includes recommendations for improvement. In addition to reducing health-related social inequities, the implementation of these tools can also help to improve the efficiency of public health interventions., (Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Interventions implemented by governments are very frequently related to the determinants of health. Health impact assessment (HIA) is used as a predictive tool to include health in nonhealth policymaking. This paper defines HIA, describes its methods, procedures and applications, and discusses opportunities and challenges associated with HIA. Doing a HIA implies studying the intervention, profiling the target population, and estimating its impacts on health by means of combining quantitative and qualitative evidence. HIA has been used in different kinds of policies (transports, urban regeneration, culture, energy development etc.), at different levels (local, national, European) and in many countries. Despite its scarce use in Spain, HIA allows to consider health in sectorial policymaking, taking into account social inequalities in health, so that healthier public policies can be designed. On the other hand, HIA is a tool under methodological development which use is hindered due to the existing narrow biomedical perspective on the determinants of health, and to the difficulties in working in public policy-making with multisectorial and participative perspectives.

The paper comments on present and future scenarios for the pharmaceutical sector in Spain, framed a highly regulated system. So far the drug industry has evolved under the short term public financial constraints for additional health care spending and the long term efforts to innovate. This has not proved to offer a stable setting for the relationship between the industry and Health Authorities. The author offers from the economic analysis and a subjective appraisal from his experience some recommendations for regulatory changes in order to better align the incentives of the parts for improving the health system as a whole. The basic point is that 'consumption levels' (quantities) and not <> (unit costs) are the main challenge to tackle today in our Public Health Care system, and for this the decentralisation of financial responsibility is not in itself 'the' problem but it may well be a part of the solution.

Objective: To measure the mediatic effect of different communication strategies used in public health advocacy. More specifically, to compare the effectiveness of the World Wide Web as a tool to attract the attention of journalists, with other more traditional formulas., Methods: For the Spanish Public Health Association (SESPAS) Report 2000, two types of media strategies to communicate the report contents were programmed: a) traditional and passive strategies, centred in approaching journalists through press releases and press conferences around the SESPAS meeting (November 15-20 1999); b) interactive strategies, since August 15 to December 30, focused towards attracting health journalists to the non-embargoed, full text SESPAS report launched in a web site. To facilitate the web page use, we wrote a letter, in the first week of August, to all the members of the Spanish Health Communicators Association giving them the URL and the website map. In parallel, a monitoring system of the media impact was established from August to December 99, covering 250 magazines and 70 newspapers, in order to locate and recover all the stories about the SESPAS report for further analysis., Results: Sixty-six stories were recovered; they were published in 32 press media from 24 provinces with an advertising value of 18,243,873 Ptas. As a whole, smaller circulation rate papers published more stories than larger ones. During five months, the SESPAS report was present in the press agenda, even though stories were not distributed homogeneously over time. Information concentrated around three moments: the first one, a week after our summer mailing; the second one, in the occasion of the publication of a story about the increase in traffic accidents in El País, and the third one during the SESPAS meeting. There were significant differences among those stories published from the traditional strategies of communication and those published from the interactive ones, the latter being more diverse, with more contributions of the journalists and tackling a wider range of issues., Conclusions: The combination of traditional and alternative communication strategies was a effective option. Unlike previous experiences in this occasion, with the network aid, the presence of SESPAS in media was not punctual around the Congress, but maintained during five months. The results and the obtained experience of this research can be useful for future public health advocacy interventions in Spain.