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This paper aims to identify the inter-relationships between the social factors that influence epidemiological patterns in the city neighbourhood of Casablanca, Zaragoza (Spain). Data for a cross-sectional survey were collected between January 2008 and April 2008 from a representative random sample of 1032 residents aged more than 15 years. The study interview contained information scales on healthcare behaviours, treatment evaluation, the number of medical consultations in the weeks pervious to the interview and the perceived health status of the respondents, using The Health Perception Questionnaire. The global index (continuous variable) allowed inferences to be made on the individual's perception of his/her own health. The assessment of social vulnerability was based on the occupational, educational and economic conditions of the interviewees. An individual was considered to belong to a vulnerable subeconomic group if he/she had a personal income of 6000 euros or less; or had no formal education or had been educated up to primary school level only; or was not in paid employment at the time of the interview. A descriptive and comparative analysis of the vulnerable and non-vulnerable population groups for perceived and diagnosed health variables was undertaken using parametric and non-parametric tests. A total of 550 interviewees (53.3%) were considered vulnerable people. Low level of instruction (primary or no education) was the main characteristic of this group (356 subjects, 64.7% of those identified as vulnerable). Binary logistic regression was used to analyse the association between belonging to the vulnerable group and a number of health variables adjusted for gender, age and area of residence. The vulnerable group had worse levels of perceived health even when controlled for gender and area of residence. In Casablanca, the place of residence is an important social stratification indicator reflected in the characteristics of the vulnerable population group and its perceived health. [ABSTRACT FROM AUTHOR]

As people age, they tend to increase their use of health services. For this, the aims of this study were to analyse the frequency and variability in the use of different health services by people over 65 years, their evolution from 2009 to 2017 and the factors associated it. We carried out a cross‐sectional study with 25,465 people over 65 years who participated in the National Health Survey in Spain in 2011/2012 and 2017 and the European Health Survey in Spain in 2009 and 2014. A descriptive analysis was performed using the attendance records of family/general physicians, nurse consultations, or both over the last 12 months as well as these data over the following years of study. Our findings show that approximately 93.2% of the participants had consulted with a family/general physician over the last year, and women were almost twice as likely to do so compared with men (61.2% vs. 38.8%). The use of health services gradually increased from 2009 to 2017, being the visits to nursing that more increased their frequency. Being a woman and a widower as well as having no higher education, a low social class, a serious or long‐term illness, obesity and bed restraint were associated with a greater use of health services. Findings suggested that the increased health services due to ageing and comorbidities associated with it present new challenges. It is necessary to determine realistic plans that can meet future healthcare demands and not lead to a collapse of the health system. For this it is very important the primary prevention of chronic diseases, functional limitations, obesity and disability. [ABSTRACT FROM AUTHOR]

Study of the long‐term impact of economic recession on lifestyle according to socioeconomic groups is scarce. This study examines health‐related lifestyle and preventive medical attendance in different socioeconomic groups in the Spanish adult population (18–64 years of age) before, during and after an economic recession. Data were collected from three waves of the Spanish National Health Survey (2006, 2012 and 2017). Self‐perceived health, health‐related lifestyle and common preventive medical attendance were evaluated by means of multivariate logistic models. The increase in good self‐perceived health in 2006–2012 was 7.1%, 6.9% and 8.3% for the high, middle and low group, respectively, and 5.2%, 5.9% and 7.9% for the high, middle and low group, respectively, in 2006–2017. In 2006–2012 and 2006–2017, the gap increased between people of the high and low groups in smoking prevalence (2.8%–4.7%), physical activity (2.0%–4.0%), daily fruit (1.0%–6.3%) and vegetable intake (2.5%–6.1%). The probability of women´s gynaecological attendance increased statistically significant for cytology in three groups in 2006–2012 and 2006–2017 (OR = 1.35, 95% CI = 1.08–1.67; OR = 1.42, 95% CI = 1.18–1.7; OR = 1.34, 95% CI = 1.21–1.47 for the high, middle and low groups, respectively, in 2006–2012 and OR = 1.34, 95% CI = 1.08–1.67; OR = 1.62, 95% CI = 1.35–1.95; OR = 1.51, 95% CI = 1.37–1.66 for the high, middle and low groups, respectively, in 2006–2017), but not for mammography. This study reveals long‐term socioeconomic inequalities in lifestyle behaviours after the economic recession. Health policies must be emphasised in these population subgroups and in more disadvantaged populations. [ABSTRACT FROM AUTHOR]

Ageing well involves individuals continuing participating in personal, social and civic affairs even in older age. From this standpoint, limitations in individual's functioning (beyond the mere absence of disease) may drastically impact on how well people becoming older. This study aimed to identify functional status profiles in a nationally representative sample of older adults, using latent class analysis methods. Moreover, it intended to study the how identified classes would be related to health‐related outcomes later in life, as a way to provide some evidence on predictive validity. Data from a nationally representative sample of Spanish older adults (N = 2,118; 56.18% women; M = 71.50 years, SD = 7.76), were used. Profiles were identified according to a large set of functioning indicators from multiple domains using latent class analysis. Outcomes were studied over a 3‐year follow‐up, considering both the individual (quality of life, well‐being and mortality) and institutional level (health service utilisation). As a result, seven profiles were identified: normative profile (showed by most participants), limited cognitive functioning class, limited global functioning class, limited mental and mobility functioning class, poor self‐reported health class, limited sensory functioning class and limited objective functioning class. All the profiles with limitations across domains showed poor outcomes. Multidimensional limitations were related to the worst outcomes, especially when psychosomatic complaints and high feelings of loneliness were reported. To sum up, latent class analysis constitutes a suitable alternative to study population heterogeneity, providing relevant evidence to help making decision in public and community health. [ABSTRACT FROM AUTHOR]

With the start of the great economic recession in 2007, homelessness increased fivefold in some regions of southern Europe. Larger numbers of people experiencing homelessness, compounded by a lowered capacity for social and health services to respond to their needs, precipitated an increase in so‐called 'chronic homelessness'. The aim of this study was to establish the presence of chronic homelessness in a defined geographical area of Spain, and to determine the prevalence of diagnosed mental disorders within both the chronic and non‐chronic homeless population. A prospective and descriptive study was designed to monitor a cohort of 826 individuals experiencing homelessness who constituted the entire identified homeless population in the relevant territory in 2006. This sample was followed until 2016 and sociodemographic as well as clinical information was collected, including the time spent homeless. The results obtained indicated that one in 10 participants met the criteria for chronic homelessness, a rate that is lower than in the US, where the definition of chronicity that was applied originates from. Alcohol use disorder was the most common mental health disorder that contributed to the chronicity associated with homelessness. Being born in the country (Spain) where the study was conducted and being older were the main other variables associated with chronicity. People defined as chronically homeless in Spain were on average younger than in the US, but women were present in the chronic subgroup at a similar rate. We also reflect on the limitations of the study and in particular the appropriateness of the concept of chronicity as applied to homelessness. [ABSTRACT FROM AUTHOR]

Scene‐Based Psychodramatic Family Therapy (SB‐PFT) is a multiple‐family intervention for adolescents with behavioural problems implemented by Child Welfare Services in Spain. This intervention is aimed at promoting adolescent well‐being. The aim of this study was to evaluate the effectiveness of SB‐PFT in 17 trials, measuring its impact on the emotional intelligence, parental attachment, peer attachment and antisocial behaviour of 216 adolescents (109 participating in the intervention and 107 in the control group). Repeated measures ANOVAs for pretest/posttest differences and long‐term growth models were estimated. In the short term, the intervention had a positive impact on emotional intelligence and had a stabilising effect on parental attachment, whereas the long‐term results showed significant logarithmic growth in emotional intelligence and exponential growth in parental attachment and a decrease in antisocial behaviour. However, no changes in peer attachment were shown. This study demonstrates SB‐PFT to be a potentially effective intervention for adolescents with behavioural problems and emphasises the importance of fostering emotional intelligence. [ABSTRACT FROM AUTHOR]

Telecare is a healthcare resource based on new technologies that, through the services offered, attempt to help elderly people to continue living in their homes. In this sense, first-generation telecare services have quickly developed in Europe. The aim of this work was to define the profile, pattern of medication consumption and disease frequencies of elderly users of a telecare service. The cross-sectional study involved 742 Spanish community-dwelling elders (85.3% of the total users aged 65 years and over who used a telecare service before the end of the data collection period). Data were collected between March and September 2012. Subjects' mean age was 83.3 ( SD 6.6) years, and the majority lived alone (78.3%) and were female (85.8%). The mean Charlson comorbidity index score was 1.13 ( SD 1.1), and the mean number of prescribed medications per day was 5.6 ( SD 3.0). The most frequent diseases were hypertension (51.1%) and rheumatic disorders (44%); and the most consumed medications were those for the cardiovascular (75%) and nervous (65.2%) systems. For the total sample, the three main determinants of polymedication (five or more medications) were hypertension, anxiety-depressive symptoms and coronary heart disease. Regardless of the social elements contributing to the implementation of telecare services, specific health characteristics of potential users, such as morbidity and polypharmacy, should be carefully considered when implementing telecare services in the coming years. [ABSTRACT FROM AUTHOR]