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Background: A low socioeconomic status (SES) presents lower physical activity; however, the relationship between SES and sedentary behavior (SB) remains unclear. We aimed to assess this association of SES with physical activity (PA) and SB. Methods: We employed representative self-reported data of the European Union from the cross-sectional survey Eurobarometer 2017, comprising a final sample of 13,708 citizens (18–64 y old), to assess the association of SES (education, occupation, and economic issues) with PA and sitting time quartiles, and to describe inequalities in vigorous, moderate, and walking activity and sitting time. Results: Multinomial regressions revealed that people from higher SESs were more likely to report higher PA; nonetheless, higher educational attainment and occupations were also associated with higher sitting time but not with lower economic issues. The inequality, shown by Gini coefficients, describes a socioeconomic gradient in vigorous and moderate activity, from higher inequality in lower statuses to lower inequality in higher statuses. The Gini coefficients also indicated higher socioeconomic inequalities in PA than SB. Conclusions: Higher SESs showed paradoxically more PA and SB; however, sitting time presented smaller differences and a more homogeneous distribution across the population. [ABSTRACT FROM AUTHOR]

Aims Obesity levels have increased worldwide with serious public health concerns. However, weight status is related to socioeconomic status (SES), which may also influence health-related lifestyles. Here, we study the association between SES and obesity mediated by diet and physical activity. Methods and results Using cross-sectional data from 2006, 2011, 2014, and 2017 Spanish health surveys (the final sample consisted of 61 768 adults aged between 18 and 64 years), we conducted a latent class analysis to estimate health-related lifestyle clusters (based on dietary patterns and physical activity) and mediation analyses to evaluate the association of SES and obesity through the clustering of health-related lifestyles. In both men and women, SES was inversely related to obesity (P<0.001) and positively related to healthier lifestyle classes (P< 0.001). Obesity was inversely related to healthier lifestyle classes (P<0.001). A small--although significant--proportion mediated by the clustering of lifestyles was found as follows: 4.9%, 95% CI (6.6%, 3.2%) in men and 2.3%, 95% CI (3.4%, 1.3%) in women for educational attainment, 5.3%, 95% CI (7.2%, 3.6%) in men and 2.0%, 95% CI (2.9%, 1.1%) in women for occupational social class, and 4.9%, 95% CI (6.5%, 3.1%) and 1.9%, 95% CI (2.9%, 1.1%) combining the above two SES indicators. Conclusions SES is related to obesity through clustering health-related lifestyles, with greater emphasis on men. However, the complex relationship between SES and weight status also suggests other indicators that contribute to the social gradient of obesity. [ABSTRACT FROM AUTHOR]

Background Misinformation hampers vaccine uptake. The European Union (EU) employed a coordinated effort to curb misinformation during the Covid-19 pandemic. In this context, we investigated relationships between sources of information, vaccine safety/effectiveness, satisfaction with government vaccination strategy, and vaccination intent. Methods We used cross-sectional survey data (May 2021) from Flash Eurobarometer 494, a population-adjusted dataset comprised of a representative sample of those ≥15 years from 27 EU nations. We employed a latent class analysis to create clusters of information sources as the independent variable and beliefs in vaccine safety/efficacy, satisfaction with government vaccination strategy, and vaccine intent as four outcome variables. We first estimated the association between source clusters and each of the first three outcomes separately. Then, using these three as intermediate variables, we employed structural equation modeling to estimate the relationship between sources and vaccine intent. We adjusted for individual and country-level variables. Results Among 23 012 respondents, four clusters of information sources emerged: (1) national authorities/health professionals (n  = 9602; 42%), (2) mostly health professionals (6184; 27%), (3) mixed (n  = 1705; 17%) and (4) social media/family/friends (n  = 5524; 24%). Using cluster (3) as the referent, we found decreasing odds of beliefs in vaccine safety/effectiveness, satisfaction and vaccine intent across clusters (1), (2) and (4), respectively. Demographics played a role. Conclusion In the context of the Covid pandemic, these results provide the first EU-wide estimates of the association between sources of information about vaccine safety/effectiveness, satisfaction and vaccine intent. The coordinated approach promulgated by the EU to minimize misinformation provides a model for managing future pandemics. [ABSTRACT FROM AUTHOR]

Objective: We examine the health‐related lifestyle behaviors of informal Spanish caregivers while controlling for sociodemographic characteristics. Background: Informal caregiving is an essential, albeit invisible, component of any health care delivery system that results in vast savings for national economies. Nevertheless, it remains unknown whether healthy lifestyle behaviors and the subsequent well‐being of informal caregivers may compromise their ability to continue providing their essential service. Method: We compared the health‐related lifestyle behaviors between informal caregivers and non‐caregivers, applying generalized estimating equations analysis. Results: We observed no significant differences in self‐rated health status between caregivers and non‐caregivers. Women and men older than 44 years of age with less than 20 hours of care per week were more likely to eat fruit and engage in physical activity. Younger women caregivers (18–44 years) with less than 20 hours of care per week were also more physically active. However, younger men with less than 20 hours of care per week smoked more, and women were more likely to use alcohol. No differences were observed between non‐caregivers and caregivers with 20 or more of care per week. Conclusions: Informal caregiving affects women and men equally, being hours of care per week a determinant of caregiver/non‐caregiver differences on diet, physical activity, smoking, and drinking. Implications: The results from these nationally representative data suggest both a healthy and unhealthy lifestyle caregiver effect for both women and men. This effect differs on the different health‐related behaviors and is related to the amount of time devoted to care. [ABSTRACT FROM AUTHOR]

Background Living standards determine population's physical activity (PA); however, more women are systemically insufficiently active, suggesting social gender inequality factors. Thus, we assessed the association between gender inequality, PA differences between genders, and total PA. Methods We used three independent cross-sectional databases at country-level: PA prevalence (i.e. Active Lifestyle) from the World Health Organization with 1.9 million individuals from 168 countries; daily steps (smartphone registers) of 693 806 people from 46 countries and sport participation in the 2016 Summer Olympics with 11 191 athletes. Gender Inequality Index was used to evaluate aspects surrounding gender equality controlling for overall economic and health status. Results Higher gender inequality was associated with gender differences in PA (Active Lifestyle, 0.402, P  < 0.001; Steps, 0.542, P  < 0.001; Olympic participation, 0.346, P  = 0.001). Likewise, lower gender inequality was associated with increased women activity (Active Lifestyle, −0.838, P  < 0.001; Steps, −0.81, P  < 0.001; Olympic participation, −0.577, P  < 0.001), and men activity (Active Lifestyle, −0.453, P  < 0.001; Steps, −0.461, P  = 0.002). Conclusions Lower women PA levels could be influenced by gender inequality. Public health policies aimed to improve women living conditions which may promote their participation in PA and sport. [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]

Introduction: Background: physical activity is a health-related behavior that is associated with increased well-being in people living with musculoskeletal disease. Objective: we assessed the association of different health and lifestyle factors with physical activity in the Spanish population living with musculoskeletal disease. Method: we used data from the 2014 European Health Survey for Spain. The population was classified according to their musculoskeletal disease (including osteoarthritis, back pain, osteoporosis, or several of these diseases) diagnostic status. The survey collected data on habitual physical activity and other health-related behaviors (diet, alcohol and tobacco consumption, among others) and other health indicators (self-perceived health status, perceived pain, mental health, physical limitations, among others). We used multivariate logistic regression models to analyze the relationship between the different variables studied in the population living with musculoskeletal disease. Results: physical activity is associated with daily fruit and vegetable intake, regardless of age and sex, and with daily fish consumption in women aged 45 years and older. Tobacco smoking is higher in inactive women and men, while weekly consumption of alcohol is associated with more physical activity (except in women aged 15-44 years). Conclusions: physical activity is a behavior associated with a better health status and healthier lifestyle in the Spanish population living with musculoskeletal disease. [ABSTRACT FROM AUTHOR]

Background: Misinformation hampers vaccine uptake. The European Union (EU) employed a coordinated effort to curb misinformation during the Covid-19 pandemic. In this context, we investigated relationships between sources of information, vaccine safety/effectiveness, satisfaction with government vaccination strategy, and vaccination intent., Methods: We used cross-sectional survey data (May 2021) from Flash Eurobarometer 494, a population-adjusted dataset comprised of a representative sample of those ≥15 years from 27 EU nations. We employed a latent class analysis to create clusters of information sources as the independent variable and beliefs in vaccine safety/efficacy, satisfaction with government vaccination strategy, and vaccine intent as four outcome variables. We first estimated the association between source clusters and each of the first three outcomes separately. Then, using these three as intermediate variables, we employed structural equation modeling to estimate the relationship between sources and vaccine intent. We adjusted for individual and country-level variables., Results: Among 23 012 respondents, four clusters of information sources emerged: (1) national authorities/health professionals (n = 9602; 42%), (2) mostly health professionals (6184; 27%), (3) mixed (n = 1705; 17%) and (4) social media/family/friends (n = 5524; 24%). Using cluster (3) as the referent, we found decreasing odds of beliefs in vaccine safety/effectiveness, satisfaction and vaccine intent across clusters (1), (2) and (4), respectively. Demographics played a role., Conclusion: In the context of the Covid pandemic, these results provide the first EU-wide estimates of the association between sources of information about vaccine safety/effectiveness, satisfaction and vaccine intent. The coordinated approach promulgated by the EU to minimize misinformation provides a model for managing future pandemics., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.)

Introduction: Background: physical activity is a health-related behavior that is associated with increased well-being in people living with musculoskeletal disease. Objective: we assessed the association of different health and lifestyle factors with physical activity in the Spanish population living with musculoskeletal disease. Method: we used data from the 2014 European Health Survey for Spain. The population was classified according to their musculoskeletal disease (including osteoarthritis, back pain, osteoporosis, or several of these diseases) diagnostic status. The survey collected data on habitual physical activity and other health-related behaviors (diet, alcohol and tobacco consumption, among others) and other health indicators (self-perceived health status, perceived pain, mental health, physical limitations, among others). We used multivariate logistic regression models to analyze the relationship between the different variables studied in the population living with musculoskeletal disease. Results: physical activity is associated with daily fruit and vegetable intake, regardless of age and sex, and with daily fish consumption in women aged 45 years and older. Tobacco smoking is higher in inactive women and men, while weekly consumption of alcohol is associated with more physical activity (except in women aged 15-44 years). Conclusions: physical activity is a behavior associated with a better health status and healthier lifestyle in the Spanish population living with musculoskeletal disease.

Objective: Smoking is one of the health risk factors most associated with population morbidity and mortality. In Spain, legal restrictions have been introduced for the use of tobacco. The objective of this study was to analyse the smoking prevalence in Spain during the period 2009-2017, following the implementation of these legal restrictions, and the relationship and evolution between smoking and other health-related lifestyle factors., Methods: We analyzed data in 2019 from the European Health Survey in Spain 2009 and National Health Surveys of Spain 2012 and 2017. Smoking, selfperceived health status, weight status and other health-related lifestyle behaviors (physical activity, vegetable intake, fruit intake and alcohol use). A multinomial logistic regression analysis was used to obtain the odds ratio adjusted to sex and age ("odds ratio" and 95% confidence interval)., Results: Smoking decreased by 3.13% during 2009-2012, and by 4.81% during 2009-2017. Smoking population presenting 2 or 3 risk factors in 2009 was OR=1.17 (1.08-1.26), p<0.0001, in 2012 OR=1.23 (1.12-1, 34), p<0.0001, and in 2017 OR=1.32 (1.21-1.44), p<0.0001. For 4 or 5 risk factors it was in 2009 OR=1.51 (1.31-1.74), p<0.0001, in 2012 OR=1.60 (1.42-1.81), p <0.0001, and in 2017 OR=1.70 (1.51-1.92), p <0.0001. For ex-smokers, the probability of presenting 2 or 3 risk factors in 2009 is not significant, in 2012 OR=0.88 (0.80-0.98), p = 0.013, and in 2017 it is not significant. In the case of 4 or 5 risk factors in 2009 it is not significant, in 2012 OR=0.86 (0.75-1.00), p = 0.045, and in 2017 OR=1.15 (1.02 -1.30), p =0.028., Conclusions: There is a decrease in the smoking population in Spain during 2009-2017. People who smoke have also an unhealthy lifestyle. People who smoke presented a greater number of health-related risk factors., Competing Interests: Disclosure The authors report no conflicts of interest in this work.