Publications (43)23.8 Total impact
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Article: [Assets health model: are possible salutogenic policies?].
Revista Española de Salud Pública 04/2011; 85(2):123-7. · 0.71 Impact Factor -
Article: [Deaf communities: patients or citizens?].
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ABSTRACT: The concept of disability is related to discrimination and social exclusion; that is, this issue is a socio-political question whose effects go well beyond the health of the individual. The social and human rights based model of disability points the way to fresh opportunities for action to promote the wellbeing and health of the seventy million Deaf people living in the world today. The key factors in preventing discrimination against the Deaf are recognition of their specific cultural and linguistic identity (including sign languages and Deaf culture), bilingual education, the availability of professional sign language interpreting, and access to information and communication. The present article aims to encourage greater understanding of the significance of adopting this new perspective on disability, its congruence with current national and international legislation on the rights of persons with disabilities in general and of Deaf persons in particular, and its implications in the policies and praxis due to be implemented in Spain over the next few years on enhancing the health of the Deaf community through significant examples of good practice. Examples of good practice for distinct Deaf communities include collaboration between these communities and the health sector, health training for sign language users, the inclusion of the language and culture of Deaf persons in training programs for healthcare professionals, training of Deaf specialists as future health researchers and workers, and health care services that are more accessible via different sign languages.Gaceta Sanitaria 02/2011; 25(1):72-8. · 1.33 Impact Factor -
Article: [Gender-related achievements and challenges in the 2006 National Health Survey: analysis of adults and households].
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ABSTRACT: To examine the ability of the 2006 Spanish Health Survey (SHS-2006) to analyze the population's health from a gender perspective and identify gender-related inequalities in health, and to compare the 2006 version with that of 2003. A contents analysis of the adults and households questionnaires was performed from the gender perspective, taking gender as (a) the basis of social norms and values, (b) the organizer of social structure: gender division of labor, double workload, vertical/horizontal segregation, and access to resources and power, and (c) a component of individual identity. The 2006 SHS uses neutral language. The referent is the interviewee, substituting the head of the family/breadwinner of past surveys. A new section focuses on reproductive labor (caregiving and domestic tasks) and the time distribution for these tasks. However, some limitations in the questions about time distribution were identified, hampering accurate estimations. The time devoted to paid labor is not recorded. The 2006 version includes new information about family commitments as an obstacle to accessing healthcare and on the delay between seeking and receiving healthcare appointments. The SHS 2006 introduces sufficient variations to confirm its improvement from a gender perspective. Future surveys should reformulate the questions about the time devoted to paid and reproductive labor, which is essential to characterize gender division of labor and double workload. Updating future versions of the SHS will also involve gathering information on maternity/paternity and parental leave. The 2006 survey allows delays in receiving healthcare to be measured, but does not completely allow other delays, such as diagnostic and treatment delays, to be quantified.Gaceta Sanitaria 10/2010; 25(1):6-12. · 1.33 Impact Factor -
Article: Treatment of accommodative and nonstrabismic binocular dysfunctions: a systematic review.
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ABSTRACT: The aim of this study was to analyze the scientific evidence available on the nonsurgical treatment of accommodative and nonstrabismic binocular dysfunctions, identifying the types of treatment used and their efficacy. A systematic review of reports published from 1986 to 2007 was completed using several health science databases: FRANCIS, Medline, Cinahl, and PsycINFO. Those papers that analyzed the treatment of accommodative and nonstrabismic binocular anomalies were included. Of the 565 articles identified, 16 met the inclusion criteria. Only 3 were clinical trials. All analyzed treatment of convergence insufficiency. Results of clinical trials support the conclusion that vision therapy improves symptoms and signs for convergence insufficiency. Further, the evidence indicates that pencil push-up treatment is not as effective as vision therapy and that prism glasses are no more effective than placebo glasses. For the other nonstrabismic binocular conditions and accommodative disorders, there is a lack of published randomized, clinical trials that support the evidence for the efficacy of each treatment. Scientific evidence exists for the efficacy of vision therapy for convergence insufficiency. Insufficient scientific evidence exists on the best therapeutic options for treatment of the other nonstrabismic binocular anomalies and accommodative disorders.Optometry (St. Louis, Mo.) 12/2009; 80(12):702-16. -
Article: Political and social context of not attaining the Millennium Development Goal to reduce poverty.
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ABSTRACT: Eradication of poverty is Target 1 of the first of eight Millennium Development Goals, which were adopted by world leaders at the United Nations General Assembly in the year 2000. This study aims to explore the influence of political and social context in the achievement of poverty eradication. A retrospective ecological study was carried out to explore associations between progress towards the achievement of Target 1 in 2002 and political and social context variables. The study contained cross-sectional estimates in 1990, 1995, 2000 and 2002. The analysis and observation unit was the countries (n = 88). A descriptive analysis was made, as well as simple and multiple analyses with logistic regression. Of the 88 countries studied, 71 (80.7%) are not on track to achieving the target of eradicating poverty. The factor most associated with non-attainment of this goal was reduced government consumption per capita (odds ratio, OR: 13.8; 95% confidence interval, CI: 2.92-65.26). In the multiple regression analysis, the most significant factors are: reduced government consumption per capita (OR: 9.8; 95% CI: 1.82-52.75), losses in the balance between imports and exports (OR: 5.3; 95% CI: 1.32-21.54) and more inequality in family income (OR: 4.7; 95% CI: 1.12-20.01). Progress towards achievement of Target 1 seems to be hindered, fundamentally, by the significant reduction in government consumption in certain countries and the absence of redistribution policies. To understand the political determinants of poverty, more attention must be paid to the national and international political milieu, which seem to have a relevant impact on this problem and hence on population health.Bulletin of the World Health Organisation 11/2008; 86(10):772-9. · 4.64 Impact Factor -
Article: A framework to analyse gender bias in epidemiological research.
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ABSTRACT: The design and analysis of research may cause systematic gender dependent errors to be produced in results because of gender insensitivity or androcentrism. Gender bias in research could be defined as a systematically erroneous gender dependent approach related to social construct, which incorrectly regards women and men as similar/different. Most gender bias can be found in the context of discovery (development of hypotheses), but it has also been found in the context of justification (methodological process), which must be improved. In fact, one of the main effects of gender bias in research is partial or incorrect knowledge in the results, which are systematically different from the real values. This paper discusses some forms of conceptual and methodological bias that may affect women's health. It proposes a framework to analyse gender bias in the design and analysis of research carried out on women's and men's health problems, and on specific women's health issues. Using examples, the framework aims to show the different theoretical perspectives in a social or clinical research context where forms of selection, measurement and confounding bias are produced as a result of gender insensitivity. Finally, this paper underlines the importance of re-examining results so that they may be reinterpreted to produce new gender based knowledge.Journal of Epidemiology & Community Health 01/2008; 61 Suppl 2:ii46-53. · 3.19 Impact Factor -
Article: A tool to analyse gender mainstreaming and care-giving models in support plans for informal care: case studies in Andalusia and the United Kingdom.
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ABSTRACT: To present a tool to analyse the design of support plans for informal care from a gender perspective, using the plans in Andalusia and the United Kingdom as case studies. Methodology: A tool was drawn up to analyse gender mainstreaming and care-giving models involved in the documents. In the gender mainstreaming aspect, a symbolic dimension (gender mainstreaming in the plan's theoretical framework and analysis of situation) and an operational dimension (gender mainstreaming in the plan's proposals and actions) were defined. Four care-giving models were analysed using the following categories: the plan's definition of carer, focal point of interest, objectives and acknowledgement or otherwise of conflict of interests. A qualitative discourse analysis methodology was used. The analysis tool used shows that the plans do not incorporate gender mainstreaming systematically, but there are interesting aspects from a gender perspective that are present at both a symbolic and an operational level. Both plans use a combination of care-giving models, but the model for superseding informal care is not included in either plan. The proposed tool proved useful for the examination of the gender perspective in the formulation of the plans selected for analysis. Both plans introduce measures to improve the quality of life of informal carers. However, gender mainstreaming also implies interventions that will change situations of sexual inequality and injustice that occur in informal care in the long term. Likewise, aspects of feminist theory must be considered in order to draw up plans and policies that are sensitive to informal care and the emancipation of women carers.Journal of Epidemiology & Community Health 01/2008; 61 Suppl 2:ii32-38. · 3.19 Impact Factor -
Article: Abortion in democratic Spain: the parliamentary political agenda 1979-2004.
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ABSTRACT: Since Spain's transition to democracy, abortion has been a public policy issue both inside and outside parliament. This paper describes the history of abortion law reform in Spain from 1979 to 2004 and analyses the discourse on abortion of members of the Spanish parliament by sex and political allegiance. The analysis is based on a retrospective study of the frequency of legislative initiatives and the prevalence of different arguments and positions in debates on abortion found through a systematic search of the parliamentary database. Little time was given to abortion in the parliamentary agenda compared to other women's issues such as violence against women. There were 229 bills and other parliamentary initiatives in that period, 60% initiated and led by pro-choice women. 143 female and 72 male parliamentarians took part in the debates. The inclusion of socio-economic grounds for legal abortion (64%), and making abortion on request legal in the first 12 weeks of pregnancy (60%) were the most frequent forms of law reform proposed, based most often on pro-women's rights arguments. Male and female members of anti-choice parties and most male members of other parties argued for fetal rights. Pro-choice parties tabled more bills than anti-choice parties but till now all reforms proposed since 1985 have been voted down.Reproductive Health Matters 06/2007; 15(29):85-96. · 1.37 Impact Factor -
Article: [Gender bias in the language of the health questionnaire of the Spanish National Health Survey 2003].
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ABSTRACT: To identify possible gender bias in the language of the adults' and children's questionnaires of the Spanish National Health Survey, 2003, its style and language was analyzed for inaccurate generalizations, inequalities due to the use of terms that reflect social stereotypes and hide unequal social roles, and grammatical gender disagreement. Both questionnaires show language bias, mainly lexical, as they use masculine singular nouns to refer to all individuals (for example, carer, employer, worker, doctor, interviewer, interviewee). Gender stereotypes are reinforced by the use of the term "carer", referring to women, and by examples of jobs traditionally done by men. Equally, specific sex denomination for relatives in the same category such as brother/sister is lacking, despite the distinct social roles played by women and men. In conclusion, women are less visible than men in the Spanish National Health Survey, 2003. This study could contribute to the identification and elimination of gender bias in the language of other questionnaires.Gaceta Sanitaria 20(2):161-5. · 1.33 Impact Factor -
Article: [Gender systems and/in the Spanish National Health Interview Survey].
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ABSTRACT: To analyze the Spanish National Health Interview Survey (NHIS) from a gender perspective, with special emphasis on gender division of labor. We analyzed the 2003 Spanish NHIS from the perspective of the levels of gender observation, with gender understood as: a) the basis of social norms (responsibilities by sex, health risks, and problems related to masculine/feminine roles); b) the organizer of the social structure: gender division of labor, work overload, vertical/horizontal segregation, time spent in activities according to social times, access to resources), and c) a component of individual identity (conflicts due to multiple roles, body image dissatisfaction, self-esteem, self-perceived recognition of the work performed, assimilation of the sexual gender role, sex differences in health conditions). The Spanish NHIS is centered on the main provider, referred to in masculine grammatical form. Gender division of domestic labor is identified only by a general question. When using the concept of main activity for productive or reproductive work, the survey requires respondents to evaluate them and select only one, thus losing information and hampering analysis of the impact of an overload of work on health. Information on time used for reproductive work and leisure is not solicited. Assaults (intentional) and accidents (non-intentional) are combined in the same question, thus preventing research on gender-related violence. The Spanish NHIS includes the variable of sex, but its more descriptive than analytic focus limits gender analysis. The survey allows specific circumstances of employment-related inequalities between sexes to be measured, but does not completely allow other indicators of gender inequalities, such as the situation of housewives or work overload, to be measured.Gaceta Sanitaria 20(6):427-34. · 1.33 Impact Factor -
Article: Beauty and the Doctor. Moral issues in health care with regard to appearance
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ABSTRACT: This report presents a summary of the research stimulated by the Concerted Action: Beauty & the Doctor: Moral Issues in Health Care with Regard to Appearance, funded by the European Commission, Directorate General XII, Biomedicine and Health Research Programme (BIOMED). European Commission, Directorate General XII, Biomedicine and Health Research Programme (BIOMED). -
Article: Effect of democracy on health: ecological study
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ABSTRACT: Can political regimes be singled out as a factor affecting health? Rating countries by the extent of their freedom is a useful proxy for measuring the effects of democracy on health related variables. Although the influence of democracy in preventing famines has been reported, there have been no empirical studies on the relation between the extent of freedom allowed by political regimes and the effect on a nation’s health. We explored the effect of democracy on life expectancy and maternal and infant mortality in most countries, taking into account a country’s wealth, its level of inequality, and the size of its public sector. Centro de Estudios Mario Benedetti and Observatory of Public Policies and Health -
Article: Knowledge gaps in scientific literature on maternal mortality: a systematic review
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ABSTRACT: Issues related to maternal mortality have generated a lot of empirical and theoretical information. However, despite the amount of work published on the topic, maternal mortality continues to occur at high rates and solutions to the problem are still not clear. Scientific research on maternal mortality is focused mainly on clinical factors. However, this approach may not be the most useful if we are to understand the problem of maternal mortality as a whole and appreciate the importance of economical, political and social macrostructural factors. In this paper, we report the number of scientific studies published between 2000 and 2004 about the main causes of maternal death, as identified by WHO, and compare the proportion of papers on each cause with the corresponding burden of each cause. Secondly, we systematically review the characteristics and quality of the papers on the macrostructural determinants of maternal mortality. In view of their burden, obstructed labour, unsafe abortion and haemorrhage are proportionally underrepresented in the scientific literature. In our review, most studies analysed were cross-sectional, and were carried out by developed countries without the participation of researchers in the developing countries where maternal mortality was studied. The main macrostructural factors mentioned were socioeconomic variables. Overall, there is a lack of published information about the cultural and political determinants of maternal mortality. We believe that a high-quality scientific approach must be taken in studies of maternal mortality in order to obtain robust comparative data and that study design should be improved to allow causality between macrostructural determinants and maternal mortality to be shown. Los temas relacionados con la mortalidad materna han generado abundante información empírica y teórica. Sin embargo, pese a los muchos trabajos publicados sobre el tema, las tasas de mortalidad materna siguen siendo altas, y las soluciones a este problema siguen también sin estar claras. Las investigaciones científicas sobre la mortalidad materna se centran principalmente en los factores clínicos. Sin embargo, puede que este enfoque no sea el más conveniente para lograr comprender el problema de la mortalidad materna en su globalidad y apreciar la importancia de los factores macroestructurales de índole económica, política y social. En este artículo analizamos el número de estudios científicos publicados entre 2000 y 2004 sobre las causas principales de mortalidad materna según la OMS, comparando la proporción de artículos sobre cada causa con la carga correspondiente a la misma. En segundo lugar, examinamos sistemáticamente las características y la calidad de los artículos sobre los determinantes macroestructurales de la mortalidad materna. A la vista de la carga que representan, el parto obstruido, el aborto peligroso y la hemorragia están subrepresentados proporcionalmente en la bibliografía científica. En nuestra revisión, la mayoría de los estudios analizados eran transversales, y habían sido realizados por países desarrollados sin la participación de investigadores de los países en desarrollo donde se estudió la mortalidad materna. Los principales factores macroestructurales mencionados eran variables socioeconómicas. En términos generales, se observa una escasez de publicaciones sobre los determinantes culturales y políticos de la mortalidad materna. Consideramos que los estudios sobre ésta deben adoptar un enfoque científico de calidad que permita obtener datos robustos y comparables, y que el diseño de esos estudios debe mejorarse para poner de manifiesto las relaciones de causalidad entre los determinantes macroestructurales y la mortalidad materna. -
Article: Identificación de barreras a las políticas de nutrición y alimentación en Colombia: estudio por el método Delfos
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ABSTRACT: Objetivos. Identificar las barreras más importantes al desarrollo del Plan Nacional de Alimentación y Nutrición de Colombia (PNAN), tanto desde el punto de vista de sus planificadores y ejecutores, como de los académicos. Métodos. Se realizó una investigación en dos partes: un estudio piloto basado en entrevistas individuales a 35 informadores clave con conocimiento de las políticas de nutrición en Colombia para identificar los posibles grupos de expertos con experiencia en el desarrollo del PNAN y verificar la pertinencia y factibilidad de la investigación; y un estudio por el método Delfos con la participación de 77 expertos que identificaron las principales barreras al PNAN. Posteriormente, en una segunda etapa del Delfos, 58 de los expertos ordenaron según su importancia las 10 barreras más frecuentemente mencionadas durante la primera etapa, aplicando una puntuación de 1 a 10. Para analizar las respuestas individuales globalmente y por grupos (planeadores y ejecutores del PNAN y académicos) se calcularon la media, la mediana y la desviación estándar de las puntuaciones y se ordenaron las barreras identificadas según los valores de las medianas de las puntuaciones. Cuando los valores de las medianas eran iguales se recurría a la media mayor o a la menor desviación estándar. Los resultados fueron discutidos con los expertos participantes para valorar la fiabilidad de las interpretaciones, explorar la utilidad del estudio y formular recomendaciones. Resultados. Las cinco barreras más importantes fueron: 1) la desarticulación del PNAN del resto de las políticas sociales y económicas y su falta de correspondencia con las políticas agraria y exterior; 2) la falta de coordinación entre diferentes sectores e instancias de la administración colombiana; 3) la corrupción administrativa, agravada por la violencia y la inseguridad; 4) la falta de equidad en la distribución de los recursos; y 5) la falta de continuidad de los compromisos de los diferentes sectores involucrados. En la sesión en que se discutieron los resultados, los expertos asistentes consideraron correcta la interpretación de sus opiniones y valoraron posibles estrategias para mejorar el funcionamiento del PNAN en el país. Conclusiones. El desarrollo y la implementación de las políticas de alimentación y nutrición en Colombia han encontrado barreras, tanto externas como dentro de las propias políticas, que pueden limitar su utilidad social. Se propone crear una entidad coordinadora del PNAN en Colombia. Objective. To identify the most important barriers to the development and progress of Colombia’s National Food and Nutrition Plan (NFNP) (which was enacted in 1996), from the viewpoint of food and nutrition plan planners, implementers, and academicians. Methods. The research was carried out in two stages. The first stage consisted of a pilot study in 1998 based on individual interviews with 35 key informants with knowledge of nutrition policies in Colombia, in order to identify possible groups of experts with experience in the development of the NFNP and also to confirm the relevance and feasibility of the research. The second stage consisted of a study using the Delphi method with 77 experts who identified the principal barriers that the NFNP was facing. In a second step in the Delphi process, 58 of the experts took the 10 barriers that had been mentioned most frequently in the first step and then ranked those barriers, using a point scale from 1 to 10. In order to analyze the individual responses overall and by the three groups (planners, implementers, and academicians), we calculated the mean, the median, and the standard deviation of the scores, and we then ranked the barriers according to their median point scores. When median values were the same, we then utilized the higher mean or the smaller standard deviation. We had meetings to discuss those results with the participating experts in order to assess the soundness of our interpretations, to explore the usefulness of the study, and to formulate recommendations. Results. The five most important barriers identified were: (1) the poor linkage between the NFNP and other social and economic policies, and the lack of consistency with agriculture and foreign policies; (2) the lack of coordination between different sectors and administrative organizations in Colombia; (3) administrative corruption, which was made worse by violence and the lack of security; (4) inequity in the distribution of resources; and (5) the lack of continuity in the commitment by the different sectors that are involved. The experts who attended the sessions where the results were discussed said that their opinions had been interpreted correctly, and they also suggested possible ways to apply the study results and thus improve the operations of the NFNP. Conclusions. Food and nutrition policies in Colombia have faced various obstacles, both from outside sources and from within the policies themselves, which can limit their usefulness to society. There is need to create a coordinating body for the NFNP. Agencia Española de Cooperación Internacional, (AECI) de intercambio de profesorado para estancias en la Universidad de Alicante y la Secretaría de Relaciones Internacionales de la Universidad de Alicante. -
Article: Modelos de atención a los síntomas somáticos sin causa orgánica. De los trastornos fisiopatológicos al malestar de las mujeres
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ABSTRACT: Los síntomas somáticos sin causa orgánica (SSCO) permanecen médicamente inexplicados. Su abordaje podría estar limitado por un concepto biologicista de la salud. Diversas teorías críticas estudian factores contextuales, de género y subjetivos para los SSCO y sus modelos de atención. El objetivo de este trabajo ha sido revisar literatura española (1995-2002) explorando modelos explicativos y de atención a los SSCO relacionándolos con las teorías subyacentes sobre salud. Se realizó búsqueda en Medline, Sociologycal Abstracts, Psycinfo, Doyma, Google y Scirus, bajo palabras clave: Gender and health, Primary care, Somatic complaints and women or gender, Fibromialgy, Chronic fatigue, Functional syndromes, Feminist studies and primary care, malaise women. Seleccionando 31 artículos. Se clasificaron según teorías sobre salud: biomédica, psicosocial, socialista, biopsicosocial, ecosocial, psicoanalítica y feminista. Después, se identificaron modelos explicativos/de atención por bloques teóricos según: términos utilizados para SSCO; factores causales/asociados; modelos de atención; factores relación médicopaciente. En el marco biomédico se encuentran: explicaciones fisiopatológicas; atención directiva, centrada en la visión médica, tendente a adaptación del enfermo a su cronicidad con tratamientos sintomáticos y antidepresivos. En modelos teóricos críticos: relacionan síntomas con contexto social, experiencias subjetivas y de género; centrado en la visión de la/el paciente; evitan la medicalización, dirigido a construir el significado subjetivo de los síntomas, al empoderamiento de la mujer y su autorresponsabilidad. Conviene reconocer la existencia de teorías alternativas a la biomédica que amplían la comprensión de los SSCO, incluyendo factores contextuales, de género y subjetivos asociados al proceso de salud-enfermedad, que producen modelos de atención con mayor potencial de atención integral. Somatic symptoms of no identifiable organic cause remain medically unexplained and have been delved into to only a limited degree from a biologicist conception of health. Different critical theories study contextual, gender-related and subjective factors for Somatic Symptoms of No Identifiable Organic Cause and their care models. This study has been aimed at reviewing published Spanish studies (1995-2002) exploring explanatory SSNIOC's by relating them to the underlying health theories. A search was run in Medline, Sociologycal Abstracts, Psycinfo, Doyma, Google and Scirus, using the key words: Gender and health, Primary care, Somatic complaints and women or gender, Fibromialgy, Chronic fatigue, Functional syndromes, Feminist studies and primary care, malaise women, a total of 31 articles having been selected and classified by health theories: biomedical, psychosocial, socialist, biopsychosocial, ecosocial, psychoanalytical and feminist.. Explanatory/care models were then identified by theory-related blocks, according to: terms use for SNIOC's; related/causal factors, care models, physician-patient relationship factors. Within the biomedical framework, physicpathological, directive care explanations were found focusing on the medical viewpoint, tending toward adapting the patient to his/her degree of chronicity with symptomatic and antidepressant treatments. In critical theory models: symptoms are related to the social context, subjective gender experiences, focusing on the patient viewpoint; avoiding medicalization, aimed at constructing the subjective significance of the symptoms, on empowering the woman and on her taking responsibility for herself. It is advisable to recognize the existence of theories alternative to biomedical theory which broaden the comprehension of SSNIOC's, by including contextual, gender-related subjective factors related to the wellness-illness process which give rise to care models of greater integral care potential. -
Article: Abortion in Democratic Spain: The Parliamentary Political Agenda 1979–2004
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ABSTRACT: Desde la transición de España a la democracia, el aborto ha sido asunto de políticas públicas dentro y fuera del parlamento. En este artículo se describe la historia de la reforma de la ley de aborto en España desde 1979 hasta 2004, y se analiza el discurso sobre el aborto por parte de los parlamentarios españoles, por sexo y afiliación política. El análisis se basa en un estudio retrospectivo de la frecuencia de iniciativas legislativas y la prevalencia de diferentes argumentos y posiciones en debates sobre aborto, encontradas mediante una búsqueda sistemática en la base de datos parlamentaria. No se dedicó mucho tiempo al aborto en la agenda parlamentaria, comparado con otros asuntos relacionados con las mujeres, como la violencia contra éstas. Hubo 229 iniciativas parlamentarias en ese período, el 60% iniciadas y dirigidas por mujeres por el derecho a decidir; 143 diputadas y 72 diputados participaron en los debates. La aceptación de motivos socioeconómicos para tener un aborto legal (64%) y la legalización de la práctica de abortos a petición en el primer trimestre del embarazo (60%) fueron las formas más frecuentes propuestas para reformar la ley, principalmente a raíz de argumentos referentes a los derechos de las mujeres. Hombres y mujeres afiliados a partidos contra el derecho a decidir, y la mayoría de los hombres afiliados a otros partidos abogaron por los derechos del feto. Los partidos por el derecho a decidir presentaron más proyectos de ley que aquellos en contra, pero hasta ahora, se ha votado en contra de todas las reformas propuestas desde 1985. Since Spain’s transition to democracy, abortion has been a public policy issue both inside and outside parliament. This paper describes the history of abortion law reform in Spain from 1979 to 2004 and analyses the discourse on abortion of members of the Spanish parliament by sex and political allegiance. The analysis is based on a retrospective study of the frequency of legislative initiatives and the prevalence of different arguments and positions in debates on abortion found through a systematic search of the parliamentary database. Little time was given to abortion in the parliamentary agenda compared to other women’s issues such as violence against women. There were 229 bills and other parliamentary initiatives in that period, 60% initiated and led by pro-choice women. 143 female and 72 male parliamentarians took part in the debates. The inclusion of socio-economic grounds for legal abortion (64%), and making abortion on request legal in the first 12 weeks of pregnancy (60%) were the most frequent forms of law reform proposed, based most often on pro-women’s rights arguments. Male and female members of anti-choice parties and most male members of other parties argued for fetal rights. Pro-choice parties tabled more bills than anti-choice parties but till now all reforms proposed since 1985 have been voted down. Depuis la transition de l’Espagne vers la démocratie, l’avortement est une question politique à l’intérieur et à l’extérieur du Parlement. Cet article retrace l’histoire de la réforme de la législation sur l’avortement en Espagne de 1979 à 2004 et analyse le discours des députés espagnols, par sexe et appartenance politique. L’analyse est fondée sur une étude de la fréquence des initiatives législatives et de la prévalence des différents arguments dans les débats sur l’avortement, effectuée à l’aide d’une recherche systématique dans la base de données parlementaire. Les travaux parlementaires ont consacré peu de temps à l’avortement par comparaison à d’autres questions intéressant les femmes, comme la violence contre les femmes. On a recensé 229 propositions de lois et autres initiatives parlementaires pendant cette période, dont 60% lancées et dirigées par des femmes favorables à l’avortement. Parmi les députés ayant participé au débat, il y avait 143 femmes et 72 hommes. L’inclusion de motifs socio-économiques pour l’avortement légal (64%) et la légalisation de l’avortement pendant les 12 premières semaines de grossesse (60%) étaient les propositions les plus fréquentes, basées le plus souvent sur le droit des femmes à choisir. Les membres masculins et féminins de partis opposés à l’avortement et la plupart des membres masculins d’autres partis militaient pour les droits du foetus. Les partis pour le libre choix ont présenté davantage de propositions de loi que les partis contre l’avortement, mais, depuis 1985, toutes les réformes ont été refusées. Spanish Research Network on Health and Gender, Institute of Health Carlos III, Ministry of Health, Spain -
Article: The recall function of the press for public health advocacy: the case of AIDS
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Article: A framework to analyse gender bias in epidemiological research
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ABSTRACT: The design and analysis of research may cause systematic gender dependent errors to be produced in results because of gender insensitivity or androcentrism. Gender bias in research could be defined as a systematically erroneous gender dependent approach related to social construct, which incorrectly regards women and men as similar/different. Most gender bias can be found in the context of discovery (development of hypotheses), but it has also been found in the context of justification (methodological process), which must be improved. In fact, one of the main effects of gender bias in research is partial or incorrect knowledge in the results, which are systematically different from the real values.This paper discusses some forms of conceptual and methodological bias that may affect women’s health. It proposes a framework to analyse gender bias in the design and analysis of research carried out on women’s and men’s health problems, and on specific women’s health issues.Using examples, the framework aims to show the different theoretical perspectives in a social or clinical research context where forms of selection, measurement and confounding bias are produced as a result of gender insensitivity. Finally, this paper underlines the importance of re-examining results so that they may be reinterpreted to produce new gender based knowledge. Spanish Research Network on Health and Gender (RISG) -
Article: Historia reciente de la cobertura periodística de la violencia contra las mujeres en el contexto español (1997-2001)
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ABSTRACT: Objetivos: Explorar el tratamiento periodístico de la violencia contra las mujeres entre 1997 y 2001, y describir la evolución temporal de las muertes por esta causa en España para ilustrar el contexto social en el que acontecen los eventos mediáticos. Métodos: Análisis de contenido cuantitativo de 865 noticias de violencia contra las mujeres en El País, ABC y El Mundo (1997-2001). Cálculo de frecuencias absolutas y relativas y riesgos relativos (RR) con intervalos de confianza (IC) del 95%. Cálculo de las tasas de mortalidad brutas (1998-2003) basado en los datos del Registro de la Federación de Mujeres Separadas y Divorciadas. Resultados: Se observaron incrementos de la cobertura periodística coincidiendo con acontecimientos dramáticos y respuestas políticas al problema. En este contexto, la mortalidad por esta causa se mantiene. Las noticias sobre sucesos (65%) superan a las de medidas de intervención (35%). En las noticias en que se pudo identificar el sexo (35% del total), las mujeres (n = 151) y los varones (n = 150) compartieron el papel de fuente informativa principal. Los varones juristas (RR = 1,77; IC del 95%, 1,44-2,17), las mujeres sanitarias (RR = 0,39; IC del 95%, 0,14-1,08) y las asociaciones (RR = 0,33; IC del 95%, 0,13-0,81) tienen mayor probabilidad de ser fuente informativa principal en comparación con sus compañeros. Los varones tienen una probabilidad mayor que las mujeres de ser fuente informativa principal en las noticias de medidas de castigo (RR = 1,42; IC del 95%, 1,12-1,81). Conclusiones: En un contexto de estabilidad en la mortalidad por violencia contra las mujeres, las noticias sobre este tema han aumentado, coincidiendo con acontecimientos dramáticos y respuestas políticas al respecto. Los políticos de ambos sexos, los varones juristas y las mujeres sanitarias y de diversas asociaciones son las fuentes informativas principales. Los varones son la fuente informativa principal en las noticias de medidas de castigo. Objectives: To explore press coverage of violence against women between 1997 and 2001, and to analyze the temporal development of murders due to this cause in Spain and the social context in which these media events take place. Methods: Quantitative content analyses were performed of 865 news items on violence against women in the Spanish newspapers El País, ABC and El Mundo (1997-2001). Absolute and relative frequencies, and relative risk (RR), 95% confidence intervals (95% CI), were calculated. Crude mortality rates were calculated for violence against women (1998-2003) based on the Register of the Federation of Separated and Divorced Women. Results: Press coverage of violence against women increased, coinciding with dramatic events and political responses to the problem. In this context, mortality from this cause remained constant. News about incidents (65%) were more frequent than news about interventions (35%). In news items in which sex was identified (35% of the total), women (n = 151) and men (n = 150) shared the role of principle information source. Men from law institutions (RR = 1.77; 95% CI, 1.44-2.17) and women from health institutions (RR = 0.39; 95% CI, 0.14- 1.08) and associations (RR = 0.33; 95% CI, 0.13-0.81) were more likely to be the main source of information than their counterparts. Men had a higher probability than women of being the main source of information in news about punishment (RR = 1.42; 95% CI, 1.12-1.81). Conclusions: In a context in which mortality from violence against women remains constant, news about this subject has increased, coinciding with dramatic events and political responses. The main sources of information are politicians of both sexes, men from law institutions, and women from health institutions and associations. Men are the main source of information in news about punishment. Instituto de Cultura Juan Gil Albert; Diputación de Alicante; Instituto de la Mujer; Ministerio de Trabajo y Asuntos Sociales; ISC-III -
Article: Political and social context of not attaining the Millennium Development Goal to reduce poverty
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ABSTRACT: Objective: Eradication of poverty is Target 1 of the first of eight Millennium Development Goals, which were adopted by world leaders at the United Nations General Assembly in the year 2000. This study aims to explore the influence of political and social context in the achievement of poverty eradication. Methods: A retrospective ecological study was carried out to explore associations between progress towards the achievement of Target 1 in 2002 and political and social context variables. The study contained cross-sectional estimates in 1990, 1995, 2000 and 2002. The analysis and observation unit was the countries (n = 88). A descriptive analysis was made, as well as simple and multiple analyses with logistic regression. Findings: Of the 88 countries studied, 71 (80.7%) are not on track to achieving the target of eradicating poverty. The factor most associated with non-attainment of this goal was reduced government consumption per capita (odds ratio, OR: 13.8; 95% confidence interval, CI: 2.92–65.26). In the multiple regression analysis, the most significant factors are: reduced government consumption per capita (OR: 9.8; 95% CI: 1.82–52.75), losses in the balance between imports and exports (OR: 5.3; 95% CI: 1.32–21.54) and more inequality in family income (OR: 4.7; 95% CI: 1.12–20.01). Conclusion: Progress towards achievement of Target 1 seems to be hindered, fundamentally, by the significant reduction in government consumption in certain countries and the absence of redistribution policies. To understand the political determinants of poverty, more attention must be paid to the national and international political milieu, which seem to have a relevant impact on this problem and hence on population health. Objetivo: La erradicación de la pobreza es la meta 1 del primero de los ocho Objetivos de Desarrollo del Milenio adoptados por los líderes mundiales en la Asamblea General de las Naciones Unidas en el año 2000. La finalidad del presente estudio ha sido analizar la influencia del contexto político y social en el logro de la erradicación de la pobreza. Métodos: Se llevó a cabo un estudio ecológico retrospectivo para determinar el grado de asociación entre los progresos hacia la meta 1 en 2002 y diversas variables relacionadas con el contexto político y social. El estudio incluyó estimaciones transversales realizadas en 1990, 1995, 2000 y 2002. La unidad de análisis y observación empleada fueron los países (n = 88). Se hizo un análisis descriptivo, así como análisis de regresión logística simple y múltiple. Resultados: De los 88 países estudiados, 71 (80,7%) no están bien encaminados para alcanzar la meta de erradicación de la pobreza. El factor más relacionado con el fracaso en la consecución de esa meta fue la disminución del consumo del sector público por habitante (razón de posibilidades, OR: 13,8; intervalo de confianza (IC) del 95%: 2,92-65,26). El análisis de regresión múltiple revela que los factores más importantes con miras a la erradicación son el aumento del consumo del sector público por habitante (OR: 9,8; IC95%: 1,82-52,75), el predominio de las exportaciones sobre las importaciones (OR: 5,3; IC95%: 1,32-21,54), y el incremento de la igualdad en los ingresos familiares (OR: 4,7; IC95%: 1,12-20,01). Conclusión: Los progresos hacia la meta 1 parecen verse frenados fundamentalmente por una reducción considerable del consumo público en algunos países y por la ausencia de políticas de redistribución. A fin de comprender los determinantes políticos de la pobreza, es necesario prestar más atención al entorno político nacional e internacional, que parece tener una importante influencia en este problema y, por consiguiente, en la salud de la población. WK Kellogg Foundation, Observatorio de Políticas Públicas y Salud, Generalitat Valenciana, AECI, Centro de Estudios Iberoamericanos Mario Benedetti.
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Institutions
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2007–2011
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University of Alicante
- • Departamento de Enfermería comunitaria, medicina preventiva y salud pública e historia de la ciencia
- • Optics, Pharmacology and Anatomy
Alicante, Valencia, Spain
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2008
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Universidad Autónoma de Yucatán
Mérida, Yucatan, Mexico -
The Andalusian School of Public Health
Granada, Andalusia, Spain
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