Catherine Pérez

Agència de Salut Pública de Barcelona · Servei de Sistemes d'Informació Sanitaria

Monitoring of the mental health status of the population and assessment of its determinants are 2 of the most relevant pillars of public mental health, and data from population health surveys could be instrumental to support them. Although these surveys could be an important and suitable resource for these purposes, due to different limitations and...

Purpose: We aimed to analyse the presence and changes of socioeconomic inequalities in excess weight and body dissatisfaction, stratified by sex, in 13- to 19-year-olds in a large Mediterranean city (Barcelona, Spain). Methods: We used data from the 2016 and 2021 editions of the FRESC survey, which is a representative citywide survey that captures...

Objectives: To address existing inequalities, the Barcelona City Council launched a Neighbourhood Plan in 2016-2020. During the first wave of the COVID-19 pandemic, the Neighbourhood Plan interventions were intensified. This study aimed to assess the effect of the plan on the incidence of COVID-19 during the first wave of the pandemic in Barcelona...

Background: The emergence of SARS-CoV-2 affected urban areas. In Barcelona, six waves of COVID-19 hit the city between March 2020 and March 2022. Inequalities in the incidence of COVID-19 have been described. However, no studies have examined the daily trends of socioeconomic inequalities and how they changed during the different phases of the pan...

Background: The 8-item version of the Patient Health Questionnaire (PHQ-8) is one of the self-reported questionnaires most frequently used worldwide for the screening and severity assessment of depression. However, in some European countries its reliability is unknown, and it is unclear whether its psychometric properties vary between European cou...

UNSTRUCTURED Monitoring of the mental health status of the population and assessment of its determinants are 2 of the most relevant pillars of public mental health, and data from population health surveys could be instrumental to support them. Although these surveys could be an important and suitable resource for these purposes, due to different li...

This study aimed to evaluate the effectiveness of the Safe Routes to School (SRTS) intervention in Barcelona, Spain, at reducing the number of road traffic collisions and injuries in the school environment. It was a pre-post, quasi-experimental evaluation with a matched comparison group. Road traffic injuries were significantly reduced in the inter...

Introduction: In the past, health inequalities were not prioritised in the political agenda of Barcelona. The change of city government (2015) was an opportunity to develop a Surveillance System for Social Health Inequalities in the city, which is described in this article. Methods: The design of the Surveillance System formed part of the Joint...

Background The Barcelona Superblock model transforms urban public spaces into active-friendly spaces, a key issue for public health. This study assessed the extent to which a newly developed Superblock in St. Antoni Market Square was used by citizens to perform physical activities and for sedentary behaviour during the first year of implementation....

To guarantee the right to adequate housing is crucial worldwide, and even more so in Spain, where there is an accumulated delay in public housing policies compared to other European countries. This situation has led to an increase in Catalonia of cooperative housing under a grant-of-use (GoU) model based on collective ownership, and the intention o...

Objective: To analyse the trend in life expectancy (LE), healthy life expectancy (HLE) and socio-economic inequalities by neighbourhood in Barcelona from the pre-pandemic period (2018-2019) to the pandemic period (2020-2021). Method: LE and HLE at birth were computed using the municipal register of inhabitants and quality of life (EuroQol) from the...

Background Municipalities are important actors in the implementation of policies to tackle health inequalities, which requires political will, the availability of financial support, and technical and human resources. With the aim of aligning with local government political priorities, in 2017 the Barcelona Public Health Agency (Agència de Salut Púb...

Background: The Barcelona Superblock model transforms urban public spaces into active-friendly spaces, a key issue for public health. This study assessed the use of a newly developed Superblock in St. Antoni Market Square for physical activity and sedentary behaviour during the first year of implementation. It then compared citizens’ use of the Sup...

Objective Obtaining reliable health estimates at the small area level (such as neighbourhoods) using survey data usually poses the problem of small sample sizes. To overcome this limitation, we explored smoothing techniques in order to estimate poor mental health prevalence at the neighbourhood level and analyse its profile by income in Barcelona c...

Objective To analyse the gap in life expectancy by educational level in the city of Barcelona from 2004 to 2018 and to decompose this gap by age and causes of death. Method We computed abridged life tables at the age of 25 years by sex from 2004 to 2018 using standard methods. Educational level was categorised in two groups (lower secondary or les...

The COVID-19 pandemic currently affects populations worldwide. Although everyone is susceptible to the virus, there are numerous accounts of the pandemic having a greater impact on lower socioeconomic groups and minorities, which is a ubiquitous phenomenon. It is essential for public health administrations and governments to uncover and understandi...

While the negative effects of housing insecurity and unaffordability on health are well known, most of the studies in Spain have focused on very specific social groups so their findings cannot be extrapolated to the general population. The aim of this study is to assess the effects of housing stress and risk of displacement due to economic reasons,...

In Barcelona, Advanced Stop Lines (ASL) for motorcycles, were implemented since 2009. This paper aims to describe the process followed in determining the best statistical model to analyse the effectiveness of ASL in preventing road traffic injury collisions. A quasi-experimental design of an evaluation study of an intervention with comparison group...

Objectives Sedentary behavior is a risk factor for comorbidities independently of physical activity. Some studies have reported screen time as an unhealthier form of sedentary behavior. This study assessed the association between recreational screen-time behavior and self-perceived health. Study design This is a cross-sectional study. Methods As...

Background Housing is a social determinant of health. Extensive research has highlighted its adverse effects on health. However, less is known about the effects of cohousing typology on health, which has the potential to create lively social networks and healthy communities and environments. We report the findings of a scoping study designed to gat...

In Spain, the Public Health Law approved in 2011 foresees the creation of a Surveillance System on Social Determinants of Health and Equity. However, although information on health inequalities has been reported in technical reports and scientific articles before, it is not until now with the change of the Spanish government the political will to s...

Superblocks are currently being introduced in Barcelona to respond to the city’s scarcity of green spaces and high levels of air pollution, traffic injuries, and sedentariness. The aim is to calm the streets by reducing the number of square meters dedicated to private vehicles and to reclaim part of this public space for people. Salut als Carrers (...

Background In Barcelona, Advanced Stop Lines (ASL) for motorcycles, were implemented since 2009. This paper aims to assess the effectiveness of ASL for motorcycles in preventing road traffic collisions. Methods A quasi-experimental design of an evaluation study of an intervention with comparison group was performed. 35 ASL were implemented in 2009...

There is limited suggestive evidence of relationships between public transport strikes and either increased air pollution or worse population health. In this study we aimed to assess whether public transport strikes were associated with increases in health events (overall, cardiovascular and respiratory mortality, and cardiovascular and respiratory...

Background: Car-dependent city planning has resulted in high levels of environmental pollution, sedentary lifestyles and increased vulnerability to the effects of climate change. The Barcelona Superblock model is an innovative urban and transport planning strategy that aims to reclaim public space for people, reduce motorized transport, promote sus...

There is a wealth of information and research on health inequalities in Barcelona, but this issue has not been clearly prioritised on the political agenda. The arrival in government of a new left-wing party (Barcelona en Comú) in 2015, gave an important boost to the political agenda to reduce inequalities and health inequalities. The aim of this re...

The aim of this chapter is to offer a conceptual framework for understanding intimate partner violence (IPV) and its impact on health based on a structural context that determines gender norms and hierarchies, as well as the intersection between various types of inequalities. Preventing IPV demands intersectoral work, where having a conceptual fram...

El objetivo de este capítulo es proponer un marco conceptual para comprender la violencia machista en el ámbito de la pareja (VMAP) y su impacto en la salud, basado en un contexto estructural que determina normas y jerarquías de género, así como la intersección entre varios ejes de desigualdad. La prevención de la VMAP exige un trabajo intersectori...

L'objectiu d'aquest capítol és proposar un marc conceptual per comprendre la violència masclista en l'àmbit de la parella (VMAP) i el seu impacte en la salut basat en un context estructural que determina normes i jerarquies de gènere, així com la intersecció entre diversos eixos de desigualtat. La prevenció de la VMAP exigeix un treball intersector...

The following essay outlines the intervention and presents a framework that will serve as a guide in the evaluation of the different effects of the Superblocks. Superblocks consist of amalgamations of blocks throughout the city, with the goal of improving the habitability of public spaces, advancing sustainable mobility, increasing urban green, and...

The EU research project SafetyCube pays specific attention to serious road injuries, defined as nonfatal road traffic casualties with an injury severity level of MAIS3+. By means of surveys, information was collected on current practices concerning the estimation of the number of MAIS3+ casualties and on costs related to serious road injuries in di...

To determine accurately the number of serious injuries at EU level and to compare serious injury rates between different countries it is essential to use a common definition. In January 2013, the High Level Group on Road Safety established the definition of serious injuries as patients with an injury level of MAIS3+(Maximum Abbreviated Injury Scale...

Background: Information about the burden of (non-fatal) road traffic injury is very useful to further improve road safety policy. Previous studies calculated the burden of injury in individual countries. This paper estimates and compares the burden of non-fatal serious road traffic injuries in six EU countries/regions: Austria, Belgium, England, T...

Resumen Se describe la metodología usada en el diagnóstico de salud de un programa orientado a mejorar la salud en los barrios más desfavorecidos de la ciudad de Barcelona. En el proceso de diagnóstico se utiliza una metodología mixta (cuantitativa y cualitativa) para obtenera información sobre el estado de salud de la comunidad, sus determinantes...

Background In 2009-2010 advanced zones for motorcycles (ZAM) were implemented. The objective is to assess the impact of ZAMs on road traffic collisions Methods This is a quasi-experimental design of an intervention (ZAM) evaluation study with comparison group. The study population is people travelling through Barcelona. The ZAM is a grid of 4 mete...

Background Governments wish to compare their performance in preventing serious injury. International comparisons based on hospital inpatient records are typically contaminated by variations in health services utilisation. To reduce these effects, a serious injury case definition has been proposed based on diagnoses with a high probability of inpati...

Promoting active travel and public transport has both health and environmental benefits due to increased physical activity, reduced air and noise pollution, and decreased greenhouse gas emissions. Barcelona promoted during the last decade cycling, public transportation, and traffic calming. In this study we i) used the Health Economic Assessment To...

La mayor?a de los estudios sobre las lesiones de tr?fico relacionadas con el trabajo (LTT) en Espa?a se basan en informaci?n de la administraci?n laboral. El objetivo de este estudio fue realizar una descripci?n de las LTT mortales en Espa?a seg?n el motivo de desplazamiento entre 2010 y 2013. M?todos: Estudio descriptivo de las LTT mortales ocurri...

Objective: Most studies about work-related traffic injuries in Spain are based in labor administration information. The aim of this study was to carry out a description of fatal work-related traffic injuries in Spain according to travelling reason between 2010 and 2013, based on the Transport Authority database. Methods: Descriptive study of fat...

Background Road traffic injuries are decreasing in the last decades in Spain. However, the percentage of traffic-related occupational injuries was increasingly rising in relation to the total occupational injuries. The aims of this study were (1) to analyse the incidence rate of fatal work-related road traffic injuries between 2000 and 2013; and (2...

Background Reliable data on the number of serious road injuries is a prerequisite for monitoring and evaluation purposes. In January 2013, the High Level Group on Road Safety representing all EU Member States established the definition of serious injuries as in-patients with an injury level of MAIS3+ (Maximum Abbreviated Injury Scale). Since then i...

To describe the magnitude and characteristics of crashes and drivers involved in head-on crashes on two-way interurban roads in Spain between 2007 and 2012, and to identify the factors associated with the likelihood of head-on crashes on these roads compared with other types of crash. A cross-sectional study was conducted using the National Crash R...

Experimental studies have shown a decrease in driving performance at high temperatures. The epidemiological evidence on the relationship between heat and motor vehicle crashes is not consistent. To estimate the impact of high ambient temperatures on the daily number of motor vehicle crashes and, in particular, on crashes involving driver performanc...

Background Since the first Road Safety Plan was approved in Barcelona in 2000, other plans followed and were integrated into the overall mobility plans of the city. Actions stimulating active transportation included increasing pedestrian priority areas, implementation of zones 30, audits of crosswalks, bike lanes, public bicycle program, reduction...

The aim of this study was to analyze inequalities in the prevalence of poor mental health and their association with socioeconomic variables and with the care network in the Autonomous Communities in Spain. A cross-sectional multilevel study was performed, which analyzed individual data from the National Health Survey in Spain (ENS), in 2006 ( n =...

Motorized traffic may discourage people walking. This study analyses the influence of motorization on pedestrian mobility in the neighbourhoods of a European city, controlling for environmental, sociodemographic, mobility and road safety characteristics of the neighbourhood in which each trip was made. Cross-sectional ecological study using the 38...

In this paper a unified methodology is presented for the modelling of the evolution of road safety in 30 European countries. For each country, annual data of the best available exposure indicator and of the number of fatalities were simultaneously analysed with the bivariate latent risk time series model. This model is based on the assumption that...

The significant growth in the elderly population expected in the coming years demands a thorough and up-to-date understanding of the incidence of injuries in this group for purposes of prevention polices and their evaluation. The aim of this study was to describe the incidence of injuries in hospital inpatients over 64 years of age in Spain, strati...

Publication of recent papers such as the one by Schoenbaum and colleagues entitled 'Mortality Amenable to Health Care in the United States: The Roles of Demographics and Health Systems Performance' has stimulated this commentary. We discuss strengths and limitations of amenable and avoidable mortality in health-care systems' performance and their c...

Road traffic injury surveillance involves methodological difficulties due, among other reasons, to the lack of consensus criteria for case definition. Police records have usually been the main source of information for monitoring traffic injuries, while health system data has hardly been used. Police records usually include comprehensive informatio...

Objectives: To analyze gender inequalities in socioeconomic factors affecting the amount of time spent travelling for work-related and home-related reasons among working individuals aged between 30 and 44 years old during a weekday in Catalonia (Spain). Methods: A cross-sectional study was conducted. Data were obtained from employed individuals age...

This study analysed socioeconomic inequalities in mortality due to injuries in small areas of 15 European cities, by sex, at the beginning of this century. A cross-sectional ecological study with units of analysis being small areas within 15 European cities was conducted. Relative risks of injury mortality associated with the socioeconomic deprivat...

Objective: The objective was to identify individual or contextual inequalities in visits to psychiatrists in Spain, a country with a regionalized health care system and variable integration of mental health and primary care. Methods: This cross-sectional study used data for the noninstitutionalized population from the 2006 Spanish Health Intervi...

Objective: To compare the risk of road traffic injury calculated using an exposure measure based on people's mobility, person-hours travelled (person-hours), with the risk obtained using population census, vehicle fleet and vehicle-kilometres travelled. Methods: The rate of road traffic injury on a working day in Catalonia in 2006 was calculated...

Objective: To analyse trends in socio-economic inequalities in mortality due to all injuries, as well as, suicide and motor vehicle injuries, in men in the census tracts of 26 Spanish cities for the periods 1996-2001 and 2002-2007. Methods: Ecological study of trends based on two periods (1996-2001 and 2002-2007). The study population consisted...

Objectives: To analyze gender inequalities in socioeconomic factors affecting the amount of time spent travelling for work-related and home-related reasons among working individuals aged between 30 and 44 years old during a weekday in Catalonia (Spain). Methods: A cross-sectional study was conducted. Data were obtained from employed individuals...

Background: Among traumatic injuries, spinal cord injuries (SCI) and traumatic brain injuries (TBI) are of major importance because of their epidemiological and economic impact on society. The overall objective of this study was to estimate the economic cost associated with people with SCI and TBI in Spain in 2007. Methods: A cost-of-illness ana...

The aim of this study was to analyze individual and contextual inequalities in psychiatrist and psychologist visits in Catalonia. This is a multilevel cross-sectional study using data from the 2006 Catalan Health Interview Survey (n = 15,554). 5.3 % of men and 9.0 % of women visited a psychologist and/or psychiatrist in the last 12 months. People a...

Background: We aimed to quantify the number of women and men, in Catalonia, among those not achieving physical activity recommendations, making short motorized trips which could have been made on foot, and to estimate the annual economic benefit due to reducing mortality as a result of replacing one short, daily, motorized journey with walking. M...

In the past few years, there has been increasing interest in studying the association between problems in the neighbourhood environment and health indicators. The objective of this study is to examine the relationship between the perception of environmental problems by individuals and the prevalence of common mental disorders (CMD) in Spain. A cros...

To analyse socio-economic inequalities in mortality due to injuries among census tracts of ten Spanish cities by sex and age in the period 1996-2003. This is a cross-sectional ecological study where the units of analysis are census tracts. The study population consisted of people residing in the cities during the period 1996-2003. For each census t...

The authors of this study sought to compare the socioeconomic factors related to perceived sexism in employed and non-employed Spanish women and to examine whether the relationship of perceived sexism with mental health outcomes is reduced when such factors are taken into account. Data were taken from the 2006 Spanish Health Survey, including women...

To perform a cost-benefit analysis of the installation of speed cameras on the beltways of Barcelona. The analysis was performed from the society perspective over a 2-year period using a controlled before-and-after study design. The net benefit was calculated using, as benefits, the willingness to pay for the estimated number of people who avoided...

To determine the effect of criminalizing some traffic behaviours, after the reform of the Spanish penal code in 2007, on the number of drivers involved in injury collisions and of people injured in traffic collisions in Spain. This study followed an interrupted times-series design in which the number of drivers involved in injury collisions and of...