Background
Methods
Data setting
Statistical methods
Results
% population in 2006 (N = 29,478) | % population in 2011 (N = 21,007) | % with poor SRH 2006 | % with poor SRH 2011 | |
---|---|---|---|---|
Reported good SRHa
| 62.10 | 67.90 | ||
Gender: Male | 38.80 | 45.90 | 32.08 | 25.91 |
Female | 61.20 | 54.10 | 43.80 | 37.32 |
Age: From 15 to 35 y.o.b
| 22.90 | 22.90 | 19.33 | 11.33 |
From 36 to 45 y.o. | 19.90 | 18.70 | 26.01 | 18.58 |
From 46 to 55 y.o. | 16.50 | 16.70 | 36.66 | 28.14 |
From 56 to 65 y.o. | 14.50 | 14.90 | 50.26 | 39.82 |
From 66 to 75 y.o. | 14.00 | 12.90 | 58.15 | 48.56 |
≥75 y.o | 12.20 | 13.80 | 67.10 | 65.92 |
Regions: Catalonia | 8.10 | 10.80 | 39.82 | 30.26 |
Andalusia | 8.20 | 11.90 | 39.90 | 32.79 |
Aragon | 9.30 | 4.10 | 34.94 | 36.00 |
Asturias | 3.30 | 3.90 | 42.66 | 37.15 |
Balearic Islands | 5.80 | 3.50 | 30.97 | 30.03 |
Canary Islands | 3.80 | 5.10 | 38.48 | 38.98 |
Cantabria | 5.90 | 3.60 | 34.43 | 32.04 |
Castile- Leon | 4.50 | 6.20 | 35.91 | 31.56 |
Castile- La Mancha | 3.70 | 4.90 | 39.05 | 31.28 |
Region of Valencia | 5.70 | 8.10 | 42.07 | 31.16 |
Extremadura | 3.10 | 4.10 | 44.28 | 33.76 |
Galicia | 11.50 | 6.00 | 52.75 | 41.11 |
Madrid | 6.90 | 9.20 | 34.10 | 25.26 |
Murcia | 6.70 | 3.80 | 44.39 | 35.90 |
Navarre | 5.60 | 3.70 | 34.53 | 25.91 |
Basque Country | 3.70 | 5.60 | 32.77 | 30.30 |
La Rioja | 2.40 | 3.40 | 30.96 | 28.51 |
Ceuta and Melilla | 1.80 | 2.10 | 39.21 | 29.02 |
Hypertension | 25.81 | 25.66 | 60.43 | 55.31 |
Diabetes | 7.61 | 8.84 | 70.45 | 66.40 |
High cholesterol level | 19.10 | 21.64 | 56.99 | 53.23 |
Varicose veins in the legs | 15.91 | 14.25 | 60.58 | 56.61 |
Arthrosis, arthritis or rheumatism | 26.82 | 23.89 | 71.82 | 68.12 |
Upper back pain | 23.48 | 18.48 | 66.00 | 62.44 |
Lower back pain | 23.94 | 21.77 | 65.60 | 59.93 |
Chronic allergies | 11.89 | 12.32 | 44.67 | 38.45 |
Anxiety, depression | 17.54 | 9.15 | 72.22 | 74.45 |
Migraine or frequent headaches | 13.28 | 10.23 | 60.65 | 55.33 |
Days of hospitalisation | 0.76 | 0.24 | ||
Smoking | ||||
No | 52.40 | 54.70 | 43.84 | 34.88 |
Yes | 26.60 | 25.30 | 31.32 | 25.28 |
In the past | 21.00 | 19.90 | 37.86 | 32.96 |
Alcohol | 52.30 | 49.30 | 32.14 | 23.08 |
BMIc
| ||||
Underweight to normal | 46.00 | 45.20 | 30.26 | 22.54 |
Overweight | 37.50 | 37.20 | 38.94 | 31.33 |
Obese | 16.50 | 17.50 | 51.73 | 45.08 |
Mental health (mean) | 1.68 | 1.59 | ||
Education | ||||
No education | 14.40 | 14.60 | 66.97 | 62.20 |
Primary | 46.60 | 44.60 | 43.86 | 35.53 |
Secondary | 18.20 | 19.90 | 26.06 | 20.24 |
Tertiary | 20.90 | 20.90 | 21.51 | 14.90 |
Employment status | ||||
Employed | 45.80 | 40.40 | 25.05 | 17.27 |
Pensioner | 28.50 | 25.80 | 61.35 | 54.03 |
Student | 3.30 | 5.90 | 12.07 | 6.94 |
Housewife | 16.00 | 15.10 | 47.18 | 44.08 |
Short-term unemployed | 5.00 | 6.40 | 32.03 | 18.92 |
Long-term unemployed | 1.40 | 6.40 | 45.25 | 31.84 |
Marital status | ||||
Single | 24.10 | 28.20 | 26.86 | 19.68 |
Married | 57.40 | 52.30 | 39.20 | 31.66 |
Widowed | 12.90 | 13.10 | 62.49 | 59.21 |
Separated | 3.10 | 2.40 | 38.44 | 34.51 |
Divorced | 2.50 | 4.00 | 41.62 | 34.84 |
% population in 2006 (N = 15,926) | % population in 2011 (N = 3901) | % with poor SRH 2006 | % with poor SRH 2011 | |
---|---|---|---|---|
Reported good SRHa
| 74.30 | 76.30 | ||
Gender: Male | 49.50 | 50.10 | 20.54 | 19.68 |
Female | 50.50 | 49.90 | 30.74 | 27.71 |
Age: From 15 to 35 y.o.b
| 33.40 | 32.80 | 7.49 | 8.29 |
From 36 to 45 y.o. | 17.90 | 17.90 | 14.84 | 12.05 |
From 46 to 55 y.o. | 14.90 | 14.40 | 26.05 | 21.39 |
From 56 to 65 y.o. | 12.50 | 13.20 | 37.89 | 33.33 |
From 66 to 75 y.o. | 10.60 | 9.40 | 50.09 | 43.84 |
≥ 75 y.o | 10.60 | 12.50 | 61.85 | 58.11 |
Hypertension | 21.10 | 25.71 | 49.96 | 44.47 |
Diabetes | 6.28 | 8.02 | 64.70 | 60.06 |
High cholesterol level | 15.36 | 21.10 | 46.47 | 40.83 |
Varicose veins in the legs | 19.86 | 19.35 | 46.82 | 44.77 |
Arthrosis, arthritis or rheumatism | 24.37 | 27.20 | 59.31 | 51.27 |
Upper back pain | 28.01 | 25.07 | 46.90 | 48.26 |
Lower back pain | 30.13 | 29.61 | 46.19 | 48.66 |
Chronic allergies | 15.70 | 14.84 | 31.51 | 31.09 |
Anxiety, depression | 17.83 | 20.51 | 55.99 | 53.38 |
Migraine or frequent headaches | 18.87 | 19.41 | 42.96 | 43.86 |
Days of hospitalisation | 0.7 | |||
Number hospitalisations | 0.13 | |||
Smoking | ||||
No | 52.30 | 51.60 | 27.64 | 24.52 |
Yes | 28.20 | 28.70 | 17.42 | 17.05 |
In the past | 19.40 | 19.80 | 25.77 | 23.89 |
Alcohol | 71.90 | 66.60 | 19.74 | 17.62 |
BMIc
| ||||
Underweight to normal | 50.20 | 50.60 | 18.70 | 14.29 |
Overweight | 36.40 | 35.30 | 29.36 | 19.30 |
Obese | 13.40 | 14.10 | 42.27 | 35.90 |
Mental health | ||||
Mean | 0.78 | |||
Risk poor mental health | 11.90 | |||
Education | ||||
No education/qualification | 14.70 | 12 | 56.80 | 58.00 |
Primary | 42.40 | 38.20 | 29.22 | 26.95 |
Secondary | 20.30 | 21.90 | 13.71 | 15.83 |
Tertiary | 22.60 | 27.90 | 9.54 | 10.65 |
Employment status | ||||
Employed | 58.80 | 51.70 | 13.13 | 11.58 |
Pensioner | 17.30 | 18.90 | 50.57 | 46.28 |
Student | 6.40 | 8.60 | 3.69 | 5.03 |
Housewife | 13.10 | 10.20 | 44.60 | 42.71 |
Short-term unemployed | 3.50 | 8.90 | 24.13 | 13.72 |
Long-term unemployed | 0.90 | 1.80 | 36.36 | 26.15 |
Marital status | ||||
Single | 30.50 | 31.60 | 11.64 | 11.92 |
Married | 57.10 | 55.10 | 28.39 | 25.10 |
Widowed | 8.30 | 8.20 | 57.81 | 57.01 |
Separated | 2.50 | 2.50 | 28.25 | 28.87 |
Divorced | 1.70 | 2.50 | 26.77 | 26.26 |
2006 | 2011 | |||
---|---|---|---|---|
OR (95 % CI) | OR (95 % CI) | |||
Gender: (Male) | ||||
Female | 1.04 |
(0.96, 1.12) | 0.96 | (0.87, 1.05) |
Age (From 15 to 35 years old) | ||||
From 36 to 45 y.o.b
| 1.13 | (1.02, 1.25) | 1.29 | (1.11, 1.49) |
From 46 to 55 y.o. | 1.39 | (1.25, 1.56) | 1.54 | (1.33, 1.78) |
From 56 to 65 y.o. | 1.50 | (1.32, 1.70) | 1.76 | (1.49, 2.08) |
From 66 to 75 y.o. | 1.38 | (1.18, 1.62) | 1.92 | (1.57, 2.35) |
≥ 75 y.o | 2.00 | (1.69, 2.36) | 3.66 | (2.96, 4.52) |
Regions (Catalonia) | ||||
Andalusia | 0.72 | (0.62, 0.83) | 0.93 | (0.79, 1.09) |
Aragon | 0.70 | (0.61, 0.81) | 1.21 | (0.99, 1.49) |
Asturias | 0.73 | (0.60, 0.89) | 0.90 | (0.72, 1.12) |
Balearic Islands | 0.50 | (0.42, 0.59) | 0.78 | (0.62, 0.99) |
Canary Islands | 0.69 | (0.57, 0.83) | 1.16 | (0.95, 1.41) |
Cantabria | 0.88 | (0.75, 1.04) | 0.74 | (0.59, 0.91) |
Castile- Leon | 0.69 | (0.58, 0.82) | 0.90 | (0.75, 1.08) |
Castile- La Mancha | 0.70 | (0.58, 0.84) | 0.77 | (0.62, 0.94) |
Region of Valencia | 1.01 | (0.86, 1.18) | 0.97 | (0.82, 1.16) |
Extremadura | 0.84 | (0.69, 1.03) | 0.79 | (0.64, 0.99) |
Galicia | 1.22 | (1.07, 1.40) | 1.22 | (1.01, 1.47) |
Madrid | 0.63 | (0.54, 0.74) | 0.81 | (0.68, 0.96) |
Murcia | 1.06 | (0.91, 1.24) | 1.02 | (0.82, 1.27) |
Navarre | 0.63 | (0.54, 0.75) | 0.72 | (0.57, 0.91) |
Basque Country | 0.73 | (0.60, 0.88) | 0.90 | (0.74, 1.09) |
La Rioja | 0.83 | (0.67, 1.04) | 0.88 | (0.70, 1.11) |
Ceuta and Melilla | 0.79 | (0.62, 1.02) | 1.50 | (1.15, 1.96) |
Hypertension | 1.38 | (1.28, 1.49) | 1.39 | (1.27, 1.52) |
Diabetes | 2.04 | (1.81, 2.30) | 1.85 | (1.63, 2.12) |
Cholesterol | 1.25 | (1.15, 1.35) | 1.44 | (1.32, 1.58) |
Varicous veins | 1.24 | (1.14, 1.35) | 1.23 | (1.11, 1.37) |
Arthrosis, arthritis or rheumatism | 2.44 | (2.26, 2.63) | 2.37 | (2.16, 2.61) |
Upper back pain | 1.67 | (1.54, 1.81) | 1.60 | (1.44, 1.78) |
Lower back pain | 1.93 | (1.78, 2.09) | 1.76 | (1.60, 1.94) |
Allergy | 1.26 | (1.14, 1.38) | 1.32 | (1.17, 1.47) |
Anxiety, depression | 2.11 | (1.94, 2.30) | 1.86 | (1.63, 2.14) |
Migraine | 1.54 | (1.40, 1.69) | 1.57 | (1.39, 1.78) |
Days of hospitalisation | 1.15 | (1.14, 1.17) | 1.00 | (1.00, 1.01) |
Smoking (No) | ||||
Yes | 1.18 | (1.09, 1.28) | 1.24 | (1.12, 1.37) |
In the past | 1.14 | (1.05, 1.23) | 1.16 | (1.05, 1.29) |
Alcohol | 0.77 | (0.72, 0.82) | 0.71 | (0.66, 0.76) |
BMIc (Underweight to normal) | ||||
Overweight | 1.03 | (0.95, 1.11) | 1.00 | (0.92, 1.10) |
Obese | 1.29 | (1.18, 1.42) | 1.26 | (1.13, 1.42) |
Mental health | 1.26 | (1.25, 1.28) | 1.24 | (1.22, 1.26) |
Education (No education/qualification) | ||||
Primary | 0.72 | (0.65, 0.79) | 0.72 | (0.65, 0.81) |
Secondary | 0.58 | (0.51, 0.65) | 0.53 | (0.46, 0.62) |
Tertiary | 0.46 | (0.41, 0.52) | 0.46 | (0.40, 0.54) |
Employment status (Employed) | ||||
Pensioner | 1.60 | (1.43, 1.80) | 1.30 | (1.12, 1.50) |
Student | 0.57 | (0.45, 0.71) | 0.61 | (0.47, 0.79) |
Housewife | 1.13 | (1.02, 1.25) | 1.21 | (1.05, 1.38) |
Short-term unemployed | 1.13 | (0.98, 1.30) | 0.93 | (0.78, 1.12) |
Long-term unemployed | 1.48 | (1.16, 1.88) | 1.30 | (1.11, 1.52) |
Marital status (single) | ||||
Married | 0.98 | (0.90, 1.07) | 0.87 | (0.78, 0.97) |
Widowed | 0.76 | (0.67, 0.87) | 0.68 | (0.59, 0.80) |
Separated | 0.83 | (0.69, 1.00) | 0.82 | (0.64, 1.06) |
Divorced | 1.11 | (0.90, 1.37) | 1.06 | (0.87, 1.29) |
Mean | 0.46 | 0.43 | ||
DICd
| 26929.17 | 18098.01 | ||
EPOe
| 57.29 | 57.07 | ||
Random effects-heterogeneity | 5.4E–05 | (7.86E–04, 1.49E–05) | 5.4E–05 | (7.96E–04, 1.50E–05) |
2006 | 2011 | |||
---|---|---|---|---|
OR (95 % CI) | OR (95 % CI) | |||
Gender (Male) | ||||
Female | 0.97 | (0.87, 1.10) | 0.76 | (0.59, 0.97) |
Age (From 15 to 35 years old) | ||||
From 36 to 45 y.o.b
| 1.53 | (1.28, 1.84) | 0.99 | (0.68, 1.45) |
From 46 to 55 y.o. | 2.14 | (1.79, 2.57) | 1.47 | (1.00, 2.18) |
From 56 to 65 y.o. | 2.19 | (1.78, 2.68) | 1.40 | (0.91, 2.15) |
From 66 to 75 y.o. | 2.70 | (2.10, 3.46) | 1.48 | (0.85, 2.56) |
≥ 75 y.o | 4.12 | (3.17, 5.35) | 2.13 | (0.92, 4.95) |
Hypertension | 1.42 | (1.28, 1.59) | 1.20 | (0.96, 1.51) |
Diabetes | 2.33 | (1.96, 2.76) | 2.34 | (1.71, 3.21) |
Cholesterol | 1.21 | (1.07, 1.34) | 1.15 | (0.91, 1.44) |
Varicous veins | 1.34 | (1.20, 1.49) | 1.31 | (1.04, 1.66) |
Arthrosis, arthritis or rheumatism | 1.98 | (1.77, 2.22) | 1.80 | (1.44, 2.25) |
Upper back pain | 1.53 | (1.37, 1.71) | 1.36 | (1.08, 1.73) |
Lower back pain | 1.74 | (1.56, 1.93) | 2.62 | (2.10, 3.27) |
Allergy | 1.32 | (1.17, 1.50) | 1.15 | (0.88, 1.51) |
Anxiety, depression | 1.78 | (1.58, 2.00) | 2.32 | (1.84, 2.92) |
Migraine | 1.39 | (1.24, 1.56) | 2.11 | (1.66, 2.66) |
Days of hospitalisation | 1.05 | (1.03, 1.06) | 1.52 | (1.25, 1.89) |
Smoking (No) | ||||
Yes | 1.23 | (1.08, 1.39) | 1.02 | (0.78, 1.33) |
In the past | 1.11 | (0.98, 1.27) | 0.84 | (0.64, 1.10) |
Alcohol | ||||
Alcohol (No drinking) | ||||
Moderate drinking | 0.75 | (0.68, 0.83) | 0.76 | (0.61, 0.94) |
Risk drinking | 0.74 | (0.56, 0.96) | 0.66 | (0.38, 1.13) |
BMIc (Underweight to normal) | ||||
Overweight | 1.13 | (1.02, 1.26) | 0.90 | (0.70, 1.17) |
Obese | 1.30 | (1.13, 1.49) | 1.49 | (1.09, 2.04) |
Mental health | 1.29 | (1.25, 1.32) | ||
Mental health (normal) | ||||
Risk poor mental health | 2.45 | (1.84, 3.27) | ||
Education (No education/qualification) | ||||
Primary | 0.85 | (0.75, 0.97) | 0.61 | (0.46, 0.82) |
Secondary | 0.63 | (0.53, 0.74) | 0.53 | (0.37, 0.76) |
Tertiary | 0.47 | (0.39, 0.56) | 0.38 | (0.27, 0.55) |
Employment status (Employed) | ||||
Pensioner | 1.60 | (1.33, 1.92) | 2.12 | (1.40, 3.21) |
Student | 0.56 | (0.38, 0.82) | 0.70 | (0.34, 1.37) |
Housewife | 1.30 | (1.10, 1.53) | 1.49 | (1.01, 2.19) |
Short-term unemployed | 1.59 | (1.24, 2.03) | 1.06 | (0.70, 1.58) |
Long-term unemployed | 1.40 | (0.88, 2.22) | 1.42 | (0.70, 2.78) |
Marital status (single) | ||||
Married | 1.09 | (0.95, 1.26) | 0.96 | (0.71, 1.30) |
Widowed | 0.86 | (0.70, 1.06) | 0.99 | (0.64, 1.54) |
Separated | 1.19 | (0.88, 1.61) | 0.96 | (0.49, 1.84) |
Divorced | 0.92 | (0.63, 1.32) | 0.82 | (0.43, 1.52) |
Mean | 0.37 | 0.35 | ||
DICd
| 11861.07 | inf | ||
EPO | 40.98 | inf | ||
Random effects- heterogeneity | 5.37E–05 | (7.90E–04, 1.49E–05) | 5.38E–05 | (7.90E–04, 1.49E–05) |
ENSE data SRHa
| 0.09 | (−0.26, 0.44) |
For groups lineal approach | ||
Gender [Male] | −0.21 | (−1.08, 0.66) |
Gender [Female] | 0.30 | (−0.10, 0.71) |
Age [From 15 to 35 years old] | 0.98 | (−2.24, 4.18) |
Age [From 36 to 45 y.o.b] | 0.34 | (−1.82, 2.50) |
Age [From 46 to 55 y.o.] | −1.60 | (−3.25, 0.04) |
Age [From 56 to 65 y.o.] | −0.27 | (−1.25, 0.71) |
Age [From 66 to 75 y.o.] | 0.60 | (−0.47, 1.67) |
Age [≥ 76 y.o.] | 0.47 | (−0.07, 1.02) |
Education [No education] | 0.30 | (−0.31, 0.88) |
Education [Primary] | −0.26 | (−0.76, 0.26) |
Education [Secondary] | 1.78 | (−0.85, 4.39) |
Education [Tertiary] | −1.08 | (−4.31, 2.14) |
Employment status [Employed] | 0.14 | (−0.22, 0.50) |
Employment status [Unemployed] | −1.81 | (−3.92, 0.24) |
ESCA data SRHa
| −0.07 | (−0.57, 0.43) |
For groups lineal approach | ||
Gender [Male] | −0.20 | (−1.21, 0.79) |
Gender [Female] | 0.06 | (−0.54, 0.66) |
Age [From 15 to 35 years old] | 0.96 | (−0.37, 2.21) |
Age [From 36 to 45 y.o.b] | 0.04 | (−1.57, 1.57) |
Age [From 46 to 55 y.o.] | −0.14 | (−1.76, 1.33) |
Age [From 56 to 65 y.o.] | −1.15 | (−2.65, 0.31) |
Age [From 66 to 75 y.o.] | 1.35 | (−0.03, 2.75) |
Education [No education] | 0.42 | (−0.66, 1.51) |
Education [Primary] | −0.23 | (−1.05, 0.58) |
Education [Secondary] | 0.25 | (−0.98, 1.44) |
Education [Tertiary] | −0.16 | (−1.48, 1.08) |
Employment status [Employed] | −0.07 | (−0.59, 0.44) |
Employment status [Unemployed] | 0.71 | (−1.52, 2.86) |
Discussion
Limitations
Conclusions
Key points
-
This is the first study to analyse the increase in SRH in the 2006 and 2011 surveys carried out in Spain.
-
The probability of reporting poor health in 2006 is not significantly different in 2011.
-
Decision-makers must take into consideration that SRH actually do not improve, in contrast to the last National Health Survey’s conclusion (ENSE).
-
Cross-sectional problems can be controlled with exact matching and propensity score-matching.