[The study of social inequalities in child and adolescent health in Spain]

Abstract

Objective: To identify and describe studies on social inequalities in child and adolescent health conducted in Spain with special emphasis on social determinants.

Methods: In July 2012, we conducted a systematic review in the PubMed, MEDES, SCOPUS and COCHRANE databases. We included studies on social inequalities in child and adolescent health in Spain published between 2000 and 2012. A total of 2147 abstracts were reviewed by two researchers and 80 manuscripts were fully reviewed by three researchers. Risk of bias was assessed. Seventy-two articles were finally included.

Results: A total of 83% of the studies were cross-sectional and the most frequently studied age group consisted of 13-15-year-olds. More than 20 individual or group determinants were identified. The most frequently analyzed determinants were the most advantaged educational level and occupation of the mother or the father. In 38% of the studies analyzing education and occupation, there was no definition of the determinant. Social inequalities were detected in dental health with all determinants and in all age groups (9% of studies with a high risk of bias). Social inequalities were also detected in obesity, physical activity and mental health with some determinants. Specific data were missing for younger children. No social inequalities were found in the use of health services, excluding dental care. Few studies analyzed immigration and 42% of them had a high risk of bias.

Conclusion: Wide diversity was found in the measurement of social determinants, with a lack of studies in preschoolers and of studies with longitudinal designs. The results of this study confirm social inequalities in some aspects of health.

Keywords: Adolescent; Adolescente; Child; Desigualdades en el estado de salud; Factores socioeconómicos; Health status disparities; Niño; Preescolar; Preschooler; Review; Revisión; Socioeconomic factors.