Skip to main content
NCBI home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2000 Jan;54(1):24–30. doi: 10.1136/jech.54.1.24

Social inequalities in health related behaviours in Barcelona

C Borrell 1, F Dominguez-Berjon 1, M Pasarin 1, J Ferrando 1, I Rohlfs 1, M Nebot 1
PMCID: PMC1731540  PMID: 10692958

Abstract

OBJECTIVE—This study describes social class inequalities in health related behaviours (tobacco and alcohol consumption, physical activity) among a sample of general population over 14 years old in Barcelona.
DESIGN—Cross sectional study (Barcelona Health Interview Survey).
SETTING—Barcelona city (Spain).
PARTICIPANTS—A representative stratified sample of the non-institutionalised population resident in Barcelona was obtained. This study refers to the 4171 respondents aged over 14.
DATA—Social class was obtained from a Spanish adaptation of the British Registrar General classification. In addition, sociodemographic variables such as family structure and employment status were used. As health related behaviours tobacco consumption, alcohol consumption, usual physical activity and leisure time physical activity were analysed. Age adjusted percentages were compared by social class. Multivariate analysis was performed using logistic regression models.
MAIN RESULTS—Women in the upper social classes were more likely to smoke, the adjusted odds ratio (OR) for social class V in reference to social class I was 0.36 (95% confidence intervals (95%CI): 0.19, 0.67), while the opposite occurred among men although it was not statistically significant in multivariate analysis. Smoking cessation was more likely among men in the higher classes (OR for class V 0.41, 95%CI: 0.18, 0.90). Excessive alcohol consumption among men showed no differences between classes, while among women it was greater in the upper classes. Engaging in usual physical activity classified as "light or none" in men decreased with lowering social class (OR class IVa: 0.55 and OR class IVb: 0.47). Women of social classes IV and V were less likely to have two or more health risk behaviours (OR for class V 0.33, 95% CI: 0.18, 0.62).
CONCLUSION—Health damaging behaviours are differentially distributed among social classes in Barcelona. Health policies should take into account these inequalities.


Keywords: health related behaviours; social class; health survey

Full Text

The Full Text of this article is available as a PDF (101.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alvarez F. J., Queipo D., Del Rio M. C., Garcia M. C. Patterns of alcohol consumption among the general population of Castile and Leon (Spain). Alcohol Alcohol. 1993 Jan;28(1):43–54. [PubMed] [Google Scholar]
  2. Amos A. Women and smoking. Br Med Bull. 1996 Jan;52(1):74–89. doi: 10.1093/oxfordjournals.bmb.a011534. [DOI] [PubMed] [Google Scholar]
  3. Anderson P., Cremona A., Paton A., Turner C., Wallace P. The risk of alcohol. Addiction. 1993 Nov;88(11):1493–1508. doi: 10.1111/j.1360-0443.1993.tb03135.x. [DOI] [PubMed] [Google Scholar]
  4. Arber S. Comparing inequalities in women's and men's health: Britain in the 1990s. Soc Sci Med. 1997 Mar;44(6):773–787. doi: 10.1016/s0277-9536(96)00185-2. [DOI] [PubMed] [Google Scholar]
  5. Arias A., Rebagliato M., Palumbo M. A., Bellver R., Ashton J., Colomer C., Costa J., Flynn P., Alvarez-Dardet C. Desigualdades en salud en Barcelona y Valencia. Med Clin (Barc) 1993 Feb 27;100(8):281–287. [PubMed] [Google Scholar]
  6. Ariza i Cardenal C., Nebot i Adell M. Factores asociados al consumo de tabaco en una muestra de escolares de enseñanza primaria y secundaria. Gac Sanit. 1995 Mar-Apr;9(47):101–109. doi: 10.1016/s0213-9111(95)71223-7. [DOI] [PubMed] [Google Scholar]
  7. Borrell C., Arias A. Socioeconomic factors and mortality in urban settings: the case of Barcelona, Spain. J Epidemiol Community Health. 1995 Oct;49(5):460–465. doi: 10.1136/jech.49.5.460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Borrell C., Pasarín M. I. The study of social inequalities in health in Spain: where are we? J Epidemiol Community Health. 1999 Jul;53(7):388–389. doi: 10.1136/jech.53.7.388. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Borrell C., Plasència A., Pasarin I., Ortún V. Widening social inequalities in mortality: the case of Barcelona, a southern European city. J Epidemiol Community Health. 1997 Dec;51(6):659–667. doi: 10.1136/jech.51.6.659. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Borrell C., Regidor E., Arias L. C., Navarro P., Puigpinós R., Domínguez V., Plasència A. Inequalities in mortality according to educational level in two large Southern European cities. Int J Epidemiol. 1999 Feb;28(1):58–63. doi: 10.1093/ije/28.1.58. [DOI] [PubMed] [Google Scholar]
  11. Dishman R. K., Sallis J. F., Orenstein D. R. The determinants of physical activity and exercise. Public Health Rep. 1985 Mar-Apr;100(2):158–171. [PMC free article] [PubMed] [Google Scholar]
  12. Domingo Salvany A., Marcos Alonso J. Propuesta de un indicador de la "clase social" basado en la ocupación. Gac Sanit. 1989 Jan-Feb;3(10):320–326. doi: 10.1016/s0213-9111(89)70948-1. [DOI] [PubMed] [Google Scholar]
  13. Domínguez-Berjón M. F., Borrell C., Nebot M., Plasència A. La actividad física de ocio y su asociación con variables sociodemográficas y otros comportamientos relacionados con la salud. Gac Sanit. 1998 May-Jun;12(3):100–109. [PubMed] [Google Scholar]
  14. Dunbar G. C., Morgan D. D. The changing pattern of alcohol consumption in England and Wales 1978-85. Br Med J (Clin Res Ed) 1987 Oct 3;295(6602):807–810. doi: 10.1136/bmj.295.6602.807. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Fernández E., Carné J., Schiaffino A., Borràs J., Saltó E., Tresserras R., Rajmil L., Villalbí J., Segura A. El abandono del hábito tabáquico en Cataluña. Gac Sanit. 1999 Sep-Oct;13(5):353–360. doi: 10.1016/s0213-9111(99)71386-5. [DOI] [PubMed] [Google Scholar]
  16. Ford E. S., Merritt R. K., Heath G. W., Powell K. E., Washburn R. A., Kriska A., Haile G. Physical activity behaviors in lower and higher socioeconomic status populations. Am J Epidemiol. 1991 Jun 15;133(12):1246–1256. doi: 10.1093/oxfordjournals.aje.a115836. [DOI] [PubMed] [Google Scholar]
  17. Garfinkel L. Trends in cigarette smoking in the United States. Prev Med. 1997 Jul-Aug;26(4):447–450. doi: 10.1006/pmed.1997.0191. [DOI] [PubMed] [Google Scholar]
  18. Graham H. Smoking prevalence among women in the European community 1950-1990. Soc Sci Med. 1996 Jul;43(2):243–254. doi: 10.1016/0277-9536(95)00369-x. [DOI] [PubMed] [Google Scholar]
  19. Gutiérrez-Fisac J. L. Indicadores de consumo de alcohol en España. Med Clin (Barc) 1995 Apr 15;104(14):544–550. [PubMed] [Google Scholar]
  20. Hellerstedt W. L., Jeffery R. W., Murray D. M. The association between alcohol intake and adiposity in the general population. Am J Epidemiol. 1990 Oct;132(4):594–611. doi: 10.1093/oxfordjournals.aje.a115703. [DOI] [PubMed] [Google Scholar]
  21. Hill C. Trends in tobacco use in Europe. J Natl Cancer Inst Monogr. 1992;(12):21–24. [PubMed] [Google Scholar]
  22. Hupkens C. L., Knibbe R. A., Drop M. J. Alcohol consumption in the European community: uniformity and diversity in drinking patterns. Addiction. 1993 Oct;88(10):1391–1404. doi: 10.1111/j.1360-0443.1993.tb02026.x. [DOI] [PubMed] [Google Scholar]
  23. Iribarren C., Luepker R. V., McGovern P. G., Arnett D. K., Blackburn H. Twelve-year trends in cardiovascular disease risk factors in the Minnesota Heart Survey. Are socioeconomic differences widening? Arch Intern Med. 1997 Apr 28;157(8):873–881. [PubMed] [Google Scholar]
  24. Kunst A. E., Groenhof F., Mackenbach J. P., Health E. W. Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies. EU Working Group on Socioeconomic Inequalities in Health. BMJ. 1998 May 30;316(7145):1636–1642. doi: 10.1136/bmj.316.7145.1636. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. La Vecchia C., Pagano R., Decarli A., Ferraroni M. Smoking in Italy, 1990-1991. Tumori. 1994 Jun 30;80(3):175–180. doi: 10.1177/030089169408000303. [DOI] [PubMed] [Google Scholar]
  26. Mackenbach J. P. Socio-economic health differences in The Netherlands: a review of recent empirical findings. Soc Sci Med. 1992 Feb;34(3):213–226. doi: 10.1016/0277-9536(92)90264-q. [DOI] [PubMed] [Google Scholar]
  27. Marín Tuyà D. Tabaco y adolescentes: más vale prevenir. Med Clin (Barc) 1993 Apr 3;100(13):497–500. [PubMed] [Google Scholar]
  28. McAlister A. L., Perry C., Maccoby N. Adolescent smoking: onset and prevention. Pediatrics. 1979 Apr;63(4):650–658. [PubMed] [Google Scholar]
  29. Nebot M., Borrell C., Ballestín M., Villalbí J. R. Prevalencia y características asociadas al consumo de tabaco en población general en Barcelona entre 1983 y 1992. Rev Clin Esp. 1996 Jun;196(6):359–364. [PubMed] [Google Scholar]
  30. Pate R. R., Pratt M., Blair S. N., Haskell W. L., Macera C. A., Bouchard C., Buchner D., Ettinger W., Heath G. W., King A. C. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995 Feb 1;273(5):402–407. doi: 10.1001/jama.273.5.402. [DOI] [PubMed] [Google Scholar]
  31. Pierce J. P. International comparisons of trends in cigarette smoking prevalence. Am J Public Health. 1989 Feb;79(2):152–157. doi: 10.2105/ajph.79.2.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Pomerleau J., Pederson L. L., Ostbye T., Speechley M., Speechley K. N. Health behaviours and socio-economic status in Ontario, Canada. Eur J Epidemiol. 1997 Sep;13(6):613–622. doi: 10.1023/a:1007339720807. [DOI] [PubMed] [Google Scholar]
  33. Rice N., Carr-Hill R., Dixon P., Sutton M. The influence of households on drinking behaviour: a multilevel analysis. Soc Sci Med. 1998 Apr;46(8):971–979. doi: 10.1016/s0277-9536(97)10017-x. [DOI] [PubMed] [Google Scholar]
  34. Romelsjö A., Lundberg M. The changes in the social class distribution of moderate and high alcohol consumption and of alcohol-related disabilities over time in Stockholm County and in Sweden. Addiction. 1996 Sep;91(9):1307–1323. doi: 10.1046/j.1360-0443.1996.91913076.x. [DOI] [PubMed] [Google Scholar]
  35. Salonen J. T., Slater J. S., Tuomilehto J., Rauramaa R. Leisure time and occupational physical activity: risk of death from ischemic heart disease. Am J Epidemiol. 1988 Jan;127(1):87–94. doi: 10.1093/oxfordjournals.aje.a114794. [DOI] [PubMed] [Google Scholar]
  36. Stephens T., Jacobs D. R., Jr, White C. C. A descriptive epidemiology of leisure-time physical activity. Public Health Rep. 1985 Mar-Apr;100(2):147–158. [PMC free article] [PubMed] [Google Scholar]
  37. Villalbí J. R., Nebot M., Ballestín M. Los adolescentes ante las sustancias adictivas: tabaco, alcohol y drogas no institucionalizadas. Med Clin (Barc) 1995 May 27;104(20):784–788. [PubMed] [Google Scholar]
  38. Waldron I. Patterns and causes of gender differences in smoking. Soc Sci Med. 1991;32(9):989–1005. doi: 10.1016/0277-9536(91)90157-8. [DOI] [PubMed] [Google Scholar]
  39. van Reek J., Adriaanse H. Cigarette smoking cessation rates by level of education in five western countries. Int J Epidemiol. 1988 Jun;17(2):474–475. doi: 10.1093/ije/17.2.474. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES