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Jung EJ, Kim DY, Bae HJ, Ko KP. Assessing regional disparities and vulnerability in stroke care across Gyeonggi Province: A focus on hospital service areas. J Stroke Cerebrovasc Dis 2024; 33:107817. [PMID: 38880365 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/09/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND This study aims to illuminate regional disparities and identify vulnerable areas in stroke care across Gyeonggi Province's hospital service areas. METHODS Using data from the Korea National Cardio-cerebrovascular Disease Management Commission, we included 4,427 acute stroke patients admitted in 2018 to hospitals within Gyeonggi Province. Our evaluation focused on: 1) stroke care quality indicators, including rates of defect-free care, intravenous thrombolysis (IVT), endovascular thrombectomy (EVT), and acute reperfusion therapy (either IVT or EVT); 2) intra-regional treatment rates; and 3) one-year mortality across the province and its 12 hospital service areas. These were compared both with national averages and inter-regionally. Vulnerable areas were pinpointed by evaluating the number of quality indicators falling below the national average and through visual distribution mapping, categorizing each indicator into higher (ranks 1-4), middle (ranks 5-8), and lower (ranks 9-12) tiers. RESULTS Despite fewer qualified stroke centers and specialists, Gyeonggi Province exhibited higher defect-free care rates (84.6 % vs. 80.7 %), intra-regional treatment rates (57.8 % vs. 51.0 %), and marginally lower one-year mortality (16.2 % vs. 17.3 %) compared to national averages. Notable regional disparities were observed; the highest-performing areas for defect-free care and acute reperfusion therapy exceeded the lowest by 1.4 and 3.3 times, respectively. Nine out of twelve areas fell below the national average for EVT rates, seven for IVT and reperfusion therapy rates, and five for intra-regional treatment rates. Pyeongtaek, with all stroke care quality indicators below the national average coupled with the highest one-year mortality, emerges as a critical area needing improvement in acute stroke care. CONCLUSION This study not only exposes the regional disparities in stroke care within Gyeonggi Province's hospital service areas but also identifies areas most vulnerable. Consequently, a customized support strategy for these areas is imperative.
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Affiliation(s)
- En-Joo Jung
- Public Healthcare Center, Seoul National University Hospital, Seoul, Korea
| | - Do Yeon Kim
- Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital; Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea; Headquarters for Public Health Care, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Neurology, Gyeonggi Provincial Medical Center Icheon Hospital, Icheon
| | - Hee-Joon Bae
- Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital; Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kwang-Pil Ko
- Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea; Clinical Preventive Medicine Center, Seoul National University Bundang Hospital, Seongnam, Korea.
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Matilla-Santander N, Matthews AA, Gunn V, Muntaner C, Kreshpaj B, Wegman DH, Sánchez-Martínez N, Hernando-Rodriguez JC, Albin M, Balogh R, Davis L, Bodin T. Causal effect of shifting from precarious to standard employment on all-cause mortality in Sweden: an emulation of a target trial. J Epidemiol Community Health 2023; 77:736-743. [PMID: 37620008 PMCID: PMC10579471 DOI: 10.1136/jech-2023-220734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/05/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND We aimed at estimating the causal effect of switching from precarious to standard employment on the 6-year and 12-year risk of all-cause mortality among workers aged 20-55 years in Sweden. METHODS We emulated a series of 12 target trials starting every year between 2005 and 2016 using Swedish register data (n=251 273). We classified precariously employed individuals using a multidimensional approach at baseline as (1) remaining in precarious employment (PE) (73.8%) and (2) shifting to standard employment (26.2%). All-cause mortality was measured from 2006 to 2017. We pooled data for all 12 emulated trials and used covariate-adjusted pooled logistic regression to estimate intention-to-treat and per-protocol effects via risk ratios (RRs) and standardised risk curves (the parametric g-formula). RESULTS Shifting from precarious to standard employment decreases the 12-year risk of death by 20% on the relative scale (RR: 0.82, 95% CI: 0.73; 0.93), regardless of what happens after the initial shift. However, we estimated a 12-year risk reduction of 30% on the relative scale for workers shifting from precarious to standard employment and staying within this employment category for the full 12 years (RR: 0.71, 95% CI: 0.54; 0.95). CONCLUSIONS This study finds that shifting from low to higher-quality employment conditions (ie, stable employment, sufficient income levels and high coverage by collective agreements) decreases the risk of death. Remaining in PE increases the risk of premature mortality. Our results emphasise the necessity of ensuring decent work for the entire working population to accomplish the 2030 Agenda for Sustainable Development.
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Affiliation(s)
| | - Anthony A Matthews
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Virginia Gunn
- Unit of Occupational Medicine, Karolinska Institute, Stockholm, Sweden
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
- School of Nursing, Cape Breton University, Sydney, New South Wales, Canada
| | - Carles Muntaner
- Bllomberg Faculty of Nursing, Division of Social and Behavioural Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Bertina Kreshpaj
- Unit of Occupational Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - David H Wegman
- Public Health, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Néstor Sánchez-Martínez
- Unit of Occupational Medicine, Karolinska Institute, Stockholm, Sweden
- Public Health, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Maria Albin
- Unit of Occupational Medicine, Karolinska Institute, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm Region, Stockholm, Sweden
| | - Rebeka Balogh
- Interface Demography, Vrije Universiteit Brussel, Brussels, Belgium
- Institute for Employment Research, University of Warwick, Coventry, UK
| | | | - Theo Bodin
- Unit of Occupational Medicine, Karolinska Institute, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm Region, Stockholm, Sweden
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Bhattarai A, Dimitropoulos G, Bulloch AGM, Tough SC, Patten SB. Association between childhood adversities and premature and potentially avoidable mortality in adulthood: a population-based study. BMC Public Health 2023; 23:2036. [PMID: 37853382 PMCID: PMC10585893 DOI: 10.1186/s12889-023-16935-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/08/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The association of childhood adversities with mortality has rarely been explored, and even less studied is the question of whether any excess mortality may be potentially preventable. This study examined the association between specific childhood adversities and premature and potentially avoidable mortality (PPAM) in adulthood in a representative sample of the general population. Also, we examined whether the associations were potentially mediated by various adult socioeconomic, psychosocial, and behavioral factors. METHODS The study used data from the National Population Health Survey (NPHS-1994) linked to the Canadian Vital Statistics Database (CVSD 1994-2014) available from Statistics Canada. The NPHS interview retrospectively assessed childhood exposure to prolonged hospitalization, parental divorce, prolonged parental unemployment, prolonged trauma, parental problematic substance use, physical abuse, and being sent away from home for doing something wrong. An existing definition of PPAM, consisting of causes of death considered preventable or treatable before age 75, was used. Competing cause survival models were used to examine the associations of specific childhood adversities with PPAM in adulthood among respondents aged 18 to 74 years (rounded n = 11,035). RESULTS During the 20-year follow-up, 5.4% of the sample died prematurely of a cause that was considered potentially avoidable. Childhood adversities had a differential effect on mortality. Physical abuse (age-adjusted sub-hazard ratio; SHR 1.44; 95% CI 1.03, 2.00) and being sent away from home (age-adjusted SHR 2.26; 95% CI 1.43,3.57) were significantly associated with PPAM. The associations were attenuated when adjusted for adulthood factors, namely smoking, poor perceived health, depression, low perceived social support, and low income, consistent with possible mediating effects. Other adversities under study were not associated with PPAM. CONCLUSION The findings imply that the psychological sequelae of childhood physical abuse and being sent away from home and subsequent uptake of adverse health behavior may lead to increased risk of potentially avoidable mortality. The potential mediators identified offer directions for future research to perform causal mediation analyses with suitable data and identify interventions aimed at preventing premature mortality due to potentially avoidable causes. Other forms of adversities, mostly related to household dysfunction, may not be determinants of the distal health outcome of mortality.
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Affiliation(s)
- Asmita Bhattarai
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada.
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada.
| | - Gina Dimitropoulos
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Faculty of Social Work, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Andrew G M Bulloch
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Suzanne C Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Scott B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
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Leal M, Hudson P, Mobini S, Sörensen J, Madeira PM, Tesselaar M, Zêzere JL. Natural hazard insurance outcomes at national, regional and local scales: A comparison between Sweden and Portugal. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 322:116079. [PMID: 36063696 DOI: 10.1016/j.jenvman.2022.116079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
This study addresses the role of natural hazard insurance in two European countries with different insurance markets and socioeconomic conditions: Sweden and Portugal. The analyses were conducted at the national, regional (Southern Sweden and Lisbon Metropolitan Area - LMA), and local (Malmö and Lisbon cities) scales. Most damage caused by weather and climate-related (WCR) hazards during the 1980-2019 period was not covered by insurance companies in Sweden (71%) and Portugal (91%). An insurance affordability analysis was performed using income for the national and regional scales. Unaffordability is higher in Southern Sweden than in LMA, implying that better socioeconomic conditions do not necessarily mean a higher average capacity to pay for insurance. At the local scale, urban flooding was analysed for Malmö (1996-2019) and Lisbon (2000-2011) using insurance databases, in which the most relevant 21st century rainfall events for each city are included (2014 and 2008, respectively). The influence of terrain features on flooding claims and payouts was determined using Geographic Information Systems (GIS) spatial analyses. The flat Malmö favours ponding and extensive flooding, while the distance to the drainage network and flow accumulation are key factors to promote flooding along valley bottoms in the hilly Lisbon. Flooding hotspots tend to result from a combination of higher depths/lower velocities (accumulation of floodwaters and ponding) and not from a pattern of lower depths/higher velocities (shallow overland flow). More detailed data on insurance, flooding, and socioeconomic conditions, at regional and mainly local scales, is needed to improve affordability and urban flooding risk assessments.
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Affiliation(s)
- Miguel Leal
- Centre of Geographical Studies and Associated Laboratory TERRA, Institute of Geography and Spatial Planning, Universidade de Lisboa. Lisbon, Portugal; Forest Research Centre and Associated Laboratory TERRA, School of Agriculture, Universidade de Lisboa. Lisbon, Portugal.
| | - Paul Hudson
- Department of Environment and Geography, University of York. York, UK
| | - Shifteh Mobini
- Division of Water Resources Engineering, Lund University. Lund, Sweden
| | - Johanna Sörensen
- Division of Water Resources Engineering, Lund University. Lund, Sweden
| | - Paulo Miguel Madeira
- Centre of Geographical Studies and Associated Laboratory TERRA, Institute of Geography and Spatial Planning, Universidade de Lisboa. Lisbon, Portugal; Institute of Social Sciences, Universidade de Lisboa. Lisbon, Portugal
| | - Max Tesselaar
- Institute for Environmental Studies, Vrije Universiteit. Amsterdam, the Netherlands
| | - José Luís Zêzere
- Centre of Geographical Studies and Associated Laboratory TERRA, Institute of Geography and Spatial Planning, Universidade de Lisboa. Lisbon, Portugal
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Choi MH, Moon MH, Yoon TH. Avoidable Mortality between Metropolitan and Non-Metropolitan Areas in Korea from 1995 to 2019: A Descriptive Study of Implications for the National Healthcare Policy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063475. [PMID: 35329162 PMCID: PMC8955663 DOI: 10.3390/ijerph19063475] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 01/27/2023]
Abstract
This study aims to investigate the trends of avoidable mortality and regional inequality from 1995 to 2019 and to provide evidence for policy effectiveness to address regional health disparities in Korea. Mortality and population data were obtained from the Statistics Korea database. Age-standardized all-cause, avoidable, preventable, and treatable mortality was calculated for each year by sex and region. Changes in mortality trends between metropolitan and non-metropolitan areas were compared with absolute and relative differences. Avoidable mortality decreased by 65.7% (350.5 to 120.2/100,000 persons) in Korea, 64.5% in metropolitan areas, and 65.8% in non-metropolitan areas. The reduction in avoidable mortality was greater in males than in females in both areas. The main causes of death that contribute to the reduction of avoidable mortality are cardiovascular diseases, cancer, and injuries. In preventable mortality, the decrease in non-metropolitan areas (−192.4/100,000 persons) was greater than that in metropolitan areas (−142.7/100,000 persons). However, in treatable mortality, there was no significant difference between the two areas. While inequalities in preventable mortality improved, inequalities in treatable mortality worsened, especially in females. Our findings suggest that regional health disparities can be resolved through a balanced regional development strategy with an ultimate goal of reducing health disparities.
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Affiliation(s)
- Min-Hyeok Choi
- Department of Preventive and Occupational & Environmental Medicine, Medical College, Pusan National University, Yangsan 50612, Korea;
- Office of Public Healthcare Service, Pusan National University Yangsan Hospital, Yangsan 50612, Korea;
| | - Min-Hui Moon
- Office of Public Healthcare Service, Pusan National University Yangsan Hospital, Yangsan 50612, Korea;
| | - Tae-Ho Yoon
- Department of Preventive and Occupational & Environmental Medicine, Medical College, Pusan National University, Yangsan 50612, Korea;
- Correspondence: ; Tel.: +82-51-510-8030
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Ivankova V, Gavurova B, Khouri S, Szabo G. Examining the Economic Perspective of Treatable Mortality: The Role of Health Care Financing and the Importance for Economic Prosperity. Front Public Health 2021; 9:780390. [PMID: 34966714 PMCID: PMC8710442 DOI: 10.3389/fpubh.2021.780390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/19/2021] [Indexed: 12/04/2022] Open
Abstract
Health is an essential element of economic life and is therefore considered a source of comparative economic development of countries. The aim of the study was to examine the associations between health care financing, specific treatable mortality of males and females of working age, and economic prosperity, taking into account to the classification of health systems applied in the countries of the Organization for Economic Co-operation and Development (OECD). An insurance-based health system and a tax-based health system were identified in these countries, and data were collected for the period 1994-2016. Descriptive analysis, panel regression analysis and cluster analysis were used to achieve the aim. The analytical process included economic indicators [health expenditure, gross domestic product (GDP)] and health indicators (treatable mortality from circulatory system diseases and endocrine, nutritional and metabolic diseases). The results revealed significant negative associations of health care financing with treatable mortality from circulatory system diseases and endocrine, nutritional, and metabolic diseases in both health systems and both gender categories. There were also negative associations between treatable mortality in both diagnosis groups and economic prosperity. These results have shown that health care financing is linked to economic prosperity also through health variability in the working age population. In terms of assessing economic and health outcomes, less positive and more positive countries were identified using cluster analysis. Countries such as Latvia with a tax-based health system and Hungary, Lithuania, Estonia with an insurance-based health system were characterized by great potential for improvements. Although reducing treatable mortality is a great motivation for public health leaders to increase health care financing, the importance for economic prosperity may be a more compelling argument. Effective interventions should be considered in the light of their regional, social and economic contexts.
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Affiliation(s)
| | - Beata Gavurova
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
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Martinez-Beneito MA, Vergara-Hernández C, Botella-Rocamora P, Corpas-Burgos F, Pérez-Panadés J, Zurriaga Ó, Aldasoro E, Borrell C, Cabeza E, Cirera L, Delfrade Osinaga J, Fernández-Somoano A, Gandarillas A, Lorenzo Ruano PL, Marí-Dell’Olmo M, Nolasco A, Prieto-Salceda MD, Ramis R, Rodríguez-Sanz M, Sánchez-Villegas P. Geographical Variability in Mortality in Urban Areas: A Joint Analysis of 16 Causes of Death. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115664. [PMID: 34070635 PMCID: PMC8197960 DOI: 10.3390/ijerph18115664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 01/29/2023]
Abstract
The geographical distribution of mortality has frequently been studied. Nevertheless, those studies often consider isolated causes of death. In this work, we aim to study the geographical distribution of mortality in urban areas, in particular, in 26 Spanish cities. We perform an overall study of 16 causes of death, considering that their geographical patterns could be dependent and estimating the dependence between the causes of death. We study the deaths in these 26 cities during the period 1996-2015 at the census tract level. A multivariate disease mapping model is used in order to solve the potential small area estimation problems that these data could show. We find that most of the geographical patterns found show positive correlations. This suggests the existence of a transversal geographical pattern, common to most causes of deaths, which determines those patterns to a higher/lower extent depending on each disease. The causes of death that exhibit that underlying pattern in a more prominent manner are chronic obstructive pulmonary disease (COPD), lung cancer, and cirrhosis for men and cardiovascular diseases and dementias for women. Such findings are quite consistent for most of the cities in the study. The high positive correlation found between geographical patterns reflects the existence of both high and low-risk areas in urban settings, in general terms for nearly all the causes of death. Moreover, the high-risk areas found often coincide with neighborhoods known for their high deprivation. Our results suggest that dependence among causes of death is a key aspect to be taken into account when mapping mortality, at least in urban contexts.
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Affiliation(s)
- Miguel A. Martinez-Beneito
- Departament d’Estadística e Investigaciò Opertiva, Universitat de València, 46100 Burjassot, Spain
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- Correspondence:
| | | | - Paloma Botella-Rocamora
- Dirección General de Salut Pública i Adiccions, Conselleria de Sanitat Universal y Salut Pública, 46020 Valencia, Spain; (P.B.-R.); (J.P.-P.)
| | - Francisca Corpas-Burgos
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- FISABIO Foundation, 46020 Valencia, Spain;
| | - Jordi Pérez-Panadés
- Dirección General de Salut Pública i Adiccions, Conselleria de Sanitat Universal y Salut Pública, 46020 Valencia, Spain; (P.B.-R.); (J.P.-P.)
| | - Óscar Zurriaga
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- FISABIO Foundation, 46020 Valencia, Spain;
- Dirección General de Salut Pública i Adiccions, Conselleria de Sanitat Universal y Salut Pública, 46020 Valencia, Spain; (P.B.-R.); (J.P.-P.)
- Departament de Medicina Preventiva, Salut Pública, Ciències de l’Alimentación, Toxicología i Medicina Legal, Universitat de València, 46010 Valencia, Spain
| | - Elena Aldasoro
- Dirección de Salud Pública y Adicciones, 48013 Bilbao, Spain;
| | - Carme Borrell
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
- Institut d’Investigació Biomèdica (IIB Sant Pau), 08025 Barcelona, Spain
| | - Elena Cabeza
- Institut d’investigació sanitària de les Illes Balears, 07120 Palma de Mallorca, Spain;
| | - Lluís Cirera
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- Department of Epidemiology, Regional Health Council-IMIB-Arrixaca, 30008 Murcia, Spain
| | - Josu Delfrade Osinaga
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- Instituto de Salud Pública y Laboral de Navarra, 31003 Pamplona, Spain
| | - Ana Fernández-Somoano
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- IUOPA-Medicine Department, Universidad de Oviedo, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33001 Oviedo, Spain
| | | | | | - Marc Marí-Dell’Olmo
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
- Institut d’Investigació Biomèdica (IIB Sant Pau), 08025 Barcelona, Spain
| | - Andreu Nolasco
- Universidad de Alicante, 03690 San Vicente del Raspeig, Spain;
| | | | - Rebeca Ramis
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Maica Rodríguez-Sanz
- CIBER de Epidemiología y Salud Pública, 28029 Madrid, Spain; (F.C.-B.); (Ó.Z.); (C.B.); (L.C.); (J.D.O.); (A.F.-S.); (M.M.-D.); (R.R.); (M.R.-S.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
- Institut d’Investigació Biomèdica (IIB Sant Pau), 08025 Barcelona, Spain
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