Mapping of Outdoor Food and Beverage Advertising around Spanish Schools

Overweight and obesity rates have increased worldwide in the last decades. The marketing strategies of food considered to be unhealthy significantly exacerbate the childhood obesity dilemma. Studies typically analyze the content of advertisement in television, movies, or social media, but there is a gap in the assessment of the real-life promotion of food and beverages around the schools. The primary aim of the study was to assess the products advertised around public and concerted schools in three cities in the north of Spain, and to categorize them as healthy (core) or unhealthy (discretionary). The secondary aim was to describe the types of food and beverages in advertisements, as well as to determine the density of core and discretionary product advertisements. A cross-sectional descriptive study was carried out between September and December 2021. The units of analysis were outdoor food and beverage advertisements that were located around public and concerted schools of three cities in the north of Spain. We found 104 schools that met the criteria. We identified 6469 products advertised, 35.1% core and 61.2% discretionary, observing significant differences (p < 0.001) among the cities. Fruit (core) and alcohol (discretionary) were the most heavily advertised products. In conclusion, children attending schools located in the assessed cities are currently exposed to a significant amount of discretionary product advertisement, a situation that should be regulated.

Activos de salud, calidad de vida y morbimortalidad de la población en Asturias

INTRODUCCIÓN

n promoción de la salud se ha detectado en los últimos años un incremento de investigaciones con enfoques teóricos basados en activos de salud. Pese a los estudios identificados, no se dispone de suficiente evidencia sobre los efectos que diferentes tipos de activos pueden tener en la calidad de vida y en la morbimortalidad de la población.

OBJETIVO

analizar la relación entre los activos de salud disponibles con indicadores de morbilidad, mortalidad y calidad de vida de la población asturiana en el año 2018.

METODOLOGÍA

diseño ecológico a partir de datos agregados municipales procedentes de los 78 municipios de Asturias (1.034.960 habitantes). Tras aplicar la definición de activos de salud como aquellas variables que pudieran redundar en una mejora de la salud y del bienestar de los individuos y de las comunidades, se seleccionaron 19 variables de activos agrupados en cuatro categorías: individuales, socioeconómicas, comunitarias e infraestructura. Una vez controladas las variables relacionadas con las características demográficas de la población, se analizó la asociación de los activos con las tasas de morbimortalidad y de calidad de vida. Se desarrollaron 5 modelos predictivos a partir de modelos de regresión lineal múltiple para las variables dependientes: calidad de vida, enfermedades crónicas, mortalidad por todas las causas, mortalidad por enfermedades cardiovasculares (ECV) y por cáncer.

RESULTADOS

la disponibilidad de recursos sanitarios (beta = 0.474), coberturas sociales (beta = 0.305) y redes de apoyo social (beta = 0.225) constituyen los activos de salud con mayor peso explicativo en los resultados de salud de la población asturiana. Las variables incluidas en los modelos predictivos de calidad de vida (R² = 0.650) y de mortalidad por ECV (R² = 0.544) son las que mostraron una mayor capacidad explicativa.

CONCLUSIONES

la inversión en recursos sociosanitarios y la mejora de redes de apoyo social impulsados desde el ámbito de la salud pública pueden producir importantes mejoras en la salud de la población asturiana.

[What we mean when we talk about "community health". SESPAS Report 2018]

"Community health" is a widely used term in our context. Although interest in the concept has gradually increased over the past decade, we believe the term is still vague. Therefore, we think a better working definition is required. We conducted a review of the specialized literature on the topic. This was later contrasted with the professional backgrounds of the authors, as well as with the results of field work consisting of interviews with individuals with recognized experience and intellectual authority in the area. As a result, we intend to clarify some core terms to achieve a better working definition of community health; we describe the main theoretical influences on the formation of the term; we propose some levels of community action that could be developed through the primary health care and public health services; and finally, we identify some core aspects that should be taken into account in every action for improving community health.

[Tools to assess the impact on health of public health programmes and community interventions from an equity perspective]

It is essential to develop a comprehensive approach to institutionally promoted interventions to assess their impact on health from the perspective of the social determinants of health and equity. Simple, adapted tools must be developed to carry out these assessments. The aim of this paper is to present two tools to assess the impact of programmes and community-based interventions on the social determinants of health. The first tool is intended to assess health programmes through interviews and analysis of information provided by the assessment team. The second tool, by means of online assessments of community-based interventions, also enables a report on inequality issues that includes recommendations for improvement. In addition to reducing health-related social inequities, the implementation of these tools can also help to improve the efficiency of public health interventions.

[Health promotion based on assets: how to work with this perspective in local interventions?]

An asset-based approach could be useful to revitalise health promotion or community health interventions combining work with multiple partnerships, positive health, community engagement, equity and orientation of health determinants. We set some recommendations about how to incorporate the assets model in programmes, projects and interventions in health promotion. Some techniques are described for assets mapping and some experiences with this methodology being developed in different regions are systematised. We propose the term "Asset-based Health Promotion/Community Health" as an operational definition to work at the local level with a community engagement and participatory approach, building alliances between different institutions at the state-regional level and trying to create a framework for action with the generation of evaluations and evidence to work on population interventions from the perspective of positive health.

[Evaluation of the Health Observatory of Asturias (Spain): web and social network metrics and health professionals' opinions]

OBJECTIVE

To evaluate the Health Observatory of Asturias (Observatorio de Salud de Asturias [OBSA]), which collects and disseminates health data from Asturias through a website and social networks.

METHOD

A cross-sectional study was conducted between 2012 and 2013. The study included a process evaluation that analyzed the reach of the OBSA's website, Facebook and Twitter accounts through web metrics and the use made by health professionals in Asturias of these media. Satisfaction was assessed through an online questionnaire. To estimate the potential effects of the OBSA, the study also included an evaluation of the results with a non-experimental design.

RESULTS

The total number of visits to the website increased in 2012, with more than 37,000 visits. The questionnaire (n=43) showed that 72.1% of the health professionals knew of the OBSA and that 81.5% of them had used it. Most health professionals reported they were satisfied with the OBSA and believed that it encouraged cooperation among professionals (51.6%).

CONCLUSION

The OBSA is known and consulted by most health professionals and is achieving some of its main objectives: to inform health staff and stimulate discussion. According to the results, information and communication technologies could play an important role in the presentation of health data in a more interactive and accessible way.

[Methodology for health assets mapping in a community]

Within the development of a regional strategy for community health engagement in Asturias (Spain), and connected to the Health Observatory, we carried out a methodology to initiate the mapping of health assets at a local level. This methodology begins with a description of the most formal resources and of the pre-existing community activities, together with a characterization of the most informal, personal and symbolic health resources. We introduce our tools, grouped for the development of mapping, and explain their connection with the theoretical models of salutogenesis, asset model and community development.

[How should population health be approached? SESPAS Report 2012]

The health of the population largely depends on environmental factors, raising the issue of what the role of health professionals, particularly those in public health and primary care, should be in the planning of objectives and actions for improvement. The present article proposes a trajectory, starting with knowledge of the community's strong points in health and its needs, and ending with taking action. This trajectory requires discussion on how information can be transformed into action. We analyze the current situation and its strengths and weaknesses, and make proposals for the entire process: from information to action. Information is more than just the available data gathered from different sources; it is also knowledge of those who belong to the community or are very close to it. This perspective should include both health deficits and health assets. This information should be used not only by health professionals, but by all those in a position to influence the determinants of health. Finally, when considering the actions required to improve the health of a community, we emphasize the benefits of health promotion, in the genuine sense of the term, by reflecting on effectiveness and efficiency. The question of whether the failure of an intervention to improve health is due to the futility of the action, or to be action being undertaken in an inefficient way, is discussed.