Socioeconomic inequalities in sexual and reproductives health in Spain
- Autores: Dolores Ruiz-Muñoz
- Directores de la Tesis: Gloria Pérez Albarracín (dir. tes.)
- Lectura: En la Universitat Pompeu Fabra ( España ) en 2013
- Idioma: español
- Tribunal Calificador de la Tesis: Lucía Artazcoz Lazcano (presid.), Carme Coll Capdevila (secret.), Nathalie Bajos (voc.)
- Materias:
- Enlaces
- Tesis en acceso abierto en: TDX e-Repositori UPF
- Resumen
INTRODUCCIÓN La salud sexual y reproductiva es un importante aspecto de la salud general de una persona. Por otro lado, el garantizar un buen estado de salud sexual y reproductiva ha sido reconocido como una parte inseparable de los derechos humanos. En este contexto sin embargo, hay muy pocos estudios en España que estudien la salud sexual y reproductiva, por eso el objetivo general de esta tesis fue estudiar el estado de salud sexual y reproductiva de la población española en edad reproductiva, centrándonos especialmente en las desigualdades socioeconómicas individuales y contextuales.
METODOLOGÍA Para alcanzar este objetivo se diseñaron cinco estudios diferentes, uno dedicado al estado de salud sexual, tres al uso de anticoncepción y el último a la práctica de aborto inducido, estudiando en cada caso la influencia de los factores socioeconómicos. Mediante el uso de fuentes de información como la Encuesta de Fecundidad de 2006, la primera Encuesta Nacional de Salud Sexual de 2009 y el Registro anual de Interrupciones Voluntarias del Embarazo, se realizaron estudios de regresión multivariados, con un enfoque multinivel cuando fue posible, para estudiar las desigualdades socioeconómicas en los diferentes aspectos relacionados con la salud sexual y reproductiva detallados. El análisis multinivel facilita tener en cuanta la estructura jerárquica de los datos y estimar la contribución tanto de los factores individuales como de los factores contextuales.
CONCLUSIONES Los estudios de esta tesis sugieren que el estado general de salud sexual y reproductiva de la población española en edad reproductiva es bastante bueno. Los niveles de satisfacción con las relaciones sexuales y con la vida sexual en general son altos, así como los niveles de uso de anticoncepción durante la primera relación sexual y las relaciones sexuales más recientes, mientras que las tasas de aborto inducido están en el rango de las de otros países europeos similares, y las de abuso sexual no exceden las de otros países desarrollados.
Se detectan desigualdades socioeconómicas individuales en la mayoría de los aspectos estudiados de la salud sexual y reproductiva. Los factores socioeconómicos estudiados mantienen su fuerte asociación incluso cuando se tienen en cuenta los factores socioeconómicos contextuales. La genete de menor posición socioeconómica tiende a tener relaciones sexuales menos satisfactorias y más inseguras, sufren más abuso sexual y recurren más frecuentemente al aborto inducido.
Los factores socioeconómicos individuales se asocian a los aspectos estudiados de la salud sexual y reproductiva más fuertemente en mujeres que en hombres. También estas asociaciones son más fuertes en la primera relación sexual que en relaciones sexuales más recientes, especialmente en el uso de anticoncepción. Una vez que las mujeres aumentan de edad y sus relaciones sexuales se vuelven parte integral de sus vidas, los factores relacionados con su ciclo vital, como la edad, el estar en parea y los hijos, se vuelven más importantes.
El uso de anticoncepción, principalmente durante la primera relación sexual, y la práctica de aborto, no se distribuyen de igual manera entre las diferentes comunidades autónomas de España, y parte de esta variación se debe a los factores socioeconómicos contextuales, de manera adicional e independiente a los factores socioeconómicos individuales.
Los factores socioeconómicos contextuales de las comunidades autónomas afectan a los aspectos estudiados de la salud sexual y reproductiva de diferentes formas: - Las mujeres que viven en comunidades autónomas más deprimidas y que tienen menos políticas públicas redistributivas usan menos anticoncepción durante su primera relación sexual.
- Las mujeres que viven en comunidades autónomas más deprimidas y que tienen menos políticas públicas redistributivas usan más anticoncepción durante las relaciones sexuales del último mes.
- Las mujeres que viven en comunidades autónomas menos tradicionales, menos deprimidas y que tienen menos políticas públicas redistributivas son más propensas a tener un aborto inducido.
La salud sexual y reproductiva debería ser vista como el resultado de múltiples interacciones de una variedad de factores actuando a diferentes niveles. Para un mayor entendimiento de la relación entre los factores socioeconómicos y los diferentes resultados evaluados, es necesario estudiar en más profundidad las relaciones de las variables contextuales que actuan a diferentes niveles.
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