Spain

Regions

The central government issues some regulations, but each of the autonomous regions develops policies in different ways. The most common mechanism for addressing social determinants of health inequalities is to develop strategic plans.

Policy responses

Regions are the most active in implementing comprehensive policies to tackle health inequalities. Three regions (the Basque Country, Navarra and Madrid) have published their Regional Health Plans, where each has a chapter on tackling health inequalities, including relevant targets. For example, in Basque country, targets were set to reduce the social inequalities in mortality resulting from cardiovascular and circulatory system diseases. Most interventions implemented by the administration or the NGOs in Basque still focus on the excluded populations rather that on population at wide, which constitutes an obstacle for conducting intervention research.

An overview of regional policy responses addressing health inequalities can be found in our Policy Database.

Good practices

An overview of local and regional projects and initiatives that are currently taking place or that have successfully been finalized, and that are addressing health inequality issues, can be found in our Project Database.

Key actors

Please find below an overview of key actors in Spain working on health inequality issues:

• The Municipal Public Health Institutes of the 17 autonomous communities (Instituto municipal de Salud Publica)

• Escuela andaluza de Salud publica, Andalusia Public Health Training School

• Generalitat de Catalunya – Departament de la Salud, Departament de Benestar Social i Familia – Catalunya government – Department of Health and Department of Social Welfare and Family

• Gobierno Vasco – Departamento de Sanidad y Consumo (Department of Health and Consumers Affairs of the Basque Country)

• ARARTEKO – the Ombudsman for the Basque Country The Ombudsman is devoted to human rights’ protection, ensuring that all public policies respect people’s rights, that they efficiently combat inequality, discrimination and exclusion.

• EMAKUNDE Instituto Vasco de la Mujer (Women Institute of the Basque Country)

• Universidad de Alicante, University of Alicante

• Universidad Pompeu Fabra de Barcelona, University of Pompeu Fabra, Barcelona

• Universidad Autonoma de Madrid, Autonomous University of Madrid

• Universidad Complutense de Madrid

Are you aware of any other key actors that should be added to this list? 
Please let us know!

Key resources

Please find below a short overview of key documents and resources (produced at regional level) addressing health inequality issues in Spain. More publications can be found in our Publications Database.

• Primer Informe sobre Desigualdades y Salud en Andalucía – 2008 (First Report on Health Inequalities in Andalusia) Report by the Association for the Defence of Public Health Andalucia. The document presents an overview of the current situation, followed by recommendations of actions to be taken in the different sectors (political level, media and information, health care system, environment, research) to tackle HI. The presentation includes recommendations for group-specific actions as regards health.

• Desigualdades sociales en la población de la Comunidad Autónoma del País Vasco. La clase social y el género como determinantes de la salud (2007) (Social

• inequalities in the population of the Autonomous Community of the Basque Country. Social class and gender as health determinants)

• Plan integral del poble gitano a Catalunya – 2006 (Integrated Plan for the Roma People in Catalunya)

• V Plan para la igualdad de mujeres y hombres en el País Vasco- 2010 (V Plan for equality of women and men in the Basque Country) Report by the Women Institut of the Basque Country.

• II Plan interinstitucional de inclusión social 2007-2009 (II Social Inclusión Plan) Report by the Ministry of Employment and Social Affairs of the Basque Country

Are you aware of any other key resources that should be added to this list?
Please let us know!