title: Time trends in health inequalities due to care in the context of the Spanish Dependency Law.
abstract: OBJECTIVE
  In Spain, responsibility for care of old people and those in situations of dependency is assumed by families, and has an unequal social distribution according to gender and socioeconomic level. This responsibility has negative health effects on the carer. In 2006, the Dependency Law recognised the obligation of the State to provide support. This study analyses time trends in health inequalities attributable to caregiving under this new law.
  
  
  METHODS
  Study of trends using two cross-sectional samples from the 2006 and 2012 editions of the Spanish National Health Survey (27,922 and 19,995 people, respectively). We compared fair/poor self-rated health, poor mental health (GHQ-12 >2), back pain, and the use of psychotropic drugs between non-carers, carers sharing care with other persons, and those providing care alone. We obtain prevalence ratios by fitting robust Poisson regression models.
  
  
  RESULTS
  We observed no change in the social profile of carers according to gender or social class. Among women, the difference in all health indicators between carers and non-carers tended to decrease among those sharing care but not among lone carers. Inequalities tend to decrease slightly in both groups of men carers.
  
  
  CONCLUSIONS
  Between 2006 and 2012, trends in health inequalities attributable to informal care show different trends according to gender and share of responsibility. It is necessary to redesign and implement policies to reduce inequalities that take into account the most affected groups, such as women lone carers. Policies that strengthen the fair social distribution of care should also be adopted.
authors.affiliation: Agència de Salut Pública de Barcelona, Barcelona, Spain; Unidad Docente de Medicina Preventiva y Salud Pública PSMar-UPF-ASPB, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain. Electronic address: msalvadorwork@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Salvador-Piedrafita
authors.affiliation: Agència de Salut Pública de Barcelona, Barcelona, Spain; Biomedical Research Insitutute Sant Pau (IIB-Sant Pau), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain.
authors.forename: Davide
authors.initials: D
authors.lastname: Malmusi
authors.affiliation: Agència de Salut Pública de Barcelona, Barcelona, Spain; Biomedical Research Insitutute Sant Pau (IIB-Sant Pau), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006299:Health Services for the Aged / Q000331:legislation & jurisprudence*; D054625:Healthcare Disparities / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013030:Spain; D013997:Time Factors; D055815:Young Adult
keywords: Carer; Cuidadores; Desigualdades en salud; Gender; Género; Health inequalities; Mental health; Políticas públicas; Public policy; Salud autopercibida; Salud mental; Self-rated health