España sufre una brecha norte-sur en ceguera y discapacidad visual

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La riqueza de una comunidad autónoma está relacionada con el número de casos de ceguera y discapacidad visual que sufren sus habitantes. A menor Producto Interior Bruto en una región, más personas hay con deficiencias visuales operables y otras que ya han quedado ciegas. Así lo indican los resultados del primer estudio a nivel nacional sobre la prevalencia de este tipo de problemas visuales y que desvela una brecha norte-sur en España. Los resultados son similares a los que ya arrojó el atlas de mortalidad de España, en el que también se registraba una brutal desigualdad entre regiones ricas y pobres en cuanto a muerte por cáncer, enfermedades cardiovasculares, diabetes y otras dolencias.

“Sólo por el hecho de vivir en una u otra comunidad autónoma tendrás más riesgos de sufrir estos problemas”, explica a Materia Anna Rius, investigadora de la Universidad Politécnica de Cataluña. El estudio es parte de su trabajo de tesis doctoral dentro de la Cátedra UNESCO de Desarrollo y Salud Visual. El trabajo ha sido dirigido por el Grupo de Investigación en Desigualdades en Salud de la Universidad Pompeu i Fabra de Barcelona.

Los datos muestran que las comunidades en las que más casos de ceguera y discapacidad visual se registran son Andalucía y Extremadura, y las ciudades de Ceuta y Melilla. Por el contrario, las regiones donde la salud visual estudiada es mayor son La Rioja, Cataluña, Madrid, País Vasco y Navarra. En general, se observó “un patrón creciente de  norte a sur en la prevalencia” de las dolencias estudiadas, según el estudio, recién publicado en la revista Ophtalmology. Otro patrón “consistente” que se ha observado es que la ceguera y los problemas visuales afectan más a mujeres que a hombres en España.

mapa          Ampliar
El mapa de los problemas de vista analizados (ajustados por edad) muestra la mayor prevalencia en el sur y entre las mujeres / Ophtalmology

El estudio ha analizado datos de 213. 626  personas recogidos en la Encuesta sobre Discapacidades, Autonomía personal y Situaciones de Dependencia de 2008. De ellas, 360 eran ciegas, 4.048 tenían problemas para ver de cerca y 4.034 para ver de lejos, en ambos casos a pesar de medidas correctivas como las gafas o lentes de contacto. Se contemplaron tres variables: sexo, nivel económico individual (el indicador era el nivel de estudios) y riqueza de la comunidad autónoma. El trabajo observó desigualdades “fuertes” entre regiones relacionadas con el PIB de las mismas. La prevalencia de ceguera y problemas visuales era además consistentemente más alta entre las mujeres.”La magnitud de esas desigualdades”, resalta el trabajo, “se mantuvieron cuando ajustamos por edad y nivel educativo”.

Listas de espera, diabetes y mala dieta

Rius resalta algunos datos de su estudio. Por ejemplo en el caso de Extremadura, una de las comunidades que salen peor paradas, “el riesgo de ceguera es el doble de la media”, resalta. Los extremeños también tendrían un 50% más de riesgo de sufrir problemas de visión que la media, señala la autora.

El estudio apunta a varios factores que podrían explicar las desigualdades observadas. Entre ellos, señala Rius, podrían estar las listas de espera sanitarias para las operaciones de cataratas, que son las más largas del país y las que tienen un mayor número de días de espera en España, según el trabajo.

La mayor prevalencia de la diabetes podría explicar la desigualdad registrada

Otra posible explicación es una brecha sanitaria más de nuestro país: la de la diabetes. En España esta dolencia está “asociada a niveles socioeconómicos más bajos y tiene más prevalencia entre mujeres y en las regiones del sur”, dice el estudio. La diabetes provoca lesiones en la vista, incluidas las cataratas. Por ello, la mayor prevalencia de la diabetes podría explicar la desigualdad registrada, más aún cuando esta enfermedad está también asociada a la dieta, que también registra importantes desigualdades dependiendo del nivel social y cultural de las personas.

Los extremeños tienen un 50% más de riesgo de sufrir problemas de visión que la media

En cuanto a la desigualdad de las mujeres, Rius explica: “desgraciadamente es habitual en todo el mundo que las mujeres padezcan mayores prevalencias de ceguera y discapacidad visual y curiosamente las diferencias de género se incrementan en países desarrollados”. “Nuestra hipótesis”, detalla “es que existe un sesgo de tratamiento, de que las tratan menos que a los hombres y de hecho hay bibliografía en España y en otros países desarrollados sobre este sesgo en otras patologías”.

Los autores reconocen dos limitaciones de su trabajo. En primer lugar el tipo de datos de la encuesta nacional, que elabora el Instituto Nacional de Estadística, no permiten observar la migración interna y los cambios poblacionales. Por otro lado, al tratarse de una encuesta, es posible que, por error, parte de la muestra incluya a personas cuyos problemas de vista son corregibles con gafas o lentes de contacto.

“El grupo de investigación en epidemiología que realiza este trabajo está vinculado a estructuras estables de investigación y tiene una  amplia trayectoria en el tema”, resalta Luis Fernández-Vega, presidente de la Sociedad Española de Oftalmología. “Deberíamos tener en cuenta estos datos para facilitar el acceso a los servicios médicos, para optimizar el tiempo para el diagnóstico y tratamiento, y para llevar a cabo campañas de educación sanitaria en oftalmología preventiva, como en cataratas,  diabetes o glaucoma”, añade.

Las clínicas privadas podrían generar más desigualdad

¿Un rico en Extremadura tiene más riesgo de sufrir problemas de vista o ceguera que un rico de Navarra? Es una pregunta que el estudio actual no puede responder, aunque sí ofrece reflexiones sobre estas posibilidades. El trabajo no ha podido analizar los niveles de renta individuales y la prevalencia de ceguera y discapacidades visuales. Lo más lógico es que las personas con dinero que tengan cataratas, por ejemplo, acudan a una clínica privada para operarse, argumenta el estudio. Y este comportamiento “crearía nuevas desigualdades relativas a la capacidad de pagar de cada individuo”, resalta el trabajo.

Fuente: Nuño Domínguez – www.esmateria.com

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