http://hdl.handle.net/10498/6712 2026-09-21T17:18:36Z 2026-09-21T17:18:36Z Camacho García, María Serrano-Macias, M. Ortega Martín, María Esther Álvarez Gálvez, Javier http://hdl.handle.net/10498/39553 2026-05-09T04:04:13Z 2025-01-01T00:00:00Z

Drivers of health polarization during the COVID-19 pandemic: A systematic review Camacho García, María; Serrano-Macias, M.; Ortega Martín, María Esther; Álvarez Gálvez, Javier Health polarization has emerged as a critical factor shaping public health attitudes and behaviors, particularly during crises such as the COVID-19 pandemic. This study provides a systematic review of the key determinants driving health polarization, highlighting the complex interplay of political, social, economic, and psychological factors. By synthesizing findings from 90 studies, we identify six primary drivers: political ideology and partisanship, misinformation and disinformation, social media structures and dynamics, trust in health institutions and professionals, risk and public health perceptions, and socioeconomic factors. Our analysis reveals how these determinants reinforce societal divisions, exacerbate health inequalities, and influence adherence to public health measures. Furthermore, we discuss the implications of these findings for designing effective interventions that address the root causes of health polarization. Understanding the mechanisms underlying these divisions is essential for mitigating their negative impact on public health and fostering more cohesive, evidence-based health communication strategies.

2025-01-01T00:00:00Z Álvarez Gálvez, Javier Carretero Bravo, Jesús Ángel Lagares Franco, Carolina María Ramos Fiol, Begoña Ortega Martín, María Esther http://hdl.handle.net/10498/39552 2026-05-08T04:04:37Z 2025-11-21T00:00:00Z

Development of a Conceptual Framework of Health Misinformation During the COVID-19 Pandemic: Systematic Review of Reviews Álvarez Gálvez, Javier; Carretero Bravo, Jesús Ángel; Lagares Franco, Carolina María; Ramos Fiol, Begoña; Ortega Martín, María Esther Background: Despite the wide variety of studies that have focused on the recent COVID-19 infodemic, defining health misor disinformation remains a challenge due to the dynamic nature of the social media ecosystem and, in particular, the different terminologies from different fields of knowledge. Objective: In this work, we aim to develop a conceptual framework of health misinformation during pandemic contexts that will enable the establishment of an interoperable definition of this concept and consequently a better management of these problems in the future. Methods: We conducted a systematic review of reviews to develop a conceptual framework for health misinformation during the pandemic context as a case study. Results: This review comprises 51 reviews from which we developed a conceptual framework that integrates 6 key domains—sources, drivers, content, dissemination channels, target audiences, and health-related effects of mis- or disinformation—offering a structured approach to analyze and categorize health misinformation. These 6 domains collectively form the basis of our proposed conceptual framework. Conclusions: Our results highlight the complexity and multifaceted nature of health disinformation and underscore the need for a common language across disciplines addressing this global problem in order to use interoperable definitions and advance this evolving field of study. By offering a structured conceptual framework, we also provide a valuable foundation for interventions aimed at surveillance, public communication, and digital content moderation in future health emergencies.

2025-11-21T00:00:00Z Pérez Peña, María del Carmen Ruiz Chico, José Jiménez García, Mercedes Peña Sánchez, Antonio Rafael http://hdl.handle.net/10498/39530 2026-05-07T04:04:52Z 2026-11-01T00:00:00Z

The Economic Impact of Perceived Energy Poverty: A Population-level Analysis and its Relationship with the SDGs Pérez Peña, María del Carmen; Ruiz Chico, José; Jiménez García, Mercedes; Peña Sánchez, Antonio Rafael This study analyses perceived energy poverty in Jerez de la Frontera (Spain) during the first half of 2023 and examines its economic and social consequences at the population level. The main objective is to establish lines of improvement that can alleviate this situation and contribute to achieving the Sustainable Development Goals (SDGs), specifically SDGs 3, 7, 10 and 13, in the context of a knowledgebased economy and policy-driven knowledge mobilisation. To this end, 418 surveys were conducted among people in vulnerable situations and beneficiaries of social services. For this purpose, we used structural equation modelling (PLS-SEM) due to its effectiveness with small samples and complex latent relationships. The main findings show that a significant proportion of the population is unable to maintain an adequate temperature in their homes during winter or summer, has severe economic difficulties, and shows high levels of stress, anxiety and life dissatisfaction. The PLS results show that energy poverty impacts physical health, mental health, and social support, with the most potent effect on material deprivation. It also affects wellbeing negatively. Social variables and housing conditions influence energy poverty, highlighting its multidimensional nature. This work stands out for its pioneering and exploratory approach in a little-studied local context, contributing novel empirical evidence to the scientific literature. The study proposes integrated strategies promoting SDGs 3, 7, 10 and 13, demonstrating how knowledge guides socio-environmental challenges and inclusive development policies.

2026-11-01T00:00:00Z Atienza Montero, Pedro Hierro Recio, Luis Ángel Garzón Gordon, Antonio José http://hdl.handle.net/10498/39375 2026-04-24T23:06:18Z 2026-01-01T00:00:00Z

The effectiveness of pharmaceutical tenders as a cost containment mechanism: analysis through the Synthetic Control Method. The case of Andalusia (Spain) Atienza Montero, Pedro; Hierro Recio, Luis Ángel; Garzón Gordon, Antonio José Background: Outpatient pharmaceutical tenders are not a widespread measure. In Spain, the sub-central government of the Andalusian region is the only Spanish health administration to have applied them. Objective: This work aims to evaluate the effectiveness of this measure in reducing public pharmaceutical expenditure during the period it was in force –from June 2012 to December 2020. Methods: We use the Synthetic Control Method (SCM), which estimates a counterfactual (synthetic) value for our variable of interest (outpatient pharmaceutical expenditure per capita) based on a set of predictor variables from a combination of units from the potential control group (in this case, the rest of the regions in Spain). Results: The results of the SCM show no evidence that the pharmaceutical tender implemented in Andalusia reduced pharmaceutical spending. Statistical tests show that the null hypothesis of no differential effect of the measure on pharmaceutical spending during the period in which it was in force cannot be rejected. These results are robust to various robustness tests. Conclusions: Public tenders for outpatient pharmaceuticals in Andalusia did not prove effective as a mechanism for controlling public expenditure during the period it was in force and failed to lead to a reduction in expenditure when compared to the rest of the regions in Spain, which did not apply it.

2026-01-01T00:00:00Z