Revista Española de Comunicación en Salud
The Spanish Journal of Health Communication is a publication edited by the Spanish Association of Health Communication (AECS) and the Madrid University Carlos III , Spain. The journal will consider manuscripts for review related to Health Communication in any of its fields, aiming to disseminate and improve health communication in today's society, positioning itself as the scientific journal of health communication in Spanish. It is published every six months in open access electronic format and its reference languages are Spanish, Portuguese, English and Italian. Articles may be submitted in any of these languages.
UC3M MediaLab y Asociación Española de Comunicación Sanitaria
All articles published in this journal –unless otherwise stated- are distributed under the terms of the Creative Commons Attribution-NoDerives (CC-BY-ND 3.0 ES) Spain 3.0 License, which allows others to copy, distribute and transmit in a public way as long as they credit the author(s), journal and institution that publish these articles, and provided that they are not altered or modified. The complete license can be consulted in: https://creativecommons.org/licenses/by/3.0/es/deed/.es The copyright belongs to the manuscript’s author just on the basis of creating this work: Moral rights are undeniable and inalienable. Economic or exploitation rights can be transferred to third parties, as it occurs when articles are published and authors partially or totally transfer their exploitation rights to publishers Authors can archive their own articles in an institutional repository as long as their publications are cited in this journal.
Risk Communication in Global Emerging Health Crises
Copyright (c) 2026 Daniel Catalán-Matamoros https://creativecommons.org/licenses/by-nd/3.0/es/deed.es
Introduction: Virtual technologies offer an alternative for Comprehensive Sexuality Education (CSE) and sexual health prevention, although their reach among excluded groups such as the LGTBIQ+ community remains limited. The post-pandemic period revealed that digital communication is a viable alternative for health promotion. Objective: This study designed and implemented a multimedia digital campaign to prevent STIs in this population in the southern-macrozone of Chile, using a participatory methodology that incorporates interdisciplinarity and social media. Methodology: A participatory methodology was used involving activists and experts. A shared script was created between activists and researchers, supported by professionals from various disciplines.Results: Two audiovisual capsules were created with a non-heteronormative approach, inclusive language, and a gender perspective, combining animation and real people. Dissemination occurred through social media (Instagram), digital platforms, posters, and infographics distributed via partnerships with ONGs in key spaces (educational centers, public offices, among others), including QR codes. Conclusion: It is concluded that these campaigns are effective when they include inclusive content and social actors who contribute a territorial perspective and strategic alliances.
Copyright (c) 2026 Cynthia Vergara-Maldonado, Laurita Morales, Patricia Águila, JR. Urdaneta Machado https://creativecommons.org/licenses/by-nd/3.0/es/deed.es
Design and validation of an Animated Character for Healthy Food Promotion in Mexican Schoolchildren
Introduction: The food environment in Mexico promotes the consumption of unhealthy foods, with advertising characters being a common resource used by the food industry to encourage the consumption of ultra-processed among children. However, their effectiveness suggests potential for repurposing them into educational tools to promote healthy eating habits. The objective of this study was to design and validate an animated character to promote healthy foods among schoolaged children. Methodology: A descriptive-analytical cross-sectional study with 70 children aged 6–12 years, carried out in two phases: 1) design and 2) validation of the animated character. Population validation was measured using a Likert scale (appearance) and a Stapel scale (attitudes and emotions), with a criterion of ≥4 considered acceptable. Informed consent was obtained from parents and assent from the children. Results: Acceptance of the character was positive (4.0, SD: 0.86; “I like it”). The highest-rated attributes were “Intelligent” (μ: 4.18, SD: 1.26), “Friendly” (μ: 4.14, SD: 1.37), “Fun” (μ: 4.09, SD: 1.18), and “Trustworthy” (μ: 4.06, SD: 1.21), with no differences across school grades. Conclusions: The animated character met the validation criteria, demonstrating favorable acceptance in appearance and positive attributes, confirming its potential use as an educational tool to promote healthy eating habits.
Copyright (c) 2026 Anaid Guadalupe Martín-Díaz, Virginia Gabriela Aguilera-Cervantes, Fatima Ezzahra Housni, Patricia Núñez-Gómez, Yolanda Campos-Uscanga, Nora Edith Rangel-Bernal https://creativecommons.org/licenses/by-nd/3.0/es/deed.es
Hospital external communication management during covid-19 in Spain
Introduction: The COVID-19 pandemic has positioned healthcare centers as key benchmarks not only for medical care but also for communication. Objectives: To gain an in-depth understanding of the experiences and perceptions of CCOs (Chief Communication Officers) regarding the hospital response in both care and communication during the COVID-19 pandemic in Spain, in order to identify strengths, weaknesses, and recommendations related to resources, information management, and communicative practices toward the public. Methodology: A qualitative method was employed, based on eight descriptive and conclusive in-depth interviews (11/2022–12/2024) conducted in public hospitals across five Autonomous Communities. Results: Key findings highlight the learning process and the strengthening of coordination under the umbrella of Regional Health Departments. A notable alignment was found between institutional information and media coverage. Conclusions: Communication management is recognized for conveying information to the population in a professional, ethical, and pedagogical manner, collaborating with reputable media outlets and authorities to control panic and misinformation (fake news).
Copyright (c) 2026 Carmen Peñafiel Saiz, Milagros Ronco López https://creativecommons.org/licenses/by-nd/3.0/es/deed.es
Topic Analysis During Public Health Crises
Introduction: This study examines the evolution of thematic frameworks in Mexican media coverage of COVID-19 vac cines between 2020 and 2021, given that media narratives shape public perception and institutional trust during health crises. Objectives: The research aims to identify and analyze the dominant themes in COVID-19 vaccine coverage in Mexico and track their temporal evolution. Methodology: A corpus of 43.358 articles from major national newspapers in Mexico was analyzed. Using Latent Dirichlet Allocation (LDA), a topic modeling technique from Natural Language Processing, news content was categorized quarterly to map thematic developments over time. Results: Five key topics were identified: global health and economic crisis, international relations, pandemic management at the state level, institutional responses to social groups, and national public health policy. Findings show a clear progression from global crisis frames to more localized policy discussions. Conclusion: The study highlights how media coverage evolves in response to social and epidemiological changes, providing insights for designing timely, culturally appropriate health communication strate gies.
Copyright (c) 2026 Erick Cruz-Mendoza, Oscar Fontanelli Espinosa https://creativecommons.org/licenses/by-nd/3.0/es/deed.es
Introduction: This study analyses media coverage of obesity in the Spanish press from a visual perspective, examining not only how obesity is framed as an epidemic but also how bodies associated with this issue are represented in two periods (2000–2005 and 2015–2020). Methodology: A content analysis was conducted on a sample of 149 news items published in the Spanish press across both periods. The study coded the characteristics of individuals depicted in images, considering gender, age, body type and associated activities. Results: Findings indicate that while the first period shows a balanced representation of men and women, the second period features a higher presence of men, particularly adult men. Although some progress in visual diversity is observed, imagery remains largely stigmatising, especially due to the persistence of the “headless fatty” trope. A paradoxical pattern also emerges: activities linked to negative stereotypes about fatness are more frequently portrayed through normal-weight bodies than fat bodies. Conclusions: Visual coverage functions not merely as illustration but as a normative device reproducing stereotypes and reinforcing stigmatising discourses about body, health and individual responsibility.
Copyright (c) 2026 Lara Martín Vicario, Javier Bustos Díaz, Marta Gil Ibáñez https://creativecommons.org/licenses/by-nd/3.0/es/deed.es
Introduction: Contributing to research on the quality of news content in the face of a health emergency from a psychosocial perspective is what drives this study to focus on determining the accuracy of COVID-19 information shared via WhatsApp. Objective: To determine whether the quality of information differs between true and false messages about COVID-19 shared via WhatsApp to university students. Methodology: A systematic review of information quality studies was conducted. Subsequently, the Electronic Media Information Quality Scale (EMIQS) was pilot tested. Finally, EMIQS was administered, using a non-experimental, cross-sectional design with a correlational level. Results: There are significant differences between the dimensions of information quality such as source, relevance, credibility, intelligibility and originality; however, differences between the groups of subjects observed are minimal, which indicates that the true message and the false message are evaluated as similar. Conclusion: A message can be constructed with textual and visual elements that can give the impression of being credible, regardless of the falseness or truth of the content, which affects the decision of individuals on how the message should be valued.
Copyright (c) 2026 Ennio Héctor Carro Pérez, Alejandro Josafat Pólito de los Reyes, Arturo Secundino Hernández Gómez, Oscar Eliezer Mendoza de los Santos, Juan Gilberto Silva Treviño https://creativecommons.org/licenses/by-nd/3.0/es/deed.es
Health misinformation and recommendation algorithms
The development of digital platforms and social media has profoundly transformed the way in which the public accesses health-related information. In this context, algorithmic recommendation systems play a decisive role in the selection, prioritisation and dissemination of health content. This article analyses how these systems may facilitate the spread of health misinformation and affect media pluralism in Spain during the period 2020–2025. Based on a conceptual and regulatory review, it examines the tensions between algorithmic transparency, freedom of expression and the protection of public health. It also analyses how these dynamics fit within the Spanish and European legal frameworks, paying particular attention to new digital regulations. Finally, it proposes criteria for transparency, auditing and institutional cooperation aimed at reducing the risks associated with health misinformation in digital environments.
Copyright (c) 2026 Miguel Cembellín Fernández https://creativecommons.org/licenses/by-nd/3.0/es/deed.es
Journalistic Coverage of Blood Collection and Transfusion Services in European Countries
Objective: This article identified and characterized the news about blood and hemotherapy services, according to the components of the health services system, published in the main widely circulated newspapers in Malta and France. Methodology: The study was based on the 2022 publications of the Times of Malta and Le Monde, and the corpus of analysis consisted of 69 news items. Results: The results pointed to: the population - blood donors and the public in need of transfusions; the need for infrastructure - technologies and knowledge - to organize and operate the services. The distribution and layout of services was informative. With regard to management and regulation, there was a predominance of updates on blood donation criteria, regardless of the applicant’s sexual orientation. Safety and hemovigilance were cross-cutting aspects, in addition to rare content on financing. Conclusion: It can be concluded that the media are important for expanding knowledge, positioning and contributing to changing attitudes on various subjects, constituting a possibility for the elaboration of a corpus for the development of studies, analysis and theoretical reflection on health topics, highlighted here on the organization and operation of blood collection and transfusion services.
Copyright (c) 2025 Revista Española de Comunicación en Salud
Fifteen years of growth, progress, and international reach
Communicative Competencies in Nursing Education
Introduction: Communication competencies are essential for ensuring quality healthcare and fostering effective collaborative practice. Objective: To analyze the inclusion of communication competencies in the Nursing Degree curricula of public and private universities in Spain. Methodology: A documentary review was conducted to identify mandatory communication-related courses and to examine the competencies included. Data were obtained from institutional websites and the Registry of Universities, Centers, and Degrees (RUCT) of the Spanish Ministry of Universities. Results: A total of 38 mandatory courses were identified across 61 universities, showing variability in titles and characteristics. Most courses (n=29) accounted for 6 European Credit Transfer and Accumulation System (ECTS). Discrepancies were observed between the integration and classification of competencies in university programs and the RUCT. Conclusion: The study highlights a lack of uniformity in the classification of communication competencies between university curricula and the RUCT. Differences between official records and academic programs underscore the need to improve coherence and standardization in the provision of communication competencies, which are critical for the quality of nursing education and patient care.
O Exploring Health Literacy Perspectives Among Portuguese Community Pharmacists
Introduction: HL is a broad concept that encompasses the knowledge, motivation and skills to access, understand, evaluate and apply health information and is a critical element for patient autonomy and improved outcomes in healthcare systems. Objectives: This study aims to explore Portuguese community pharmacists' perspectives on health literacy (HL) and their role in improving it in patients. HL is becoming an even more relevant issue nowadays, as health systems are under increasing pressure due to longevity, lifestyles and environmental changes leading to new diseases. Methodology: A survey of 394 pharmacists across Portugal found that 96.95% recognise the importance of assessing patients' HL. Results: The majority of pharmacists use a variety of techniques, such as screening questions and the teach-back method, to measure HL levels and adapt their communication. This is a key element in influencing patients' health behaviour and improving their knowledge of their own health. Pharmacists also actively promote positive health behaviours and medication adherence, especially for non-communicable diseases. The findings underline the key role of pharmacists in improving HL, thereby contributing to better health outcomes and the sustainability of health systems.
Science-related conversations during family visits to a health exhibition at the Fiocruz Museum of Life (Rio de Janeiro/RJ)
Introduction: In this article, we investigate science-related conversations that took place during family visits to the exhibition “Aedes: What Mosquito Is This?” at the Museu da Vida Fiocruz (Rio de Janeiro/RJ/Brazil). Objectives: To analyze group dynamics within these conversations; identify strategies used by adult family members to promote children’s learning; reflect on the potential and challenges for children’s engagement and health learning during the visits. Methodology: Interactions during the visits were recorded using a GoPro camera attached to the chest of one child from each group. Science-related conversations considered complex were qualitatively analyzed. Family dynamics were identified through analysis categories that emerged from the data. Results: Adult visitors played an active and leading role, seeking to promote children’s learning through various strategies, with explanations given by adults to children being predominant. Identifications and associations with everyday life and prior experiences were also recurrent, mainly in the form of accounts of experiences with diseases, which proved fruitful for engagement and learning. Conclusion: The visit to the exhibition enabled health-related learning.
Tayana Galvão Scheiffer de Paula Antunes
School Violence and Mental Health in Chilean Digital Media Post-COVID-19
Introduction: According to the National Institute for Human Rights, in the first half of 2022, following the end of the Covid-19 pandemic, 1,700 more reports of school violence were recorded in the first half of 2022 compared to the previous two years and media coverage of violent crime has increased significantly. Objectives: to identify -under the model of Subjective Theories (ST)- those aspects present in the media discourse related to the causes, intervening conditions and strategies for dealing with school violence after the return to face-to-face attendance in Chilean educational establishments. This violence, exacerbated in the post-pandemic context, has a negative impact on the mental health of students, which makes it a relevant phenomenon for public health policies. Methodology: a comparative content analysis of the publications of SoyChile.cl and El Mostrador.cl during the last month of classes in 2022 was carried out. Results: both media explained the phenomenon as ‘a structural problem’, distancing diagnosis and treatment from the actors directly involved. Conclusion: school violence is considered an unavoidable and unapproachable reality, factors that exempt caregivers, teachers, principals, authorities and students who could eventually take an active part in the prevention or solution of the phenomenon from responsibility.
Fabiana Carola Rodríguez-Pastene Vicencio
Influencers, brands and sexual health promotion
Introduction: This research explores the case of Durex Spain’s branded content strategy on TikTok, specifically through its sexual advice series “Hay tema.” This project has been recognized and awarded at the TikTok Awards Spain (2022), Inspirational Awards (2023), BCMA Spain Awards (2023), and National Marketing Awards (2024). Objectives: The study aims to analyze the profile and characteristics of the influencers involved, their impact in terms of engagement, and the content formats used. Methodology: A quantitative-qualitative methodological triangulation has been adopted, combining content analysis with in-depth interviews. Results: The findings indicate that the reach and interaction of the content are not influenced by the influencer’s gender or their original audience, but rather by the interest generated by the topic of each post. Additionally, Durex demonstrates an adaptation to common content types and narratives on the platform, such as explanatory videos, video podcasts, and street interviews. Conclusion: The conclusions emphasize the importance for brands with educational goals to adapt their digital strategies to the preferences of younger generations. This involves adopting an accessible tone and popular formats that integrate infotainment and credibility.
Design and pilot testing of an educational strategy based on behavioral and communication models within Mutual Aid Groups to improve the lifestyle of people living with type 2 diabetes in Mexico
Abstract Introduction: Mutual Aid Groups (MAGs) are essential for the self-care of people living with type 2 diabetes (PLD) in Mexico. However, they have areas for improvement, particularly in communication between healthcare providers and PLD. Objective: To design and pilot a Healthy Living Educational Strategy for PLD (HLED) and evaluate its impact on their lifestyle. Methodology: The HLED was implemented in two MAGs (urban and rural) in Cuernavaca, Morelos. It was based on behavioral models and structured on the Multimedia Training Methodology, grounded in the Theoretical Model of Communication for Development and the Participatory Communication Model. The strategy included four monthly theoretical-practical workshops. Pre- and post-tests were conducted using the Validated Instrument to Measure the Lifestyle of PLD, generating a lifestyle index (0–100; higher scores indicate healthier lifestyles). Multiple regression models were used to evaluate the impact. Results: The study included 19 women and 4 men (mean age: 56.2 ± 10 years). Participants attending all workshops scored 34.04 points higher on the lifestyle index compared to those attending only one workshop (95% CI: 20.77, 47.31; p<0.01). Conclusion: The HLED shows potential to improve the lifestyle of PLD in MAGs.
Instagram and its influence on the mental health of young people in Extremadura
Introduction: The arrival of social networks today has caused the way we communicate, entertain and inform ourselves to evolve and, although they can provide multiple advantages, they can also be harmful, especially to the mental health of young people. Objective: To analyze the behavior and habits of young people from Extremadura on the Instagram platform, in order to understand its correlation with mental health. Methodology: A survey was administered covering four dimensions: socio-demographic profile; knowledge and usage of social media; usage and influence; and mental health and harmful habits. A total of 103 responses were collected from young people aged between 12 and 30 years. Results: It is noteworthy that young people from Extremadura are not fully informed about the risks that SM can pose, limiting their ability to recognize and address symptoms and negative consequences. Conclusion: It is vital to promote comprehensive digital education aimed at children, adolescents, and young adults, fostering the adoption of healthy practices and habits online.
Introduction: Podcasting has emerged as an easily accessible and user-friendly educational resource, utilized by educators to enhance the delivery of knowledge and academic content. Objectives: Analyze the use of a collection of podcasts - Xpódcast - in nursing degree teaching through students' consumption patterns and the satisfaction with this resource. Methodology: A cross-sectional descriptive study was conducted on a sample of 130 students who completed a questionnaire that included sociodemographic questions, inquiries about podcast playback, and the Educational Podcast Satisfaction Questionnaire (SSEPQ). Results: The results showed that, overall, students were highly satisfied with the implementation of Xpódcast in the course (35.94 points on the SSEPQ scale), with all items rated above 3.4 points on average. There were gender differences regarding the location (p=0,042) and time of day (p=0.039) chosen by men and women for podcast playback. Conclusion: The evidence obtained positions podcasting as an effective academic tool for knowledge transmission. Its use and ubiquity facilitate the reinforcement of educational content that is taught in traditional classroom settings.
Public communication in the Region of Madrid about health and climate change
Introduction: To develop awareness among citizens on the deep relationship between socioeconomical model, climate change and health is a key element in tackling effective environmental and health policies. Objectives: This study plans to analyse if the communication policies address to the citizenship by the regional government of Madrid incorporate the deep interlinkage between socioeconomical model, climate change and health. Methodology: For that purpose, this work mainly focuses on the analysis of the discourses transmitted through the webpages belonging to the competent bodies in Health, Environment and Consumption. Results: The research performed reveals that the regional government of Madrid do not offer a frame that attends to the anthropogenic origin of climate change and its impact in the human health and introduce basically adaptation and mitigation solutions mainly based in individual action and responsibility. Conclusion: It is urgent, that government institutions offer to the citizenship a more holistic and transformative frame that integrate clime change in a public health context.
Introduction: Developing competencies for mental health care communication in media is fundamental, and Protection Motivation Theory (PMT) provides a model to guide the design of communicative interventions. Objective: To evaluate the effectiveness of training to improve communicators competencies in designing effective strategies for mental health care in Colombian rural populations. Methodology: A convergent mixed methods study was conducted, integrating quantitative data (pre- and post-intervention questionnaires) and qualitative data (participant observation and follow-up focus group). Results: A statistically significant increase in the evaluated competencies was evidenced (from 4.6 to 7.5 points, p<0.001). The workshop enabled participants to experience the effectiveness of balancing threat and coping appraisals and to propose strategies for applying these guidelines in strategy design. The focus group confirmed that the practical-collaborative approach and adult education techniques were crucial for facilitating meaningful appropriation, although theoretical concept recall was limited. Conclusion: The training proved to be an effective strategy for improving competencies in designing communicative interventions to promote the adoption of mental health care behaviors, balancing threat appraisal with coping resources.
Implications of the COVID-19 infodemic for scientific communication and diffusion
Introduction: The COVID-19 infodemic complicated public adherence to public health measures during the pandemic and required strategies to improve communication and scientific dissemination. Objective: To review the literature on the implications of the infodemic for communication and scientific dissemination. Methodology: An integrative review was conducted based on a systematic search in the MEDLINE/PubMed, Scielo, Scopus, and Web of Science (WoS) databases between March and April 2024. A total of 62 articles were selected for analysis. Results: The articles were grouped into three main themes: (1) The impact of the COVID-19 pandemic on scientific communication; (2) Infodemic control; and (3) Communication and scientific dissemination practices. Discussion: The widespread use of social media intensified communication and scientific dissemination but also amplified the spread of misinformation, requiring strategies for information control and greater collaboration among scientists, media, and government organizations. Scientific literacy and community engagement with science were widely recommended. Conclusion: It is essential to preserve the integrity of science and promote open dialogue between scientists and the public to improve trust and understanding of science.
Building Credible Brands through Corporate Websites
Introduction: Hospitals manage their websites to reinforce their relationships with stakeholders and build the brand collectively with them. Objective: This paper aims to analyze how French hospitals use their websites to share content that reinforces relationships with stakeholders and promotes their brands. Methodology: We conducted a literature review of hospitals’ corporate communication initiatives, branding efforts, and online branding initiatives. Then, we defined 40 brand indicators to quantitatively analyze how France’s 100 best hospitals managed their corporate websites to interact with healthcare professionals, patients, media companies, and shareholders. Results: Our results proved that most hospitals had a section for healthcare professionals (61,62%), patients (96,97%), media companies (98,99%), and shareholders (100%); however, they only respected, on average, 12,39 brand indicators out of 40 applicable. Conclusion: We concluded that most French hospitals used their websites to share administrative information, not to promote their healthcare professionals' brand value or to establish an emotional connection with patients.
Digital Identity and Content Communication of Well-being Influencers from Hispanic America
Introduction: The post-pandemic health crisis has amplified the pursuit of physical and mental well-being. Within this context, influencers have become significant figures in the dissemination of emotional wellness content, influencing perceptions and promoting self-care practices. Objectives: This study investigates the digital identity and communication strategies employed by Spanish-speaking influencers specializing in emotional and spiritual well-being on Instagram. Specifically, it examines their digital identity, engagement metrics, publication objectives, thematic content, and resource utilization. Methodology: A quantitative content analysis was performed on 300 Instagram posts from 15 influencers, categorized into three distinct currents: academic (psychology, psychoanalysis, philosophy), non-academic (new age, holistic approaches, coaching), and religious/wisdom traditions (Eastern, Western, and ancestral). Results: The findings reveal that a majority of influencers possess verified accounts and use transmedia communication reach more audience. Despite substantial follower counts, engagement levels are predominantly low to moderate. Content primarily centers on reflective insights, practical advice, and self-promotional material.Influencers prioritize accessible and motivational resources, such as inspirational quotes, captions, and music, over more complex visual formats for message delivery. Conclusions: Wellness influencers mold perceptions of emotional health by employing accessible communication strategies and marketable lifestyle narratives.
New paradigms for conducting content analysis in health-related information
Challenges of Primary Healthare and stakes of health communication
Primary Care (PC) has a prominent role in public health because it includes the whole of society and aims to ensure the highest possible level of health and well-being. The Member States of the European Union are committed to renewing and expanding PC as the cornerstone of a sustainable health system to achieve Universal Health. Objectives. To show the values of PA as the main interface between the health system and individuals and the main current gaps. PA can shape and reshape health systems to make them more accessible, more integrated and more sustainable. . A qualitative-documentary methodology of a criticalinterpretative nature was used to analyze the texts produced by the Institutions and Organizations, chosen by means of a systematic selective sampling based on a deliberate and intentional selection criterion for their perceived importance in the field of PA. Conclusions. The efficiency offered by PA and its potential to achieve the Sustainable Development Goals is still struggling with insufficient resources and quality PA requires time, collaboration, specialized training and investment in professionals.
At the core of the genome of Primary Care lies its vocation for universality and its rejection of the logic of the market. The purpose of the primary care is to solve the health need, even if not demanded, and protecting the patient from the excess of the medical activity. Countries with a strong PC achieve better health outcomes, greater equity and lower costs. However, for the last two decades, politicians have done practically nothing to empower and strengthen Spanish PC. To do this, they must reinforce their essential characteristics: accessibility, continuity, versatility and coordination. Gradually abandoned by the citizens with a higher level of education, income status and greater political and media influence (sociological skimming), our PC is further weakened thanks to the invaluable collaboration of politicians who, for many years, have been strangling its budget and offering to these influential citizens private health care alternatives, without PC, financed with public resources (“Mutualismo Administrativo”) or fiscally incentivized (private health insurance). It seems that Spanish politicians want a PC degenerated into charity for those who don't have other choices. Is it because many of them are part of those influential sectors of population?
More is not always better (in health services)
In the current Western societies there is a problem of variability in the use of healthcare services and products, without it being proven that greater use produces better health, but rather the opposite. We have a false idea that more is always better. Although it may seem counterintuitive, the truth is that prevention, for example, is not always better than cure. Early diagnosis is not always beneficial. Through the four specific situations analyzed throughout the article, it is clear that, currently, in health services, we have a double problem: access for marginalized populations and excess for the rest of the population. Finally, some proposals of “what to do” are provided to counteract the harmful effects of medical excesses and inequities in the provision of health care services. In this sense, the role of the general practitioner and primary care is vital for our universal health care system, because it is they who reach the most disadvantaged and marginalized groups, “defend” all their patients from overdiagnosis and overtreatment, and offer generalist, assertive, reflective clinical care that transforms the provision of health care.
The paradoxical strength of primary healthcare and the course of the National Health System
Health systems based on strong primary care are superior because they achieve more health at lower cost and with equity. Primary care in Spain has generally good indicators, but young physicians shy away from family medicine in primary care and there is a dissociation between private and social values: what is socially necessary is not individually attractive to many professionals. In recent years there have been multiple plans and strategies, at international, state and regional levels, to “save” primary care, and an intense debate, tinged with interests, in which the labor demands of workers are sometimes identified with social welfare. The main idea of the organizational changes is that every minute of professional contributes value, and that each professional works at the limit of his or her competencies. Some clear and exemplary signals can be very effective, such as improving economic and working conditions in primary care, the greater presence of family medicine in universities and the encouragement of research in primary care. The generational renewal of family physicians and the potential of digitalization to consolidate networks where rural professionals do not feel isolated are reasons for optimism.
Despite the immense strengths of Primary Care (PC) and Family and Community Medicine (FCM) as health investment strategies, there is a social invisibilization surrounding them. The invisibility of PC is basically due to: 1/ the invisibility of promotion and prevention, and of quaternary prevention; 2/ the hospital-centrism of teaching, care, management, politics, research and the media, and 3/ its “media invisibility”. These threats are analyzed, and solutions are proposed such as reversing the hospital-centrism teaching model, starting with the addition of FCM as a core element in medical schools; abandoning the terms primary care physician or general practitioner, since the official term has been family doctor since 1998; recognizing the work performed by PC teams and family doctors in their capacity to resolve the most prevalent health problems; adequately funding PC, improving human resource planning; enhancing the organization and internal management of PC teams; redirecting research towards biopsychosocial, community, digital aspects, etc. And commit to structuring external assessment and the role of the media.
This article explores the complex and often problematic relationships between the healthcare system and the pharmaceutical lobby, with a particular focus on the dynamics in primary care. It analyses how pharmaceutical multinationals exert their influence through lobbying activities, which, at a professional level, compromise transparency and independence in clinical decision-making. In healthcare systems, these practices include setting high prices, extending patents and using marketing strategies that can distort medical care, impacting both the sustainability of the National Health System (NHS) and the quality of care received by patients. Furthermore, the text highlights the fundamental role of Primary Care (PC) as a key pillar to counteract these influences. PC, with its patient-centred approach and evidence-based medicine, can act as a brake on commercial interests. In this context, the importance of transparent and responsible communication is underlined to ensure that medical decisions continue to prioritise public health. Finally, the article calls for reforms to promote transparency and safeguard the integrity of the health system.