Why Spain wants income and sexual orientation added to medical records
Spain's Ministry of Health has proposed that extra personal information be included in medical records that isn't strictly medical, including sexuality, education levels, social class and income.
Spain's Ministry of Health has published a document proposing that digital health records include more personal information, including sexuality and income, among other characteristics, in order to provide a more holistic care model for patients.
The document, entitled 'Social and family contextual conditions advisable to include in the digital health record', is a report that Spain's regional authorities also participated in and is intended to help medical professionals build a fuller socioeconomic picture of patients.
This new 'bio-psychosocial' direction, Ministry sources say, is necessary to contextualise and better understand patient needs.
Migratory history, gender and sexual identity will likely be included, but health records could soon also include information on income level, employment status, educational level, social class and even a "poverty screening" in which patients are asked if they have had difficulties in making ends meet.
READ ALSO: Getting a medical certificate for Spanish residency: What you need to know
Though this was first published back in December, it has sparked political controversy more recently, around a month later.
Speaking to La Razón, Spain's opposition party Partido Popular (PP) secretary for Health, Ana Pastor, suggested adding this sort of personal information could go further than current legislation allows: "Medical records are regulated in our legal system by up to six different regulations, which includes the minimum set of data for clinical reports in the health system and regulates the individual health card, and none of them include what the government intends to do.”
However, the government document stresses a more holistic, socioeconomic approach to health is now necessary.
Considering "the social conditioning factors of a person and their family context" allows professionals, the text says, to "take into account the living conditions of the person when making a diagnosis, a recommendation, a follow-up or a proposal for management, care or community action, which should be agreed by consensus, involving people in making decisions about their own health."
READ ALSO: Spain to offer non-binary gender option on foreigners' residency cards
Currently, digital health records in Spain do not allow social and family contextual determinants to be recorded and updated in a simple way.
This has the several drawbacks, according to the study: it makes it difficult to properly understand social determinants and integrate them into care; it makes evaluating health outcomes in terms of social variables more difficult, which in turn can make identifying vulnerable groups more difficult; and it complicates adequate and more effective bio-psychosocial, family and community-based approaches to health for both individuals and communities.
Therefore, the government hopes to find consensus among the regions on a set of social and family context data to be included in digital health records.
The report proposes a number of personal details be included, including:
Gender: female, male and intersex or indeterminate.
Sexual orientation (according to the paper, "based on the European Commission's 2023 guide on the collection and use of data for LGBTIQ equality")
Migration history and origin.
Address, including a deprivation index according to census section and rural or urban area data.
Degrees of disability and dependency.
The paper also proposes social class data be included. This would include income level, in which "it would be advisable to include simple but sufficiently exhaustive income brackets to determine social class".
As such, current employment situation, level of education, occupation, and a poverty screening would also be included.
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Spain's Ministry of Health has published a document proposing that digital health records include more personal information, including sexuality and income, among other characteristics, in order to provide a more holistic care model for patients.
The document, entitled 'Social and family contextual conditions advisable to include in the digital health record', is a report that Spain's regional authorities also participated in and is intended to help medical professionals build a fuller socioeconomic picture of patients.
This new 'bio-psychosocial' direction, Ministry sources say, is necessary to contextualise and better understand patient needs.
Migratory history, gender and sexual identity will likely be included, but health records could soon also include information on income level, employment status, educational level, social class and even a "poverty screening" in which patients are asked if they have had difficulties in making ends meet.
READ ALSO: Getting a medical certificate for Spanish residency: What you need to know
Though this was first published back in December, it has sparked political controversy more recently, around a month later.
Speaking to La Razón, Spain's opposition party Partido Popular (PP) secretary for Health, Ana Pastor, suggested adding this sort of personal information could go further than current legislation allows: "Medical records are regulated in our legal system by up to six different regulations, which includes the minimum set of data for clinical reports in the health system and regulates the individual health card, and none of them include what the government intends to do.”
However, the government document stresses a more holistic, socioeconomic approach to health is now necessary.
Considering "the social conditioning factors of a person and their family context" allows professionals, the text says, to "take into account the living conditions of the person when making a diagnosis, a recommendation, a follow-up or a proposal for management, care or community action, which should be agreed by consensus, involving people in making decisions about their own health."
READ ALSO: Spain to offer non-binary gender option on foreigners' residency cards
Currently, digital health records in Spain do not allow social and family contextual determinants to be recorded and updated in a simple way.
This has the several drawbacks, according to the study: it makes it difficult to properly understand social determinants and integrate them into care; it makes evaluating health outcomes in terms of social variables more difficult, which in turn can make identifying vulnerable groups more difficult; and it complicates adequate and more effective bio-psychosocial, family and community-based approaches to health for both individuals and communities.
Therefore, the government hopes to find consensus among the regions on a set of social and family context data to be included in digital health records.
The report proposes a number of personal details be included, including:
Gender: female, male and intersex or indeterminate.
Sexual orientation (according to the paper, "based on the European Commission's 2023 guide on the collection and use of data for LGBTIQ equality")
Migration history and origin.
Address, including a deprivation index according to census section and rural or urban area data.
Degrees of disability and dependency.
The paper also proposes social class data be included. This would include income level, in which "it would be advisable to include simple but sufficiently exhaustive income brackets to determine social class".
As such, current employment situation, level of education, occupation, and a poverty screening would also be included.
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