Results of lifestyle habits survey in Barcelona

A Lifestyle Habits Survey (LHS-SCOREwater) was developed by IERMB, with the support of ICRA and BCASA, to assess health habits, as well as the environmental behaviour of Barcelona citizens. The surveyed population included the citizens from the three neighbourhoods of Barcelona with different socio-economic status selected as study areas (el Carmel, Poblenou and Sant Gervasi).

Why this survey?

The aim of the survey was to compare its results with the analysis of wastewater-based epidemiology (WBE), so as to double validate the WBE study. Thus, the survey questionnaire included in its design validation questions matching the biomarkers analysed in wastewater samples from the three neighbourhoods monitored in Barcelona. Data regarding five main aspects was collected: 1) health status and risk factors (e.g., self-related health, physical activity, weight, smoking and alcohol behaviour), 2) diet quality (e.g., adherence to Mediterranean diet, caffeine consumption, vegetarianism), 3) adherence to medical therapy and intake of pharmaceuticals (e.g., analgesics, antihypertensives, sedatives, antibiotics), 4) household waste management (e.g., oils and greases, food waste, wet wipes and other single-use hygiene products), and 5) socio-economic status of inhabitants.

Description of the survey

The questionnaire was administered by IERMB and an external fieldwork company between June 21 – July 14, 2021. A total sample of 1,004 interviews were conducted: 354 in Carmel low socio-economic status area, 325 in Poblenou middle socio-economic status area, and 325 in Sant Gervasi high socio-economic status area. Sample design was made to be representative of the populations living within these three sewersheds of Barcelona. The questionnaire was conducted in a mixed format, through computer-assisted telephone interviews (CATI) (n = 776; 77.3%) and computer-assisted personal interviews (CAPI) (n = 228; 22.7%) to complete most difficult quotas per sampling area.

Main results of the survey

Results show differences between the populations of the three study areas in terms of health, health risk factors, and diet quality in the anticipated directions according to the area socio-economic status. For some variables, such as self-rated health and body mass index, it was also related to the personal socio-economic status. Antibiotics prescriptions were more frequent in the middle- and high-socio-economic areas of Poblenou and Sant Gervasi, where people also reported to have kept antibiotics leftovers and used them without prescription more often than the residents from the low-socio-economic status area of Carmel.

Regarding household waste management, single-use wet wipes were more frequently used in the low- and middle-socio-economic status areas of Carmel and Poblenou, respectively (see Figure 1). However, occasional inadequate disposal of those was more frequent in the high-socio-economic area of Sant Gervasi. Similarly, occasional inadequate disposal of waste cooking oil was more frequent in Sant Gervasi (high socio-economic status area), as well as in Poblenou (middle socio-economic status).

Next steps

Survey data and wastewater data will be analysed in tandem to compare and validate both results. The outputs of this comparative analysis will be disseminated in a scientific publication through a co-authored peer-reviewed article published in an international journal.