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Background: Several studies in wealthy countries suggest that utilization of GP and hospital services, after adjusting for health care need, is equitable or pro-poor, whereas specialist care tends to favour the better off. Horizontal equity in these studies has not been evaluated appropriately, since the use of healthcare services is analysed without distinguishing between public and private services. The purpose of this study is to estimate the relation between socioeconomic position and health services use to determine whether the findings are compatible with the attainment of horizontal equity: equal use of public healthcare services for equal need.

Objective: To examine the associations between lifestyle factors and active commuting to school in Spanish adolescents. Design: Cross-sectional study. Lifestyle factors (overall/extracurricular physical activity, television viewing, reading as a hobby, sleep duration, breakfast/fruit intake, smoking and alcohol intake) as well as mode and duration of commuting to school were self-reported. Active commuters were defined as those adolescents who walked or cycled to school. Setting: Secondary schools in Madrid, Spain. Subjects: Adolescents (n 2029) aged 13 to 17 years. Results: Similar percentages of adolescent boys (57?6 %) and girls (56?1 %) were classified as active commuters to school (P 5 0?491). The analysis showed that only adequate sleep duration (OR 5 1?35, 95 % CI 1?11, 1?66; P 5 0?003) and breakfast consumption (OR 5 0?66, 95 % CI 0?49, 0?87; P 5 0?004) were independently associated with active commuting to school. Conclusions: Only those behaviours that occur immediately before commuting to school (sleep and breakfast) are associated with active commuting in Spanish adolescents.

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