Long-term research has identified significant water contamination and associated poor health outcomes in the indigenous community of Alpuyeca, located in south-central Mexico. We set out to develop a popular education initiative in this community to improve water, sanitation and hygiene (WaSH) knowledge and practices. In order to avoid recreating hierarchical power dynamics in this vulnerable community, a participatory action research (PAR) design was used, wherein the community took leadership and facilitation roles in each stage of the research process.
View Article and Find Full Text PDFThe COVID-19 pandemic has disrupted the wellbeing of the general US population, but even more so among Latinx young adults. The current study provides a detailed picture of the emotional wellbeing and coping of Latinx young adults during the first summer of the pandemic. Six virtual focus groups (n = 21) were conducted between May and August of 2020 with a community-based sample of Latinx young adults to explore (1) how the pandemic affected wellbeing and (2) how they coped with pandemic-related stress.
View Article and Find Full Text PDFFor many Latinx young adults, COVID-19 has exposed exclusionary policies that heighten risk for contracting the virus and that leave them and their parents unprotected. This study has a dual purpose; first, to quantitatively examine immigration policy impacts of discrimination, isolation, threats to family, and vulnerability, and their association to economic consequences experienced by Latinx young adults in Central Texas during the initial months of the COVID-19 pandemic. Second, to qualitatively explore how policy impacts affected Latinx young adults during the pandemic, and the coping mechanisms they utilized to minimize these impacts.
View Article and Find Full Text PDFHealth of non-migrant paid domestic workers (PDWs) has seldom been studied. This review examines the relationship between being a non-migrant paid domestic worker and manifesting depressive symptoms (DS). Following a mixed-methods systematic review protocol, we found 10 relevant cross-sectional studies conducted in African, Asian, and Latin American countries.
View Article and Find Full Text PDFAmong the modifiable health behaviors, physical activity (PA) promotion has been one of the challenges in primary care, particularly how to translate the results of proven interventions and implement them in the real world. This study was aimed to compare whether two programs designed for hypertensive patients achieve changes in clinical and anthropometric variables, quality of life, and depressive symptoms; and if higher levels of adherence to one of the interventions using an exercise referral (ER) approach achieved better health outcomes. Pragmatic cluster randomized trials were carried out in four Primary Health Care Units (PHCUs).
View Article and Find Full Text PDFThe purpose of this study was to analyze occupational and personal stressors, mental health indicators, perceived discrimination and help-seeking behaviors among healthcare workers and providers (HCWPs) serving socially vulnerable groups such as immigrants, refugees, farmworkers, homeless individuals, people living in poverty, and other disadvantaged populations in the United States (U.S.) during the COVID-19 pandemic.
View Article and Find Full Text PDFBackground: Global health diplomacy (GHD) focuses on the actions taken by diverse stakeholders from different nations -governments, multilateral agents, and civil society- to phenomena that can affect population health and its determinants beyond national borders. Although the literature on conceptual advancements of GHD exists, empirical studies about how health becomes an issue of relevance for foreign policy are scarce. We present an analysis of the entry processes of health into the foreign policy and diplomatic domains in Mexico from the perspective of key informants of three different sectors.
View Article and Find Full Text PDFSince the end of the Cold War, health has gone from a peripheral concern in foreign policy negotiations to a prominent place on the global political agenda. While the rise of health onto the foreign policy agenda is by now old news, the driving forces behind its expansion into new political spheres remain understudied and undertheorized. This article builds on empirical findings from a four-country study of the integration of health into foreign policy, and proposes a conceptual approach to GHD to improve understanding of the conditions under which health is successfully positioned on the foreign policy agenda.
View Article and Find Full Text PDFAmong the strategies developed thus far for promoting physical activity (PA), exercise-referral schemes (ERs) have gained in popularity as an effective means of preventing secondary health conditions such as hypertension. However, information on the factors affecting adherence to these programs is limited. Using a mixed-methods approach, we undertook the present study to determine the factors associated with adherence to a specific ER aimed at increasing PA among the hypertensive patients in a Social Security institution in Mexico.
View Article and Find Full Text PDFEffective management of a pandemic due to a respiratory virus requires public health capacity for a coordinated response for mandatory restrictions, large-scale testing to identify infected individuals, capacity to isolate infected cases and track and test contacts, and health services for those infected who require hospitalization. Because of contextual and socioeconomic factors, it has been hard for Latin America to confront this epidemic. In this article, we discuss the context and the initial responses of eight selected Latin American countries, including similarities and differences in public health, economic, and fiscal measures, and provide reflections on what worked and what did not work and what to expect moving forward.
View Article and Find Full Text PDFHealth inequities across the Americas are avoidable and unjust yet continue to persist. Systemic social determinants of health, which could be addressed at the policy level, are root causes of many inequities and prevent marginalized individuals and at-risk populations from reaching optimal health and well-being. In this article, we describe our approach to promote health equity through the intersectoral partnerships that were forged, and strategies that were shared, during the convening entitled "Summit 2017: Health Equity in the Americas" and the resulting emergence of the Health Equity Network of the Americas (HENA).
View Article and Find Full Text PDFBackground: Promotion of biomedical research along with the development of evidence-based prevention policies have been suggested as an effective way to reduce environmental risks for children's health in Latin America. However, there is little information on the current state of childhood environmental health research, which might help identify its strengths and limitations, as well as to design a strategy to improve the future of child environmental health research in the region.
Objective: To describe the current state of environmental health research on children exposed to environmental pollutants in Latin America.
Good governance practices are crucial for advancing research for health in LAC countries, argue
View Article and Find Full Text PDFBackground: The Mexican health system segments access and right to healthcare according to worker position in the labour market. In this contribution we analyse how access and continuity of healthcare gets interrupted by employment turnover in the labour market, including its formal and informal sectors, as experienced by affiliates to the Mexican Institute of Social Security (IMSS) at national level, and of workers with type 2 diabetes (T2DM) in Mexico City.
Methods: Using data from the National Employment and Occupation Survey, 2014, and from IMSS electronic medical records for workers in Mexico City, we estimated annual employment turnover rates to measure the loss of healthcare access due to labour market dynamics.
Objectives: The Mexican Institute of Social Security (IMSS) provides a package of health, economic and social benefits to workers employed in private firms within the formal labour market and to their economic dependants. Affiliates have a right to these benefits only while they remain contracted, thus posing a risk for the continuity of healthcare. This study evaluates the association between the time (in days) without the right to healthcare due to job loss in the formal labour market and the quality of healthcare and clinical outcomes among IMSS affiliates with Type 2 diabetes mellitus (T2DM).
View Article and Find Full Text PDFIntroduction: The effectiveness of clinical-community linkages for promotion of physical activity (PA) has not been explored in low- and middle-income countries. This study assessed the effectiveness of a primary care-based, 16-week intervention rooted in behavioral theory approaches to increase compliance with aerobic PA recommendations.
Study Design: Pragmatic cluster randomized trial.
Background: Almost seven years after the publication of the final report of the World Health Organization's Commission on Social Determinants of Health (CSDH), its third recommendation has not been attended to properly. Measuring health inequities (HI) within countries and globally, in order to develop and evaluate evidence-based policies and actions aimed at the social determinants of health (SDH), is still a pending task in most low and middle income countries (LMIC) in the Latin American region. In this paper we discuss methodological and conceptual issues to measure HI in LMIC and suggest a three-stage methodology for the creation of observatories on health inequities (OHI) and social determinants of health, based on the experience of the Brazilian Observatory on Health Inequities (BOHI) that has been successfully operating since 2010 at the Fundação Oswaldo Cruz (FIOCRUZ).
View Article and Find Full Text PDFBackground: It is desirable that health researchers have the ability to conduct research on health equity and contribute to the development of their national health system and policymaking processes. However, in low- and middle-income countries (LMICs), there is a limited capacity to conduct this type of research due to reasons mostly associated with the status of national (health) research systems. Building sustainable research capacity in LMICs through the triangulation of South-North-South (S-N-S) collaborative networks seems to be an effective way to maximize limited national resources to strengthen these capacities.
View Article and Find Full Text PDFObjective: To estimate the prevalence of frailty in a sample of rural elderly living in socially vulnerable circumstances as well as to determine its correlates.
Method: Cross-sectional study of 558 rural elderly participating in a prospective study conducted in Mexico. Frailty was defined using the Fried criteria.
Rev Panam Salud Publica
December 2014
Objective: Understand and analyze procedures used to create national integrated research agendas from 2007 to 2011 in Argentina, Guatemala, Mexico, Panama, and Paraguay.
Methods: Descriptive, cross-sectional study using an online survey of agenda preparation processes; specifically, development, integration, implementation, and use and dissemination of the agenda.
Results: The 45 respondents reported following specific methodologies for agenda construction and had a good opinion of organizational aspects with regard to prior information provided and balance among disciplines and stakeholders.
Salud Publica Mex
December 2016
Objective: To examine the research on social determinants of health (SDH) produced in Mexico during the period 2005-2012, based on the characterization of the national health research system and the scientific production on this topic.
Materials And Methods: Two-stage analyses: Review of Mexican documents and official sources on health research and systematic bibliographic review of the literature on SDH.
Results: Although SDH were mentioned in the Specific Action Plan for Health Research 2007-2012, they are not implemented in strategies and goals, as the emphasis is put mostly in infrastructure and administrative aspects of research.
Objectives: The purpose of this study was to explore in rural communities of Mexico, the association between physical activity (PA) in school-age children and exposure to migration.
Methods: We measured PA through a questionnaire validated in school-age children and used in Mexican National Surveys. Migration status was measured as the number of years a family member had been in the US, and the amount of remittances that family member had sent to their household in Mexico.
Health vulnerability refers to a lack of protection for specific population groups with specific health problems, as well as the disadvantages they face in solving them in comparison with other population groups. This major public health problem has multiple and diverse causes, including a shortage of trained health care personnel and the lack of family, social, economic, and institutional support in obtaining care and minimizing health risks. Health vulnerability is a dynamic condition arising from the confluence of multiple social determinants.
View Article and Find Full Text PDFObjective: To describe the socioeconomic and demographic characteristics of households in the Mixteca Baja and analyze differences in affiliation with health care programs and utilization, among members of households with migrants (HogMig) and without migrants (HogNoMig) to the United States.
Material And Methods: A cross-sectional, descriptive survey was used with heads of households in a representative sample from the Mixteca Baja of 702 homes with and without migrants to the US.
Results: Members of HogMig had more personal and economic resources than those of HogNoMig; they also regularly received remittances.
Background: The emigration of Mexicans to the USA has increased in the last decades, and little is known about the effect of this on the mental health of those who stay behind.
Aims: To evaluate the association of emigration of husband and depressive symptoms (DS) among women who stay in Mexico. We also tested the hypothesis that the husband's migration would increase the woman's autonomy, which in turn would decrease DS.