Browsing by Author "Vives Vergara, Alejandra"

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    A Novel International Partnership for Actionable Evidence on Urban Health in Latin America: LAC-Urban Health and SALURBAL
    (2019) Diez Roux, Ana V.; Slesinski, S. Claire; Alazraqui, Marcio; Teixeira Caiaffa, Waleska; Frenz, Patricia; Jordán Fuch, Ricardo; Miranda, J. Jaime; Rodríguez, Daniel A.; Sarmiento Dueña, Olga L.; Siri, José; Vives Vergara, Alejandra
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    Assessing cohesion and diversity in the collaboration network of the SALURBAL project
    (2023) Baquero, Sofia; Montes, Felipe; Stankov, Ivana; Sarmiento, Olga L.; Medina, Pablo; Slesinski, S. Claire; Diez-Canseco, Francisco; Kroker-Lobos, Maria F.; Teixeira, Waleska; Vives Vergara, Alejandra; Alazraqui, Marcio; Barrientos-Gutierrez, Tonatiuh; Diez Roux, Ana V.; CEDEUS (Chile)
    The SALURBAL (Urban Health in Latin America) Project is an interdisciplinary multinational network aimed at generating and disseminating actionable evidence on the drivers of health in cities of Latin America. We conducted a temporal multilayer network analysis where we measured cohesion over time using network structural properties and assessed diversity within and between different project activities according to participant attributes. Between 2017 and 2020 the SALURBAL network comprised 395 participants across 26 countries, 23 disciplines, and 181 institutions. While the cohesion of the SALURBAL network fluctuated over time, overall, an increase was observed from the first to the last time point of our analysis (clustering coefficient increased [0.83-0.91] and shortest path decreased [1.70-1.68]). SALURBAL also exhibited balanced overall diversity within project activities (0.5-0.6) by designing activities for different purposes such as capacity building, team-building, research, and dissemination. The network's growth was facilitated by the creation of new diverse collaborations across a range of activities over time, while maintaining the diversity of existing collaborations (0.69-0.75 between activity diversity depending on the attribute). The SALURBAL experience can serve as an example for multinational research projects aiming to build cohesive networks while leveraging heterogeneity in countries, disciplines, career stage, and across sectors.
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    Association between maternity leave policies and postpartum depression: a systematic review
    (Springer, 2023) Hidalgo-Padilla, Liliana; Toyama, Mauricio; Hanae, Jessica; Tanaka, Zafra; Vives Vergara, Alejandra; Diez-Canseco, Francisco; CEDEUS (Chile)
    Purpose: Working mothers are at greater risk for postpartum depression. Maternity leave characteristics, including length, wage replacement and employment protection, could have relevant implications for mothers’ mental health. We propose to explore whether there is an association between maternity leave characteristics and postpartum depression. Methods: We conducted a systematic review searching for randomized controlled trials, quasi-experimental, cohort or cross-sectional studies on five databases using search terms including maternity and parental leave and depression, as well as references in relevant articles. We identified 500 articles and included 23 of those. We used the EPHPP Quality Assessment Tool for Quantitative Studies to assess the quality of the studies. Results: Paid and longer maternity leaves tend to be associated with a reduction of postpartum depression symptoms in high-income countries. No studies explored the association between employment protection and postpartum depression. The quality of studies ranged from strong to weak, mostly influenced by study design. Conclusion: More restrictive maternity leave policies tend to be associated with higher rates of postpartum depression, although more research needs to be conducted in the Global South.
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    Building a Data Platform for Cross-Country Urban Health Studies: the SALURBAL Study
    (2019) Diez Roux, Ana V.; Bilal, Usama; Moore, Karia; Ortigoza, Ana; Rodriguez, Daniel A.; Sarmiento, Olga; Frenz, Patriciae; Friche, Amélia Augustaf; Caiaffa, Waleska Teixeiraf; Vives, Alejandrag; Miranda, J. Jaimeh; Alazraqui, Marcio; Spinelli, Hugoi; Guevel, Carlosi; Di Cecco, Vanessai; Tisnés, Adelai; Leveau, Carlos; Santoro, Adrián; Vives Vergara, Alejandra
    Studies examining urban health and the environment must ensure comparability of measures across cities and countries. We describe a data platform and process that integrates health outcomes together with physical and social environment data to examine multilevel aspects of health across cities in 11 Latin American countries. We used two complementary sources to identify cities with 100,000 inhabitants as of 2010 in Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, and Peru. We defined cities in three ways: administratively, quantitatively from satellite imagery, and based on country-defined metropolitan areas. In addition to cities, we identified sub-city units and smaller neighborhoods within them using census hierarchies. Selected physical environment (e.g., urban form, air pollution and transport) and social environment (e.g., income, education, safety) data were compiled for cities, sub-city units, and neighborhoods whenever possible using a range of sources. Harmonized mortality and health survey data were linked to city and sub-city units. Finer georeferencing is underway. We identified 371 cities and 1436 sub-city units in the 11 countries. The median city population was 234,553 inhabitants (IQR 141,942; 500,398). The systematic organization of cities, the initial task of this platform, was accomplished and further ongoing developments include the harmonization of mortality and survey measures using available sources for between country comparisons. A range of physical and social environment indicators can be created using available data. The flexible multilevel data structure accommodates heterogeneity in the data available and allows for varied multilevel research questions related to the associations of physical and social environment variables with variability in health outcomes within and across cities. The creation of such data platforms holds great promise to support researching with greater granularity the field of urban health in Latin America as well as serving as a resource for the evaluation of policies oriented to improve the health and environmental sustainability of cities.
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    Comparación de dos métodos para corregir el sesgo de no respuesta a una encuesta: sustitución muestral y ajuste según propensión a responder
    (2009) Vives Vergara, Alejandra; Ferreccio Readi, Catterina; Marshall Rivera, Guillermo
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    COVID-19 and Precarious Employment: Consequences of the Evolving Crisis
    (SAGE Publications Inc., 2021) Matilla-Santander, Nuria; Ahonen, Emily; Albin, María; Baron, Sherry; Bolíbar, Mireia; Bosmans, Kim; Burström, Bo; Cuervo, Isabel; Davis, Letitia; Gunn, Virginia; Håkansta, Carin; Hemmingsson, Tomas; Hogstedt, Christer; Jonsson, Johanna; Julià, Mirei; Kjellberg, Katarina; Kreshpaj, Bertina; Lewchuk, Wayne; Muntaner, Carles; O’Campo, Patricia; Orellana, Cecilia; Östergren, Per-Olof; Padrosa, Eva; Ruiz, Marisol E.; Vanroelen, Christophe; Vignola, Emilia; Vives Vergara, Alejandra; Wegman, David H.; CEDEUS (Chile); Department de Salud Pública.Pontificia Universidad Católica de Chile
    The world of work is facing an ongoing pandemic and an economic downturn with severe effects worldwide. Workers trapped in precarious employment (PE), both formal and informal, are among those most affected by the COVID-19 pandemic. Here we call attention to at least 5 critical ways that the consequences of the crisis among workers in PE will be felt globally: (a) PE will increase, (b) workers in PE will become more precarious, (c) workers in PE will face unemployment without being officially laid off, (d) workers in PE will be exposed to serious stressors and dramatic life changes that may lead to a rise in diseases of despair, and (e) PE might be a factor in deterring the control of or in generating new COVID-19 outbreaks. We conclude that what we really need is a new social contract, where the work of all workers is recognized and protected with adequate job contracts, employment security, and social protection in a new economy, both during and after the COVID-19 crisis.
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    Cuestionario básico y criterios metodológicos para las Encuestas sobre Condiciones de Trabajo, Empleo y Salud en América Latina y el Caribe. Basic questionnaire and methodological criteria for Surveys on Working Conditions, Employment, and Health in Latin America and the Caribbean
    (2016) Benavides, Fernando G.; Merino Salazar, Pamela; Cornelio, Cecilia; Avila Assuncão, Ada; Agudelo Suarez, Andrés A.; Amable, Marcelo; Artazcoz, Lucia; Astete, Jonh; Barraza, Douglas; Vives Vergara, Alejandra; Berho, Fabian; Carmenate Milian, Lino; Delclos, George; Funcasta, Lorena; Gerke, Johanna
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    Desarrollo de instrumentos para estudiar el impacto en salud de las transformaciones urbanas en contextos de elevada vulnerabilidad: el estudio RUCAS
    (2023) Valdebenito Herrera, Roxana Ester; Angelini Pinedo, Flavia Mónica; Schmitt Rivera, Cristián; Baeza Rivas, Fernando Antonio; Cortinez O' Ryan, Andrea Paz; González López, Francisca Teresa; Vives Vergara, Alejandra
    Este artículo describe el proceso de diseño y las características de un cuestionario y una pauta de observación intradomiciliaria desarrollados para evaluar tanto transversal como longitudinalmente la relación vivienda-barrio-salud en el marco de transformaciones urbanas llevadas a cabo en poblaciones de elevada vulnerabilidad socio-territorial. Los instrumentos se desarrollaron para el estudio longitudinal multimétodos RUCAS (Regeneración Urbana, Calidad de Vida y Salud), un experimento natural cuyo objetivo principal es evaluar el impacto en salud y calidad de vida de un programa de Regeneración de Conjuntos Habitacionales en dos conjuntos de vivienda social en Chile. El diseño de los instrumentos siguió cuatro etapas principales: (1) revisión narrativa de la literatura para definir las dimensiones del estudio, y de instrumentos existentes para identificar ítems apropiados para su medición; (2) validación de contenido con expertos; (3) pre-test; y (4) estudio piloto. El cuestionario resultante, compuesto de 262 ítems, tiene en cuenta las distintas etapas del ciclo vital y cuestiones de género. La pauta de observación intradomiciliaria (77 ítems) es aplicada por el/la encuestadora. Los instrumentos abordan (i) características de la situación residencial actual que sabidamente afectan la salud y serán intervenidas por el programa; (ii) dimensiones de la salud potencialmente afectadas por la situación residencial y/o por la intervención dentro de los plazos del estudio (4 años); (iii) otras condiciones de salud y relacionadas con la salud que sean relevantes, aun cuando no se verán modificadas dentro de los plazos del estudio, y (iv) dimensiones socioeconómicas, ocupacionales y demográficas relevantes. Los instrumentos han mostrado ser una herramienta capaz de abordar la multidimensionalidad de los procesos de transformación urbana en contextos de pobreza urbana en vivienda formal.
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    Descripción del proceso de pesquisa de accidentes del trabajo y enfermedades profesionales, a partir de licencias de origen común (tipo 1) de trabajadores afiliados a FONASA, en las Comisiones de Medicina Preventiva e Invalidez (COMPIN).
    (2019) Basualto Vásquez, Mariela Pamela; Vives Vergara, Alejandra; Pontificia Universidad Católica de Chile. Escuela de Medicina
    La Ley N°16.744 declara como obligatorio el Seguro Social contra Riesgos de Accidentes del Trabajo y Enfermedades Profesionales. Particularmente, un accidente laboral corresponde a toda lesión que sufra un trabajador a causa o con ocasión del trabajo. Por otra parte, una enfermedad profesional es la causada de una manera directa por el ejercicio de la profesión o del trabajo que realiza una persona. Con el fin de dar curso al seguro, el empleador deberá denunciar al organismo administrador todo evento que pueda ocasionar incapacidad para el trabajo. Sin embargo, se ha evidenciado que debido a múltiples factores los eventos laborales no son declarados, situación que genera una subnotificación de los mismos. Es por ello que, surge la necesidad de identificar que procesos se efectúan para investigar el origen de las enfermedades y accidentes que generan incapacidad temporal, es decir, licencias médicas. Es por lo anterior que, la pregunta de investigación de este estudio hace referencia a ¿Qué procedimientos efectúan las Comisiones de Medicina Preventiva e Invalidez (COMPIN), para pesquisar afecciones laborales, a partir de licencias médicas emitidas como de origen común?. El diseño de investigación es un método cualitativo, ya que se recogerá información a través de entrevistas para el posterior análisis de contenido. El marco muestral de esta investigación serán los funcionarios de las COMPIN, que tengan relación con las temáticas de la N°16.744. En definitiva, los resultados de este estudio evidencian la heterogeneidad de procedimientos llevados a cabo en las COMPIN para efectuar la investigación del origen de las licencias médicas. Por tanto, esta investigación justifica la necesidad de inyectar recursos estatales para indagar las afecciones cubiertas por el sistema público. Lo anterior, con el fin de velar por el cumplimiento a las prestaciones contempladas en la Ley Nº16.744 y que entregan una protección a la población trabajadora.
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    Efectos del nivel socioeconómico individual y comunal en la salud de las personas en áreas urbanas de Chile : estudio multinivel en base a la Encuesta Nacional de Salud 2016-2017
    (2022) Padilla Pérez, Oslando; Vives Vergara, Alejandra; Pontificia Universidad Católica de Chile. Facultad de Medicina
    Objetivo: Determinar el aporte relativo del nivel socioeconómico comunal y su interrelación con el nivel socioeconómico individual en la prevalencia de autoreporte de Buena Salud y de Síntomas Depresivos en áreas urbanas de Chile a partir de la ENS 2016-2017. Metodología: Se realiza un análisis multinivel a partir de los datos individuales de la Encuesta Nacional de Salud 201 y de los datos de la comuna obtenidos a partir del Sistema Nacional de Información Municipal (SINIM) y de la Encuesta de Caracterización socioeconómica (CASEN). Resultados: La Autopercepción de Salud sólo se explica por variables individuales como sexo, edad, nivel educacional e ingresos del hogar. Para síntomas Depresivos, las variables de entorno más importantes son la Superficie comunal y el porcentaje de superficie de parques urbanos. Su prevalencia se explica por variables individuales como sexo, nivel educacional e ingresos del hogar y por la variable de entorno superficie comunal. Conclusiones: La comuna contribuye a explicar el 2% de la Varianza de la Autopercepción de Salud y el 6% de la varianza de Síntomas Depresivos. Existe un riesgo basal diferente para las Comunas no explicado por las variables estudiadas de Nivel Socio Económico comunal.
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    Effects of an urban regeneration program on related social determinants of health in Chile: A pre-post intervention study
    (Elsevier Ltd, 2021) López-Contreras, Natalia; Puig-Barrachina, Vanessa; Vives Vergara, Alejandra; Olave-Müller, Paola; Gotsens, Mercè; CEDEUS (Chile); Pontificia Universidad Católica de Chile. Escuela de Medicina
    Urban regeneration programs, such as “Programa Quiero mi Barrio” (PQMB) that is carried out in neighborhoods with greater deprivation across Chile, can improve health and quality of life in socio-economically deprived neighborhoods. The aim of this study was to analyze the effects of this program on the physical, social, and safety environments of neighborhoods intervened between 2011 and 2018, according to gender and socioeconomic position. Four indices and six sub-indices were constructed to measure physical, social, and safety environments of the neighborhoods. We conducted a pre- and post-intervention analysis with 2095 people using linear models adjusted for repeated measurements. After the intervention, participants had an improved perception of physical, social, and safety environments, as well as the use of spaces, particularly among women and people with higher levels of education. Therefore, the PQMB program is a form of public policy that can improve the quality of life and health of people living in underprivileged areas.
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    Effects of the Great Recession on suicide mortality in Chile and contributing factors
    (2022) Baeza Rivas, Fernando Antonio; González López, Francisca Teresa; Benmarhnia, Tarik; Vives Vergara, Alejandra
    Between 2008 and 2009 suicide rates in Chile were higher than those observed before and after, increasing more than in other countries in Latin America. The Great Recession has been suggested as an important factor behind this increase. This study assesses the excess of suicide attributable to the crisis in Chile, a “mature” neoliberal society with a precarious social security system, low salaries, and high levels of indebtedness, and identifies the most relevant economic variables that may contribute to this excess. We pooled data since 2000 on monthly suicide rates, unemployment, economic activity and perception of problematic indebtedness for different sex and age groups. We adopted an interrupted time series design with Poisson regressions models adjusted for monthly variations and non-linear pre-crisis trajectories via restricted cubic splines. We then further controlled for economic variables to evaluate their possible contributions to suicide increase attributable to the economic crisis. Suicide mortality during the crisis period was higher than in the previous period in all sex and age groups. Overall, we estimated that 301 suicides (95% CI: 181 to 422) were attributable to the crisis in Chile. This excess was concentrated among men younger than 65 and women 65 and older. Including unemployment and indebtedness perception in the models reduced the excess of suicides. The increase was concentrated in the first half of the crisis and an early pre-crisis effect could be observed when anticipating the crisis beginning by three months. Results suggest that the Great Recession had an impact on suicide mortality in Chile and that increase in unemployment and indebtedness could be related to this increase. Results by sex and age are consistent with the most vulnerable groups in the context of Chilean neoliberalism. For future crises, improving unemployment insurance, and reinforcing suicide prevention attending to the economic context should be a priority.
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    Empleo precario en España: prevalencia, distribución social y riesgo atribuible poblalcional porcentual para mal estado de salud mental
    (2012) Vives Vergara, Alejandra; Vanroelen, C.; Amable, Marcelo; Ferrer, M.; Moncada, S.; Llorens, C.
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    Employment Precariousness and Poor Mental Health : Evidence from Spain on a New Social Determinant of Health
    (2013) Vives Vergara, Alejandra; Amable, Marcelo; Ferrer, Montserrat; Moncada, Salvador; Llorens, Clara; Muntaner, Carles; Benavides, Fernando G.; Benach, Joan
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    Evaluating the health effects of place-based slum upgrading physical environment interventions: A systematic review (2012-2018)
    (PERGAMON-ELSEVIER SCIENCE LTD, 2020) Henson, Rosie Mae; Ortigoza, Ana; Martinez Folgar, Kevin; Baeza, Fernando; Caiaffa, Waleska; Vives Vergara, Alejandra; Diez Roux, Ana, V; Lovasi, Gina; CEDEUS (Chile)
    Rapid urbanization in low- and middle-income countries (LMIC) is associated with increasing population living in informal settlements. Inadequate infrastructure and disenfranchisement in settlements can create environments hazardous to health. Placed-based physical environment upgrading interventions have potential to improve environmental and economic conditions linked to health outcomes. Summarizing and assessing evidence of the impact of prior interventions is critical to motivating and selecting the most effective upgrading strategies moving forward. Scientific and grey literature were systematically reviewed to identify evaluations of physical environment slum upgrading interventions in LMICs published between 2012 and 2018. Thirteen evaluations that fulfilled inclusion criteria were reviewed. Quality of evaluations was assessed using an adapted Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Findings were then pooled with those published prior to 2012. Narrative analysis was performed. Of thirteen evaluations, eight used a long-itudinal study design ("primary evaluations"). All primary evaluations were based in Latin America and included two housing, two transportation, and four comprehensive intervention evaluations. Three supporting evaluations assessed housing interventions in Argentina and South Africa; two assessed a comprehensive intervention in India. Effects by intervention-type included improvements in quality of life and communicable diseases after housing interventions, possible improvements in safety after transportation and comprehensive interventions, and possible non-statistically significant effects on social capital after comprehensive interventions. Effects due to interventions may vary by regional context and intervention scope. Limited strong evidence and the diffuse nature of comprehensive interventions suggests a need for attention to measurement of intervention exposure and analytic approaches to account for confounding and selection bias in evaluation. In addition to health improvements, evaluators should consider unintended health consequences and environmental impact. Understanding and isolating the effects of place-based interventions can inform necessary policy decisions to address inadequate living conditions as rapid urban growth continues across the globe.
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    Experiences of insecurity among non-standard workers across different welfare states: A qualitative cross-country study
    (2023) Bosmans, Kim; Vignola, Emilia F.; Alvarez-Lopez, Valentina; Julia, Mireia; Ahonen, Emily Q.; Bolibar, Mireia; Gutierrez-Zamora, Mariana; Ivarsson, Lars; Kvart, Signild; Muntaner, Carles; O'Campo, Patricia; Ruiz, Marisol E.; Vanerhagen, Kristian; Cuervo, Isabel; Davis, Letitia; Diaz, Ignacio; Escrig-Pinol, Astrid; Gunnj, Virginia; Lewchuk, Wayne; Ostergren, Per-Olof; Padrosa, Eva; Vilchez, David; Vives Vergara, Alejandra; Vos, Mattias; Zaupa, Alessandro; Bodin, Theo; Baron, Sherry L.; CEDEUS (Chile)
    In recent decades, economic crises and political reforms focused on employment flexibilization have increased the use of non-standard employment (NSE). National political and economic contexts determine how employers interact with labour and how the state interacts with labour markets and manages social welfare policies. These factors influence the prevalence of NSE and the level of employment insecurity it creates, but the extent to which a country's policy context mitigates the health influences of NSE is unclear. This study describes how workers experience insecurities created by NSE, and how this influences their health and well-being, in countries with different welfare states: Belgium, Canada, Chile, Spain, Sweden, and the United States. Interviews with 250 workers in NSE were analysed using a multiple-case study approach. Workers in all countries experienced multiple insecurities (e.g., income and employment insecurity) and relational tension with employers/clients, with negative health and well-being influences, in ways that were shaped by social inequalities (e.g., related to family support or immigration status). Welfare state differences were reflected in the level of workers' exclusion from social protections, the time scale of their insecurity (threatening daily survival or longer-term life planning), and their ability to derive a sense of control from NSE. Workers in Belgium, Sweden, and Spain, countries with more generous welfare states, navigated these insecurities with greater success and with less influence on health and well-being. Findings contribute to our understanding of the health and well-being influences of NSE across different welfare regimes and suggest the need in all six countries for stronger state responses to NSE. Increased investment in universal and more equal rights and benefits in NSE could reduce the widening gap between standard and NSE.
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    Fiabilidad y cumplimiento de las preguntas sobre condiciones de trabajo incluidas en el cuestionario CTESLAC: resultados del Estudio sobre Condiciones de trabajo, Seguridad y Salud en Perú
    (2018) Sabastizagal, Iselle; Vives Vergara, Alejandra; Astete, Jonh; Burgos, Miguel; Ruiz de Porras, David Gimeno; Benavides, Fernando G.
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    Gender and ageing at work in Chile: employment, working conditions, work-life balance and health of men and women in an ageing workforce
    (2018) Vives Vergara, Alejandra; Gray, Nora; González, Francisca; Molina, Agustín; CEDEUS (Chile)
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    Gender and urban health: a Latin American structured tool for research and policy
    (CADERNOS SAUDE PUBLICA, 2024) Morais, Lidia Maria de Oliveira; Borde, Elis; Guevara, Paula; Valdebenito Montenegro, Roxana Andrea; Baldovino-Chiquillo, Laura; Sarmiento, Olga L.; Vives Vergara, Alejandra; Friche, Amelia Augusta de Lima; Caiaffa, Waleska Teixeira
    Latin American cities have evolved via exclusionary historical processes, resulting in hasty and unplanned urbanization, insufficient infrastructure, and extreme levels of violence. These issues have well-documented health implications. In urban settings, gender may lead to unequal access to opportunities and services, however, its consideration into policies, interventions, and research remains insufficient, potentially exacerbating urban inequities. Drawing inspiration from feminist urbanism and urban health research, we propose a structured tool for Latin American cities to develop gender-sensitive urban policies, interventions, and urban health research. The study encompassed: (1) a narrative literature review of feminist urbanism frameworks and the Delphi method to select the most appropriate dimensions; (2) a thorough examination of data availability and indicators in three studies of urban transformation interventions in Brazil, Colombia, and Chile to evaluate data availability and local interest; and (3) an urban health dialogue with the relevant indicators. We identified three key dimensions: "proximity," "autonomy," and "representativeness". Neighborhood was considered the most meaningful level for analyses. The indicators were organized into subdimensions, considering existing literature on their implications for gender and health. The proposed tool is comprehensive and adaptable, thus, it can be used in diverse Latin American urban contexts. It is a valuable resource for incorporating a gender-sensitive perspective into urban policymaking, interventions, and health-related research.