Public health services, an essential determinant of health during crisis. Lessons from Cuba, 1989–2000

Vos, Pol De; García-Fariñas, Anaí; Alvarez-Pérez, A.; Rodríguez-Salvá, A; Bonet-Gorbea, Mariano; Stuyft, Patrick Van der

doi:10.1111/j.1365-3156.2011.02941.x

Cited by 17 publications

(19 citation statements)

References 41 publications

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“…The Cuban population could be a particular case worth to study, where exceptionally the high antigenic load typical of a developing country in the tropical belt is coincident with low infant mortality, high life expectancy [27] and an aged demographic pyramid [28], as a consequence of social interventions.…”

Section: Discussionmentioning

confidence: 99%

Immunosenescence and gender: a study in healthy Cubans

et al. 2013

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BackgroundThe progressive decline in the immune function during ageing is termed immunosenescence. Previous studies have reported differences between males and females in the distribution and cell responses of lymphocyte subsets. Most studies of immunosenescence have been done in populations of industrialized countries living in a rather cold environment, and facing lower antigenic challenges such as Cytomegalovirus (CMV). The aim of this study was to determine the effect of ageing on lymphocytes in a population with a high prevalence of CMV infection in all ages, and to compare gender differences related to the immunosenescence markers.ResultsDifferent populations of peripheral blood leukocytes from healthy young and old IgG-CMV seropositive individuals were examined using flow cytometry. With age, the number and frequency of B cells and T cells significantly decreased, while highly differentiated T cells increased. Such changes were different in males and females. The age-associated decline of less differentiated lymphocyte subsets (CD19, CD4 and CD8 cells) and the increase of highly differentiated T cells were more prominent in females. In males, there were no significant changes in CD19, CD4 and CD8 subsets but there was a significant increase in the proportion of highly differentiated T cells.ConclusionShifts in lymphocyte subsets distribution were influenced by age and gender in an IgG-CMV seropositive population. These results suggest different patterns of immunosenescence in respect to gender differences. These patterns could have implications in the design of immunotherapy in the elderly.

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Section: Discussionmentioning

confidence: 99%

Immunosenescence and gender: a study in healthy Cubans

et al. 2013

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“…Considering that the establishment of the universal healthcare and perinatal health services over the last 30 years has improved maternal and child health indicators in Portugal 1617 It is appropriate to investigate the impact of adverse social and macroeconomic conditions on birth weight by monitoring time-based and social patterns of LBW 910 Therefore, we examined time trends in LBW during the past two decades in Portugal, researching the impact of the 2007–2008 global financial crisis and taking into consideration individual and contextual changes.…”

Section: Introductionmentioning

confidence: 99%

Impact of the global financial crisis on low birth weight in Portugal: a time-trend analysis

et al. 2017

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BackgroundThe 2007–2008 global financial crisis had adverse consequences on population health of affected European countries. Few contemporary studies have studied its effect on perinatal indicators with long-lasting influence on adult health. Therefore, in this study, we investigated the impact of the 2007–2008 global financial crisis on low birth weight (LBW) in Portugal.MethodsData on 2 045 155 singleton births of 1995–2014 were obtained from Statistics Portugal. Joinpoint regression analysis was performed to identify the years in which changes in LBW trends occurred, and to estimate the annual per cent changes (APC). LBW risk by time period expressed as prevalence ratios were computed using the Poisson regression. Contextual changes in sociodemographic and economic factors were provided by their trends.ResultsThe joinpoint analysis identified 3 distinct periods (2 jointpoints) with different APC in LBW, corresponding to 1995–1999 (APC=4.4; 95% CI 3.2 to 5.6), 2000–2006 (APC=0.1; 95% CI −050 to 0.7) and 2007–2014 (APC=1.6; 95% CI 1.2 to 2.0). For non-Portuguese, it was, respectively, 1995–1999 (APC=1.4; 95% CI −3.9 to 7.0%), 2000–2007 (APC=−4.2; 95% CI −6.4 to −2.0) and 2008–2014 (APC=3.1; 95% CI 0.8 to 5.5). Compared with 1995–1999, all specific maternal characteristics had a 10–15% increase in LBW risk in 2000–2006 and a 20–25% increase in 2007–2014, except among migrants, for which LBW risk remained lower than in 1995–1999 but increased after the crisis. The increasing LBW risk coincides with a deceleration in gross domestic product growth rate, reduction in health expenditure, social protection allocation on family/children support and sickness.ConclusionsThe 2007–2008 global financial crisis was associated with a significant increase in LBW, particularly among infants of non-Portuguese mothers. We recommend strengthening social policies aimed at maternity protection for vulnerable mothers and health system maintenance of social equity in perinatal healthcare.

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“…Effects on health outcomes can be limited if public action compensates the threats. 34 This study stresses the importance of continuous and reinforced assessment of suicidal risk in times of recession. Monitoring of people's health is essential.…”

Section: Implications For Research and Practicementioning

confidence: 99%

Employment loss during economic crisis and suicidal thoughts in Belgium: a survey in general practice

Vanderoost¹,

Wielen²,

Nunen³

et al. 2013

Br J Gen Pract

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BackgroundThe economic crisis of 2009 led to a wave of corporate reorganisations and bankruptcies, with many dismissals of employees. GPs were confronted with subsequent health consequences. AimTo assess the possible relationship between losing one's job and having suicidal thoughts. Design and settingA survey of patients aged 18-49 years recruited from GP practices in Belgium in Deurne (Flemish region) and La Louvière (Walloon region) from September to December 2010. MethodAnonymous self-administered questionnaire. ResultsOf all eligible patients (n = 1818), 831 were offered the questionnaire and 377 completed it (45.4%). More than one in five had been confronted with employment loss in the past year (the responder or someone close losing their job). Almost one in ten had lost their job themselves in the past year. More than one in four had experienced suicidal thoughts and 11.7% had seriously considered ending their life in the past year. In the logistic regression analysis, the following characteristics showed a statistically significant relationship with having suicidal thoughts: being single (odds ratio [OR] = 4.8, 95% confidence interval [CI] = 1.7 to 13.8), not having satisfying social contacts (OR = 5.1, 95% CI = 1.6 to 16.2), having depressive complaints (OR = 18.4, 95% CI = 5.8 to 58.4), and having lost one's employment in the past year (OR = 8.8, 95% CI = 2.0 to 39.3). ConclusionThis study points to a statistically significant relationship between losing one's employment in the past year and having suicidal thoughts. It emphasises the important role of the GP in the continuous and reinforced assessment of suicidal risk in times of recession.

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Public health services, an essential determinant of health during crisis. Lessons from Cuba, 1989–2000

Cited by 17 publications

References 41 publications

Immunosenescence and gender: a study in healthy Cubans

Immunosenescence and gender: a study in healthy Cubans

Impact of the global financial crisis on low birth weight in Portugal: a time-trend analysis

Employment loss during economic crisis and suicidal thoughts in Belgium: a survey in general practice

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