Understanding inequities in health and health systems in Latin America and the Caribbean: a thematic series

Ruano, Ana Lorena; Rodríguez, Daniela; Gaitán-Rossi, Pablo; Maceira, Daniel

doi:10.1186/s12939-021-01426-1

Cited by 58 publications

(45 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Unfortunately, the disparities persist across Latin American countries, and health systems are still deeply fragmented [68][69][70]. Consequently, healthcare access is still limited by several factors, such as educational level, rural status, or ethnicity [71]. Also, high out-of-pocket expenditure and financial vulnerability and delay in new technologies incorporation are still challenging to be overcome [72,73].…”

Section: Socioeconomic Differences Healthcare Access and Treatments A...mentioning

confidence: 99%

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Díaz

Ayares

Arnold

et al. 2022

Curr Treat Options Gastro

View full text Add to dashboard Cite

Purpose of review To assess the current challenges regarding liver diseases, including the burden of disease, access to care, screening, and treatment needs in Latin America. Recent findings Latin America is a region with a rich multicultural heritage and important socioeconomic differences. The burden of liver diseases is high and mainly determined by a high level of alcohol intake and the surge of risk factors associated with NAFLD (i.e., sedentary lifestyles, broader access to highly processed foods, obesity, and type 2 diabetes mellitus). Hepatotropic viruses also play a role in the development of chronic liver diseases, although their comparative frequency has been decreasing over the last decades. There are important disparities in access to screening and treatment for liver diseases in Latin America, which are reflected in low accessLiver (E Tapper, Section Editor) to critical treatments such as direct-acting antiviral agents and drugs to treat hepatocellular carcinoma. Also, important barriers to liver transplantation are present in multiple countries, including a low deceased donors' rate and a lack of availability in several countries (especially in Central America). Our region also has disadvantages in research and education in liver diseases, which limits regional academic development and improvement in quality of care of liver diseases. Summary In order to tackle an increasing health burden due to liver diseases, Latin America urgently needs tailored interventions aiming to control the main risk factors for these disorders through the establishment of effective public health policies. Also, development of liver transplantation programs and improvement of medical education and research capabilities as well as extensive collaboration between all stakeholders are keys to address the liver disease agenda in the region. AbbreviationsACLF Acute-on-chronic liver failure ALD Alcohol-associated liver disease ALF Acute liver failure AUD Alcohol use disorder DALYs Disability-adjusted life-years DILI Drug-induced liver injury GDP Gross domestic product HBV Hepatitis B virus HCV Hepatitis C virus HDV Hepatitis delta virus HCC Hepatocellular carcinoma LT Liver transplantation MAFLD Metabolic dysfunction-associated fatty liver disease NAFLD Non-alcoholic fatty liver disease NASH Non-alcoholic steatohepatitis PHP Public health policies PNPLA3 Patatin-like phospholipase domain-containing 3 US United States USD United States Dollars WHO World Health Organization * Updated to 2019 + Updated to 2020 Country Population in 2019 GDP + Gini index* Life expectancy from birth (years)* Deceased donors' rate* DDLT rate* LDLT rate* Argentina 44,938,712

show abstract

Section: Socioeconomic Differences Healthcare Access and Treatments A...mentioning

confidence: 99%

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Díaz

Ayares

Arnold

et al. 2022

Curr Treat Options Gastro

View full text Add to dashboard Cite

show abstract

“…These trends are also of concern from the perspective of health inequalities since they can directly or indirectly undermine health and exacerbate the existing deep gaps in this area and Latin America is widely known as the world's top unequal region [4]. Therefore, it is a region that is difficult to define and to understand [5][6][7]. Around 80 % of the Latin American population lives in urban areas at different levels of urbanization and different stages in the mobility transition [5].…”

Section: Introductionmentioning

confidence: 99%

“…5 Department of Physical Education, Federal University of Sergipe -UFS, São Cristóvão, Brazil. 6 Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina. 7 Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica.…”

unclassified

Sociodemographic inequities and active transportation in adults from Latin America: an eight-country observational study

Ferrari

Guzmán-Habinger

Chávez³

et al. 2021

Int J Equity Health

View full text Add to dashboard Cite

Background Active transportation is a crucial sort of physical activity for developing sustainable environments and provides essential health benefits. This is particularly important in Latin American countries because they present the highest burden of non-communicable diseases relative to other worldwide regions. This study aimed to examine the patterns of active transportation and its association with sociodemographic inequities in Latin American countries. Methods This cross-sectional study was conducted in eight countries. Participants (n = 8547, 18–65 years) self-reported their active transportation (walking, cycling, and total) using the International Physical Activity Questionnaire. Sex, age, ethnicity, socioeconomic level, education level, public and private transport use, and transport mode were used as sociodemographic inequities. Results Participants spent a total of 19.9, 3.1, and 23.3 min/day with walking, cycling, and total active transportation, respectively. Mixed and other ethnicity (Asian, Indigenous, Gypsy, and other), high socioeconomic level as well as middle and high education level presented higher walking than Caucasian, low socioeconomic and education level. Private transport mode and use of ≥ 6 days/week of private transport showed lower walking than public transport mode and ≤ 2 days/week of private transport. Use of ≥ 3 days/week of public transport use presented higher walking than ≤ 2 days/week of public transport. Men had higher cycling for active transportation than women. Use of ≥ 3 days/week of public transport use presented higher cycling than ≤ 2 days/week of public transport. ≥6 days/week showed lower cycling than ≤ 2 days/week of private transport use. Men (b: 5.57: 95 %CI: 3.89;7.26), black (3.77: 0.23;7.31), mixed (3.20: 1.39;5.00) and other ethnicity (7.30: 2.55;12.04), had higher total active transportation than women and Caucasian. Private transport mode (-7.03: -11.65;-2.41) and ≥ 6 days/week of private transport use (-4.80: -6.91;-0.31) showed lower total active transportation than public transport mode and ≤ 2 days/week of private transport use. Use of 3–5 (5.10: 1.35;8.85) and ≥ 6 days/week (8.90: 3.07;14.73) of public transport use presented higher total active transportation than ≤ 2 days/week of public transport use. Differences among countries were observed. Conclusions Sociodemographic inequities are associated differently with active transportation across Latin American countries. Interventions and policies that target the promotion of active policies transportation essential to consider sociodemographic inequities. Trial registration ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.

show abstract

“…Countries are faced with the challenge of balancing the priorities of infection prevention, control, and treatment, while also ensuring that essential public health services continue to be safe and accessible. In Latin America, where public health systems are often overburdened, fragmented, and unequal [3], the COVID-19 pandemic has highlighted the failures of underfunding and exacerbated racial, gender, economic, and health disparities [4,5]. Social determinants of health directly relate to health inequalities [6].…”

Section: Introductionmentioning

confidence: 99%

Effect of COVID-19 on Patient Access to Health Services in Latin America: A Key Informant Survey

Kruse

Durstine

Evans

2021

Preprint

View full text Add to dashboard Cite

BackgroundCOVID-19 has been felt acutely in Latin America with several countries having among the highest numbers of COVID-19 cases and deaths. The purpose of this study was to assess the effects of COVID-19 on access to health services in Latin America, as reported by patient advocacy organizations representing autoimmune, chronic, and noncommunicable diseases.MethodsIn August 2020, we conducted an online key informant survey in Spanish and Portuguese among patient advocacy organizations in 18 countries in Latin America. Univariate and bivariate analysis was conducted across two main subject areas: perceived patient effects from COVID-19 and patient access to health services. The main outcomes of analysis considered patient access to care during COVID-19 based on type of chronic illness and geographical region in Latin America.ResultsA total of 81 survey responses were analyzed. A majority (83%) of patient advocacy organizations reported their patients experienced delays receiving their treatment and care services; 52% experienced delays of 30 days or more. Telemedicine was considered available, but not accessible to patients (37%) and a majority (76%) of patients faced challenges with electronic prescriptions. Patients were not likely to receive a multi-month prescription from their doctor (38%) or successfully fill it at the pharmacy (26%).ConclusionsPeople living with noncommunicable diseases in Latin America have been seriously impacted by the COVID-19 pandemic. As countries re-evaluate their health systems, it is critical that chronic diseases are considered so that all can fully realize the right to health.

show abstract

Understanding inequities in health and health systems in Latin America and the Caribbean: a thematic series

Cited by 58 publications

References 15 publications

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Sociodemographic inequities and active transportation in adults from Latin America: an eight-country observational study

Effect of COVID-19 on Patient Access to Health Services in Latin America: A Key Informant Survey

Contact Info

Product

Resources

About