Sexual and gender minority health in Chile: findings from the 2016-2017 Health Survey

ABSTRACT OBJECTIVE To expose visibility of the health concerns of sexual and gender minority groups in Chile, as well as to provide a platform to advocate for policies that support the health and well-being of sexual and gender minority people in the country. METHODS The health conditions and risk factors of participants identified as sexual and gender minority were compared to those identified as cisgender heterosexual using data from the 2016-2017 National Health Survey. RESULTS Despite reporting higher self-rated health than heterosexual men, gay men had a higher risk of lifetime diagnosis of sexually transmitted infections. Compared to heterosexual women, the prevalence of depression was higher among bisexual women, who were also less likely to have been tested for HIV. Moreover, transgender participants were more likely to report depression and worse self-rated health than cisgender heterosexual participants. CONCLUSION Small sample sizes of sexual and gender minority subgroups might have obscured some differences that would have been observable in larger samples. Despite this, we found statistically significant sexual and/or gender identity differences in several health areas, especially mental, sexual, and overall health.

Encuesta Nacional de Salud, ENS 2016-2017: un aporte a la planificación sanitaria y políticas públicas en Chile / National Health Survey, ENS 2016-2017: a contribution to planning health and public policies in Chile

Las enfermedades crónicas no transmisibles del adulto son el principal desafío de los sistemas de salud en el mundo. Se requiere información local para planificación sanitaria. Objetivos: Estimar la magnitud y distribución de problemas de salud crónicos prioritarios y sus determinantes en una muestra nacional representativa de la población general chilena. Métodos: ENS 2016-2017 es un estudio transversal con muestra de hogares aleatoria, estratificada, multietápica y por conglomerados representativa del nivel nacional, regional, urbano rural de 6233 personas de 15 y más años. Personal capacitado (encuestadores y enfermeras) en sucesivas visitas al hogar, administraron cuestionarios, examen dental, presión arterial, antropometría, recolectaron muestras de sangre en ayunas y orina. Se estimó la magnitud de 72 problemas de salud. Resultados: Se observa un elevado nivel absoluto de morbilidad por enfermedades crónicas y sus factores de riesgo. Se estima una magnitud de al menos 11 millones de personas con multimorbilidad que requieren atención médica y control crónico anual de por vida. Algunos ejemplos de altas prevalencias son: hipertensión (27,6 por ciento), dislipidemia HDL (46 por ciento), obesidad (34,4 por ciento), caries cavitadas (55 por ciento), diabetes (12,3 por ciento), tabaquismo actual (33,4 por ciento), problemas asociados al consumo de alcohol (12 por ciento), síntomas depresivos (15,8 por ciento), consumo excesivo de sal (98 por ciento), bajo consumo de frutas y verduras (85 por ciento), sedentarismo de tiempo libre (87 por ciento). Las mayores diferencias entre hombres y mujeres se observan en el uso riesgoso de alcohol y los síntomas depresivos. Conclusiones: la magnitud de población que requiere atención médica y cuidados crónicos supera la capacidad de respuesta del sistema de salud. Urgen fuertes estrategias preventivas de tipo poblacional (medidas regulatorias masivas) complementadas con una priorización de las estrategias de alto riesgo individual más costo efectivas. ENS aporta a la evaluación y vigilancia de ambas estrategias.(AU)

Chronic non communicable diseases are the main challenge for health systems in the world. Local information is required for health planning and policy design. Objectives: To estimate the magnitude and distribution of major chronic health problems and their determinants in the general population. Methods: ENS 2016-2017 is a cross-sectional study using a stratified, multistage and clustered random sample of households at the national, regional, rural and urban level including 6233 people aged 15 and over. Trained interviewers and nurses apply health questionnaires, physical examinations, collect blood and urine samples in successive household visits. Results: there is a high level of morbidity due to chronic diseases and their risk factors in Chile. At least 11 million people would need chronic long life medical care. Some prevalence magnitudes are: hypertension (27.6 percent), low HDL cholesterol (46 percent), obesity (34.4 percent), dental cavities (55 percent), diabetes (12.3 percent), current smoking (33.4 percent), at risk for alcohol use disorders(12 percent), depressive symptoms (15.8 percent), excessive salt consumption (98 percent), low consumption of fruits and vegetables (85 percent), Leisure-time physical inactivity (87 percent). Higher gender differences are related withalcohol use and depressive symptoms. Conclusions: the absolute number of people in need of medical chronic care exceeds our Health System's capacity. Population-wide preventive strategies (regulatory policies) coupled with carefully prioritized cost effective individual health care interventions are needed. ENS data contributes to the assessment and planning of both strategies.(AU)