Social Inequalities in Mental Health and Self-Perceived Health in the First Wave of COVID-19 Lockdown in Latin America and Spain: Results of an Online Observational Study.

COVID-19 lockdowns greatly affected the mental health of populations and collectives. This study compares the mental health and self-perceived health in five countries of Latin America and Spain, during the first wave of COVID 19 lockdown, according to social axes of inequality. This was a cross-sectional study using an online, self-managed survey in Brazil, Chile, Ecuador, Mexico, Peru, and Spain. Self-perceived health (SPH), anxiety (measured through GAD-7) and depression (measured through PHQ-9) were measured along with lockdown, COVID-19, and social variables. The prevalence of poor SPH, anxiety, and depression was calculated. The analyses were stratified by gender (men = M; women = W) and country. The data from 39,006 people were analyzed (W = 71.9%). There was a higher prevalence of poor SPH and bad mental health in women in all countries studied. Peru had the worst SPH results, while Chile and Ecuador had the worst mental health indicators. Spain had the lowest prevalence of poor SPH and mental health. The prevalence of anxiety and depression decreased as age increased. Unemployment, poor working conditions, inadequate housing, and the highest unpaid workload were associated with worse mental health and poor SPH, especially in women. In future policies, worldwide public measures should consider the great social inequalities in health present between and within countries in order to tackle health emergencies while reducing the health breach between populations.

Impacto del confinamiento por la COVID-19 en la salud autopercibida en Chile según género / Impact of COVID-19 lockdown on self-perceived health in Chile by gender

Objetivo: Analizar los factores sociales asociados a la salud autopercibida durante el confinamiento en la población residente en Chile según la perspectiva de género. Método: Estudio transversal realizado mediante encuesta online durante el confinamiento por la COVID-19 entre el 17 de mayo y el 17 de agosto de 2020. Se analizó la salud autopercibida en población de 18 años o más en relación con variables sociales. Se construyeron modelos de regresión logística multivariante para evaluar la asociación entre las variables independientes con la salud autopercibida, a través de odds ratio ajustadas (ORa). Los análisis se estratificaron por sexo (H: hombres; M: mujeres). Resultados: Se analizaron 5981 personas (el 63,9% mujeres). El 29,6% de las mujeres y el 19,2% de los hombres reportaron mala salud autopercibida. En las mujeres, empeora al aumentar la edad. La peor salud autopercibida se asoció principalmente con la falta de apoyo social (ORa H: 2,05; ORa M: 2,34), la preocupación por la convivencia en el hogar (ORa H: 1,66; ORa M: 1,38), percibir inadecuadas condiciones de la vivienda (ORa H: 1,89; ORa M: 2,63) y el desacuerdo con las medidas gubernamentales (ORa H: 2,80; ORa M: 1,82). En las mujeres, además, se asoció al trabajo informal o estar inactivas laboralmente (ORa: 2,11). En los hombres, una peor salud autopercibida se asoció a ser trabajador independiente (autónomo) (ORa: 1,65; intervalo de confianza [IC]: 1,11-2,45) y tener educación secundaria (ORa: 2,81; IC: 1,32-5,98). Conclusiones: El impacto social del confinamiento en la salud autopercibida se relaciona con el género, la edad, el trabajo de cuidados y las condiciones socioeconómicas, así como con el desacuerdo con las medidas implementadas para gestionar la pandemia.

Objective: To analyse the social factors associated with self-perceived health during the COVID-19 lockdown in the Chilean resident population according to gender perspective. Method: Cross-sectional study conducted during the COVID-19 lockdown between May 17 and August 17, 2020 with an online survey. Self-perceived health was analysed in the population aged 18 years or older in relation to social variables. Multivariate logistic regression models were constructed to assess the association between independent variables with self-perceived health, through adjusted odds ratio (aOR). Analyses were stratified by sex (M: men; W: women). Results: 5981 persons were analysed (women: 63.9%). 29.6% of women and 19.2% of men reported poor self-perceived health. In women it worsens with increasing age. Worse self-perceived health was mainly associated with lack of social support (ORa M: 2.05; ORa W: 2.34), concern about living together at home (ORa M: 1.66; ORa W: 1.38), perceived inadequate housing conditions (ORa M: 1.89; ORa W: 2.63), and disagreement with government measures (ORa M: 2.80; ORa W: 1.82). In women, it was also associated with informal work or being inactive in the labour market (ORa: 2.11). In men worse self-perceived health was associated with being self-employed (ORa: 1.65; confidence interval [CI]: 1.11–2.45) and has secondary education (ORa: 2.81; CI: 1.32–5.98). Conclusions: The social impact of lockdown in self-perceived health is related to gender, age, care work, and socioeconomic conditions, as well as, by disagreement with the measures implemented to manage the pandemic. (AU)

[Impact of COVID-19 lockdown on self-perceived health in Chile by gender]. / Impacto del confinamiento por la COVID-19 en la salud autopercibida en Chile según género.

OBJECTIVE: To analyse the social factors associated with self-perceived health during the COVID-19 lockdown in the Chilean resident population according to gender perspective. METHOD: Cross-sectional study conducted during the COVID-19 lockdown between May 17 and August 17, 2020 with an online survey. Self-perceived health was analysed in the population aged 18 years or older in relation to social variables. Multivariate logistic regression models were constructed to assess the association between independent variables with self-perceived health, through adjusted odds ratio (aOR). Analyses were stratified by sex (M: men; W: women). RESULTS: 5981 persons were analysed (women: 63.9%). 29.6% of women and 19.2% of men reported poor self-perceived health. In women it worsens with increasing age. Worse self-perceived health was mainly associated with lack of social support (ORa M: 2.05; ORa W: 2.34), concern about living together at home (ORa M: 1.66; ORa W: 1.38), perceived inadequate housing conditions (ORa M: 1.89; ORa W: 2.63), and disagreement with government measures (ORa M: 2.80; ORa W: 1.82). In women, it was also associated with informal work or being inactive in the labour market (ORa: 2.11). In men worse self-perceived health was associated with being self-employed (ORa: 1.65; confidence interval [CI]: 1.11-2.45) and has secondary education (ORa: 2.81; CI: 1.32-5.98). CONCLUSIONS: The social impact of lockdown in self-perceived health is related to gender, age, care work, and socioeconomic conditions, as well as, by disagreement with the measures implemented to manage the pandemic.

Caracterización epidemiológica de los nuevos diagnósticos de infección por virus de inmunodeficiencia humana en Chile período 2010-2019

Resumen Introducción: Chile lidera el porcentaje de aumento de nuevas infecciones de VIH en Latinoamérica. Objetivo: Caracterizar los nuevos diagnósticos de infección por VIH/SIDA y describir la evolución de las tasas en las regiones durante el período 2010-2019. Métodos: Diseño ecológico. Se utilizó los casos de infección por VIH/SIDA obtenidos del ISP y las estimaciones de población del INE. Las variables fueron año, sexo, edad, nacionalidad y región. Se describió la muestra en número y porcentajes, se estimó la incidencia y se evaluó la tendencia con el modelo Prais Winsten. Se utilizó Stata V.14 y ArcGis versión 10 en los mapas. Resultados: El 84,3% (38.863/46.125) fueron hombres. La mediana de edad fue 30 y 34 años en hombres y mujeres, respectivamente. La incidencia aumentó hasta el año 2018, y presentó una leve disminución en el 2019. Las tasas aumentaron, en ambos sexos, en todas las edades y regiones. A diferencia de la población nacional, los casos en inmigrantes aumentaron y alcanzaron a 40% en el 2019, evidenciando un franco incremento en adultos jóvenes, con predominio de la nacionalidad venezolana 35,2% y haitiana 22%. La tendencia de las tasas mostró un aumento significativo en hombres y una distribución heterogénea en magnitud en todas las regiones. Conclusiones: Existen cambios en la epidemiología del VIH y especial vulnerabilidad en jóvenes, mujeres, inmigrantes y adultos mayores.

Abstract Background: Chile leads the percentage increase of new HIV infections in Latin America. Aim: To characterize new diagnosis of HIV/AIDS and describe the rates evolution in the regions during the 2010-2019 period. Methods: Ecological design. The HIV/AIDS cases used were obtained from the ISP (Instituto de Salud Pública de Chile) and the population estimates from the INE (Instituto Nacional de Estadísticas). The variables studied were year, sex, age, nationality, and region. The sample was described in numbers and percentages, then, the incidence was estimated and the trend was evaluated with the Prais Winsten model. Stata V.14 and ArcGis version 10 were used for the maps. Results: 84.3% (38,863/46,125) were men. The median for age were 30 and 34 years for men and women, respectively. The incidence increased until 2018 and showed a slight decrease in 2019. The rates increased for both sexes and all ages. Unlike the national population, immigrant's cases increased and reached 40% in 2019, with a frank increase in young adults, with a predominance for Venezuelan (35,2) and Haitian (22%) nationals. According to region, all the samples showed a rate increase with a heterogeneous distribution in statistically significant magnitude in men. Conclusions: There are changes in the epidemiology of HIV and special vulnerability in young people, women, immigrants and the elderly.

Pulmonary tuberculosis infection among workers in the informal public transport sector in Lima, Peru.

BACKGROUND: Because a strong association was observed between pulmonary tuberculosis (TB) and the use of public transport, increasing with duration of journey, a study was carried out to assess infection by Mycobacterium tuberculosis and working conditions among workers in this sector. METHODS: A cross-sectional study was conducted between June and September 2008. A total of 104 workers from two public transport minibus ('combi') cooperatives covering marginal areas of the Ate-Vitarte district in Lima were interviewed. Demographic and occupational details were collected as well as prior family and personal history of TB and BCG vaccination. The tuberculin skin test (TST) was administered to each study subject and an induration of ≥ 10 mm was considered positive. Statistical analysis was based on logistic models, ORs and their 95% CIs. RESULTS: TST results were obtained for 70.2% (n=73), of whom 76.6% (n=56) were positive. Positivity was significantly associated with those who had worked for more than 2 years (crude OR 11.04; 95% CI 3.17 to 38.43) and more than 60 h/week (crude OR 9.8; 95% CI 2.85 to 33.72). These associations remained significant in a multivariate model as well. CONCLUSION: The association observed between years of working and weekly work burden among minibus workers suggests an occupational risk in service jobs in low-income countries with high TB prevalence. Consequently, other types of users are at increased risk for TB infection, with a causal relationship between effect and duration of exposure.