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Prenatal care is intended to preserve and improve maternal and child health; however, the quality of this service and the attendance rates vary, with developing countries having the lowest rates. There are cultural gaps that prevent adequate access to prenatal care, putting the maternal and child health at risk. Our objective was to carry out an updated review on cultural gaps and their impact on prenatal care. This narrative review was conducted by searching all articles published until December 17, 2022, in English databases such as PubMed and Scopus, and Spanish databases such as SciELO. There are various situations that force pregnant women not to attend prenatal appointment, including machismo, reported as a common cause of non-attendance to prenatal checkups in developing countries and especially in rural communities; poor education in families, so women do not attend prenatal checkups due to ignorance about pregnancy care and risks, as well as their beliefs and customs about pregnancy; difficulty accessing health care services due to geographic issues; mistreatment from health professionals while receiving prenatal care or lack of inclusion in the health center; immigration status and the resulting problems with access to health care. Recognizing these situations is as important as knowing their consequences since, once identified, different solution alternatives can be sought from the primary health care. Health personnel must be trained to help the population understand the importance of prenatal care by knowing and respecting the customs and traditions of each patient, and not undermining their ideologies. [ABSTRACT FROM AUTHOR]

Objective. To estimate the mortality gap due to interpersonal violence in adolescents and young people in 'social territories' made up of 17 Latin American countries, by age and sex for the years 1990 and 2019, based on estimates from the Global Burden of Diseases, Injuries and Risk Factors (GBD) Study, 2019. Methods. Ecological epidemiological study of mortality due to interpersonal violence. Countries were divided into three strata according to the social development index (SDI). To estimate the gaps, the Poisson regression model was used, and the odds ratio and its respective 95% confidence interval were calculated. Results. The global burden of mortality due to interpersonal violence showed a significant increase in men in strata 1 and 2, and a decrease in stratum 3; a significant decrease was observed in women in stratum 2. By age group, the burden of interpersonal violence increased in both men and women aged 20 years and older. Conclusions. Interpersonal violence continues to be an important public health problem in Latin America, affecting mainly adolescents and young people in countries with lower socioeconomic development. It is urgent to evaluate the public policies that have been implemented in order to determine the causes that prevent the reduction of current gaps, and to implement plans that act on the social determinants of interpersonal violence and that promote a positive transformation with equity. The GBD report can serve as an important tool in the design, implementation, and monitoring of public policies aimed at preventing interpersonal violence in the Region. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the evolution of the incidence and prevalence of hearing loss in the elderly in low-, middleand high-income countries by means of system dynamics simulation according to global parameters and to analyze the influence of the implementation of health strategies. Methods: A causal loop diagram was developed to relate the incidence, prevalence and treatment of hearing loss to the level of inequality, risk factors (RF), use of hearing aids (HA), audiologist and otolaryngologist (ENT) workforce by country income level. A flow chart was then constructed to run the simulations over a 100-year period. In addition, four simulations were run with health strategies (reduction of RF, improvement in HA use, increase in the number of audiologists and ENT specialists) and the percentage change from the baseline model was estimated. Results: Low-income countries showed a higher incidence and prevalence of hearing loss, less access to adequate treatment, and a higher prevalence of untreated or inadequately treated hearing loss. The reduction of RF increased the population with normal hearing by 15% and 33% over the next 50 and 100 years, respectively. In addition, the improvement in the use of ha achieved a 60% reduction in the population with inadequate or untreated treatment, and the increase in audiologists and ENT specialists improved the access to adequate treatment by 250%. Conclusions: The evolution of hearing health is conditioned by economic factors, where the most disadvantaged environments show worse indicators. In addition, the implementation of combined strategies would favor hearing health in the future. System dynamics is a very useful methodology for health managers because it enables to understand how a disease evolves and define what are the best health interventions considering different scenarios [ABSTRACT FROM AUTHOR]

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Background: Common mental disorders are among the leading contributors to the burden of disease in Chile and Latin America. Gender and socioeconomic position are important social determinants of mental health. Objective: This study is aimed at determining the role of the double burden of paid job and unpaid domestic work in the association of social determinants with common mental disorders. Methods: Secondary analyses of a sample representative of the employed or recently employed Chilean population between 2009-2010. Logistic models were used to determine the association between the variables of interest and positive screen for common mental disorders. Results: Positive screen for common mental disorders was two times as frequent in women, compared to men, but the association between gender and the outcome was not observed when controlling for the double burden of paid and unpaid work. Income was associated with common mental disorders only among men. Conclusions: The distribution of the double burden of paid and unpaid work, which is more frequent among women, could contribute to the higher frequency of common mental disorders among them. It is important that social and labor public policies address this issue, to reduce the gap experienced by women with respect to paid work, and to foster co-responsibility in domestic and care tasks. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To determine the existence of disparities in access for diagnosis and treatment in women diagnosed with breast cancer in Colombia, and to describe the main associated risk factors. Methodology: A systematic search was conducted with the terms "Breast neoplasms" AND "Health disparities" OR "Health status disparities" OR "Socioeconomic factors" AND "Colombia", in the Pubmed databases (Medline), Scielo, Cochrane, EBSCO, Ovid, Elsevier, Lilacs, Imbiomed, in Spanish, English, and Portuguese, published from January 1, 2000 back to October 31, 2019. Results: 14 publications were selected for the writing of the manuscript. It was identified that the socioeconomic level, the level of education and the type of insurance, in most of the studies, showed significant association to disparities in the disease. They also had variable effects on the risk of breast cancer and an impact in its early detection and treatment. These factors influence the full survival of the patient and their becoming disease-free. Conclusions: Health disparities of patients with breast cancer in Colombia are identified. Factors such as type of insurance, socioeconomic level, educational level were identified, which impact the delay in diagnosis and worsen the clinical condition and the quality of life of the patients. [ABSTRACT FROM AUTHOR]

Copyright of Revista Latinoamericana de Población is the property of Revista Latinoamericana de Poblacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. Quantitatively describe relative risk, trends, and geographical inequalities in suicide in adolescents and young adults in regions of Chile, from 2000 to 2017. Methodology. Ecological population study based on records of death by suicide. Suicide death rates and relative risk (RR) were estimated, by sex, age, and region. Trends and geographical inequalities in suicide in regions of Chile were studied; absolute and relative measures of geographical inequalities were estimated. Results. Between 2000 and 2017, there were 6,292 suicides in adolescents and young adults in Chile. The average rates of death by suicide in Chile were 8.5, 5.4, and 14.7 per 100,000 in the 10-24, 10-19, and 20-24-year age groups, respectively, in the period 2000-2017. The highest suicide death rates were found in the Aisén, Los Lagos, Magellan and Los Ríos regions. The highest risk of suicide was estimated in men (RR = 3.5), young adults (RR = 2.7), and the Aisén region (RR = 2.0). The national average rate in the 1024 age group remained at 8.5 per 100,000 in the periods 20002008 and 2009-2017. The greatest geographical inequality was found in men 2024 years old in the period 2000-2008. Conclusions. Suicide in young adults and adolescents in Chile remained unchanged in the study period. Men have a higher risk of suicide than women. There are geographical inequalities in suicide between Chile's regions and they are highest in men between ages 20 and 24. It is recommended to evaluate and strengthen suicide prevention programs in adolescents and young adults, especially in the most vulnerable regions and population groups. [ABSTRACT FROM AUTHOR]

Introduction: As an initiative to improve the quality of health care, the trend in biomedical research focused on health disparities and sex has increased. Objective: Carry out a characterization of the scientific evidence on health disparity, defined as the gap between the distribution of health and the possible gender bias in access to medical services. Materials and methods: A simultaneous search of the scientific literature was performed in the MEDLINE PubMed database of two fundamental descriptors: Healthcare disparities and Sexism. Subsequently, a main semantic network was built and some structural subunits (communities) were identified for the analysis of information organization patterns. Open source software was used: Cytoscape to analyze and visualize the semantic network and MapEquation for community detection, as well as ad hoc code available in a public access repository. Results: The core network corpus showed that the terms on heart disease were the most common among the descriptors of medical conditions. Patterns of information related to public policies, health services, social determinants and risk factors were identified from the structural subunits, but with a certain tendency to remain indirectly connected to the nodes of medical conditions. Conclusions: Scientific evidence indicates that gender disparity does matter for the quality of care for many diseases, especially those related to the circulatory system. However, there is still a gap between the medical and social factors that give rise to possible disparities by sex. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. To identify differences in socioeconomic indicators, health conditions and use of services between the indigenous (IP) and non-indigenous population (NIP) of the country. Materials and methods. Descriptive crosssectional study carried out with information obtained by the 2018-19 National Health and Nutrition Survey. Results. Most IP are in the lowest socioeconomic quintile and they use less health services. Indigenous women reported a higher number of children, as well as childbirth care with midwives. IP go for medical care to institutions for the population without social security as the first option but expressed less desire to return to the same place. Conclusions. IPs use less health services. An epidemiological panorama of double burden and inequity in access indicators that affect IP is configured. Reproductive health is the area where the greatest inequalities are observed. [ABSTRACT FROM AUTHOR]

Objective: To identify the place of congenital syphilis on the health agenda and analyze the process of social determination and social determinants having an influence, at different levels, on the health policy agenda setting, from a right to health perspective. Methods: Qualitative exploratory, descriptive and transversal study, based on primary data (semistructured interviews with those involved in the subject at the global, regional and local level) as well as secondary data. A model was developed to analyze the health agenda and the position that a topic occupies in it, in this case, congenital syphilis. Results: Social determinants, at different levels, linked to foreign policy, trade, science / technological innovation and production systems, hinder the advance of congenital syphilis from a formal agenda to a decision agenda. This process is also influenced by the absence of pressure groups and a low visibility of the disease as a public health problem. Conclusions: Congenital syphilis persists as a public health problem, and in many countries of the region, this issue does not move up to a decision agenda, which hinders its effective control. The elaborated model and the social determinants identified at its different levels constitute a contribution in this direction. [ABSTRACT FROM AUTHOR]

Objective. To measure health inequality in the use of screening services in adults from 20 to 59 years of age from the 2006 and 2012 national health and nutrition surveys. Materials and methods. Considering the selection of five indicators of screening in adults (detection of diabetes, hypertension, breast cancer, cervical cancer and prostate cancer), the Kuznets index, the slope inequality index and the health concentration index were estimated. Considering as social indicators schooling, ethnicity, unemployment, socioeconomic level and type of health protection. Results. The coverage of the five tests increased, but the inequality observed only decreased in the interventions in women; and in the case of the detection of prostate cancer it was increased. Conclusions. While it is important to monitor the performance of curative services, the challenge remains to ensure effective and equitable access to early diagnosis services. [ABSTRACT FROM AUTHOR]

Objective: there is a need to find the relationships between socioeconomic inequality in early childhood and the health impacts on adult life. Latin America is the region with the greatest socioeconomic inequality, which influences health in early childhood and have repercussions that are manifested throughout life. Materials and methods: a bibliographic search was conducted in ClinicalKey, PubMed, SciELO, Google Scholar and Springer. The search and selection criteria were made from the PICOT model. Twenty-five articles and official documents were selected. Results: the socioeconomic inequality that characterizes Latin America injure the most vulnerable populations such as early childhood. Likewise, crucial stages such as growth and neurodevelopment are affected when there are no conditions that allow stimulation through the environment. In addition, early childhood includes a critical stage where the environment will determine significantly in the state of health in adulthood, through the presence of risk factors and the adoption of lifestyles. Conclusions: the regions must understand the situation of socioeconomic inequality of their population and the responsibility that generates in early childhood health, in order to establish social reforms that allow an improvement in living conditions, housing, food, education, access to public services and health care. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The proposals of community care models are fundamentally based on the need to standardize the language and action of professionals regarding the articulation of different organizations and groups of individuals present in the community, in order to protect their health. The objective of this study is to comment on strategies aimed at an inclusive community approach for the attention of vulnerable groups. To do this, we review the issues of inequality and vulnerability, key in the 2030 Agenda. In scenarios such as rural communities in Ecuador, the community care strategy promotes actions on health problems and needs detected as prevalent, through local activities targeted at promoting health and increasing the quality of life of the inhabitants. [ABSTRACT FROM AUTHOR]

Objective: To understand relationships of power according to gender experienced in scenarios of professional performance by Colombian female physicians. Materials and Methods: Qualitative study with phenomenological approach, from in-depth interviews to 33 female physicians, ranging in age between 29 and 60 years, and with over five years of professional exercise. Between October 2017 and March 2018, with prior informed consent, the interviews were conducted with questions about the relationships of power and the inequalities experienced with their male colleagues in scenarios of professional performance. Results: In the reports by the female physicians interviewed, it is possible to perceive gender inequalities in wages, forms of hiring, responsibilities assigned, recognition by the patients, and access to positions of power in comparison with their male colleagues. Conclusions: Medicine maintains a power structure centered on men, with differential opportunities by gender, and characterized by a lower wage, more responsibilities, lesser recognition, and limited access to positions of prestige for women. This phenomenon needs to be explored in other professionals from the health area. [ABSTRACT FROM AUTHOR]

Introduction: Despite advances in treatment, opportunistic infections (OIs) are the major causes of morbidity and mortality among patients with human immunodeficiency virus (HIV). Objectives: To estimate the prevalence of OIs among insured HIV patients, and to establish its association with socio-demographic and clinical factors. Materials and methods: An observational with analytical perspective. We analysed 37325 records of insured people with HIV. A Bivariate analysis, using Chi-square and ANOVA, adjusted by Bonferroni and a multiple logistic regression for adult population were done to explore the association among any opportunistic infections, as response variable, and socio-demographic and clinical factors. Results: 18% experienced any opportunistic infection. The most frequent were tuberculosis and brain toxoplasmosis for adults, and pneumonias and diarrhoeas for under 13 years of age. The prevalence of any OIs was significantly higher in men (OR=1,5; CI95% 1,4-1,6), >40 years of age (OR=1,6; CI95% 1,3-2,0), forcibly displaced (OR=1,7; CI95% 1,5-1,9), people belonging to Subsidized and Exception regimen (OR= 2,7; CI95% 2,1-3,4). Regarding to Clinical Risk factor, OIs were statistically associated to time since diagnosis >10 years (OR= 1,6; CI95% 1,5-1,7), people receiving TAR (OR= 4,4; CI95% 3,9-5,1), and those with discontinuous treatment (OR= 1,7; CI95% 1,6-1,8). The Multivariate analysis for adults in clinical stage A shown similar results. Conclusion: Despite the preventable of OIs, the prevalence is still high, and predominantly affects the disadvantaged people. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Health equity is a guiding principle for public health action. Its noble purpose is to build healthier, sustainable societies that are also more just and inclusive. This is reflected in the global commitment to "leave no one behind", expressed in the 2030 Agenda for Sustainable Development, although none of the Agenda's 169 targets focuses on reducing health inequalities, either conceptually or quantitatively. Recognizing the urgency to go beyond words and move forward decidedly in the design and implementation of pro-equity social and health policies at both the local and global levels, this special report reviews the conceptual and methodological framework for tackling health equity. Concepts and methodology are explicitly linked in a practical proposal that promotes the analytical use of subnationally disaggregated administrative data to inform decision-making in that area. This report concludes by proposing the need to institutionalize the measurement, analysis, and monitoring of social disparities in health to create effective national capacity to act on the social and environmental determinants of health and ensure accountability in the commitment to "leave no one behind" on the road to sustainable development, universal health, and social justice. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to evaluate the impact of the economic crisis on the disparities in the prevalence and risk of low birth weight (LBW) according to the maternal socioeconomic profile.Methods: the data analysed corresponds to 1,779,506 single births to Spanish mothers in the years 2007, 2009, 2011, 2013 and 2015. The temporal changes in available maternal-foetal variables are described. Secondly, the possible increase in disparities in prevalence and risk of LBW due to the occupation and education of the mother is evaluated, taking 2007 as the reference year.Results: a trend of the maternal profile is described among women who had children during this period, with an increasing contribution of highly qualified professional and educated women, a trend already existing before the economic crisis, but which was deepened by the recession. The prevalence of LBW increased in all socio-economic groups, with a marked increase in disparities during the worst years of the economic crisis.Conclusion: results confirm the persistence of social inequalities in perinatal health described prior to the economic crisis, as well as a possibly negative effect of the recession between 2007 and 2015. Results also confirm that disparities in LBW are more clearly associated with the educational level of mothers than with their occupation. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this letter, the authors respond to the comment received, arguing that the main contribution of their article was to show that the place of habitual residence, as well as the sex and age of the individual, determine the main causes of mortality among Mexican older adults. [ABSTRACT FROM AUTHOR]