1. Inequity and vulnerability in Latin American Indigenous and non-Indigenous populations with rheumatic diseases: a syndemic approach
- Author
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Bernardo A Pons-Estel, Rosana Quintana, Ruben Burgos-Vargas, Everardo Álvarez-Hernández, John Londono, Ana M Santos, Adalberto Loyola-Sanchez, Mario H Cardiel, Maria Victoria Goycochea-Robles, Ingris Peláez-Ballestas, Ysabel Granados, Flor Julián-Santiago, Celenia Rosillo, Jose Alvarez-Nemegyei, Natalia Santana, Mario Goñi, Ligia Cedeño, Romina Nieto, Silvana Conti, María Elena Calvo, Eugenia Picco, Rosa Chacón, Jorge Delgado, Alfonso Gastelum Strozzi, Sergio Guevara-Pacheco, Vicente Juarez, Mario Alberto Garza-Elizondo, Juan Camilo Rueda, Amaranta Manrique de Lara, Nora Mathern, Marisa Jorfen, Alvaro Sanabria, Cristina Prigione, Adriana MR Silvestre, Vanina García, Julio Miljevic, Daniel Dhair, Matias Laithe, Fadua Midauar, Maria Celeste Martin, Maria Cecilia Barrios, María Elena Crespo, Mariana Aciar, Emilio Buschiazzo, Natalia L Cucchiaro, Mario Ruiz, José Adolfo Sánchez, Rodolfo Franco, Natalia Estrella, Silvia Jorge, Cinthya Retamozo, Sofia Fernandez, Martina Fay, Cecilia Camacho, Graciela Gomez, Jazmin Petrelli, Andrés Honeri, Viviana Arenas Solórzano, Ana Bensi, Marcela Valdata, Rodrigo Giraldo, Ignacio Angarita, Jesus G Ballesteros, Sofia Arias, Andres Vásquez, Lina Valero, Ani Cortes, Estafania Castañeda, Elias Forero, Astrid Feicán, Fernando Vintimilla, Jaime Vintimilla, Veronica Ochoa, Angelita Lliguisaca, Holger Dután, Jacqueline Rodríguez-Amado, Julio Casasola-Vargas, Conrado Garcia, Imelda García-Olivera, César Pacheco, Susana Aidee Gonzalez-Chávez, Hazel Garcia Morales, Arturo Velasco Gutierrez, JF Moctezuma-Rios, Eduardo Navarro-Zarza, Angelia Angulo, Rosana Flores, Janeth Galván Padrón, B Lorena Pérez, Janett Riega, Brenda Vaquez Fuentes, Miguel A Villarreal, Cassandra Skinner Taylor, Sara Marín, Dionicio Galarza Delgado, Diana Flores Alvarado, Jorge A Esquivel Varerio, Luz Helena Sanín, Marco Maradiaga Ceceño, Jorge Zamudio Lerm, Ivan Stekman, Yanira Martínez, and Gloris Sánchez
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Medicine - Abstract
Objective To estimate health inequity and vulnerability among Indigenous and non-Indigenous populations with rheumatic and musculoskeletal diseases (RMD) in Latin America using the syndemic approach.Design This is a secondary analysis of a previously published large-scale study on the prevalence of RMD.Setting Studies carried out in five Latin American countries (Argentina, Colombia, Ecuador, Mexico and Venezuela). Health inequity and vulnerability in RMD were identified through a syndemic approach using network and cluster analysis.Participants A total of 44 560 individuals were studied: 29.78% self-identified as Indigenous, 60.92% were female, the mean age was 43.25 years. Twenty clusters were identified in the Indigenous population and 17 in the non-Indigenous population.Results The variables associated with RMD among Indigenous populations were rurality, public health system, high joint biomechanical stress, greater pain, disability and alcoholism; and among non-Indigenous people they were being a woman, urban origin, older age, private health system, joint biomechanical stress, greater pain and disability. We identified different health inequities among patients with RMD (ie, lower educational attainment, more comorbidities), associated with factors such as Indigenous self-identification and rural residence.Conclusions A syndemic approach enables us to identify health inequities in RMD, as shown by higher prevalence of comorbidities, disability and socioeconomic factors like lower educational attainment. These inequities exist for the overall population of patients with RMD, although it is more evident in Indigenous groups with added layers of vulnerability.
- Published
- 2023
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