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An estimated 7.7 million Venezuelans have fled a severe humanitarian crisis in their country, most (70%) to other middle-income host countries in the same Andean region. Migration-related exposures during periconception and other critical gestational periods can adversely impact maternal-perinatal outcomes. Emerging evidence suggests that Venezuelan refugee and migrant women (VRMW) who migrate to Andean host countries are at-risk for delivering preterm and low birthweight infants and for Cesarean-sections. However, relatively few studies have examined obstetrical complications that could contribute to these or other short- and longer-term health outcomes of VRMW and/or their offspring. Our exploratory study analyzed four recent years of national hospital discharge data (2018–2021) from Ecuador to compare the primary discharge diagnoses of VRMW (n = 29,005) and Ecuadorian nationals (n = 1,136,796) for ICD-10 O code obstetrical complications related to or aggravated by pregnancy, childbirth, or the puerperium. Our findings indicated that VRMW were hospitalized for 0.5 days longer than Ecuadorian reference group women and they had higher adjusted odds (aOR) for a primary discharge diagnosis for obstetrical complications including preeclampsia (aOR:1.62, 95% CI:1.55,1.69), preterm labor (aOR:1.20, 95% CI:1.11,1.31), premature rupture of membranes (aOR: 1.72, 95% CI:1.63,1.83), oligohydraminos (aOR:1.24, 95% CI:1.12,1.36), obstructed labor (aOR: 1.39, 95% CI:1.31,1.47), perineal lacerations/other obstetric trauma (aOR:1.76, 95% CI:1.63, 1.91), STIs (aOR:2.59, 95% CI:1.29,2.92), anemia (aOR:1.33, 95% CI:1.24,1.42), and ectopic pregnancy (aOR:1.16 95% CI:1.04,1.28). They had similar aOR for diagnosed gestational diabetes and spontaneous abortion (SAB) compared to the reference group but a reduced aOR for genitourinary infections (aOR:0.79, 95% CI:0.74,0.84) and early pregnancy hemorrhage not ending in SAB (aOR:0.43, 95% CI:0.36,0.51). Our findings underscore the vulnerability of VRMW for a number of potentially serious obstetrical complications with the potential to adversely impact the short- and longer-term health of mothers and their offspring. Future studies should collect more detailed information on the migration status, experiences, and exposures of MRMW that influence their risk for obstetrical complications. These are needed to expand our findings to better understand why they have excess risk for these and to inform social and public health policies, programs and targeted interventions aimed at reducing the risk of this vulnerable refugee and migrant group. [ABSTRACT FROM AUTHOR]

Household food and water insecurity has been previously associated with adverse health consequences in children. However, these relationships are understudied in middle‐income Latin American populations such as in Ecuador, where a high prevalence of food and water insecurity has been reported. Using cross‐sectional data from 2018 Ecuadorian National Health and Nutrition Survey, we examined the association of household food insecurity (HFI), household water insecurity (HWI), and concurrent HFI‐HWI with diarrhoea, respiratory illness (RI), and stunting in 20,510 children aged ≤59 months. HFI was measured using the Food Insecurity Experience Scale. HWI was defined when households responded negatively to one or more of four drinking water indicators. Maternal caregivers reported on child diarrhoea and RI episodes during the previous 2 weeks. Measured length or height was used to assess stunting. We constructed log‐binomial regression models to estimate the associations of HFI, HWI, and concurrent HFI‐HWI with child outcomes. Moderate‐severe HFI was associated with a higher prevalence of diarrhoea (PR = 1.39; 95% CI: 1.18, 1.63) and RI (PR = 1.34; 95% CI: 1.22, 1.47), HWI with a higher prevalence of RI (PR = 1.13; 95% CI: 1.04, 1.22), and concurrent HFI‐HWI with a higher prevalence of diarrhoea (PR = 1.30; 95% CI: 1.05, 1.62) and RI (PR = 1.45; 95% CI: 1.29, 1.62). Stunting was not associated with HFI, HWI nor concurrent HFI‐HWI. These findings suggest that HFI and HWI can independently and jointly act to negatively affect children's health. Policies and interventions aimed at alleviating both food and water insecurity are needed to bring sustained health improvements in Ecuadorian children. Key messages: High prevalence of household food insecurity, household water insecurity, and concurrent household food and water insecurity exist in Ecuadorian households.Household food insecurity and household water insecurity were independently associated with detrimental health outcomes in Ecuadorian infants and young children.Infants and young children experiencing concurrent moderate‐severe household food insecurity and household water insecurity appear to be particularly vulnerable to diarrhoea and respiratory illness symptoms. [ABSTRACT FROM AUTHOR]

Background: Ecuador is a major host country for Colombians fleeing violence and Venezuelans escaping a complex humanitarian crisis, many of whom are pregnant women. Methods: We used national birth registry data (2018–2020) to compare the maternal care and infant outcomes of Venezuelan and Colombian immigrants with Ecuadorian nationals. Results: Venezuelan immigrants had a lower adjusted odds (AOR) for adequate prenatal care (AOR = 0.64;95%CI = 0.62,0.67) but a higher AOR for institutional (AOR = 2.68;95%CI = 1.84,3.93) and C-section delivery (AOR = 1.28;95%CI = 1.23,1.32) and birthing infants who were moderate-late preterm (AOR = 1.12;95%CI = 1.05,1.20), very preterm (AOR = 1.20;95%CI = 1.04,1.40), extremely pre-term (AOR = 1.65;95%CI = 1.27,2.14), low birthweight (LBW) (AOR = 1.11;95%CI = 1.05,1.17), very LBW (AOR = 1.35;95%CI = 1.12,1.62), and extremely LBW (AOR = 1.71;95%CI = 1.36,2.16). Colombians had decreased AORs for adequate prenatal care (AOR = 0.82;95%CI = 0.78,0.87) but increased AORs for institutional (AOR = 2.03;95%CI = 1.19,3.46) and C-section deliveries (AOR = 1.07;95%CI = 1.01,1.13) and birthing infants with moderate-late preterm (AOR = 1.17;95%CI = 1.05,1.30) but not LBW. Discussion: The findings underscore the need to address the causes of adequate prenatal care, excess C-sections, and poorer infant outcomes among refugee and immigrant women, especially Venezuelans. [ABSTRACT FROM AUTHOR]

Household food insecurity (HFI) has been linked to poorer cardiometabolic health and reduced health care access but few studies have examined these issues in the large Mexican immigrant population living on the U.S.-Mexico border. This exploratory study examined the association of HFI with cardiometabolic conditions and health care in 40–84 year urban border immigrants (n = 75). Data were collected on HFI, self-reported and clinical cardiometabolic conditions, health care sources and use. HFI affected 45% of participants. HFI was associated with self-reported and clinical diabetes but not hypertension, hyperlipidemia, obesity, or metabolic syndrome. It also was associated with increased emergency room visits and hospitalizations but not source of primary health care or preventative health care use. These findings highlight the need for additional research on the relationship of HFI with cardiometabolic health and health care in border immigrants as well as reassessment of current immigrant food security and health laws and policies. [ABSTRACT FROM AUTHOR]

Size at birth is an important indicator of future infant morbidity and mortality. Ethnic/racial disparities in birth weight and other fetal growth outcomes are well documented for US and Canadian minority groups but not for those in Latin America. The study compared the growth outcomes of 1,227 full-term Ecuadorian newborns delivered by Afro-descendant and indigenous minority women with those of ethnic majority (mestizo) women. Minority newborns had higher risk for congenital microcephaly but no excess risk for low birth weight or stunted linear growth compared to mestizos. However, minority newborns were significantly heavier at birth, weighing an average of 3-5% more than mestizos. Afro-Ecuadorians newborns also were fatter. The risk profile of Ecuadorian ethnic groups for certain fetal growth outcomes differs from some of those reported for North American minorities. Further studies are needed to investigate the origins of these between-group differences and to develop ethnic specific interventions for adverse growth outcomes. [ABSTRACT FROM AUTHOR]

The U.S. migrant and seasonal farmworker (MSFW) workforce is aging. Aging causes functional changes that can affect work performance and increase injury/accident risk. It also has been linked with deferred health-seeking. The exploratory study was conducted to investigate occupational injuries and health-seeking in Hispanic MSFW on the U.S.-Mexico border. Data were collected using an abbreviated Spanish-version of the California Agricultural Worker Health Survey. Nearly 60% of the 141 participants were middle-aged or older. Musculoskeletal injuries and those consistent with agrochemical and environmental exposures were common. Farmworkers aged >40 years were 2.5-5 times more likely than younger MSFW to report persistent single and multiple injuries involving the knees, shoulder, feet, and hands. Except for neck and back injuries, few received any medical treatment. Although many self-treated with traditional home remedies, few used CAM practitioners. The study findings highlight the multiple workplace health and health-seeking challenges faced by aging immigrant MSFW. [ABSTRACT FROM AUTHOR]