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To reduce health inequities, Chile´s Ministry of Health embarked on an ambitious process to implement policy redesign involving six public health programs that used a system-level theory of change. The process brought together a large and diverse group of national and local actors from within and outside the health sector organized in a network of program nodes, who worked together on well-defined tasks over the course of a year with high-level political and technical support. The tasks were part of a coconstructed stepwise assessment methodology, based on understanding and testing program theory and uncovering theories of inequities, drawing on realistic evaluation approaches, the social determinants of health framework, and models of effective program coverage. Almost simultaneously, the program nodes proposed new program theories to address equities with an implementation strategy, which necessarily engaged other sectors and community actors. This chapter highlights some of the lessons to explain the success of Chile´s redesign process: (a) the diversity of knowledge and experiences across nodes enriched and enabled system-level change, (b) the key distinction between theory of change and theory of inequities required to address inequities, and (c) the long-lasting transformative capital for institutional change of training a network of agents for change. [ABSTRACT FROM AUTHOR]

Objective. To analyze links between social class and health-related indicators and behaviors in Chilean workers, from a neo-Marxian perspective. Methods. A cross-sectional study based on the First National Survey on Employment, Work, Health, and Quality of Life of Workers in Chile, done in 2009-2010 (n = 9 503). Dependent variables were self-perceived health status and mental health, examined using the General Health Questionnaire (GHQ-12). Health-related behavior variables included tobacco use and physical activity. The independent variable was neo-Marxian social class. Descriptive analyses of prevalence were performed and odds ratio (OR) models and 95% confidence intervals (95%CI) were estimated. Results. Medium employers (between 2 and 10 employees) reported a lower prevalence of poor health (21.6% [OR 0.68; 95%CI 0.46-0.99]). Unskilled managers had the lowest mental health risk (OR 0.43; 95%CI 0.21-0.88), with differences between men and women. Large employers (more than 10 employees) reported smoking the least, while large employers, expert supervisors, and semi-skilled workers engaged in significantly more physical activity. Conclusions. Large employers and expert managers have the best health-related indicators and behaviors. Formal proletarians, informal proletarians, and unskilled supervisors, however, have the worst general health indicators, confirming that social class is a key determinant in the generation of population health inequalities. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze the association between social class and psychosocial occupational risk factors and self-rated health and mental health in a Chilean population. A cross-sectional study analyzed data from the First National Survey on Employment, Work, Quality of Life, and Male and Female Workers in Chile (N = 9,503). The dependent variables were self-rated health status and mental health. The independent variables were social class (neo-Marxist), psychosocial occupational risk factors, and material deprivation. Descriptive and logistic regression analyses were performed. There were inequalities in the distribution of psychosocial occupational risk factors by social class and sex. Furthermore, social class and psychosocial occupational risk factors were associated with unequal distribution of self-rated health and mental health among the working population in Chile. Occupational health interventions should consider workers' exposure to socioeconomic and psychosocial risk factors.

Objective: To analyze links between social class and health-related indicators and behaviors in Chilean workers, from a neo-Marxian perspective., Methods: A cross-sectional study based on the First National Survey on Employment, Work, Health, and Quality of Life of Workers in Chile, done in 2009-2010 (n = 9 503). Dependent variables were self-perceived health status and mental health, examined using the General Health Questionnaire (GHQ-12). Health-related behavior variables included tobacco use and physical activity. The independent variable was neo-Marxian social class. Descriptive analyses of prevalence were performed and odds ratio (OR) models and 95% confidence intervals (95%CI) were estimated., Results: Medium employers (between 2 and 10 employees) reported a lower prevalence of poor health (21.6% [OR 0.68; 95%CI 0.46-0.99]). Unskilled managers had the lowest mental health risk (OR 0.43; 95%CI 0.21-0.88), with differences between men and women. Large employers (more than 10 employees) reported smoking the least, while large employers, expert supervisors, and semi-skilled workers engaged in significantly more physical activity., Conclusions: Large employers and expert managers have the best health-related indicators and behaviors. Formal proletarians, informal proletarians, and unskilled supervisors, however, have the worst general health indicators, confirming that social class is a key determinant in the generation of population health inequalities.