Loss of job-related right to healthcare is associated with reduced quality and clinical outcomes of diabetic patients in Mexico.

OBJECTIVES: The Mexican Institute of Social Security (IMSS) provides a package of health, economic and social benefits to workers employed in private firms within the formal labour market and to their economic dependants. Affiliates have a right to these benefits only while they remain contracted, thus posing a risk for the continuity of healthcare. This study evaluates the association between the time (in days) without the right to healthcare due to job loss in the formal labour market and the quality of healthcare and clinical outcomes among IMSS affiliates with Type 2 diabetes mellitus (T2DM). DESIGN: Retrospective cohort study 2013-2015. SETTING: Six IMSS family medicine clinics (FMC) in Mexico City. PARTICIPANTS: T2DM patients (n = 27 217) affiliated with job-related health insurance and at least one consultation with a family doctor during 2013. SOURCE OF INFORMATION: IMSS affiliation department database and electronic health records and clinical laboratory databases. MAIN OUTCOME MEASURE(S): Quality of the processes (eight indicators) and outcomes (three indicators) of healthcare. RESULTS: The results indicated that losing IMSS right to healthcare is frequent, occurring to one-third of T2DM patients during the follow-up period. The time without the right to healthcare in the observed period was of 120 days on average and was associated with a 43.2% loss of quality of care and a 19.2% reduction in clinical outcomes of T2DM. CONCLUSION: Policies aimed at ensuring access and continuity of care, regardless of job status, are critical for improving the quality of processes and outcomes of healthcare for diabetic patients.

[A first analysis of research on social determinants of health in Mexico: 2005-2012]. / Un primer análisis de la investigación en México sobre los determinantes sociales de la salud: 2005-2012.

OBJECTIVE: To examine the research on social determinants of health (SDH) produced in Mexico during the period 2005-2012, based on the characterization of the national health research system and the scientific production on this topic. MATERIALS AND METHODS: Two-stage analyses: Review of Mexican documents and official sources on health research and systematic bibliographic review of the literature on SDH. RESULTS: Although SDH were mentioned in the Specific Action Plan for Health Research 2007-2012, they are not implemented in strategies and goals, as the emphasis is put mostly in infrastructure and administrative aspects of research. In the period studied, 145 articles were published on SDH topics such as health conditions, health systems and nutrition and obesity. CONCLUSIONS: In spite of the availability of research on SDH in Mexico, the operationalization of such findings into health policies has not been possible. The current Sectorial Program on Health 2013-2018 represents a window of opportunity to position research findings that promote health equity policies.

Perinatal Outcomes Among Venezuelan Immigrants in Colombia: A Cross-Sectional Study.

In the last decade, Venezuela suffers a humanitarian crisis, leading to massive emigration. One of the most vulnerable migrants´ groups is pregnant women. We analyzed the perinatal outcomes of Venezuelan migrants in Colombia and identified if migration was associated with perinatal outcomes. Birth data were obtained from the 2017 Colombian national birth registry (1085 births in migrants and 654,829 in Colombians). Logistic and linear regression models were used to identify the association between the demographic, obstetric and neonatal characteristics with premature birth (PB), low birth weight (LBW), 1-min, and 5-min Apgar score. Venezuelan were more likely to have newborns with LBW, lower Apgar scores at 1-min and 5-min in comparison to Colombians. Furthermore, a difference was observed in the low health insurance coverage and antenatal care visits among Venezuelan in comparison to natives. Access to health care services for the migrants is desirable for the improvement of perinatal health conditions.

Capacidades de investigación sobre determinantes sociales de la salud en Brasil, Colombia y México / Research capacities on social determinants of health in Brazil, Colombia and Mexico / Capacidades de investigação sobre determinantes sociais da saúde no Brasil, Colômbia e México

RESUMEN Objetivo: analizar las capacidades de investigación sobre determinantes sociales y determinación social de los procesos saludenfermedad (DSS) en Brasil, Colombia y México con base en los sistemas nacionales de ciencia, tecnología e innovación (SNCTI) y la producción científica sobre DSS (2005-2012) de cada país. Metodología: se realiza un estudio exploratorio a partir de revisión de literatura, consulta de plataformas nacionales de cada SNCTI, entrevistas y foros de consulta, contemplando las siguientes categorías de estudio para analizar las capacidades de: 1. Producción científica, formación de investigadores y políticas relativas a capacidades de investigación; 2. Redes de colaboración; 3. Infraestructura para la investigación y 4. Producción y apropiación social del conocimiento. Resultados y Discusión: la investigación sobre DSS se divulga principalmente en revistas científicas de circulación nacional, en Brasil y Colombia, mientras que en México se publica principalmente en revistas extranjeras. Los tres países cuentan con SNCTI consolidados, sin embargo, son escasos los montos de financiamiento para investigación sobre DSS. Conclusiones: es necesario articular acciones de fortalecimiento de capacidades de investigación, fortaleciendo redes y posicionando los DSS en agendas estratégicas.

ABSTRACT Objective: to analyze the research capacities on social determinants and social determination of the health-disease process (SDH) in Brazil, Colombia and Mexico based on the characteristics of the National Systems of Science, Technology and Innovation (SNCTI) and the scientific production on SDH between 2005 and 2012. Methodology: an exploratory study was conducted. Data were obtained from literature reviews, the national platforms for each SNCTI, interviews and forums. The following categories of study were taken into account when analyzing capabilities: 1. Scientific production, training of researchers and policies concerning research capabilities. 2. Collaborative networks; 3. Infrastructure for research and 4. Production and social appropriation of knowledge. Results and discussion: research on SDH is primarily published in scientific journals. In Brazil and Colombia, findings are primarily published in national journals, while the majority of research on SDH from Mexico is published in international journals. All three countries have solid SNCTI. However, funding for research on SDH is scarce. Conclusion: it is necessary to coordinate actions to strengthen the capacities for research on SDH in order to strengthen networks and position SDH on strategic agendas.

RESUMO Objetivo: analisar as capacidades de investigação sobre determinantes sociais e determinação social dos processos saúdedoença (DSS) no Brasil, Colômbia e México com base nos sistemas nacionais de ciência, tecnologia e inovação (SNCTI) e a produção científica sobre DSS (2005-2012) de cada país. Metodologia: Se realiza um estudo exploratório a partir da revisão de literatura, consulta de plataformas nacionais de cada SNCTI, entrevistas e foros de consulta, contemplando as seguintes categorias de estudo para analisar as capacidades: 1. Produção científica, formação de investigadores e políticas relativas a capacidades de investigação; 2. Redes de colaboração; 3. Infraestrutura para a investigação e 4. Produção e apropriação social do conhecimento. Resultados e discussão: A investigação sobre DSS se divulga principalmente em revistas científicas de circulação nacional, em Brasil e Colômbia, entanto que no México se publica principalmente em revistas estrangeiras. Os três países contam com SNCTI consolidados, mas, são escassos os montantes de financiamento para investigação sobre DSS. Conclusão: È necessário articular ações de fortalecimento de capacidades de investigação, fortalecendo redes e posicionando os DSS em agendas estratégicas.

Un primer análisis de la investigación en México sobre los determinantes sociales de la salud: 2005-2012 / A first analysis of research on social determinants of health in Mexico: 2005-2012

Objetivo. Examinar la investigación hecha en México sobre los determinantes sociales de la salud (DSS) durante el periodo 2005-2012 con base en la caracterización del sistema nacional de investigación en salud y la producción científica sobre este tema. Material y métodos. Análisis en dos etapas: revisión documental de fuentes oficiales sobre investigación en salud en México y búsqueda sistemática de literatura sobre DSS. Resultados. Los DSS fueron mencionados en el Programa de Acción Específico de Investigación en Salud 2007-2012, pero no figuran en las estrategias y objetivos; en su lugar, se enfatizan primordialmente aspectos de infraestructura y administrativos. En el periodo se publicaron 145 artículos sobre DSS, cuyas temáticas más abordadas fueron "condiciones de salud", "sistemas de salud" y "nutrición y obesidad". Conclusiones. A pesar de que existe investigación en México sobre DSS, la instrumentación de esos hallazgos en políticas de salud no se ha implementado. El Programa Sectorial de Salud 2013-2018 representa una ventana de oportunidad para posicionar resultados de investigación que promuevan políticas de equidad en salud.

Objective. To examine the research on social determinants of health (SDH) produced in Mexico during the period 2005-2012, based on the characterization of the national health research system and the scientific production on this topic. Materials and methods. Two-stage analyses: Review of Mexican documents and official sources on health research and systematic bibliographic review of the literature on SDH. Results. Although SDH were mentioned in the Specific Action Plan for Health Research 2007-2012, they are not implemented in strategies and goals, as the emphasis is put mostly in infrastructure and administrative aspects of research. In the period studied, 145 articles were published on SDH topics such as health conditions, health systems and nutrition and obesity. Conclusions. In spite of the availability of research on SDH in Mexico, the operationalization of such findings into health policies has not been possible. The current Sectorial Program on Health 2013-2018 represents a window of opportunity to position research findings that promote health equity policies.