Cross-border COVID-19 spread amidst malaria re-emergence in Venezuela: a human rights analysis.

BACKGROUND: Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region. RESULTS: Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency. CONCLUSIONS: International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela's capacity to deal with this crisis, is critical to protecting rights and health in the country and region.

Worldwide trends in suicide mortality from 1990 to 2015 with a focus on the global recession time frame.

OBJECTIVES: To report worldwide trends in suicide mortality during a period that covers 7 years after the 2008 global crisis. METHODS: We performed a time trend analysis with joinpoint regression. RESULTS: Over the 2000s, suicide mortality decreased with the largest declines observed in some Eastern European countries. The downward trends were followed by an increase in concomitance with the 2008 global crisis in some countries, including Greece (annual percentage change = + 6 in men and + 11.8 in women), the Netherlands (+ 4.2 in men and + 4.0 in women), and the UK (+ 1.6 in men), while the pre-crisis downward trends stopped in Germany, Italy, and Spain. The joinpoint analysis also revealed long-term rises in Brazil (+ 0.8 since 1990 in men and + 1.8 since 1999 in women), Mexico (+ 1.3 since 1995 in men and + 3.6 since 1990 in women), the USA (+ 1.7 since 2005 in men and + 4.2 since 2010 in women), and Australia (+ 1.8 in men and + 3.7 in women, since 2006 in both sexes). CONCLUSIONS: Despite downward trends in several areas of the world, in some countries suicide rates increased since the 2008 global crisis.

The food security and nutrition crisis in Venezuela.

As Venezuela's economic and political crises continues to evolve, hyperinflation, declining food production and food shortages are contributing to the deterioration of the food and nutrition situation. While official data is largely unavailable, food security and nutrition data from a variety of sources suggest that nearly the entire population is food insecure and that prevalence of acute malnutrition among children is reaching crisis levels in vulnerable populations. In the most recent national survey, 80% of households were food insecure and most households receiving government food assistance reported only occasional receipt. Prevalence of acute malnutrition among children under five increased in vulnerable communities across many states, surpassing serious or critical thresholds in multiple states. Hospitals across the country are reporting increases in both the number and proportion of pediatric consultations and admissions with acute malnutrition, and malnutrition deaths are increasingly common. Declining food security, increases in prevalence of acute malnutrition among children in vulnerable communities, rising pediatric hospital admissions with acute malnutrition and clinician reports of child deaths due to acute malnutrition are indicative of a crisis. The response to the nutrition and food security crisis to date has been limited. There is an urgent need to begin taking steps to address widespread food insecurity and to support treatment for children with acute malnutrition.

Venezuela's public health crisis: a regional emergency.

The economic crisis in Venezuela has eroded the country's health-care infrastructure and threatened the public health of its people. Shortages in medications, health supplies, interruptions of basic utilities at health-care facilities, and the emigration of health-care workers have led to a progressive decline in the operational capacity of health care. The effect of the crisis on public health has been difficult to quantify since the Venezuelan Ministry of Health stopped publishing crucial public health statistics in 2016. We prepared a synthesis of health information, beyond what is available from other sources, and scholarly discussion of engagement strategies for the international community. Data were identified through searches in MEDLINE, PubMed, and the grey literature, through references from relevant articles, and governmental and non-governmental reports, and publicly available databases. Articles published in English and Spanish until Dec 1, 2018, were included. Over the past decade, public health measures in Venezuela have substantially declined. From 2012 to 2016, infant deaths increased by 63% and maternal mortality more than doubled. Since 2016, outbreaks of the vaccine-preventable diseases measles and diphtheria have spread throughout the region. From 2016 to 2017, Venezuela had the largest rate of increase of malaria in the world, and in 2015, tuberculosis rates were the highest in the country in 40 years. Between 2017 and 2018, most patients who were infected with HIV interrupted therapy because of a lack of medications. The Venezuelan economic crisis has shattered the health-care system and resulted in rising morbidity and mortality. Outbreaks and expanding epidemics of infectious diseases associated with declines in basic public health services are threatening the health of the country and the region.

Explaining the decline in Mexico-U.S. Migration: the effect of the Great Recession.

The rate of Mexico-U.S. migration has declined precipitously in recent years. From 25 migrants per thousand in 2005, the annual international migration rate for Mexican men dropped to 7 per thousand by 2012. If sustained, this low migration rate is likely to have a profound effect on the ethnic and national-origin composition of the U.S. population. This study examines the origins of the migration decline using a nationally representative panel survey of Mexican households. The results support an explanation that attributes a large part of the decline to lower labor demand for Mexican immigrants in the United States. Decreases in labor demand in industrial sectors that employ a large percentage of Mexican-born workers, such as construction, are found to be strongly associated with lower rates of migration for Mexican men. Second, changes in migrant selectivity are also consistent with an economic explanation for the decline in international migration. The largest declines in migration occurred precisely among the demographic groups most affected by the Great Recession: namely, economically active young men with low education. Results from the statistical analysis also show that the reduction in labor demand in key sectors of the U.S. economy resulted in a more positive educational selectivity of young migrants.

Impact of economic crisis on mental health of migrant workers: what happened with migrants who came to Spain to work?

OBJECTIVES: To assess changes in mental health in a sample of migrant workers after the eruption of the economic crisis in Spain. METHODS: 318 migrant workers were interviewed. Mental health, sociodemographic, and economic crisis related variables were obtained through face-to-face (2008) and phone (2011) interviews. Prevalence of poor mental health (PMH) was compared (2011-2008) and multivariate logistic regression models were fitted. RESULTS: Change in prevalence of PMH was higher in men (aOR 4.63; 95 % CI 2.11-10.16). Subgroups of men showing the largest detrimental mental health effects were: unemployed, with low salaries (≤1,200 euros) and those reporting family burden. An increase of PMH was found in women, without significant associations. CONCLUSIONS: Mental health of migrant workers in Spain has worsened during the economic crisis.

The association between living through a prolonged economic depression and the male:female birth ratio--a longitudinal study from Cuba, 1960-2008.

The Trivers-Willard hypothesis suggests that populations respond to scarcity by decreasing the ratio of males to females at livebirth. Cuba experienced an extreme economic depression in the 1990s called the "special period." Using time-series analysis, the authors studied the impact of this event on the male:female sex ratio at birth in Cuba from 1960 to 2008. From 1990 to 1993, the per capita gross domestic product in Cuba decreased by 36%. By use of a definition of the special period from 1991 to 1998, there was a prolonged increase in the male:female ratio of livebirths during this period of economic depression (P < 0.001), from 1.06 at baseline to a peak of 1.18. This association persisted when using alternative definitions of the duration of economic depression in sensitivity analyses. Once the period of economic depression was over, the male:female ratio returned to the baseline value. These data suggest that, in Cuba, contrary to the Trivers-Willard hypothesis, the human population responded to conditions of scarcity by increasing the ratio of males to females at livebirth. These data may be relevant in the modeling of demographic projections in countries that experience prolonged economic depression and in understanding adaptive human reproductive responses to environmental change.

Effects of macroeconomic conditions on health in Brazil.

OBJECTIVE: To analyze the relationship between macroeconomic conditions and health in Brazil. METHODS: The analysis of the impact of employment and income on mortality in Brazil was based on panel data from Brazilian states between 1981 and 2002. Mortality rates obtained from the national mortality database was used as a proxy for health status, whereas the variables employment, income, and illiteracy rates were used as proxies for macroeconomic and socioeconomic conditions. Static and dynamic models were applied for the analysis of two hypotheses: a) there is a positive relationship between mortality rates and income and employment, as suggested by Ruhm; b) there is a negative relationship between mortality rates and income and employment, as suggested by Brenner. RESULTS: There was found a negative relationship between mortality rates (proxy for health) and macroeconomic conditions (measured by employment rate). The estimates indicated that the overall mortality rate was higher during economic recession, suggesting that as macroeconomic conditions improved, increasing employment rates, there was a decrease in the mortality rate. The estimate for the relationship between illiteracy (proxy for education level) and mortality rate showed that higher levels of education can improve health. CONCLUSIONS: The results from the static and dynamic models support Brenner's hypothesis that there is a negative relationship between mortality rates and macroeconomic conditions.