Assessment of Factors Influencing Personal Exposure to Air Pollution on Main Roads in Bogota: A Mixed-Method Study.

Background and Objectives: Particulate Matter (PM), particles of variable but small diameter can penetrate the respiratory system via inhalation, causing respiratory and/or cardiovascular diseases. This study aims to evaluate the association of environmental particulate matter (PM2.5) and black carbon (BC) with respiratory health in users of different transport modes in four roads in Bogotá. Materials and Methods: this was a mixed-method study (including a cross sectional study and a qualitative description of the air quality perception), in 300 healthy participants, based on an exploratory sequential design. The respiratory effect was measured comparing the changes between pre- and post-spirometry. The PM2.5 and black carbon (BC) concentrations were measured using portable devices. Inhaled doses were also calculated for each participant according to the mode and route. Perception was approached through semi-structured interviews. The analysis included multivariate models and concurrent triangulation. Results: The concentration of matter and black carbon were greater in bus users (median 50.67 µg m-3; interquartile range (-IR): 306.7). We found greater inhaled dosages of air pollutants among bike users (16.41 µg m-3). We did not find changes in the spirometry parameter associated with air pollutants or transport modes. The participants reported a major sensory influence at the visual and olfactory level as perception of bad air quality. Conclusions: We observed greater inhaled doses among active transport users. Nevertheless, no pathological changes were identified in the spirometry parameters. People's perceptions are a preponderant element in the assessment of air quality.

Salud y ruralidad en Colombia: análisis desde los determinantes sociales de la salud / Health and rurality in Colombia: an analysis from the standpoint of the social determinants of health / Saúde e ruralidade na Colômbia: análise desde os determinantes sociais da saúde

RESUMEN La salud es un concepto que ha tenido diferentes transformaciones. Actualmente, a nivel mundial se promueve el término determinantes sociales, por tanto, ha sido apropiado por diferentes países para el desarrollo de políticas públicas en salud. Colombia ha acogido este concepto tanto en el plan nacional de desarrollo como en el plan decenal de salud pública. Por otro lado, el concepto de ruralidad ha cambiado, lo cual incide en las políticas públicas y decisiones que impactan en las poblaciones. La presente investigación se centró en un ejercicio de revisión sobre la ruralidad y el sistema de acceso a la salud en Colombia, así como de las propuestas de desarrollo rural en el país. El objetivo fue reflexionar sobre dos preguntas: i) ¿qué tan viable es mantener un sistema de aseguramiento con las características del SGSSS en la ruralidad colombiana?, ii) ¿lo ofertado por este régimen puede dar solución a los impactos asociados con condiciones de vida y las diferencias en necesidades básicas? Lo anterior busca proponer nuevos ejercicios investigativos, nuevos marcos de aproximarse a la ruralidad y la relación de esta con la salud.

ABSTRACT the concept of health has undergone a number of transformations. Today, the concept of social determinants of health is promoted globally; for this reason, different countries have included it in their health-related public policies. Colombia has embraced this concept in both the national development program and the decennial public policy health program. Furthermore, the concept of rurality has changed as well, which in turn influences the governmental plans and decisions affecting communities. The research described in this paper focused on reviewing rurality and health system access in Colombia together with the rural development proposals expressed in different government plans. The objective of this work is to reflect on two issues: i) is it possible to maintain a security health system like the SGSSS in the rural areas of Colombia? ii) Can this health care system address the effects on life conditions and the differences in terms of basic social needs? Finally, this document aims to propose new research and approaches to think about the rural context and its relationship with health.

RESUMO A saúde é um conceito que ha presentado diferentes transformações. Na atualidade no nível mundial se promove o termo: determinantes sociais, por tanto, tem sido acolhido por diferentes países para o desenvolvimento de políticas públicas em saúde. Colômbia tem acolhido este conceito tanto no plano nacional de desenvolvimento como no plano decenal de saúde pública. Pelo outro lado, o conceito de ruralidade tem cambiado, o qual incide nas políticas públicas e as decisões que impactam nas populações. A investigação que cá se descreve se centrou num exercício de revisão sobre a ruralidade e o sistema de acesso á saúde em Colômbia, assim como das propostas de desenvolvimento rural no país. O objetivo foi reflexionar sobre duas perguntas: i) ¿ O que tão viável é manter um sistema de segurança com as características do SGSSS na ruralidade colombiana? ii) ¿o ofertado por este regime pode dar solução aos impactos associados com condiciones de vida ás diferencias em necessidades básicas?. O anterior, busca propor novos exercícios investigativos, novos marcos de aproximar-se á ruralidade e a relação desta com a saúde.

[Informal employment, unemployment and underemployment: a matter of public health]. / Informalidad, desempleo y subempleo: un problema de salud pública.

Unemployment and underemployment are problems that have been studied from the economy and politics points of view. Although public health has taken an approach to this problem, it has been mainly disciplinary, since it has focused on the health effects of the unemployed and underemployed but it has failed to propose alternatives from the public policy to solve this problem. The purpose of this essay is to examine the unemployment as an economic, social and health problem of the population. According to records of diagnosis, we review this situation (which requires different strategies at various levels) including different groups involved and their organizations, the State, companies, trade unions and employers unions, not just people unemployed and underemployed.

Informalidad, desempleo y subempleo: Un problema de salud pública / Informal employment, unemployment and underemployment: a matter of public health

La informalidad, el desempleo y subempleo son problemas que han sido estudiados en profundidad desde la economía y la política y aunque la salud pública ha tenido una aproximación a esta problemática, el abordaje, principalmente disciplinario, se ha enfocado en los efectos en la salud de los desempleados y subempleados pero está en deuda de proponer alternativas desde la política pública en salud para enfrentar ésta problemática. El propósito de este ensayo es: hacer una reflexión del desempleo y la informalidad como problema económico, social y de salud de la población, que requiere estrategias en diferentes niveles en las que se incluyan a los diversos colectivos involucrados y a sus organizaciones, es decir al Estado, las empresas, los gremios y sindicatos, entre otros y no sólo a las personas en situación de desempleo, subempleo o informalidad. Para tal fin se parte de la comparación de los registros de los diagnósticos efectuados a trabajadores afiliados a una Empresa Promotora de Salud con los mismos datos pero de las personas que utilizaron la red pública de hospitales de Bogotá.

Unemployment and underemployment are problems that have been studied from the economy and politics points of view. Although public health has taken an approach to this problem, it has been mainly disciplinary, since it has focused on the health effects of the unemployed and underemployed but it has failed to propose alternatives from the public policy to solve this problem. The purpose of this essay is to examine the unemployment as an economic, social and health problem of the population. According to records of diagnosis, we review this situation (which requires different strategies at various levels) including different groups involved and their organizations, the State, companies, trade unions and employers unions, not just people unemployed and underemployed.