Canasta alimentaria normativa: perspectivas actuales e implicaciones para la salud pública en Venezuela / Normative Food Basket current perspectives and implications for public health in Venezuela

La Canasta Alimentaria Normativa (CAN) es un instrumento estratégico de planificación y seguimiento, que impacta el ámbito económico (fijación del salario mínimo SM y del umbral de la pobreza relativa), la seguridad alimentaria y la salud pública. El objetivo fue describir la evolución histórica de la CAN en Venezuela, contrastando su valoración económica respecto al SM durante el período 1990 ­ 2023. Tipo de estudio: Descriptivo. Se empleó la CAN del Instituto Nacional de Estadísticas/Instituto Nacional de Nutrición (INE/INN) y su comparación con la canasta del Centro de Documentación y Análisis Social de la Federación Venezolana de Maestros(CENDAS ­ FVM). Los valores mensuales de la CAN y del SM se recalcularon a dólares USA, de acuerdo a la tasa de cambio oficial. No se incluyó evaluación de la estructura interna, ni sus expresiones en términos de aporte de energía y nutrientes. Resultados: Desde 1990 hasta el año 2015, se requirieron entre1,0 y 1,8 SM y entre 0,6 y 1,7 Ingresos Mínimos Legales (IML)para acceder a la CAN. Para el año 2023 se requirieron hasta 78,3SM y 51,6 IML. El valor promedio de la canasta del CENDAS-FVM fue superior al valor de la CAN INE/INN, en una proporción de 1,7: 1. Conclusiones: la CAN resultó sensible en identificar los cambios y tendencias de su estimación económica, en el ambiente inflacionario venezolano. El uso de sus resultados está sujeta a cierto grado de discrecionalidad política. El costo de la CAN, expresa una contracción del poder de compra de los hogares venezolanos con potenciales impactos sobre la nutrición y la salud física y mental a corto y largo plazo.

The Normative Food Basket (NFB) represents astrategic planning and monitoring instrument, which impactsthe economic sphere (setting of the minimum wage (MW) andthe relative poverty threshold), food security and public health.The objective was to describe the historical evolution of the NFB in Venezuela, contrasting its economic valuation with respect to the MW during the period 1990 ­ 2023. Type of study: Descriptive. The NFB of the National Institute of Statistics/National Institute of Nutrition (NIS/NIN) was used and itscomparison with the basket of the Center for Documentationand Social Analysis of the Venezuelan Federation of Teachers (CENDAS ­ FVM). The monthly values of the NFB and theMW were recalculated into dollars (US$), according to theofficial exchange rate. No evaluation of the internal structurewas included, nor its expressions in terms of energy and nutrientcontribution. Results: From 1990 to 2015, between 1.0 and1.8 MW and between 0.6 and 1.7 Minimum Legal Income(MLI) were required to access the NFB. By 2023, up to 78.3MW and 51.6 MLI were required. The average value of the CENDAS-FVM basket was higher than the value of the NFBNIS/NIN, in a proportion of 1.7: 1. Conclusions: As a statistical operation, the NFB was sensitive in identifying changes andtrends in its estimate economic, in the Venezuelan inflationaryenvironment. The use of its results is subject to a certain degree ofpolitical discretion. The cost of CAN expresses a contraction inthe purchasing power of Venezuelan households with potentialimpacts on nutrition and physical/mental health in the shortand long term.

Racionamiento, inflación e inequidad sanitaria en Venezuela: caso de las enfermedades cardiovasculares / Rationing, inflation and health inequity in Venezuela: case of cardiovascular diseases

los modelos público-sanitarios de caráctermonopólico como el venezolano, suelen asociarse a tendencias al racionamiento de los bienes y servicios que proveen a sus usuarios, así como a la merma de la calidad de estos. Por otro lado, la provisión de dichos bienes y servicios por la vía de mecanismos de mercado, tiene ante sí, el inconveniente que supone el ambiente inflacionario de su economía, cuyo impacto en los precios limita el acceso del paciente a su consumo. El caso de la enfermedad cardiovascular ofrece algunas claves para la comprensión de este fenómeno en el medio venezolano.

Public-health models of a monopolistic nature, suchas the Venezuelan, bring with them trends in the rationing ofthe goods and services they provide to their users, as well as inthe reduction of their quality. On the other hand, the provisionof these goods and services by means of market mechanisms hasbefore it, in our environment, the enormous impediment posedby the inflationary environment of its economy, whose impacton prices limits the patient's access to consumption. The case of cardiovascular disease offers some keys to understanding thisphenomenon in the Venezuelan environment.

Crises econômicas, mortalidade de crianças e o papel protetor do gasto público em saúde / Economic crises, child mortality and the protective role of public health expenditure

Resumo O objetivo do estudo foi analisar como as crises econômicas afetam a saúde infantil a nível global e entre subgrupos de países com diferentes níveis de renda. Foram utilizados dados do Banco Mundial e da OMS para 127 países entre os anos de 1995 e 2014. Foi utilizado um modelo de efeitos fixos, avaliando o efeito da mudança em indicadores macroeconômicos (PIB per capita, taxa de desemprego e de inflação, e taxa de desconforto) na taxa de mortalidade neonatal, infantil, e de menores de cinco anos. Adicionalmente, avaliou-se a modificação do efeito da associação de acordo com a renda dos países e também a influência do gasto público em saúde nessa relação. As evidências mostraram que piores indicadores econômicos (menor PIB per capita e maiores inflação, taxa de desemprego e taxa de desconforto) estão associados com maiores taxas de mortalidade infantil. Nas subamostras por estrato de renda, observa-se a mesma relação, porém com efeitos de maior magnitude entre os países de renda baixa e média. Verificou-se ainda que um maior percentual nos gastos públicos em saúde ameniza os efeitos dos indicadores econômicos nas taxas de mortalidade infantil. Desta forma, é necessário aumentar a atenção aos efeitos nocivos das crises macroeconômicas para garantir melhorias na saúde infantil.

Abstract The aim of the study was to analyze how economic crises affect child health globally and between subgroups of countries with different levels of income. Data from the World Bank and the World Health Organization were used for 127 countries between 1995 and 2014. A fixed effects model was used, evaluating the effect of the change on macroeconomic indicators (GDP per capita, unemployment and inflation rates and misery index) in neonatal, infant and under-five mortality rates. Moreover, we evaluated whether there was a change in the association effect according to the income of the countries and also analyzed the role of public health expenditure in this association. Evidence has shown that worse economic indicators (lower GDP per capita, higher inflation, unemployment rates and misery index) are associated with higher child mortality rates. In the subsamples by income strata, the same association is observed, but with effects of greater magnitude for low- and middle-income countries. We also verified that a higher percentage in public health expenditures alleviates the effects of economic indicators on child mortality rates. Thus, more attention needs to be paid to the harmful effects of the macroeconomic crises to ensure improvements in child health.

Economic and health indicators: correlation between inflation and mortality / Indicadores econômicos e de saúde: a relação entre inflação e mortalidade / Indicadores económicos y de salud: correlación entre inflación y mortalidad

The hypothesis that economic downturn periods have contributed to increase the overall mortality rate has been discussed by several authors. There is an immeasurable literature that associates socioeconomic levels with the individual´s health status. This paper seeks to analyze the correlation between mortality and the variables inflation, unemployment and income in Brazil in the period 1980?2009, examining whether the economic instabilities affect the individuals´ health status. This is an empirical-analytic study of historical series of Health Indicators (overall, infant, maternal mortality, and external causes) and Macroeconomic Indicators (Inflation, Unemployment and Income) in the period 1980 to 2009 in Brazil. The hypothesis corroboration was developed through regression analysis. The theoretical rationale of the results is based on Philips´ theory, whereby the lower the inflation rate is, the higher the unemployment becomes, or vice versa. Regression analysis performed suggests that the IPCA decrease and unemployment increase raise the overall mortality rate. The correlation of mortality with income was positive, confirming the hypothesis of some authors that high income leads to increased mortality due to factors such as stress, traffic accidents, among others. The mortality pattern follows the general behavior of the economic variables chosen. Based on Philips´ theory, the inflation drop raises unemployment levels; moreover, worse living and health conditions increase mortality rates.

A hipótese de que períodos de recessão econômica tem contribuido com o aumento da mortalidade geral tem sido discutida por diversos autores. Existe uma vasta literatura que correlaciona os níveis socioeconômicos com o estado de saúde do indivíduo. O presente trabalho busca analisar a correlação entre a mortalidade geral com as variáveis inflação, desemprego e renda no Brasil, no período de 1980?2009, analisando-se as instabilidades econômicas interferem na saúde dos indivíduos. Trata-se de um estudo empirico-analítico de séries históricas dos Indicadores de Saúde (mortalidade geral, infantil, materna e causas externas) e dos Indicadores Macroeconômicos (Inflação, desemprego e renda) no período de 1980 a 2009 no Brasil. A prova da hipótese foi desenvolvida por meio da Análise de Regressão. A fundamentação teórica dos resultados tem como base a teoria de Philips, segundo a qual quanto menor a taxa de inflação, maior a taxa de desemprego, ou vice-versa. As análises de regressão efetuadas sugerem que a diminuição do IPCA e o aumento do desemprego elevam a mortalidade geral. A correlação da mortalidade com a renda foi positiva, comprovando a hipótese de alguns autores, em que elevada renda gera aumento da mortalidade, devido a fatores como estresse, acidente de trânsito, entre outros. O comportamento da mortalidade geral acompanha o comportamento das variáveis econômicas escolhidas. Com base na teoria de Philips, a queda da inflação, eleva os níveis de desemprego; ademais, piores condições de vida e saúde majoram as taxas de mortalidade.

La hipótesis de que las crisis económicas han contribuido al aumento de la mortalidad general ha sido discutida por varios autores. Existe una vasta literatura que correlaciona los niveles socioeconómicos con el estado de salud del individuo. Este estudio tiene como objetivo analizar la correlación entre la mortalidad global y las variables inflación, desempleo y renta en Brasil, durante el período 1980?2009, analizando si las inestabilidades económicas afectan a la salud de las personas. Este método es un estudio empírico-analítico de series históricas de los Indicadores de Salud (mortalidad general, infantil, materna y causas externas) y de los Indicadores Macroeconómicos (inflación, desempleo y renta) en el período 1980?2009 en Brasil. La prueba de la hipótesis fue desarrollada a través del Análisis de Regresión. La fundamentación teórica de los resultados se basa en la teoría de Philips, según la cual lo más baja sea la tasa de inflación, mas alta será la tasa de desempleo, o viceversa. Los análisis de regresión realizados sugieren que la reducción del IPCA y el aumento del desempleo aumentan la mortalidad general. La correlación de la mortalidad con la renta fue positiva, lo que confirma la hipótesis de algunos autores, que una renta alta genera aumento de la mortalidad debido a factores como el estrés, los accidentes de tráfico, entre otros. El comportamiento de la mortalidad general acompaña el comportamiento de las variables económicas escogidas. Basado en la teoría de Philips, la caída de la inflación eleva los niveles de desempleo; además, las peores condiciones de vida y salud aumentan las tasas de mortalidad.

Mortalidad infantil e indicadores económicos en Chile: 1985-1999 / Infant mortality and socioeconomic indicators in Chile: 1985-1999

Background: The link between economy and some public health indicators like Infant Mortality Rate (IMR) is widely demonstrated. Aim: To explore the relationship between some economic indicators and infant mortality in Chile between 1985 and 1999. Material and methods: An ecological study, obtaining information from Demographic Annual Reports edited by the National Institute of Statistics, Health Ministry, Planning Ministry and the Central Bank. Results: There is an inverse association between the Gross National Product, per capita and Real Salary Index and a direct relationship between inflation and unemployment rates with an increased infant mortality. Conclusions: The reduction in infant mortality observed in Chile depends more on socio demographic than on economical factors

Experimentaçöes econômicas governamentais e bioética / Government economics experimentotions and bioethics

Comentários do ex-ministro Adib Jatene sobre a equipe econômica do governo mostrando que experimentações econômicas desastrosas vem de longa data e parecem incluir desatualização de conhecimentos e desvios de conduta

Trends in admission and case fatality for acute malnutrition: Kingston 1892-1991

The case fatality ratio (CFR) in acute protein-energy malnutrition (PEM) achieved in the Tropical Metabolism Research Unit (TMRU) was compared with that of other tertiary care facilities in Kingston. Trends in admission and fatality rates, case severity and complications were also examined. From ward admission registers for Bustamante Hospital for Children (BHC), the University Hospital of the West Indies (UHWI), children's wards and the TMRU all cases of PEM admitted from 1982 through 1991 were enumerated and there was a docket search for random subsamples. Ten-year mean CFR percent for BHC was 8.8 (n=1974); for UHWI wards 5.5 (n=658); for TMRU 7.1 (n=662). BHC has the least restrictions on admission and showed most clearly that the peak time in Kingston for admission of PEM was around 1985, falling to a minimum in 1988 - 1990 and rising again in 1991; however, the other sites also showed similar trends. BHC had a range of CFR precent p.a. of 20.0 to 3.0, with a striking fall in the second half of the decade. There was no temporal CFR trend for the UHWI or TMRU. The latter institution had the highest proportion of admissions with marasmic-kwashiorkor and the lowest proportion with recorded infection. The annual variation in numbers of PEM deaths at BHC was best accounted for by (a) percentage change in consumer price index and (b) percentage change in the US$ value of the Jamaican $, in the preceding year, and (c) annual number of admissions, together. Generally, our findings suggest a minor role for expert in-patient management in reducing deaths from PEM

Estado, economia y salud en America Latina a principios de los anos noventa: Informe del Seminario / State, economy and health in Latin America in the early 90's

Incluye bibliografia al final de cada capitulo

Estado, Economia y Salud en America Latina a Principios de los Anos Noventa. Organización Panamericana de la Salud; jul. 1990

. Brasil. Universidad Estatal de Campinas

. Union de Universidades de America Latina