Browsing by Author "Diez Roux, Ana V."

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    A Novel International Partnership for Actionable Evidence on Urban Health in Latin America: LAC-Urban Health and SALURBAL
    (2019) Diez Roux, Ana V.; Slesinski, S. Claire; Alazraqui, Marcio; Teixeira Caiaffa, Waleska; Frenz, Patricia; Jordán Fuch, Ricardo; Miranda, J. Jaime; Rodríguez, Daniel A.; Sarmiento Dueña, Olga L.; Siri, José; Vives Vergara, Alejandra
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    Assessing cohesion and diversity in the collaboration network of the SALURBAL project
    (2023) Baquero, Sofia; Montes, Felipe; Stankov, Ivana; Sarmiento, Olga L.; Medina, Pablo; Slesinski, S. Claire; Diez-Canseco, Francisco; Kroker-Lobos, Maria F.; Teixeira, Waleska; Vives Vergara, Alejandra; Alazraqui, Marcio; Barrientos-Gutierrez, Tonatiuh; Diez Roux, Ana V.; CEDEUS (Chile)
    The SALURBAL (Urban Health in Latin America) Project is an interdisciplinary multinational network aimed at generating and disseminating actionable evidence on the drivers of health in cities of Latin America. We conducted a temporal multilayer network analysis where we measured cohesion over time using network structural properties and assessed diversity within and between different project activities according to participant attributes. Between 2017 and 2020 the SALURBAL network comprised 395 participants across 26 countries, 23 disciplines, and 181 institutions. While the cohesion of the SALURBAL network fluctuated over time, overall, an increase was observed from the first to the last time point of our analysis (clustering coefficient increased [0.83-0.91] and shortest path decreased [1.70-1.68]). SALURBAL also exhibited balanced overall diversity within project activities (0.5-0.6) by designing activities for different purposes such as capacity building, team-building, research, and dissemination. The network's growth was facilitated by the creation of new diverse collaborations across a range of activities over time, while maintaining the diversity of existing collaborations (0.69-0.75 between activity diversity depending on the attribute). The SALURBAL experience can serve as an example for multinational research projects aiming to build cohesive networks while leveraging heterogeneity in countries, disciplines, career stage, and across sectors.
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    Building a Data Platform for Cross-Country Urban Health Studies: the SALURBAL Study
    (2019) Diez Roux, Ana V.; Bilal, Usama; Moore, Karia; Ortigoza, Ana; Rodriguez, Daniel A.; Sarmiento, Olga; Frenz, Patriciae; Friche, Amélia Augustaf; Caiaffa, Waleska Teixeiraf; Vives, Alejandrag; Miranda, J. Jaimeh; Alazraqui, Marcio; Spinelli, Hugoi; Guevel, Carlosi; Di Cecco, Vanessai; Tisnés, Adelai; Leveau, Carlos; Santoro, Adrián; Vives Vergara, Alejandra
    Studies examining urban health and the environment must ensure comparability of measures across cities and countries. We describe a data platform and process that integrates health outcomes together with physical and social environment data to examine multilevel aspects of health across cities in 11 Latin American countries. We used two complementary sources to identify cities with 100,000 inhabitants as of 2010 in Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, and Peru. We defined cities in three ways: administratively, quantitatively from satellite imagery, and based on country-defined metropolitan areas. In addition to cities, we identified sub-city units and smaller neighborhoods within them using census hierarchies. Selected physical environment (e.g., urban form, air pollution and transport) and social environment (e.g., income, education, safety) data were compiled for cities, sub-city units, and neighborhoods whenever possible using a range of sources. Harmonized mortality and health survey data were linked to city and sub-city units. Finer georeferencing is underway. We identified 371 cities and 1436 sub-city units in the 11 countries. The median city population was 234,553 inhabitants (IQR 141,942; 500,398). The systematic organization of cities, the initial task of this platform, was accomplished and further ongoing developments include the harmonization of mortality and survey measures using available sources for between country comparisons. A range of physical and social environment indicators can be created using available data. The flexible multilevel data structure accommodates heterogeneity in the data available and allows for varied multilevel research questions related to the associations of physical and social environment variables with variability in health outcomes within and across cities. The creation of such data platforms holds great promise to support researching with greater granularity the field of urban health in Latin America as well as serving as a resource for the evaluation of policies oriented to improve the health and environmental sustainability of cities.
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    Gender inequality, women's empowerment, and adolescent birth rates in 363 Latin American cities
    (2023) Braverman-Bronstein, Ariela; Ortigoza, Ana F.; Vidaña-Pérez, Dèsirée; Barrientos-Gutiérrez, Tonatiuh; Baldovino-Chiquillo, Laura; Bilal, Usama; Friche, Amélia Augusta de Lima; Diez-Canseco, Francisco; Maslowsky, Julie; Vives Vergara, Alejandra; Diez Roux, Ana V.; CEDEUS (Chile)
    Background: Gender inequality is high in Latin America (LA). Empowering girls and young women and reducing gender gaps has been proposed as a pathway to reduce adolescent pregnancy. We investigated the associations of urban measures of women's empowerment and gender inequality with adolescent birth rates (ABR) in 366 Latin American cities in nine countries. Methods: We created a gender inequality index (GII) and three Women Achievement scores reflecting domains of women's empowerment (employment, education, and health care access) using censuses, surveys, and political participation data at city and sub-city levels. We used 3-level negative binomial models (sub-city-city-countries) to assess the association between the GII and scores, with ABR while accounting for other city and sub-city characteristics. Results: We found within country heterogeneity in gender inequality and women's empowerment measures. The ABR was 4% higher for each 1 standard deviation (1-SD) higher GII (RR 1.04; 95%CI 1.01,1.06), 8% lower for each SD higher autonomy score (RR 0.92; 95%CI 0.86, 0.99), and 12% lower for each SD health care access score (RR 0.88; 95%CI 0.82,0.95) after adjustment for city level population size, population growth, homicide rates, and sub-city population educational attainment and living conditions scores. Conclusion: Our findings show the key role cities have in reducing ABR through the implementation of strategies that foster women's socioeconomic progress such as education, employment, and health care access.
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    Inequalities in life expectancy in six large Latin American cities from the SALURBAL study: an ecological analysis
    (ELSEVIER SCI LTD, 2019) Bilal, Usama; Alazraqui, Marcio; Caiaffa, Waleska T.; Lopez Olmedo, Nancy; Martinez Folgar, Kevin; Miranda, J. Jaime; Rodriguez, Daniel A.; Vives, Alejandra; Diez Roux, Ana V.; CEDEUS (Chile)
    Background Latin America is one of the most unequal regions in the world, but evidence is lacking on the magnitude of health inequalities in urban areas of the region. Our objective was to examine inequalities in life expectancy in six large Latin American cities and its association with a measure of area-level socioeconomic status.
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    The Regeneración Urbana, Calidad de Vida y Salud - RUCAS project: a Chilean multi-methods study to evaluate the impact of urban regeneration on resident health and wellbeing
    (2021) Baeza Rivas, Fernando; Vives Vergara, Alejandra; González López, Francisca Teresa; Orlando, Laura; Valdebenito, Roxana; Cortínez-O’Ryan, Andrea; Slesinski, Claire; Diez Roux, Ana V.; CEDEUS (Chile)
    Abstract Background The available evidence of the health effects of urban regeneration is scarce In Latin America, and there are no studies focused on formal housing that longitudinally evaluate the impact of housing and neighborhood interventions on health. The “Regeneración Urbana, Calidad de Vida y Salud” (Urban Regeneration, Quality of Life, and Health) or RUCAS project is a longitudinal, multi-method study that will evaluate the impact of an intervention focused on dwellings, built environment and community on the health and wellbeing of the population in two social housing neighborhoods in Chile. Methods RUCAS consists of a longitudinal study where inhabitants exposed and unexposed to the intervention will be compared over time within the study neighborhoods (cohorts), capitalizing on interventions as a natural experiment. Researchers have developed a specific conceptual framework and identified potential causal mechanisms. Proximal and more distal intervention effects will be measured with five instruments, implemented pre- and post-interventions between 2018 and 2021: a household survey, an observation tool to evaluate dwelling conditions, hygrochrons for measuring temperature and humidity inside dwellings, systematic observation of recreational areas, and qualitative interviews. Survey baseline data (956 households, 3130 individuals) is presented to describe sociodemographics, housing and health characteristics of both cohorts, noting that neighborhoods studied show worse conditions than the Chilean population. Discussion RUCAS’ design allows for a comprehensive evaluation of the effects that the intervention could have on various dimensions of health and health determinants. RUCAS will face some challenges, like changes in the intervention process due to adjustments of the master plan, exogenous factors –including COVID-19 pandemic and associated lockdowns– and lost to follow-up. Given the stepped wedge design, that the study capitalizes on within household changes over time, the possibility of adjusting data collection process and complementarity of methods, RUCAS has the flexibility to adapt to these circumstances. Also, RUCAS’ outreach and retention strategy has led to high retention rates. RUCAS will provide evidence to inform regeneration processes, highlighting the need to consider potential health effects of regeneration in designing such interventions and, more broadly, health as a key priority in urban and housing policies.