Browsing by Author "Vives, Alejandra"

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    Association between informal employment and depressive symptoms in 11 urban cities in Latin America
    (ELSEVIER SCI LTD, 2022) Huynh, Tran B.; Oddo, Vanessa M.; Trejo, Bricia; Moore, Kari; Quistberg, D. Alex; Kim, Jannie J.; Diez-Canseco, Francisco; Vives, Alejandra
    Background: Mental health is an important contributor to the global burden of disease, and depression is the most prevalent mental disorder in Latin America and the Caribbean (LAC). Informal jobs, often characterized by precarious working conditions, low wages, and limited employment benefits, are also highly prevalent in LAC and may be associated with poorer mental health. Our study tests the association between informal employment and major depressive symptoms in LAC cities.Methods: We used individual-level data collected by the Development Bank of Latin America via their "Encuesta CAF" (ECAF) 2016, a cross-sectional household survey of 11 LAC cities (N = 5430). Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Short Depression Scale with possible total score ranging from 0 to 30. Scores were dichotomized, with a score > 16 indicating the presence of major depressive symptoms. Informal employment was defined based on self-reported lack of contribution to the social security system. We used generalized estimating equation (GEE) log-binomial models to estimate the association between informal employment and depressive symptoms overall and by gender. Models were adjusted for age, education, and household characteristics.Results: Overall, individuals employed in informal jobs had a 27% higher prevalence of major depressive symptoms (Prevalence Ratio [PR]: 1.27; 95% Confidence Interval [CI]: 1.00, 1.62) compared to those in formal jobs. The prevalence of depressive symptoms among individuals with informal jobs was higher compared to those with formal jobs in both women (PR: 1.36, 95% CI: 1.06, 1.74) and men (PR: 1.22; 95% CI: 0.90, 1.65).Conclusions: Informal employment in LAC was associated with a higher prevalence of major depressive symptoms. It is important to develop policies aiming at reducing informal jobs and increasing universal social protection for informal workers.
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    COVID-19 and the worsening of health inequities in Santiago, Chile
    (OXFORD UNIV PRESS, 2021) Bilal, Usama; Alfaro, Tania; Vives, Alejandra; CEDEUS (Chile)
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    Excess Mortality during the COVID-19 Pandemic in Cities of Chile: Magnitude, Inequalities, and Urban Determinants
    (SPRINGER, 2022) Alfaro, Tania; Martinez-Folgar, Kevin; Vives, Alejandra; Bilal, Usama; CEDEUS (Chile)
    We estimated excess mortality in Chilean cities during the COVID-19 pandemic and its association with city-level factors. We used mortality, and social and built environment data from the SALURBAL study for 21 Chilean cities, composed of 81 municipalities or "comunas", grouped in 4 macroregions. We estimated excess mortality by comparing deaths from January 2020 up to June 2021 vs 2016-2019, using a generalized additive model. We estimated a total of 21,699 (95%CI 21,693 to 21,704) excess deaths across the 21 cities. Overall relative excess mortality was highest in the Metropolitan (Santiago) and the North regions (28.9% and 22.2%, respectively), followed by the South and Center regions (17.6% and 14.1%). At the city-level, the highest relative excess mortality was found in the Northern cities of Calama and Iquique (around 40%). Cities with higher residential overcrowding had higher excess mortality. In Santiago, capital of Chile, municipalities with higher educational attainment had lower relative excess mortality. These results provide insight into the heterogeneous impact of COVID-19 in Chile, which has served as a magnifier of preexisting urban health inequalities, exhibiting different impacts between and within cities. Delving into these findings could help prioritize strategies addressed to prevent deaths in more vulnerable communities.
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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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    Life expectancy and mortality in 363 cities of Latin America
    (2021) Bilal, Usama; Hessel, Philipp; Perez-Ferrer, Carolina; Michael, Yvonne L.; Alfaro, Tania; Tenorio-Mucha, Janeth; Friche, Amelia A. L.; Pina, Maria Fatima; Vives, Alejandra; Quick, Harrison; Alazraqui, Marcio; Rodriguez, Daniel A.; Miranda, J. Jaime; Diez-Roux, Ana V.; Alazraqui, Marcio; Alazraqui, Marcio; Spinelli, Hugo; Guevel, Carlos; Di Cecco, Vanessa; Tisnes, Adela; Leveau, Carlos; Santoro, Adrian; Herkovits, Damian; Trotta, Andres; Aguirre, Patricia; Lopez, Santiago Rodriguez; Tumas, Natalia; Gouveia, Nelson; Mascolli, Maria Antonietta; Slovic, Anne Dorothee; Martins, Lucas Soriano; Kanai, Claudio Makoto; Barreto, Mauricio; Santos, Gervasio; de Freitas, Anderson Dias; De Castro, Caio Porto; Filho, Jose Firmino de Sousa; Bell, Maria Izabel dos Santos; Andrade, Roberto Fernandes Silva; Cardoso, Leticia; Menezes, Mariana Carvalho de; Pina, Maria de Fatima de; Skaba, Daniel Albert; Guimaraes, Joanna Miguez Nery; Matos, Vanderlei Pascoal de; Caiaffa, Waleska Teixeira; Friche, Amelia Augusta de Lima; Andrade, Amanda Cristina de Souza; Vaz, Camila Teixeira; Coelho, Debora Moraes; Sales, Denise Marques; Aguilar, Guilherme Aparecido Santos; Nascimento, Julia de Carvalho; Morais, Lidia Maria de Oliveira; Santos, Mariana de Melo; Silva, Uriel Moreira; Frenz, Patricia; Alfaro, Tania; Cordova, Cynthia; Ruiz, Pablo; Fuentes, Mauricio; Castillo, Marianela; Pedrero, Sebastian; Rodriguez, Lorena; Doberti, Tamara; Vergara, Alejandra Vives; Salazar, Alejandro; Cortinez-O'Ryan, Andrea; Schmitt, Cristian; Gonzalez, Francisca; Baeza, Fernando; Angelini, Flavia; Orlando, Laura; Sarmiento, Olga Lucia; Higuera, Diana; Gonzalez, Catalina; Montes, Felipe; Useche, Andres F.; Guaje, Oscar; Jaramillo, Ana Maria; Guzman, Luis Angel; Cuesta, Diego Lucumi; Guerra, John Alexis; Bonilla, Jorge Alexander; Guzman, Luis Angel; Linares, Mario; Hessel, Philipp; Morales, Ricardo; Triana, Camilo; Wilches, Maria Alejandra; Palacio, Alejandro; Pena, Fabian Camilo; Sabogal, Joaquin Hernando Jaramillo; Lopez, Julieth; Fajardo, Karen; Botero, Marcelo; Cely, Natalia; Martinez, Paola; Moncada, Carlos; Meisel, Jose David; Martinez, Eliana; Kroker-Lobos, Maria Fernanda; Ramirez-Zea, Manuel; Mazariegos, Monica; Morales, Anali; Barrientos-Gutierrez, Tonatiuh; Perez-Ferrer, Carolina; Prado-Galbarro, Javier; Lopez-Olmedo, Nancy Paulina; de Castro, Filipa; Rojas-Martinez, Rosalba; Jauregui, Alejandra; Stern, Dalia; Riojas, Horacio; Texcalac, Jose Luis; Perez, Desiree Vidana; Miranda, J. Jaime; Vasquez, Akram Hernandez; Diez-Canseco, Francisco; Garcia, Lorena Saavedra; Hammond, Ross; Rodriguez, Daniel; Dronova, Iryna; Wang, Xize; Moran, Mika; Zhao, Yuanyuan; Ju, Yang; Delclos-Alio, Xavier; Hovmand, Peter; Ballard, Ellis; Kuhlberg, Jill; Diez-Roux, Ana V.; Auchincloss, Amy; Barber, Sharrelle; Bilal, Usama; Garcia-Espana, Felipe; Langellier, Brent; Lovasi, Gina; McClure, Leslie; Michael, Yvonne; Moore, Kari; Ortigoza, Ana; Quick, Harrison; Quistberg, D. Alex; Sanchez, Brisa N.; Stankov, Ivana; Tapia-Granados, Jose; Yamada, Goro; Rodriguez-Hernandez, Jordan; Melly, Steve; Avila-Palencia, Ione; Kephart, Josiah; Mullachery, Pricila; Trejo, Bricia; Braverman, Ariela; Fry, Dustin; Henson, Rosie Mae; Martinez-Folgar, Kevin; Slesinski, S. Claire; Indvik, Katherine; Bolinaga, Andrea
    The concept of a so-called urban advantage in health ignores the possibility of heterogeneity in health outcomes across cities. Using a harmonized dataset from the SALURBAL project, we describe variability and predictors of life expectancy and proportionate mortality in 363 cities across nine Latin American countries. Life expectancy differed substantially across cities within the same country. Cause-specific mortality also varied across cities, with some causes of death (unintentional and violent injuries and deaths) showing large variation within countries, whereas other causes of death (communicable, maternal, neonatal and nutritional, cancer, cardiovascular disease and other noncommunicable diseases) varied substantially between countries. In multivariable mixed models, higher levels of education, water access and sanitation and less overcrowding were associated with longer life expectancy, a relatively lower proportion of communicable, maternal, neonatal and nutritional deaths and a higher proportion of deaths from cancer, cardiovascular disease and other noncommunicable diseases. These results highlight considerable heterogeneity in life expectancy and causes of death across cities of Latin America, revealing modifiable factors that could be amenable to urban policies aimed toward improving urban health in Latin America and more generally in other urban environments.
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    Non-Standard Employment and Unemployment during the COVID-19 Crisis: Economic and Health Findings from a Six-Country Survey Study
    (MDPI, 2022) Gunn, Virginia; Vives, Alejandra; Zaupa, Alessandro; Hernando-Rodriguez, Julio C.; Julia, Mireia; Kvart, Signild; Lewchuk, Wayne; Padrosa, Eva; Vos, Mattias Philippe; Ahonen, Emily Q.; Baron, Sherry; Bosmans, Kim; Davis, Letitia; Diaz, Ignacio; Matilla-Santander, Nuria; Muntaner, Carles; O'Campo, Patricia; Ostergren, Per-Olof; Vanroelen, Christophe; Vignola, Emilia F.; Bodin, Theo; CEDEUS (Chile)
    The COVID-19 crisis is a global event that has created and amplified social inequalities, including an already existing and steadily increasing problem of employment and income insecurity and erosion of workplace rights, affecting workers globally. The aim of this exploratory study was to review employment-related determinants of health and health protection during the pandemic, or more specifically, to examine several links between non-standard employment, unemployment, economic, health, and safety outcomes during the COVID-19 pandemic in Sweden, Belgium, Spain, Canada, the United States, and Chile, based on an online survey conducted from November 2020 to June 2021. The study focused on both non-standard workers and unemployed workers and examined worker outcomes in the context of current type and duration of employment arrangements, as well as employment transitions triggered by the COVID-19 crisis. The results suggest that COVID-19-related changes in non-standard worker employment arrangements, or unemployment, are related to changes in work hours, income, and benefits, as well as the self-reported prevalence of suffering from severe to extreme anxiety or depression. The results also suggest a link between worker type, duration of employment arrangements, or unemployment, and the ability to cover regular expenses during the pandemic. Additionally, the findings indicate that the type and duration of employment arrangements are related to the provision of personal protective equipment or other COVID-19 protection measures. This study provides additional evidence that workers in non-standard employment and the unemployed have experienced numerous and complex adverse effects of the pandemic and require additional protection through tailored pandemic responses and recovery strategies.
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    The Employment Precariousness Scale (EPRES): psychometric properties of a new tool for epidemiological studies among waged and salaried workers
    (BMJ PUBLISHING GROUP, 2010) Vives, Alejandra; Amable, Marcelo; Ferrer, Montserrat; Moncada, Salvador; Llorens, Clara; Muntaner, Carles; Benavides, Fernando G.; Benach, Joan
    Background Despite the fact that labour market flexibility has resulted in an expansion of precarious employment in industrialised countries, to date there is limited empirical evidence concerning its health consequences. The Employment Precariousness Scale (EPRES) is a newly developed, theory-based, multidimensional questionnaire specifically devised for epidemiological studies among waged and salaried workers.
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    The Relation Between Precarious Employment Arrangements and Social Precarity: Findings from the PREMIS Study in Stockholm, Sweden
    (SAGE PUBLICATIONS LTD, 2021) Matilla Santander, Nuria; Jonsson, Johanna; Kreshpaj, Bertina; Orellana, Cecilia; Benach, Joan; Badarin, Kathryn; Burstrom, Bo; Vives, Alejandra; Kjellberg, Katarina; Stromdahl, Susanne; Johansson, Gun; Ostergren, Per Olof; Bodin, Theo; CEDEUS (Chile)
    Precarious employment (PE) is a well-known social determinant of health and health inequalities. However, as most previous studies have focused on physical and mental well-being, less is known about the social-related outcomes (ie, social precarity) associated with precarious arrangements. This cross-sectional study aims to investigate whether PE is associated with social precarity in a working population of 401 nonstandard employed workers in Stockholm, Sweden (2016-2017). PE was assessed with the Swedish version of the Employment Precarious Scale (EPRES-Se) and analyzed in relation to social precarity related to working life (eg, task quality and job security) and living conditions (eg, restraint in social activities and financial constraints). We found positive adjusted associations between quartiles of EPRES-Se and social precarity related to working life (eg, being locked in an occupation [aPR(q4):1.33 [1.10-1.61]]) and living conditions (eg, inability to participate in social activities because of work [aPR(q4):1.27 [1.10-1.46]]). Our findings suggest that individuals in PE experience social precarity, stressing that PE may have negative effects on well-being. Further studies using multidimensional constructs of PE and larger samples should analyze these findings according to social and policy contexts in order to be able to inform policymakers.
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    Validation of the Employment Precariousness Scale and its associations with mental health outcomes: results from a prospective community-based study of pregnant women and their partners in Dresden, Germany
    (2024) Karl, Marlene; Staudt, Andreas; Vives, Alejandra; Kopp, Marie; Weise, Victoria; Mack, Judith T.; Steudte-Schmiedgen, Susann; Seidler, Andreas; Garthus-Niegel, Susan
    Objective To translate the Employment Precariousness Scale (EPRES) from Spanish into German (EPRES-Ge), adapt it to the German context, assess the psychometric properties and show prospective associations with mental health outcomes within the peripartum period.Design Analyses encompassed descriptive statistics, exploratory factor analysis, confirmatory factor analysis (CFA) to validate the structure of the EPRES, and multivariate regression analyses with mental health outcomes 8 weeks after birth.Participants Self-report data from 3,455 pregnant women and their partners within the Dresden Study on Parenting, Work, and Mental Health prospective longitudinal cohort study were used.Results The EPRES-Ge with five dimensions and 20 items showed good internal consistency (Cronbach's alpha=0.77). All scales showed good reliability coefficients of alpha=0.73-0.85 and good item-subscale correlations of r=0.63-0.98, with the exception of subscale rights, which showed poor reliability of alpha=0.30 and item-subscale correlations of r=0.45-0.68. Exploratory analysis and CFA confirmed the proposed five-dimensional structure, explaining 45.08% of the cumulative variance. Regression analyses with mental health outcomes after birth revealed statistically significant associations (beta=0.12-0.20).Conclusions The EPRES-Ge is a valuable tool for assessing employment precariousness as a multidimensional construct. The scales could be adapted to the German working context. Precarious employment, as measured by the EPRES-Ge, is a determinant of mental health problems in young families.