Población en Situación de Calle en la Ciudad de México Durante la Pandemia por la Enfermedad COVID-19

Health care for urban poor falls through the gap

The situation of social exclusion in which older adults live in extreme poverty is a problem that leads to psychological alterations such as depression or cognitive deterioration. Our objective was to analyze the living conditions and the psychosocial sphere of older adult people living in extreme poverty in Requena del Tapiche in Peru. This was an observational, descriptive, cross-sectional study. Sixty participants between 60 and 100 years of age of both sexes were included who gave their informed consent. Sociodemographic variables were analyzed, and the Gijón, family Apgar, Yesavage, and Pfeiffer scales were used. The sample was composed of 55% women and 45% men, with a mean age of 79.2 years (SD 6.67). More than half live alone or with their spouse. Fifty-seven percent sleep on the floor or on wood, and about 82% do not have safe water. Family dysfunction is found in 40%, and 98% are at social risk or with an established social problem and a precarious economic situation. More than 60% suffer from depressive symptoms, which are more frequent in women. We conclude that older adults perceive deficient family support, observing a deteriorated social situation. Most of them are at risk of social exclusion and loneliness, making them more vulnerable. They show sadness, with a high rate of depression. People with more cognitive impairment live alone, and those in social exclusion suffer a higher degree of depression. More cooperative projects and health promotion interventions developed in the peripheral neighborhoods of Requena del Tapiche are needed to improve the impact on the health of older adult people in extreme poverty.

Jesuits, Nahuas, and the Good Death Society in Mexico City, 1710-1767

This article analyses the ways in which Spanish society is dealing with extreme poverty and social exclusion. Spanish society exhibits a paradoxical combination of widespread precariousness and a limited degree of extreme poverty and exclusion. Social exclusion is still, to a great extent, a remnant of the past rather than a result of recent trends in employment. Some of the social policy actions carried out during the last fifteen years with an impact on this problem are the development of a means-tested benefit system, the setting up of minimum income for social integration programmes targeting the most excluded, and the building of a network of public local social services. We analyse these programmes in the context of economic modernization in Spain in recent years.

Questions surrounding the fight against poverty and social exclusion have become a global priority. Poverty and its causes are perceived as differences in the economic and social development of each individual continent and country. Social risk management was developed by the World Bank as a specific conceptual framework of social protection strategy and includes prevention, mitigation and the management of social risks. The diverging causes of poverty across the European continent assume a different approach in identifying causes and social risk management. An important aspect of the EU’s social policy is to combat unemployment and social exclusion with the support of the European fund to help the extreme poor and other EU funds, e.g. EQUAL. The appropriate implementation of social risk management in each country is a prerequisite for reducing extreme poverty. Social risk management as a global strategy to combat poverty and extreme poverty is a challenge in the field of education which offers a new range of views and is generating more complex professional competencies in education and new possibilities for university graduates in the labor market.

In low-income and middle-income countries, such as those in sub-Saharan Africa and Latin America, the COVID-19 pandemic has had substantial implications for women's wellbeing. Policy responses to the COVID-19 pandemic have highlighted the gendered aspect of pandemics; however, addressing the gendered implications of the COVID-19 pandemic comprehensively and effectively requires a planetary health perspective that embraces systems thinking to inequalities. This Viewpoint is based on collective reflections from research done by the authors on COVID-19 responses by international and regional organisations, and national governments, in Latin America and sub-Saharan Africa between June, 2020, and June, 2021. A range of international and regional actors have made important policy recommendations to address the gendered implications of the COVID-19 pandemic on women's health and wellbeing since the start of the pandemic. However, national-level policy responses to the COVID-19 pandemic have been partial and inconsistent with regards to gender in both sub-Saharan Africa and Latin America, largely failing to recognise the multiple drivers of gendered health inequalities. This Viewpoint proposes that addressing the effects of the COVID-19 pandemic on women in low-income and middle-income countries should adopt a systems thinking approach and be informed by the question of who is affected as opposed to who is infected. In adopting the systems thinking approach, responses will be more able to recognise and address the direct gendered effects of the pandemic and those that emerge indirectly through a combination of long-standing structural inequalities and gendered responses to the pandemic.

En este artículo estimamos la magnitud probable de los cambios en la distribución del ingreso, la pobreza y la pobreza extrema del país en las áreas metropolitanas del Valle de México, Guadalajara y Monterrey, así como en la Ciudad de México, de acuerdo con diferentes hipótesis de conducta del ingreso laboral basadas en información disponible hasta el inicio de la pandemia y que consideran los cierres de actividades llamadas no esenciales y el impacto de éstos en ocupaciones específicas. La pandemia apareció en el contexto de un incipiente proceso de aumento en los salarios reales y en el empleo iniciado en 2019; nuestros resultados muestran que el freno en las actividades derivado de la emergencia sanitaria, tanto en México como en el mundo, provocó el aumento de la pobreza y la extrema pobreza, además del crecimiento de la desigualdad medida por el índice de Gini.

People living in extreme poverty or social exclusion mainly come from poor families, and their social difficulties tend to become chronic. This situation appears to be especially pronounced in countries with lower levels of development. This article analyzes different aspects of people (n = 99) who make their living collecting trash from dumps in León, Nicaragua, one of the countries with the lowest levels of development in Latin America. This group is difficult to access, heavily stigmatized, lives in chronic and extreme poverty and their families were also poor. The results show that the pickers in León whose families were poorest had the highest illiteracy rates, were poorest in health, had experienced more stressful life events, and had poorer future expectations. Negative health and life circumstances, low levels of education, and fatalism may lead to the pickers’ situations of social exclusion becoming chronic.

Extreme poverty is a complex and multifaceted challenge that cannot be solely addressed through economic interventions. Traditional economic indicators, such as GDP, do not fully capture the realities of vulnerable populations who often experience discrimination and social exclusion. This has legal and human rights implications, particularly in regions such as Sub-Saharan Africa where extreme poverty is concentrated. In light of these concerns, this article critically examines the existing literature on poverty economics and law and presents an analysis of key data. Ultimately, the article argues for a comprehensive approach that prioritises law and justice as crucial components of efforts to achieve target 1 of the United Nations’ Agenda 2030 for Sustainable Development. This approach should entail the establishment of legal frameworks that promote accountability for political actors and protect the rights of the poor.

The understanding of the relationship between human rights and extreme poverty at the United Nations owes much to Joseph Wresinski, the founder of the International Movement ATD Fourth World. While Wresinski was a Catholic priest, he deliberately created an inter-denominational organization and developed a unique spirituality rooted in a shared life experience with the extreme poor. He considered that spirituality, broadly understood, should be at the heart of the fight against extreme poverty and social exclusion. He hoped that his message could be heard by men and women from all faiths who are concerned about the plight of the extreme poor.

The socio-spatial differentiation in the urban space refers to the geographic concentration of poverty. In the literature there is an absence of studies about poverty spaces in cities, relating the socio-economic situation of the underprivileged to particular urban spaces. Poor neighbourhoods tend to group together in clusters dominated by situations of social exclusion. This study presents an analysis of the main features and disadvantages of families living in poor spaces in Mexico City through the results of 329 surveys applied in poor neighbourhoods of the urban periphery and the inner suburb. Special attention is given to the measure of poverty levels, identifying four categories: non-poverty, moderate poverty, extreme poverty and indigence. This measuring is based on access to basic needs, labour condition, and social cohesion according to peripheral and suburban location.

IntroductionResearch is ongoing to increase our understanding of how much a previous diagnosis of type 2 diabetes mellitus (T2DM) affects someone’s risk of becoming seriously unwell following a COVID-19 infection. In this study we set out to determine the relative likelihood of death following COVID-19 infection in people with T2DM when compared to those without T2DM. This was conducted as an urban population study and based in the UK.MethodsAnalysis of electronic health record data was performed relating to people living in the Greater Manchester conurbation (population 2.82 million) who had a recorded diagnosis of T2DM and subsequent COVID-19 confirmed infection. Each individual with T2DM (n = 13,807) was matched with three COVID-19-infected non-diabetes controls (n = 39,583). Data were extracted from the Greater Manchester Care Record (GMCR) database for the period 1 January 2020 to 30 June 2021. Social disadvantage was assessed through Townsend scores. Death rates were compared in people with T2DM to their respective non-diabetes controls; potential predictive factors influencing the relative likelihood of admission were ascertained using univariable and multivariable logistic regression.ResultsFor individuals with T2DM, their mortality rate after a COVID-19 positive test was 7.7% vs 6.0% in matched controls; the relative risk (RR) of death was 1.28. From univariate analysis performed within the group of individuals with T2DM, the likelihood of death following a COVID-19 recorded infection was lower in people taking metformin, a sodium-glucose cotransporter 2 inhibitor (SGLT2i) or a glucagon-like peptide 1 (GLP-1) agonist. Estimated glomerular filtration rate (eGFR) and hypertension were associated with increased mortality and had odds ratios of 0.96 (95% confidence interval 0.96–0.97) and 1.92 (95% confidence interval 1.68–2.20), respectively. Likelihood of death following a COVID-19 infection was also higher in those people with a diagnosis of chronic obstructive pulmonary disease (COPD) or severe enduring mental illness but not with asthma, and in people taking aspirin/clopidogrel/insulin. Smoking in people with T2DM significantly increased mortality rate (odds ratio of 1.46; 95% confidence interval 1.29–1.65). In a combined analysis of patients with T2DM and controls, multiple regression modelling indicated that the factors independently relating to a higher likelihood of death (accounting for 26% of variance) were T2DM, age, male gender and social deprivation (higher Townsend score).ConclusionFollowing confirmed infection with COVID-19 a number of factors are associated with mortality in individuals with T2DM. Prescription of metformin, SGLT2is or GLP-1 agonists and non-smoking status appeared to be associated with a reduced the risk of death for people with T2DM. Age, male sex and social disadvantage are associated with an increased risk of death.

I offer a reflection on the challenges and difficulties to give continuity to maternal and neonatal health care and services during 2020 in Mexico; what could be considered the initial stage of the sanitary emergency produced by the SARS-COV-2 virus. The text is based on the ethnographic work carried out with Catalina, a woman who gave birth to her first child, in June 2020 in Mexico City -the country's capital-, four months after the COVID-19 disease was defined as a health event of global proportions. I analyze the overlap between problems prior to the onset of the pandemic - social asymmetries, violence against women and the increase in health services - and the measures generated by state health authorities to control the disease - for example: the mandate government of social isolation and the reconversion of the health system. I argue that it is necessary to reevaluate these measures considering the effects differentiated by gender, age, social class and geographic location. Taking into account the power relations that undermine the construction of pregnant and postpartum women as a “vulnerable” population.

The chapter aims to reflect on cognitive processes linked to situations of extreme poverty or social exclusion. The method used is quantitative. Investigations developed in Nicaragua and Spain were used. Cognitive schemes, attributions, stereotypes or meta-stereotypes seem to function as cognitions that, due to their characteristics, may have a very relevant impact on the inclusion processes of the most disadvantaged groups. It was identified that the attributions carried out on the main causes of poverty refer mainly to individual factors and fatality, with few attributions to structural social causes.

The purpose of this paper is to assess changes in the risk of poverty in European Union Member States and the extent of poverty in rural areas and farming households after Poland’s accession to the EU. The above aspect was consid- ered against the background of urban residents and other so- cioeconomic groups of households. The study was based on EU-SILC, Eurostat and CSO data. For a comparative assess- ment across EU countries, the poverty and/or social exclusion risk index was used. For a comparative assessment of rural and urban areas, the following basic poverty thresholds (as es- timated by the Central Statistical Office), were used: extreme poverty (subsistence minimum), relative poverty and statutory poverty. Despite the high level of socioeconomic development in the European Union, the risk of poverty or social exclusion is widespread and varies strongly across countries, regions and social groups. In Poland, rural areas are more affected by poverty than urban areas, mainly because rural households have lower incomes than urban households. The risk of pov- erty in the EU has declined. After the accession to the EU, Poland has experienced a decrease in the extent of poverty. This positive change was the combined result of many factors, mainly including an increase in incomes of the farming and rural population. In Poland, income disparities between rural and urban residents and between farm and landless families have decreased. Reducing poverty and social exclusion is one of the most important goals of the EU social policy.