Social participation through the lens of diversity: insights from three social groups of older people in Chile

Chile is currently updating the Comprehensive Policy on Positive Aging, which establishes a positive association between Subjective Well-being, Self-perceived Health, Functional status, and Social Participation in older people. To study the relationship between Subjective Well-being, General Health, Functional status, and Social Participation in older people in Chile. In a cross-sectional observational study, 2.031 people aged 60 years and over were included in the National Health Survey 2016-2017 (ENS). The study included analysis of correlations between the relevant variables, in addition to binomial logistic regression with Subjective Well-being as a response variable, as well as the application of structural equation techniques (SEM). Subjective Well-being had a positive association with Self-perceived Health (Rho = 0.370), functional status (Rho = 0.360), and Social Participation (Rho = 0.290). However, in the logistic regression analysis only Self-perceived Health (OR = 0.293) and Functional status (OR = 0.932) had predictive capacity for Subjective Well-being. The relevance of Self-perceived Health and Functionality in the sensation of Well-being among older people, reinforces the need to improve health care within a framework of a comprehensive policy for this age group.

The burden of hematological malignancies in Latin America and the Caribbean: A 30-year global burden of disease analysis

In the last decade, the socioeconomic relationship between Latin America and the Caribbean (LAC) and the People´s Republic of China has increased massively. How has this new qualitative relationship between LAC and China affected inequality in LAC? This paper highlights the degrees of concentration of trade since the 1990s until 2011 and its technological content. Future research will have to deepen this relationship at the national, regional and even firm-level. Based on a brief critical review of the relationship between trade and equality/inequality, the document analyzes several of the outstanding features of the booming trade relationship between LAC and China. It concludes, among other issues, that both academics and policy makers have to overcome the bias against the agricultural sector and natural resources based on the concepts of global commodity chains, systemic competitiveness and territorial endogeneity. In addition, one of the most striking features of the new LAC-China trade is its increasing concentration, both compared with historical levels of LAC-China trade, as well as with the rest of the world, a development that will affect inequality in LAC substantially. It is not “old wine in new bottles”, but rather a new socioeconomic relationship with dynamic and profound impacts in LAC that will have to be considered in more detail by scholars and policy makers in the future.

In 2014, during a visit to Havana after travelling to Brazil for the Sixth BRICS summit, Chinese president Xi Jinping visited Havana and gave Cuban revolutionary leader Fidel Castro seeds of the moringa plant as a new symbol of bilateral friendship. Not long before the meeting, the two countries had signed a cooperation agreement on the research and cultivation of moringa, named as the Plant of the Year 2008 by the National Institute of Health in the U.S. for its high nutritional value. Chinese scientists consider the plant a promising source of proteins, vitamins, and minerals nutrition for both farm animals and humans. In order to advance cooperation in moringa, the Cuban and Chinese governments set up two complementary research centres – the Moringa Science & Technology Cooperation Center at the Tropical Crop Research Institute of Yunnan in China and the Institute of Pasture and Forage of the Ministry of Agriculture of Cuba – to lead and implement collaborative projects (CMoA, 2014). The moringa project is a far cry from the usual imaginary of China-LACagricultural trade and investment, which has focused heavily on soybeans. Hence it hints not only at an intensification of China’s role in the agricultural sector in Latin America and the Caribbean (LAC), but also a gradual diversification of these ties. This chapter asks why agricultural cooperation and food trade relations between China and LAC have evolved since the turn of the millennium, and analyses the implications of this trend for LAC. As LAC becomes an increasingly important component of China’s globalized food strategy, the dual processes of intensification and diversification pose new social and environmental challenges within LAC. China’s agricultural ‘Go Out’ strategy, as manifested in expanding invest-ments in LAC, is in line with the government’s changing policy mentality on national food security caused by the Chinese population’s growing demand and shifting consumption patterns accompanying urbanization and the expansion of the middle classes. Consequently, the Chinese government has played a proactive role in opening up new channels and establishing mechanisms to facilitate and diversify investments. Indeed, in May 2015,during a four-country tour of Latin America (Brazil, Colombia, Peru and Chile), Chinese premier Li Keqiang announced China’s plan to invest tens of billions in the region’s agriculture, among other sectors (Reuters Beijing, 2015). At the same time, Chinese companies would also invest in LAC infrastructure to ensure the delivery of export-bound grains and other agricultural products to China. Against this backdrop, LAC’s importance as a producer and net exporter ofagricultural commodities – the region’s agricultural heterogeneity notwithstanding – has made it an increasingly vital frontier for China’s agricultural ‘Go Out’ policy. Although LAC itself faces growing contradictions due to poor distribution channels, rich yet poorly utilized natural endowments, and increasing environmental and climate change challenges, its agricultural production is expected to further expand in coming years, making the region essential to fulfil China’s goal of improving supply of grains and other agricultural products. For LAC, these investments look promising insofar as they can continue tofuel trade, generate prosperity and improve the region’s sorely lacking infrastructure. However, two key challenges lie ahead. First, this model of engagement reinforces pre-existing patterns of investment in export-oriented agricultural production and its associated social grievances and environmental pressures. To mitigate social and environmental costs, LAC stakeholders must better leverage their role in China’s food security and overseas investment. Second, owing to the limited impact of the proposed infrastructure – aimed at ensuring transport of commodities from inland regions to seaports – on regional integration, LAC stakeholders must negotiate deals with China with regional priorities in mind, rather than individual bilateral initiatives. However, these responses must take into account not only the heterogeneity of the region itself, but also the widely varying forms of China’s involvement in LAC agriculture. The chapter is structured as follows. The first part explains Chinese inves-tors growing interest in LAC agriculture, as well as the growing importance of LAC to China’s food security policy. The second part shows the changing patterns of Chinese investments in LAC agriculture over time, and the kinds of reaction on the part of LAC stakeholders. The last part discusses the key implications that the dual movement of intensification and diversification of China-LAC agricultural ties has for the region.

América Latina y el Caribe (ALC) es una región en rápido crecimiento con casi 600 millones de habitantes compuesta por México, América Central y del Sur y las islas del Caribe. Las Américas fueron habitadas por primera vez por personas que cruzaron el Puente de la Tierra de Bering desde el noreste de Asia hacia Alaska hace más de 10,000 años. Los nativos americanos descienden de al menos tres corrientes de flujo genético asiático. Los europeos llegaron después de 1492 siguiendo los viajes de Cristóbal Colón. Los africanos fueron capturados y llevados a América por el comercio transatlántico de esclavos del siglo XVI al XIX. Por lo tanto, la población de ALC comprende una variedad de ancestros, grupos étnicos y razas, lo que hace de la región una de las más diversas del mundo. La composición específica varía de un país a otro: muchos tienen un predominio de la población europea-nativa americana o mestiza; en otros, los nativos americanos son mayoría; algunos están dominados por habitantes de ascendencia europea; La población de algunos países es principalmente mulata. En menor medida, también se identifican regularmente negros, asiáticos y zambo (mezcla de negros y nativos americanos). Cabe destacar que la autoidentificación étnica es cultural y biológicamente compleja y no está correlacionada con la ascendencia autoinformada, que ya no debe evaluarse mediante un cuestionario, sino mediante el uso de marcadores informativos de ascendencia (AIM) a nivel molecular. (Tomado del cuerpo del escrito)

Introduction. The aging process is characterised by socio-demographic, physical, and psychological changes that lead to increased frailty among older populations. The aim of this research was to determine the association between life course determinants and biopsychosocial frailty in community-dwelling Older People (OP). Methodology. Cross-sectional study. A convenience sample of 51 OP in central Chile was analysed to examine the association between age, sex, marital status, country of birth, education level, monthly income, healthy lifestyle, chronic illnesses, life events influence biopsychosocial frailty, using the Tilburg Frailty Indicator (TFI). Results. A predominance of female participants (86.3%) and a higher representation of married (43.1%) and widowed (29.4%) individuals. Perception of a healthy lifestyle was reported by 62.8% of participants. In the older age group, higher income was inversely associated with the physical (β: -3.84, IC 95%: -6.71; -0.96), psychological (β: -2.55, IC 95%: -4.38; -0.73), and total scores (β= -8.16; IC 95%: -12.38 to -3.95) of the Tilburg Frailty Index (TFI). Additionally, in this older group, having a healthy lifestyle was inversely associated with the physical (β: -1.96, IC 95%: -3.46; -0.47) and total TFI (β= -3.10, IC 95%: -5.29 to -0.92) scores. Discussion. These findings provide valuable information on Life course determinants that may influence multidimensional, and specific (biological, psychological and social) frailty, of OP and underscore the importance of early detection and tailored interventions to improve the health and functionality of OP. Conclusion. It is crucial to conduct a Comprehensive Gerontological Assessment to equally identify the needs, problems, and opportunities of OP in biomedical, mental (cognitive and mood), functional, and social aspects; and consequently, generate multicomponent interventions adjusted at the individual and group levels of OP.

This paper aims to study whether China’s OFDI has a significant crowding-out effect on the United States’ OFDI in Latin America and the Caribbean （LAC）, and to consider the impact of the Belt and Road Initiative. In the context of the strategic contraction of the United States and the active expansion of China’s global participation, western public opinion is worried about China’s rapidly expanding influence in LAC, the traditional sphere of influence of the United States. As OFDI is an important indicator of a country’s overseas economic activities, the study on whether China’s OFDI is crowding out the United States’ OFDI provides an important reference for judging the state of China-US relations in LAC. This paper uses a panel data set containing 35 LAC countries （regions） from 2003 to 2017, and divides the total sample into two sub-samples respectively according to the scale of natural resource abundance and government efficiency. Based on the gravity model, this paper uses the individual fixed effect model for empirical analysis, and the Spatial Durbin Model （SDM） to test the robustness of the regression results. The regression results of the individual fixed effect model show that, on the whole, every $1 increase in China’s OFDI will lead to a $2.23 increase in the United States’ OFDI. For resource-rich countries and regions, every $1 increase in China’s OFDI will lead to a $1.71 increase in the United States’ OFDI. For resource-poor countries and regions, China’s OFDI has no significant impact on the United States’ OFDI. For countries and regions with high-efficient governments, every $1 increase of China’s OFDI will lead to a $6.31 increase in the United States’ OFDI. However, if the host country and China sign a cooperation document to jointly build the Belt and Road, the promotion effect will be reduced to $0.04. For countries and regions with low-efficient governments, every $1 increase in China’s OFDI will lead to a $2.02 increase in the United States’ OFDI. Therefore, this paper concludes that in LAC, overall, China’s OFDI attracts the United States’ OFDI, and the Belt and Road Initiative has no significant negative impact on the United States’ OFDI, and also has no significant negative impact on the attraction of China’s OFDI to the United States’ OFDI. However, for resource-poor countries and regions in LAC, the positive impact on the attraction of China’s OFDI to the United States’ OFDI is insignificant. For countries and regions with high-efficient governments in LAC, the Belt and Road Initiative weakens the attraction of China’s OFDI to the United States’ OFDI. The regression results of SDM verify this conclusion. The results show that Chinese and American capital can coexist in LAC. In the future, these two countries can strengthen cooperation and deepen mutual trust under the framework of the Belt and Road Initiative, so as to eliminate the negative impact of the initiative on the United States’ OFDI in some countries and regions. This paper creatively takes the impact of the Belt and Road Initiative into account when studying the crowding-out effect of China’ OFDI, and empirically tests the conjecture that China’s ODFI has crowded out the United States’ OFDI in LAC through econometrics research. It enriches current research ideas in the field of OFDI.

ObjectiveProvide a synthesis of the COVID-19 policies targeting older people in Chile, stressing their short- and long-term challenges.MethodCritical analysis of the current legal and policy measures, based on national-level data and international experiences.ResultsAlthough several policies have been enacted to protect older people from COVID-19, these measures could have important unintended negative consequences in this group’s mental and physical health, as well as financial aspects.DiscussionA wider perspective is needed to include a broader definition of health—considering financial scarcity, access to health services, mental health issues, and long-term care—in the policy responses to COVID-19 targeted to older people in Chile.

This report examines the health and economic impact of noncommunicable diseases (NCD) in Latin America and the Caribbean and the governance, design, and implementation of multisectoral policies to prevent these conditions. These include polices to improve diets, increase physical activity, and reduce tobacco use and alcohol abuse. The report focuses on how policy decisions involving multi-sectoral interventions to prevent health risk factors are taken, which stakeholders directly or indirectly participate in these decisions, which incentives they face, and what strategies they use in these processes.

After a two-year recession, something last experienced over three decades ago, the Latin America and the Caribbean (LAC) region is growing again. The challenge now is to accelerate and sustain growth to continue making progress on the social front as in the first decade and a half of the new century: between 2000 and 2014 the region managed to reduce poverty (US$4 a day poverty line) from 42.9 percent to 23.3 percent, cutting the number of poor people by 80 million at a time when the Latin American population increased by 100 million. A renewed emphasis on productivity comes up during any discussion of LAC’s growth agenda. After all, labor productivity in the region has stalled at around 30 percent of that of the U.S. Moreover, improvements on the productivity front would result not only in faster growth but also, as basic economic theory suggests, in better salaries for the workforce, therefore further contributing to poverty reduction and shared prosperity. But why is there such a gap in LAC’s productivity with respect to the developed countries? One factor is the large infrastructure investment and service gaps. Infrastructure investments can be a powerful engine for reviving and sustaining growth. A recent regional study on the determinants of growth in LAC indicates that infrastructure has been the main structural driver of growth in the region. Yet, LAC governments are well aware that public resources are not enough to satisfy infrastructure needs, especially in the context of ongoing fiscal adjustments across the region and the enormous need for infrastructure investment: an estimated $180 billion per year investment gap. And LAC governments are also aware that the private sector can play a central role to finance the existing gap. Not surprisingly then, LAC has made considerable strides in attracting private sector investments in infrastructure: the region has the largest stock of active Public-Private Partnerships (PPP) investments and the largest pipeline of infrastructure projects by volume globally, reflecting the central role of the private sector in the regional development agenda. Going forward, LAC countries will benefit from an improved environment for private investments, as well as for further developing a robust pipeline of bankable projects. This report showcases the different ways the World Bank Group has been part of these efforts to support the mobilization of private financing for infrastructure in the region, following what authors call the Cascade approach. These encompass everything from policy and regulatory advice to structuring support, guarantees schemes and financing. Country-specific examples presented in this report illustrate how private financing mobilization in LAC has been supported by the WBG. While not exhaustive, these examples are representative of the different strategies and instruments used by governments at the central and subnational levels to help leverage private sector participation in infrastructure. The WBG stands ready to continue to assist the region in that endeavor with financial support, as well as knowledge and convening services.

The objective of this study is to determine the factors that influence the adoption and use of e-learning platforms by older people in Chile, based on the Unified Theory of Acceptance and Use of Technology 2 (UTAUT-2) and the theory of Personal Innovativeness in Information Technology (PIIT). Data were collected from 138 elder people from various communes in the province of Concepción, Chile, through a survey. For the analysis of the data and validation of the hypotheses, a structural equation model was used. The results indicate that effort expectancy, social influence, hedonic motivation, and facilitating conditions significantly influence the intention to use e-learning platforms by these people. In addition, it was found that facilitating conditions and the intention to use are positively related to the use of e-learning platforms. The results indicate the importance of considering the innovative characteristics of the elderly in all the variables that precede the intention to use e-learning platforms. It is relevant to consider that this age group be part of the social and technological development that society is experiencing. In this way, they would improve their quality of life, remain active and independent for longer time.

Summary Background The COVID-19 pandemic disrupted care for non-communicable diseases globally. This study synthesizes evidence on disruptions to primary care, focusing on hypertension and diabetes care and mitigation approaches taken during the pandemic in Latin America and the Caribbean (LAC). Methods We conducted a scoping review, searching nine electronic databases for studies from January 2020 to December 2022 on COVID-19-related primary care disruptions and interventions, including studies on hospital-based interventions given their relevance to the pandemic response in LAC. We adapted the Primary Health Care Performance Initiative framework to develop our search strategy and synthesize data. For studies reporting interventions, we included studies conducted outside of LAC. Findings Of 33,510 references screened, 388 studies were included (259 reported disruptions in LAC, 61 interventions in LAC, 63 interventions outside LAC, and five interventions from countries within and outside LAC), with three-quarters presenting data from Brazil, Argentina, Mexico, and Peru; few studies focused on rural areas. Additionally, the few studies that adequately quantified care disruptions reported a reduction in hypertension and diabetes control during the pandemic (e.g., hypertension control rate decreased from 68% to 55% in Mexico). Frequently reported causes of disruption included burnout and mental health challenges among healthcare workers (with disproportionate effects by type of worker), reduced medication supplies, and reduced frequency of clinic visits by patients (e.g., due to financial constraints). The most reported interventions included remote care strategies (e.g., smartphone applications, virtual meeting platforms) and mental health programs for healthcare workers. Remote care strategies were deemed feasible for care delivery, triaging, and clinical support for non-physicians. Patients were generally satisfied with telemedicine, whereas providers had mixed perceptions. Robust evidence on the effectiveness of remote care strategies for diabetes and hypertension care was unavailable in LAC. Interpretation Hypertension and diabetes control appeared to worsen in LAC during the pandemic. Major reported causes of care disruptions were workforce issues, reduced medication supply, and changes in patient perceptions of seeking and receiving primary healthcare. Remote care strategies were feasible for various purposes and were well received by patients. However, the lack of data on intervention effectiveness underscores the importance of strengthening research capacity to generate robust evidence during future pandemics. Developing resilient healthcare systems able to provide care for hypertension and diabetes during future pandemics will depend on investment in the healthcare workforce, medical supply chain, health data and research infrastructure, and technology readiness.

Neuroepidemiology of transverse myelitis and its etiologies in Latin America: A systematic review and meta-analysis.

ABSTRACTDiscourses on successful ageing have changed the way older age is viewed and the possibilities associated with it. However, such discourses do not always take into account differential capacities and resources that may shape disadvantage for women. The aim of this article is to examine gender differences in the experience of difficulties carrying out basic and instrumental activities of daily living (ADLs) in community-living people over the age of 65, using Chile as a case study. We also examine the effect of healthcare provider on performance of ADLs. We carried out logistic regressions on cross-sectional data from a sample of over 33,000 men and women, drawn from the 2015 National Socioeconomic Characterisation Survey, conducted by the Ministry of Social Development of the Government of Chile. We found significant gender differences in experiences of performing ADLs for older people in Chile, with women consistently reporting more problems than men. The affiliation with the public health provider was also associated with gender differences. The results of our study indicate that women in Chile experience structural disadvantage in their efforts to age successfully, reporting higher levels of functional limitations. We argue that it is important that gender-sensitive public health initiatives be developed, focusing on the prevention of functional disability.

BackgroundCountries in Latin America and the Caribbean (LAC) have experienced a rapid increase in their proportion of older people. This region is marked by a high prevalence of chronic diseases and disabilities among aging adults. Frailty appears in the context of LAC negatively affecting quality of life among many older people.AimTo investigate the prevalence of frailty among community-dwelling older people in LAC through a systematic review and meta-analysis.MethodsA literature search was performed in indexed databases and in the grey literature. Studies investigating the prevalence of frailty with representative samples of community-dwelling older people in Latin America and the Caribbean were retrieved. Independent investigators carried out the study selection process and the data extraction. A meta-analysis and meta-regression were performed using STATA 11 software. The systematic review was registered at the International Prospective Register of Systematic Reviews under the number CRD42014015203.ResultsA total of 29 studies and 43,083 individuals were included in the systematic review. The prevalence of frailty was 19.6% (95% CI: 15.4–24.3%) in the investigated region, with a range of 7.7% to 42.6% in the studies reviewed. The year of data collection influenced the heterogeneity between the studies.ConclusionFrailty is very common among older people in LAC. As a result, countries in the region need to adapt their health and social care systems to demands of an older population.