Browsing by Author "Alfaro, Tania"

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    Case-Control Study of Risk Factors for Meningococcal Disease in Chile
    (2017) Olea, Andrea; Matute, Isabel; González, Claudia; Delgado, Iris; Poffald, Lucy; Pedroni, Elena; Alfaro, Tania; Hirmas, Macarena; Nájera, Manuel; Ferreccio Readi, Catterina; Gormaz, Ana; López, Darío; Loayza, Sergio; Gallegos, Doris; Fuentes, Rodrigo; Vial, Pablo; Aguilera, Ximena
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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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    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; CEDEUS (Chile)
    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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    Socioeconomic Urban Environment in Latin America: Towards a Typology of Cities
    (2023) Santos, Gervasio F. Dos; Vives Vergara, Alejandra; Fuentes-Alburquenque, Mauricio; Sousa Filho, José Firmino de; Paiva, Aureliano Sancho; Useche, Andrés Felipe; Yamada, Goro; Alfaro, Tania; Lima Friche, Amelia A.; Andrade, Roberto F. S.; Barreto, Mauricio L.; Caiaffa, Waleska Teixeira; Diez-Roux, Ana V.; CEDEUS (Chile)
    This paper aims to identify typologies of Latin American cities based on socioeconomic urban environment patterns. We used census data from 371 urban agglomerations in 11 countries included in the SALURBAL project to identify socioeconomic typologies of cities in Latin America. Exploratory factor analysis was used to select a set of variables, and finite mixture modelling (FMM) was applied to identify clusters to define the typology of cities. Despite the heterogeneities among the Latin American cities, we also found similarities. By exploring intersections and contrasts among these clusters, it was possible to define five socioeconomic regional typology patterns. The main features of each one are low-education cities in Northeast Brazil; low-unemployment cities in Peru and Panama; high-education cities in Argentina, Chile, Colombia, Costa Rica, Nicaragua and Mexico; high female labor participation, with high primary education in Argentina and low primary education in Brazil; and low female labor participation and low education in Brazil, Colombia, El Salvador, Guatemala, and Mexico. Identifying clusters of cities with similar features underscores understanding of the urban social and economic development dynamics and assists in studying how urban features affect health, the environment, and sustainability.
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    Using community-based system dynamics modeling to understand the complex systems that influence health in cities: The SALURBAL study
    (ELSEVIER SCI LTD, 2019) Langellier, Brent A.; Kuhlberg, Jill A.; Ballard, Ellis A.; Slesinski, S. Claire; Stankov, Ivana; Gouveia, Nelson; Meisel, Jose D.; Kroker Lobos, Maria F.; Sarmiento, Olga L.; Caiaffa, Waleska Teixeira; Roux, Ana V. Diez; Alazraqui, Marcio; Spinelli, Hugo; Guevel, Carlos; Di Cecco, Vanessa; Tisnes, Adela; Leveau, Carlos; Santoro, Adrian; Herkovits, Damian; Gouveia, Nelson; Barreto, Mauricio; Santos, Gervasio; Cardoso, Leticia; de Menezes, Mariana Carvalho; de Pina, Maria de Fatima; Caiaffa, Waleska Teixeira; de Lima Friche, Amelia Augusta; de Souza Andrade, Amanda Cristina; Frenz, Patricia; Alfaro, Tania; Cordova, Cynthia; Ruiz, Pablo; Fuentes, Mauricio; Vives Vergara, Alejandra; Salazar, Alejandro; Cortinez O'Ryan, Andrea; Schmitt, Cristian; Gonzalez, Francisca; Baeza, Fernando; Angelini, Flavia; Sarmiento Duenas, Olga Lucia; Higuera, Diana; Gonzalez, Catalina; Montes, Felipe; Useche, Andres F.; Guaje, Oscar; Maria Jaramillo, Ana; Angel Guzman, Luis; Hessel, Philipp; Lucumi, Diego; David Meisel, Jose; Martinez, Eliana; Kroker Lobos, Maria F.; Ramirez Zea, Manuel; Martinez Folgar, Kevin; Barrientos Gutierrez, Tonatiuh; Perez Ferrer, Carolina; Prado Galbarro, Javier; de Castro, Filipa; Rojas Martinez, Rosalba; Jaime Miranda, J.; Hernandez Vasquez, Akram; Diez Canseco, Francisco; Hammond, Ross; Rodriguez, Daniel; Dronova, Iryna; Wang, Xize; Moran, Mika; Hovmand, Peter; Fuchs, Ricardo Jordan; Braslow, Juliet; Siri, Jose; Roux, Ana Diez; Auchincloss, Amy; Bilal, Usama; Garcia Espana, Felipe; Langellier, Brent; Lovasi, Gina; McClure, Leslie; Michael, Yvonne; Moore, Kari; Quick, Harrison; Quistberg, D. Alex; Sanchez, Brisa N.; Stankov, Ivana; Granados, Jose Tapia; SALURBAL Grp
    We discuss the design, implementation, and results of a collaborative process designed to elucidate the complex systems that drive food behaviors, transport, and health in Latin American cities and to build capacity for systems thinking and community-based system dynamics (CBSD) methods among diverse research team members and stakeholders. During three CB SD workshops, 62 stakeholders from 10 Latin American countries identified 98 variables and a series of feedback loops that shape food behaviors, transportation and health, along with 52 policy levers. Our findings suggest that CBSD can engage local stakeholders, help them view problems through the lens of complex systems and use their insights to prioritize research efforts and identify novel solutions that consider mechanisms of complexity.