Browsing by Author "Cabieses, Baltica"

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    How to implement Chile's new anti-tobacco law within the university
    (PAN AMER HEALTH ORGANIZATION, 2008) Cabieses, Baltica; Munoz, Monica; Zuzulich, Soledad; Contreras, Aixa
    On the 16th of May 2006, the Diario Oficial de la Republica de Chile (Official News of the Republic of Chile), published Law No. 20.105, which modified Law No. 19.419 regarding advertising and consumption of tobacco. Since it entered into force, different institutions and public spaces have had to enact its regulations. The purpose of this article is to share how the new anti-tobacco law is being implemented, with a health promotion angle, by the Pontificia Universidad Catolica de Chile (UC). As such, we highlight key findings from a review of the literature on the subject and describe the implementation strategies developed and substantiated in theory as well as by how they address the concerns of the university community. The main accomplishments of the anti-tobacco implementation were: reaching a compromise between the university directorate and the student leaders, who in turn motivated the student body to participate during the large-scale roll-out of the new law; the participation of all of the UC stakeholders; utilizing the varied methods of mass communication; and lastly, providing an opportunity for reflection and analysis for those directly affected: the smokers. The challenge is to evaluate the strategies implemented in the incorporation of the new Chilean anti-tobacco law.
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    Perception of discrimination against immigrants compared to Chilean-born and its relationship with access to services and health outcomes
    (2022) Oyarte, Marcela; Cabieses, Baltica; Espinoza, Manuel; Teresa Valenzuela, Maria; Delgado, Iris
    OBJECTIVES: Compare self-perceived discrimination between immigrants and locals in Chile and analyze the relationship between immigration and perceived discrimination and immigration, discrimination and health outcomes, adjusting for sociodemographic characteristics and social capital. METHODS: Cross-sectional study, using population-based survey (CASEN2017). We selected 2,409 immigrants (representative of N = 291,270) and 67,857 locals (representative of N = 5,438,036) over 18 years of age surveyed. We estimated logistic regression models, considering the complex sample, with discrimination, self-rated health, medical treatment, healthcare system membership, complementary health insurance, medical consultation and problems when consulting as dependent variables, immigration and discrimination as main exposure variables, and social capital and sociodemographic variables as covariates of the models. RESULTS: Immigrants were more likely to perceive discrimination in general compared to locals (OR = 2.31; 95%CI: 1.9-2.9). However, this does not occur for all specific reasons for discrimination; skin color and physical appearance were the most frequent causes of discrimination in immigrants. The interaction between immigration and discrimination was significantly related to worse self-rated health outcomes and treatment for pathologies, disfavoring discrimination against immigrants. In both locals and immigrants, discrimination was not associated with health care access outcomes, except for problems during consultation in locals (OR = 1.61; 95%CI 1.4-1.8). CONCLUSIONS: In Chile, experiences of discrimination are intertwined with other forms of rejection and social exclusion, so it is urgent to raise awareness among the population to prevent these discriminatory practices, especially in health care and daily use places. It is essential to address discrimination in order to have an impact on intermediate variables and health outcomes. The extension of the results to the entire immigrant population could be very useful to deepen the problem and improve the estimates made.
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    PROMOTION OF CIGARETTES AMONG CHILEAN MAGAZINES FOR FEMALES: WHAT ARE THE MESSAGES ABOUT SMOKING?
    (SPRINGER, 2012) Repetto, Paula; Cabieses, Baltica; Bernales, Margarita; Vanderbloemen, Laura; Mediano, Fernanda
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    The impact of hypoglycemia on healthcare costs: a modeling study from Chile
    (2022) Balmaceda, Carlos; Espinoza, Manuel A.; Cabieses, Baltica; Espinoza, Nazareth
    Background: This study aimed to estimate the expected cost of hypoglycemia in Diabetes Mellitus type-2 patients receiving hypoglycemic treatment in Chile and to explore the effect of the potential reduction of hypoglycemia over the total cost incurred by its public health system.
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    The legal path for priority setting in Chile: a critical analysis to improve health planning and stewardship
    (2024) Espinoza, Manuel Antonio; Cabieses, Baltica; Goic, Carolina; Andrade, Alejandro
    Health systems have committed their path to universal health coverage using health planning to accomplish their goals of efficiency, equity and sustainability. Chile, a high-income country with a public-private mix health system, has made significant progress through several successive health policies implemented in the last 20 years which have been consistent with this approach. However, in the last 5 years, the national congress has produced several disease-specific laws, which have been mainly promoted by the civil society. These laws indicate the actions the health authority must perform to tackle the needs of the affected population, which ultimately determine the priorities of the health system. We argue that this legal pattern has become an alternative path to priority-setting, as opposed to health planning. We claim this "legal path" is a mechanism used by civil society in a context where the health authority fails to implement a robust and legitimate prioritization process. Although these laws have brought benefits to patients suffering the corresponding conditions, we highlight this approach does not guarantee improvements in equity, efficiency and health system performance. Instead, we advocate for taking back the control of the priority-setting based on health planning, through a new institutionalization of health technology assessment and quality of care.
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    The power of chameleonic ideas in the policy decision-making process: the case of the 'students' revolution' in Chile
    (ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2012) Cabieses, Baltica; Espinoza, Manuel
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    The social and health protection of migrants in Chile: qualitative analysis of civil society proposals for constitutional change
    (2023) Esnouf, Sophie; Blukacz, Alice; Obach, Alexandra; Mezones-Holguin, Edward; Espinoza Sepúlveda, Manuel Antonio; DeJong, Jocelyn; Cabieses, Baltica
    Background: A sustained period of social, economic, and political unrest took place during October of 2019 in Chile. As an institutional solution, the “Agreement for Social Peace and the New Constitution” was signed. In this document, most political parties committed to reestablishing peace and public order in Chile, agreeing on the initiation of a constitutional process. To promote participation of civil society actors, the “Popular Initiative for Norms” was enabled. This was a platform where civilians could submit proposals for constitutional norms to be discussed by the Constitutional Convention. We aimed to analyze proposals related to migrants and migrant health. Methods: We conducted a qualitative thematic analysis of the proposals. Sixteen of them were related to migrants, and we analyzed their association to health. We also evaluated their link to the Health Goals 2030 set out by the Chilean Ministry of Health and the Global Action Plan 2019–2023 for Promoting the Health of Refugees and Migrants by the World Health Organization. Results: Four main thematic categories were identified: 1) Humans rights of migrants, refugees, and asylum seekers; 2) Nationality and regularization of migrants and refugees; 3) Political participation and cultural integration of migrants and refugees; and 4) Specific regulations on slavery and human trafficking. These resonated with broader frameworks established in the Health Goals 2030 (Chile) and the Global Action Plan 2019–2023 for Promoting the Health of Refugees and Migrants by the World Health Organization. Conclusions: The ‘Popular Initiative for Norms’ was a non-binding participatory mechanism. Although the proposals sent through were not guaranteed to be included in the constitutional draft—and despite the final draft being rejected last September 2022—the platform allowed to gain insights into civilian opinions. Our findings showed that there is an incipient yet weak recognition of the rights and situation of migrants in Chile. There was no direct mention of health nor an explicit contemplation of social determinants of health. Despite there being an urgent need to define strategies for migrants’ health in Chile, this study demonstrated that civil awareness and interest are still insufficient.
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    Type 2 diabetes in young people: Adding socioeconomic inequality to the discussion
    (2019) Ortiz, Manuel S.; Cabieses, Baltica; Repetto Lisboa, Paula Beatriz
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    Unequal Access and Use of Health Care Services among Settled Immigrants, Recent Immigrants, and Locals: A Comparative Analysis of a Nationally Representative Survey in Chile
    (2023) Oyarte, Marcela; Cabieses, Baltica; Rada, Isabel; Blukacz, Alice; Espinoza, Manuel; Mezones-Holguin, Edward
    Globally, and particularly in the Latin American region, international migration continues to grow. Access and use of health care services by migrants vary according to their country of origin and residence time. We aimed to compare the access and use of health care services between international migrants (including settled migrants from Peru, Argentina, Bolivia, Ecuador; Emerging migrants from Venezuela, Dominican Republic, Colombia, Haiti; and migrants from other countries) and the Chilean population. After performing a secondary data analysis of population-based nationally representative surveys (CASEN 2011-2017), access and use patterns (insurance, complementary insurance, non-consultation, and non-treatment coverage) were described and compared among settled immigrants, recent emerging immigrants, others, and locals. Immigrants had a significantly higher uninsured population compared to locals. Specifically, in CASEN 2017, 19.27% of emerging (95% CI: 15.3-24.1%), 11.79% of settled (95% CI: 10.1-13.7%), and 2.25% of locals (95% CI: 2.1-2.4%) were uninsured. After 2013, settled and recent emerging migrants showed higher percentages of non-consultation. Collaborative and interculturally relevant strategies from human rights and equity perspectives are needed. Initiatives with a particular focus on recent immigrants can contribute to reducing the existing disparities in health care access and use with locals due to lack of insurance and treatment coverage.
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    Universities and health promotion: how can the two come together?
    (PAN AMER HEALTH ORGANIZATION, 2008) Munoz, Monica; Cabieses, Baltica
    Universities play a leading role in the communities in which they are found. Focused on leadership and developing knowledge, universities are the stage on which community members are formed. Through education, research, and by spreading knowledge, universities guide and support changes at the national and international levels. The university that advances health is one that joins health promotion with its purpose, aiming to foster human development and improve quality of life for its students and employees, thus impacting both the labor and social circles. It aspires to take a leading role in cultural change by raising awareness among the more educated, open, enterprising, and upstanding, and those committed to progress.