The burden of obesity differs by socioeconomic status. We aimed to characterise the prevalence of obesity among adult men and women in Latin America and the Caribbean by socioeconomic measures and the shifting obesity burden over time. We did a cross-sectional series analysis of obesity prevalence by socioeconomic status by use of national health surveys done between 1998 and 2017 in 13 countries in Latin America and the Caribbean. We generated equiplots to display inequalities in, the primary outcome, obesity by wealth, education, and residence area. We measured obesity gaps as the difference in percentage points between the highest and lowest obesity prevalence within each socioeconomic measure, and described trends as well as changing patterns of the obesity burden over time. 479 809 adult men and women were included in the analysis. Obesity prevalence across countries has increased over time, with distinct patterns emerging by wealth and education indices. In the most recent available surveys, obesity was most prevalent among women in Mexico in 2016, and the least prevalent among women in Haiti in 2016. The largest gap between the highest and lowest obesity estimates by wealth was observed in Honduras among women (21·6 percentage point gap), and in Peru among men (22·4 percentage point gap), compared with a 3·7 percentage point gap among women in Brazil and 3·3 percentage points among men in Argentina. Urban residents consistently had a larger burden than their rural counterparts in most countries, with obesity gaps ranging from 0·1 percentage points among women in Paraguay to 15·8 percentage points among men in Peru. The trend analysis done in five countries suggests a shifting of the obesity burden across socioeconomic groups and different patterns by gender. Obesity gaps by education in Mexico have reduced over time among women, but increased among men, whereas the gap has increased among women but remains relatively constant among men in Argentina. The increase in obesity prevalence in the Latin American and Caribbean region has been paralleled with an unequal distribution and a shifting burden across socioeconomic groups. Anticipation of the establishment of obesity among low socioeconomic groups could provide opportunities for societal gains in primordial prevention. None.

The objective of this study was to determine the prevalence of home birth in low-middle income countries (LMIC) according to geographic area and sociodemographic characteristics between 2000 and 2019. A meta-analysis was carried out using the most recent demographic and health surveys as a data source (total countries: 67). A random-effects meta-analysis was obtained to calculate pooled prevalence estimates of home birth for all the countries included and by geographic region of the world. Likewise, a subgroup analysis was performed to estimate the prevalence of home birth according to the sociodemographic factors considered for this study. The global prevalence of home birth was 28% (95% CI: 0.24–0.33), with the lowest prevalence in the region of Europe & Central Asia (5%, 95% CI: 0.03–0.07) and the highest in East Asia & Pacific region (38%, 95% CI: 0.26–0.51). Twelve countries had proportions of home births greater than 50% (seven belonged to the Sub-Saharan Africa region). The countries with the highest proportion of home births were Chad (78%), Ethiopia (73%), and Niger and Yemen (70% each). Concerning the wealth index, in general, the richest quintile (quintile 5) presented the lowest proportion of home births. In contrast, the poorest (quintile 1) generally had the highest prevalence of home births. Regarding educational level, women without education presented the highest proportions of home births in general. In relation to the area of residence, in almost all the countries studied, women in rural areas generally had a higher proportion of home births than those in urban areas. Home births occurred in approximately 3 out of 10 women in LMIC. There are also differences in the proportion of home births according to socioeconomic factors such as educational level, wealth index, and rurality.

Background: Socioeconomic inequalities in the population influence access to health services and constitute a challenge for health systems, especially in low- and middle-income countries. In Peru, an increase in the use of medical services has been estimated; however, the study of inequalities in the use of medical services is limited. Therefore, the objective of this research was to analyze and decompose socioeconomic inequalities in the use of medical consultation services in Peru. Methods: A cross-sectional analytical study was conducted using data from the National Household Survey 2019. The outcome variable was the use of a consultation attended by a physician in the last 4 weeks in persons who presented symptom or discomfort, illness, relapse of chronic disease and/or accident. Concentration curves and Erreygers concentration indices were used to determine socioeconomic inequalities, and a generalized linear regression model was used for the decomposition analysis of inequalities. Results: A total of 52,715 persons were included in the study. The frequency of medical consultation was 25.4% (95% confidence interval: 24.8 − 26.1%). In the inequality analysis, it was found that the use of medical consultations was concentrated among the wealthiest individuals. The main contributing factors were having another type of health insurance (social health insurance [EsSalud], private health insurance, health provider, the Armed Forces, and the Police), residing in an urban area, belonging to the richest wealth quintile, having a chronic disease, and residing in the highlands of Peru. Conclusions: Based on our findings, government institutions seeking to achieve equitable access to health services should consider the main factors contributing to this inequality in the formulation of strategies to lessen the negative impact of inadequate disease control in the population.

It is estimated that Latin America and the Caribbean (LAC) is the region with the second highest figures for food insecurity (FI) globally, with a prevalence of 40.9% in the entire region. This cross-sectional study analyzes the household factors associated with FI across 13 LAC countries. We used data from the first round of high-frequency phone surveys, conducted by the World Bank. Approximately 4 out of 10 people in LAC experienced FI during the first phase of the COVID-19 pandemic. FI was positively associated with the number of individuals aged from 5 to 18 years, the number of men, the illness, accident, or death of an income-earning household member, and health expenditure due to COVID-19 or other illnesses, as well as the increase in food prices, reduced family income, and job loss by a member of the household. On the other hand, households located in capital cities and those with more bedrooms were less likely to have experienced FI. The design of social policies must focus on the economic deficiencies experienced by the LAC population, with unemployment, reduced income, and high food costs being the main factors that must be addressed to ensure adequate nutrition.

The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death. This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age. Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions. Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.