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      Epidemiology in Latin America and the Caribbean: current situation and challenges

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          Abstract

          Background This article analyses the epidemiological research developments in Latin America and the Caribbean (LAC). It integrates the series commissioned by the International Epidemiological Association to all WHO Regions to identify global opportunities to promote the development of epidemiology.

          Methods Health situations of the regions were analysed based on published data on selected mortality, morbidity and risk factors. Epidemiological publication output by country was estimated by Medline bibliometrics. Internet and literature searches and data provided by key informants were used to describe perspectives on epidemiological training, research and funding.

          Findings Despite important advances in recent decades, LAC remains the world's most unequal region. In 2010, 10% of the LAC's people still lived in conditions of multidimensional poverty, with huge variation among countries. The region has experienced fast and complex epidemiological changes in past decades, combining increasing rates of non-communicable diseases and injuries, and keeping uncontrolled many existing endemic and emerging diseases. Overall, epidemiological publications per year increased from 160 articles between 1961 and 1970 to 2492 between 2001 and 2010. The increase in papers per million inhabitants in the past three decades varied from 57% in Panama to 1339% in Paraguay. Universities are the main epidemiological training providers. There are at least 34 universities and other institutions in the region that offer postgraduate programmes at the master’s and doctoral levels in epidemiology or public health. Most LAC countries rely largely on external funding and donors to initiate and sustain long-term research efforts. Despite the limited resources, the critical mass of LAC researchers has produced significant scientific contributions.

          Future needs The health research panorama of the region shows enormous regional discrepancies, but great prospects. Improving research and human resources capacity in the region will require establishing research partnerships within and outside the region, between rich and poor countries, promoting collaborations between LAC research institutions and universities to boost postgraduate programmes and aligning research investments and outputs with the current burden of disease.

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          Most cited references 78

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          World Health Organization.

           Ala Alwan (2007)
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            Health conditions and health-policy innovations in Brazil: the way forward.

            Brazil is a large complex country that is undergoing rapid economic, social, and environmental change. In this Series of six articles, we have reported important improvements in health status and life expectancy, which can be ascribed largely to progress in social determinants of health and to implementation of a comprehensive national health system with strong social participation. Many challenges remain, however. Socioeconomic and regional disparities are still unacceptably large, reflecting the fact that much progress is still needed to improve basic living conditions for a large proportion of the population. New health problems arise as a result of urbanisation and social and environmental change, and some old health issues remain unabated. Administration of a complex, decentralised public-health system, in which a large share of services is contracted out to the private sector, together with many private insurance providers, inevitably causes conflict and contradiction. The challenge is ultimately political, and we conclude with a call for action that requires continuous engagement by Brazilian society as a whole in securing the right to health for all Brazilian people. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Indigenous health in Latin America and the Caribbean.

              This review is the second in a series on Indigenous health, covering different regions and issues. We look briefly at the current state of Indigenous health in Latin America and the Caribbean, a region with over 400 different indigenous groups and a total population of 45 to 48 million people. We describe the complex history and current reality of Indigenous peoples' situation within the American continent. We discuss the importance of Indigenous health systems and medicines, and look at changing political environments in the region. The paper concludes with a discussion of the changing political and legislative environment in Latin American countries.
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                Author and article information

                Journal
                Int J Epidemiol
                Int J Epidemiol
                ije
                intjepid
                International Journal of Epidemiology
                Oxford University Press
                0300-5771
                1464-3685
                April 2012
                8 March 2012
                8 March 2012
                : 41
                : 2
                : 557-571
                Affiliations
                1Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil, 2CRONICAS, Center of Excellence in Chronic Diseases, 3Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Peru, 4University of the West Indies, Mona, Kingston, Jamaica, 5Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Brazil, 6Department of Public Health, School of Medicine, Universidad de La Frontera, Chile, 7Facultad de Medicina, Universidad Nacional Autónoma de Mexico and 8Health Surveillance Secretariat, Ministry of Health, Brazil
                Author notes
                *Corresponding author. Universidade Federal de Minas Gerais, Av Alfredo Balena 190, sl 814, Belo Horizonte, CEP 30190100, MG, Brazil. E-mail: sbarreto@ 123456medicina.ufmg.br
                Article
                dys017
                10.1093/ije/dys017
                3324459
                22407860
                Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2012; all rights reserved.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Pages: 15
                Categories
                Global Status of Epidemiology

                Comments

                An article that perfectly highlights current challenges in Latin America and Caribbean region. It raises important issues such as inequalities and discrepancies in the region, but also shows what progress is made and elaborates on future needs.

                2015-06-11 11:16 UTC
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