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Conducting research on the health and living conditions of the elderly populations in the emerging economies of Latin America and the Caribbean. Maria Victoria Zunzunegui Professeur titulaire, Université de Montréal Axe Santé Mondiale Centre de recherche de CHUM. Outline. Background on:
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Conducting research on the health and living conditions of the elderly populations in the emerging economies of Latin America and the Caribbean Maria Victoria Zunzunegui Professeur titulaire, Université de Montréal Axe Santé Mondiale Centre de recherche de CHUM
Outline • Background on: • tworesearchexperiencesfunded by the InteramericanDevelopment Bank • one researchprojectfunded by the Canadian Institutes of Health Research • Briefsummary of researchresults • Evaluation of impact of research on health and social policy ? • Knowledgetransfer ? • Sustainable global healthpartnerships ?
Background on Latin America and Caribbeanaging • Life expectancies are high (often over 70 or 75) • Aging in poverty and social/economic crisis • Little social protection, important family roles • Lifecourse trajectories: • early infection and prevalent chronic malnutrition in childhood, • little education and unstable manual informal work in adulthood, • few and insufficient pensions in old age.
Bahamas Cuba Jamaica Mexico Barbados Trinidad & Tobago, Surinam and Guyana Brasil Chile Uruguay Argentina The countries and cities where we have conducted research projects
Banco Interamericano de Desarrollo ESTUDIO DEL ADULTO MAYOR EN ARGENTINA, CHILE Y URUGUAY SITUACIÓN Y ESTRATEGIAS (2000-2002) • Federación Internacional de la Vejez Oficina Regional para América Latina y El Caribe • Escuela Andaluza de Salud Pública • Instituto de Nutrición y Tecnología de los Alimentos. Universidad de Chile • Centro de Estudios de Población. Argentina. • Ministerio de Salud Pública del Uruguay • Fundación ISALUD de Argentina • Instituto Nacional de Geriatría de Chile • Centro de Investigaciones Económicas de Uruguay • Instituto Español de Comercio Exterior • Organización Panamericana de la Salud/OPS/PAHO
Caribbean Health Research Council University of West Indies, Mona Campus Université de Montréal Sponsored by the Interamerican Development Bank Research team: MV Zunzunegui BE Alvarado-Llano P Cloos D Eldemire-Shearer D Simeon CARIBBEAN AGING STUDY 2006-2008
CIHR Institute of Gender and Health 2004-2007 Health differences in later life: A study of gender and social exclusion as determinants of health and functioning in the urban elderly populations of Latin America and the Caribbean
Research products:ESTUDIO DEL ADULTO MAYOR EN ARGENTINA, CHILE Y URUGUAYSITUACIÓN Y ESTRATEGIAS (2000-2002) • Book « Mas vale por viejo », Interamerican Development Bank, 2002 • Country reports • Three regional seminars in 2000 in Buenos Aires, Santiago and Montevideo • Workshop in Washington on Aging in Latin America and the Caribbean, 2002
Research products:CaribbeanAgingStudy • Country reports for: • Jamaica, Bahamas, Barbados, Guyana, Suriname, and Trinidad and Tobago • Regional seminar in Port of Spain, Trinidad • Final report to funding agency (IADB) • Research paper in revision on Ageing and Society
Research productsHealth differences in later life: A study of gender and social exclusion as determinants of health and functioning in the urban elderly populations of Latin America and the Caribbean • Scientific articles: • Journal Aging and Health (2) • Journals of Gerontology (2) • Aging and Mental Health (1) • Aging (1) • Social Science and Medicine (1) • Preventive Medicine (1) • Presentation in Congress (10)
Evaluation of impact of research on health and social policy ? • What is the impact of « our » research? • No structured evaluation of research impact • Need to carry out qualitative and quantitative analyses of these efforts • EX: Brazil has taken important steps to face population aging- Impact of many kinds of research or political opportunity? Effect Lula • Chile has the worst health outcomes in the amidst of privatisation of health care and pensions. • ECLAC/CELADE papers on the need for social protection as a human right issue • Recognition by World Bank of errors in structural adjustment policies
Knowledge transfer ? • Publications: Enter Gender & Health & Aging (only one article can be retrieved from PubMed) • Courses: • Example: Course on social Gerontology, Manizales (Colombia), May 2009 • Research Training • Pilot project on stress biomarkers: development of measurement instruments (March 2009) • Research exchange • Short stays: Failure, lack of understanding, research as a luxury, need to make a living among practitioners • Sabbatical periods (one-to –one basis)
PUBMED: Aging & Latin America (2 out of 8 retrieved on May 4 2009) • 1: Alvarado BE, Zunzunegui MV, Béland F, Bamvita JM. Life course social and health conditions linked to frailty in Latin American older men and women. J Gerontol A Biol Sci Med Sci. 2008 Dec;63(12):1399-406. PubMed PMID: 19126855. • 2: Zunzunegui MV, Alvarado BE, Béland F, Vissandjee B. Explaining health differences between men and women in later life: a cross-city comparison in Latin America and the Caribbean. Soc Sci Med. 2009 Jan;68(2):235-42. Epub 2008 Nov 25. PubMed PMID: 19036488. • 3: Couture MC, Nguyen CT, Alvarado BE, Velasquez LD, Zunzunegui MV. Inequalities in breast and cervical cancer screening among urban Mexican women. Prev Med. 2008 Nov;47(5):471-6. Epub 2008 Jul 15. PubMed PMID: 18675296. • 4: Sicotte M, Alvarado BE, León EM, Zunzunegui MV. Social networks and depressive symptoms among elderly women and men in Havana, Cuba. Aging Ment Health. 2008 Mar;12(2):193-201. PubMed PMID: 18389399. • 5: Nguyen CT, Couture MC, Alvarado BE, Zunzunegui MV. Life course socioeconomic disadvantage and cognitive function among the elderly population of seven capitals in Latin America and the Caribbean. J Aging Health. 2008 • Apr;20(3):347-62. PubMed PMID: 18332188. • 6: Guerra RO, Alvarado BE, Zunzunegui MV. Life course, gender and ethnic inequalities in functional disability in a Brazilian urban elderly population. Aging Clin Exp Res. 2008 Feb;20(1):53-61. PubMed PMID: 18283229. • 7: Alvarado BE, Guerra RO, Zunzunegui MV. Gender differences in lower extremity function in Latin American elders: seeking explanations from a life-course perspective. J Aging Health. 2007 Dec;19(6):1004-24. PubMed PMID: 18165293. • 8: Alvarado BE, Zunzunegui MV, Béland F, Sicotte M, Tellechea L. Social and gender inequalities in depressive symptoms among urban older adults of latin america and the Caribbean. J Gerontol B Psychol Sci Soc Sci. 2007 Jul;62(4):S226-36. PubMed PMID: 17673536.
Sustainable global healthpartnerships? • Limited sucess in the aboveprojects • Change of leadership in International Development Bank • Somecontatcsremain, mainlypersonal contacts, in most places: Brazil, Argentina, Cuba, Mexico, Uruguay, Trinidad and Jamaica. • How to go fromindividual exchange to long termpartnerships?- MONEY and INSTITUTIONAL AGREEMENTS
Questions • How to establish long term confidence relationships? • Recognize the long term nature of enterprises • Patience • Seize opportunities when available • Sincere collaboration among researchers of the wealthy countries instead of fierce competition for scarce resources • Are these suggestions possible?