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:
– two research experiences funded by the
Interamerican Development Bank
– one research project funded by the Canadian
Institutes of Health Research
• Brief summary of research results
• Evaluation of impact of research on health and
social policy ?
• Knowledge transfer ?
• Sustainable global health partnerships ?
Background on Latin America and
Caribbean aging
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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.
Mexico
Bahamas
Cuba Jamaica
Barbados
Trinidad & Tobago,
Surinam and Guyana
Brasil
Chile
Uruguay
Argentina
The countries and cities where we have conducted research projects
ESTUDIO DEL ADULTO MAYOR EN ARGENTINA, CHILE Y URUGUAY
SITUACIÓN Y ESTRATEGIAS (2000-2002)
Banco
Interamericano
de Desarrollo
•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
RESEARCH RESULTS
Research products:
ESTUDIO DEL ADULTO MAYOR EN ARGENTINA, CHILE Y URUGUAY
SITUACIÓN 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:
Caribbean Aging Study
• 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
10
Research products
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
• 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)
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1: Alvarado BE, Zunzunegui MV, Béland F, Bamvita JM. Life course social and
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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 health
partnerships?
• Limited sucess in the above projects
• Change of leadership in International
Development Bank
• Some contatcs remain, mainly personal
contacts, in most places: Brazil, Argentina,
Cuba, Mexico, Uruguay, Trinidad and Jamaica.
• How to go from individual exchange to long
term partnerships?- 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?