Conducting research on the health and living conditions of the elderly populations in the emerging e

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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

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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 ?

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Background on Latin America and Caribbean aging

• 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.

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Bahamas
Jamaica
Cuba
Mexico
Barbados
Trinidad Tobago,
Surinam and Guyana
Brasil
Uruguay
Chile
Argentina
The countries and cities where we have conducted
research projects
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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

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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
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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
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Research results
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Research productsESTUDIO 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

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Research productsCaribbean 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

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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)

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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

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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)

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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
  Dec63(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 Jan68(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 Nov47(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 Mar12(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
• Apr20(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
  Feb20(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
  Dec19(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 Jul62(4)S226-36.
  PubMed PMID 17673536.

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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

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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?