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Thumbnail of Commute Patterns of Depression report

Commute patterns and depression: Evidence from eleven Latin American cities

Although travel behavior is expected to influence personal health, few studies have examined associations with mental health. This study examines associations between commute patterns and mental health using survey data in 11 Latin American cities. The findings provide preliminary evidence that better access to mass transit systems and less congestion may be linked to better mental health among urban residents.


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The food environment in Latin America: a systematic review with a focus on environments relevant to obesity and related chronic diseases

Rising obesity and increasing recognition of the food environment's role in creating and addressing this challenge has led to increased attention on this topic within scientific literature in recent years. This study reviews literature describing the food environment in Latin America and policies targeting the food environment (FEP), as well as analytic studies that investigate associations between the FEP and dietary behaviors, overweight/obesity and obesity related chronic diseases. Findings suggest that health claims on food packaging are prevalent and mostly misleading; there is widespread use of marketing strategies for unhealthy foods aimed at children; and food prices are lower for processed relative to fresh foods. More work is needed to better understand policy impacts over time and the impacts of food prices and digital marketing on diet and health.


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Using community-based system dynamics modeling to understand the complex systems that influence health in cities: The SALURBAL study

This article describes the design, implementation, and results of a collaborative process designed to elucidate the complex systems that drive food behaviors, transport, and health in Latin American cities and to build capacity for systems thinking and community-based system dynamics (CBSD) methods among diverse research team members and stakeholders. During three CBSD workshops, 62 stakeholders from 10 Latin American countries identified 98 variables and a series of feedback loops that shape food behaviors, transportation and health, along with 52 policy levers. Our findings suggest that CBSD can engage local stakeholders, help them view problems through the lens of complex systems and use their insights to prioritize research efforts and identify novel solutions that consider mechanisms of complexity.


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A Novel International Partnership for Actionable Evidence on Urban Health in Latin America: LAC-Urban Health and SALURBAL

This article describes the origins and characteristics of an interdisciplinary multinational collaboration aimed at promoting and disseminating actionable evidence on the drivers of health in cities in Latin America and the Caribbean: The Network for Urban Health in Latin America and the Caribbean and the Wellcome Trust funded SALURBAL (Salud Urbana en América Latina, or Urban Health in Latin America) Project. Both initiatives have the goals of supporting urban policies that promote health and health equity in cities of the region while at the same time generating generalizable knowledge for urban areas across the globe. The processes, challenges, as well as the lessons learned to date in launching and implementing these collaborations, are described. By leveraging the unique features of the Latin American region (one of the most urbanized areas of the world with some of the most innovative urban policies), the aim is to produce generalizable knowledge about the links between urbanization, health, and environments and to identify effective ways to organize, design, and govern cities to improve health, reduce health inequalities, and maximize environmental sustainability in cities all over the world.


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Complex Systems Approaches to Diet: A Systematic Review

Complex systems approaches can help to elucidate mechanisms that shape population-level patterns in diet and inform policy approaches. This study reports results of a structured review of key design elements and methods used by existing complex systems models of diet.


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Data in the SALURBAL Project

Data in the SALURBAL Project provides an overview of the process of selecting cities, compiling data, and the types of questions the dataset may help to answer. The document was developed to inform future SALURBAL studies and to receive feedback from stakeholder working in urban health in the region regarding how SALURBAL research can support their efforts.


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Building a Data Platform for Cross-Country Urban Health Studies: the SALURBAL Study

Studies examining urban health and the environment must ensure comparability of measures across cities and countries. We describe a data platform and process that integrates health outcomes together with physical and social environment data to examine multilevel aspects of health across cities in 11 Latin American countries. We used two complementary sources to identify cities with ≥ 100,000 inhabitants as of 2010 in Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, and Peru. We defined cities in three ways: administratively, quantitatively from satellite imagery, and based on country-defined metropolitan areas. In addition to "cities," we identified sub-city units and smaller neighborhoods within them using census hierarchies. Selected physical environment (e.g., urban form, air pollution and transport) and social environment (e.g., income, education, safety) data were compiled for cities, sub-city units, and neighborhoods whenever possible using a range of sources. Harmonized mortality and health survey data were linked to city and sub-city units. Finer georeferencing is underway. We identified 371 cities and 1436 sub-city units in the 11 countries. The median city population was 234,553 inhabitants (IQR 141,942; 500,398). The systematic organization of cities, the initial task of this platform, was accomplished and further ongoing developments include the harmonization of mortality and survey measures using available sources for between country comparisons. A range of physical and social environment indicators can be created using available data. The flexible multilevel data structure accommodates heterogeneity in the data available and allows for varied multilevel research questions related to the associations of physical and social environment variables with variability in health outcomes within and across cities. The creation of such data platforms holds great promise to support researching with greater granularity the field of urban health in Latin America as well as serving as a resource for the evaluation of policies oriented to improve the health and environmental sustainability of cities.


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Food and Urban Health 

Food and Urban Health: Lessons from Latin America presents leading challenges in urban nutrition in the context of demographic changes, poverty, and markets and regulations. The policy brief describes mechanisms that can be implemented to affect food-related behaviors and consumption, and highlights innovative policies, laws, and programs from the region. Recommendations build upon best regional practices and suggest integrated and intersectoral responses.


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Planning Health Evaluations of Housing and Neighborhood Interventions

Planning Health Evaluations of Housing and Neighborhood Interventions: Lessons from Latin America​ discusses opportunities to integrate health evaluations into the design and implementation of urban policies. Housing and neighborhood interventions can be important interventions that deliver packaged benefits to improve urban health and well-being, but more evidence is needed regarding their effects under different conditions and the pathways underlying these effects to inform policy changes. The policy brief details potential health effects and evaluation designs, recommendations for intersectoral planning, and shares three case studies of current evaluations from the SALURBAL project.


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Health in All Urban Policies

This brief outlines the core principles of a Health in All Policies (HiAP) approach to understanding how urban environments affect health, and how urban policies and interventions across sectors can impact the health of people living in cities. This policy brief was co-produced by the SALURBAL project in collaboration with the Pan American Health Organization (PAHO) and describes initiatives by each organization to advance HiAP implementation. The 12-page booklet provides an introduction to key concepts related to HiAP, research and evidence to support this approach, and recommendations for policymakers and for the academic community for leveraging action across sectors to promote health, equity, and environmental sustainability.


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Cover page of the SALURBAL mortality and life expectancy data brief

Mortality and Life Expectancy in Latin American Cities

There is a high level of variation in life expectancy and causes of death across urban areas in Latin America. Global and regional summaries of life expectancy and causes of death can hide significant variability across cities. Studies that characterize mortality across heterogeneous cities are needed to inform urban policies. Urban environments that differ across neighborhoods, cities, and countries can have a major impact on life expectancy and causes of death.

This data brief overviews the experiences of the SALURBAL project in harmonizing and describing mortality data across 366 cities in 10 countries.


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Sustainable Transport and Urban Health 

Sustainable Transport and Urban Health: Lessons from Latin American Cities explores strategies and interventions from throughout the region that support active transport and mobility in cities. The policy brief gives an overview of the key areas of transportation policies, regional trends, case studies of policies in major cities, and discusses the contributions of Latin America to global efforts in urban policies and health. 


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