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Health and Health Equity in Latin America

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 August 2026 | Viewed by 4874

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Prof. Dr. Thankam S. Sunil

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Guest Editor

Department of Public Health, University of Tennessee, Knoxville, TN 37916, USA
Interests: health disparities; global health; heat health

Special Issue Information

Dear Colleagues,

Health and health equity in Latin America face significant challenges due to the region’s deeply fragmented and segmented health systems. Despite progress in some areas, such as increased life expectancy and reduced child and maternal mortality, substantial inequities persist. These disparities are particularly pronounced among vulnerable populations, including women, indigenous peoples, and the LGBTQ+ community. Efforts towards universal health coverage (UHC) have shown promise, with countries like Brazil and Mexico making strides in expanding access to healthcare services and reducing out-of-pocket expenses. However, the region still struggles with high levels of inequality, political instability, and limited management capacities in public healthcare, which hinder the realization of equitable health outcomes. Further, we invite manuscripts looking at social and political determinants of health and their role in impacting health inequity in these countries.

Prof. Dr. Thankam S. Sunil
Guest Editor

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Keywords

chronic diseases
social determinants of health
behavioral determinants
health disparities
policy differentials

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Published Papers (4 papers)

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Research

Jump to: Review

15 pages, 431 KB

Open AccessArticle

Patient-Centered Leadership and Co-Design of Services for Breast Cancer Program in Nicaragua

by María Esther Suárez, Karen Vanessa Herrera, Alma Celeste Avilés, Gonzalo Granados, Ena Patricia García and Chepita Rivera

Int. J. Environ. Res. Public Health 2025, 22(10), 1482; https://doi.org/10.3390/ijerph22101482 - 25 Sep 2025

Viewed by 354

Abstract

Introduction: The direct participation and leadership of breast cancer patients in program design and implementation can facilitate a nuanced understanding of how individuals perceive and address challenges within their unique contexts. To achieve truly patient-centered care, patients must be formally integrated as a critical component of multidisciplinary healthcare teams. Materials and Methods: A descriptive, retrospective observational study was conducted. A group of 122 patients (“Breast Unit”) was formed and actively implemented initiatives related to education, prevention, peer support, co-design, and institutional guidance over two years. A second group, consisting of 466 individuals diagnosed with and treated for breast cancer, served as the Beneficiary Patient group. From the “Breast Unit”, 93 patients responded to a structured interview about their experience. Results: The Breast Unit group developed strong leadership skills and collaborated with the multidisciplinary healthcare team to improve care workflows, contributing at both strategic and operational levels. In total, 97% of patients received their first oncology evaluation within 48 h, ensuring timely intervention. The percentage of early-stage breast cancer diagnoses improved, from 67% to 76%. Furthermore, patients who participated in the support group reported no new diagnoses of clinical depression in the past two years. Conclusions: By elevating the patient voice into a substantive role within leadership, strategic planning, and co-design initiatives, healthcare systems can advance a more equitable, effective, and sustainable model of care. Integrating patient contributions with multidisciplinary collaboration is essential for optimizing care processes, improving clinical outcomes. It strengthens the person-centered culture, impacting on a personal and organizational level. Full article

(This article belongs to the Special Issue Health and Health Equity in Latin America)

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11 pages, 269 KB

Open AccessArticle

Predictors of High Obesity in Rural Nicaragua: A Cross-Sectional Study

by Karen Herrera, Milena Marquina de Reyes and Thankam Sunil

Int. J. Environ. Res. Public Health 2025, 22(5), 660; https://doi.org/10.3390/ijerph22050660 - 22 Apr 2025

Viewed by 693

Abstract

Chronic disease prevalence continues to increase in low- and middle-income countries, and the countries in the Central American region are no exception. Recent reports have shown that women are particularly at higher risk for being obese or overweight in several countries in Central America, including Nicaragua. In the present study, we conducted a cross-sectional analysis of a sample of respondents (n = 200) who were aged 30 years and over and living in rural communities in Nicaragua. This study’s results show that a higher percentage of the respondents reported their health as being fair or poor, and female respondents were found to have higher BMIs compared to their male counterparts (p < 0.05). While previous studies have noted that, traditionally, the body mass index (BMI) has been the most widely used measure to assess overweight prevalence in populations and to evaluate individual health risks, this study used the waist–hip ratio to measure the prevalence of obesity in adults. In recent years, the central obesity indicators, primarily waist circumference and the waist-to-hip ratio, have been recognized as more accurate at describing body fat distribution compared to the BMI. These measures have also been found to have a stronger association with morbidity and mortality. Behavioral factors, such as vegetable consumption and hours of sleep, were found to be significant predictors of obesity/overweight among rural residents in Nicaragua. This study’s results highlight the need for targeted behavioral change interventions, including promoting the regular consumption of fruits and vegetables in the diets of rural residents. Full article

(This article belongs to the Special Issue Health and Health Equity in Latin America)

13 pages, 1514 KB

Open AccessArticle

Rehabilitation Needs Across Heterogenous Brazilian Regions: Secondary Analysis of the Global Burden of Disease Study

by Rogério Olmedija de Araújo, Tiótrefis Gomes Fernandes and Tiago Silva Jesus

Int. J. Environ. Res. Public Health 2025, 22(4), 486; https://doi.org/10.3390/ijerph22040486 - 25 Mar 2025

Viewed by 979

Abstract

Aim: This study aimed to determine the evolving rehabilitation needs in Brazil, considering five main impairment categories for nationwide health-service planning, stratified per age groups, as well as Brazilian regions with inequitable development. Methods: Secondary analysis of the Global Burden of Disease study (1990–2019), using Years Lived with Disability (YLD) rates for all ages and age-standardized metrics. The set of health conditions amenable to rehabilitation were selected and organized based on the five impairment types, derived from Brazil’s public-based Care Network for People with Disabilities. Results: A Brazil-wide 24% growth (1990–2019) in overall rehabilitation needs per capita (i.e., YLD rates per 100,000 population) was observed, in addition to a 6% negative growth for age-standardized YLD rates. “Physical” impairments accounted for 77% of the Brazilian rehabilitation needs in 2019; 69% of these impairments come from musculoskeletal conditions. Rehabilitation needs growth was also observed across the five Brazilian regions, ranging from 16% to 25%. Conclusions: Rehabilitation needs are growing across Brazil and its regions as a result of population ageing and epidemiological transition. Brazilian regions with lower income and lower population density (e.g., with more rural or remote populations) also experienced growth in rehabilitation needs, even though these regions are often underserved by rehabilitation professionals. Full article

(This article belongs to the Special Issue Health and Health Equity in Latin America)

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Review

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55 pages, 1012 KB

Open AccessReview

Precision Medicine for Cancer and Health Equity in Latin America: Generating Understanding for Policy and Health System Shaping

by Ana Rita González, Lizbeth Alexandra Acuña Merchán, Jorge A. Alatorre Alexander, Diego Kaen, Catalina Lopez-Correa, Claudio Martin, Allira Attwill, Teresa Marinetti, João Victor Rocha and Carlos Barrios

Int. J. Environ. Res. Public Health 2025, 22(8), 1220; https://doi.org/10.3390/ijerph22081220 - 5 Aug 2025

Viewed by 2036

Abstract

This study presents and discusses evidence on the value of biomarker testing and precision medicine in Latin America through a health equity lens. It is essential to explore how to harness the benefits of precision medicine to narrow the health equity gap, ensuring all patients have access to the best cancer treatment. The methodology employed to develop this document consists of a non-systematic literature review, followed by a process of validation and feedback with a group of experts in relevant fields. Precision medicine could help reduce health inequities in Latin America by providing better diagnosis and treatment for everyone with cancer. However, its success in achieving this depends on the implementation of policies that promote equitable access. Findings indicate that the current policy landscape in the Latin American region is not conducive to improving access, reach, quality, or outcome-related problems in cancer care, nor to realizing the full potential of precision medicine. The study explores how precision medicine can advance health equity, concluding with an analysis of the challenges and recommendations for overcoming them. Full article

(This article belongs to the Special Issue Health and Health Equity in Latin America)

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