Nieto-Martínez Ramfis, Babagoli Masih A, Gonzalez-Rivas Juan Pablo, Ugel Eunice, Duran Maritza, Marulanda María Inés, Mechanick Jeffrey I, Danaei Goodarz
Precision Care Clinic Corp, Saint Cloud, FL, USA.
Departments of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
BMC Public Health. 2025 Jun 7;25(1):2133. doi: 10.1186/s12889-025-23125-0.
Venezuela has faced a crisis over the past decade. This study aims to characterize the crisis and identify the population's most vulnerable subgroups.
Follow-up data (2018-2020) from 1,257 subjects (35% of the total) who participated in the nationally representative sample of the Venezuelan Study of Cardiometabolic Health (EVESCAM, 2014-2017) were analyzed. The distribution of seven crisis indicators- food insecurity, stressful life events, family separation, disruption in access to utilities (water, electricity, gas, or sanitation), lack of access to medications, lack of access to transportation, and disruption of childhood education- were analyzed across five subgroups (age, sex, ethnicity, socioeconomic status [SES], and education). Logistic regression adjusted by other socio-demographic variables was used to analyze associations among variables.
Of the total sample, 71.8% were female, 67.0% ≥ 50 years old, 52% low SES, and 80.2% Mixed ethnicity. Overall, 77.3% reported disruption in access to at least one utility and 31.7% to two or more utilities. The former was higher in females (OR 1.46, 95% CI 1.08-1.98) and those with lower education (OR 2.03, 1.27-3.23). Lack of electricity (70.2%) was similar across subgroups. Lack of transportation (76.2%) affected females (OR 1.36, 1.10-1.67) and those of Mixed ethnicity more strongly. Disruption of children's education was reported more in homes with the youngest, Amerindian, low SES, and less educated participants. Family separation (49.2%) affected older and female participants more strongly. Food insecurity (60.2%) was more frequent in the low SES group compared with the high SES group (OR 2.17, 1.45-3.25). Stressful life events (67.2%) and lack of medications (43.8%) did not differ across subgroups.
The Venezuelan humanitarian crisis has heightened vulnerability to crisis indicators among women, elders, those with low SES, and less educated subgroups of the population. These findings should prompt cost-effective programs targeted at those most vulnerable.
委内瑞拉在过去十年中面临危机。本研究旨在描述这场危机的特征,并确定人群中最脆弱的亚组。
分析了参与委内瑞拉心脏代谢健康研究(EVESCAM,2014 - 2017年)全国代表性样本的1257名受试者(占总数的35%)的随访数据(2018 - 2020年)。分析了七个危机指标的分布情况,这些指标包括粮食不安全、生活压力事件、家庭分离、公用事业(水、电、气或卫生设施)供应中断、无法获得药物、无法获得交通工具以及儿童教育中断,涉及五个亚组(年龄、性别、种族、社会经济地位[SES]和教育程度)。使用经其他社会人口学变量调整的逻辑回归分析变量之间的关联。
在总样本中,71.8%为女性,67.0%年龄≥50岁,52%社会经济地位低,80.2%为混血种族。总体而言,77.3%的人报告至少一项公用事业供应中断,31.7%的人报告两项或更多公用事业供应中断。前者在女性(比值比[OR] 1.46,95%置信区间[CI] 1.08 - 1.98)和教育程度较低的人群中更高(OR 2.03,1.27 - 3.23)。停电(70.2%)在各亚组中情况相似。交通不便(76.2%)对女性(OR 1.36,1.10 - 1.67)和混血种族人群影响更大。在有最年幼子女、美洲印第安人、社会经济地位低且教育程度低的参与者的家庭中,儿童教育中断的报告更多。家庭分离(49.2%)对年长和女性参与者影响更大。与高社会经济地位组相比,低社会经济地位组粮食不安全情况(60.2%)更频繁(OR 2.17,1.45 - 3.25)。生活压力事件(67.2%)和药物短缺(43.8%)在各亚组中无差异。
委内瑞拉的人道主义危机加剧了女性、老年人、社会经济地位低以及教育程度较低的人群亚组对危机指标的脆弱性。这些发现应促使针对最脆弱人群制定具有成本效益的项目。