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Background: Household transmission studies seek to understand the transmission dynamics of a pathogen by estimating the risk of infection from household contacts and community exposures. We estimated within/extra-household SARS-CoV-2 infection risk and associated factors in a household cohort study in one of the most vulnerable neighbourhoods in Rio de Janeiro city. Methods: Individuals ≥1 years-old with suspected or confirmed COVID-19 in the past 30 days (index cases) and household members aged ≥1 year were enrolled and followed at 14 and 28 days (study period November/2020-December/2021). RT-PCR testing, COVID-19 symptoms, and SARS-CoV-2 serologies were ascertained in all visits. Chain binomial household transmission models were fitted using data from 2024 individuals (593 households). Findings: Extra-household infection risk was 74.2% (95% credible interval [CrI] 70.3-77.8), while within-household infection risk was 11.4% (95% CrI 5.7-17.2). Participants reporting having received two doses of a COVID-19 vaccine had lower extra-household (68.9%, 95% CrI 57.3-77.6) and within-household (4.1%, 95% CrI 0.4-16.6) infection risk. Within-household infection risk was higher among participants aged 10-19 years, from overcrowded households, and with low family income. Contrastingly, extra-household infection risk was higher among participants aged 20-29 years, unemployed, and public transportation users. Interpretation: Our study provides important insights into COVID-19 household/community transmission in a vulnerable population that resided in overcrowded households and who struggled to adhere to lockdown policies and social distancing measures. The high extra-household infection risk highlights the extreme social vulnerability of this population. Prioritising vaccination of the most socially vulnerable could protect these individuals and reduce widespread community transmission. Funding: Fundação Oswaldo Cruz, CNPq, FAPERJ, Royal Society, Instituto Serrapilheira, FAPESP.

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RESULTS: Hispanic children have higher odds of growth stunting than non-Hispanic White children. Native American children die younger and have higher odds of respiratory diseases and porous lesions than Hispanic and non-Hispanic Whites. Rural/urban location does not significantly impact age at death, but housing type does. Individuals who lived in trailers/mobile homes had earlier ages at death. When intersections between housing type and housing location are considered, children who were poor and from impoverished areas lived longer than those who were poor from relatively well-off areas. CONCLUSIONS: Children's health is shaped by factors outside their control. The children included in this study embodied experiences of social and ELS and did not survive to adulthood. They provide the most sobering example of the harm that social factors (structural racism/discrimination, socioeconomic, and political structures) can inflict.

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Rocky Mountain spotted fever (RMSF) is an international and quintessential One Health problem. This paper synthesizes recent knowledge in One Health, binational RMSF concerns, and veterinary and human medical perspectives to this fatal, reemerging problem. RMSF, a life-threatening tick-borne disease caused by the bacterium Rickettsia rickettsii, emerged during the first decade of the 21st century in impoverished communities in the southwestern US and northern Mexico. Lack of an index of suspicion, delay in diagnosis, and delayed initiation of antibiotic treatment contribute to fatality. Campaigns targeting dog neutering, restraint to residents' properties, and on-dog and on-premises treatment with acaricides temporarily reduce prevalence but are often untenable economically. Contemporary Mexican RMSF is hyperendemic in small communities and cities, whereas epidemics occur in the western US primarily in small tribal communities. In in both locations, the epidemics are fueled by free-roaming dogs and massive brown dog tick populations. In the US, RMSF has a case fatality rate of 5% to 7%; among thousands of annual cases in Mexico, case fatality often exceeds 30%.1,2 Numerous case patients in US border states have recent travel histories to northern Mexico. Veterinarians and physicians should alert the public to RMSF risk, methods of prevention, and the importance of urgent treatment with doxycycline if symptomatic. One Health professionals contribute ideas to manage ticks and rickettsial disease and provide broad education for the public and medical professionals. Novel management approaches include vaccine development and deployment, acaricide resistance monitoring, and modeling to guide targeted dog population management and other interventions.

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BACKGROUND: Multidimensional health-related quality of life (HRQOL) instruments, such as the EQ-5D, are increasingly used to assess inequalities in health. However, it is necessary to explore the ability of these instruments to capture differences between population groups, especially in low/middle-income countries. This study aimed to investigate whether the EQ-5D-3L instrument can detect differences in HRQOL between groups of different socioeconomic status (SES) in Brazil. METHODS: Data collection occurred during the Brazilian EQ-5D-3L valuation study and included respondents aged 18 to 64 years enrolled in urban areas. SES was aggregated into three categories: "higher" (A and B), "intermediate" (C) and "lower" (D and E). EQ-5D-3L index was calculated considering the Brazilian value set. A mixed-effects regression model was estimated with random effects on individuals and marginal effects on SES, sex, and educational attainment. Odds ratios for the chance of reporting problems for each EQ-5D dimension were estimated by logistic regression. RESULTS: A total of 9,148 respondents were included in the study. Mean age was 37.80 ± 13.13 years, 47.4% were men and the majority was ranked as classes B or C (38.4% and 50.7%, respectively). Participants in lower SES classes reported increasingly poorer health compared to individuals in higher classes. The mean EQ-5D-3L index decreased as SES deteriorates being significantly higher for classes A and B (0.874 ± 0.14) compared to class C (0.842 ± 0.15) and classes D and E (0.804 ± 0.17) (p < 0.001). The same was observed for the mean EQ-VAS scores (84.0 ± 13.8 in classes A and B, 81.0 ± 17 in class C and 78.3 ± 18.7 in class C [p < 0.001]). The multivariate analysis confirmed that SES is an independent factor that effects EQ-5D-3L index measures. Participants in intermediate and lower SES classes have a statistically significant lower EQ-5D-3L index compared to participants in classes A and B, regardless of age, sex, and educational attainment. CONCLUSION: In a Brazilian population sample, the EQ-5D-3L instrument was able to detect important differences between groups with distinct socioeconomic statuses (SES). The EQ-5D-3L is useful for exploring inequities in health.

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BACKGROUND: The prevalence of teenage pregnancy in Colombia is higher than the worldwide average. The identification of socio-geographical disparities might help to prioritize public health interventions. AIM: To describe variation in the probability of teenage maternity across geopolitical departments and socio-geographical intersectional strata in Colombia. METHODS: A cross-sectional study based on live birth certificates in Colombia. Teenage maternity was defined as a woman giving birth aged 19 or younger. Multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) was applied using multilevel Poisson and logistic regression. Two different approaches were used: (1) intersectional: using strata defined by the combination of health insurance, region, area of residency, and ethnicity as the second level (2) geographical: using geopolitical departments as the second level. Null, partial, and full models were obtained. General contextual effect (GCE) based on the variance partition coefficient (VPC) was considered as the measure of disparity. Proportional change in variance (PCV) was used to identify the contribution of each variable to the between-strata variation and to identify whether this variation, if any, was due to additive or interaction effects. Residuals were used to identify strata with potential higher-order interactions. RESULTS: The prevalence of teenage mothers in Colombia was 18.30% (95% CI 18.20-18.40). The highest prevalence was observed in Vichada, 25.65% (95% CI: 23.71-27.78), and in the stratum containing mothers with Subsidized/Unaffiliated healthcare insurance, Mestizo, Rural area in the Caribbean region, 29.08% (95% CI 28.55-29.61). The VPC from the null model was 1.70% and 9.16% using the geographical and socio-geographical intersectional approaches, respectively. The higher PCV for the intersectional model was attributed to health insurance. Positive and negative interactions of effects were observed. CONCLUSION: Disparities were observed between intersectional socio-geographical strata but not between geo-political departments. Our results indicate that if resources for prevention are limited, using an intersectional socio-geographical approach would be more effective than focusing on geopolitical departments especially when focusing resources on those groups which show the highest prevalence. MAIHDA could potentially be applied to many other health outcomes where resource decisions must be made.

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INTRODUCTION: The objective of this study was to analyze the geographic variability and the relationship between social determinants of health and COVID-19 lethality in Bariloche. METHODS: A database from the National Epidemiological Surveillance System was used to analyze COVID-19 positive cases from January 2020 to December 2021. The data were geocoded and incorporated into a geographic information system (GIS). A three-step analytical framework was applied to measure health inequity, using socioeconomic indicators and access to services. A multivariate analysis was conducted to predict fatality. RESULTS: A total of 25 020 COVID-19 cases were diagnosed in Bariloche during the study period. The fatality rate was 2.1%. Significant variability in socioeconomic indicators was observed among different territorial delegations of the city. DISCUSSION: The results showed health inequities and an association between social determinants and COVID-19 lethality in Bariloche. Individuals living in areas with higher socioeconomic vulnerability had a higher risk of mortality. These findings highlight the importance of addressing health inequities in a pandemic response.

Introducción: El objetivo de este estudio fue examinar cómo la variabilidad geográfica y los determinantes sociales de la salud influyen en la tasa de letalidad por COVID-19 en Bariloche. Métodos: Se utilizó una base de datos del Sistema Nacional de Vigilancia Epidemiológica para analizar los casos positivos de COVID-19 desde enero de 2020 hasta diciembre de 2021. Los datos se geo-codificaron y se incorporaron en un sistema de información geográfica (SIG). Se aplicó un marco de análisis en tres pasos para medir la inequidad en salud, utilizando indicadores socioeconómicos y de acceso a servicios. Se realizó un análisis multivariado para predecir la letalidad. Resultados: Se diagnosticaron un total de 25 020 casos de COVID-19 en Bariloche durante el período de estudio. La letalidad fue del 2.1%. Se observó una variabilidad significativa en indicadores socioeconómicos entre las diferentes delegaciones territoriales de la ciudad. Discusión: Los resultados mostraron inequidades en salud y una asociación entre determinantes sociales y letalidad por COVID-19 en Bariloche. Las personas que vivían en áreas con mayor vulnerabilidad socioeconómica presentaron un mayor riesgo de mortalidad. Estos hallazgos resaltan la importancia de abordar las inequidades en salud en la respuesta a una pandemia.

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The purpose of workplace public health programmes and regulations is to promote safety and health for the entire working population nationwide. Some countries limit the scope of such programmes to medium or big-sized companies, leaving out small and micro-enterprises, thus discriminating against many workers exposed to risks. This Viewpoint aims to identify inequalities in occupational health generated by the new Regulation for Workplace Health Promotion (WHP) in Ecuador. We showed how the regulation excludes all micro-enterprises and displayed the essential role of micro-enterprises in the business fabric and the Ecuadorian labour market. More than 93% of the registered companies are micro-enterprises and these include more than 25% of the employees in the formal economy. Integrating occupational health into the public health system will require deep analysis to improve protection for the working population.

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RESUMEN La inasistencia a citas dentales es un problema relevante en la atención sanitaria debido a las consecuencias negativas que implica. El presente artículo tiene como objetivo revisar las causas de la inasistencia y las estrategias implementadas para su prevención a nivel internacional. Los factores socioeconómicos, culturales, geográficos y demográficos son identificados como las principales causas del ausentismo. Se ha observado una relación inversamente proporcional entre el nivel socioeconómico y el ausentismo, donde aquellos pacientes con mayores recursos tienden a tener una menor inasistencia. El factor socioeconómico y cultural, junto con la educación en salud oral, influyen en la preocupación y la frecuencia de los controles dentales. Se han propuesto diversas soluciones, como el recordatorio telefónico o mediante mensajes de texto (SMS), aunque su efectividad puede variar debido a la familiaridad y el acceso de los pacientes a la tecnología. Se requiere abordar este problema de manera integral y considerar diferentes enfoques para reducir la inasistencia a citas dentales.

ABSTRACT Non-attendance at dental appointments is a relevant problem in health care due to the negative consequences it entails. This article aims to review the causes of nonattendance and the strategies implemented for its prevention at the international level. Socioeconomic, cultural, geographic, and demographic factors are identified as the main causes of absenteeism. An inversely proportional relationship has been observed between socioeconomic status and absenteeism, with those patients with greater resources tending to have lower absenteeism. Socioeconomic and cultural factors, together with oral health education, influence the concern and frequency of dental checkups. Various solutions have been proposed, such as telephone or SMS reminders, although their effectiveness may vary due to patient familiarity and access to technology. There is a need to address this problem comprehensively and consider different approaches to reduce missed dental appointments.

RESUMO A não comparência às consultas de medicina dentária é um problema relevante nos cuidados de saúde pelas consequências negativas que acarreta. Este artigo tem como objetivo rever as causas do absentismo e as estratégias implementadas para a sua prevenção a nível internacional. Os fatores socioeconómicos, culturais, geográficos e demográficos são identificados como as principais causas do absentismo. Foi observada uma relação inversamente proporcional entre o estatuto socioeconómico e o absentismo, sendo que os doentes com mais recursos tendem a ter menos absentismo. Os fatores socioeconómicos e culturais, juntamente com a educação para a saúde oral, influenciam a preocupação e a frequência das consultas dentárias. Têm sido propostas várias soluções, como lembretes por telefone ou SMS, embora a sua eficácia possa variar devido à familiaridade do paciente e ao acesso à tecnologia. É necessário abordar este problema de forma abrangente e considerar diferentes abordagens para reduzir a não comparência às consultas dentárias.

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BACKGROUND: This study aimed to verify leisure-time physical activity trends over 15 years and monitor inequalities according to gender, self-reported skin color, and socioeconomic position in a Southern Brazilian city. A secondary aim is to evaluate intersectionalities in physical activity. METHODS: Trend analysis using 3 population-based surveys carried out in 2004, 2010, and 2021. Main outcome assessed was the prevalence of physical activity according to recommendations (150 min/wk). Inequalities dimensions measured were sex, self-reported skin color, and wealth. Intersectionalities were evaluated using Jeopardy index combining all inequality dimensions. Trend analysis was performed using least-squares weighted regression. RESULTS: We included data from 3090, 2656, and 5696 adults in 2004, 2010, and 2021, respectively. Prevalence of physical activity remains stable around 25% in the 3 years. In the 3 periods evaluated, men presented a prevalence in average 10 percentage points higher than women (SII2004 = -11.1 [95% confidence interval, CI, -14.4 to -7.8], SII2021 = -10.7 [95% CI, -13.7 to -7.7]). Skin color inequalities did not present a clear pattern. Richest individuals, in general presented a prevalence of leisure-time physical activity level 20pp higher than poorest ones (SII2004 = 20.5 [95% CI, 13.7 to 27.4]; SII2021 = 16.7 [95% CI, 11.3 to 22.0]). Inequalities were widely marked, comparing the most privileged group (represented by men, the wealthiest, and White) and the most socially vulnerable group (represented by women, the poorest, and Black/Brown). The Slope Index of Inequality for intersectionalities was -24.5 (95% CI, -31.1 to -17.9) in 2004 and -18.8 in 2021 (95% CI, -24.2 to -13.4). CONCLUSIONS: Our analysis shows that women, Black/Brown, and poor present lower leisure-time physical activity level. This group is often neglected regarding other health and social outcomes.

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PURPOSE: Spanish Lung Cancer Group (SLCG) conducted a review to analyze the barriers to access to innovative targeted therapies for non-small cell lung cancer (NSCLC) in clinical practice in Spain. METHODS: Review all relevant content published on websites of European Commission, European Medicines Agency, and Spanish Agency of Medicines and Medical Products regarding the authorization and access to oncology treatments. RESULTS: More than 20 targeted therapies are available to treat different molecular alterations in patients with NSCLC. European Commission has approved treatments for genomic alterations involving the following genes: ALK, RET, ROS1, EGFR, BRAF, NTRK, KRAS, MET. However, the availability of these therapies in Spain is not complete, as innovative treatments are not reimbursed or funded late, with only five of these alterations currently covered by National Health System. CONCLUSION: SLCG considers imperative to improve the access in Spain to innovative treatments for NSCLC to reduce inequity across European countries.

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ABSTRACT Objective: To investigate inequalities related to race/ethnicity and socioeconomic status in self-reported positive diagnosis for COVID-19 in Brazilian adults. Methods: Data available from the National Household Sample Survey COVID-19 (PNAD COVID 19) (July/September/November, 2020) were used in this retrospective investigation. The analyses considered the sampling design, primary sampling units, strata and sample weights. Poisson regression with robust variance was used to estimate prevalence ratio (PR) and the 95% confidence interval (95%CI) of the associations. Results: In July, September and November 2020, with regard to the rapid test, indigenous people were 2.45 (95%CI 1.48-4.08), 2.53 (95%CI 1.74-4.41) and 1.23 (95%CI 1.11-1.86) times more likely to report a positive history of SARS-CoV-2 infection, respectively. With regard to the RT-PCR test in November, indigenous people were more likely to test positive for COVID-19 (PR: 1.90; 95%CI 1.07-3.38). It was observed that the indigenous group was 1.86 (95%CI 1.05-3.29) and 2.11 (95%CI 1.12-3.59) times more likely to test positive for COVID-19 in September and November (2020). Income was associated with testing positive for COVID-19: in November, individuals whose income ranged from R$0.00-R$1.044 were more likely (PR: 1.69; 95%CI 1.16-23.06) to test positive using the RT-PCR test; participants whose income was in this range were also more likely to be diagnosed with COVID-19 using blood tests (PR: 1.72; 95%CI 1.43-2.07). Conclusion: The data presented show an association between race/ethnicity and economic status with a positive diagnosis of COVID-19.

RESUMO Objetivo: Investigar as desigualdades relacionadas a raça/etnia e condição socioeconômica no autorrelato de resultado positivo para COVID-19 em adultos brasileiros. Métodos: Os dados disponibilizados pela Pesquisa Nacional por Amostra de Domicílios (Pnad) COVID-19 (julho/setembro/novembro, 2020) foram utilizados nesta investigação retrospectiva. As análises consideraram o desenho amostral, unidades primárias de amostragem, estratos e pesos amostrais. Regressão de Poisson com variância robusta foi utilizada para estimar as razões de prevalência (RP) e o intervalo de confiança de 95% (IC95%) das associações. Resultados: Nos meses de julho, setembro e novembro de 2020, referente ao teste rápido, os indígenas tinham 2,45 (IC95% 1,48-4,08), 2,53 (IC95% 1,74-4,41) e 1,23 (IC95% 1,11-1,86) vezes maior probabilidade de reportar o histórico positivo de infecção por SARS-CoV-2, respectivamente. Com relação ao teste RT-PCR no mês de novembro, os indígenas apresentaram mais chance de testarem positivo para COVID-19 (RP: 1,90; IC95% 1,07-3,38). Foi observado que o grupo de indígenas apresentou 1,86 (IC95% 1,05-3,29) e 2,11 (IC95% 1,12-3,59) vezes mais chances de positivarem para COVID-19 em setembro e novembro (2020). A renda esteve associada com a testagem positiva para a COVID-19: no mês de novembro, indivíduos com renda variando entre R$ 0,00-R$ 1,044 tiveram maior probabilidade (RP: 1,69; IC95% 1,16-23,06) de testarem positivo através do teste RT-PCR; participantes com renda variando na referida faixa de valor também apresentaram maior chance de serem diagnosticados com COVID-19 através de testes sanguíneos (RP: 1,72; IC95% 1,43-2,07). Conclusão: Os dados apresentados evidenciam a associação entre a raça/etnia e o status econômico com o resultado positivo para COVID-19.

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Resumen Introducción : El objetivo de este estudio fue exami nar cómo la variabilidad geográfica y los determinantes sociales de la salud influyen en la tasa de letalidad por COVID-19 en Bariloche. Métodos : Se utilizó una base de datos del Sistema Nacional de Vigilancia Epidemiológica para analizar los casos positivos de COVID-19 desde enero de 2020 hasta diciembre de 2021. Los datos se geo-codificaron y se incorporaron en un sistema de información geográfica (SIG). Se aplicó un marco de análisis en tres pasos para medir la inequidad en salud, utilizando indicadores socioeconómicos y de acceso a servicios. Se realizó un análisis multivariado para predecir la letalidad. Resultados : Se diagnosticaron un total de 25 020 casos de COVID-19 en Bariloche durante el período de estudio. La letalidad fue del 2.1%. Se observó una variabilidad significativa en indicadores socioeconó micos entre las diferentes delegaciones territoriales de la ciudad. Discusión : Los resultados mostraron inequida des en salud y una asociación entre determinantes sociales y letalidad por COVID-19 en Bariloche. Las personas que vivían en áreas con mayor vulnerabili dad socioeconómica presentaron un mayor riesgo de mortalidad. Estos hallazgos resaltan la importancia de abordar las inequidades en salud en la respuesta a una pandemia.

Abstract Introduction : The objective of this study was to ana lyze the geographic variability and the relationship between social determinants of health and COVID-19 lethality in Bariloche. Methods : A database from the National Epidemiologi cal Surveillance System was used to analyze COVID-19 positive cases from January 2020 to December 2021. The data were geocoded and incorporated into a geo graphic information system (GIS). A three-step analytical framework was applied to measure health inequity, us ing socioeconomic indicators and access to services. A multivariate analysis was conducted to predict fatality. Results : A total of 25 020 COVID-19 cases were diag nosed in Bariloche during the study period. The fatality rate was 2.1%. Significant variability in socioeconomic indicators was observed among different territorial delegations of the city. Discussion : The results showed health inequities and an association between social determinants and COVID-19 lethality in Bariloche. Individuals living in areas with higher socioeconomic vulnerability had a higher risk of mortality. These findings highlight the importance of addressing health inequities in a pan demic response.

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los modelos público-sanitarios de caráctermonopólico como el venezolano, suelen asociarse a tendencias al racionamiento de los bienes y servicios que proveen a sus usuarios, así como a la merma de la calidad de estos. Por otro lado, la provisión de dichos bienes y servicios por la vía de mecanismos de mercado, tiene ante sí, el inconveniente que supone el ambiente inflacionario de su economía, cuyo impacto en los precios limita el acceso del paciente a su consumo. El caso de la enfermedad cardiovascular ofrece algunas claves para la comprensión de este fenómeno en el medio venezolano.

Public-health models of a monopolistic nature, suchas the Venezuelan, bring with them trends in the rationing ofthe goods and services they provide to their users, as well as inthe reduction of their quality. On the other hand, the provisionof these goods and services by means of market mechanisms hasbefore it, in our environment, the enormous impediment posedby the inflationary environment of its economy, whose impacton prices limits the patient's access to consumption. The case of cardiovascular disease offers some keys to understanding thisphenomenon in the Venezuelan environment.

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During the pandemic, Mexico experienced one of the longest periods of school closures in Latin America. After the first year of COVID-19, thousands of college students dropped out of school, which has been partially attributed to difficulties in adapting to online learning. This study examines how some college students in Mexico coped with and overcame these challenges. Our research draws on journals of and in-depth interviews with Mexican college students who participated in the Pandemic Journaling Project-a combined online journaling platform and research study. Participant accounts describe challenges students experienced navigating the rapid roll-out of online education. However, over time, many of the students in our study cultivated a renewed sense of purpose in their educational activities. They attributed this shift in perspective to their ability to carve out new approaches to social support, the development of professional capacities, and insight into the potential for technology to promote a more inclusive society. Our work shows how students' ability to integrate digital competencies into their broader life projects and aspirations for the future played an important role in college perseverance and reducing mental health distress. Findings have important implications for the potential role of increased access to technological resources in mitigating social inequity and improving mental health outcomes among young adults.

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Background: Globally, it has been reported that different social determinants of health affect health outcomes in lung cancer (LC). Research on the therapeutic trajectories of patients (TTP) is a novel field for identifying barriers and facilitators in health. The objective of this study was to reveal perceived differences in TTP with LC in Chile according to selected social determinants of health (SDH) and the experiences of patients, health professionals, and civil society leaders. Methods: This is a qualitative paradigm, one case-study design. Online semi-structured interviews were conducted with patients with LC, health professionals, and civil society leaders. The strategies for the recruitment process included social networks, civil society organizations, health professionals, and the snowball technique. A thematic analysis was carried out. Results: Selected SDH impact LC's TTP in Chile, particularly concerning health system access, health services, information, and patient navigation experiences. The analysis of the experiences of the participants allowed us to identify barriers related to the selected SDH in three stages of the TTP: initiation, examinations, and diagnosis and treatment. Individuals with limited education, those residing outside the capital, women, and those in the public health system encountered more barriers throughout their TTP. Discussion: Study findings suggest that being a woman with low education, from the public health system, and not from the capital might represent one of the most powerful intersections for experiencing barriers to effective healthcare in LC in Chile. It is necessary to monitor the TTP from an SDH perspective to guarantee the rights of access, opportunity, quality, and financial protection.

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Women's contributions to science have been consistently underrepresented throughout history. Despite many efforts and some progresses being made to reduce gender inequity in science, pursuing an academic career across disciplines, including Alzheimer's disease (AD) and other dementias, remains challenging for women. Idiosyncratic difficulties of Latin American countries likely accentuate the gender gap. In this Perspective, we celebrate outstanding contributions from Argentinian, Chilean, and Colombian colleagues in dementia research and discuss barriers and opportunities identified by them. We aim to acknowledge Latin American women's work and bring visibility to the challenges they face throughout their careers in order to inform potential solutions. Also, we highlight the need to perform a systematic assessment of the gender gap in the Latin American dementia community of researchers.

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Disproportionate mortality and morbidity burdens of the COVID-19 pandemic and coinciding media coverage of public acts of violence perpetrated against people of color in 2020 precipitated reckonings with structural inequities in global, national, and local contexts. This cross-country comparative analysis aims to describe how people voice and make sense race, racism, and privilege in their experiences with COVID-19 infection in the United States, United Kingdom, and Brazil. Anchored by continuous reflection on our individual and collective positionality, we conducted an inductive comparative analysis conceptually situated in intersectionality and critical race theory. Countries used a shared qualitative methodology to collect and analyze 166 narratives of people with experience of COVID-19 infection from 2020 to 2023. We selected 19 cases that illustrate cross-national differences in peoples' acknowledgment and narration of structural privilege and disadvantage in their observations of COVID-19 in their countries and in their personal experiences. People in the US had the most fluency with voicing race directly. In Brazil, while some respondents (especially younger people) demonstrated high racial consciousness, others struggled to identify and talk about racial relationships. In the UK, people voiced racial identifications, though often within white norms of politeness and an accompanying sense of discomfort. The findings overall illustrate moments the interview becomes or does not become a space for voicing social categories and systemic underpinnings of difference in COVID-19 infections and healthcare experiences. We reflect on cross-country differences in historical and contemporary racialized discourse and elaborate on implications of focusing on voicing in qualitative research.

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OBJECTIVES: The aim of this study was to test the hypothesis that ethnic and ethnolinguistic discrimination, and Post-Traumatic Stress Disorder (PTSD) related to being Indigenous as well as different aspects of acculturative stress, are associated with poorer health and higher levels of depression among the Nahua Indigenous communities. MATERIALS AND METHODS: Our quantitative survey was carried out in four different regions inhabited by the Nahua people in Mexico. Self-rated health and depression, the symptoms of PTSD, two facets of acculturative stress and ethnolinguistic discrimination were assessed by questionnaires. The data were analyzed using binary logistic regression models. RESULTS: The symptoms of PTSD and acculturative stress experienced in the workplace were significantly associated with a higher risk of poor self-rated health, adjusted for various socio-demographic characteristics. Acculturative stress, discouragement of language use, language avoidance and ethnolinguistic discrimination were related to a higher risk of depression and PTSD. DISCUSSION: Our research implies that ethnic and linguistic discrimination, acculturative stress and the memory of harm linked to being Indigenous reflected in the symptoms of PTSD, are important predictors of poorer health and depression among Nahua groups in Mexico. These adverse effects could be significantly counteracted by effective dealing with stigmatization and discrimination against Indigenous people in Mexico and by replacing strong assimilation pressures with integrational approaches that respect ethnolinguistic diversity and reduce socioeconomic marginalization.

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This paper is an ethnographic case study of COVID-19 emergence in Santo Tomé (South America, NE Argentina, ≂25,000 inhabitants). Based on interviews with healthcare personnel, we describe local containment and prevention policies in a context of national lockdown measures. We reconstruct a tree diagram of infections, index cases and close contacts that spread infection locally. In parallel, fieldwork in a sample of impoverished subsistence agricultures and fishermen allows us to describe drought and fresh food production decline during confinement as convergent ecocrises (pluralea interactions) with the SARS-CoV-2 outbreak. The core idea of the article, which emerged from ethnographic fieldwork evidence, is that in the context of climate change, the sudden onset of an infectious disease interacts with convergent ecocrises.