Suchergebnisse

OBJECTIVES: In 2018, Spain adopted a national law that significantly expanded healthcare access to all residents, including undocumented migrants. This was a substantial shift from a more restrictive system of coverage in previous years. However, irregular migrants continue to experience challenges accessing healthcare in Spain. This study aimed to describe the legislative and administrative barriers to implementation of this law from the perspective of providers and administrators of the healthcare system. DESIGN: We interviewed 12 individuals using a semistructured format. SETTING: Spain. PARTICIPANTS: 12 participants were interviewed; 7 males, 5 females. Participants included Spanish healthcare workers, government officials, hospital administrators, individuals working with non-governmental organisations focused on the provision of healthcare, and experts studying healthcare for underserved populations. PRIMARY AND SECONDARY OUTCOME MEASURES: Interviews delved into personal experiences and knowledge of the entitlements and barriers of providing or trying to access care for undocumented migrants. RESULTS: The interviews yielded eight key themes: (1) context of universal healthcare in Spain pre-2012; (2) erosion of trust as rationale for more restrictive policies of 2012; (3) challenges of the 3-month residency requirement; (4) areas of ambiguity: exceptions in the 2012 Royal Decree Law not discussed in the 2018 Royal Decree Law; (5) jurisdictional authority and conflicts between national and AC government; (6) near impossibility of obtaining documentation for exportation of healthcare; (7) difficulties obtaining necessary paperwork to register residency; and (8) rise of NGOs to provide support to irregular migrants. CONCLUSION: While there has been a general political movement to expand healthcare access for undocumented migrants in Spain, there remains a fundamental need to clarify the legal entitlements for undocumented migrants nationally and create administrative consistency across autonomous communities ...

Objectives In 2018, Spain adopted a national law that significantly expanded healthcare access to all residents, including undocumented migrants. This was a substantial shift from a more restrictive system of coverage in previous years. However, irregular migrants continue to experience challenges accessing healthcare in Spain. This study aimed to describe the legislative and administrative barriers to implementation of this law from the perspective of providers and administrators of the healthcare system. Design We interviewed 12 individuals using a semistructured format. Setting Spain. Participants 12 participants were interviewed; 7 males, 5 females. Participants included Spanish healthcare workers, government officials, hospital administrators, individuals working with non-governmental organisations focused on the provision of healthcare, and experts studying healthcare for underserved populations. Primary and secondary outcome measures Interviews delved into personal experiences and knowledge of the entitlements and barriers of providing or trying to access care for undocumented migrants. Results The interviews yielded eight key themes: (1) context of universal healthcare in Spain pre-2012; (2) erosion of trust as rationale for more restrictive policies of 2012; (3) challenges of the 3-month residency requirement; (4) areas of ambiguity: exceptions in the 2012 Royal Decree Law not discussed in the 2018 Royal Decree Law; (5) jurisdictional authority and conflicts between national and AC government; (6) near impossibility of obtaining documentation for exportation of healthcare; (7) difficulties obtaining necessary paperwork to register residency; and (8) rise of NGOs to provide support to irregular migrants. Conclusion While there has been a general political movement to expand healthcare access for undocumented migrants in Spain, there remains a fundamental need to clarify the legal entitlements for undocumented migrants nationally and create administrative consistency across autonomous communities for providing health cards for undocumented migrants. Other countries may be able to draw lessons from the Spanish experience about the legislative frameworks surrounding access to healthcare for undocumented migrants. ; This project was partially supported by the University of California San Francisco; National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number UL1 TR001872; and the Fulbright-Schuman Program.

This study aims at understanding how scientific evidence to substantiate nutrition and health claims in food commercial communication is regulated in Europe and the USA. A literature review was performed on the scientific evidence required by the European Food Safety Authority and the US Food and Drug Administration to substantiate food nutrition and health claims. Studies published in Scopus, Medline, Scirus, and Google Scholar from 2007 to 2012 were reviewed as well as documents released by both agencies. A total of 38 documents met our inclusion criteria out of 743 documents initially identified during our search. These agencies provide general guidelines on how to conduct food and health studies, intended to demonstrate a cause‐and‐effect relationship between a given food and a benefit to health. Despite this, they need to broaden the depth and scope of the guidelines provided to companies seeking to substantiate their claims and to provide further and more precise information concerning the evaluation of studies and application processes. No review has hitherto specifically focused on the subject of scientific evidence required by EU and US food agencies to substantiate health claims. This research thus leads to significant recommendations on how to improve current food industry guides. ; This research was conducted under the R&D&i project "Reclamos de salud en la publicidad de alimentos y comprensión del consumidor" ("Health claims in food advertising and consumer understanding"- GV/2016/088), funded by the Generalitat Valenciana, Spain and directed by Cristina González Díaz.

Issues related to maternal mortality have generated a lot of empirical and theoretical information. However, despite the amount of work published on the topic, maternal mortality continues to occur at high rates and solutions to the problem are still not clear. Scientific research on maternal mortality is focused mainly on clinical factors. However, this approach may not be the most useful if we are to understand the problem of maternal mortality as a whole and appreciate the importance of economical, political and social macrostructural factors. In this paper, we report the number of scientific studies published between 2000 and 2004 about the main causes of maternal death, as identified by WHO, and compare the proportion of papers on each cause with the corresponding burden of each cause. Secondly, we systematically review the characteristics and quality of the papers on the macrostructural determinants of maternal mortality. In view of their burden, obstructed labour, unsafe abortion and haemorrhage are proportionally underrepresented in the scientific literature. In our review, most studies analysed were cross-sectional, and were carried out by developed countries without the participation of researchers in the developing countries where maternal mortality was studied. The main macrostructural factors mentioned were socioeconomic variables. Overall, there is a lack of published information about the cultural and political determinants of maternal mortality. We believe that a high-quality scientific approach must be taken in studies of maternal mortality in order to obtain robust comparative data and that study design should be improved to allow causality between macrostructural determinants and maternal mortality to be shown.

Objetivo: Determinar la relación entre el tamaño del Estado (medido como el gasto público) y los indicadores de salud en una muestra de países de todas las regiones del mundo, en la década 1990-2000. Métodos: Se realizó un estudio ecológico a partir de datos sobre gasto gubernamental central (GGC) y producto interior bruto (PIB) per cápita, obtenidos del Fondo Monetario Internacional, y de esperanza de vida, mortalidad materna y mortalidad infantil, de la Organización Mundial de la Salud. Se construyó un modelo de regresión lineal múltiple para estimar el efecto del GGC sobre salud, introduciendo también el PIB per cápita y la región. Resultados: El GGC varía poco durante el período estudiado y converge alrededor de una media del 28%, pero aún dentro de un amplio rango (7,80-53,0%); los países con economías altas (según PIB per cápita) presentan mayor GGC. Su efecto tiene especial importancia en la mortalidad infantil (r= 0,40; beta = –1,327; EE = 0,237; t = –5,590; p < 0,001). También el PIB per cápita y la ubicación regional se asocian con los cambios en la salud y coinciden con el empeoramiento de los indicadores de salud en algunos países pobres de África y Asia. En el modelo ajustado, el GGC mantiene la asociación estadística con la mortalidad infantil y materna. Conclusión: El estudio sugiere un efecto importante del tamaño del Estado en la situación de la salud, específicamente en la mortalidad. Aunque tienen limitaciones, dada la reducida ventana temporal utilizada, estos resultados deben ser considerados en el debate político y epidemiológico actual. ; Objective: To determine the relationship between central government expenditure (CGE), as an expression of the size of the state, and a selection of health indicators in a sample of states worldwide from 1990 to 2000. Methods: An ecological study was performed using data on CGE and per capita gross national product (GNP), obtained from the official statistics of the International Monetary Fund, and data on life expectancy, maternal and infant mortality, obtained from the World Health Organization. We fitted a multiple regression model to adjust for the effect of CGE on health. Per capita GNP and region were also introduced into the model. Results: The CGE varied little during the study period, converging around a mean of 28%, but within a wide range (min.7.80%, max. 53.50%). The countries with high income economies (according to per capita GNP) showed greater CGE. The size of the state had a strong influence on infant mortality (r = 0.40; beta = –1.327; EE = 0.237; t = –5.590; p < 0.001). Per capita GNP and region (especially Africa) were also associated with changes in health, coinciding with the worsening of health indicators in some poor countries of Africa and Asia. In the adjusted model, CGE maintained the statistically significant association with infant and maternal mortality. Conclusion: The study suggests that the size of the state has a strong influence on health, especially on mortality. Although this study has certain limitations, given the reduced time window used, the results should be taken into consideration in the current political and epidemiologist debate.

The Millennium Development Goals (MDG) progress targets have not been met. Nevertheless, the United Nations (UN) has not yet undertaken in-depth review in order to discover the reasons behind this lack of progress in achieving the MDG. From a political epidemiology perspective, the intention here is to identify the political elements affecting the social factors impeding MDG fulfilment and, at the same time, to suggest future public policies and appropriate proposals that are both more coherent and supported by broader, empirical knowledge of the relevant issues.

Issues related to maternal mortality have generated a lot of empirical and theoretical information. However, despite the amount of work published on the topic, maternal mortality continues to occur at high rates and solutions to the problem are still not clear. Scientific research on maternal mortality is focused mainly on clinical factors. However, this approach may not be the most useful if we are to understand the problem of maternal mortality as a whole and appreciate the importance of economical, political and social macrostructural factors. In this paper, we report the number of scientific studies published between 2000 and 2004 about the main causes of maternal death, as identified by WHO, and compare the proportion of papers on each cause with the corresponding burden of each cause. Secondly, we systematically review the characteristics and quality of the papers on the macrostructural determinants of maternal mortality. In view of their burden, obstructed labour, unsafe abortion and haemorrhage are proportionally underrepresented in the scientific literature. In our review, most studies analysed were cross-sectional, and were carried out by developed countries without the participation of researchers in the developing countries where maternal mortality was studied. The main macrostructural factors mentioned were socioeconomic variables. Overall, there is a lack of published information about the cultural and political determinants of maternal mortality. We believe that a high-quality scientific approach must be taken in studies of maternal mortality in order to obtain robust comparative data and that study design should be improved to allow causality between macrostructural determinants and maternal mortality to be shown. ; Los temas relacionados con la mortalidad materna han generado abundante información empírica y teórica. Sin embargo, pese a los muchos trabajos publicados sobre el tema, las tasas de mortalidad materna siguen siendo altas, y las soluciones a este problema siguen también sin estar claras. Las investigaciones científicas sobre la mortalidad materna se centran principalmente en los factores clínicos. Sin embargo, puede que este enfoque no sea el más conveniente para lograr comprender el problema de la mortalidad materna en su globalidad y apreciar la importancia de los factores macroestructurales de índole económica, política y social. En este artículo analizamos el número de estudios científicos publicados entre 2000 y 2004 sobre las causas principales de mortalidad materna según la OMS, comparando la proporción de artículos sobre cada causa con la carga correspondiente a la misma. En segundo lugar, examinamos sistemáticamente las características y la calidad de los artículos sobre los determinantes macroestructurales de la mortalidad materna. A la vista de la carga que representan, el parto obstruido, el aborto peligroso y la hemorragia están subrepresentados proporcionalmente en la bibliografía científica. En nuestra revisión, la mayoría de los estudios analizados eran transversales, y habían sido realizados por países desarrollados sin la participación de investigadores de los países en desarrollo donde se estudió la mortalidad materna. Los principales factores macroestructurales mencionados eran variables socioeconómicas. En términos generales, se observa una escasez de publicaciones sobre los determinantes culturales y políticos de la mortalidad materna. Consideramos que los estudios sobre ésta deben adoptar un enfoque científico de calidad que permita obtener datos robustos y comparables, y que el diseño de esos estudios debe mejorarse para poner de manifiesto las relaciones de causalidad entre los determinantes macroestructurales y la mortalidad materna.

Objetivo Describir y analizar el debate parlamentario español sobre inmigración y salud. Métodos Búsqueda sistemática de las iniciativas parlamentarias (IP) sobre inmigración e inmigración y salud desde el inicio del periodo democrático español en 1979 hasta 2007. Se aplicó un protocolo de recogida de información para identificar las características del debate parlamentario y los principales temas en las IP relacionadas con inmigración y salud. Se calcularon la proporción de IP de inmigración sobre el total de iniciativas y la proporción de población inmigrante sobre la población española por cada año de estudio. Resultados Se identificaron 4 022 IP sobre inmigración en el periodo estudiado. Se destaca la generación de datos estadísticos sobre aspectos que afectan a la población inmigrante (57,2 %). En 116 IP sobre inmigración y salud, destaca la discusión sobre estrategias de atención sanitaria (25 %) y el acceso a servicios de salud (24,1 %). El 94 % de estas IP fueron preguntas correspondientes a la función de control del gobierno. En 113 IP (97,4 %) sobre inmigración y salud no se tomaron decisiones. Junto a la presencia cada vez mayor de población inmigrante por año, no se observan cambios notorios en las IP sobre inmigración hasta el año 1996 y en inmigración y salud hasta 1999. Conclusión El debate sobre inmigración y salud es heterogéneo. Seria conveniente fomentar la discusión sobre estrategias para el fomento de la salud basadas en las necesidades de la población inmigrante. ; Objective Describing and analysing the Spanish Parliamentary debate on immigration and health. Methods A systematic search regarding parliamentary initiatives (PI) on immigration and immigration and health was conducted from the beginning of the Spanish democratic period (1979 to 2007). A protocol for collecting information was used to identify the parliamentary debate's main characteristics and the main topics related to PI concerning immigration and health. The PI immigration rate was calculated regarding the total rate of PI about the immigrant population based on the Spanish population per year. Results 4,022 PI concerning "immigration" were identified. The main content concerned statistical information about the immigrant population (57.2 %). 116 PI about "immigration and health" were analysed. The most frequently recurring topics were health-care strategies (25 %), health-service access (24.1 %) and epidemiological information (19.8 %). Most PI concerned questions related to the function of government control (94 %). No decisions were taken in 113 PI (97.4 %). Immigrant population rates increased per year; however, notable changes in PI regarding immigration were not observed until 1996 and PI about immigration and health until 1999. Conclusion The immigration and health debate on the parliamentary agenda is heterogeneous. It would seem necessary to increase parliamentary debate about strategies and action for promoting immigrant-based needs in health.

Objetivo Describir y analizar el debate parlamentario español sobre inmigración y salud.Métodos Búsqueda sistemática de las iniciativas parlamentarias (IP) sobre inmigración e inmigración y salud desde el inicio del periodo democrático español en 1979 hasta 2007. Se aplicó un protocolo de recogida de información para identificar las características del debate parlamentario y los principales temas en las IP relacionadas con inmigración y salud. Se calcularon la proporción de IP de inmigración sobre el total de iniciativas y la proporción de población inmigrante sobre la población española por cada año de estudio.Resultados Se identificaron 4 022 IP sobre inmigración en el periodo estudiado. Se destaca la generación de datos estadísticos sobre aspectos que afectan a la población inmigrante (57,2 %). En 116 IP sobre inmigración y salud, destaca la discusión sobre estrategias de atención sanitaria (25 %) y el acceso a servicios de salud (24,1 %). El 94 % de estas IP fueron preguntas correspondientes a la función de control del gobierno. En 113 IP (97,4 %) sobre inmigración y salud no se tomaron decisiones. Junto a la presencia cada vez mayor de población inmigrante por año, no se observan cambios notorios en las IP sobre inmigración hasta el año 1996 y en inmigración y salud hasta 1999.Conclusión El debate sobre inmigración y salud es heterogéneo. Seria conveniente fomentar la discusión sobre estrategias para el fomento de la salud basadas en las necesidades de la población inmigrante.

Objective. Exploring the self-perceptions of a group of migrants from Colombia living in Alicante, Spain, regarding their working conditions and health. Material and methods. This was a qualitative and descriptive research was conducted on a group of Colombian workers (with and without legal permission to work) having lived in Alicante (Spain) for more than 6 months. 11 interviews were carried out, plus 2 focal groups, from November 2006 to January 2007. The interviews were recorded and transcribed. A narrative analysis of the contents was carried out, a mixture of categories being obtained from different viewpoints. Results. Immigration was understood as being an action for improving an immigrant worker and family's socioeconomic conditions. Work and social recognition should lead to avoiding exclusion and discrimination. The people interviewed had associated their health problems with their living conditions. Such problems were considered to be a limitation on carrying out their daily activities. Conclusions. Working and health situations were perceived from a multi-dimensional perspective associated with biological and socio-cultural conditions. More political action should be taken for improving immigrant people's economic, work and health conditions. ; Objetivo. Explorar la autopercepción sobre condiciones laborales y salud en inmigrantes colombianos en Alicante, España. Material y método. Estudio cualitativo descriptivo mediante 11 entrevistas y 2 grupos de discusión en trabajadores con y sin permiso de trabajo y residencia de más de 6 meses en la provincia de Alicante (España), durante los meses de noviembre de 2006 a enero de 2007. Se realizó análisis narrativo de contenido y se obtuvieron categorías mixtas de acuerdo y disenso. Resultados. La inmigración es entendida como un proyecto para mejorar las condiciones socioeconómicas del trabajador inmigrante y su familia. El reconocimiento social y laboral puede evitar la aparición de fenómenos de exclusión y discriminación. Las personas entrevistadas asociaron sus problemas de salud con sus condiciones de vida, manifestando que constituyen limitaciones para la realización de actividades cotidianas. Conclusiones. La situación laboral y de salud es considerada desde una perspectiva multidimensional, asociada a condiciones biológicas y socioculturales. Sería necesaria una mayor acción política para mejorar la situación económica, laboral y de salud de la población inmigrante.

Objetivo: Explorar la autopercepción sobre condiciones laborales y salud en inmigrantes colombianos en Alicante, España. Material y método: Estudio cualitativo descriptivo mediante 11 entrevistas y 2 grupos de discusión en trabajadores con y sin permiso de trabajo y residencia de más de 6 meses en la provincia de Alicante (España), durante los meses de noviembre de 2006 a enero de 2007. Se realizó análisis narrativo de contenido y se obtuvieron categorías mixtas de acuerdo y disenso. Resultados: La inmigración es entendida como un proyecto para mejorar las condiciones socioeconómicas del trabajador inmigrante y su familia. El reconocimiento social y laboral puede evitar la aparición de fenómenos de exclusión y discriminación. Las personas entrevistadas asociaron sus problemas de salud con sus condiciones de vida, manifestando que constituyen limitaciones para la realización de actividades cotidianas. Conclusiones: La situación laboral y de salud es considerada desde una perspectiva multidimensional, asociada a condiciones biológicas y socioculturales. Sería necesaria una mayor acción política para mejorar la situación económica, laboral y de salud de la población inmigrante. ; Objective Exploring the self-perceptions of a group of migrants from Colombia living in Alicante, Spain, regarding their working conditions and health. Material and methods This was a qualitative and descriptive research was conducted on a group of Colombian workers (with and without legal permission to work) having lived in Alicante (Spain) for more than 6 months. 11 interviews were carried out, plus 2 focal groups, from November 2006 to January 2007. The interviews were recorded and transcribed. A narrative analysis of the contents was carried out, a mixture of categories being obtained from different viewpoints. Results Immigration was understood as being an action for improving an immigrant worker and family's socioeconomic conditions. Work and social recognition should lead to avoiding exclusion and discrimination. The people interviewed had associated their health problems with their living conditions. Such problems were considered to be a limitation on carrying out their daily activities. Conclusions: Working and health situations were perceived from a multi-dimensional perspective associated with biological and socio-cultural conditions. More political action should be taken for improving immigrant people's economic, work and health conditions. ; Conselleria de Empresa, Universidad y Ciencia, Generalitat Valenciana.

Objetivos: Describir sistemáticamente las características de los procesos de formulación y toma de decisiones vinculadas al poder legislativo del Estado español en materia de violencia de género. Métodos: Búsqueda y análisis de contenido cuantitativo de todas las iniciativas parlamentarias del Congreso de los Diputados y del Senado sobre violencia de género (1979-2004). Se calculó la razón entre las iniciativas de violencia de género y las iniciativas de otros temas por años y legislaturas. Se analizó la probabilidad de presentar iniciativas sobre violencia de género por sexo y según pertenencia al gobierno u oposición (odds ratio [OR], intervalo de confianza [IC] del 95% y significación estadística [método Mantel-Haenszel]). Resultados: En 26 años se produjeron 322.187 iniciativas parlamentarias, de las que 569 fueron sobre violencia de género. Destacan las tasas de iniciativas de 1998 (4,12 por 1.000), 2001 (4,49 por 1.000) y 2004 (9,19 por 1.000). El 67% fueron preguntas al gobierno. La mayoría fueron tramitadas sin acuerdo o decisión (81%). Los hombres presentaron mayor probabilidad de incluir preguntas en sus iniciativas (OR = 17,08; IC del 95%, 5,91-55,62), pero las mujeres promovieron el 60% de las iniciativas sobre el tema. La probabilidad de preguntar fue mayor entre los miembros del gobierno (OR = 2,63; IC del 95%, 1,32-5,31), aunque la oposición lideró el 88% de las iniciativas. Conclusiones: En España, se ha producido una incipiente construcción política de la violencia de género que puede llevar al desarrollo de verdaderas estrategias. La actividad parlamentaria sobre el tema debería mantenerse a largo plazo, puesto que el problema persiste. ; Aims: To systematically examine the characteristics of the processes of formulating and taking decisions on gender-based violence in the Spanish Parliament. Methods: A search was performed for all parliamentary initiatives on gender-based violence in the Spanish parliament (1979-2004) and their qualitative content was analyzed. The ratio between initiatives on gender-based violence and those on other issues was calculated by years and legislatures. The probability of presenting initiatives on gender-based violence was analyzed by sex and political group (government vs. opposition) (odds ratio, 95% CI and statistical significance using the Mantel-Haenszel method). Results: In the 26 years studied, there were 322,187 initiatives, of which 569 concerned gender-based violence. Initiatives on this issue increased in 1998 (4.12 per 1,000), 2001 (4.49 per 1,000) and 2004 (9.19 per 1,000). Sixty-seven percent were questions to the government. The majority of the initiatives were registered without agreement or decision (81%). Men had a higher probability of asking questions (OR = 17.08; 95%CI, 5.91-55.62), but women instigated 60% of the initiatives. Parliamentary groups in government showed a higher probability of asking questions (OR = 2.63; 95%CI, 1.32-5.31), but 88% of the initiatives were promoted by the opposition. Conclusions: The process of policy construction has been started in Spain, which could lead to the development of true policies on gender-based violence in the future. Parliamentary activity on this issue should be maintained in the longterm, as the problem shows no sign of abating. ; Red de Investigación sobre Salud y Género (Instituto de Salud Carlos III); Instituto de la Mujer y Ministerio de Trabajo y Asuntos Sociales.

Objective: Eradication of poverty is Target 1 of the first of eight Millennium Development Goals, which were adopted by world leaders at the United Nations General Assembly in the year 2000. This study aims to explore the influence of political and social context in the achievement of poverty eradication. Methods: A retrospective ecological study was carried out to explore associations between progress towards the achievement of Target 1 in 2002 and political and social context variables. The study contained cross-sectional estimates in 1990, 1995, 2000 and 2002. The analysis and observation unit was the countries (n = 88). A descriptive analysis was made, as well as simple and multiple analyses with logistic regression. Findings: Of the 88 countries studied, 71 (80.7%) are not on track to achieving the target of eradicating poverty. The factor most associated with non-attainment of this goal was reduced government consumption per capita (odds ratio, OR: 13.8; 95% confidence interval, CI: 2.92–65.26). In the multiple regression analysis, the most significant factors are: reduced government consumption per capita (OR: 9.8; 95% CI: 1.82–52.75), losses in the balance between imports and exports (OR: 5.3; 95% CI: 1.32–21.54) and more inequality in family income (OR: 4.7; 95% CI: 1.12–20.01). Conclusion: Progress towards achievement of Target 1 seems to be hindered, fundamentally, by the significant reduction in government consumption in certain countries and the absence of redistribution policies. To understand the political determinants of poverty, more attention must be paid to the national and international political milieu, which seem to have a relevant impact on this problem and hence on population health. ; Objetivo: La erradicación de la pobreza es la meta 1 del primero de los ocho Objetivos de Desarrollo del Milenio adoptados por los líderes mundiales en la Asamblea General de las Naciones Unidas en el año 2000. La finalidad del presente estudio ha sido analizar la influencia del contexto político y social en el logro de la erradicación de la pobreza. Métodos: Se llevó a cabo un estudio ecológico retrospectivo para determinar el grado de asociación entre los progresos hacia la meta 1 en 2002 y diversas variables relacionadas con el contexto político y social. El estudio incluyó estimaciones transversales realizadas en 1990, 1995, 2000 y 2002. La unidad de análisis y observación empleada fueron los países (n = 88). Se hizo un análisis descriptivo, así como análisis de regresión logística simple y múltiple. Resultados: De los 88 países estudiados, 71 (80,7%) no están bien encaminados para alcanzar la meta de erradicación de la pobreza. El factor más relacionado con el fracaso en la consecución de esa meta fue la disminución del consumo del sector público por habitante (razón de posibilidades, OR: 13,8; intervalo de confianza (IC) del 95%: 2,92-65,26). El análisis de regresión múltiple revela que los factores más importantes con miras a la erradicación son el aumento del consumo del sector público por habitante (OR: 9,8; IC95%: 1,82-52,75), el predominio de las exportaciones sobre las importaciones (OR: 5,3; IC95%: 1,32-21,54), y el incremento de la igualdad en los ingresos familiares (OR: 4,7; IC95%: 1,12-20,01). Conclusión: Los progresos hacia la meta 1 parecen verse frenados fundamentalmente por una reducción considerable del consumo público en algunos países y por la ausencia de políticas de redistribución. A fin de comprender los determinantes políticos de la pobreza, es necesario prestar más atención al entorno político nacional e internacional, que parece tener una importante influencia en este problema y, por consiguiente, en la salud de la población. ; WK Kellogg Foundation, Observatorio de Políticas Públicas y Salud, Generalitat Valenciana, AECI, Centro de Estudios Iberoamericanos Mario Benedetti.