Alejandra Vives

Alejandra Vives
Pontificia Universidad Católica de Chile | UC · Departamento de Salud Pública

MD, MPH, PhD

About

83
Publications
24,787
Reads
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2,782
Citations
Citations since 2017
45 Research Items
2326 Citations
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20172018201920202021202220230100200300400500600
20172018201920202021202220230100200300400500600
Additional affiliations
March 2011 - present
Pontificia Universidad Católica de Chile
Position
  • Professor (Assistant)
September 2006 - December 2010
Universitat Pompeu Fabra
Position
  • PhD (c)
January 2006 - present
Pontificia Universidad Católica de Chile
Position
  • Professor (Assistant)
Education
March 2007 - November 2010
University Pompeu Fabra
Field of study
  • Epidemiology and Public Health
March 1989 - December 1995
University of Chile
Field of study
  • Medicine

Publications

Publications (83)
Preprint
Full-text available
The SALURBAL (Urban Health in Latin America) Project is an interdisciplinary multinational network aimed at generating and disseminating actionable evidence on the drivers of health in cities of Latin America. We conducted a temporal multilayer network analysis where we measured cohesion over time using the structural properties of the network and...
Article
Full-text available
Objetivo: Establecer las propiedades psicométricas de una medida de Precariedad Laboral (PL) en seis países centroamericanos de habla española (Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua y Panamá) mediante un conjunto de ítems incluidos en la II Encuesta Centroamericana de Condiciones de Trabajo y Salud (II ECCTS) de 2018 que se corres...
Article
Objetivo Estimar el impacto de la pandemia de la COVID-19 durante el año 2020, a través del exceso de mortalidad por todas las causas y los años potenciales de vida laboral perdidos en la población en edad de trabajar, de una selección de países latinoamericanos y el Caribe. Métodos Estudio basado en datos de defunciones por todas las causas entre...
Article
Full-text available
We estimated excess mortality in Chilean cities during the COVID-19 pandemic and its association with city-level factors. We used mortality, and social and built environment data from the SALURBAL study for 21 Chilean cities, composed of 81 municipalities or “comunas”, grouped in 4 macroregions. We estimated excess mortality by comparing deaths fro...
Article
Full-text available
The COVID-19 crisis is a global event that has created and amplified social inequalities, including an already existing and steadily increasing problem of employment and income insecurity and erosion of workplace rights, affecting workers globally. The aim of this exploratory study was to review employment-related determinants of health and health...
Article
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Background Mental health is an important contributor to the global burden of disease, and depression is the most prevalent mental disorder in Latin America and the Caribbean (LAC). Informal jobs, often characterized by precarious working conditions, low wages, and limited employment benefits, are also highly prevalent in LAC and may be associated w...
Article
Full-text available
Between 2008 and 2009 suicide rates in Chile were higher than those observed before and after, increasing more than in other countries in Latin America. The Great Recession has been suggested as an important factor behind this increase. This study assesses the excess of suicide attributable to the crisis in Chile, a “mature” neoliberal society with...
Article
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Decent work, defined by the International Labor Organization (ILO) in 1999 in relation to promoting productive and freely chosen employment, fair income, security in the workplace, guaranteeing rights at work, granting social protection, freedom of organization and creating social dialogue, is a basic condition for the health and wellbeing of worke...
Article
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Precarious employment (PE) is a well-known social determinant of health and health inequalities. However, as most previous studies have focused on physical and mental well-being, less is known about the social-related outcomes (ie, social precarity) associated with precarious arrangements. This cross-sectional study aims to investigate whether PE i...
Article
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Background The available evidence of the health effects of urban regeneration is scarce In Latin America, and there are no studies focused on formal housing that longitudinally evaluate the impact of housing and neighborhood interventions on health. The “Regeneración Urbana, Calidad de Vida y Salud” (Urban Regeneration, Quality of Life, and Health)...
Article
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The PRESSED project aims to explain the links between a multidimensional measure of precarious employment and stress and health. Studies on social epidemiology have found a clear positive association between precarious employment and health, but the pathways and mechanisms to explain such a relationship are not well-understood. This project aims to...
Article
Urban regeneration programs, such as "Programa Quiero mi Barrio" (PQMB) that is carried out in neighborhoods with greater deprivation across Chile, can improve health and quality of life in socio-economically deprived neighborhoods. The aim of this study was to analyze the effects of this program on the physical, social, and safety environments of...
Article
Full-text available
The concept of a so-called urban advantage in health ignores the possibility of heterogeneity in health outcomes across cities. Using a harmonized dataset from the SALURBAL project, we describe variability and predictors of life expectancy and proportionate mortality in 363 cities across nine Latin American countries. Life expectancy differed subst...
Article
Full-text available
The world of work is facing an ongoing pandemic and an economic downturn with severe effects worldwide. Workers trapped in precarious employment (PE), both formal and informal, are among those most affected by the COVID-19 pandemic. Here we call attention to at least 5 critical ways that the consequences of the crisis among workers in PE will be fe...
Article
Full-text available
Introdução: o teletrabalho no domicílio, uma das medidas adotadas para controlar a pandemia de COVID-19 e, ao mesmo tempo, manter o emprego, tem aumentado em vários países. Objetivo: refletir sobre o significado, a magnitude e as tendências do teletrabalho no domicílio, antes e durante a pandemia, enfatizando seus potenciais efeitos na saúde do tr...
Article
Full-text available
Background: Social epidemiologic research in relation to the health impacts of precarious employment has grown markedly during the past decade. While the multidimensional nature of precarious employment has long been acknowledged theoretically, empirical studies have mostly focused on one-dimensional approach only (based either on employment tempo...
Article
Full-text available
This study aims to assess the accuracy of temporary employment as indicator or proxy measure of precarious employment. Using sensitivity and specificity analysis, we compared type of contract (temporary versus permanent) with the Chilean version of the multidimensional Employment Precariousness Scale. Temporary employment exhibited very low sensiti...
Article
Latin America is the most unequal and urbanized region of the world. The physical and social environments of Latin American cities, the lack of public health and health-care infrastructure, and pronounced social and health inequities make these cities especially vulnerable to COVID-19. It is too soon to know the true impact of the pandemic and how...
Technical Report
Full-text available
En el momento en que nos encontramos, todos los ojos están dirigidos -y con razón- a la crisis social y sanitaria que estamos viviendo, y a las estrategias para enfrentarla. Sin embargo, hay muchos trabajos previos y experiencia investigativa acumulada en territorios socialmente vulnerables que nos permiten, en paralelo, pensar escenarios probables...
Article
Full-text available
The development and application of urban sustainability indicators has gained momentum in recent years, especially since the generation of specific urban indicators for the Agenda 2030. Urban sustainability is a broad concept involving many dimensions, therefore the generation of a short, but comprehensive list of indicators is a significant challe...
Article
Full-text available
Rapid urbanization in low- and middle-income countries (LMIC) is associated with increasing population living in informal settlements. Inadequate infrastructure and disenfranchisement in settlements can create environments hazardous to health. Placed-based physical environment upgrading interventions have potential to improve environmental and econ...
Chapter
This chapter examines the topic of precarious employment in the context of health outcomes in two global regions: (a) Latin America and the Caribbean and (b) East Asia. First, drawing from several recent reports released by the International Labour Organization, it compares and contrasts the concepts of precarious employment and nonstandard employm...
Article
En el momento en que nos encontramos, todos los ojos están dirigidos -y con razón- a la crisis social y sanitaria que estamos viviendo, y a las estrategias para enfrentarla. Sin embargo, hay muchos trabajos previos y experiencia investigativa acumulada en territorios socialmente vulnerables que nos permiten, en paralelo, pensar escenarios probables...
Article
Full-text available
Background: Latin America is one of the most unequal regions in the world, but evidence is lacking on the magnitude of health inequalities in urban areas of the region. Our objective was to examine inequalities in life expectancy in six large Latin American cities and its association with a measure of area-level socioeconomic status. Methods: In...
Article
Full-text available
Objectives Precarious employment (PE) is a determinant of poor health and health inequality. However, the evidence of health consequences and mechanisms underlying the associations, are still limited due to a lack of a comprehensive multidimensional definition and measurement instrument. The Employment Precariousness Scale (EPRES) is a Spanish, mul...
Article
This study aims to assess differences in the working population of Chile under the definition of informal employment. A new categorization of informal employment is proposed, with a focus on social protection as a key element in the definition of informal employment status, thereby making visible different groups of workers that until now remained...
Article
Introduction: It is widely known that women have a higher prevalence of depression than men. These differences may be explained by social differences between women and men due to gender roles. In Chile, as elsewhere, women have greater household responsibilities, lower job incomes, and especially low labor market participation. However, the incide...
Article
Full-text available
People engaged in informal employment are not insured by any labour or social protection. Welfare state regimes could affect the relationship between informal employment and health. This study aimed to assess the relationship between informal employment and health status in the non-agricultural working population in Central America, by welfare stat...
Article
Full-text available
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 complementa...
Article
Background The aim of this study is to estimate the prevalence of informal workers and their working conditions and employment precariousness in the EU-27; and to explore the association of different contract arrangements with health outcomes and how they are influenced by working and employment conditions. Methods A sample of 27 245 working-age e...
Article
Full-text available
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 Urban...
Conference Paper
Full-text available
Introduction Employment and working conditions are recognised as social determinants of health; however, there are limited data on the relationship of informal work and employment conditions with health inequalities. Methods As part of The Work, Employment, and Health Equity Program was conducted a study to identify available data on informal work...
Conference Paper
Full-text available
Introduction Around the world exist the expansion of the informal economy and traditionally people -working in the informal economy (WIE) do not have access to the established state-run healthcare systems. Understanding the barriers that explain the low participation of people-working informal economy in health systems and social security systems,...
Article
Objectives: In Chile, working after retirement age has grown substantially over the last years. This, in addition to the country's current discussion about extending retirement age, motivates the need of generating evidence on the occupational health and safety of the working old, with a special focus on women, who are critically disadvantaged in...
Chapter
Precarious employment is both a powerful social determinant of health, well-being, and quality of life, and also a historical phenomenon linked to the power relationships between employers and employees. Employment precariousness refers to employment insecurity, individualized bargaining relations between workers and employers, low wages, limited w...
Book
Full-text available
ESTA PUBLICACIÓN REÚNE 17 DOCUMENTOS PARA POLÍTICA PÚBLICA CON MIRADAS LOCALES SOBRE LA NUEVA AGENDA URBANA DE LA ONU QUE BUSCA SER UN APORTE A LA DISCUSIÓN DE LA CALIDAD DE VIDA EN LAS CIUDADES CHILENAS. CEDEUS es un centro interdisciplinario de investigación que busca la generación e intercambio de conocimiento con el fin de enfrentar los desafío...
Article
Informal employment is an employment condition and a social determinant of health. Although it can represent a serious problem for public health, it is seldom studied as such. The aim of this study was to determine if there is a relationship between informal employment and health among different groups of workers in Chile.We used a cross-sectional...
Article
Employment precariousness (EP) has expanded over recent years. The aim of this study is to test the existence of a general precarisation of the Spanish labour market and its association with mental health for different types of contract.On the subsample of salaried workers from the second Psychosocial Work Environment Survey and using the revised E...
Article
Full-text available
The purpose of this study is to perform a psychometric analysis (acceptability, reliability and factor structure) of the Chilean version of the new Employment Precariousness Scale (EPRES). The data is drawn from a sample of 4,248 private salaried workers with a formal contract from the first Chilean Employment Conditions, Work, Health and Quality o...
Article
Objective To describe working and employment conditions, and health status between non-agricultural employees with a written contract from Colombia, Argentina, Chile, Central America and Uruguay. Methods We compared data from the first working condition surveys (WCS) of Colombia, Argentina, Chile, Central America and Uruguay. For comparative purpo...
Article
Full-text available
El objetivo de este trabajo es presentar un cuestionario básico y criterios metodológicos mínimos, para ser considerados en futuras Encuestas sobre Condiciones de Trabajo, Empleo y Salud (ECTES) en América Latina y el Caribe. Para ello, se llevó a cabo un proceso de consenso, tanto virtual como presencial, con la participación de un grupo internaci...
Article
Introduction Employment and working conditions are key determinants of health and health inequities in middle and high-income countries like Chile. They are also key determinants of occupational health outcomes and occupational health inequities. Individual determinants of poor employment conditions and health have been abundantly studied, mainly r...
Article
Introduction Informal employment has been conceptualised as an employment condition and as a social determinant of health because of its impact on self-reported health and health inequalities. However, currently evidence on the effects on health is scarce and its definition remains unclear. The aim of this study was to propose a new conceptualizati...
Article
Introduction Social class is a key determinant of inequalities in working conditions and health. We analysed, for the first time, the association between social class, working conditions and occupational health outcomes in Argentina. Methods Data come from the first Argentinian working conditions survey (2010) conducted on non-agricultural formal...
Article
Objective Temporary employment is the most frequently used indicator of precarious employment for both monitoring and epidemiologic research. However, concerns have been raised regarding its capacity to correctly identify subjects, given temporary jobs are heterogeneous and not always precarious, and there is a spill-over of employment precariousne...
Article
Introduction Employment conditions are key determinants of health at all ages. In Chile almost 13% of workers are aged 60 or more, and the pension system is currently experiencing a severe coverage crisis resulting in insufficient income-replacement rates. It has been recommended that retirement age should be postponed and the work of the elderly e...
Article
Introduction Transformations in the world of work have led to a growth of temporary employment, job instability and perceived of job insecurity, and an overall precarisation of employment relations. In Chile, transformations in employment relations go back to the 1979 Plan Nacional, but scarce epidemiologic research has addressed the effects on psy...
Conference Paper
Introduction Employment precariousness has expanded over recent years. It needs to be analysed as part of a continuum of different employment conditions and in a multidimensional way. The aims of this study were to test the existence of a general precarization of the Spanish labour market and its association with mental health for workers in differ...
Conference Paper
Introduction Informal employment is an employment condition and an important social determinant of health. Although it can represent a serious problem for public health, it has been seldom studied in Chile as in other countries. The aim of this study was to determine if there is a relationship between informal employment and health among different...
Conference Paper
Introduction Informal employment, despite infrequent in the European Union compared with middle and low-income countries, affects an important number of workers. However, little is known about informal employment and its association with health. The aims of this study were to estimate the prevalence of informal employment in the EU-27, a well as th...
Article
Objectives To describe working and employment conditions, and health-related outcomes in non-agricultural employees in Colombia, Argentina, Chile, Central America and Uruguay on the basis of the working conditions surveys (WCSs) available in Latin America. In addition, we aimed to discuss the methodological barriers that hinder the comparability of...
Article
Objectives To assess the relationship between paid work, family characteristics and health status in Central American workers; and to examine whether patterns of association differ by gender and informal or formal employment. Methods Cross-sectional study of 8680 non-agricultural workers, based on the First Central American Survey of Working Condit...
Article
Full-text available
Background Maule Cohort (MAUCO), a Chilean cohort study, seeks to analyze the natural history of chronic diseases in the agricultural county of Molina (40,000 inhabitants) in the Maule Region, Chile. Molina´s population is of particular interest because in the last few decades it changed from being undernourished to suffering excess caloric intake,...
Article
The generalization of flexible labour markets, the declining influence of unions and the degradation of social protection has led to the emergence of new forms of employment at the expense of the Standard Employment Relationship, as well as a considerable amount of research across social and scientific disciplines. Years ago we suggested the urgent...
Article
Full-text available
This study examines the psychometric properties of the revised Employment Precariousness Scale (EPRES-2010) in a context of economic crisis and growing unemployment. Data correspond to salaried workers with a contract (n=4,750) from the second Psychosocial Work Environment Survey (Spain, 2010). Analyses included acceptability, scale score distribut...
Article
Full-text available
Objetivo: Mostrar por vez primera la prevalencia de la precariedad laboral medida en forma multidimensional en Cataluña y su asociación con la salud mental y autopercibida. Método: Estudio transversal con datos de la II Encuesta Catalana de Condiciones de Trabajo (2010) con una submuestra de personas asalariadas con contrato. Se calculó la prevalen...
Article
Full-text available
Employment precariousness is a social determinant that affects the health of workers, families, and communities. Its recent popularity has been spearheaded by three main developments: the surge in "flexible employment" and its associated erosion of workers' employment and working conditions since the mid-1970s; the growing interest in social determ...
Article
Full-text available
Background Women experience poorer health than men despite their longer life expectancy, due to a higher prevalence of non-fatal chronic illnesses. This paper aims to explore whether the unequal gender distribution of roles and resources can account for inequalities in general self-rated health (SRH) by gender, across social classes, in a Southern...
Book
Full-text available
This report provides an in-depth analysis of the quality of employment conditions and employment relations in the European employed workforce. Employment in the report is viewed as the contractual relationship between an employer and a worker, specifically how the rights and duties embedded into the relationship are translated into real rights. The...
Article
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Precarious employment is becoming an increasingly important social determinant of health inequalities among workers. The way in which contemporary employment arrangements and their health consequences are addressed in empirical research is mostly based on the contract-related or employment instability dimension. A broader conceptual approach includ...
Article
Full-text available
Background: Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods: Cross-sectional study of...
Article
Full-text available
Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. is study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679...
Article
Full-text available
Social determinants of health are major factors responsible for a population's health and health inequalities.1 Public health surveillance was originally developed for the control of infectious diseases, but today its principles have also been applied to other public health problems such as chronic diseases and occupational and traffic injuries.2 M...
Article
The aim of this literature review is to identify whether differences between welfare regimes can manifest diverse consequences for the health effects of insecure and precarious employment, as well as to address challenging issues and implications for future research. By searching PubMed, PsychINFO, Stork Social Science Citation Index, and Index Lil...
Article
As a consequence of labor market flexibilization, nonstandard employment has expanded and standard employment has declined. In many cases, these transformations are best described as an evolution toward precarious employment, which is considered a major determinant of health and health inequalities. Using the Employment Precariousness Scale (EPRES)...
Article
Full-text available
Despite the fact that labour market flexibility has resulted in an expansion of precarious employment in industrialised countries, to date there is limited empirical evidence concerning its health consequences. The Employment Precariousness Scale (EPRES) is a newly developed, theory-based, multidimensional questionnaire specifically devised for epi...