RESUMEN Objetivo: Analizar los factores sociales asociados a la salud autopercibida durante el confinamiento en la población residente en Chile según la perspectiva de género. Método: Estudio transversal realizado mediante encuesta online durante el confinamiento por la COVID-19 entre el 17 de mayo y el 17 de agosto de 2020. Se analizó la salud autopercibida en población de 18 años o más en relación con variables sociales. Se construyeron modelos de regresión logística multivariante para evaluar la asociación entre las variables independientes con la salud autopercibida, a través de odds ratio ajustadas (ORa). Los análisis se estratificaron por sexo (H: hombres; M: mujeres). Resultados: Se analizaron 5981 personas (el 63,9% mujeres). El 29,6% de las mujeres y el 19,2% de los hombres reportaron mala salud autopercibida. En las mujeres, empeora al aumentar la edad. La peor salud autopercibida se asoció principalmente con la falta de apoyo social (ORa H: 2,05; ORa M: 2,34), la preocupación por la convivencia en el hogar (ORa H: 1,66; ORa M: 1,38), percibir inadecuadas condiciones de la vivienda (ORa H: 1,89; ORa M: 2,63) y el desacuerdo con las medidas gubernamentales (ORa H: 2,80; ORa M: 1,82). En las mujeres, además, se asoció al trabajo informal o estar inactivas laboralmente (ORa: 2,11). En los hombres, una peor salud autopercibida se asoció a ser trabajador independiente (autónomo) (ORa: 1,65; intervalo de confianza [IC]: 1,11-2,45) y tener educación secundaria (ORa: 2,81; IC: 1,32-5,98). Conclusiones: El impacto social del confinamiento en la salud autopercibida se relaciona con el género, la edad, el trabajo de cuidados y las condiciones socioeconómicas, así como con el desacuerdo con las medidas implementadas para gestionar la pandemia.

ABSTRACT Objective: To analyse the social factors associated with self-perceived health during the COVID-19 lockdown in the Chilean resident population according to gender perspective. Method: Cross-sectional study conducted during the COVID-19 lockdown between May 17 and August 17, 2020 with an online survey. Self-perceived health was analysed in the population aged 18 years or older in relation to social variables. Multivariate logistic regression models were constructed to assess the association between independent variables with self-perceived health, through adjusted odds ratio (aOR). Analyses were stratified by sex (M: men; W: women). Results: 5981 persons were analysed (women: 63.9%). 29.6% of women and 19.2% of men reported poor self-perceived health. In women it worsens with increasing age. Worse self-perceived health was mainly associated with lack of social support (ORa M: 2.05; ORa W: 2.34), concern about living together at home (ORa M: 1.66; ORa W: 1.38), perceived inadequate housing conditions (ORa M: 1.89; ORa W: 2.63), and disagreement with government measures (ORa M: 2.80; ORa W: 1.82). In women, it was also associated with informal work or being inactive in the labour market (ORa: 2.11). In men worse self-perceived health was associated with being self-employed (ORa: 1.65; confidence interval [CI]: 1.11-2.45) and has secondary education (ORa: 2.81; CI: 1.32-5.98). Conclusions: The social impact of lockdown in self-perceived health is related to gender, age, care work, and socioeconomic conditions, as well as, by disagreement with the measures implemented to manage the pandemic.

RESUMEN Objetivo: Analizar los factores sociales asociados a la salud autopercibida durante el confinamiento en la población residente en Chile según la perspectiva de género. Método: Estudio transversal realizado mediante encuesta online durante el confinamiento por la COVID-19 entre el 17 de mayo y el 17 de agosto de 2020. Se analizó la salud autopercibida en población de 18 años o más en relación con variables sociales. Se construyeron modelos de regresión logística multivariante para evaluar la asociación entre las variables independientes con la salud autopercibida, a través de odds ratio ajustadas (ORa). Los análisis se estratificaron por sexo (H: hombres; M: mujeres). Resultados: Se analizaron 5981 personas (el 63,9% mujeres). El 29,6% de las mujeres y el 19,2% de los hombres reportaron mala salud autopercibida. En las mujeres, empeora al aumentar la edad. La peor salud autopercibida se asoció principalmente con la falta de apoyo social (ORa H: 2,05; ORa M: 2,34), la preocupación por la convivencia en el hogar (ORa H: 1,66; ORa M: 1,38), percibir inadecuadas condiciones de la vivienda (ORa H: 1,89; ORa M: 2,63) y el desacuerdo con las medidas gubernamentales (ORa H: 2,80; ORa M: 1,82). En las mujeres, además, se asoció al trabajo informal o estar inactivas laboralmente (ORa: 2,11). En los hombres, una peor salud autopercibida se asoció a ser trabajador independiente (autónomo) (ORa: 1,65; intervalo de confianza [IC]: 1,11-2,45) y tener educación secundaria (ORa: 2,81; IC: 1,32-5,98). Conclusiones: El impacto social del confinamiento en la salud autopercibida se relaciona con el género, la edad, el trabajo de cuidados y las condiciones socioeconómicas, así como con el desacuerdo con las medidas implementadas para gestionar la pandemia.

ABSTRACT Objective: To analyse the social factors associated with self-perceived health during the COVID-19 lockdown in the Chilean resident population according to gender perspective. Method: Cross-sectional study conducted during the COVID-19 lockdown between May 17 and August 17, 2020 with an online survey. Self-perceived health was analysed in the population aged 18 years or older in relation to social variables. Multivariate logistic regression models were constructed to assess the association between independent variables with self-perceived health, through adjusted odds ratio (aOR). Analyses were stratified by sex (M: men; W: women). Results: 5981 persons were analysed (women: 63.9%). 29.6% of women and 19.2% of men reported poor self-perceived health. In women it worsens with increasing age. Worse self-perceived health was mainly associated with lack of social support (ORa M: 2.05; ORa W: 2.34), concern about living together at home (ORa M: 1.66; ORa W: 1.38), perceived inadequate housing conditions (ORa M: 1.89; ORa W: 2.63), and disagreement with government measures (ORa M: 2.80; ORa W: 1.82). In women, it was also associated with informal work or being inactive in the labour market (ORa: 2.11). In men worse self-perceived health was associated with being self-employed (ORa: 1.65; confidence interval [CI]: 1.11-2.45) and has secondary education (ORa: 2.81; CI: 1.32-5.98). Conclusions: The social impact of lockdown in self-perceived health is related to gender, age, care work, and socioeconomic conditions, as well as, by disagreement with the measures implemented to manage the pandemic.

Resumen Este artículo intenta plasmar el panorama bioético-ambiental de la salud del poblador que habita en la sierra peruana, remarcando la inequidad en el acceso a los servicios de salud que existe en esta región y reflexionando sobre las posibles causas contextuales, históricas y actuales que han originado diferencias entre el poblador andino del incanato y el poblador andino actual, el cambio de cosmovisón sobre el ambiente y los recursos, el deterioro del enfoque de justicia, solidaridad, bienestar y respeto hacia el ser humano y la naturaleza. Además, se describe la salud desde el escenario histórico de esta región, donde la salud pública tiene y tendrá como desafío la aplicación de programas que respondan a las necesidades específicas de esta población, con un enfoque dirigido hacia lo ambiental.

Abstract This article attempts to capture the bioethical-environmental panorama of the health in the residents who live on the Peruvian highlands, highlighting the inequity in access to health services that exist in this region and reflecting on the possible historical and current contextual causes that have originated differences between Inca-Andean settler and modern-Andean settler. The change in the view of the world about the environment and natural resources, the decline of justice approach, loss of solidarity, welfare, and respect to human being and nature. Besides, we describe health from a historical scenario of this region, where Public health has and will have as a challenge the application of programs that respond to the specific needs of this population, with a focus on the environment.

Resumo Este artigo tenta capturar o panorama bioético-ambiental da saúde dos habitantes que vivem nas ser as peruanas, destacando a desigualdade no acesso aos serviços de saúde que existe nesta região e refletindo sobre as possíveis causas contextuais, históricas e atuais que têm originado diferenças entre o habitante andino do Incanato e a atual população andina, a mudança de cosmovisão sobre o meio ambiente e os recursos, a deterioração da abordagem de justiça, solidariedade, bem-estar e respeito pelos seres humanos e a natureza. Além disso, a saúde é descrita a partir do cenário histórico desta região, onde a saúde pública tem e terá como desafio a aplicação de programas que respondam às necessidades específicas dessa população, com uma abordagem dirigida para o meio ambiente.

During the last decades, Chile experienced substantial socioeconomic, epidemiológica! and demographic changes. These resulted, among other consequences, in a deceleration of population growth, a notorious decrease in fertility rates, and one of the most rapid and deepest drop in general and infant mortality rates in the Latin American region. These changes resulted in a sustained increase of life expectancy and a substantial ageing of the Chilean population. This process is also changing the disease burden of the population. Infectious and perinatal diseases lost relevance as major causes of mortality, and have been replaced by chronic non transmissible diseases, specifically cardiovascular conditions and cancer, that are becoming the main causes of death. High blood pressure, cardiovascular risk, hypercholesterolemia, diabetes, overweight and obesity, smoking, sedentary lifestyle and depression will have a great impact on health conditions during the XXI century. These factors and a persistent social inequity will hinder the efforts to reduce the impact and consequences of chronic non transmissible, diseases in the Chilean population