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Sexual and reproductive health in local mining contexts in Colombia

Wilches-Gutierrez, Jose / MD MPH (2019) Sexual and reproductive health in local mining contexts in Colombia. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Background. Research on the relationship between mining and sexual and reproductive health (SRH) is limited, almost exclusively concerned on the HIV spread in mining contexts. Colombia, like other Latin American and Caribbean countries, experienced an unprecedented mining boom since the mid-2000’s with insufficient evidence on its effects on SRH. This dissertation study examined the relationship between the gold-mining boom and fertility—as a comprehensive measure for SRH, in Colombian municipalities, between 2001 and 2015.
Methods. I conducted a longitudinal ecological study using a multilevel model of change. I used data of gold-mining production and births of each of the 1112 municipalities of Colombia—excluding ten municipalities created after 2001. For the independent variable, I constructed the time-varying categorical variable Stages of gold-mining boom (SGMB). This variable represented the municipal status regarding a gold-mining boom at each year, by defining categories of pre-boom, boom—rapid increase (boom-up) and rapid decline (boom-down)—, and post-boom. For the dependent variable, I calculated general fertility rates (GFR), age-specific fertility rates (ASFR), and total fertility rates (TFR). I performed multilevel regression models of change to test the association between the stages of gold-mining boom and fertility change, controlling for socioeconomic confounders. I conducted a sensitivity analysis by including only the municipalities with acceptable live birth coverage by 2005 (N=191).
Results. The results indicated a positive longitudinal association between the gold-mining boom and fertility, in Colombian municipalities, between 2001 and 2015. Fertility (GFR and TFR) increased in the boom-down and post-boom periods. Among different age-groups, fertility (ASFR) increased in the periods of boom-up (age group 10-14), boom-down (age groups in the range 15-25, and 35-39), and post-boom (age group 15-19). The sensitivity analysis indicated the results were robust.
Conclusions. The rapid fertility change (including of adolescent fertility) observed in the short period of the boom stages suggests that SRH is deeply impacted in gold-mining boom contexts. This study provides a baseline for further global research on this critical but neglected topic of public health significance. New investigations must consider the gender dynamics triggered by a mining boom, which may configure contexts of unbalanced gendered power relations.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Wilches-Gutierrez, Jose / MD MPHjlw161@pitt.edujlw1610000-0001-8541-6133
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairDocumet, Patricia / MD DrPHpdocumet@pitt.edu
Committee MemberBurke, Jessica / PhDjgburke@pitt.edu
Committee MemberYouk, Ada / PhDayouk@pitt.edu
Committee MemberBear, Todd / PhDtobst2@pitt.edu
Committee MemberNelson, Paul / PhDpjnelson@pitt.edu
Date: 30 January 2019
Date Type: Publication
Defense Date: 28 November 2018
Approval Date: 30 January 2019
Submission Date: 26 November 2018
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 110
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Behavioral and Community Health Sciences
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Sexual health; reproductive health; mining industry; Latin America
Date Deposited: 30 Jan 2019 19:00
Last Modified: 30 Jan 2019 19:00
URI: http://d-scholarship.pitt.edu/id/eprint/35604

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