Int Health 2019; 11: 265–271 doi:10.1093/inthealth/ihy081 Advance Access publication 14 November 2018 Guatemala City youth: an analysis of health indicators through the lens of a clinical registry Sarah A. Golub a,b, * †§ , Juan Carlos Maza Reyes c,d,† , Catherine Stamoulis a,b , Alejandra Leal Pensabene d , Pablo Alejandro Tijerino Cordón d , Erwin Calgua d,‡ and Areej Hassan a,b,‡ a Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA 02115, USA; b Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA; c Departamento Pediatria Adolescentes, Hospital San Juan De Dios, Guatemala City 01001, Guatemala; d School of Medicine, Universidad de San Carlos de Guatemala, Guatemala City 01011, Guatemala *Corresponding author: Seattle Children’s Hospital, Division of Adolescent Medicine, CSB-200, PO Box 5371, Seattle, WA 98145, USA. Tel: +1 206 987-2028; E-mail: sarah.golub@seattlechildrens.org † Co first authors ‡ Co senior authors. § Dr. Golub is currently a faculty member in the Division of Adolescent Medicine at Seattle Children’s Hospital. Received 31 May 2018; revised 29 August 2018; editorial decision 7 September 2018; accepted 13 September 2018 Background: Despite the inclusion of adolescent health in recent global frameworks, limited data exist on health indicators in low-income countries. Our objective was to identify socioeconomic measures, risk beha- viors and health indicators of young people in Guatemala. Methods: We conducted a secondary data analysis of the Pan American Health Organization’s Sistema Informático del Adolescente of 2831 participants ages 10–24 y from 2008 to 2014. We examined frequencies for a core set of items, and generalized regression models assessed correlations between age, sex and ethni- city with health outcomes of interest. Results: Fewer than 17% of participants reported a history of chronic illness (16.6%) and severe psychological pro- blems (16.8%). While 66.1% of participants’ mothers and 36.6% of fathers reported job instability, far fewer families had housing instability (1.9% with no electricity, 6.3% with no running water). Fewer than one-third (29.1%) were sexually active and the majority (76.0%) routinely used condoms. About one-quarter (22.6%) reported abnormal mood. Indigenous participants were significantly more likely to have experienced psychological problems (odds ratio [OR] 1.75 [confidence interval {CI} 1.65–1.86]) and violence (OR 1.34 [CI 1.27–1.42]) compared with whites. Conclusions: The prevalence of risk behaviors and mental health concerns is low compared with other sources of national and regional data. Further work is needed to examine the benefits and limitations of this system in order to improve health surveillance. Keywords: adolescent health, data registry, global health, Guatemala, health surveillance Introduction Young people aged 10–24 y comprise approximately a quarter of the world’s 1.8 billion inhabitants, 1 with about 90% of this population living in low- and middle-income countries (LMICs). 2,3 As a result, LMICs bear the heaviest burden of glo- bal morbidity and mortality in this age group. In 2015 there were an estimated 1.2 million deaths worldwide of adoles- cents aged 10–19 y; more than two-thirds of these were con- centrated in LMICs in Southeast Asia and sub-Saharan Africa. 4 High-income countries (HICs) continue to account for the lowest numbers, with Latin and Central America between these extremes. Among the major struggles in improving the health of ado- lescents and young adults (from here onward referred to as ‘young people’, in accordance with current definitions estab- lished by the United Nations 2 ) globally is substantial gaps in data collection. Although health surveillance systems are in place for monitoring health indicators in most HICs, systematic collection of these data has been limited in LMICs. This shortage of global and nationally representative data poses significant ORIGINAL ARTICLE © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 265 Downloaded from https://academic.oup.com/inthealth/article/11/4/265/5181598 by guest on 02 January 2024