Women's reproductive rights in the inter-American system of human rights: conclusions from the Field, June - September 2014

The Inter-American System of Human Rights has proven to be a forum for the advancement of women’s reproductive rights in the Inter-American region. However, the Inter-American System faces significant challenges in promoting structural transformative change that enables women’s enjoyment of their reproductive health rights. This report examines three reproductive rights cases from the Inter- American Commission on Human Rights and the Inter-American Court of Human Rights: María Mamerita Mestanza Chávez v. Peru; Paulina Ramirez Jacinto v. Mexico; and Artavia Murillo et al. v. Costa Rica. In the summer of 2014, interviews were conducted with representatives in each of the case study countries, with the objective of the research being two-fold: (1) to understand how each of the cases developed, and the subsequent challenges and advancements; and (2) to learn from these cases in order to suggest recommendations for how actors can make better use of the Inter-American System as one of several avenues for protecting, promoting and fulfilling women’s reproductive rights. The report first discusses challenges in implementing women’s reproductive health rights, and then explores how the Inter-American System can strengthen its work on women’s reproductive health rights

Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study

Puerto Ricans living in the United States mainland present multiple disparities in prevalence of chronic diseases, relative to other racial and ethnic groups. Allostatic load (AL), or the cumulative wear and tear of physiological responses to stressors such as major life events, social and environmental burden, has been proposed as a possible mechanism for the inequalities observed in minority groups, but has not been studied in Puerto Ricans. The aim of this study was to determine the association of AL to six chronic diseases (abdominal obesity, hypertension, diabetes, and self-reported cardiovascular disease (CVD), arthritis and cancer) in Puerto Ricans, and to contrast AL to metabolic syndrome (MetS). Participants of the Boston Puerto Rican Health Study (n = 1116, ages 45–75 years) underwent a home-based interview, where questionnaires were completed and biological samples collected. A summary definition of AL was constructed using clinically-defined cutoffs and medication use for 10 physiological parameters in different body systems. Logistic regression models were run to determine associations between AL score and disease status, controlling for age, sex, smoking, alcohol use, physical activity, total fat intake and energy intake. Parallel models were also run with MetS score replacing AL. We found that increasing categories of AL score were significantly associated with abdominal obesity, hypertension, diabetes and self-reported cardiovascular disease (CVD) and arthritis, but not with self-reported cancer. The strength of associations of AL with all conditions, except diabetes and cancer, was similar to or larger than those of MetS score. In conclusion, Puerto Rican older adults experienced physiological dysregulation that was associated with increased odds of chronic conditions. AL was more strongly associated with most conditions, compared to MetS, suggesting that this cumulative measure may be a better predictor of disease. These results have prospective research implications for Puerto Ricans and other ethnic groups