Pollution and Safety Incidents: A Case Study with Property and Violent Incidents in Medillin, Colombia, 2017-2019 (Forthcoming, 2023)

The goal of this paper is to explore the relationship between levels of air pollution and safety incidents in Medellín, Colombia, during the period 2017-2019. The data for this paper comes from two main sources, first the System of Early Alert of Medellín and the Valley of Aburrá for environmental measures, and second a geolocated list of public safety incidents from the Secretary of Security of Medellín. In the middle of an air quality crisis, the city of Medellín has been implementing measures to clean the air, while policymakers are grappling with the cost of these policies; this paper seeks to inform that process by outlying the public safety implications of better air quality. The empirical strategy is achieved by combining the daily safety incidents in every neighborhood in the city, with air monitor data comprising of PM2.5 and weather measures. The identification strategy is based on a Poisson quasi-maximum likelihood (PQML) model that includes a set of fixed effects tests, lagged indicators, and a dose-response analysis. Furthermore, an IV approach is implemented using Wind Direction, to account for unobserved sources of bias in the relationship between pollution and incidents. We find a positive relationship between PM2.5 and daily incidents, where a 10% increase in PM2.5 is associated with a 0.21% increase in incidents per day, and this relationship holds for different categories such as property and violent incidents. In terms of policy implications, both safety and environmental concerns are key issues in the policy-agenda in Latin America, and so the findings become a key contribution to research, and a valuable tool for cost-benefit analysis of environmental policy that uses an approach focused on its effects on safety that is currently absent in the conversation of air quality in Medellín.

A comparison of rural-urban differences in out-of-pocket expenses among older Mexicans with diabetes

Objective: To compare total out-of-pocket expenses for physician visits and medications among older adults living with diabetes in Mexico from urban, semi-urban, and rural areas.

Methods: The sample included 2,398 Mexicans aged 65 years and older with self-reported diabetes from the 2018 Mexican Health and Aging Study. Out- of-pocket expenses for physician visits and medications were regressed on locality, controlling for several factors.

Results: The profile of those with higher out-of-pocket medication expenditures included rural localities, higher education, unmarried, depressive symptoms, participation in Seguro Popular, and lacking insurance. In the multivariate analysis, rural older adults with diabetes paid a higher amount in medication expenditures compared with other localities.

Conclusion: Differences in locality are closely tied to the effective implementation of Seguro Popular. Although this program has improved access to care, participants have higher out-of-pocket expenditures for medications than those on employer-based plans across all localities. Among all groups, the uninsured bare the highest burden of expenditures, highlighting a continued need to address health inequities for the most underserved populations.

The Intersection Between Dwelling Environment and Health and Wellbeing in Impoverished Rural Puebla, Mexico

This paper forms part of a major health needs assessment research project of small-scale subsistence farming households in three relatively impoverished villages located close to an active volcano (Popocatépetl) in the rural hinterland of the town of Atlixco, Puebla, Mexico. Our overarching research question is: how do housing conditions, the micro-environment of the lot and dwelling, air and water quality, patterns of food preparation and household behaviors impact health and wellbeing in each community? We use a mixed-methods strategy starting with a survey of almost 250 households to generate baseline data on the health status, treatment, and perceptions of health in each of the four communities. Our housing and health assessment also focusses upon the dwelling structure and perceived problems such as damp and pests; the use of rooms and yard space; and on-site environmental sampling of the water and air quality. In addition, we apply an intensive case-study methodology to five purposively selected farming households in order to highlight how different dwelling structures and conditions, room use, lot maintenance and organization, practices of animal husbandry, fertilizer and agrochemical storage, open fire cooking with wood, and other behaviors shape and impact health and wellbeing. Our findings and conclusions emphasize the need for further research to better understand the epidemiology of these and similar communities. We conclude by offering a series of policy actions to mitigate the risks and hazards that we identify, and argue that in these rural communities the intersections between housing, home, and yard management presents hazards and challenges to health outcomes that are more dynamic and more volatile, than those of most urban housing environments.

Understanding community health needs and forging an academic global health partnership in Puebla, Mexico: a mixed-methods study

Background: Academic global health partnerships can help address population health needs, particularly in low-resource settings. To be effective, they must start with a detailed understanding of community health needs, and involve the voice of the community. In Puebla, Mexico, a team from the Benemerita Universidad Autonoma de Puebla (BUAP) and the University of Texas at Austin (UT), undertook a comprehensive community health needs assessment of four low-income communities.

Methods: An interdisciplinary team was formed from staff and students at UT and BUAP, along with local community organisers from the Fundacion Communitaria de Puebla (FCP) in Mexico. We selected one urban community and three rural agrarian communities from the region surrounding the town of Atlixco in Puebla, Mexico. We designed a comprehensive health needs assessment with the following objectives: to understand the perceptions and priorities of the health needs of families; to characterise health behaviours, risk factors, resource use patterns, and access issues; and to describe the intersection between the built environment and health through an exploration of housing, water, and air quality. To achieve these objectives, we implemented a comprehensive, pragmatic, and responsive mixed-methods approach including semi-quantitative household surveys, key informant qualitative interviews, focus group discussions, intensive case studies of dwelling units, and technical air and water quality sampling of each household surveyed.

Findings: We included data from 242 household surveys, four key-informant interviews, six focus group discussions, and five case studies of dwelling units collected between June 3 and July 26, 2019. Mean household size was four people and mean focus group discussion size was ten participants. We noted common, and unique, issues and patterns emerging across each community. These included misinformation on the causes and treatment of diabetes; mental health trauma after the 2017 Puebla earthquake; housing conditions, agricultural practices, and indoor air pollution that jeopardise the health of families; and socioeconomic barriers affecting access to care, particularly in the rural agrarian communities. Furthermore, this project helped forge the working relationships between UT, BUAP, FCP, local community leaders, and the Ministry of Health in developing an academic global health partnership that can further explore and respond to these findings.

Interpretation: Engagement with communities to develop a deep understanding of their needs and priorities is of great importance. Addressing these needs will require a combination of further research, education, clinical care, public health interventions, and new policy proposals. This community health-needs assessment galvanised the start of an academic global health partnership between UT and BUAP that will adapt the Academic Model Providing Access to Healthcare (AMPATH) paradigm to work with communities and public-sector health-care delivery systems to improve population health outcomes.

Expansion of Health Care Coverage in Two Federal Countries: Mexico and the United States (Working Paper)

Are College Students more anxious? A binational study during COVID-19 (Working Paper)

Migration, Earthquake Trauma, Health and Community Social Capital in four low-income communities of Puebla, Mexico (Working Paper)

Mental Health Needs and Access to Health Care: Data from Three Rural Pueblos and One Urban Colinia In Puebla, Mexico (Working Paper)

Acquisition of heroin, cocaine and marijuana among people who use heroin regularly (Working Paper)

Effects of Removing the GRE requirement for graduate admissions at the LBJ School, 2013-2023 (Working Paper)

US-Mexico Elites Study: a binational survey of political perspectives in bordering countries (Working Paper)

UT Austin, LBJ School of Public Affairs

• Instructor, Introduction to Empircal Methods - Spring 2023, Fall 2023

• Instructor, Quantitative Readiness Program - Summer 2023

• Team Leader, Executive Certificate in Data Literacy and Evidence Building - Fall 2023

• Instructor, Fundamentals of Statistics and Algebra for Public Policy - Fall 2022

• Teaching Assistant, Applied Economics for Policy Analysis - Fall 2018, Fall 2020

• Teaching Assistant, Environmental Economics - Spring 2018, Spring 2021

• Co-Instructor, Global Learning Seminar - Spring 2019, Spring 2021

UC Berkeley, Haas School of Business

• Graduate School Instructor, Microeconomic Analysis for Business Decisions - Fall 2013, Spring 2014, Fall 2014, Spring 2015
• Graduate School Instructor, People, Power, and Organizations - Spring 2015

Universidad Internacional de las Americas, School of International Affairs

• Instructor, Political Geography - 2016
• Instructor, International Economics - 2012, 2013

Universidad Latina de Costa Rica, School of International Affairs

• Instructor, Economic Geography - 2016

2023

• ICAA Conference 2023 - Los Angeles, California
• NASPAA 2023 Annual Conference - Pittsburgh, Pennsylvania

2022

• SLAS International Conference - Bath, United Kingdom

2021

• LASA Hybrid Congress - Vancouver, Canada

2020

• SLAS International Conference - Amsterdam, Netherlands
• XXXVIII International Confress of LASA - Guadalajara, Mexico
• 6th Global Sympossium on Health Systems Research - Dubai, United Arab Emirates
• International Affairs Seminar - Universidad Nactional de Costa Rica
• Political Affairs Seminar - San Judas University

2019

• ConectaR Data Science Latin American Conference - San Jose, Costa Rica
• SPSA Annual Meeting Conference - San Juan, Puerto Rico
• Latin American and Caribbean HSG Pre-Conferences on Health Systems Research - Washington, D.C.

2018

• APPAM International Conference - Mexico City, Mexico