Person: Cifuentes, Enrique
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Publication A Qualitative Analysis of Environmental Policy and Children's Health in Mexico
(BioMed Central, 2010) Cifuentes, Enrique; Trasande, Leonardo; Ramirez, Martha; Landrigan, PhilipBackground: Since Mexico’s joining the North American Free Trade Agreement (NAFTA) and the Organization for Economic Cooperation and Development (OECD) in 1994, it has witnessed rapid industrialization. A byproduct of this industrialization is increasing population exposure to environmental pollutants, of which some have been associated with childhood disease. We therefore identified and assessed the adequacy of existing international and Mexican governance instruments and policy tools to protect children from environmental hazards. Methods: We first systematically reviewed PubMed, the Mexican legal code and the websites of the United Nations, World Health Organization, NAFTA and OECD as of July 2007 to identify the relevant governance instruments, and analyzed the approach these instruments took to preventing childhood diseases of environmental origin. Secondly, we interviewed a purposive sample of high-level government officials, researchers and nongovernmental organization representatives, to identify their opinions and attitudes towards children’s environmental health and potential barriers to child-specific protective legislation and implementation. Results: We identified only one policy tool describing specific measures to reduce developmental neurotoxicity and other children’s health effects from lead. Other governance instruments mention children’s unique vulnerability to ozone, particulate matter and carbon monoxide, but do not provide further details. Most interviewees were aware of Mexican environmental policy tools addressing children’s health needs, but agreed that, with few exceptions, environmental policies do not address the specific health needs of children and pregnant women. Interviewees also cited state centralization of power, communication barriers and political resistance as reasons for the absence of a strong regulatory platform. Conclusions: The Mexican government has not sufficiently accounted for children’s unique vulnerability to environmental contaminants. If regulation and legislation are not updated and implemented to protect children, increases in preventable exposures to toxic chemicals in the environment may ensue.
Publication The obesogenic environment around elementary schools: food and beverage marketing to children in two Mexican cities
(BioMed Central, 2018) Barquera, Simón; Hernández-Barrera, Lucia; Rothenberg, Stephen J.; Cifuentes, EnriqueBackground: Unhealthy environments and food advertisements are major determinants of childhood obesity. Recent regulation has banned unhealthy foods from schools in Mexico. However, currently there is no regulation limiting exposure to food marketing around schools. Thus, our objective was to analyze the characteristics of food advertising practices around 60 elementary schools in two cities and to evaluate compliance with the Pan American Health Organization (PAHO) recommendations and the local food industry self-regulatory marketing code. Methods: Data were collected during the period of October 2012 to March 2013. A random sample of elementary schools was selected from two Mexican cities. Using geographic information systems, we drew a 100-m-diameter buffer around each school. Trained personnel obtained photographs to assess the locations and types of food advertisements. Our results were stratified by school type and by indicators of compliance with the PAHO and industry recommendations. We developed a multivariate negative binomial regression model to determine factors predicting the number of advertisements around schools. Results: The number of advertisements was significantly higher around public schools than around private schools (6.5 ± 5.6 vs. 2.4 ± 3.5, p < 0.05). Printed posters were the most common type of marketing medium (97%), showing mostly sugar-sweetened beverages, sweet breads, candies, and bottled water. Promotions, such as special prices or gifts, were included on 30% of printed posters. Food advertising practices were often in compliance with industry recommendations (83%) but not with those from the PAHO (32%) (p < 0.001). Conclusion: Our results support the importance of monitoring the obesogenic environment and identifying policy tools to protect children from food marketing not only inside schools but also around them, particularly in lower income communities.