Abstract
BACKGROUND: Venezuela has faced a crisis over the past decade. This study aims to characterize the crisis and identify the population's most vulnerable subgroups. METHODS: Follow-up data (2018-2020) from 1,257 subjects (35% of the total) who participated in the nationally representative sample of the Venezuelan Study of Cardiometabolic Health (EVESCAM, 2014-2017) were analyzed. The distribution of seven crisis indicators- food insecurity, stressful life events, family separation, disruption in access to utilities (water, electricity, gas, or sanitation), lack of access to medications, lack of access to transportation, and disruption of childhood education- were analyzed across five subgroups (age, sex, ethnicity, socioeconomic status [SES], and education). Logistic regression adjusted by other socio-demographic variables was used to analyze associations among variables. RESULTS: Of the total sample, 71.8% were female, 67.0% ≥ 50 years old, 52% low SES, and 80.2% Mixed ethnicity. Overall, 77.3% reported disruption in access to at least one utility and 31.7% to two or more utilities. The former was higher in females (OR 1.46, 95% CI 1.08-1.98) and those with lower education (OR 2.03, 1.27-3.23). Lack of electricity (70.2%) was similar across subgroups. Lack of transportation (76.2%) affected females (OR 1.36, 1.10-1.67) and those of Mixed ethnicity more strongly. Disruption of children's education was reported more in homes with the youngest, Amerindian, low SES, and less educated participants. Family separation (49.2%) affected older and female participants more strongly. Food insecurity (60.2%) was more frequent in the low SES group compared with the high SES group (OR 2.17, 1.45-3.25). Stressful life events (67.2%) and lack of medications (43.8%) did not differ across subgroups. CONCLUSIONS: The Venezuelan humanitarian crisis has heightened vulnerability to crisis indicators among women, elders, those with low SES, and less educated subgroups of the population. These findings should prompt cost-effective programs targeted at those most vulnerable.