Effects of 2019’s Social Protests on Health System Services Utilization in Santiago, Chile

Thomas Wagner

Name: Thomas Daniel Wagner
School: Vagelos College of Physicians and Surgeons, Class of 2023. Varmus Global Scholar 2020
Mentor: Kim Hekimian, PhD and Álvaro Castillo Carniglia, PhD, MSc



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On October 18th, 2019, protestors gathered across Chile to call for equality and demand a new constitution. The government responded by declaring a state of emergency and deploying the Chilean police, who utilized anti-riot shotguns and tear gas for crowd control. Despite the notorious impact of social protests on peoples’ lives, there is little scientific evidence of their broader health effects, and most of what we know comes from non-scientific media coverage. This project aimed to quantify the effects of the October 2019 Chilean protests on patient utilization of health system services using emergency consultation data in the Santiago metropolitan region. Public data was pulled from the Chilean Ministry of Health and refined to isolate cases from age 15-64 within 1 and 3 kilometers of the protest focal point. A negative binomial model was fitted from 2015–2018 to forecast what would have happened in the absence of October’s social protests regarding trauma and respiratory cases. Predictions were compared to actual cases using t-tests and Mann-Whitney tests. Although increases in all trauma and respiratory cases were hypothesized, preliminary results varied. After October 18th, trauma consultations within 1km decreased by 19.74% while hospitalizations increased by 30.45%. Respiratory consultations and hospitalizations were relatively stable. This study demonstrates that shifts in patient utilization of emergency services occurred in response to widespread social protests. These preliminary results will be complemented with additional strategies to quantify whether shifts in trauma and respiratory cases were similar to those observed for other causes of emergency service utilization.