The purpose of this study is to perform a psychometric analysis (acceptability, reliability and factor structure) of the Chilean version of the new Employment Precariousness Scale (EPRES). The data is drawn from a sample of 4,248 private salaried workers with a formal contract from the first Chilean Employment Conditions, Work, Health and Quality of Life (ENETS) survey, applied to a nationally representative sample of the Chilean workforce in 2010. Item and scale-level statistics were performed to assess scaling properties, acceptability and reliability. The six-dimensional factor structure was examined with confirmatory factor analysis. The scale exhibited high acceptability (roughly 80%) and reliability (Cronbach's alpha 0.83) and the factor structure was confirmed. One subscale (rights) demonstrated poorer metric properties without compromising the overall scale. The Chilean version of the Employment Precariousness Scale (EPRES-Ch) demonstrated good metric properties, pointing to its suitability for use in epidemiologic and public health research.

Background: With the turn of the century, most countries in Latin America witnessed an increased concern with universalism and redistribution. In the health sector, this translated into a wide range of reforms to advance Universal Health Coverage (UHC) that, however, have had to cope with health systems that stratified the population since their foundation and the further segmentation inherited by market-oriented policies in the 1980s and 1990s. Studies on social welfare stress the relevance of cross-class alliances between the middle and working classes to reach universal and sustainable social benefits. Consequently, the endurance of separate health schemes across groups of the population in most countries in Latin America may seriously hamper the efforts towards UHC. Aim: This article addresses the potential of current policy architectures of health care to tackle segmentation between social classes in access to health services in two of the best performers of health coverage in the region, namely Chile and Uruguay. Methods: The article is a comparative case study based on a literature review and applies an analytical framework that links universal outputs to the policy architectures of health care. The study assesses universal outputs in terms of coverage, generosity and financial protection, identifying equity gaps in each of these dimensions across groups of the population. Findings: Latest processes of reform for UHC in Chile and Uruguay perform highly regarding population coverage. Nevertheless, equity gaps in access to quality services and financial protection remain. In both countries, such gaps relate to the eligibility criteria. In Chile, segmentation is reinforced by the persistence of separated pools of resources that hinder solidarity. Besides, the significant role of private actors and differences in quality between public and private service providers continue to push middle and upper-middle classes to private options. Uruguay's health reform reinforced the public system and promoted financial solidarity by pooling and progressively allocating resources. Despite this, fragmentation in service provision continues the segmentation of access to health care. Conclusions: The study shows differences in the options of reforms for UHC in Chile and Uruguay and the relevance of policy architectures to reverse, or conversely deepen, segmentation across groups of the population.

Forma de citarClase social, desigualdades en salud y conductas relacionadas con la salud de la población trabajadora en Chile salud (21,6% [RP 0,68; IC95% 0,99]). En relación a la salud mental, los que presentaban menor riesgo eran los gerentes básicos (RP 0,43; IC95% 0,88), observándose diferencias entre hombres y mujeres. Los que refirieron fumar con menor frecuencia fueron los empresarios, mientras que los que realizaban significativamente más actividad física fueron los empresarios, los supervisores expertos y los trabajadores semicalificados. Conclusiones. Los empresarios y gerentes expertos son los que presentan mejores indicadores y conductas relacionados con la salud. El proletario formal, el proletario informal y los supervisores básicos, en cambio, son los que presentan los peores indicadores de salud global, confirmando así que la clase social es un determinante clave en la generación de desigualdades en materia de salud de la población.Clase social; desigualdades en la salud; tabaquismo; actividad motora; género y salud; conductas saludables; Chile. resumen Palabras claveLa perspectiva de clase social neomarxista (CSNM) constituye una valiosa alternativa frente a la estratificación social, al poner el foco en las relaciones de propiedad y control sobre los recursos productivos -físicos, financieros y organizativos-como principal determinante de las desigualdades sociales -y de salud (1). Contrariamente a los análisis que utilizan el concepto de estratificación social, centrados en categorías nominales u ordinales y jerarquías -como nivel de estudios, ingresos u ocupación-, la CSNM parte de comprender la forma en que las sociedades capitalistas son sistemáticamente estructuradas a partir de la división de clases y cómo los actores sociales se vinculan a través de relaciones de producción, propiedad, dominación y control sobre la toma de decisiones Investigación original / Original research 1 Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brasil. La correspondencia se debe dirigir a Kátia Bones Rocha. Correo