Beatriz Caicedo-Velásquez1, Luz Stella Álvarez-Castaño2, Marc Marí-Dell'Olmo3, Carme Borrell4. 1. Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación Demografía y Salud. Electronic address: bcaicedov@gmail.com. 2. Escuela de Nutrición y Dietética, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación de los Determinantes Sociales del Estado de Salud y Nutrición. 3. CIBER de Epidemiología y Salud Pública (CIBERESP), España; Agència de Salut Pública de Barcelona, Barcelona, España; Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, España; Universitat Rovira i Virgili, Tarragona, España. 4. Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, España; Universitat Pompeu Fabra, Barcelona, España.
Abstract
OBJECTIVE: To analyse the trend in inequalities in mortality due to external causes among municipalities in Antioquia, department of Colombia, from 2000 to 2010, and its association with socioeconomic conditions. External causes included violent deaths, such as homicides, suicides and traffic accidents, among others. METHODS: Ecological design of mortality trends, with the 125 municipalities of Antioquia as the unit of analysis. The age-adjusted smoothed standardized mortality ratio (SMR) was estimated for each of the municipalities by using an empirical Bayesian model. Differences in the SMR between the poorest and least poor municipalities were estimated by using a two-level hierarchical model (level-1: year, level-2: municipality). RESULTS: Mortality due to external causes showed a downward trend in the department in the period under review, although the situation was not similar in all municipalities. The findings showed that the risk of death from external causes significantly increased in poor and underdeveloped municipalities. CONCLUSIONS: Intervention is required through policies that take into account local differences in mortality due to external causes.
OBJECTIVE: To analyse the trend in inequalities in mortality due to external causes among municipalities in Antioquia, department of Colombia, from 2000 to 2010, and its association with socioeconomic conditions. External causes included violent deaths, such as homicides, suicides and traffic accidents, among others. METHODS: Ecological design of mortality trends, with the 125 municipalities of Antioquia as the unit of analysis. The age-adjusted smoothed standardized mortality ratio (SMR) was estimated for each of the municipalities by using an empirical Bayesian model. Differences in the SMR between the poorest and least poor municipalities were estimated by using a two-level hierarchical model (level-1: year, level-2: municipality). RESULTS: Mortality due to external causes showed a downward trend in the department in the period under review, although the situation was not similar in all municipalities. The findings showed that the risk of death from external causes significantly increased in poor and underdeveloped municipalities. CONCLUSIONS: Intervention is required through policies that take into account local differences in mortality due to external causes.
Keywords:
Análisis espacial; Desigualdades en salud; Determinantes sociales de la salud; Distribución espacial de la población; Geographic mapping; Healthcare disparities; Mapeo geográfico; Mortalidad; Mortality; Residence characteristics; Social determinants of health; Spatial analysis; Violence; Violencia
Authors: Juan Carlos Bossio; Iván Sanchis; María Belén Herrero; Gustavo Ariel Armando; Sergio Javier Arias Journal: Rev Panam Salud Publica Date: 2020-11-02