Inequalities in mortality by cardiovascular diseases in the Colombian Coffee Growing Region, 2009-2011

Abstract

Introduction: The impact of mortality from cardiovascular diseases requires the measurement of the relationship between the local socioeconomic conditions and these death causes.

Objective: To determine the inequality in mortality from cardiovascular diseases in the municipalities of the Colombian Coffee Growing Region (2009-2011).

Materials and methods: We conducted an ecological study to compare the mortality from cardiovascular diseases (hypertensive, ischemic, cerebrovascular) in municipalities and their economic situation. Mortality rates and the index of unsatisfied basic needs were obtained from the Colombian Departamento Administrativo Nacional de Estadística (DANE) vital statistics, while the municipal gross domestic product per capita was estimated for this study. The inequality indices were calculated using regression models, and concentration and Theil indices with Epidat 3.1.

Results: The death risk resulting from ischemic or hypertensive diseases was greater in those municipalities with a higher index of unsatisfied basic needs. Mortality due to hypertensive disease tended to concentrate in municipalities with a higher level of unsatisfied basic needs. The municipalities with a lower gross domestic product showed a higher rate of deaths due to hypertensive disease in years 2009 and 2010, and due to ischemic disease in years 2010 and 2011. Nevertheless, this indicator does not measure the gap existing among poor communities.

Conclusions: Disaggregated inequality indicators at municipal level are lacking. Suggested indicators are estimated only for country and provincial levels and they do not favor the characterization of health social inequalities at territorial level.