Inequality indicators and cardiometabolic diseases mortality in Guatemala

Authors

DOI:

https://doi.org/10.36829/63CTS.v8i2.1084

Keywords:

Health Status Disparities, Noncommunicable Diseases, Epidemiology

Abstract

Measuring health inequalities within low- and middle-income countries is needed for planning, monitoring, and evaluation of public health interventions, especially for problems that represent a high burden of disease, like cardio metabolic diseases. The goal of this study was to characterize inequality patterns in mortality rates from cardio metabolic causes in Guatemala. Data from the 2018 National Population Census, and official vital statistics were used to estimate crude mortality rates for diabetes (DM), acute myocardial infarction (IAM), and stroke (ACV). Simple and complex indicators of absolute and relative inequality (difference, ratio, slope index, concentration index, distance from the mean, Theil index, population attributable risk, and percentage of population attributable risk) were calculated for six dimensions of inequality: sex, race/ethnicity, education level, type of occupation, department, and municipality. A total of 6,445 DM deaths, 5,761 IAM deaths, and 3,218 ACV deaths were documented. Indicators showed marked inequalities for the six dimensions studied. Massive deprivation was the predominant inequality pattern for sex, race/ethnicity, and department. Staggered increments were identified for education level and type of occupation. Overlapping marginal exclusion was found for education level, occupation, and municipality. We conclude that inequality patterns found for the three causes of death suggest overlapping patterns of mass deprivation, staggered increments, and marginal exclusion.

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References

Anand, S., Diderichsen, F., Evans, T., Shkolnikov, V., & Wirth, M. (2001). Measuring disparities in health: Methods and indicators. En T. Evans, M. Whitehead, F. Diderichsen, A. Bhuiya, & M. Wirth, (Eds.), Challenging inequities in health: From ethics to action (pp. 48-67). Oxford University Press.

Braveman, P. (1998). Monitoring equity in health: A policy-oriented approach in low- and middle-income countries. World Health Organization.

Breilh, J. (2021). Critical Epidemiology and the People's Health: Theory and Context. Oxford University Press.

Cerón, A., & Goldstein, G. (2021a). Mortalidad por accidente cerebrovascular en Guatemala 2018: Patrones e inequidades. Análisis de la Realidad Nacional, 10(203), 66-88.

Cerón, A., & Goldstein, G. (2021b). Mortalidad por diabetes en Guatemala 2018: Patrones e inequidades. Análisis de la Realidad Nacional, 10(198), 76-98.

Cerón, A., & Goldstein G. (2021c). Mortalidad por infarto agudo de miocardio en Guatemala 2018: patrones e inequidades. Análisis de la Realidad Nacional, 10(201), 76-97.

Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health: Final report of the commission on social determinants of health. World Health Organization.

Enríquez Nava, M. F., Esquivel Velásquez, A. D., Patón Sanjines, M., Pooley Ayarza, B. C., Alarcón, R., Hernández Muñoz, R., & Sanhueza, A. (2020). Comportamiento y desigualdades sociales en indicadores priorizados del Objetivo de Desarrollo Sostenible 3 en Bolivia. Revista Panamericana de Salud Pública, 44, Artículo e101. https://doi.org/10.26633/RPSP.2020.101

Flores Ramírez, C. (2002). Análisis y tendencias de la mortalidad en Guatemala, 1986 a 1999. . Ministerio de Salud Pública y Asistencia Social.

GBD 2019 Diseases and Injuries Collaborators. (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 396(10258),1204-1222. https://doi.org/10.1016/S0140-6736(20)30925-9

Green, M. A., Evans, C. R., & Subramanian, S.V. (2017). Can intersectionality theory enrich population health research? Social Science and Medicine, 178, 214-216. https://doi.org/10.1016/j.socscimed.2017.02.029

Gutiérrez, J. P., García-Saisó, S., Espinosa-de la Peña, R., & Balandrán, D. A. (2016). Desigualdad en indicadores de enfermedades crónicas y su atención en adultos en México: Análisis de tres encuestas de salud. Salud Pública de México, 58(6), 666-675. https://doi.org/10.21149/spm.v58i6.7923

Guzmán, I. (2013). Estado actual de los factores de riesgo cardiovascular en población general en Guatemala. Revista Medicina Interna, 17(Suppl 1), s3-s7.

Institute for Health Metrics and Evaluation. (2020a). Global Burden of Disease summaries. Institute for Health Metrics and Evaluation, University of Washington. http://www.healthdata.org/results/gbd_summaries/2019/

Institute for Health Metrics and Evaluation. (2020b). Guatemala. En Country profiles. Institute for Health Metrics and Evaluation, University of Washington. http://www.healthdata.org/guatemala

Instituto Nacional de Estadística. (2019). Base de datos de defunciones en Guatemala, año 2018. https://www.ine.gob.gt/ine/vitales

Instituto Nacional de Estadística. (2020). Base de datos del XII Censo Nacional de Población y VII de Vivienda 2018. http://redatam.censopoblacion.gt/bingtm/RpWebEngine.exe/Portal?BASE=CPVGT2018&lang=esp

Keppel, K., Pamuk, E., Lynch, J., Carter-Pokras, O., Insun, K., Mays, V., Pearcy, J., Schoenbach, V., & Weissman, J. S. (2005). Methodological issues in measuring health disparities. Vital and Health Statistics, (141), 1–16.

Krieger, N. (2011). Epidemiology and the People's Health: Theory and Context. Oxford University Press.

Mendis, S., Puska, P., & Norrving, B. (2011). Global Atlas on cardiovascular disease prevention and control.World Health Organization, World Heart Federation, and World Stroke Organization. https://apps.who.int/iris/rest/bitstreams/53236/retrieve

Moscoso, V., & Flores, C. (2008). Retratos de muertes evitables. El Sistema de Salud en Guatemala, ¿hacia dónde vamos? Programa de las Naciones Unidas para el Desarrollo. https://desarrollohumano.org.gt/biblioteca/serie-sobre-salud/

Mújica, O. J., & Moreno, C. M. (2019). De la retórica a la acción: Medir desigualdades en salud para “no dejar a nadie atrás”. Revista Panamericana de Salud Pública, (43), Articulo e12. https://doi.org/10.26633/RPSP.2019.12

Organización Panamericana de la Salud. (2018). Sociedades justas, equidad en salud y vidas dignas. Resumen ejecutivo del informe final de la Comisión OPS sobre equidad y desigualdades sociales en salud en las américas.

Pan American Health Organization. (1995). The search for equity: Annual report of the Director.

Regidor, E. (2004a). Measures of health inequalities: Part 1. Journal of Epidemiology and Community Health, 58(10), 858-861. https://doi.org/10.1136/jech.2003.015347

Regidor, E. (2004b). Measures of health inequalities: Part 2. Journal of Epidemiology and Community Health, 58(11), 900-903. https://doi.org/10.1136/jech.2004.023036

Rodas Estrada, M. A., Rodas Díaz, M. A., Montenegro, P., Corona, V., Sánchez, C., Rodas, A., Escaler, B., Wyss, F., & Guzmán Melgar, I. (2013). Síndrome coronario agudo en Guatemala / Accute coronary syndrome in Guatemala. Revista Medicina Interna, 17(Suppl 1), s35-s42.

Sam Colop, B. (2017). Sala de Situación: Enfermedades no transmisibles 2017. Ministerio de Salud Pública y Asistencia Social, Departamento de Epidemiología. http://epidemiologia.mspas.gob.gt/files/Publicaciones%202018/Enfermedades%20No%20Transmisibles/Analisis%20anual%20ENT%202017.pdf

Sam Colop, B. (2018). Sala de Situación: Enfermedades no transmisibles 2018. Guatemala: Ministerio de Salud Pública y Asistencia Social, Departamento de Epidemiología. http://epidemiologia.mspas.gob.gt/files/Publicaciones%202018/Enfermedades%20No%20Transmisibles/Analisis%20anual%20ENT%202018.pdf

The WHO CVD Risk Chart Working Group. (2019). World Health Organization cardiovascular disease risk charts: Revised models to estimate risk in 21 global regions. Lancet Global Health, 7(10), Artículo E1332-E1345. https://doi.org/10.1016/S2214-109X(19)30318-3

Tullo, E., Lerea, M. J., González, R., Galeano, J., Insfrán, M. D., Muñoz, M., Aragón, M., & Sanhueza, A. (2020). Desigualdades sanitarias y sociales en la salud materna y del niño en Paraguay. Revista Panamericana de Salud Pública, (44), Artículo e107. https://doi.org/10.26633/RPSP.2020.107

Wagstaff, A., Paci, P., & Doorslaer, E. V. (1991). On the measurement of inequalities in health. Social Science and Medicine, 33(5), 545-557. https://doi.org/10.1016/0277-9536(91)90212-U

World Health Organization. (2013). Handbook on health inequality monitoring: With a special focus on low- and middle-income countries.

World Health Organization. (2017). National health inequality monitoring: A step-by-step manual.

World Health Organization. (2019). World Health Statistics 2019: Monitoring health for the SDGs. https://www.who.int/gho/publications/world_health_statistics/2019/en/

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Published

2021-12-12

How to Cite

Cerón, A., & Goldstein, G. (2021). Inequality indicators and cardiometabolic diseases mortality in Guatemala. Ciencia, Tecnología Y Salud, 8(2), 202–210. https://doi.org/10.36829/63CTS.v8i2.1084

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Artículos científicos