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Inequalities on mortality due to acute respiratory infection in children: A Colombian analysis
Nelson Jose Alvis-Zakzuk1, Carlos Castañeda-Orjuela, Diana Patricia Díaz
1Observatorio Nacional de Salud, Instituto Nacional de Salud, Bogotá, D.C., Colombia; Departamento de Gestión Organizacional, Universidad de la Costa, Barranquilla, Colombia. alviszakzuk@gmail.com.
Insights
Acute respiratory infections (ARI) disproportionately affect boys and girls in Colombia, with higher mortality rates in impoverished areas. These socioeconomic disparities in child mortality due to ARI remain a significant public health challenge.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Acute respiratory infections (ARI) represent a significant global public health concern.
- Child mortality remains a critical issue, particularly in low-resource settings.
Purpose of the Study:
- To investigate socioeconomic inequalities in mortality rates among children under five years old due to ARI in Colombia.
- To analyze the trends and extent of these inequalities over time.
Main Methods:
- Ecological analysis of official death records in Colombia from 2000 to 2013.
- Stratification of the population by socioeconomic status and measurement of inequality using rate ratios, differences, and concentration curves.
- Focus on ARI-specific under-5 mortality rates (ARI-U5MR).
Main Results:
- A total of 18,012 deaths from ARI in children under five were recorded between 2000 and 2013.
- ARI-U5MR was higher in boys than in girls, with an increasing mortality gap observed over the study period.
- In 2013, boys in the poorest municipalities had a 1.6-fold higher risk of dying from ARI compared to those in the least poor municipalities. For girls, the ARI-U5MR in the poorest tercile was 1.5 to 2 times greater than in the wealthiest tercile in 2005 and 2013.
Conclusions:
- Significant socioeconomic inequalities persist in ARI mortality rates among children under five in Colombia.
- The disparity between the poorest and richest municipalities highlights a major public health challenge requiring targeted interventions.
Introduction:
Acute respiratory infections (ARI) are a leading public health issue worldwide.
Objective:
To explore the inequalities in ARI mortality rates in under-5, according to socioeconomic characteristics.
Materials And Methods:
We conducted an ecological analysis to study inequalities at municipal level due to ARI mortality in children under 5 years. The data were obtained from official death records of the Departamento Administrativo Nacional de Estadística. The analysis of inequalities in the under-5 mortality rate (U5MR) included: 1) Classification of the population in different socio-economic strata, and 2) measurement of the degree of inequality. We used the ARI-U5MR as an outcome measurement.The mortality rates were estimated at national and municipal levels for the years 2000, 2005, 2010, and 2013. Rate ratios, rates differences, and concentration curves were calculated to observe the inequalities.
Results:
A total of 18,012 children under 5 years died by ARI in Colombia from 2000 to 2013. ARIU5MR was greater in boys than in girls. During this period, an increase in the infant mortality relative gap in both boys and girls was observed. In 2013, the U5MR evidenced that for boys from municipalities with the highest poverty had a 1.6-fold risk to die than those in municipalities with the lowest poverty (low tercile). In girls, the ARI-U5MR for 2005 and 2013 in the poorest tercile was 1.5 and 2 times greater than in the first tercile, respectively.
Conclusion:
Colombian inequalities in the ARI mortality rate among the poorest municipalities compared to the richest ones continue to be a major challenge in public health.
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