Determinants of Pneumonia mortality in Bogota, Colombia: A spatial econometrics approach

Bogota, the capital and largest city of Colombia, constantly fights against easily transmitted and endemic-epidemic diseases that lead to enormous public health problems. Pneumonia is currently the leading cause of mortality attributable respiratory infections in the city. Its recurrence and impact have been partially explained by biological, medical, and behavioural factors. Against this background, this study investigates Pneumonia mortality rates in Bogota from 2004 and 2014. We identified a set of environmental, socioeconomic, behavioural, and medical care factors whose interaction in space could explain the occurrence and impact of the disease in the Iberoamerican city. We adopted a spatial autoregressive models framework to study the spatial dependence and heterogeneity of Pneumonia mortality rates associated with well-known risk factors. The results highlight the different types of spatial processes governing Pneumonia mortality. Furthermore, they demonstrate and quantify the driving factors that stimulate the spatial spread and clustering of mortality rates. Our study stresses the importance of spatial modelling of context-dependent diseases such as Pneumonia. Likewise, we emphasize the need to develop comprehensive public health policies that consider the space and contextual factors.