Socioeconomic disparities in adult mortality in Latin America

Large socioeconomic disparities in healthcare utilisation and health outcomes have been well-documented in Latin American countries. However, little is known about disparities in mortality rates. We estimate socioeconomic gradients in mortality in the Latin American region and discuss their patterns.

We use death certificate data from the national vital statistics systems and population data from national censuses in Argentina, Brazil, Chile, Colombia, Ecuador, Mexico and Peru (2010-2023) to calculate mortality rates by age, sex and educational attainment. We also calculate mortality rates by cause of death. Data are harmonised to ensure comparability across countries and between death certificates and census data within countries. To analyse socioeconomic disparities, we compute the ratio between the mortality rate for individuals with a lower level of education (secondary incomplete or less) and the mortality rate for individuals with a higher level of education (secondary complete or more) by age and sex. The socioeconomic analysis is limited to adults aged 20 years or older.

Mortality rates for individuals with lower education are generally higher at any age group than for individuals with higher education, with larger disparities observed in younger age groups. Differences across countries in these inequalities are also more pronounced in younger cohorts. Particularly, in the 20-29 age group, individuals with lower education show much greater dispersion in mortality rates across countries compared with those with higher education. Lower education is associated with higher mortality rates from violent causes, particularly before age 50. Among non-violent causes, mortality due to non-communicable diseases exhibits larger socioeconomic gradients than mortality due to communicable diseases in older age groups, while for younger age groups, it depends on sex and the specific age group. Among non-communicable causes, deaths from diabetes and cardiovascular diseases exhibit more socioeconomic inequality than those from neoplasms.

Despite overall improvements in average health indicators in the region, which are concomitant to a fall in income inequality and expansion of universal health coverage, significant challenges remain in addressing disparities in mortality rates, particularly for younger populations and women.